An Inquiry-Based Distance Learning Tool for Medical Students Under Lockdown ("COVID-19 Rounds"): Cross-Sectional Study.

BACKGROUND: The COVID-19 pandemic presented significant challenges to both clinical practice and the delivery of medical education. Educators and learners implemented novel techniques, including distance learning and web-based rounds, while trying to stay updated with the surge of information regarding COVID-19 epidemiology, pathogenesis, and treatment. Hence, we designed and implemented a technologically enhanced course called "COVID-19 Rounds" to educate students about the rapidly evolving pandemic. OBJECTIVE: The objectives of this study are to describe a technologically enhanced course called "COVID-19 Rounds" and evaluate the following: (1) student satisfaction and program usefulness in achieving preset objectives, (2) perceived improvement in literacy regarding the pandemic, and (3) the impact of student engagement by designing infographics and initiating COVID-19-related research projects. METHODS: This is a cross-sectional study measuring the impact of the implementation of the web-based "COVID-19 Rounds" course. This program included web-based clinical experiences with physicians on actual rounds in COVID-19 wards in the hospital, weekly updates on evolving data and new research, and engagement in student-led projects. The study population included 47 fourth-year medical students at the Mohamed Bin Rashid University of Medicine and Health Sciences in Dubai, the United Arab Emirates, who attended the course. We designed and administered a 47-item survey to assess student satisfaction, program usefulness, impact on knowledge, and student engagement. Data were collected at the end of program delivery via Microsoft Forms. RESULTS: In total, 38 (81%) out of 47 fourth-year medical students participated in this study. The final course evaluation revealed an overall high satisfaction rate, with a mean rating of 3.9 (SD 0.94) on the 5-point Likert scale. Most students were satisfied with the course format (27/38, 71%), organization (31/38, 82%), and the learning experience (28/38, 74%) that the course offered. The course was particularly appreciated for offering evidence-based talks about aspects of the pandemic (34/38, 90%), providing weekly updates regarding emerging evidence (32/38, 84%), and enhancing understanding of the challenges of the pandemic (34/38, 90%). Satisfaction with distance learning was moderate (23/37, 62%), and a minority of students would have preferred an in-person version of the course (10/37, 27%). Student engagement in the course was high. All students participated in small group presentations of infographics of pandemic-related topics. Perceived advantages included conciseness and visual appeal, and disadvantages included the lack of detail and the time-consuming nature of infographic design, especially for students with no prior design experience. After the course ended, 27 (57%) students began research projects. This resulted in 6 abstracts presented at local meetings and 8 scientific papers published or submitted for publication. CONCLUSIONS: This inquiry-based adaptive approach to educating medical students about updates on COVID-19 via web-based learning was successful in achieving objectives and encouraging engagement in research. However, shortcomings of the course related to the lack of in-person teaching and clinical activities were also highlighted.

Toward a meta-vaccine future: Promoting vaccine confidence in the metaverse.

The metaverse has a promising role to serve as a global platform and tackle one of the most intractable public health challenges; vaccine hesitancy. Active efforts in this field can enhance vaccine acceptance thus leading to better community health protection. By embracing digital health innovations, the metaverse potentially creates an interactive environment for interdisciplinary collaborations that can foster novel approaches in tackling vaccine hesitancy as well as future pandemics. This paper aims to highlight the unique areas where the metaverse can enhance vaccination confidence, educate about vaccine working principles, and offer collaborative healthcare initiatives in this virtual community.

Democratizing the Development of Chatbots to Improve Public Health: Feasibility Study of COVID-19 Misinformation.

BACKGROUND: Chatbots enable users to have humanlike conversations on various topics and can vary widely in complexity and functionality. An area of research priority in chatbots is democratizing chatbots to all, removing barriers to entry, such as financial ones, to help make chatbots a possibility for the wider global population to improve access to information, help reduce the digital divide between nations, and improve areas of public good (eg, health communication). Chatbots in this space may help create the potential for improved health outcomes, potentially alleviating some of the burdens on health care providers and systems to be the sole voices of outreach to public health. OBJECTIVE: This study explored the feasibility of developing a chatbot using approaches that are accessible in low- and middle-resource settings, such as using technology that is low cost, can be developed by nonprogrammers, and can be deployed over social media platforms to reach the broadest-possible audience without the need for a specialized technical team. METHODS: This study is presented in 2 parts. First, we detailed the design and development of a chatbot, VWise, including the resources used and development considerations for the conversational model. Next, we conducted a case study of 33 participants who engaged in a pilot with our chatbot. We explored the following 3 research questions: (1) Is it feasible to develop and implement a chatbot addressing a public health issue with only minimal resources? (2) What is the participants' experience with using the chatbot? (3) What kinds of measures of engagement are observed from using the chatbot? RESULTS: A high level of engagement with the chatbot was demonstrated by the large number of participants who stayed with the conversation to its natural end (n=17, 52%), requested to see the free online resource, selected to view all information about a given concern, and returned to have a dialogue about a second concern (n=12, 36%). CONCLUSIONS: This study explored the feasibility of and the design and development considerations for a chatbot, VWise. Our early findings from this initial pilot suggest that developing a functioning and low-cost chatbot is feasible, even in low-resource environments. Our results show that low-resource environments can enter the health communication chatbot space using readily available human and technical resources. However, despite these early indicators, many limitations exist in this study and further work with a larger sample size and greater diversity of participants is needed. This study represents early work on a chatbot in its virtual infancy. We hope this study will help provide those who feel chatbot access may be out of reach with a useful guide to enter this space, enabling more democratized access to chatbots for all.

A Web-Based Public Health Intervention for Addressing Vaccine Misinformation: Analysis of Learner Engagement and Shift in Hesitancy to Vaccinate.

Web-based public health interventions can be a useful tool for disseminating evidence-based information to the public. However, completion rates are traditionally low, and misinformation often travels at a faster pace than evidence-based sources. This study describes the design of a web-based public health intervention to address COVID-19 vaccine hesitancy. A quasi-experimental approach was used in which a validated instrument, the Adult Vaccine Hesitancy Survey, was given to learners both pre and post intervention to observe any change in attitude towards vaccination. Our pilot observed a small positive shift in vaccine hesitancy and experienced higher than average completion rates. By integrating motivational learning design into public health interventions we increase the likelihood that learners finish the entire intervention, creating greater chance for positive behavior change.

Identification of Key Factors for Optimized Health Care Services: Protocol for a Multiphase Study of the Dubai Vaccination Campaign.

BACKGROUND: Mass vaccination of the global population against the novel COVID-19 outbreak posed multiple challenges, including effectively administering millions of doses in a short period of time while ensuring public safety and accessibility. The government of Dubai launched a mass campaign in December 2020 to vaccinate all its citizens and residents, targeting the population aged >18 years against COVID-19. The vaccination campaign involved a transformation of multiple commercial spaces into mass vaccination centers across the city of Dubai, the largest of which was the Dubai One Central (DOC) vaccination center. It was operational between January 17, 2021, and 27 January 27, 2022. OBJECTIVE: The multiphase research study aims to empirically explore the opinions of multiple health care stakeholders, elicit the key success factors that can influence the effective delivery of emergency health care services such as a COVID-19 mass vaccination center, and explore how these factors relate to one another. METHODS: To understand more about the operations of the DOC vaccination center, the study follows a multiphase design divided into 2 phases. The study is being conducted by the Institute for Excellence in Health Professions Education at Mohammed Bin Rashid University of Medicine and Health Sciences between December 2021 and January 2023. To elicit the key success factors that contributed to the vaccination campaign administered at DOC, the research team conducted 30 semistructured interviews (SSIs) with a sample of staff and volunteers who worked at the DOC vaccination center. Stratified random sampling was used to select the participants, and the interview cohort included representatives from the management team, team leaders, the administration and registration team, vaccinators, and volunteers. A total of 103 people were invited to take part in the research study, and 30 agreed to participate in the SSIs. To validate the participation of various stakeholders, phase 2 will analytically investigate one's subjectivity through Q-methodology and empirically investigate the opinions obtained from the research participants during phase 1. RESULTS: As of July 2022, 30 SSIs were conducted with the research participants. CONCLUSIONS: The study will provide a comprehensive 2-phase approach to obtaining the key success factors that can influence the delivery of high-quality health care services such as emergency services launched during a global pandemic. The study's findings will be translated into key factors that could support designing future health care services utilizing evidence-based practice. In line with future plans, a study will use data, collected through the DOC vaccination center, to develop a simulation model outlining the process of the customer journey and center workflow. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42278.

Rapid Transformation from Face to Face to Virtual Simulation During the SARS-CoV-2 Pandemic: Impact on the Simulation Process during "The Little Room of Horrors".

Objective: 1. To explore the feasibility of a rapid transformation from face to face to virtual simulation and its impact on the simulation process 2. To explore the efficacy of a rapid transformation from face to face to virtual simulation and its impact on the simulation process. Methods: The simulation process (preparation, pre-briefing, simulation, and debriefing) was investigated for feasibility and efficacy from the perspective of the educators and students. This study took place very early in the pandemic, thus highlighting the speed at which it needed to be conducted and acknowledging the limitations of technology at the time. The faculty (n = 3) involved in the virtual simulation experiment and year one medical students(n = 61) were invited to participate in the study voluntarily. The module chosen for this study was the Introduction to the Practice of Medicine, where the students were introduced to the concept of patient safety using simulation-based education. The "Little Room of Horrors" - is a simulation based educational session emphasising the importance of patient safety. Students were taken into a simulated medical ward that demonstrated common hospital-based errors. The learners were timed and asked to identify and document as many patient safety hazards as possible. The semi structured questionnaire was analysed using descriptive statistics and thematic analysis. Results: The Educator's perspective reflected that virtual simulation was technologically dependent and had limitations during debriefing but was also a sustainable and portable standardised process. The student's perspective revealed that the objectives were met, and the session helped them support the theory previously learned. The average rating was 4.09 on a 5-point scale. Innovation: When resources of the simulation center like space, mannikins, and faculty cannot be accessed for reasons like social distancing during a pandemic, virtual simulation was developed and used as a feasible alternative for our students without impacting the learning objectives. Conclusion: This study demonstrates the use of virtual simulation as a valuable option for teaching when face to face simulation is challenging or not possible.

Assessment of Clinical Information Quality in Digital Health Technologies: International eDelphi Study.

BACKGROUND: Digital health technologies (DHTs), such as electronic health records and prescribing systems, are transforming health care delivery around the world. The quality of information in DHTs is key to the quality and safety of care. We developed a novel clinical information quality (CLIQ) framework to assess the quality of clinical information in DHTs. OBJECTIVE: This study explored clinicians' perspectives on the relevance, definition, and assessment of information quality dimensions in the CLIQ framework. METHODS: We used a systematic and iterative eDelphi approach to engage clinicians who had information governance roles or personal interest in information governance; the clinicians were recruited through purposive and snowball sampling techniques. Data were collected using semistructured online questionnaires until consensus was reached on the information quality dimensions in the CLIQ framework. Responses on the relevance of the dimensions were summarized to inform decisions on retention of the dimensions according to prespecified rules. Thematic analysis of the free-text responses was used to revise definitions and the assessment of dimensions. RESULTS: Thirty-five clinicians from 10 countries participated in the study, which was concluded after the second round. Consensus was reached on all dimensions and categories in the CLIQ framework: informativeness (accuracy, completeness, interpretability, plausibility, provenance, and relevance), availability (accessibility, portability, security, and timeliness), and usability (conformance, consistency, and maintainability). A new dimension, searchability, was introduced in the availability category to account for the ease of finding needed information in the DHTs. Certain dimensions were renamed, and some definitions were rephrased to improve clarity. CONCLUSIONS: The CLIQ framework reached a high expert consensus and clarity of language relating to the information quality dimensions. The framework can be used by health care managers and institutions as a pragmatic tool for identifying and forestalling information quality problems that could compromise patient safety and quality of care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1136/bmjopen-2021-057430.

COVID-19 vaccine hesitancy: A narrative review of four South Asian countries.

Objectives: Vaccine hesitancy remains a global issue, especially within poverty-stricken countries where there's an interplay of financial and non-financial barriers. This narrative review aims to understand attitudes and behaviors toward COVID-19 vaccination in four South Asian countries and make context-specific recommendations to vaccine program drivers and decision-makers. Methods: A search was conducted using PubMed and Science Direct, and CINHAL from January 2020 up to May 2022 restricted to the English language for terms: "Afghanistan" OR "Pakistan" OR "India" OR "Bangladesh" in combination with "COVID-19 vaccine" and other related terms. All articles were initially included, and those with relevance were included in the synthesis of this paper. Results: A narrative review was performed for this study. Our narrative review included a total of eighteen studies with a sample size (n = 223-5,237) averaging about 1,325 participants per study conducted. The studies included revealed public hesitancy to receive the COVID-19 vaccine ranging from 6.3 to 56.2% with an average of 31.63% across all eighteen studies. Several reasons were linked to this observation in these four South Asian countries, and the predominant ones included: Insufficient information provided to the general public about the side effects of the vaccines, concerns regarding vaccine safety, and skepticism of vaccine efficacy. Conclusion: Vaccine hesitancy is a global problem within the context of COVID-19, and issues regarding equity, misinformation, and poverty in South Asian countries makes it difficult to meet goals for herd immunity. Policymakers and governments should aim toward financial and non-financial incentives to drive the public toward vaccination.

Profiling of Learners in Medical Schools as a Move Toward Precision Education: Protocol for a Scoping Review.

BACKGROUND: Academic experiences seek to get the best out of learners, maximizing performance and developing the skills and competencies needed to foster lifelong learning. The more personalized and tailored the academic experience among learners, the better the outcome. Precision education is a novel approach to research and practice, which is concerned with identifying and tailoring education to the precise needs of the learner. An emerging area of precision education is using data to develop learner profiles for a better understanding of individual learners relative to the characteristics and competencies of lifelong learners. OBJECTIVE: This scoping review aims to identify literature that reports on profiling learners within medical schools. Our review, as described in this paper, will describe the characteristics being measured, the methods and data sources used to generate profiles, and the resulting profiles that emerge. This review aims to provide guidance to those supporting medical school learners on the current state of learner profiling. METHODS: This scoping review will use the Population, Concept, and Context framework, published by Joanna Briggs Institute, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The search strategy was developed in collaboration with a library specialist. An initial search was conducted in PubMed, ERIC, Google Scholar, Cochrane, CINAHL, and SCOPUS. Data will be extracted, and 2 authors will undertake the screening procedure using the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews checklist. RESULTS: The database searches yielded 166 results, and title and abstract screening of 135 extracted articles is currently underway after eliminating 31 duplicates. We anticipate the scoping review to be completed in the first week of October 2022. The final scoping review will present the findings in a narrative and pictorial fashion. CONCLUSIONS: This review will help guide scholars looking to understand the current state of learner profiling within medical schools. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/41828.

Volunteering among pre-clinical medical students: Study of its association with academic performance using institutional data.

Background: Participating in volunteering activities during students' higher education experience is becoming more commonplace. Studies have noted that volunteering has a positive impact on the academic performance of undergraduate medical students. However, most of these studies rely on self-reported data like surveys, interviews, and journals. In this study, we leverage actual institutional data to examine the relationship between volunteering and academic performance among medical students in the pre-clinical phases of the Bachelor of Medicine and Bachelor of Surgery (MBBS) program. The current study also explores the factors that might influence students' volunteering behaviours. Methods: Analysis based on retrospective data was conducted in the College of Medicine at the Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU) in Dubai, United Arab Emirates. Three years of volunteering records for three cohorts of undergraduate medical students enrolled in the MBBS program between 2016 - 2018 were reviewed and analyzed to complete this study. The correlation between the annual Grade Point Average (GPA) and volunteering was studied across the three cohorts in each study year. Results:  Analysis of 153 undergraduate medical students' volunteering records revealed a significant positive relationship between the annual GPA and the number of volunteering in year two. The correlation was insignificant in year one, year three, and across the three cohorts. Conclusions:  The association between academic performance and volunteering among undergraduate medical students appeared to be positive. However, this relationship differs across the pre-clinical study years and is likely influenced by factors associated with volunteering that might influence GPA.

Contextual Conversational Agent to Address Vaccine Hesitancy: Protocol for a Design-Based Research Study.

BACKGROUND: Since the beginning of the COVID-19 pandemic, people have been exposed to misinformation, leading to many myths about SARS-CoV-2 and the vaccines against it. As this situation does not seem to end soon, many authorities and health organizations, including the World Health Organization (WHO), are utilizing conversational agents (CAs) in their fight against it. Although the impact and usage of these novel digital strategies are noticeable, the design of the CAs remains key to their success. OBJECTIVE: This study describes the use of design-based research (DBR) for contextual CA design to address vaccine hesitancy. In addition, this protocol will examine the impact of DBR on CA design to understand how this iterative process can enhance accuracy and performance. METHODS: A DBR methodology will be used for this study. Each phase of analysis, design, and evaluation of each design cycle inform the next one via its outcomes. An anticipated generic strategy will be formed after completing the first iteration. Using multiple research studies, frameworks and theoretical approaches are tested and evaluated through the different design cycles. User perception of the CA will be analyzed or collected by implementing a usability assessment during every evaluation phase using the System Usability Scale. The PARADISE (PARAdigm for Dialogue System Evaluation) method will be adopted to calculate the performance of this text-based CA. RESULTS: Two phases of the first design cycle (design and evaluation) were completed at the time of this writing (April 2022). The research team is currently reviewing the natural-language understanding model as part of the conversation-driven development (CDD) process in preparation for the first pilot intervention, which will conclude the CA's first design cycle. In addition, conversational data will be analyzed quantitatively and qualitatively as part of the reflection and revision process to inform the subsequent design cycles. This project plans for three rounds of design cycles, resulting in various studies spreading outcomes and conclusions. The results of the first study describing the entire first design cycle are expected to be submitted for publication before the end of 2022. CONCLUSIONS: CAs constitute an innovative way of delivering health communication information. However, they are primarily used to contribute to behavioral change or educate people about health issues. Therefore, health chatbots' impact should be carefully designed to meet outcomes. DBR can help shape a holistic understanding of the process of CA conception. This protocol describes the design of VWise, a contextual CA that aims to address vaccine hesitancy using the DBR methodology. The results of this study will help identify the strengths and flaws of DBR's application to such innovative projects.

Assessment as Learning in Medical Education: Feasibility and Perceived Impact of Student-Generated Formative Assessments.

BACKGROUND: Self-regulated learning (SRL) is gaining widespread recognition as a vital competency that is desirable to sustain lifelong learning, especially relevant to health professions education. Contemporary educational practices emphasize this aspect of undergraduate medical education through innovative designs of teaching and learning, such as the flipped classroom and team-based learning. Assessment practices are less commonly deployed to build capacity for SRL. Assessment as learning (AaL) can be a unique way of inculcating SRL by enabling active learning habits. It charges students to create formative assessments, reinforcing student-centered in-depth learning and critical thinking. OBJECTIVE: This study aimed to explore, from the learners' perspectives, the feasibility and perceived learning impact of student-generated formative assessments. METHODS: This study relied on a convergent mixed methods approach. An educational intervention was deployed on a cohort of 54 students in the second year of a 6-year undergraduate medical program as part of a single-course curriculum. The AaL intervention engaged students in generating assessments using peer collaboration, tutor facilitation, and feedback. The outcomes of the intervention were measured through quantitative and qualitative data on student perceptions, which were collected through an anonymized web-based survey and in-person focus groups, respectively. Quantitative survey data were analyzed using SPSS (IBM), and qualitative inputs underwent thematic analysis. RESULTS: The students' overall score of agreement with the AaL educational intervention was 84%, which was strongly correlated with scores for ease and impact on a 5-point Likert-type scale. The themes that emerged from the qualitative analysis included prominent characteristics, immediate gains, and expected long-term benefits of engagement. The prominent characteristics included individuals' engagement, effective interdependencies, novelty, and time requirements. The identified immediate gains highlighted increased motivation and acquisition of knowledge and skills. The expected long-term benefits included critical thinking, problem solving, and clinical reasoning. CONCLUSIONS: As a form of AaL, student-generated assessments were perceived as viable, constructive, and stimulating educational exercises by the student authors. In the short term, the activity provided students with a fun and challenging opportunity to dive deeply into the content, be creative in designing questions, and improve exam-taking skills. In the long term, students expected an enhancement of critical thinking and the inculcation of student-centered attributes of self-regulated lifelong learning and peer collaboration, which are vital to the practice of medicine.

Effect of introducing interprofessional education concepts on students of various healthcare disciplines: a pre-post study in the United Arab Emirates.

BACKGROUND: The value of interprofessional education (IPE) in nurturing healthcare professionals, and in shaping their professional identities, and their attitudes towards interdisciplinary teamwork and collaboration is established in the literature. IPE is an emerging concept in the Middle East and North Africa (MENA) region and is new to the United Arab Emirates (UAE). To date, the applicability and feasibility of IPE and of the corresponding collaborative practice in MENA countries remain largely unexamined. PURPOSE: To investigate the effect of one of the first experiences of IPE in the UAE, which was purposefully designed in alignment with the principles of the Situated Learning Theory (SLT), on the readiness for interprofessional learning and collaboration among students of various healthcare disciplines in the UAE. METHODS: A pre-post intervention quantitative research design was adopted for this study. The intervention focused on communication skills, and consisted of 2 tailor-made case-based scenarios. A total of 90 students (40 medical, 16 nursing, 16 pharmacy, and 18 physiotherapy), spread across two sessions (1 session per academic year across 2 academic years), took part in the IPE intervention. Readiness for Interprofessional Learning Scale (RIPLS) was used as the pre- and post- intervention assessments; aggregate data was analyzed using SPSS. RESULTS: Of those who participated in the intervention (across both rounds), 77 participants responded to the pre-assessment (85. 6%) and 84 responded to the post-assessment (93. 3%). The IPE intervention under investigation significantly increased the level of readiness to engage in cross-disciplinary learning and collaboration among participating health professions' students. In terms of the subscales, the participants' openness to engage in teamwork was raised and their professional identity was fostered. Yet, no statistical significance around clarity of roles and responsibilities was detected. CONCLUSION: The findings of this study encourage other universities in the MENA region to adopt IPE to improve future health professionals' capacity to develop shared understanding and mutual respect within cross-disciplinary teams. This, ultimately, feeds into improved quality of care and patient outcomes.

Self-reported adaptability among postgraduate dental learners and their instructors: Accelerated change induced by COVID-19.

It is forecasted that the skills and competencies necessary for post-pandemic success in higher education need to be founded upon adaptability, coping, and Self- Regulated Learning (SRL). It is worth investigating how stakeholders perceived their adaptability and coping with the accelerated change accompanying Coronavirus Disease of 2019 (COVID-19). Accordingly, the purpose of this study was to assess the self-reported adaptability of postgraduate dental learners and their instructors in the context of abrupt transition to distance learning induced by the pandemic. This study utilized a convergent mixed methods study design. The quantitative and qualitative data were concurrently collected from instructors and learners, using a tailor-made survey of items measured with a Likert-type scale, complemented with open-ended questions. The collected datasets were independently analyzed. Descriptive and inferential analysis were conducted using the quantitative data. Qualitatively, the researchers underwent a multi-staged thematic analysis. The generated information was then integrated using a joint model analysis. The percentage of the total average of self-reported adaptability for both groups of stakeholders was 81.15%. The instructors, with a mean of satisfaction of 17.94 (±1.76), rated their adaptability significantly higher than the learners, with a mean of satisfaction of 15.66 (±2.77) (p = 0.002). The thematic analysis resulted in two interrelated themes: Self and Environment. Within the Self theme, three subthemes surfaced: Cognitions, Emotions, and Behaviors. As for the Environment theme, it encapsulated two subthemes: Enablers and Impediments. The stakeholders perceived themselves to have adapted well to the transition, and SRL appeared as a cornerstone in the adaptation to the accelerated change accompanying COVID-19. There appeared to be an interplay between the cognitions, emotions, and behaviors on the level of the self as part of the adaptation process. Also, building upon existent models of SRL, this study uncovered that the stakeholders considered the environment to play a crucial role in their adaptation process. This highlights the importance of developing a climate that remains, despite external pressures, conducive to attaining learning and teaching goals. It is also crucial for university-level mental health promotion activities to proactively foster, among learners and instructors, adaptability, building 'academic resilience'.

Conversational Agent to Address COVID-19 Infodemic: A Design-Based Research Approach.

Since the beginning of the year 2020, we have been suffering from the COVID-19 pandemic and are daily exposed to misinformation, leading to myths around vaccination and COVID-19. This study focuses on creating and distributing a Conversational Agent (CA), named VWise, for a health intervention using Design-Based Research (DBR), to help profile, guide, and inform the public about COVID-19 and COVID-19 vaccination in the EMRO (Eastern Mediterranean Region of Operations) region.

A Web-Based Public Health Intervention for Addressing Vaccine Misinformation: Protocol for Analyzing Learner Engagement and Impacts on the Hesitancy to Vaccinate.

BACKGROUND: A barrier to successful COVID-19 vaccine campaigns is the ongoing misinformation pandemic, or infodemic, which is contributing to vaccine hesitancy. Web-based population health interventions have been shown to impact health behaviors positively. For web-based interventions to be successful, they must use effective learning design strategies that seek to address known issues with learner engagement and retention. To know if an intervention successfully addresses vaccine hesitancy, there must be some embedded measure for comparing learners preintervention and postintervention. OBJECTIVE: This protocol aims to describe a study on the effectiveness of a web-based population health intervention that is designed to address vaccine misinformation and hesitancy. The study will examine learner analytics to understand what aspects of the learning design for the intervention were effective and implement a validated instrument-the Adult Vaccine Hesitancy Scale-to measure if any changes in vaccine hesitancy were observed preintervention and postintervention. METHODS: We developed a fully web-based population health intervention to help learners identify misinformation concerning COVID-19 and share the science behind vaccinations. Intervention development involves using a design-based research approach to output more effective interventions in which data can be analyzed to improve future health interventions. The study will use a quasi-experimental design in which a pre-post survey will be provided and compared statistically. Learning analytics will also be generated based on the engagement and retention data collected through the intervention to understand what aspects of our learning design are effective. RESULTS: The web-based intervention was released to the public in September 2021, and data collection is ongoing. No external marketing or advertising has been done to market the course, making our current population of 486 participants our pilot study population. An analysis of this initial population will enable the revision of the intervention, which will then be marketed to a broader audience. Study outcomes are expected to be published by August 2022. We anticipate the release of the revised intervention by May 2022. CONCLUSIONS: Disseminating accurate information to the public during pandemic situations is vital to contributing to positive health outcomes, such as those among people getting vaccinated. Web-based interventions are valuable, as they can reach people anytime and anywhere. However, web-based interventions must use sound learning design to help incentivize engagement and motivate learners to learn and must provide a means of evaluating the intervention to determine its impact. Our study will examine both the learning design and the effectiveness of the intervention by using the analytics collected within the intervention and a statistical analysis of a validated instrument to determine if learners had a change in vaccine hesitancy as a result of what they learned. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38034.

Adult Vaccine Hesitancy Scale in Arabic and French: Protocol for Translation and Validation in the World Health Organization Eastern Mediterranean Region.

BACKGROUND: The world as we know it changed during the COVID-19 pandemic. Hope has emerged with the development of new vaccines against the disease. However, many factors hinder vaccine uptake and lead to vaccine hesitancy. Understanding the factors affecting vaccine hesitancy and how to assess its prevalence have become imperative amid the COVID-19 pandemic. The vaccine hesitancy scale (VHS), developed by the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization, has been modified to the adult VHS (aVHS) and validated in English and Chinese. To our knowledge, no available aVHS has been designed or validated in Arabic or French. OBJECTIVE: The aim of this research is to translate the aVHS from its original English language to Arabic and French and validate the translations in the WHO Eastern Mediterranean region. METHODS: The study will follow a cross-sectional design divided into 5 phases. In phase 1, the original aVHS will be forward-translated to Arabic and French, followed by backward translation to English. An expert committee will review and rate all versions of the translations. Expert agreement will then be measured using the Cohen kappa coefficient (k). In phase 2, the translated aVHS will be pilot-tested with 2 samples of participants (n=100): a group that speaks both Arabic and English and another that speaks French and English. Participants' responses to the English version will also be collected. In phase 3, responses will then be compared. Descriptive statistics and paired t tests or one-way analyses of variance (ANOVA) and Pearson correlation coefficient will be used in the preliminary validation. In phase 4, prefinal versions (Arabic and French) will be tested with larger sample sizes of Arabic speakers (n=1000) and French speakers (n=1000). Sociodemographic information and vaccination status will be collected and used for further analysis. In phase 5, the scale's statistical reliability and internal consistency will be measured using Cronbach alpha. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be used to examine the model fit resulting from the EFA. ANOVA and regression models will be constructed to control for confounders. All data will be electronically collected. RESULTS: As of January 2022, the scale had been translated to Arabic and French and was undergoing the process of back translation. All data collection tools have been prepared (ie, sociodemographics, vaccination status, and open-ended questions) and are ready to go into their electronic formats. We expect to reach the desired sample size in this phase by June 2022. CONCLUSIONS: This study will provide researchers with a validated tool to assess adult vaccine hesitancy within populations that speak Arabic and/or French and provide a road map to scale translation and ensure cross-cultural adaptation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/36928.

Conversational Agents in Health Education: Protocol for a Scoping Review.

BACKGROUND: Conversational agents have the ability to reach people through multiple mediums, including the online space, mobile phones, and hardware devices like Alexa and Google Home. Conversational agents provide an engaging method of interaction while making information easier to access. Their emergence into areas related to public health and health education is perhaps unsurprising. While the building of conversational agents is getting more simplified with time, there are still requirements of time and effort. There is also a lack of clarity and consistent terminology regarding what constitutes a conversational agent, how these agents are developed, and the kinds of resources that are needed to develop and sustain them. This lack of clarity creates a daunting task for those seeking to build conversational agents for health education initiatives. OBJECTIVE: This scoping review aims to identify literature that reports on the design and implementation of conversational agents to promote and educate the public on matters related to health. We will categorize conversational agents in health education in alignment with current classifications and terminology emerging from the marketplace. We will clearly define the variety levels of conversational agents, categorize currently existing agents within these levels, and describe the development models, tools, and resources being used to build conversational agents for health care education purposes. METHODS: This scoping review will be conducted by employing the Arksey and O'Malley framework. We will also be adhering to the enhancements and updates proposed by Levac et al and Peters et al. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews will guide the reporting of this scoping review. A systematic search for published and grey literature will be undertaken from the following databases: (1) PubMed, (2) PsychINFO, (3) Embase, (4) Web of Science, (5) SCOPUS, (6) CINAHL, (7) ERIC, (8) MEDLINE, and (9) Google Scholar. Data charting will be done using a structured format. RESULTS: Initial searches of the databases retrieved 1305 results. The results will be presented in the final scoping review in a narrative and illustrative manner. CONCLUSIONS: This scoping review will report on conversational agents being used in health education today, and will include categorization of the levels of the agents and report on the kinds of tools, resources, and design and development methods used. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31923.

Elements That Underpin the Design, Development, and Evaluation of Social Media Health Interventions: Protocol for a Scoping Review.

BACKGROUND: Social media use has grown tremendously over the years. Given the volume and diversity of people on social media and the amount of information being exchanged, it is perhaps unsurprising that social media is being used as an avenue to disseminate and deliver health interventions. There exists an opportunity for social media health interventions to make a positive impact on health. However, there is a need to understand more about the ways in which these interventions are designed, developed, and evaluated. This scoping protocol will review the current state of this field by charting the elements that drive the design, development, and evaluation of these interventions. This includes charting models, frameworks, and rationales for the interventions, as well as the platforms being used, and the health behaviors being targeted. This intention of this scoping review is to help inform those who wish to develop effective social media health interventions. OBJECTIVE: The objective of this review is to map the elements that drive the design, development, and evaluation of social media health interventions. We define "social media health intervention" as interventions that make use of social media platforms to disseminate or deliver health-related information and educational initiatives to the public. We will seek to chart the elements that drive the design, development, and delivery of such interventions, including their platforms and targeted health behaviors. METHODS: The methodological framework for this review is guided by Arksey and O'Malley and enhancements by later studies. We will search relevant literature from 9 databases: (1) PubMed, (2) PsycINFO, (3) EMBASE, (4) Web of Science, (5) Scopus, (6) CINAHL, (7) ERIC, (8) MEDLINE, and (9) Google Scholar. The literature will be screened by at least two reviewers in 2 stages: (1) title/abstract screening against the eligibility criteria; and (2) eligible articles will then undergo a full-text screening. Data will be charted using the data charting tool developed by the authors. RESULTS: The results of this study will be presented in a final scoping review paper, divided into 2 sections. The first section will describe the search strategy and study selection process and will contain the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart. The second section will provide key details pertaining to the review objective and question. CONCLUSIONS: This review will help guide scholars looking to build social media health interventions toward evidence-based practices in design and evaluation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/31911.

Imagining the Future of Learning in Healthcare: The GAME 2019 #FuturistForum.

The GAME 2019 #FuturistForum involved an exchange of ideas and perspectives on the future of learning in healthcare and necessary evolutions to sustain future health systems. This event allowed for reflection and discourse around a) what medical learning or learning in healthcare may look like 10-15 years from now, b) how technology would impact that evolution, and c) what collaborative roles distinct stakeholders would play. Seventy-five (75) key stakeholders, experts from various fields, participated in the two-day event. Four multifaceted themes were uncovered from the qualitative analysis, which are: learning will be lifelong and outcome-based, the health system will follow a preventive care model, technology will be an enabler of evolution in education and health systems, and that multi-level collaboration will support and sustain future progress. Future implications, exacerbated by the ongoing COVID-19 pandemic, and study limitations are described.