Using a Proximity-Detection Technology to Nudge for Physical Distancing in a Swedish Workplace During the COVID-19 Pandemic: Retrospective Case Study.

BACKGROUND: The recent COVID-19 pandemic has contributed to the emergence of several technologies for infectious disease management. Although much focus has been placed on contact-tracing apps, another promising new tactic is proximity tracing, which focuses on health-related behavior and can be used for primary prevention. Underpinned by theories on behavioral design, a proximity-detection system can be devised that provides a user with immediate nudges to maintain physical distance from others. However, the practical feasibility of proximity detection during an infectious disease outbreak has not been sufficiently investigated. OBJECTIVE: We aimed to evaluate the feasibility of using a wearable device to nudge for distance and to gather important insights about how functionality and interaction are experienced by users. The results of this study can guide future research and design efforts in this emerging technology. METHODS: In this retrospective case study, a wearable proximity-detection technology was used in a workplace for 6 weeks during the production of a music competition. The purpose of the technology was to nudge users to maintain their physical distance using auditory feedback. We used a mixed methods sequential approach, including interviews (n=8) and a survey (n=30), to compile the experiences of using wearable technology in a real-life setting. RESULTS: We generated themes from qualitative analysis based on data from interviews and open-text survey responses. The quantitative data were subsequently integrated into these themes: feasibility (implementation and acceptance-establishing a shared problem; distance tags in context-strategy, environment, and activities; understanding and learning; and accomplishing the purpose) and design aspects (a purposefully annoying device; timing, tone, and proximity; and additional functions). CONCLUSIONS: This empirical study reports on the feasibility of using wearable technology based on proximity detection to nudge individuals to maintain physical distance in the workplace. The technology supports attention to distance, but the usability of this approach is dependent on the context and situation. In certain situations, the audio signal is frustrating, but most users agree that it needs to be annoying to ensure sufficient behavioral adaption. We proposed a dual nudge that involves vibration followed by sound. There are indications that the technology also facilitates learning how to maintain a greater distance from others, and that this behavior can persist beyond the context of technology use. This study demonstrates that the key value of this technology is that it places the user in control and enables immediate action when the distance to others is not maintained. This study provides insights into the emerging field of personal and wearable technologies used for primary prevention during infectious disease outbreaks. Future research is needed to evaluate the preventive effect on transmission and investigate behavioral changes in detail and in relation to different forms of feedback.

Digital Health Testbeds in Sweden: An exploratory study.

OBJECTIVE: This study explored the Swedish digital health testbeds through the lens of complexity science. METHODS: The purposive sampling was used to identify 38 digital health testbed organizations to conduct interviews in written or audio-conferencing. The interview responses were aggregated and analyzed using thematic analysis. The themes were mainly generated through complexity theory and the principles of complex adaptive systems. RESULTS: Fifteen testbed organizations responded, comprising 13 written responses and two audio-conferencing. Five main theoretical themes were generated: agents and diversity, connections and communication, adaptation and learning, perturbations, and path dependence. Agents and diversity depicted different types of testbeds, stakeholders and innovation, and the primary function and purpose of the testbeds. Various factors enhancing connections and communications among multiple stakeholders were identified, such as the quality of e-health solutions and the 2030 Agenda for Sustainable Development. Some adaptation and learning factors, such as internal reorganization, sharing and creating learning opportunities, and additional funding, guaranteed the sustainability of testbeds. Perturbations were characterized by two factors: non-linear interactions - lack of commitment and transparency in stakeholders' engagement, and uncertainty about testbed definitions and concepts. Path dependence highlighted the importance of history, such as previous positive and negative experiences. CONCLUSION: This study provided insights into testbeds' organization, their functions, how various aspects were challenged, and how they adapted to overcome and improve the system issues. Identifying the stakeholders and relevant factors, commissioning an evaluation, backing up with a contingency plan, securing adequate funding, and disseminating the findings can improve the testbeds' design and implementation.

Going digital as a result of COVID-19: Insights from students' and teachers' impressions in a Swedish university.

During the past two years, the entire world has been coping with the consequences of the COVID-19 pandemics. The need for physical distancing, forced an accelerated digital transformation of the education sector. The emergency remote education (ERE) has been manifested differently across diverse countries in the world. In this paper, we bring a case study about students' and teachers' impressions and experiences regarding the changes that have happened due to pandemic conditions in university courses in informatics at a Swedish university. This research is conducted through a mix of quantitative and qualitative empirical data. These data have been collected through the students surveys, course logs, as well as teachers and ICT pedagogue interviews. The collected data have been analyzed through the technology-mediated learning (TML) theoretical framework. Based on the thematic analysis on the collected data, we have identified three main themes: a) Preparedness, b) Challenges with ERE and c) Opportunities with ERE. As a result, through analyzing data in the light of the ERE experiences that encompasses the educational process, affordance, and beliefs, knowledge, and practices, we provide a set of lessons-learned experiences and indicate the possible lines of actions when it comes to the learning design in the constrained pandemic situations.

Current Knowledge about Providing Drug-Drug Interaction Services for Patients-A Scoping Review.

Drug-drug interactions (DDIs) pose a major problem to patient safety. eHealth solutions have the potential to address this problem and generally improve medication management by providing digital services for health care professionals and patients. Clinical decision support systems (CDSS) to alert physicians or pharmacists about DDIs are common, and there is an extensive body of research about CDSS for professionals. Information about DDIs is commonly requested by patients, but little is known about providing similar support to patients. The aim of this scoping review was to explore and describe current knowledge about providing digital DDI services for patients. Using a broad search strategy and an established framework for scoping reviews, 19 papers were included. The results show that although some patients want to check for DDIs themselves, there are differences between patients, in terms of demands and ability. There are numerous DDI services available, but the existence of large variations regarding service quality implies potential safety issues. The review includes suggestions about design features but also indicates a substantial knowledge gap highlighting the need for further research about how to best design and provide digital DDI to patients without risking patient safety or having other unintended consequences.

Experiences with external hip protectors in homes for the aged: a report from Finland.

OBJECTIVE: Three observational studies were performed to examine the use and effectiveness of external hip protectors intended to prevent hip fractures. METHODS: Data were collected by: (1) questionnaire to health centers or homes for the aged to which hip protectors had been sent; (2) comparison of users of hip protectors and control subjects;(3) comparison of users of hip protectors, comparing time wearing versus not wearing their hip protectors for part of the study period. OBSERVATIONS: The use of external hip protectors is a good, cost-effective adjunctive tool in preventing hip fractures. However, improvements in design are still needed to increase compliance.