Prevalence and Associated Factors of Nomophobia Amongst the General Population in Makkah Province and Al-Madinah Province, Saudi Arabia: An Analytical Cross-Sectional Study.

Background: Nomophobia is a public health issue that involves the fear of being without a mobile phone. The study aimed to estimate the prevalence of nomophobia and its relation to psychological factors, including depression and insomnia, among the general population in Makkah Province and Al-Madinah Province, Saudi Arabia. Methods: This analytical cross-sectional study was conducted and data were obtained through a self-administered online questionnaire using the Patient Health Questionnaire-2 (PHQ-2) for depression, the Nomophobia Questionnaire (NMP-Q), and Insomnia Severity Index (ISI). Results: A total of 1022 participants completed the questionnaire. The prevalence of nomophobia was 96.7%. Moderate nomophobia was prevalent (47.8%). Based on the PHQ-2, possible depression was identified in 47.3% of the respondents. 37.1% had sub-threshold insomnia. In terms of personal psychiatric history, the most common mental disorders in the participants included generalized anxiety disorder (9.9%) and major depressive disorder (9.7%). 61.6% of them used mobile devices for more than four hours per day. Conclusion: Nomophobia is prevalent in the Makkah and Al-Madinah provinces in Saudi Arabia. The risk of nomophobia was significantly higher for participants who spent more hours using mobile devices, those with possible depression, and those having irritable bowel syndrome.

A systematic review of mobile device use in the primary school classroom and impact on pupil literacy and numeracy attainment: A systematic review.

Background: Investment in mobile devices to support primary or elementary education is increasing and must be informed by robust evidence to demonstrate impact. This systematic review of randomised controlled trials sought to identify the overall impact of mobile devices to support literacy and numeracy outcomes in mainstream primary classrooms. Objectives: The aim of this systematic review was to understand how mobile devices are used in primary/elementary education around the world, and in particular, determine how activities undertaken using mobile devices in the primary classroom might impact literacy and numeracy attainment for the pupils involved. Within this context, mobile devices are defined as tablets (including iPads and other branded devices), smartphones (usually those with a touchscreen interface and internet connectivity) and handheld games consoles (again usually with touchscreen and internet-enabled). The interventions of interest were those aimed at improving literacy and/or numeracy for children aged 4-12 within the primary/elementary school (or equivalent) classroom.Specifically, the review aimed to answer the following research questions: -What is the effect of mobile device integration in the primary school classroom on children's literacy and numeracy outcomes?-Are there specific devices which are more effective in supporting literacy and numeracy? (Tablets, smartphones, or handheld games consoles)-Are there specific classroom integration activities which moderate effectiveness in supporting literacy and numeracy?-Are there specific groups of children for whom mobile devices are more effective in supporting literacy and numeracy? (Across age group and gender).-Do the benefits of mobile devices for learning last for any time beyond the study?-What is the quality of available evidence on the use of mobile devices in primary/elementary education, and where is further research needed in this regard? An Expert Advisory Group supported the review process at key stages to ensure relevance to current practice. Search Methods: The search strategy was designed to retrieve both published and unpublished literature, and incorporated relevant journal and other databases with a focus on education and social sciences. Robust electronic database searches were undertaken (12 databases, including APA PsychInfo, Web of Science, ERIC, British Education Index and others, and relevant government and other websites), as well as a hand-search of relevant journals and conference proceedings. Contact was also made with prominent authors in the field to identify any ongoing or unpublished research. All searches and author contact took place between October and November 2020. The review team acknowledges that new studies will likely have emerged since and are not captured at this time. A further update to the review in the future is important and would build on the evidence reflected here. Selection Criteria: The review included children within mainstream primary/elementary/kindergarten education settings in any country (aged 4-12), and interventions or activities initiated within the primary school classroom (or global equivalent) that used mobile devices (including tablets, smartphones, or hand-held gaming devices) to intentionally support literacy or numeracy learning. In terms of study design, only Randomised Controlled Trials were included in the review. Data Collection and Analysis: A total of 668 references were identified through a robust search strategy including published and unpublished literature. Following duplicate screening, 18 relevant studies, including 11,126 participants, 14 unique interventions, and 46 relevant outcome measures were synthesised using Robust Variance Estimation and a random effects meta-analysis model. Risk of Bias assessment was undertaken by three reviewers using the ROB2 tool to assess the quality of studies, with 13 studies rated as having some concerns, and 5 as having high risk of bias. Qualitative data was also extracted and analysed in relation to the types of interventions included to allow a comparison of the key elements of each. Main Results: A positive, statistically significant combined effect was found (Cohen's d = 0.24, CI 0.0707 to 0.409, p < 0.01), demonstrating that in the studies and interventions included, children undertaking maths or literacy interventions using mobile devices achieved higher numeracy or literacy outcomes than those using an alternative device (e.g., a laptop or desktop computer) or no device (class activities as usual). However these results should be interpreted with caution given the risk of bias assessment noted above (5 studies rated high risk of bias and 13 rated as having some concerns). As the interventions and classroom circumstances differed quite widely, further research is needed to understand any potential impact more fully.Sensitivity analysis aimed to identify moderating factors including age or gender, screen size, frequency/dosage of intervention exposure, and programme implementation features/activities (based on Puentedura's [2009] SAMR model of technology integration). There were too few studies identified to support quantitative analysis of sufficient power to draw robust conclusions on moderating factors, and insufficient data to determine impact beyond immediate post-test period. Sensitivty analysis was also undertaken to exclude the five studies identified as having a high risk of bias, to identify any impact they may have on overall findings. Authors' Conclusions: Overall, this review demonstrates that for the specific interventions and studies included, mobile device use in the classroom led to a significant, positive effect on literacy and numeracy outcomes for the children involved, bringing positive implications for their continued use in primary education. However given the concerns on risk of bias assessment reported above, the differing circumstances, interventions and treatment conditions and intensities, the findings must be interpreted with caution. The review also supports the need for further robust research to better understand what works, under what circumstances, and for whom, in the use of mobile devices to support learning.

Online Signature Biometrics for Mobile Devices.

This paper addresses issues concerning biometric authentication based on handwritten signatures. Our research aimed to check whether a handwritten signature acquired with a mobile device can effectively verify a user's identity. We present a novel online signature verification method using coordinates of points and pressure values at each point collected with a mobile device. Convolutional neural networks are used for signature verification. In this paper, three neural network models are investigated, i.e., two self-made light SigNet and SigNetExt models and the VGG-16 model commonly used in image processing. The convolutional neural networks aim to determine whether the acquired signature sample matches the class declared by the signer. Thus, the scenario of closed set verification is performed. The effectiveness of our method was tested on signatures acquired with mobile phones. We used the subset of the multimodal database, MobiBits, that was captured using a custom-made application and consists of samples acquired from 53 people of diverse ages. The experimental results on accurate data demonstrate that developed architectures of deep neural networks can be successfully used for online handwritten signature verification. We achieved an equal error rate (EER) of 0.63% for random forgeries and 6.66% for skilled forgeries.

Greater mobile device-prompted phone pickups are associated with daily parent stress.

AIM: No studies have examined notifications as they relate to parent stress. We aimed to examine associations between objective daily mobile device notifications and pickups with daily parenting stress. METHODS: This was a within- and between-subjects, cross-sectional study that took place from 2020 to 2021. The study occurred during the coronavirus disease of 2019 pandemic. Data were collected in a low-contact home visit. This study included 62 parents of 62 children aged 48-71 months. Parents downloaded a passive sensing app on their Android mobile devices collecting data on duration, device notifications and device pickups. Parents completed an end-of-day stress survey for 4 days. We used random effects models to examine the variation of daily stress with smartphone duration, notification frequency, pickup frequency and device-initiated pickups, adjusting for covariates. RESULTS: Parents were on average 37.3 years old (SD ± 5.7) and were predominantly mothers (82.3%). On average, parents received 293 daily notifications and picked up their phones 93 times. Duration of smartphone use and notification frequency were not associated with daily stress. Device-initiated pickups were associated with daily parent stress. CONCLUSION: When notifications prompted parents to pick up their phones more often, parents experienced greater stress.

Event-related driver stress detection with smartphones in an urban environment: a naturalistic driving study.

Driving in urban areas can be challenging and encounter acute stress. To detect driver stress, collecting data on real roads without interfering the driver is preferred. A smartphone-based data collection protocol was developed to support a naturalistic driving study. Sixty-one participants drove on predetermined real road routes, and driving information as well as physiological, psychological, and facial data were collected. The algorithm identified potentially stressful events based on the collected data. Participants classified these events as low, medium, or highly stressful events by watching recorded videos after the experiment. These events were then used to train prediction models. The best model achieved an accuracy of 92.5% in classifying low/medium/highly stressful events. The contribution of physiological, psychological, and facial expression indices and individual profile information was evaluated. The method can be applied to visualise the geographical distribution of stressors, monitor driver behaviour, and help drivers regulate their driving habits.

The data collection protocol for driving on real roads and the stressful event identification method could potentially be applied for in-vehicle driver status monitoring and stress intervention.

Mobile audiometry for hearing threshold assessment: A systematic review and meta-analysis.

OBJECTIVES: Technological advancements in mobile audiometry (MA) have enabled hearing assessment using tablets and smartphones. This systematic review (PROSPERO ID: CRD42021274761) aimed to identify MA options available to health providers, assess their accuracy in measuring hearing thresholds, and explore factors that might influence their accuracy. DESIGN AND SETTING: A systematic search of online databases including PubMed, Embase, Cochrane, Evidence Search and Dynamed was conducted on 13th December 2021, and repeated on 30th October 2022, using appropriate Medical Subject Headings (MeSH) terms. Eligible studies reported the use of MA to determine hearing thresholds and compared results to conventional pure-tone audiometry (CA). Studies investigating MA for hearing screening (i.e. reporting just pass/fail) were ineligible for inclusion. Two authors independently reviewed studies, extracted data, and assessed methodological quality and risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. PARTICIPANTS: Adults and children, with and without diagnosis of hearing impairment. MAIN OUTCOME MEASURES: A meta-analysis was performed to obtain the mean difference between thresholds measured using MA and CA in dB HL. RESULTS: Searches returned 858 articles. After systematic review, 17 articles including 1032 participants were analysed. The most used software application was ShoeboxTM (6/17) followed by Hearing TestTM (3/17), then HearTestTM (2/17). Tablet computers were used in ten studies, smartphones in six, and a computer in one. The mean difference between MA and CA thresholds was 1.36 dB (95% CI, 0.07-2.66, p = 0.04). Significant differences between mobile audiometry (MA) and conventional audiometry (CA) thresholds were observed in thresholds measured at 500Hz, in children, when MA was conducted in a sound booth, and when MA was self-administered. However, these differences did not exceed the clinically significant threshold of 10 decibels (dB). Included studies exhibited high levels of heterogeneity, high risk of bias and low concerns about applicability. CONCLUSIONS: MA compares favourably to CA in measuring hearing thresholds and has role in providing access to hearing assessment in situations where CA is not available or feasible. Future studies should prioritize the integration of pure-tone threshold assessment with additional tests, such as Speech Recognition and Digits-in-Noise, for a more rounded evaluation of hearing ability, assesses acceptability and feasibility, and the cost-effectiveness of MA in non-specialist settings.

Dataset of inertial measurements of smartphones and smartwatches for human activity recognition.

This article describes a dataset for human activity recognition with inertial measurements, i.e., accelerometer and gyroscope, from a smartphone and a smartwatch placed in the left pocket and on the left wrist, respectively. Twenty-three heterogeneous subjects (µ = 44.3, σ = 14.3, 56% male) participated in the data collection, which consisted of performing five activities (seated, standing up, walking, turning, and sitting down) arranged in a specific sequence (corresponding with the TUG test). Subjects performed the sequence of activities multiple times while the devices collected inertial data at 100 Hz and were video-recorded by a researcher for data labelling purposes. The goal of this dataset is to provide smartphone- and smartwatch-based inertial data for human activity recognition collected from a heterogeneous (i.e., age-diverse, gender-balanced) set of subjects. Along with the dataset, the repository includes demographic information (age, gender), information about each sequence of activities (smartphone's orientation in the pocket, direction of turns), and a Python package with utility functions (data loading, visualization, etc). The dataset can be reused for different purposes in the field of human activity recognition, from cross-subject evaluation to comparison of recognition performance using data from smartphones and smartwatches.

Smartphone-derived Virtual Keyboard Dynamics Coupled with Accelerometer Data as a Window into Understanding Brain Health: Smartphone Keyboard and Accelerometer as Window into Brain Health.

We examine the feasibility of using accelerometer data exclusively collected during typing on a custom smartphone keyboard to study whether typing dynamics are associated with daily variations in mood and cognition. As part of an ongoing digital mental health study involving mood disorders, we collected data from a well-characterized clinical sample (N = 85) and classified accelerometer data per typing session into orientation (upright vs. not) and motion (active vs. not). The mood disorder group showed lower cognitive performance despite mild symptoms (depression/mania). There were also diurnal pattern differences with respect to cognitive performance: individuals with higher cognitive performance typed faster and were less sensitive to time of day. They also exhibited more well-defined diurnal patterns in smartphone keyboard usage: they engaged with the keyboard more during the day and tapered their usage more at night compared to those with lower cognitive performance, suggesting a healthier usage of their phone.

Mobile device accessibility with 3D printed devices for individuals with physical disabilities.

PURPOSE: Disparities may disproportionately exist for those with disabilities when using mobile devices, which are critical for independence in activities such as socialization and leisure. Prior 3D printing studies in rehabilitation have not focused on mobile device access to everyday preferred activities. METHODS: This study examined user satisfaction, self-rated performance and satisfaction with daily activities while using the mobile device, and the feasibility of customized 3D printed assistive devices. The design was a one-group, quantitative pre-test to post-test study of individuals (n = 10) residing in long-term care with a physical disability due to a neurological condition. RESULTS: Satisfaction with the 3D printed device, as compared to the previously used assistive device, was significantly higher (p = 0.005), as well as improvements in self-rated daily activity performance (p = 0.016) and satisfaction (p = 0.037), with acceptability and satisfaction of the intervention. CONCLUSIONS: Findings suggest that 3D printing is feasible with a potential increase in user satisfaction through a customization process that is client centred.

Recommendations for settings interested in providing customized 3D printed assistive devices, and for future studies, include client centred integration and educational support on mobile device usage during activities, familiarity with common customization and modification requests, and adjusting timelines to the facility's service delivery capacity.

Web-Based Presence for Social Connectedness in Long-Term Care: Protocol for a Qualitative Multimethods Study.

BACKGROUND: The COVID-19 pandemic and resultant restrictions on social gatherings significantly impacted many peoples' sense of social connectedness, defined as an individual's subjective sense of having close relationships with others. Older adults living in long-term care homes (LTCHs) experienced extreme restrictions on social gatherings, which negatively impacted their physical and mental health as well as the health and well-being of their family caregivers. Their experiences highlighted the need to reconceptualize social connectedness. In particular, the pandemic highlighted the need to explore novel ways to attain fulfilling relationships with others in the absence of physical gatherings such as through the use of a hybridized system of web-based and in-person presence. OBJECTIVE: Given the potential benefits and challenges of web-based presence technology within LTCHs, the proposed research objectives are to (1) explore experiences regarding the use of web-based presence technology (WPT) in support of social connectedness between older adults in LTCHs and their family members, and (2) identify the contextual factors that must be addressed for successful WPT implementation within LTCHs. METHODS: This study will take place in south western Ontario, Canada, and be guided by a qualitative multimethod research design conducted in three stages: (1) qualitive description with in-depth qualitative interviews guided by the Technology Acceptance Model (TAM) and analyzed using content analysis; (2) qualitative description and document analysis methodologies, informed by content and thematic analysis methods; and (3) explicit between-methods triangulation of study findings from stages 1 and 2, interpretation of findings and development of a guiding framework for technology implementation within LTCHs. Using a purposeful, maximum variation sampling approach, stage 1 will involve recruiting approximately 45 participants comprising a range of older adults, family members (30 participants) and staff (15 participants) within several LTCH settings. In stage 2, theoretical sampling will be used to recruit key LTCH stakeholders (directors, administrators, and IT support). In stage 3, the findings from stages 1 and 2 will be triangulated and interpreted to develop a working framework for WPT usage within LTCHs. RESULTS: Data collection will begin in fall 2023. The findings emerging from this study will provide insights and understanding about how the factors, barriers, and facilitators to embedding and spreading WPT in LTCHs may benefit or negatively impact older adults in LTCHs, family caregivers, and staff and administrators of LTCHs. CONCLUSIONS: The results of this research study will provide a greater understanding of potential approaches that could be used to successfully integrate WPTs in LTCHs. Additionally, benefits as well as challenges for older adults in LTCHs, family caregivers, and staff and administrators of LTCHs will be identified. These findings will help increase knowledge and understanding of how WPT may be used to support social connectedness between older adults in LTCHs and their family members. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50137.

The Use of Mobile Sensors by Children: A Review of Two Decades of Environmental Education Projects.

Over the past twenty years, the use of electronic mobile sensors by children and youngsters has played a significant role in environmental education projects in Portugal. This paper describes a research synthesis of a set of case studies (environmental education projects) on the use of sensors as epistemic mediators, evidencing the technological, environmental, social, and didactical dimensions of environmental education projects over the last two decades in Portugal. The triggers of the identified changes include: (i) the evolution of sensors, information and communication platforms, and mobile devices; (ii) the increasing relevance of environmental citizenship and participation; (iii) the recognition of the role of multisensory situated information and quantitative information in environmental citizenship; (iv) the cause-effect relation between didactical strategies and environmental education goals; (v) the potential of sensory and epistemic learners' practices in the environment to produce learning outcomes and new knowledge. To support the use of senses and sensors in environmental education projects, the SEAM model was created based on the developed research synthesis.

Using the MNL Model in a Mobile Device's Indoor Positioning.

Indoor Positioning Services (IPS) allow mobile devices or bionic robots to locate themselves quickly and accurately in large commercial complexes, shopping malls, supermarkets, exhibition venues, parking garages, airports, or train hubs, and access surrounding information. Wi-Fi-based indoor positioning technology can use existing WLAN networks, and has promising prospects for broad market applications. This paper presents a method using the Multinomial Logit Model (MNL) to generate Wi-Fi signal fingerprints for positioning in real time. In an experiment, 31 locations were randomly selected and tested to validate the model, showing mobile devices could determine their locations with an accuracy of around 3 m (2.53 m median).

Smartphone app aesthetics influence users' experience and performance.

Past research has demonstrated that aesthetics affect users' experiences in various ways. However, there is little research on the impact of interface aesthetics on user performance in a smartphone app context. The present paper addresses this research gap using an online experiment (N = 281). Two variants of the same web app were created and manipulated in their aesthetics. Participants were randomly assigned to either variant and asked to explore the app before answering questions concerning the app's content. Results showed a significant positive effect of aesthetics on perceived usability and aesthetics. Furthermore, results point toward a positive impact of interface aesthetics on performance (i.e., the number of questions answered correctly). Thus, results indicate that a visually appealing smartphone web app increases users' subjective experience and objective performance compared to an unaesthetic app. This suggests that user interface aesthetics impact users' experiences and provide stakeholders with quantifiable value and competitive advantage.

Knowledge, Perceptions and Attitudes of eHealth and Health Technology among Nursing Students from Gauteng Province, South Africa.

The use of technology in healthcare settings was identified as a crucial priority in many countries to provide quality healthcare services. eHealth or digital health technology is found to have a positive influence on improving the efficiency and quality of healthcare services. It has been proven to provide opportunities to strengthen health systems. This study aims to assess eHealth literacy, pre-existing knowledge and the nursing students' perceptions and attitudes towards eHealth. A quantitative, descriptive, cross-sectional survey was used in this study. The population of this study comprised 266 nursing students in the undergraduate programme of the Department of Nursing, among which 244 consented to participate in the study. A standardised and self-administered tool was utilised to collect data from nursing students across the four levels of study. Results showed that students in level four exhibit high scores of knowledge in the use of eLearning technology as compared to first-entry university nursing students. Nursing students used the internet frequently, especially to access social media and search for health and medical information for their study. Attitudes towards eHealth and technology were also found to be positive. The study recommends that digital literacy should be enhanced in the nursing education curriculum in other to further strengthen the knowledge and skills towards the use of eHealth and health technology among nursing students.

Mobile and wearable technologies for the analysis of Ten Meter Walk Test: A concise systematic review.

Physical issues started to receive more attention due to the sedentary lifestyle prevalent in modern culture. The Ten Meter Walk Test allows measuring the person's capacity to walk along 10 m and analyzing the advancement of various medical procedures for ailments, including stroke. This systematic review is related to the use of mobile or wearable devices to measure physical parameters while administering the Ten Meter Walk Test for the analysis of the performance of the test. We applied the PRISMA methodology for searching the papers related to the Ten Meter Walk Test. Natural Language Processing (NLP) algorithms were used to automate the screening process. Various papers published in two decades from multiple scientific databases, including IEEE Xplore, Elsevier, Springer, EMBASE, SCOPUS, Multidisciplinary Digital Publishing Institute (MDPI), and PubMed Central were analyzed, focusing on various diseases, devices, features, and methods. The study reveals that chronometer and accelerometer sensors measuring spatiotemporal features are the most pertinent in the Gait characterization of most diseases. Likewise, all studies emphasized the close relation between the quality of the sensor's data obtained and the system's ultimate accuracy. In other words, calibration procedures are needed because of the body part where the sensor is worn and the type of sensor. In addition, using ambient sensors providing kinematic and kinetic features in conjunction with wearable sensors and consistently acquiring walking signals can enhance the system's performance. The most common weaknesses in the analyzed studies are the sample size and the unavailability of continuous monitoring devices for measuring the Ten Meter Walk Test.

Teacher Self-regulation: Validation of Scales in Chile Applied with an Online Technological Tool / Autorregulación Docente: Validación de Escalas en Chile Aplicadas con una Herramienta Tecnológica Online

Resumen La autorregulación docente es de gran importancia porque permite un ejercicio profesional organizado y estructurado, además facilita un desempeño exitoso del proceso de enseñanza y aprendizaje, permitiendo al docente monitorear la efectividad de sus prácticas pedagógicas y modelar habilidades de autorregulación en sus estudiantes. El objetivo de este estudio fue adaptar y validar escalas para medir procesos de autorregulación docente en español y con evidencia de su funcionalidad mediante la aplicación de herramientas tecnológicas. El estudio fue cuantitativo, con un diseño instrumental. La muestra estuvo constituida por 204 profesores de Educación Media de Chile. Las escalas fueron adaptadas de la Teacher Self-regulation Scale y sometidas a procedimientos de retrotraducción, entrevistas cognitivas, análisis factorial confirmatorio y análisis de confiabilidad. Los resultados mostraron estimadores adecuados de validez y confiabilidad para las siete escalas correspondientes a establecimiento de metas, interés intrínseco, orientación a metas de desempeño, orientación a metas de dominio, autoinstrucción, control emocional y autoevaluación. En conclusión, las escalas permiten una medición válida y fiable de los procesos de autorregulación de la enseñanza.

Abstract Teacher self-regulation is of great importance because it allows an organized and structured professional exercise, it also facilitates a successful performance of the teaching and learning process, allowing the teacher to monitor the effectiveness of their pedagogical practices and modeling of selfregulatory skills in students. The objective of this study was to adapt and validate scales to measure teaching self-regulation processes in Spanish and with evidence of its functionality by application of technological tools. The study was quantitative, with an instrumental design. The sample consisted of 204 secondary school teachers in Chile. The scales were adapted from the Teacher Self-regulation Scale and underwent back-translation procedures, cognitive interviews, confirmatory factor analysis, and reliability analyses. The results showed adequate validity and reliability estimators for seven scales corresponding to goal setting, intrinsic interest, performance goal orientation, goal mastery orientation, self-instruction, emotional control, and self-evaluation. In conclusion, the scales allow valid and reliable measurement of teaching self-regulatory processes.

The role of the California tier system in controlling population mobility during the COVID-19 pandemic.

BACKGROUND: Policies to restrict population mobility are a commonly used strategy to limit the transmission of contagious diseases. Among measures implemented during the COVID-19 pandemic were dynamic stay-at-home orders informed by real-time, regional-level data. California was the first state in the U.S. to implement this novel approach; however, the effectiveness of California's four-tier system on population mobility has not been quantified. METHODS: Utilizing data from mobile devices and county-level demographic data, we evaluated the impact of policy changes on population mobility and explored whether demographic characteristics explained variability in responsiveness to policy changes. For each California county, we calculated the proportion of people staying home and the average number of daily trips taken per 100 persons, across different trip distances and compared this to pre-COVID-19 levels. RESULTS: We found that overall mobility decreased when counties moved to a more restrictive tier and increased when moving to a less restrictive tier, as the policy intended. When placed in a more restrictive tier, the greatest decrease in mobility was observed for shorter and medium-range trips, while there was an unexpected increase in the longer trips. The mobility response varied by geographic region, as well as county-level median income, gross domestic product, economic, social, and educational contexts, the prevalence of farms, and recent election results. CONCLUSIONS: This analysis provides evidence of the effectiveness of the tier-based system in decreasing overall population mobility to ultimately reduce COVID-19 transmission. Results demonstrate that socio-political demographic indicators drive important variability in such patterns across counties.

Transforming the delivery of chiropractic education through the strategic integration of educational technology in a chiropractic college program.

OBJECTIVE: Chiropractic institutions face the challenging quandary of how to prepare future doctors for entry into a society completely transformed by technology. At an increasing rate, the incoming student profile is representative of a digital generation with a high affinity for technology use. The aim of this study was 2-fold: (1) outline the basic elements of a technology integration program at our institution and (2) determine if a potential relationship exists between ongoing training and acceptance of such a programmatic shift among faculty and students. METHODS: At each phase of technology integration, electronic survey instruments were deployed to participating students and faculty members. Survey instruments included question items assessed through Likert-type scales and open-ended questions to provide students and faculty members with a vehicle for providing specific feedback. To ensure anonymity of student and faculty survey respondents, the response collection source was a different department than the deployment of the survey emails. Participants were encouraged, but not required, to complete the surveys. RESULTS: Analysis of survey responses generally found increases in overall participant satisfaction and acceptance of the technology integration with the provision of ongoing support systems. CONCLUSION: As suggested in similar scholarship in the field, the results of this study underscored the value of support systems for faculty members and students in an academic community. The systems that provided ongoing training and other support mechanisms seemed more accepted when tailored to myriad skill levels. Creating a culture in which faculty members and students felt adequately supported fostered the acceptance necessary for forward momentum of a campus initiative of significant change.

Usability Testing of a Web-Based Empathy Training Portal: Mixed Methods Study.

BACKGROUND: The prepandemic period saw a rise in web-based teaching. However, web-based tools for teaching the essential clinical skill of cognitive empathy (also known as perspective taking) remain limited. More of these tools are needed and require testing for ease of use and understanding by students. OBJECTIVE: This study aimed to evaluate the usability of the In Your Shoes web-based empathy training portal application for students using quantitative and qualitative methods. METHODS: This 3-phase formative usability study used a mixed methods design. In mid-2021, we conducted a remote observation of student participants interacting with our portal application. Their qualitative reflections were captured, followed by data analysis and iterative design refinements of the application. Overall, 8 third- and fourth-year nursing students from an undergraduate baccalaureate program at a Canadian university, in the western province of Manitoba, were included in this study. Participants in phases 1 and 2 were remotely observed by 3 research personnel while engaged in predefined tasks. In phase 3, two student participants were asked to use the application as they liked in their own environments, after which a video-recorded exit interview with a think-aloud process was conducted as participants responded to the System Usability Scale. We calculated descriptive statistics and performed content analysis to analyze the results. RESULTS: This small study included 8 students with a range of technology skills. Usability themes were based on participants' comments on the application's appearance, content, navigation, and functionality. The biggest issues that participants experienced were with navigating the application's "tagging" features during video analysis and the length of educational material. We also observed variations in 2 participants' system usability scores in phase 3. This may be because of their different comfort levels with technology; however, additional research is required. We made iterative refinements to our prototype application (eg, added pop-up messages and provided a narrated video on the application's "tagging" function) based on participant feedback. CONCLUSIONS: With increasing engagement in web-based teaching, technology has become an essential medium for receiving health care education. We developed a novel prototype application as a supplemental classroom tool to foster students' self-directed learning of empathy. This study provided direction for refinements to optimize the usability of and satisfaction with this innovative application. Qualitative feedback revealed favorable input toward learning perspective taking place on the web and helpful recommendations for improving user experiences with the application. We could not fully assess the application's key functions owing to the COVID-19 protocols. Thus, our next step is to obtain feedback from a larger sample of student users, whose experiences performing "live" video capture, annotation, and analysis will be more authentic and wholesome with the refined application. We discuss our findings in relation to research on nursing education, perspective taking, and adaptive e-learning.