Effectiveness and acceptability of conversational agents for sexual health promotion: a systematic review and meta-analysis.

Digital health interventions for sexual health promotion have evolved considerably alongside innovations in technology. Despite these efforts, studies have shown that they do not consistently result in the desired sexual health outcomes. This could be attributed to low levels of user engagement, which can hinder digital health intervention effectiveness, as users do not engage with the system enough to be exposed to the intervention components. It has been suggested that conversational agents (automated two-way communication systems e.g. Alexa) have the potential to overcome the limitations of prior systems and promote user engagement through the increased interactivity offered by bidirectional, natural language-based interactions. The present review, therefore, provides an overview of the effectiveness and user acceptability of conversational agents for sexual health promotion. A systematic search of seven databases provided 4534 records, and after screening, 31 articles were included in this review. A narrative synthesis of results was conducted for effectiveness and acceptability outcomes, with the former supplemented by a meta-analysis conducted on a subset of studies. Findings provide preliminary support for the effectiveness of conversational agents for promoting sexual health, particularly treatment adherence. These conversational agents were found to be easy to use and useful, and importantly, resulted in high levels of satisfaction, use and intentions to reuse, whereas user evaluations regarding the quality of information left room for improvement. The results can inform subsequent efforts to design and evaluate these interventions, and offer insight into additional user experience constructs identified outside of current technology acceptance models, which can be incorporated into future theoretical developments.

Low health literacy and evaluation of online health information: a systematic review of the literature.

BACKGROUND: Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. OBJECTIVE: The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. METHODS: Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. RESULTS: After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. CONCLUSIONS: The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay.

The role of mental well-being in the effects of persuasive health messages: A scoping review.

Emerging evidence in health communication and psychology suggests that a) exposure to specific persuasive health messages can have unintended effects on the mental well-being of recipients and b) recipients' mental well-being before exposure can influence message processing. Available evidence regarding the relationship between mental well-being and exposure to specific health messages lacks consistency and is scattered across different fields. This scoping review of 24 publications summarizes what is known about mental health effects in health communication and provides a research agenda for future work. Among others, key findings suggest that particularly negative emotional appeals may have broad, negative effects on indicators of hedonic well-being. Further, humor and gain appeals may positively impact mental well-being, although positive message features are strongly understudied in this space. Lower mental well-being prior to message exposure may impact message processing, but not necessarily message effectiveness. We find that potential well-being effects of health communication have been largely ignored, especially outside the realm of mental health research. Yet, initial evidence does underline the importance of such inquiry. This review summarizes initial evidence of systematic, unintended effects of health messaging on mental well-being and highlights fruitful avenues for future work in this space.

Communication in refugee and migrant mental healthcare: A systematic rapid review on the needs, barriers and strategies of seekers and providers of mental health services.

BACKGROUND: Migrants and refugees may not access mental health services due to linguistic and cultural discordance between them and health and social care professionals (HSCPs). The aim of this review is to identify the communication needs and barriers experienced by third-country nationals (TCNs), their carers, and HSCPs, as well as the strategies they use and their preferences when accessing/providing mental health services and language barriers are present. METHODS: We undertook a rapid systematic review of the literature (01/01/2011 - 09/03/2022) on seeking and/or providing mental health services in linguistically discordant settings. Quality appraisal was performed, data was extracted, and evidence was reviewed and synthesised qualitatively. RESULTS: 58/5,650 papers met the inclusion criteria. Both TCNs (and their carers) and HSCPs experience difficulties when seeking or providing mental health services and language barriers are present. TCNs and HSCPs prefer linguistically and culturally concordant provision of mental health services but professional interpreters are often required. However, their use is not always preferred, nor is it without problems. CONCLUSIONS: Language barriers impede TCNs' access to mental health services. Improving language support options and cultural competency in mental health services is crucial to ensure that individuals from diverse linguistic and cultural backgrounds can access and/or provide high-quality mental health services.

Earthquake Nucleation Size: Evidence of Loading Rate Dependence in Laboratory Faults.

Recent Global Positioning System observations of major earthquakes such as the 2014 Chile megathrust show a slow preslip phase releasing a significant portion of the total moment (Ruiz et al., 2014, https://doi.org/10.1126/science.1256074). Despite advances from theoretical stability analysis (Rubin & Ampuero, 2005, https://doi.org/10.1029/2005JB003686; Ruina, 1983, https://doi.org/10.1029/jb088ib12p10359) and modeling (Kaneko et al., 2017, https://doi.org/10.1002/2016GL071569), it is not fully understood what controls the prevalence and the amount of slip in the nucleation process. Here we present laboratory observations of slow slip preceding dynamic rupture, where we observe a dependence of nucleation size and position on the loading rate (laboratory equivalent of tectonic loading rate). The setup is composed of two polycarbonate plates under direct shear with a 30-cm long slip interface. The results of our laboratory experiments are in agreement with the preslip model outlined by Ellsworth and Beroza (1995, https://doi.org/10.1126/science.268.5212.851) and observed in laboratory experiments (Latour et al., 2013, https://doi.org/10.1002/grl.50974; Nielsen et al., 2010, https://doi.org/10.1111/j.1365-246x.2009.04444.x; Ohnaka & Kuwahara, 1990, https://doi.org/10.1016/0040-1951(90)90138-X), which show a slow slip followed by an acceleration up to dynamic rupture velocity. However, further complexity arises from the effect of (1) rate of shear loading and (2) inhomogeneities on the fault surface. In particular, we show that when the loading rate is increased from 10-2 to 6 MPa/s, the nucleation length can shrink by a factor of 3, and the rupture nucleates consistently on higher shear stress areas. The nucleation lengths measured fall within the range of the theoretical limits L b and L ∞ derived by Rubin and Ampuero (2005, https://doi.org/10.1029/2005JB003686) for rate-and-state friction laws.

[PROVA E TRASPORTA Project: results of tele-transmission of the electrocardiogram from community hospitals and emergency service ambulances in the management of ST-elevation acute coronary syndromes]. / Progetto PROVA E TRASPORTA: rete territoriale di teletrasmissione dell'elettrocardiogramma da postazioni fisse e ambulanze Bls. Utilità nella gestione della sindrome coronarica acuta con sopraslivellamento del tratto ST.

BACKGROUND: Availability of a telematic system of electrocardiogram (ECG) transmission may improve the management of ST-elevation myocardial infarction (STEMI), by reducing time to treatment. The aim of this study was to show the effectiveness of telephone transmission of ECG in improving quality of care for patients with acute STEMI. METHODS: Since January 1, 2003, we activated a management program of STEMI in healthcare district of Varese, located in the North-West of Lombardy (Italy), comprising one fourth-level hospital, equipped with a cath lab on call 24/24 h for primary angioplasty since 1993 and cardiac surgery, and 2 community hospitals, placed in a mountain area approximately 30 km far from Varese. The emergency medical system (EMS) transport was activated 24/24 h and has 15 basic life support (BLS) ambulances with trained nurse staff and 2 mobile units with medical staff, all of them equipped with semiautomatic defibrillator Lifepack 12, enabling a GSM telephone transmission of a 12-lead ECG, coupled with 3-lead continuous rhythm recording and clinical data, if necessary. The ECGs were transmitted to a core unit placed in the coronary care unit (CCU) of the Hospital di Circolo of Varese, directly connected with the EMS core unit. RESULTS: From January 2003 to August 2005, a total of 2063 ECGs were transmitted, 538 of them (26%) recorded by EMS ambulances. Of 144 ECGs (7%) showing a persistent ST-elevation suggesting an acute STEMI (group A), 112 subjects underwent reperfusion: 73 were treated with angioplasty and 39 by lysis alone. By comparing data of group A with a group of 256 patients (180 reperfused) with acute STEMI, admitted to our hospital in the same period without ECG teletransmission (group B), we observed no statistical difference in mortality and reperfusion rates but a significative reduction in the pre-hospital and in-hospital times in group A patients treated by primary angioplasty and thrombolysis. CONCLUSIONS: Our study confirms previous results in that an early availability of a 12-lead ECG, transmitted from peripheral community hospitals and BLS ambulances, is able to reduce time to management of patients with an acute STEMI, thus improving quality of decision-making and treatment.