Human-Technology Interaction Factors Associated With the Use of Electronic Personal Health Records Among Younger and Older Adults: Secondary Data Analysis.

BACKGROUND: An electronic personal health record (ePHR), also known as a personal health record (PHR), has been broadly defined as an electronic application through which individuals can access, manage, and share their health information in a secure and confidential environment. Although ePHRs can benefit individuals as well as caregivers and health care providers, the use of ePHRs among individuals continues to remain low. OBJECTIVE: The current study aims to examine the relationship between human-technology interaction factors and ePHR use among adults and then to compare the different effects of human-technology interaction factors on ePHR use between younger adults (18-54 years old) and older adults (55 years of age and over). METHODS: We analyzed data from the Health Information National Trends Survey (HINTS 5 cycle 3) collected from US adults aged 18 years old and over in 2019. Descriptive analysis was conducted for all variables and each item of ePHR use. Bivariate tests (Pearson correlation coefficient for categorical variable and F test for continuous variables) were conducted over 2 age groups. Finally, after adjustments were made for sociodemographics and health care resources, a weighted multiple linear regression was conducted to examine the relationship between human-technology interaction factors and ePHR use. RESULTS: The final sample size of 1363 (average age 51.19) was divided into 2 age groups: 18 to 54 years old and 55 years old and older. The average level of ePHR use was low (mean 2.76, range 0-8). There was no significant difference in average ePHR use between the 2 age groups. Including clinical notes was positively related to ePHR use in both groups: 18 to 54 years old (ß=.28, P=.005), 55 years old and older (ß=.15, P=.006). Although accessing ePHRs using a smartphone app was only associated with ePHR use among younger adults (ß=.29; P<.001), ease of understanding health information in ePHRs was positively linked to ePHR use only among older adults (ß=.13; P=.003). CONCLUSIONS: This study found that including clinical notes was positively related to ePHR use in both age groups, which suggested that including clinical notes as a part of ePHRs might improve the effective use of ePHRs among patients. Moreover, accessing ePHRs using a smartphone app was associated with higher ePHR use among younger adults while ease of understanding health information in ePHRs was linked to higher ePHR use among older adults. The design of ePHRs should provide the option of being accessible through mobile devices to promote greater ePHR use among young people. For older adults, providers could add additional notes to explain the health information recorded in the ePHRs.

Central aspects when implementing an electronic monitoring system for assessing hand hygiene in clinical settings: A grounded theory study.

Background: New technologies, such as electronic monitoring systems, have been developed to promote increased adherence to hand hygiene among healthcare workers. However, challenges when implementing these technologies in clinical settings have been identified. Aim: The aim of this study was to explore healthcare workers' experiences when implementing an electronic monitoring system to assess hand hygiene in a clinical setting. Method: Interviews with healthcare workers (registered nurses, nurse assistants and leaders) involved in the implementation process of an electronic monitoring system (n = 17) were conducted and data were analyzed according to the grounded theory methodology formulated by Strauss and Corbin. Results: Healthcare workers' experiences were expressed in terms of leading and facilitating, participating and contributing, and knowing and confirming. These three aspects were merged together to form the core category of collaborating for progress. Leaders were positive and committed to the implementation of the electronic monitoring system, endeavouring to enable facilitation and support for their co-workers (registered nurses and nurse assistants). At the same time, co-workers were positive about the support they received and contributed by raising questions and demands for the product to be used in clinical settings. Moreover, leaders and co-workers were aware of the objective of implementing the electronic monitoring system. Conclusion: We identified dynamic collective work between leaders and co-workers during the implementation of the electronic monitoring system. Leadership, participation and knowledge were central aspects of enhancing a collaborative process. We strongly recommend involving both ward leaders and users of new technologies to promote successful implementation.

The Influence of Design and Implementation Characteristics on the Use of Maternal Mobile Health Interventions in Kenya: Systematic Literature Review.

BACKGROUND: The growth of mobile technology in developing countries, coupled with pressing maternal health care challenges, has led to a widespread implementation of maternal mobile health (mHealth) innovations. However, reviews generating insights on how the characteristics of the interventions influence use are scarce. OBJECTIVE: This study aims to review maternal mHealth interventions in Kenya to explore the influence of intervention design and implementation characteristics on use by maternal health clients. We also provide a starting inventory for maternal mHealth interventions in the country. METHODS: Using a systematic approach, we retrieved a total of 1100 citations from both peer-reviewed and gray sources. Articles were screened on the basis of an inclusion and exclusion criterion, and the results synthesized by categorizing and characterizing the interventions presented in the articles. The first phase of the literature search was conducted between January and April 2019, and the second phase was conducted between April and June 2021. RESULTS: A total of 16 articles were retrieved, comprising 13 maternal mHealth interventions. The study highlighted various mHealth design and implementation characteristics that may influence the use of these interventions. CONCLUSIONS: In addition to elaborating on insights that would be useful in the design and implementation of future interventions, this study contributes to a local inventory of maternal mHealth interventions that may be useful to researchers and implementers in mHealth. This study highlights the need for explanatory studies to elucidate maternal mHealth use, while complementing existing evidence on mHealth effectiveness.

Exploring children's exposure to voice assistants and their ontological conceptualizations of life and technology.

Digital Voice Assistants (DVAs) have become a ubiquitous technology in today's home and childhood environments. Inspired by (Bernstein and Crowley, J Learn Sci 17:225-247, 2008) original study (n = 60, age 4-7 years) on how children's ontological conceptualizations of life and technology were systematically associated with their real-world exposure to robotic entities, the current study explored this association for children in their middle childhood (n = 143, age 7-11 years) and with different levels of DVA-exposure. We analyzed correlational survey data from 143 parent-child dyads who were recruited on 'Amazon Mechanical Turk' (MTurk). Children's ontological conceptualization patterns of life and technology were measured by asking them to conceptualize nine prototypical organically living and technological entities (e.g., humans, cats, smartphones, DVAs) with respect to their biology, intelligence, and psychology. Their ontological conceptualization patterns were then associated with their DVA-exposure and additional control variables (e.g., children's technological affinity, demographic/individual characteristics). Compared to biology and psychology, intelligence was a less differentiating factor for children to differentiate between organically living and technological entities. This differentiation pattern became more pronounced with technological affinity. There was some evidence that children with higher DVA-exposure differentiated more rigorously between organically living and technological entities on the basis of psychology. To the best of our knowledge, this is the first study exploring children's real-world exposure to DVAs and how it is associated with their conceptual understandings of life and technology. Findings suggest although psychological conceptualizations of technology may become more pronounced with DVA-exposure, it is far from clear such tendencies blur ontological boundaries between life and technology from children's perspective. Supplementary Information: The online version contains supplementary material available at 10.1007/s00146-022-01555-3.

Investigating user perceptions of commercial virtual assistants: A qualitative study.

As commercial virtual assistants become an integrated part of almost every smart device that we use on a daily basis, including but not limited to smartphones, speakers, personal computers, watches, TVs, and TV sticks, there are pressing questions that call for the study of how participants perceive commercial virtual assistants and what relational roles they assign to them. Furthermore, it is crucial to study which characteristics of commercial virtual assistants (both existing ones and those envisioned for the future) are perceived as important for establishing affective interaction with commercial virtual assistants. By conducting 26 interviews and performing content analysis of the interview transcripts, this study investigates how the participants in the study perceive, engage, and interact with a variety of commercial virtual assistants. The results lead to better understanding of whether forms of attachment are established or if some sort of relationship is produced between humans and commercial virtual assistants. Key takeaways from our results indicate that, in their current state, the lack of humanlike characteristics in commercial virtual assistants prevents users from forming an emotional attachment to commercial virtual assistants, but this does not deter them from using anthropomorphic language to describe commercial virtual assistants. Yet, our results reveal that users expect commercial virtual assistants' attributes to be more humanlike in the future.

Stagewise Overview of Issues Influencing Organizational Technology Adoption and Use.

This paper provides a stagewise overview of the important issues that play a role in technology adoption and use in organizations. In the current literature, there is a lack of consistency and clarity about the different stages of the technology adoption process, the important issues at each stage, and the differentiation between antecedents, after-effects, enablers, and barriers to technology adoption. This paper collected the relevant issues in technology adoption and use, mentioned dispersedly and under various terminologies, in the recent literature. The qualitative literature review was followed by thematic analysis of the data. The resulting themes were organized into a thematic map depicting three stages of the technology adoption process: pre-change, change, and post-change. The relevant themes and subthemes at each stage were identified and their significance discussed. The themes at each stage are antecedents to the next stage. All the themes of the pre-change and change stages are neutral, but the way they are managed and executed makes them enablers or barriers in effect. The thematic map is a continuous cycle where every round of technology adoption provides input for the subsequent rounds. Based on how themes have been addressed and executed in practice, they can either enhance or impair the subsequent technology adoption. This thematic map can be used as a qualitative framework by academics and practitioners in the field to evaluate technological changes.

Virtual Reality Representations of Nature to Improve Well-Being amongst Older Adults: a Rapid Review.

Poor well-being amongst older adults poses a serious health concern. Simultaneously, research shows that contact with nature can improve various facets of well-being, including physical, social, and mental well-being. However, nature is not always accessible for older adults due to mobility restrictions and related care needs that come with age. A promising strategy aims at bringing nature inside through pervasive technologies. However, so far, there is little academic understanding of essential nature characteristics, psychological processes involved, and means for implementation in practice. The current study used a three-folded rapid review to assess current understanding and strategies used for improving well-being for older adults through virtual reality representations of nature. Searches were performed across three databases, followed-up by content-based evaluation of abstracts. In total, a set of 25 relevant articles was identified. Only three studies specifically focus on digital nature as an intervention strategy for improving well-being amongst older adults. Although these studies provide useful starting points for the design and (technological) development of such environments, they do not generate understanding of how specific characteristics of virtual nature representations impact social well-being measures in particular, and of the underlying psychological processes involved. We conclude that follow-up research is warranted to close the gap between insights and findings from nature research, gerontology, health research, and human-technology interaction.

Trust Toward Robots and Artificial Intelligence: An Experimental Approach to Human-Technology Interactions Online.

Robotization and artificial intelligence (AI) are expected to change societies profoundly. Trust is an important factor of human-technology interactions, as robots and AI increasingly contribute to tasks previously handled by humans. Currently, there is a need for studies investigating trust toward AI and robots, especially in first-encounter meetings. This article reports findings from a study investigating trust toward robots and AI in an online trust game experiment. The trust game manipulated the hypothetical opponents that were described as either AI or robots. These were compared with control group opponents using only a human name or a nickname. Participants (N = 1077) lived in the United States. Describing opponents with robots or AI did not impact participants' trust toward them. The robot called jdrx894 was the most trusted opponent. Opponents named "jdrx894" were trusted more than opponents called "Michael." Further analysis showed that having a degree in technology or engineering, exposure to robots online and robot use self-efficacy predicted higher trust toward robots and AI. Out of Big Five personality characteristics, openness to experience predicted higher trust, and conscientiousness predicted lower trust. Results suggest trust on robots and AI is contextual and it is also dependent on individual differences and knowledge on technology.

Acceptance of Mobile Health Applications: Examining Key Determinants and Moderators.

Mobile health applications are increasingly numerous and varied. However, despite high expectations and large budgets involved in their development they are often rejected by potential users, and little is known on why this happens. This study aimed to fill this gap by investigating the determinants of technology acceptance and its moderators. Aligned with the Unified Theory of Acceptance and Use of Technology, we examined the moderating roles of age, gender, and smartphone experience in the relationship between technology acceptance determinants (performance expectancy, effort expectancy, social influence, and facilitating conditions) and the intention to use mobile health applications (N = 394, 18-65 years). A stepwise multiple linear regression was conducted. Results showed that the intention to use mobile health applications was determined by performance expectancy moderated by age and smartphone experience, and that the role of the other determinants depended on age and gender (e.g., more intention to use in older men if less effort, and in younger men if better facilitating conditions). These findings show that user characteristics are relevant moderators and should be considered when targeting specific populations to use mobile health applications.

Does a Passive Unilateral Lower Limb Exoskeleton Affect Human Static and Dynamic Balance Control?

Exoskeletons are wearable devices closely coupled to the human, which can interact with the musculoskeletal system, e. g., to augment physical and functional capabilities. A main prerequisite for the development and application of exoskeletons is to investigate the human-exoskeleton interaction, particularly in terms of potential inferences with human motor control. Therefore, the purpose of the present study was to investigate whether a passive unilateral lower limb exoskeleton has an impact on static and dynamic reactive balance control. Eleven healthy subjects (22.9 ± 2.5 years, five females) volunteered for this study and performed three different balance tasks: bipedal standing, single-leg standing, and platform perturbations in single-leg standing. All the balance tasks were conducted with and without a passive unilateral lower limb exoskeleton, while force plates and a motion capture system were used to capture the center of pressure mean sway velocity and the time to stabilization, respectively. Dependent t-tests were separately run for both static balance tests, and a repeated-measure analysis of variance with factors exoskeleton and direction of perturbation was calculated for the dynamic reactive balance task. The exoskeleton did not significantly influence postural sway in bipedal stance. However, in single-leg stance, the mediolateral mean sway velocity of the center of pressure was significantly shorter for the exoskeleton condition. For the dynamic reactive balance task, the participants tended to regain stability less quickly with the exoskeleton, as indicated by a large effect size and longer time to stabilization for all directions of perturbation. In summary, the study showed that the exoskeleton provided some assistive support under static conditions, which however may disappear when sufficient stability is available (bipedal stance). Besides, the exoskeleton tended to impair dynamic reactive balance, potentially by impeding adequate compensatory adjustments. These are important findings with strong implications for the future design and application of exoskeletons, emphasizing the significance of taking into account the mechanisms of human motor control.

Is Wearable Technology Becoming Part of Us? Developing and Validating a Measurement Scale for Wearable Technology Embodiment.

BACKGROUND: To experience external objects in such a way that they are perceived as an integral part of one's own body is called embodiment. Wearable technology is a category of objects, which, due to its intrinsic properties (eg, close to the body, inviting frequent interaction, and access to personal information), is likely to be embodied. This phenomenon, which is referred to in this paper as wearable technology embodiment, has led to extensive conceptual considerations in various research fields. These considerations and further possibilities with regard to quantifying wearable technology embodiment are of particular value to the mobile health (mHealth) field. For example, the ability to predict the effectiveness of mHealth interventions and knowing the extent to which people embody the technology might be crucial for improving mHealth adherence. To facilitate examining wearable technology embodiment, we developed a measurement scale for this construct. OBJECTIVE: This study aimed to conceptualize wearable technology embodiment, create an instrument to measure it, and test the predictive validity of the scale using well-known constructs related to technology adoption. The introduced instrument has 3 dimensions and includes 9 measurement items. The items are distributed evenly between the 3 dimensions, which include body extension, cognitive extension, and self-extension. METHODS: Data were collected through a vignette-based survey (n=182). Each respondent was given 3 different vignettes, describing a hypothetical situation using a different type of wearable technology (a smart phone, a smart wristband, or a smart watch) with the purpose of tracking daily activities. Scale dimensions and item reliability were tested for their validity and Goodness of Fit Index (GFI). RESULTS: Convergent validity of the 3 dimensions and their reliability were established as confirmatory factor analysis factor loadings (>0.70), average variance extracted values (>0.50), and minimum item to total correlations (>0.40) exceeded established threshold values. The reliability of the dimensions was also confirmed as Cronbach alpha and composite reliability exceeded 0.70. GFI testing confirmed that the 3 dimensions function as intercorrelated first-order factors. Predictive validity testing showed that these dimensions significantly add to multiple constructs associated with predicting the adoption of new technologies (ie, trust, perceived usefulness, involvement, attitude, and continuous intention). CONCLUSIONS: The wearable technology embodiment measurement instrument has shown promise as a tool to measure the extension of an individual's body, cognition, and self, as well as predict certain aspects of technology adoption. This 3-dimensional instrument can be applied to mixed method research and used by wearable technology developers to improve future versions through such things as fit, improved accuracy of biofeedback data, and customizable features or fashion to connect to the users' personal identity. Further research is recommended to apply this measurement instrument to multiple scenarios and technologies, and more diverse user groups.