Testing the Effectiveness of a Community-Based Peer Support Intervention to Mitigate Social Isolation and Stigma of Adolescent Motherhood in Zimbabwe.

OBJECTIVES: Social isolation and stigma contribute to poor mental health outcomes. Adolescent mothers in Zimbabwe often experience isolation and stigma, lacking social support and resources to navigate motherhood. The study tested the effectiveness of a community-based peer support intervention to mitigate social isolation and stigma of adolescent motherhood in Harare, Zimbabwe. METHODS: Community health workers (n = 12) and peer educators (n = 12) in the intervention arm were recruited and trained on co-facilitating peer support groups. Adolescent mothers aged 15-18 years from two low-income high-density communities in Harare were recruited, using a quasi-experimental design. The intervention arm (n = 104) participated in the peer support groups and both arms completed sociodemographic, base-, mid-, and end-line surveys (control arm n = 79). Peer support groups (12 groups with 6-12 participants in each) met in-person twice a month and completed 12 sessions from May to August 2019 addressing participant-identified topics such as income generation and depression. WhatsApp Messenger was used for training and implementation support. Key community stakeholders discussed project progress and recommendations to improve adolescent mothers' health. Data were analyzed using Stata 15. RESULTS: The intervention arm reported lower depressive symptoms and common mental disorders and higher overall, family, friends, and significant-other support, compared to control. The intervention arm felt more engaged with peers, knew who and where to turn to for help, and had coping, parenting and communication strategies to manage life challenges. CONCLUSIONS FOR PRACTICE: The intervention mitigated social isolation and stigma and thereby improved mental health and social support among adolescent mothers in Harare. Trial Registration This trial is registered at Clinical Trials.gov, NCT05213182 https://clinicaltrials.gov/ct2/show/NCT05213182 .

What is already known on this subject? Social isolation and stigma contribute to poor mental health outcomes. Adolescent mothers often experience isolation and stigma, lacking social support and resources to navigate motherhood. There is a need for interventions that identify and address the unique needs of adolescent mothers.What this study adds? A community-based peer-support intervention can mitigate social isolation and stigma and thereby improve mental health and social support of adolescent mothers. WhatsApp Messenger is a potential intervention tool for providing training and implementation support, and enhancing communication between peer support group facilitators and participants.

A pilot program evaluating WhatsApp as an interactive educational tool for pediatric radiology in Eastern Africa.

The widespread use of WhatsApp as a communication tool makes it a candidate platform to facilitate the delivery of educational materials to radiology trainees in Eastern Africa. The aim of this pilot program is to assess the novel approach of using WhatsApp as a learning tool in pediatric radiology for residents in Kenya, Rwanda, Tanzania and Uganda. We recruited radiology residents to participate in a 3-month case-based pediatric radiology learning module that was delivered through WhatsApp to personal cell phones. Residents were presented with a multiple choice question once a week. Once they submitted their answer, the correct answer and explanations for each choice were provided. Questionnaires investigated comfort with reading pediatric radiology imaging, perception of the module content and convenience of the approach. Of the 72  participants, 40 (56%) responded to all 12 questions and both questionnaires, of whom 22 (55%) reported little to no comfort before the module and feeling very comfortable after. Confidence decreased with the number of incorrect answers. There was no correlation between the number of correct answers and the year level of the resident. Participants reported that the module was useful for learning pediatric radiology, found the material moderately difficult and found the application convenient for learning. Pediatric radiology educational content delivered over WhatsApp to residents in Eastern Africa is perceived as beneficial and convenient. This interactive learning platform provides opportunities for mentorship and enhanced learning of pediatric radiology.

Teleconsultation Platforms Versus WhatsApp Consultations: Evaluating Patients and Physicians' Attitudes.

Background: Since the 1990s, society has witnessed a surge in information and communication technologies that extended to the health care system. Teleconsultation platforms have become widely established tools that provide an opportunity for emerging countries such as Lebanon to expand and advance health care services. However, their use in Lebanon remains limited considering many people's preference to resort to nonmedical platforms such as WhatsApp for consultations. Methods: The purpose of this mixed-method study is to evaluate patients' and physicians' attitudes toward teleconsultation platforms versus WhatsApp consultations in Lebanon. In the quantitative component, 1,467 patients were administered a self-developed questionnaire, while in the qualitative component, a semistructured interview was conducted with 14 physicians practicing in Lebanon. Results: Results revealed that teleconsultation platforms and WhatsApp are not interchangeable. Patients' and physicians' experiences, perceptions, and satisfaction with teleconsultation platforms and WhatsApp are discussed. Conclusions: Individual and governmental recommendations for safer, more controlled, and more ethical online consultation practices are provided for both physicians and patients, through both modalities.

Monitoring negative pressure wound therapy for diabetic foot ulcers using WhatsApp.

Foot complications of patients with diabetes could lead to amputations and early death. Diabetic foot ulcers (DFU) are usually difficult to treat and impose huge financial burden. Monitoring wound progress is the mainstay of any treatment and alternatives to face-to-face consultations such as tele-medicine have been proposed. Very few papers explored the utility and effectiveness of monitoring DFU through instant messaging application such as WhatsApp. The aim of this study is to evaluate the validity of WhatsApp in monitoring diabetic wounds treated with negative pressure wound therapy (NPWT). Twenty-two patients were prospectively recruited. All patients had an initial face-to-face consultation and debridement. Dressings were changed twice per week at patient's residence and media files were sent by the wound nurse via Short Message Service (SMS). A subsequent face to face consultation was scheduled whenever a complication was suspected. The primary outcomes were the percentages of accurate cases a) where a new or recurrent infection was suspected, and a b) where a debridement was thought to be needed. Complete healing of the defect using NPWT was achieved in 10 patients and a skin graft procedure was needed in another 4 patients. Five patients needed further surgical debridement. Failure to heal was observed in 3 patients. Out of the seven cases where a new infection was suspected, five (71.5%) were confirmed on face-to-face consultation. No confirmed cases of infection were observed during follow-up for those estimated as clean. Out of the 11 cases where debridement was favored based on WhatsApp media files, confirmation of a needed debridement was recorded in 8 (73%) cases. NPWT monitoring of for diabetic foot and leg ulcers using WhatsApp application was found to be an excellent method to document and track the wound process and complications. The excellent specificity and high sensibility should encourage for common use by healthcare. The results of this study could be also valuable for patients living in rural areas and in case of future pandemics.

WhatsApp-based intervention for people with type 2 diabetes: A randomized controlled trial.

Diabetes mellitus is a metabolic disease characterized by prolonged elevated blood glucose levels. Diabetes self-management education and support programs are widely used in western countries. The impact of social media education and support interventions such as a WhatsApp-based program and the nurses' role in supporting and implementing this self-management program unclear. Using a WhatsApp-based program, we evaluated the effects of a 6-week program in improving self-efficacy and education among people with type 2 diabetes mellitus in Saudi Arabia. Eligible participants (n = 80) were recruited with the support of nurses into a randomized controlled trial and randomly assigned into self-management intervention and control groups. The intervention group (n = 40) received the self-management program support and the usual care. The control group (n = 40) received only the usual care with nurses' support. Results from generalized estimating equation analysis showed a significant increase in self-efficacy, self-management, and education in the WhatsApp-based intervention support group compared with the control group at 6 and 12 weeks (follow-up). Implementing the program via social media improves self-efficacy. The use of social media platforms should be promoted for global diabetes management.

ChatDashboard: A Framework to collect, link, and process donated WhatsApp Chat Log Data.

In this paper, we present ChatDashboard, a framework for collecting, linking, and processing donated WhatsApp chat log data. The framework consists of the WhatsR R package for parsing, anonymizing, and preprocessing donated WhatsApp chat logs, the ChatDashboard R Shiny web app for uploading, reviewing, and securely donating WhatsApp chat logs, and DashboardTester, an automated script for testing the correct setup of the framework by simulating participants. With ChatDashboard, researchers can set up their own data collections to gather transparently donated WhatsApp chat log data from consenting participants and link them to survey responses. It enables researchers to retrospectively collect highly granular data on interpersonal interactions and communication without building their own tools from scratch. We briefly discuss the advantages of donated WhatsApp chat log data for investigating social relationships and provide a detailed explanation of the ChatDashboard framework. Additionally, we provide a step-by-step guideline in the supplementary materials for researchers to set up their own data donation pipelines.

Assessing effectiveness of WhatsApp messaging program in oral hygiene care for orthodontic patients: A randomised controlled trial.

OBJECTIVE: To evaluate the difference in the oral hygiene status of participants with fixed appliances between a 'weekly WhatsApp application oral hygiene message reminders' trial group and a 'verbal instructions' control group over a follow-up duration of 12 weeks. DESIGN: Prospective, single-blind, randomised controlled trial with an allocation ratio of 1:1 over a 12-week follow-up. SETTING: Government Orthodontic Unit, Raub Dental Clinic, Raub, Pahang, Ministry of Health, Malaysia. PARTICIPANTS: A total of 40 patients aged 13-25 years undergoing orthodontic treatment with fixed appliances. METHODS: The 40 patients were recruited and randomly allocated to a control (n = 20) or trial group (n = 20). Participants in the trial group received weekly oral hygiene reminders via the WhatsApp application for 12 weeks, while the control group did not receive any reminders. The primary outcome was oral hygiene, which was measured by the single-blinded examiner using the Orthodontic Plaque Index (OPI) at three orthodontic check-ups: baseline (T0); 6-week follow-up (T1); and 12-week follow-up (T2). RESULTS: The mean age was 17 years, and 80% were female patients. At the end of the 12-week follow-up, improvements in OPI scores were observed, regardless of the intervention. At T2, the median OPI score for the trial group (n = 20) was 0 (interquartile range [IQR = 0) while that for the control group (n = 20) was 2 (IQR = 0). A Mann-Whitney U test revealed a statistically significant difference (P <0.05), with effect size r = 0.87 between the control and trial groups, whereby the latter witnessed marked improvement in OPI throughout the visits. No harms or adverse effects occurred in this trial. CONCLUSION: The short-term findings demonstrated that participants receiving regular reminders of oral hygiene via WhatsApp messaging had a significant improvement in oral hygiene compared to the control group.

"Whenever you need support, you first turn to the group": motivations and functions of WhatsApp groups for youth living with HIV.

Social support is a critical component of achieving positive health outcomes for youth living with HIV (YLWH). Mobile health (mHealth) has significant potential for providing social support to YLWH. However, little is known about the domains of social support most needed by YLWH which mHealth interventions might address. Drawing on the spontaneous creation of WhatsApp support groups by YLWH in Nairobi, Kenya, we characterized Kenyan YLWH's social support needs and potential roles of social media groups in meeting them. We conducted interviews and focus-groups with 68 YLWH, 24 caregivers and 20 healthcare workers, and observed two YLWH-led WhatsApp groups for 6 weeks. Youth reported that existing support systems, including family and healthcare workers, already provided informational and instrumental support. However, they emphasized unmet companionship and emotional support needs, leading to isolation, hopelessness, and medication adherence challenges. Participants identified connection with other YLWH as a unique source of emotional and companionship support that allowed them to feel more secure and less isolated. Interviews and observed WhatsApp chats demonstrated that WhatsApp groups were a desirable medium for companionship support that overcame barriers to in-person connection.

The role of messaging services in day-to-day practice in pediatric neurosurgery, advantages of a bubble network, and an international survey.

INTRODUCTION: Messaging services (MS) are used widely worldwide. The implications of MS usage in daily hospital patient care have not been investigated. In this study, we discuss the extensive usage of MS in our Pediatric Neurosurgical Department, introduce our bubble algorithm, and provide additional input from an international survey. METHODS: WhatsApp activity in the department of pediatric neurosurgery at Dana Children's Hospital, Tel Aviv, Israel, was analyzed. We designed a graphic representation of the content of the different conversation bubbles and how they interact. We also described a survey evaluating MS use in daily neurosurgical practice was sent to 25 neurosurgeons around the world. Collected data included details on the usage of MS, the type of information being transferred, and the participants' opinion of the potential risks and benefits of these systems. We began collecting messaging data November 2018, before the COVID pandemic era. We continued to collect data over the course of almost 3 years. RESULTS: We identified a bubble network structure that reflects a logical method of communication between different segments of pediatric neurosurgical care in our institution. Additionally, we analyzed 22 survey responses, received from 14 different countries. The vast majority of centers with "department groups" use messaging services to transfer multimedia files of patient-related data. Nineteen responders believe that MS significantly improve overall patient care. CONCLUSION: MS has revolutionized and improved the patterns of communication in our department. The great benefits of quick, simple access to information strongly outweigh formality and the potential for medicolegal disadvantages (e.g., HIPAA).

The role of WhatsApp™ in pediatric difficult airway management: A study from the PeDI Collaborative.

BACKGROUND: Management of the pediatric difficult airway can present unique clinical challenges. The Pediatric Difficult Intubation Collaborative (PeDI-C) is an international collaborative group engaging in quality improvement and research in children with difficult airways. The PeDI-C established a WhatsApp™ group to facilitate real-time discussions around the management of the difficult airway in pediatric patients. The goals of this study were to evaluate the patterns of use of the WhatsApp™ group, themes on messages posted on pediatric difficult airway management and to assess the perceived usefulness of the WhatsApp™ group by the PeDI-C members. METHOD: Following research ethics approval, we performed a database analysis on the archived discussion of the PeDI-C WhatsApp™ group from 2014 to 2019 and surveyed members to assess the perceived usefulness of the PeDI-C WhatsApp™ group. RESULTS: 5781 messages were reviewed with 350 (6.0%) original stems. The three most common original stem types were advice seeking 98 (28%), announcements 85 (24.2%), and clinical case-sharing 78 (22.2%). The median number of responses to original stems was 9 [2-21.3]. Post types associated with increased responses included those seeking advice on medication/equipment (regression coefficient 0.78, 95% CI [0.41-1.16]; p < .0001); seeking advice on patient care (regression coefficient 1.16, 95% CI [0.86-1.45]; p < .0001), sharing advice on medication/equipment availability (regression coefficient 0.87, 95% CI [0.33-1.40], p < .0016), and clinical case-sharing (regression coefficient 1.2547, 95% CI [0.9401-1.5693] p < .0001). 46/64 members of the group responded to the survey. Replies offering advice regarding patient management scenarios were found to be of most interest and 77% of surveyed members found the discussion translatable into their own clinical practice. DISCUSSION: The PeDI-C WhatsApp™ group has facilitated timely knowledge exchange on pediatric difficult airway management across the world. Participants are satisfied with the role the Whatsapp™ group is playing.

Use and Acceptance of Digital Communication Technology by Older Adults for Social Connectedness During the COVID-19 Pandemic: Mixed Methods Study.

BACKGROUND: Older adults are at higher risk for health issues, including mental health problems. This was especially apparent during the COVID-19 pandemic, where older adults were simultaneously more vulnerable to the disease and the mental health concerns created by social distancing. Subsequently, the use of digital communication technology (DCT) became a critical option for maintaining social connectedness in older adults. Prior to the pandemic, the low uptake and use of technology by older adults was an established problem, known as the digital divide. However, not much is known about how this may have changed as a result of the pandemic. OBJECTIVE: This study aims to explore how older adults maintained social connectedness through DCT during the pandemic and to understand factors influencing the use and acceptance of DCT. METHODS: A mixed methods explorative field study was set up, involving surveys and interviews of 25 community-dwelling older adults (65-88 years old) living in the United Kingdom. The surveys included the internet acceptance questionnaire (based on the Technology Acceptance Model [TAM]); COVID-19 dysfunctional anxiety was captured using the COVID-19 Anxiety Scale (CAS). Background information (demographics, use of technology) was gathered before conducting semistructured interviews. We hypothesized that CAS would affect constructs of TAM and that predictive constructs of TAM would have remained valid during the pandemic. We also posited that there would be unidentified themes outside TAM that impacted the acceptance and use of DCT. We used the quantitative data to guide the semistructured interviews, which were then analyzed through thematic analysis to identify additional themes. RESULTS: Correlational analysis showed that CAS influences all constructs of TAM. We also saw that the predictive constructs of TAM, especially the perceived ease of use (PEU) and perceived usefulness (PU), remained valid during the pandemic. Common acceptance-influencing themes were encountered in both quantitative and qualitative analyses, with 3 matching the known constructs of TAM (PU, PEU, and behavioral intention). We identified 2 additional themes affecting acceptance, namely influence of the pandemic (situational context) and privacy and security concerns. DCT use (especially email and videoconferencing use) increased during the pandemic, but the results related to social networking sites were mixed. CONCLUSIONS: The COVID-19 pandemic impacted technology acceptance and use by older adults, encouraging their use of certain DCT apps (email and videoconferencing apps, such as WhatsApp). These apps helped insulate them from adverse effects (social isolation and loneliness). Other social networking apps, however, exerted a negative influence, increasing anxiety and a general feeling of negativity. Future studies should maximize older adult agency related to design, privacy, security, and user requirements for development. We also recommend that when studying DCT acceptance for older adults, our additional identified themes should be considered alongside the existing TAM constructs.

Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial.

BACKGROUND: Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults. OBJECTIVE: This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting. METHODS: This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention. RESULTS: There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (ß=-.12; P=.002; Cohen d=0.23), willingness to sext (ß=-.16; P<.001; Cohen d=0.40), knowledge (ß=.12; P<.001; Cohen d=0.39), attitude (ß=-.11; P=.001; Cohen d=0.31), perceived norms (ß=-.06; P=.04; Cohen d=0.18), and prototype perceptions (ß=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months. CONCLUSIONS: In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module. TRIAL REGISTRATION: Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

Use of telemedicine in the postoperative assessment of proctological patients: a case-control study.

BACKGROUND: Telemedicine is emerging as an easy way to communicate between patients and surgeons. Use of telemedicine increased during the coronavirus disease 2019 (COVID-19) pandemic. WhatsApp is one of the most common smartphone applications for user-friendly telemedicine. The aim of this study was to evaluate patient perception of health quality and positive outcomes using a diary sent by the patient to the surgeon via WhatsApp during the first post-discharge week after proctologic surgery. METHODS: Ninety-eight patients discharged after proctologic surgery at the Israelite Hospital of Rome and the AOU Policlinico Umberto I of Rome in 1 January-31 December 2019 were divided into two groups: the WhatsApp group (group A), (n = 36) and the no WhatsApp group (group B) (n = 62). Group A patients received a protocol to follow for the day-by-day diary during the first post-discharge week and sending it by WhatsApp to the surgeon. Group B patients only received recommendations at discharge. The tool's usefulness was assessed by a questionnaire one month after the intervention. RESULTS: The two groups were homogeneous for age, sex, schooling, employment, and proctologic pathology. Group A patients had less difficulty keeping a diary (p < 0.0001). Group A patients had the perception of better follow-up post-discharge (p = 0.002). The use of the diary sent by WhatsApp significantly improved the perception of positive post-intervention outcomes (p = 0.007). WhatsApp was the only independent predictor of perception of post-surgical positive outcomes (odds ratio = 4.06; 95% CI 1.35-12.24; p = 0.01). CONCLUSIONS: The use of WhatsApp in the post-discharge period improves the lifestyle quality of the patients and their perception of the safety and quality of care received.

Client States: Australia's Offshore Detainees and the Limits of Therapy.

Mental health has become an exceptionally important social and public health issue in Australia. The government has invested billions of dollars in new services, while ubiquitous ad campaigns call on ordinary people to tend to their psychological well-being. This national valorization of mental health is striking, given the well-documented psychiatric harm suffered by refugees under Australia's offshore detention regime. This article draws on ethnographic work with a group of volunteer therapists who provide crisis counseling to these detained refugees over WhatsApp, allowing them to intervene in scenarios where therapy is inaccessible but badly needed. Highlighting the predictable challenges and surprising affordances of delivering care in this restrictive and high-stakes context, I show how my informants forge a genuine therapeutic connection with their clients. While this intervention is meaningful, I argue that the volunteers are aware that it is no substitute for winning political freedom.

The Effect of Mandala Activity and Technology-Based Breastfeeding Program on Breastfeeding Self-Efficacy and Mother-Infant Attachment of Primiparous Women: A Randomized Controlled Study.

The use of art therapy methods such as mandala is becoming increasingly popular in mother-infant health education and counseling. The aim of the study was to evaluate the effect of a mandala and technology-based breastfeeding program on women's breastfeeding self-efficacy and attachment between mother and infant. This randomized controlled, single-blind, and parallel-group trial design was conducted in foundation university hospital. The study was completed by 66 women and their infants (intervention group: n = 33; control group: n = 33). The women who are at the 32-37th gestational week in the intervention group participated in the mandala and technology-based breastfeeding (including Zoom and WhatsApp platforms) program. They received three education module via WhatsApp. Women in control group received routine care. The Maternal Attachment scale and Breastfeeding Self-efficacy Scale were applied in the first week and second month postpartum. Growth follow-ups of the infants were evaluated in the first week, first month and second month postpartum. The registration number of this study on ClinicalTrials.gov is NCT05199298. In the second month postpartum, it was determined that the women in the intervention group had higher Breastfeeding Self-efficacy and Maternal Attachment scale scores compared to the control group (p < 0.05). Also, the rates of breastfeeding in the intervention group were higher than in the control group. Mandala and technology-based breastfeeding program increased women's breastfeeding self-efficacy and maternal attachment. Health care professionals should make use of technology-based educations to give holistic care in maternal and infant health.

Survey of the Relationship Between Online Committee of Friends Meetings, Burials, and Coping With Bereavement Among Nigerians in Ebonyi State.

Online committee of friends meeting is a new trend in Nigeria. There is a continuous online interaction that goes on among the group members. The qualitative research design was used to carry out the study. The unstructured interview method was used to get information from the study participants. It was found among other things that the bereaved read, digest and accept the online condolence messages which serve as a coping tool to the loss of the loved one. Online COF is also a veritable tool in soliciting for and raising funds from online to facilitate the burial of loved ones owing to rising cost of conducting burials in Nigeria. It was concluded that coping with death is achieved in online COF through formation of whatsapp group, condolence messaging, friends digestion of information and acceptance of the pieces of advice raised and as divine will which comes when it will.

The Effects of Mobile Technology on Learning Performance and Motivation in Mathematics Education.

Due to rapid developments, mobile technologies started to play an essential role in designing seamless learning environments. Due to the availability of mobile technologies, students can access learning materials without being bound by time and place. On the grounds that these applications allow information exchange, time and space limitations such as classrooms or school bells have been eliminated. Therefore, this study aims to assess mobile-assisted seamless learning environments' effects on students' success and motivation in the secondary school 7th grade mathematics class algebra unit and student opinions about the application. The research is designed using the descriptive pattern of mixed-method research. The sample of the study is 73 middle school students (30 male and 43 female) in Turkey. Augmented Reality (AR) applications developed in teaching algebra to support individual learning and to utilize mobile technologies, WhatsApp groups were created. Algebra Achievement Test (AAT), Mathematics Motivation Scale (MMS), and semi-structured interview forms were used as data collection tools in the research. The results of the study showed that there were statistically significant differences in favor of the experiment group in AAT and MMS scores. However, no significant difference was found between the groups in intrinsic goal orientation and test anxiety scores, which are motivation sub-dimensions. The findings obtained from AAT, MMS, and the students' opinions showed that mobile technology applications used in out-of-school learning environments positively affect the learning process.

Exploring the viability of augmented reality game- enhanced education in WhatsApp flipped and blended classes versus the face-to-face classes.

The application of augmented reality games (ARG) as an emerging innovative technology has become a significant component of instructional learning contexts in recent years. ARG-based education as a form of student-centered learning situates students in a learning environment that integrates virtual elements with physical environments through three-dimensional pictures and videos on mobile devices for educational purposes. To connect the use of digital tools into the language classrooms and allow learners to view the real world, this study examined the viability of ARG-enhanced education on English foreign language (EFL) learners' learning of giving and asking for directions in flipped and blended contexts. The study involved 60 EFL elementary students of homogenous English proficiency, organized into two comparative and one control group, with 20 participants in each group. For the pre-test, an 18-item multiple-choice test with one written and oral question was administered to assess the learners' knowledge of asking for and giving directions. After taking the pre-test, the two comparative groups received 16 sessions of ARG-enhanced education (one with a blended and the other with a flipped classroom approach), while the control group received placebo instructions. The flipped group received the instructional materials preceding the online group, while the blended group received instruction in both online and face-to-face classes. The control group received instruction in a face-to-face context. After 8-weeks of treatment sessions, all participants of the study took the post-test. According to the results, both flipped and blended groups receiving ARG-enhanced education performed better than the control group in learning how to give and ask for directions. The results of this study may pave the way for EFL teachers and students to use ARG-based technology in online and traditional classes.

A Pilot Study of a Mobile Intervention to Support Mental Health and Adherence Among Adolescents Living with HIV in Western Kenya.

Mobile technologies represent potentially novel and scalable intervention delivery platforms for adolescents living with HIV (ALWH) in low- and middle-income countries. We conducted a prospective, mixed methods pilot study to evaluate the acceptability and feasibility of the WhatsApp® platform to deliver individual counseling services and facilitate peer support for ALWH in western Kenya. Thirty ALWH (17 female, mean age 15.4) on ART, engaged in HIV care and aware of their status, were enrolled. After 6 months, participants described their experiences with the intervention. Treatment adherence, stigma, and mental and behavioral health were assessed prospectively. Participants reported overall positive experiences and indicated that the platform encouraged peer network development. They endorsed potential benefits for treatment adherence, stigma reduction, and mental and behavioral health. All participants supported intervention expansion. In western Kenya, WhatsApp® was an acceptable and feasible platform for mobile counseling and peer support for ALWH.

Knowledge, empathy, and willingness to counsel patients with HIV among Indonesian pharmacists: a national survey of stigma.

This study aimed to assess the level of HIV treatment knowledge, empathy, and HIV stigma of pharmacy students and pharmacists working with patients as well as potential factors associated with stigma. This survey included 250 hospital pharmacists within 33 provinces and 1013 final-year pharmacy students from Java, the most populated island in Indonesia. The data were collected via Qualtrics® and distributed by WhatsApp. The mean age of the participants was (Mean ± SD) 24.68 ± 5.30 years, and 80.0% were female. The mean knowledge score of students and pharmacists were 14.14 ± 2.01 and 15.39 ± 1.87, respectively, out of the maximum score of 21. The mean empathy score of students and pharmacists was 72.06 ± 5.39 and 77.40 ± 1.35, respectively out of the maximum score of 105. The mean stigma score of students and pharmacists was 21.02 ± 4.65 and 20.66 ± 4.41, respectively, out of a maximum score of 48. Regression analysis showed that knowledge, empathy, and willingness to counsel patients were negatively associated with stigma. Working with patients was positively associated with stigma. A multi-level intervention including education may reduce stigma and strengthen the role of pharmacists in caring for patients.