1
|
Nabelsi V, Lévesque-Chouinard A. Successful Electronic Consultation Service Initiative in Quebec, Canada With Primary Care Physicians' and Specialists' Experiences on Acceptance and Use of Technological Innovation: Cross-Sectional Exploratory Study. JMIR Form Res 2024; 8:e52921. [PMID: 38814689 DOI: 10.2196/52921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Electronic consultation (eConsult) is an eHealth service that allows primary care providers (PCPs) to electronically consult specialists regarding their patients' medical issues. Many studies have demonstrated that eConsult services improve timely access to specialist care; prevent unnecessary referrals; improve PCPs', specialists', and patients' satisfaction; and therefore have a large impact on costs. However, no studies have evaluated PCPs' and specialists' acceptance of eConsult services in Quebec, Canada, and worldwide. OBJECTIVE This exploratory study aims to identify factors affecting eConsult service acceptance by PCPs and specialists in urban and rural primary care clinics across 3 regions in the province of Quebec, Canada, by integrating the Unified Theory of Acceptance and Use of Technology and Task-Technology Fit (TTF) models and user satisfaction. This research was designed to broaden and assist in scaling up this effective eHealth service innovation across the province. METHODS A cross-sectional web-based survey was sent to all PCPs (n=263) and specialists (n=62) who used the eConsult Quebec Service between July 2017 and May 2021. We proposed a unified model integrating the Unified Theory of Acceptance and Use of Technology model and TTF model and user satisfaction by endorsing 11 hypotheses. The partial least squares was used to investigate factors influencing the acceptance of the eConsult Quebec Service. RESULTS Of the 325 end users, 136 (41.8%) users responded (PCPs: 101/263, 38.4%; specialists: 35/62, 57%). The results of the analysis with partial least squares method indicate that 9 of our 11 hypotheses are supported. The direct relationships uniting the various constructs of the model highlighted the importance of several key constructs and predominant correlations. The results suggest that satisfaction is the key driver behind the use of the eConsult Quebec Service. Performance expectancy (P<.001) and effort expectancy (P=.03) can have a positive impact on behavioral intention (BI), and BI (P<.001) can impact adoption. TTF has an influence on performance expectancy (P<.001), adoption (P=.02), and satisfaction (P<.001). However, the results show that there is no direct effect between social influence (P=.38) and BI or between facilitating conditions (P=.17) and adoption. CONCLUSIONS This study provides a better understanding of the factors influencing PCPs' and specialists' intention to adopt the eConsult Quebec Service. Furthermore, this study tests a research model and a technology that have never been explored in Quebec until now. On the basis of the results, the service is a good fit to meet the users' need to improve access to specialized medical advice. Therefore, the results of our study have made a valuable contribution to the implementation of the service by policy makers in order to maximize acceptance, use, adoption, and success across the province of Quebec. Moreover, after 4 successful years, the eConsult Quebec pilot project is now the Conseil Numérique digital consultation service.
Collapse
Affiliation(s)
- Véronique Nabelsi
- Department of Administrative Sciences, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Annabelle Lévesque-Chouinard
- GMF-U de la Haute-Ville du Centre intégré universitaire de santé et des services sociaux de la Capitale-Nationale, Sainte-Foy, QC, Canada
| |
Collapse
|
2
|
Giebel GD, Speckemeier C, Schrader NF, Abels C, Plescher F, Hillerich V, Wiedemann D, Börchers K, Wasem J, Blase N, Neusser S. Quality assessment of mHealth apps: a scoping review. FRONTIERS IN HEALTH SERVICES 2024; 4:1372871. [PMID: 38751854 PMCID: PMC11094264 DOI: 10.3389/frhs.2024.1372871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Introduction The number of mHealth apps has increased rapidly during recent years. Literature suggests a number of problems and barriers to the adoption of mHealth apps, including issues such as validity, usability, as well as data privacy and security. Continuous quality assessment and assurance systems might help to overcome these barriers. Aim of this scoping review was to collate literature on quality assessment tools and quality assurance systems for mHealth apps, compile the components of the tools, and derive overarching quality dimensions, which are potentially relevant for the continuous quality assessment of mHealth apps. Methods Literature searches were performed in Medline, EMBASE and PsycInfo. Articles in English or German language were included if they contained information on development, application, or validation of generic concepts of quality assessment or quality assurance of mHealth apps. Screening and extraction were carried out by two researchers independently. Identified quality criteria and aspects were extracted and clustered into quality dimensions. Results A total of 70 publications met inclusion criteria. Included publications contain information on five quality assurance systems and further 24 quality assessment tools for mHealth apps. Of these 29 systems/tools, 8 were developed for the assessment of mHealth apps for specific diseases, 16 for assessing mHealth apps for all fields of health and another five are not restricted to health apps. Identified quality criteria and aspects were extracted and grouped into a total of 14 quality dimensions, namely "information and transparency", "validity and (added) value", "(medical) safety", "interoperability and compatibility", "actuality", "engagement", "data privacy and data security", "usability and design", "technology", "organizational aspects", "social aspects", "legal aspects", "equity and equality", and "cost(-effectiveness)". Discussion This scoping review provides a broad overview of existing quality assessment and assurance systems. Many of the tools included cover only a few dimensions and aspects and therefore do not allow for a comprehensive quality assessment or quality assurance. Our findings can contribute to the development of continuous quality assessment and assurance systems for mHealth apps. Systematic Review Registration https://www.researchprotocols.org/2022/7/e36974/, International Registered Report Identifier, IRRID (DERR1-10.2196/36974).
Collapse
Affiliation(s)
- Godwin Denk Giebel
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Christian Speckemeier
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nils Frederik Schrader
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Carina Abels
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Felix Plescher
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Vivienne Hillerich
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Desiree Wiedemann
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | | | - Jürgen Wasem
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Nikola Blase
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| | - Silke Neusser
- Institute for Healthcare Management and Research, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
3
|
Qian Y, Wang X, Huang X, Li J, Jin C, Chen J, Sha M. Bounded rationality in healthcare: unraveling the psychological factors behind patient satisfaction in China. Front Psychol 2024; 15:1296032. [PMID: 38605837 PMCID: PMC11008602 DOI: 10.3389/fpsyg.2024.1296032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction Patient satisfaction is a crucial metric to gauge the quality of medical services, but the psychological factors influencing patient satisfaction remain insufficiently explored. Methods This study examines these psychological factors by applying the theory of bounded rationality to 1,442 inpatients in Hangzhou, China, whose data were collected using a questionnaire. One-way ANOVA, correlation analysis, and hierarchical regression were used to analyze patient satisfaction and its associated factors. Additionally, the path analysis of the structural equation model revealed the mechanisms behind the key psychological factors that influenced patient satisfaction. Results Medical risk perception, the social cognition of the medical environment, and social desirability bias had significant positive impacts on patient satisfaction. By contrast, negative emotions had a significant negative impact on patient satisfaction. Notably, patients' negative emotions had both a suppressive effect and a positive moderating effect on the relationship between medical risk perception and patient satisfaction. Similarly, social desirability bias had a suppressive effect on the correlation between the social cognition of the medical environment and patient satisfaction, albeit with a negative moderating effect. Discussion These results suggest that when evaluating and improving patient satisfaction, accounting only for the factors that directly influence medical service quality is insufficient, as the indirect and moderating effects of patients' negative emotions and the social cognition of the medical environment must also be considered. Medical service providers should thus address patients' negative emotions, establish good doctor-patient relationships, optimize service environments, provide managers with medical risk education and training on negative emotions, and prioritize patient-centered care. Additionally, the government and relevant health departments should optimize medical policies, enhance fairness and accessibility, and create a positive social cognitive environment through public education and awareness campaigns.
Collapse
Affiliation(s)
- Yu Qian
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
- Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, China
| | - Xiaohe Wang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Xianhong Huang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jinwen Li
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Chen Jin
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jie Chen
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - MengYi Sha
- Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, China
| |
Collapse
|
4
|
Pomey MP, Le Roux E, Nadon N, Perron J, Barry A, Bémeur C, Poder TG, Duford F, Laviolette L, Tétrault-Lassonde J, Vialaron C, Escalona MJ, Normandin L, Huard G, Girardin C, Rose C, Malas K, Ouellet D, Vincent C. Telehealth-Delivered Program and Accompanying Patients to Enhance the Clinical Condition of Patients Throughout a Liver Transplant: Protocol for a Mixed Methods Study. JMIR Res Protoc 2024; 13:e54440. [PMID: 38517464 PMCID: PMC10998179 DOI: 10.2196/54440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Liver transplantation (LT) is indicated in patients with severe acute or chronic liver failure for which no other therapy is available. With the increasing number of LTs in recent years, liver centers worldwide must manage their patients according to their clinical situation and the expected waiting time for transplantation. The LT clinic at the Centre hospitalier de l'Université de Montréal (CHUM) is developing a new health care model across the entire continuum of pre-, peri-, and posttransplant care that features patient monitoring by an interdisciplinary team, including an accompanying patient; a digital platform to host a clinical plan; a learning program; and data collection from connected objects. OBJECTIVE This study aims to (1) evaluate the outcomes following the implementation of a patient platform with connected devices and an accompanying patient, (2) identify implementation barriers and facilitators, (3) describe service outcomes in terms of health outcomes and the rates and nature of contact with the accompanying patient, (4) describe patient outcomes, and (5) assess the intervention's cost-effectiveness. METHODS Six types of participants will be included in the study: (1) patients who received transplants and reached 1 year after transplantation before September 2023 (historical cohort or control group), (2) patients who will receive an LT between December 2023 and November 2024 (prospective cohort/intervention group), (3) relatives of those patients, (4) accompanying patients who have received an LT and are interested in supporting patients who will receive an LT, (5) health care professionals, and (6) decision makers. To describe the study sample and collect data to achieve all the objectives, a series of validated questionnaires, accompanying patient logbooks, transcripts of interviews and focus groups, and clinical indicators will be collected throughout the study. RESULTS In total, 5 (steering, education, clinical-technological, nurse prescription, and accompanying patient) working committees have been established for the study. Recruitment of patients is expected to start in November 2023. All questionnaires and technological platforms have been prepared, and the clinicians, stakeholders, and accompanying patient personnel have been recruited. CONCLUSIONS The implementation of this model in the trajectory of LT recipients at the CHUM may allow for better monitoring and health of patients undergoing transplantation, ultimately reducing the average length of hospital stay and promoting better use of medical resources. In the event of positive results, this model could be transposed to all transplant units at the CHUM and across Quebec (potentially affecting 888 patients per year) but could also be applied more widely to the monitoring of patients with other chronic diseases. The lessons learned from this project will be shared with decision makers and will serve as a model for other initiatives involving accompanying patients, connected objects, or digital platforms. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/54440.
Collapse
Affiliation(s)
- Marie-Pascale Pomey
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre d'excellence sur le partenariat avec les patients et le public, Montreal, QC, Canada
| | - Enora Le Roux
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Université Paris Cité, ECEVE UMR 1123, Inserm, Faculté de Médecine, Paris, France
- AP-HP.Nord-Université Paris Cité, Hôpital Universitaire Robert Debré, Unité d'épidémiologie clinique, Inserm, CIC 1426, Paris, France
| | - Nathalie Nadon
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Jessie Perron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Regroupement cardio-vasculaire, hépatologie et transplantation, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Angèle Barry
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Réseau transplantation et cliniques externes de transplantation et d'hépatologie, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Chantal Bémeur
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Thomas G Poder
- Département de gestion, évaluation et politique de santé, école de santé publique, Université de Montréal, Montreal, QC, Canada
- Centre de recherche de l'IUSMM, CIUSSS de l'Est de l'Île de Montréal, Montreal, QC, Canada
| | - Fernand Duford
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Louise Laviolette
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Johanne Tétrault-Lassonde
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Cécile Vialaron
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Manuel J Escalona
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Louise Normandin
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Geneviève Huard
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Catherine Girardin
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| | - Christopher Rose
- Axe Cardiométabolique, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Carrefour de l'Innovation, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Denis Ouellet
- Direction de la biovigilance et de la biologie médicale, Ministère de la Santé et des Services sociaux du Québec, Montreal, QC, Canada
| | - Catherine Vincent
- Axe immunopathologie, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Département d'hépatologie, Centre hospitalier universitaire de Montréal (CHUM), Montreal, QC, Canada
| |
Collapse
|
5
|
Nkabane-Nkholongo E, Mpata-Mokgatle M, Jack BW, Julce C, Bickmore T. Usability and Acceptability of a Conversational Agent Health Education App (Nthabi) for Young Women in Lesotho: Quantitative Study. JMIR Hum Factors 2024; 11:e52048. [PMID: 38470460 DOI: 10.2196/52048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Young women in Lesotho face myriad sexual and reproductive health problems. There is little time to provide health education to women in low-resource settings with critical shortages of human resources for health. OBJECTIVE This study aims to determine the acceptability and usability of a conversational agent system, the Nthabi health promotion app, which was culturally adapted for use in Lesotho. METHODS We conducted a descriptive quantitative study, using a 22-item Likert scale survey to assess the perceptions of the usability and acceptability of 172 young women aged 18-28 years in rural districts of Lesotho, who used the system on either smartphones or tablets for up to 6 weeks. Descriptive statistics were used to calculate the averages and frequencies of the variables. χ2 tests were used to determine any associations among variables. RESULTS A total of 138 participants were enrolled and completed the survey. The mean age was 22 years, most were unmarried, 56 (40.6%) participants had completed high school, 39 (28.3%) participants were unemployed, and 88 (63.8%) participants were students. Respondents believed the app was helpful, with 134 (97.1%) participants strongly agreeing or agreeing that the app was "effective in helping them make decisions" and "could quickly improve health education and counselling." In addition, 136 (98.5%) participants strongly agreed or agreed that the app was "simple to use," 130 (94.2 %) participants reported that Nthabi could "easily repeat words that were not well understood," and 128 (92.7%) participants reported that the app "could quickly load the information on the screen." Respondents were generally satisfied with the app, with 132 (95.6%) participants strongly agreeing or agreeing that the health education content delivered by the app was "well organised and delivered in a timely way," while 133 (96.4%) participants "enjoyed using the interface." They were satisfied with the cultural adaptation, with 133 (96.4%) participants strongly agreeing or agreeing that the app was "culturally appropriate and that it could be easily shared with a family or community members." They also reported that Nthabi was worthwhile, with 127 (92%) participants reporting that they strongly agreed or agreed that they were "satisfied with the application and intended to continue using it," while 135 (97.8%) participants would "encourage others to use it." Participants aged 18-24 years (vs those aged 25-28 years) agreed that the "Nthabi app was simple to use" (106/106, 100% vs 30/32, 98.8%; P=.01), and agreed that "the educational content was well organised and delivered in a timely way" (104/106, 98.1% vs 28/32, 87.5%; P=.01). CONCLUSIONS These results support further study of conversational agent systems as alternatives to traditional face-to-face provision of health education services in Lesotho, where there are critical shortages of human resources for health. TRIAL REGISTRATION ClinicalTrials.gov NCT04354168; https://www.clinicaltrials.gov/study/NCT04354168.
Collapse
Affiliation(s)
| | | | - Brian W Jack
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, United States
| | - Clevanne Julce
- Umass Chan Medical School, University of Massachusetts, Worcester, MA, United States
| | - Timothy Bickmore
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, United States
| |
Collapse
|
6
|
Thawani SP, Minen MT, Grossman SN, Friedman S, Bhatt JM, Foo FYA, Torres DM, Weinberg HJ, Kim NH, Levitan V, Cardiel MI, Zakin E, Conway JM, Kurzweil AM, Hasanaj L, Stainman RS, Seixas A, Galetta SL, Balcer LJ, Busis NA. A Comparison of Patients' and Neurologists' Assessments of their Teleneurology Encounter: A Cross-Sectional Analysis. Telemed J E Health 2024; 30:841-849. [PMID: 37624656 DOI: 10.1089/tmj.2023.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
Background and Objectives: To better understand patients' and neurologists' assessments of their experiences regarding effectiveness of teleneurology encounters. Methods: Following an audio-video telehealth visit, neurologists asked patients to participate in a survey-based research study about the encounter, and then, the neurologists also recorded their own evaluations. Data were analyzed using standard quantitative and qualitative techniques for dichotomous and ordered-category survey responses in this cross-sectional analysis. Results: The study included unique encounters between 187 patients and 11 general neurologists. The mean patient age was 49 ± 17.5 years. Two thirds of the patients (66.8%, 125/187) were female. One third (33.2%; 62) were patients new to the NYU Langone Health neurology practices. The most common patient chief complaints were headache (69/187, 36.9%), focal and generalized numbness or tingling (21, 11.2%), memory difficulty (15, 8%), spine-related symptoms (12, 6.4%), and vertigo (11, 5.9%). Most patients (94.7%, 177/187) reported that the teleneurology encounter satisfied their needs. Patients and their neurologists agreed that the experience was effective in 91% (162/178) of encounters, regardless of whether the visit was for a new or established patient visit. Discussion: More than 90% of new and established patients and their neurologists agreed that teleneurology encounters were effective despite some limitations of the examination, the occasional need for patient assistance, and technical difficulties. Our results provide further evidence to justify and to expand the clinical use of teleneurology.
Collapse
Affiliation(s)
- Sujata P Thawani
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Mia T Minen
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Scott N Grossman
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Steven Friedman
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Jaydeep M Bhatt
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Farng-Yang A Foo
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Daniel M Torres
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Harold J Weinberg
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Nina H Kim
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Valeriya Levitan
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Myrna I Cardiel
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Elina Zakin
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Jenna M Conway
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Arielle M Kurzweil
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Lisena Hasanaj
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Rebecca S Stainman
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Azizi Seixas
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Informatics and Health Data Science, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Steven L Galetta
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA
| | - Laura J Balcer
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA
| | - Neil A Busis
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| |
Collapse
|
7
|
Yuan S, Liu M, Peng Y, Hu J, Li B, Ding X, Xie L. "Internet+Nursing Service" Mobile Apps in China App Stores: Functionality and Quality Assessment Study. JMIR Mhealth Uhealth 2024; 12:e52169. [PMID: 38409754 PMCID: PMC10912935 DOI: 10.2196/52169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 02/28/2024] Open
Abstract
Background As the Chinese society ages and the concern for health and quality of life grows, the demand for care services in China is increasing. The widespread use of internet technology has greatly improved the convenience and efficiency of web-based services. As a result, the Chinese government has been implementing "Internet+Nursing Services" since 2019, with mobile apps being the primary tools for users to access these services. The quality of these apps is closely related to user experience and the smooth use of services. Objective This study aims to evaluate the functionality, services, and quality of "Internet+Nursing Service" apps; identify weaknesses; and provide suggestions for improving service programs and the research, development, improvement, and maintenance of similar apps. Methods In December 2022, two researchers searched for "Internet+Nursing Service" apps by applying the search criteria on the Kuchuan mobile app monitoring platform. After identifying the apps to be included based on ranking criteria, they collected information such as the app developer, app size, version number, number of downloads, user ratings, and number and names of services. Afterward, 5 trained researchers independently evaluated the quality of the apps by using the Chinese version of the user version of the Mobile App Rating Scale (uMARS-C). The total uMARS-C score was based on the average of the five evaluators' ratings. Results A total of 17 "Internet+Nursing Service" apps were included. Among these, 12 (71%) had been downloaded more than 10,000 times, 11 (65%) had user ratings of 4 or higher, the median app size was 62.67 (range 22.71-103; IQR 37.51-73.47) MB, 16 (94%) apps provided surgical wound dressing change services, 4 (24%) covered first-tier cities, and only 1 (6%) covered fourth-tier cities. The median total uMARS-C score was 3.88 (range 1.92-4.92; IQR 3.71-4.05), which did not correlate with app store user ratings (r=0.003; P=.99). The quality of most apps (11/17, 65%) was average. Most apps (12/17, 71%) were rated as "good" or above (≥4 points) in terms of information quality, layout, graphics, performance, and ease of use; however, the vast majority of apps were rated as "fair" or even "poor" (<4 points) in terms of credibility (14/17, 82%) and demand (16/17, 94%). Conclusions "Internet+Nursing Service" apps need to broaden their service coverage, increase service variety, and further optimize their service structure. The overall quality of these apps is generally poor. App developers should collaborate with medical professionals and communicate with target users before launching their products to ensure accurate content, complete functionality, and good operation that meets user needs.
Collapse
Affiliation(s)
- Shuo Yuan
- School of Nursing, Anhui Medical University, Hefei, China
- Department of Cardiology II, Anhui No.2 Provincial People’s Hospital, Hefei, China
| | - Min Liu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Yuqi Peng
- School of Nursing, Anhui Medical University, Hefei, China
| | - Jinrui Hu
- School of Nursing, Anhui Medical University, Hefei, China
| | - Bingyan Li
- School of Nursing, Anhui Medical University, Hefei, China
| | - Xia Ding
- Nursing Department, Anhui No.2 Provincial People’s Hospital, Hefei, China
| | - Lunfang Xie
- School of Nursing, Anhui Medical University, Hefei, China
| |
Collapse
|
8
|
Abu Hussain SM, Miptah HN, Shibraumalisi NA, Mohamed-Yassin MS, Baharudin N, Badlishah-Sham SF, Nik Mohd Nasir NM, Kamaruddin KN, Kanoo LL, Abdul-Razak S, Abdul-Hamid H, Daud MH, Yusoff FH, Ramli AS. Factors associated with usability of the EMPOWER-SUSTAIN Self-management mobile app© among individuals with cardiovascular risk factors in primary care. Digit Health 2024; 10:20552076241242795. [PMID: 38571876 PMCID: PMC10989042 DOI: 10.1177/20552076241242795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/12/2024] [Indexed: 04/05/2024] Open
Abstract
Objective This study aimed to determine the usability of the EMPOWER-SUSTAIN Self-Management Mobile App© and evaluate the factors associated with its usability among patients with cardiovascular risk factors in primary care. Methodology This was a cross-sectional study, conducted among patients aged ≥ 18 years with cardiovascular risk factors attending a university primary care clinic. Patients were given the app to use for at least three months. Those who fulfilled the eligibility criteria were recruited. Data gathered were on sociodemographic, clinical characteristics, self-management support by doctors, utilisation of the app at home and social support in using the app. The previously translated and validated Malay version of the mHealth App Usability Questionnaire was used to measure usability. The mean usability score was calculated and linear regressions analysis was conducted to determine the factors associated with the usability of the app. Results A total of 247 patients with at least one cardiovascular risk factor(s) were recruited. The mean age was 60.2 (±8.2). The majority were Malays (86.2%) and half of them were males (52.2%). The total mean (±SD) usability score was 5.26 (±0.67) indicating a high usability of the app. Usability of the app declined with increasing age in the simple linear regressions analysis. The multiple linear regressions yielded that being Malay (b = 0.31, 95% CI 0.08,0.54), using the app at home to understand their medications (b = 0.33, 95% CI 0.12,0.53) and having social support from family members and friends (b = 0.28, 95% CI 0.07,0.49) were significantly associated with higher usability of the app. Conclusion The usability of the EMPOWER-SUSTAIN Self-Management Mobile App© was high among patients with cardiovascular risk factors in our primary care clinic. This finding supports the widespread use of this app among our patients. Involvement of family members and friends should be encouraged to improve the usability of the app.
Collapse
Affiliation(s)
- Siti M Abu Hussain
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Hayatul N Miptah
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Nur A Shibraumalisi
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Mohamed-Syarif Mohamed-Yassin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Noorhida Baharudin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Siti F Badlishah-Sham
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Nik M Nik Mohd Nasir
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Khairatul N Kamaruddin
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Lina L Kanoo
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Suraya Abdul-Razak
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Cardio Vascular and Lungs Research Institute (CaVaLRI), Hospital Al-Sultan Abdullah (HASA), Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia
| | - Hasidah Abdul-Hamid
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Maryam H Daud
- School of Occupational Safety and Health, Netherlands Maritime University College, Jalan Abdullah Ibrahim, Johor Bahru, Johor, Malaysia
| | | | - Anis S Ramli
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| |
Collapse
|
9
|
Moulaei K, Moulaei R, Bahaadinbeigy K. The most used questionnaires for evaluating the usability of robots and smart wearables: A scoping review. Digit Health 2024; 10:20552076241237384. [PMID: 38601185 PMCID: PMC11005511 DOI: 10.1177/20552076241237384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/27/2024] [Indexed: 04/12/2024] Open
Abstract
Background As the field of robotics and smart wearables continues to advance rapidly, the evaluation of their usability becomes paramount. Researchers may encounter difficulty in finding a suitable questionnaire for evaluating the usability of robotics and smart wearables. Therefore, the aim of this study is to identify the most commonly utilized questionnaires for assessing the usability of robots and smart wearables. Methods A comprehensive search of databases, including PubMed, Web of Science, and Scopus, was conducted for this scoping review. Two authors performed the selection of articles and data extraction using a 10-field data extraction form. In cases of disagreements, a third author was consulted to reach a consensus. The inclusions were English-language original research articles that utilized validated questionnaires to assess the usability of healthcare robots and smart wearables. The exclusions comprised review articles, non-English publications, studies not focused on usability, those assessing clinical outcomes, articles lacking questionnaire details, and those using non-validated or researcher-made questionnaires. Descriptive statistics methods (frequency and percentage), were employed to analyze the data. Results A total of 314 articles were obtained, and after eliminating irrelevant and duplicate articles, a final selection of 50 articles was included in this review. A total of 17 questionnaires were identified to evaluate the usability of robots and smart wearables, with 10 questionnaires specifically for wearables and 7 questionnaires for robots. The System Usability Scale (50%) and Post-Study System Usability Questionnaire (19.44%) were the predominant questionnaires utilized to assess the usability of smart wearables. Moreover, the most commonly used questionnaires for evaluating the usability of robots were the System Usability Scale (56.66%), User Experience Questionnaire (16.66%), and Quebec User Evaluation of Satisfaction with Assistive Technology (10%). Conclusion Commonly employed questionnaires serve as valuable tools in assessing the usability of robots and smart wearables, aiding in the refinement and optimization of these technologies for enhanced user experiences. By incorporating user feedback and insights, designers can strive towards creating more intuitive and effective robotic and wearable solutions.
Collapse
Affiliation(s)
- Khadijeh Moulaei
- Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Moulaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
10
|
Tacke T, Nohl-Deryk P, Lingwal N, Reimer LM, Starnecker F, Güthlin C, Gerlach FM, Schunkert H, Jonas S, Müller A. The German version of the mHealth App Usability Questionnaire (GER-MAUQ): Translation and validation study in patients with cardiovascular disease. Digit Health 2024; 10:20552076231225168. [PMID: 38303970 PMCID: PMC10832428 DOI: 10.1177/20552076231225168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/05/2023] [Indexed: 02/03/2024] Open
Abstract
Objective In Germany, only a few standardized evaluation tools for assessing the usability of mobile Health apps exist so far. This study aimed to translate and validate the English patient version for standalone apps of the mHealth App Usability Questionnaire (MAUQ) into a German version. Methods Following scientific guidelines for translation and cross-cultural adaptation, the patient version for standalone apps was forward and back-translated from English into German by an expert panel. In total, 53 participants who were recruited as part of the beta testing process of the recently developed mHealth app HerzFit, answered the questions of the German version of the MAUQ (GER-MAUQ) and the System Usability Scale. Subsequently, a descriptive as well as a psychometric analysis was performed to test validity and reliability. Results After conducting three cognitive interviews, five items were modified. The values for Cronbach alpha for the entire questionnaire and the three subscales (0.966, 0.814, 0.910, and 0.909) indicate strong internal consistency. The correlation analysis revealed that the scores of the GER-MAUQ, the subscales and the SUS were strongly correlated with each other. The correlation coefficient of the SUS and the GER-MAUQ overall score was r = 0.854, P < 0.001 and the coefficients of the subscales and the SUS were r = 0.642, P < 0.001; r = 0.866, P < 0.001 and r = 0.643, P < 0.001. Conclusions We have developed a novel German version of the MAUQ and demonstrated it as a reliable and valid measurement tool for assessing the usability of standalone mHealth apps from the patients' perspective. The GER-MAUQ allows a new form of standardized assessment of usability of mHealth apps for patients with cardiovascular disease in Germany. Further research with a larger sample and other samples is recommended.
Collapse
Affiliation(s)
- Theodora Tacke
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Pascal Nohl-Deryk
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Neelam Lingwal
- Institute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt, Germany
| | - Lara Marie Reimer
- School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Fabian Starnecker
- Department of Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
- Deutsches Zentrum für Herz- und Kreislauferkrankungen (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Corina Güthlin
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ferdinand M Gerlach
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Heribert Schunkert
- Department of Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
- Deutsches Zentrum für Herz- und Kreislauferkrankungen (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
- Medical Graduate Center, Technical University of Munich, Munich, Germany
| | - Stephan Jonas
- Institute for Digital Medicine, University Hospital Bonn, Bonn, Germany
| | - Angelina Müller
- Institute of General Practice, Goethe University Frankfurt, Frankfurt am Main, Germany
| |
Collapse
|
11
|
Nitschke M, Nwosu OB, Grube L, Knitza J, Seifer AK, Eskofier BM, Schett G, Morf H. Refinement and Usability Analysis of an eHealth App for Ankylosing Spondylitis as a Complementary Treatment to Physical Therapy: Development and Usability Study. JMIR Form Res 2023; 7:e47426. [PMID: 38085558 PMCID: PMC10751630 DOI: 10.2196/47426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Mobile eHealth apps have been used as a complementary treatment to increase the quality of life of patients and provide new opportunities for the management of rheumatic diseases. Telemedicine, particularly in the areas of prevention, diagnostics, and therapy, has become an essential cornerstone in the care of patients with rheumatic diseases. OBJECTIVE This study aims to improve the design and technology of YogiTherapy and evaluate its usability and quality. METHODS We newly implemented the mobile eHealth app YogiTherapy with a modern design, the option to change language, and easy navigation to improve the app's usability and quality for patients. After refinement, we evaluated the app by conducting a study with 16 patients with AS (4 female and 12 male; mean age 48.1, SD 16.8 y). We assessed the usability of YogiTherapy with a task performance test (TPT) with a think-aloud protocol and the quality with the German version of the Mobile App Rating Scale (MARS). RESULTS In the TPT, the participants had to solve 6 tasks that should be performed on the app. The overall task completion rate in the TPT was high (84/96, 88% completed tasks). Filtering for videos and navigating to perform an assessment test caused the largest issues during the TPT, while registering in the app and watching a yoga video were highly intuitive. Additionally, 12 (75%) of the 16 participants completed the German version of MARS. The quality of YogiTherapy was rated with an average MARS score of 3.79 (SD 0.51) from a maximum score of 5. Furthermore, results from the MARS questionnaire demonstrated a positive evaluation regarding functionality and aesthetics. CONCLUSIONS The refined and tested YogiTherapy app showed promising results among most participants. In the future, the app could serve its function as a complementary treatment for patients with AS. For this purpose, surveys with a larger number of patients should still be conducted. As a substantial advancement, we made the app free and openly available on the iOS App and Google Play stores.
Collapse
Affiliation(s)
- Marlies Nitschke
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Obioma Bertrand Nwosu
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Lara Grube
- Department of Internal Medicine 3- Rheumatology & Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3- Rheumatology & Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ann-Kristin Seifer
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Bjoern M Eskofier
- Machine Learning and Data Analytics Lab, Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
- Translational Digital Health Group, Institute of AI for Health, German Research Center for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - Georg Schett
- Department of Internal Medicine 3- Rheumatology & Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Harriet Morf
- Department of Internal Medicine 3- Rheumatology & Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Deutsches Zentrum Immuntherapie, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
12
|
Pearson SD, Singh P, Beaudoin F, Campbell J, Schapiro L, Emond SK, Pearson C. Institute for Clinical and Economic Review - Peterson Health Technology Institute value assessment framework for digital health technologies. J Comp Eff Res 2023; 12:e230154. [PMID: 37965898 PMCID: PMC10734316 DOI: 10.57264/cer-2023-0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023] Open
Abstract
Digital health technologies (DHTs) are a broad and rapidly innovating class of interventions with distinctive pathways for development, regulatory approval, uptake and reimbursement. Given the unique nature of DHTs, existing value assessment frameworks and evidence standards for health technologies such as drugs and devices are not directly applicable. The value assessment framework presented here describes a conceptual model and associated methods to guide assessments of DHTs. The framework seeks to accomplish two goals: to set evidence standards that guide technology developers to generate robust evidence on their products; and to provide reviews that help organizations adopt high-impact DHTs with the strongest evidence for delivering improved clinical outcomes and cost savings. This assessment framework will serve as the roadmap for future evaluations of DHTs by the Institute for Clinical and Economic Review (ICER) and the Peterson Health Technology Institute (PHTI). We believe that all stakeholders will benefit from comprehensive and explicit standards of evidence on the different dimensions necessary to understand the value of DHTs.
Collapse
Affiliation(s)
| | | | | | - Jon Campbell
- Institute for Clinical & Economic Review, MA 02108, USA
| | | | - Sarah K Emond
- Institute for Clinical & Economic Review, MA 02108, USA
| | | |
Collapse
|
13
|
Ramachandran M, Brinton C, Wiljer D, Upshur R, Gray CS. The impact of eHealth on relationships and trust in primary care: a review of reviews. BMC PRIMARY CARE 2023; 24:228. [PMID: 37919688 PMCID: PMC10623772 DOI: 10.1186/s12875-023-02176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 10/11/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Given the increasing integration of digital health technologies in team-based primary care, this review aimed at understanding the impact of eHealth on patient-provider and provider-provider relationships. METHODS A review of reviews was conducted on three databases to identify papers published in English from 2008 onwards. The impact of different types of eHealth on relationships and trust and the factors influencing the impact were thematically analyzed. RESULTS A total of 79 reviews were included. Patient-provider relationships were discussed more frequently as compared to provider-provider relationships. Communication systems like telemedicine were the most discussed type of technology. eHealth was found to have both positive and negative impacts on relationships and/or trust. This impact was influenced by a range of patient-related, provider-related, technology-related, and organizational factors, such as patient sociodemographics, provider communication skills, technology design, and organizational technology implementation, respectively. CONCLUSIONS Recommendations are provided for effective and equitable technology selection, application, and training to optimize the impact of eHealth on relationships and trust. The review findings can inform providers' and policymakers' decision-making around the use of eHealth in primary care delivery to facilitate relationship-building.
Collapse
Affiliation(s)
- Meena Ramachandran
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada.
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir-William-Osler, Montreal, QC, H3G 1Y5, Canada.
| | - Christopher Brinton
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada
| | - David Wiljer
- Education Technology Innovation, University Health Network, 190 Elizabeth St, Toronto, ON, M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
- Centre for Addiction and Mental Health, 1000 Queen St W, Toronto, ON, M6J 1H4, Canada
| | - Ross Upshur
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
| | - Carolyn Steele Gray
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health, 1 Bridgepoint Dr, Toronto, ON, M4M 2B5, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, M5T 3M6, Canada
| |
Collapse
|
14
|
Valencia SA, Barrientos Gómez JG, Gómez Ramirez MC, Luna IF, Caicedo HA, Torres-Silva EA, Díaz ES. Evaluation of a telehealth program for high-risk pregnancy in a health service provider institution. Int J Med Inform 2023; 179:105234. [PMID: 37776668 DOI: 10.1016/j.ijmedinf.2023.105234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/14/2023] [Accepted: 09/23/2023] [Indexed: 10/02/2023]
Abstract
INTRODUCTION eHealth offers a solution to current challenges in maternal health. Telemonitoring can rethink antenatal care, achieving more personalized medicine, especially in high-obstetric risk conditions. A home care model mediated by the development of a mobile and web application that seeks support in clinical decision-making was created in our institution. The software architecture consists of an information system (HCIS, Health Care Information System), a database, an authentication server, and an interoperability bus. METHODS The usability of the software by patients was assessed using the Information Systems Usability Questionnaire (CSUQ) version 3, as well as the satisfaction of the care model designed through a survey in a prospective observational study in 62 patients with a high-risk pregnancy. Participants were monitored in real-time through blood glucose, blood pressure, and weight measurements, and attended telemedicine appointments with an obstetrician from admission to six weeks postpartum. RESULTS The CSUQ results show a good acceptance of the use of the application by patients both in the global score and the different domains, Global, System utility (SYSUSE), Information Quality (INFOQUAL), and Interface quality (INTERQUAL). The satisfaction survey also shows good results in general and by domains. CONCLUSION The findings of this study provide some suggestions for the implementation of a technological development and a care model from the patient's perspective.
Collapse
Affiliation(s)
- Sara Arango Valencia
- School of Health Sciences, Pontifical Bolivarian University, 050005 Medellin, Colombia; Scientific Direction, Bolivarian University Clinic, 050005 Medellín, Colombia.
| | - Juan Guillermo Barrientos Gómez
- School of Health Sciences, Pontifical Bolivarian University, 050005 Medellin, Colombia; Scientific Direction, Bolivarian University Clinic, 050005 Medellín, Colombia
| | | | - Iván Felipe Luna
- School of Health Sciences, Pontifical Bolivarian University, 050005 Medellin, Colombia; Scientific Direction, Bolivarian University Clinic, 050005 Medellín, Colombia
| | | | - E A Torres-Silva
- School of Health Sciences, Pontifical Bolivarian University, 050005 Medellin, Colombia; Metropolitan Technological University, 050005 Medellín, Colombia
| | - Emmanuel Sanchez Díaz
- School of Health Sciences, Pontifical Bolivarian University, 050005 Medellin, Colombia
| |
Collapse
|
15
|
Moorthy P, Weinert L, Harms BC, Anders C, Siegel F. German Version of the mHealth App Usability Questionnaire in a Cohort of Patients With Cancer: Translation and Validation Study. JMIR Hum Factors 2023; 10:e51090. [PMID: 37910144 PMCID: PMC10652191 DOI: 10.2196/51090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/01/2023] [Accepted: 09/02/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Good usability is important for the adoption and continued use of mobile health (mHealth) apps. In particular, high usability can support intuitive use by patients, which improves compliance and increases the app's effectiveness. However, many usability studies do not use adequate tools to measure perceived usability. The mHealth App Usability Questionnaire (MAUQ) was developed specifically for end users in a medical context. MAUQ is a relatively new but increasingly used questionnaire to evaluate mHealth apps, but it is not yet available in German. OBJECTIVE This study aims to translate MAUQ into German and determine its internal consistency, reliability, and construct validity. METHODS This validation study was conducted as part of a usability evaluation project for an mHealth app used as a therapy support tool during breast cancer chemotherapy. MAUQ was translated into German through a rigorous forward-backward translation process, ensuring semantic and conceptual equivalence. Patient responses to MAUQ and System Usability Scale (SUS) were analyzed for validation. Descriptive analysis was performed for the MAUQ subscales and SUS standard scores. Significance tests and correlation coefficients assessed the relationship between the SUS and MAUQ results, confirming construct validity. Internal consistency was assessed for item reliability and consistency in measuring the target construct. Free-text questions assessed translation comprehensibility, with responses analyzed descriptively and qualitatively using content analysis. RESULTS In this study, 133 participants responded to the questionnaire, and the validation analysis showed substantially positive correlations between the overall MAUQ score and its subscales: ease of use (r=0.56), interface and satisfaction (r=0.75), and usefulness (r=0.83). These findings support the construct validity of MAUQ and emphasize the importance of these subscales in assessing the usability of the Enable app. The correlation coefficients ranging from 0.39 to 0.68 for the items further validate the questionnaire by aligning with the overall score and capturing the intended concept. The high internal consistency reliability of MAUQ (Cronbach α=.81) and its subscales further enhances the instrument's robustness in accurately evaluating the usability of mHealth apps. CONCLUSIONS We successfully validated the German translation of the MAUQ for stand-alone apps using a standardized approach in a cohort of patients with breast cancer. In our validation study, MAUQ exhibited strong internal consistency reliability (Cronbach α=.81) across its subscales, indicating reliable and consistent measurement. Furthermore, a significant positive correlation (P<.001) was found between the subscales and the overall score, supporting their consistent measurement of the intended construct. Therefore, MAUQ can be considered a reliable instrument for assessing the usability of mHealth apps among German-speaking adults. The availability of the German version of MAUQ will help other researchers in conducting usability studies of mHealth apps in German-speaking cohorts and allow for international comparability of their results.
Collapse
Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Translational Health Economics, Department for Conservative Dentistry, Heidelberg University Hospital, Heidelberg, Germany
| | - Bendix Christian Harms
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Carolin Anders
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Fabian Siegel
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
16
|
Perron JC, Leroy V, Corbel A, Saliot J, Gasmi A, Khene ZE, Bensalah K, Verhoest G, Vesval Q, Mathieu R. ["Connected device for monitoring patients treated by prostatectomy: Implementation and qualitative assessment"]. Prog Urol 2023; 33:580-585. [PMID: 38783764 DOI: 10.1016/j.purol.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Support care aims to improve the experience of patients. m-health is one of the tools recently developed to promote patient empowerment. The objective of this study was to evaluate the appreciation of an m-health application to enhance prostatectomy path for patients suffering from prostate cancer. METHOD A prospective monocentric study was conducted in the urology department of the University Hospital of Rennes from February to April 2023. MyCHU application was optimized by integrating information sheets in the postoperative period after prostatectomy on sphincter rehabilitation exercises, erectile dysfunction and urinary incontinence. The questionnaire used to evaluate the usability of "MyCHU" application was the System Usability Scale (SUS). Semi-structured interviews explored the patients' feelings about the content of the information sheets and the impact on their empowerment regarding sexual disorders. RESULTS Twelve patients participated in this study and 7 agreed to complete an interview The average SUS score was 75.58, which indicate an high usability. Patients appreciated the fact that the application structured their healthcare pathway by centralizing information. The information sheets were clear and accurate. The impact on their empowerment was positive, with a gain in their ability to take ownership of the therapies. CONCLUSION The role of digital technology in health care has been growing in recent years. Our study has shown the interest that mobile application can bring to the patient who undergoes prostatectomy. It increases his empowerment and favor the dialogue with his surgeon. LEVEL OF EVIDENCE: 3
Collapse
Affiliation(s)
- J-C Perron
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France.
| | - V Leroy
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - A Corbel
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - J Saliot
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - A Gasmi
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - Z-E Khene
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - K Bensalah
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - G Verhoest
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - Q Vesval
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| | - R Mathieu
- Service urologie, centre hospitalier universitaire de Rennes, 2, rue Henri-Le-Guilloux, Rennes, France
| |
Collapse
|
17
|
Wohlgemut JM, Pisirir E, Kyrimi E, Stoner RS, Marsh W, Perkins ZB, Tai NRM. Methods used to evaluate usability of mobile clinical decision support systems for healthcare emergencies: a systematic review and qualitative synthesis. JAMIA Open 2023; 6:ooad051. [PMID: 37449057 PMCID: PMC10336299 DOI: 10.1093/jamiaopen/ooad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/15/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023] Open
Abstract
Objective The aim of this study was to determine the methods and metrics used to evaluate the usability of mobile application Clinical Decision Support Systems (CDSSs) used in healthcare emergencies. Secondary aims were to describe the characteristics and usability of evaluated CDSSs. Materials and Methods A systematic literature review was conducted using Pubmed/Medline, Embase, Scopus, and IEEE Xplore databases. Quantitative data were descriptively analyzed, and qualitative data were described and synthesized using inductive thematic analysis. Results Twenty-three studies were included in the analysis. The usability metrics most frequently evaluated were efficiency and usefulness, followed by user errors, satisfaction, learnability, effectiveness, and memorability. Methods used to assess usability included questionnaires in 20 (87%) studies, user trials in 17 (74%), interviews in 6 (26%), and heuristic evaluations in 3 (13%). Most CDSS inputs consisted of manual input (18, 78%) rather than automatic input (2, 9%). Most CDSS outputs comprised a recommendation (18, 78%), with a minority advising a specific treatment (6, 26%), or a score, risk level or likelihood of diagnosis (6, 26%). Interviews and heuristic evaluations identified more usability-related barriers and facilitators to adoption than did questionnaires and user testing studies. Discussion A wide range of metrics and methods are used to evaluate the usability of mobile CDSS in medical emergencies. Input of information into CDSS was predominantly manual, impeding usability. Studies employing both qualitative and quantitative methods to evaluate usability yielded more thorough results. Conclusion When planning CDSS projects, developers should consider multiple methods to comprehensively evaluate usability.
Collapse
Affiliation(s)
- Jared M Wohlgemut
- Corresponding Author: Jared M. Wohlgemut, MSc, Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, 4 Newark St, London E1 2AT, UK;
| | - Erhan Pisirir
- Department of Electrical Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Evangelia Kyrimi
- Department of Electrical Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Rebecca S Stoner
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK
- Trauma Service, Royal London Hospital, Barts NHS Health Trust, London, UK
| | - William Marsh
- Department of Electrical Engineering and Computer Science, Queen Mary University of London, London, UK
| | - Zane B Perkins
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK
- Trauma Service, Royal London Hospital, Barts NHS Health Trust, London, UK
| | - Nigel R M Tai
- Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, London, UK
- Trauma Service, Royal London Hospital, Barts NHS Health Trust, London, UK
- Academic Department of Military Surgery and Trauma, Royal Centre of Defence Medicine, Birmingham, UK
| |
Collapse
|
18
|
Cox V, Sharma P, Verma GS, Gill N, Diamond-Smith NG, Duggal M, Kumar V, Bagga R, Kaur J, Singh P, El Ayadi AM. User Acceptability and Perceived Impact of a Mobile Interactive Education and Support Group Intervention to Improve Postnatal Health Care in Northern India: A Qualitative Study. RESEARCH SQUARE 2023:rs.3.rs-3320095. [PMID: 37790487 PMCID: PMC10543439 DOI: 10.21203/rs.3.rs-3320095/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background Postnatal care, crucial for preventing and assessing complications after birth, remains low in India. An interactive mHealth community-based postnatal intervention was implemented to promote healthy maternal behaviors through knowledge and social support in rural Northern India. However, there is limited information on how virtual health interventions in resource-constrained settings are perceived by the users and which elements influence their engagement and sustained participation. Objective We explored the user perceptions of acceptability and impact of a virtual interactive maternal and child health intervention pilot tested in Punjab State, India, including their perspectives on barriers and facilitators to engage with this intervention. Methods This qualitative study was embedded within extensive mixed-method research, and oriented by the Realist Evaluation approach. Sixteen participants were recruited from the parent study. They were identified by purposive sampling to cover diverse levels of attendance and engagement with the intervention. In-depth interviews were conducted by phone. Following translation, a framework analysis was completed to search for the main themes. Feedback was requested from intervention moderators during the process to prioritize local interpretation. Results Study participants reported overall satisfaction with the intervention. The mothers appreciated the educational material provided and the communication with other participants and health professionals. Across context, intervention, and actor domains, the barriers most commented on were network and connectivity challenges, lack of time due to household responsibilities, and feeling uncomfortable sharing personal experiences. Family buy-in and support were fundamental for overcoming the high domestic workload and baby care. Another facilitator mentioned was moderators' guidance on using the different intervention modalities. Regarding perceived impact, participants shared that MeSSSSage increased their capability and motivation to breastfeed, seek care as needed, and use contraception according to their preferences. Finally, participants suggested adding more topics to the educational content and adjusting the dynamics within the group calls to improve the intervention. Conclusions This study identifies the high acceptability and perceived impact of a novel postnatal care program in a rural setting, including the users' perceived barriers to engaging with the intervention and possible solutions to overcome them. These findings enable refinement of the ongoing intervention, providing a more robust framing for its scalability and long-term sustainability. On a larger scale, conclusions from this research provide new insights and encouragement to global stakeholders who aspire to improve maternal and neonatal outcomes in low-income and middle-income countries through mHealth.
Collapse
Affiliation(s)
| | | | | | - Navneet Gill
- Postgraduate Institute of Medical Education & Research
| | | | - Mona Duggal
- Postgraduate Institute of Medical Education & Research
| | | | - Rashmi Bagga
- Postgraduate Institute of Medical Education & Research
| | - Jasmeet Kaur
- Indraprastha Institute of Information Technology Delhi
| | | | | |
Collapse
|
19
|
Krafft J, Barisch-Fritz B, Krell-Roesch J, Trautwein S, Scharpf A, Woll A. A Tablet-Based App to Support Nursing Home Staff in Delivering an Individualized Cognitive and Physical Exercise Program for Individuals With Dementia: Mixed Methods Usability Study. JMIR Aging 2023; 6:e46480. [PMID: 37606974 PMCID: PMC10481225 DOI: 10.2196/46480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The promotion of physical activity in individuals with dementia living in nursing homes is crucial for preserving physical and cognitive functions and the associated quality of life. Nevertheless, the implementation of physical activity programs in this setting is challenging, as the time and expertise of nursing home staff are limited. This situation was further exacerbated by the COVID-19 pandemic. Mobile health apps may be a sustainable approach to overcome these challenges in the long term. Therefore, the Individualized Cognitive and Physical Exercise-App (the InCoPE-App) was developed to support nursing home staff in delivering and implementing tailored cognitive and physical exercise training for individuals with dementia. OBJECTIVE This study aims to assess the usability of the InCoPE-App in terms of user performance and user perception in a laboratory setting using a mixed methods approach. METHODS Nursing home staff were encouraged to perform 5 basic tasks within the InCoPE-App. Their thoughts while using the app were captured by implementing a think aloud protocol. Then, participants completed the System Usability Scale questionnaire. The think aloud transcripts were qualitatively evaluated to unveil usability issues. All identified issues were rated in terms of their necessity to be fixed. Task completion (ie, success rate and time) and perceived usability were evaluated descriptively. RESULTS A total of 14 nursing home employees (mean age 53.7, SD 10.6 years; n=13, 93% women) participated in the study. The perceived usability of the InCoPE-App, as assessed by the System Usability Scale questionnaire, can be rated as "good." The main usability issues concerned navigation logic and comprehensibility of app content. CONCLUSIONS The InCoPE-App is a user-friendly app that enables nursing home staff to deliver and implement cognitive and physical exercise training for individuals with dementia in nursing homes. The InCoPE-App can be used with little training, even by people aged ≥50 years, who may have low digital literacy. To achieve sustainable use and high user satisfaction of the InCoPE-App in the long term, it should be implemented and evaluated in a field study.
Collapse
Affiliation(s)
- Jelena Krafft
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Bettina Barisch-Fritz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sandra Trautwein
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Andrea Scharpf
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| |
Collapse
|
20
|
Louissaint J, Wilder JM, Tapper EB, Rodriguez JA, Rosenblatt R, Verna EC. Confronting Disparities in Telehepatology Research. Clin Gastroenterol Hepatol 2023; 21:1385-1389. [PMID: 36563767 DOI: 10.1016/j.cgh.2022.11.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Jeremy Louissaint
- Center for Liver Disease and Transplantation, Columbia University, New York, New York
| | - Julius M Wilder
- Division of Gastroenterology, Duke University, Durham, North Carolina; Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Elliot B Tapper
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
| | - Jorge A Rodriguez
- Division of General Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Russell Rosenblatt
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, New York
| | - Elizabeth C Verna
- Center for Liver Disease and Transplantation, Columbia University, New York, New York
| |
Collapse
|
21
|
Oakley-Girvan I, Yunis R, Fonda SJ, Neeman E, Liu R, Aghaee S, Ramsey ME, Kubo A, Davis SW. A novel smartphone application for the informal caregivers of cancer patients: Usability study. PLOS DIGITAL HEALTH 2023; 2:e0000173. [PMID: 36867639 PMCID: PMC9983832 DOI: 10.1371/journal.pdig.0000173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 11/29/2022] [Indexed: 03/04/2023]
Abstract
Informal caregivers are a critical source of support for cancer patients. However, their perspectives are not routinely collected, despite health impacts related to the burden of caregiving. We created the TOGETHERCare smartphone application (app) to collect observer-reported outcomes regarding the cancer patient's health and caregiver's perceptions of their own mental and physical health, and to provide tips and resources for self-care and patient care. We enrolled 54 caregivers between October 2020 and March 2021 from Kaiser Permanente Northern California (KPNC), an integrated healthcare system. Fifty caregivers used the app for approximately 28 days. Usability and acceptability were assessed using questions from the Mobile App Rating Scale (MARS), the System Usability Scale (SUS), the Net Promoter Score (NPS), and semi-structured interviews. The caregivers' mean age was 54.4 years, 38% were female and 36% were non-White. The SUS total mean score was 83.4 (SD = 14.2), for a percentile rank of 90-95 ("excellent"). Median MARS responses to the functionality questions were also high. The NPS score of 30 at the end of the study indicated that most caregivers would recommend the app. Themes from semi-structured interviews were consistent across the study period and indicated that the app was easy to use and helpful. Caregivers indicated a need for feedback from the app, suggested some changes to the wording of questions, the app's visuals, and timing of notifications. This study demonstrated that caregivers are willing to complete frequent surveys about themselves and their patients. The app is unique because it provides a remote method to collect caregivers' observations about the patient that may be useful for clinical care. To our knowledge, TOGETHERCare is the first mobile app developed specifically to capture adult cancer patient symptoms from the informal caregiver's perspective. Future research will examine whether use of this app can help improve patient outcomes.
Collapse
Affiliation(s)
| | - Reem Yunis
- Medable Inc., Palo Alto, California, United States of America
| | | | - Elad Neeman
- Kaiser Permanente Northern California, San Francisco Medical Center, San Francisco, California, United States of America
| | - Raymond Liu
- Kaiser Permanente Northern California, San Francisco Medical Center, San Francisco, California, United States of America
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Sara Aghaee
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Maya E. Ramsey
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Ai Kubo
- Kaiser Permanente Northern California, Division of Research, Oakland, California, United States of America
| | - Sharon W. Davis
- Medable Inc., Palo Alto, California, United States of America
| |
Collapse
|
22
|
Erlich M, Lindblad S, Haskey N, Clarkin DH, Dong T, Harvie R, Lunken G, Pirnack J, Jacobson K. User testing to modify the MyHealthyGut digital health application for inflammatory bowel disease. Digit Health 2023; 9:20552076231203664. [PMID: 37766902 PMCID: PMC10521297 DOI: 10.1177/20552076231203664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction Inflammatory bowel disease, characterized by chronic intestinal inflammation, can be subcategorized into Crohn's disease and ulcerative colitis. The treatment for these conditions is unique to each patient and may include lifestyle changes, pharmaceutical intervention, and surgery. Lifestyle changes, such as dietary intervention, are a cornerstone of inflammatory bowel disease symptom management. Given the daily burden of this disease, self-management is paramount in coping with and/or minimizing symptoms. The MyHealthyGut application, successfully proven to be a self-management tool for celiac disease, shows promise for use in an inflammatory bowel disease patient population. Objective To conduct user testing to gather valuable insights for the development of an IBD-focused version of the existing MyHealthyGut app. Methods Participants included inflammatory bowel disease patients and healthcare practitioners. Participants used the application for a 2-week period, followed by participation in a focus group or individual interview to provide feedback. Qualitative questionnaires were administered verbally and feedback was recorded. Thematic analysis techniques were used for data quantification and analysis. Results 15 participants were recruited and enrolled. Of these, 14 participants took part in the focus group and/or individual interviews. The feedback suggested changes related to clinical uses, food and symptom tracking, ease of use, and educational content. All (100%) participants reported that they would either use the application themselves or recommend it to patients, once their suggestions were implemented. Conclusion Through user testing and feedback collection, priorities for app modification were identified. Areas for modification in the app functions and features, ease of use, and content were identified. Once updated to meet the needs of inflammatory bowel disease patients, the MyHealthyGut app may be a useful tool for IBD self-management.
Collapse
Affiliation(s)
- Madeline Erlich
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Canada
| | - Sarah Lindblad
- Child and Youth Outpatient Department, Royal Victoria Regional Health Centre, Barrie, Canada
| | - Natasha Haskey
- Department of Biology, Irving K Barber Faculty of Science, University of British Columbia, Okanagan, Kelowna, Canada
| | | | - Taojie Dong
- Faculty of Land and Food Systems, University of British Columbia, Vancouver, Canada
| | - Ruth Harvie
- Human Nutrition Department, St Francis Xavier University, Antigonish, Canada
| | - Genelle Lunken
- BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
- IBD Centre of BC, Vancouver, Canada
| | - Jess Pirnack
- Food Yourself, West Vancouver, Vancouver, Canada
| | - Kevan Jacobson
- BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
- IBD Centre of BC, Vancouver, Canada
| |
Collapse
|
23
|
Usability Evaluation of Dashboards: A Systematic Literature Review of Tools. BIOMED RESEARCH INTERNATIONAL 2023; 2023:9990933. [PMID: 36874923 PMCID: PMC9977530 DOI: 10.1155/2023/9990933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/16/2023] [Accepted: 02/04/2023] [Indexed: 02/25/2023]
Abstract
Introduction In recent years, the use of dashboards in healthcare has been considered an effective approach for the visual presentation of information to support clinical and administrative decisions. Effective and efficient use of dashboards in clinical and managerial processes requires a framework for the design and development of tools based on usability principles. Objectives The present study is aimed at investigating the existing questionnaires used for the usability evaluation framework of dashboards and at presenting more specific usability criteria for evaluating dashboards. Methods This systematic review was conducted using PubMed, Web of Science, and Scopus, without any time restrictions. The final search of articles was performed on September 2, 2022. Data collection was performed using a data extraction form, and the content of selected studies was analyzed based on the dashboard usability criteria. Results After reviewing the full text of relevant articles, a total of 29 studies were selected according to the inclusion criteria. Regarding the questionnaires used in the selected studies, researcher-made questionnaires were used in five studies, while 25 studies applied previously used questionnaires. The most widely used questionnaires were the System Usability Scale (SUS), Technology Acceptance Model (TAM), Situation Awareness Rating Technique (SART), Questionnaire for User Interaction Satisfaction (QUIS), Unified Theory of Acceptance and Use of Technology (UTAUT), and Health Information Technology Usability Evaluation Scale (Health-ITUES), respectively. Finally, dashboard evaluation criteria, including usefulness, operability, learnability, ease of use, suitability for tasks, improvement of situational awareness, satisfaction, user interface, content, and system capabilities, were suggested. Conclusion General questionnaires that were not specifically designed for dashboard evaluation were mainly used in reviewed studies. The current study suggested specific criteria for measuring the usability of dashboards. When selecting the usability evaluation criteria for dashboards, it is important to pay attention to the evaluation objectives, dashboard features and capabilities, and context of use.
Collapse
|
24
|
An Investigation on Chinese Public Acceptance of COVID-19 Prevention Measures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095087. [PMID: 35564482 PMCID: PMC9102455 DOI: 10.3390/ijerph19095087] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 12/23/2022]
Abstract
China has basically succeeded in bringing the COVID-19 epidemic under control, thanks to a timely series of effective prevention and control measures taken by the Chinese government. In this study, a public acceptance questionnaire of epidemic prevention measures was designed to investigate the influencing factors of public acceptance. A total of 2062 samples were collected from 8 March 2020 to 9 April 2020, and Independent-Samples T-Test and One-way ANOVA were used to analyze the data collected in the questionnaire in SPSS version 22.0. The results show that age and educational level have a significant influence on public acceptance. With the development of the epidemic, the acceptability grew generally higher. The public acceptance of traffic measures is the highest. This study summarises China’s scientific experience in the fight against COVID-19 and the differences in public acceptance. It can provide a positive reference for the development of epidemic prevention in other countries.
Collapse
|
25
|
Langarizadeh M, Fatemi Aghda SA, Nadjarzadeh A. Design and evaluation of a mobile-based nutrition education application for infertile women in Iran. BMC Med Inform Decis Mak 2022; 22:58. [PMID: 35246119 PMCID: PMC8894566 DOI: 10.1186/s12911-022-01793-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background The prevalence of infertility in Iran is higher than the world average. Furthermorte, education and nutrition are among the effective factors in improving the quality of life of women with infertility. According to the significant role of smartphones in people's lives as well as health education, the present study aimed to design and evaluate a mobile-based nutrition education application for infertile women.
Methods This quantitative research was conducted in two stages. Initially, the educational contents were determined based on a review of the literature. Later, the obtained contents were given to 10 nutritionists and five infertility specialists to determine the necessity of each item. In the next stage, the application prototype was designed based on the results of the first stage and distributed among 220 infertile women. After two months, the Questionnaire of User Interface Satisfaction was administrated to assess the usability of the developed application. The results were analyzed via SPSS software version 20. Results According to the nutritionists and infertility specialists, the contents determined for the nutrition educational application were categorized under three general sections of user's demographic data, educational contents, required capabilities. The users' mean score of the application usability was calculated as 7.44 out of 9 indicating a good level of satisfaction. Conclusions Nutrition education of women with infertility problems can play a significant role in improving their awareness and treatment outcomes. Due to the increasing use of smartphones, designing a mobile-based nutrition educational application can be of great benefit for women with infertility according to the cultural conditions and characteristics of each community.
Collapse
Affiliation(s)
- Mostafa Langarizadeh
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ali Fatemi Aghda
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
26
|
Choi KS, Chan SH, Ho CL, Matejak M. Development of a Healthcare Information System for Community Care of Older Adults and Evaluation of Its Acceptance and Usability. Digit Health 2022; 8:20552076221109083. [PMID: 35756832 PMCID: PMC9218899 DOI: 10.1177/20552076221109083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/06/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The need for health and social care for community-dwelling elderly is on the rise as the population ages. Through the provision of comprehensive services by multiple professionals in local communities, elderly people can receive continual care in a non-medical setting, which is favorable for early detection and intervention of potential problems. However, the lack of digitalization in primary care affects the effectiveness of the services and precludes full exploitation of the data. This study proposed an information system dedicated to caring for community-dwelling elderly people and investigated its acceptance and usability. Methods An information system was designed for elderly care centers in the community, where data generated during care delivery, involving socio-demographic data, bio-measurements and health assessments and questionnaires, were digitized and stored for information management and exchange. A study was conducted to evaluate the acceptance and usability of the system after routine use of 6 months. The users of the system at an elderly care center were recruited to respond to a technology acceptance questionnaire and a system usability questionnaire. Results The mean scores of the acceptance and usability questionnaires reached 5.1 out of the highest possible score of 7. The constructs of the acceptance questionnaire had good reliability. The social influence and facilitating conditions constructs had a significant correlation with the behavioral intention construct. Conclusions The proposed information system demonstrated good acceptance and usability, which supported the feasibility of implementing it in community care centers for older adults. Further research will be conducted to address the limitation of sample size by extending the system to other elderly care centers, forming a large user base for a more in-depth and comprehensive performance evaluation.
Collapse
Affiliation(s)
- Kup-Sze Choi
- The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Sze-Ho Chan
- The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Cho-Lik Ho
- The Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | | |
Collapse
|