Background: Occupational stress is associated with detrimental consequences that are addressed by mobile health (mHealth)solutions. Previous developments of apps for occupational stress have not yet fully exploited the potential of multilevel diagnosticsthrough the integration of wearable sensors for interventions. Personalizing mHealth approaches in terms of intervention timeand content, which requires the use of artificial intelligence, is the next logical developmental step. The "Relax" approach developeda corresponding prototype of an app-wearable system, which will be evaluated for effectiveness in terms of stress reduction andusability.Objective: This study protocol describes an evaluation study used to test the effectiveness and usability of the Relax approach.Methods: The evaluation study was designed as a 2-arm randomized trial with 2 phases, each with a 3-week intervention period.In both phases, employees were required to use the app to record daily stress and to wear a wearable sensor to measure heart ratevariability. The app offered interventions based on algorithms, which altered the probability of their selection after learning fromthe data, thereby personalizing the user experience. In the second phase of the study, the sample was divided into 2 groups, varyingthe degree of personalization of the app. To analyze effectiveness, a 2-factorial mixed within-between design will be applied tocompare the outcomes between both groups as well as in a pre-post comparison. In addition, exploratory analyses of the usabilityof the approach are planned.Results: The study was conducted during the spring and summer of 2024, with a total of 46 participants enrolled, and is readyfor data analysis.Conclusions: The Relax approach, including a number of factors related to personalization that have not yet been incorporatedinto mHealth in current research, will provide new insights into the next steps of advanced mHealth solutions. Limitations of thestudy design, such as the lack of a control group and the sample representativity, have to be addressed.Trial Registration: Open Science Foundation 10.17605/OSF.IO/MYRD9; https://osf.io/myrd9
No AccessEducationJul 2010Design Thinking for Social InnovationAuthors/Editors: Tim Brown, Jocelyn WyattTim BrownSearch for more papers by this author, Jocelyn WyattSearch for more papers by this authorhttps://doi.org/10.1596/1020-797X_12_1_29SectionsAboutView ChaptersPDF (0.2 MB) ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinked In Designers have traditionally focused on enchancing the look and functionality of products. 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Assessment Using A Human-Centered Design Approach (Preprint)JMIR February mental health and in and mental framework for in of Cleaner Production, to Design Thinking to Creative and in Journal of & Design Education, August Theory in An Journal, March 2021Designing and for with January with design thinking: a case study from Journal of Environmental Education, Vol.52, January and the of Design: of Design and Design in No.122 May to Design with A for Design and July Case and the of Design Thinking in Public Education in August to Co-Created Digital to Support Activities for Socially Youth in February Innovation and Exchange a Lessons Learned from a Design Thinking Challenge in May October Sustainable Business and January Analysis of Agile Development Methodology Through Design June Sustainable Design to Environmental of Design November Case for Design May Learning in Design Thinking to April 2021Design Thinking as a Strategy to Learning in Education Across South April Inspection Management with October design methodology for A to community health and health in the Health of and Science, Vol.5, February 2021Using Design Thinking to the Educational of August factors of service design methodology for manufacturing Business & Management, Vol.8, February 2021Design and of an app for September 2021Design Innovation Methodology – Design in Journal, of the Health Mental Health Intervention for in and for a Research Vol.10, June Design Approach to Social a of Public and October Design Thinking in an Interdisciplinary Learning December Design Thinking to Design Thinking to Food Innovation for January of Design Thinking and to Food and January 2021Design Thinking to Engage in Food The January 2021Systemic and Design Towards Participatory The Journal of Design, and Innovation, Vol.7, Design Thinking October Research and Design Thinking for the Health and Social A para de de Vol.16,
Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.
BACKGROUND: Smartphones have become an integral part of our lives with unprecedented popularity and a diverse selection of apps. The continuous upgrading of information technology has also enabled smartphones to display great potential in the field of health care. OBJECTIVE: We aimed to determine the future research direction of mobile health (mHealth) by analyzing its research trends and latest research hotspots. METHODS: This study collected mHealth-related literature published between 2000 and 2020 from the Web of Science database. Descriptive statistics of publication trends of mHealth research were determined by analyzing the annual number of publications in the literature and annual number of publications by country. We constructed visualization network maps of country (or regional) collaborations and author-provided keyword co-occurrences, as well as overlay visualization maps of the average publication year of author-provided keywords to analyze the hotspots and research trends in mHealth research. RESULTS: In total, 12,593 mHealth-related research papers published between 2000 and 2020 were found. The results showed an exponential growth trend in the number of annual publications in mHealth literature. JMIR mHealth and uHealth, the Journal of Medical Internet Research, and JMIR Research Protocols were the 3 top journals with respect to number of publications. The United States remained the leading contributor to the literature in this area (5294/12,593, 42.0%), well ahead of other countries and regions. Other countries and regions also showed a clear trend of annual increases in the number of mHealth publications. The 4 countries with the largest number of publications-the United States, the United Kingdom, Canada, and Australia-were found to cooperate more closely. The rest of the countries and regions showed a clear geographic pattern of cooperation. The keyword co-occurrence analysis of the top 100 authors demonstrated 5 clusters, namely, development of mHealth medical technology and its application to various diseases, use of mHealth technology to improve basic public health and health policy, mHealth self-health testing and management in daily life, adolescent use of mHealth, and mHealth in mental health. The research trends revealed a gradual shift in mHealth research from health policy and improving public health care to the development and social application of mHealth technologies. CONCLUSIONS: To the best of our knowledge, the most current bibliometric analysis dates back to 2016. However, the number of mHealth research published between 2017 and 2020 exceeds the previous total. The results of this study shed light on the latest hotspots and trends in mHealth research. These findings provide a useful overview of the development of the field; they may also serve as a valuable reference and provide guidance for researchers in the digital health field.
Telemedicine and e-HealthVol. 26, No. 9 OpinionFree AccessTechnology Literacy as a Barrier to Telehealth During COVID-19Austin J. Triana, Roman E. Gusdorf, Kaustav P. Shah, and Sara N. HorstAustin J. TrianaVanderbilt University School of Medicine, Nashville, Tennessee, USA.Search for more papers by this author, Roman E. GusdorfVanderbilt University School of Medicine, Nashville, Tennessee, USA.Search for more papers by this author, Kaustav P. ShahVanderbilt University School of Medicine, Nashville, Tennessee, USA.Search for more papers by this author, and Sara N. HorstAddress correspondence to: Sara N. Horst, MD, MPH, Department of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, 1211 21st Avenue South, Medical Arts Building Suite 220, Nashville, TN 37232, USA E-mail Address: [email protected]Department of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Search for more papers by this authorPublished Online:10 Sep 2020https://doi.org/10.1089/tmj.2020.0155AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail During the ongoing COVID-19 pandemic, there have been many fundamental changes to the health care system, one of which has been the rapid adoption of telehealth.1 Despite technological capability for widespread implementation before the pandemic, telehealth remained limited in many areas of the United States due to state regulations and poor insurance reimbursement.2 When these policies changed in March 2020 with national widespread coverage for telemedicine, traditional clinical workflows attempted to rapidly shift to a virtual format to increase social distancing and protect vulnerable patients. At our institution alone, the number of telehealth visits increased from ∼15 per day to >2,000 per day in a matter of weeks.As the health care system rapidly reorganized and trained physicians on how to host videoconference visits, some patients have struggled to keep up. During these changes, providers reported that many patients were struggling to access their telemedicine appointments. Patients may have difficulty navigating their devices and entering the health care system virtually. Others simply do not have devices or a stable Wi-Fi to connect with providers from home. Technology literacy and access should be viewed as a major driver of health and needs to be on a large scale.As an example, Ms. P is a 70-year-old woman with diabetes and hypertension who knows she is high risk for complications from COVID-19. Taking extra precautions, she cancelled her in-person appointments and scheduled a telehealth visit with one of her providers. She spent an entire afternoon preparing her technology for the visit, but she could not connect to the virtual appointment. Despite a proactive mindset, she had difficulty downloading the necessary software. Recognizing this barrier to care Ms. P and other patients face, we started a medical student-led volunteer initiative to help patients set up and test devices for their telemedicine appointments. We rapidly created systematic processes for recruitment, volunteer training, clinic coverage, and operational support. A standardized phone script helped students guide patients as they downloaded the proper software and understood what to expect at the time of the visit.Within a month, we have had 135 medical student volunteers commit 1,300 h and assist >5,000 patients in preparing for upcoming telehealth visits. Along the way, we have seen a wide range of patient comfort with technology that has advanced our understanding of technology literacy. One patient, a computer programmer, initially scoffed when asked whether he needed help. However, he still appreciated the tip that he received about which web browser to use to access his visit, avoiding a glitch that kept some patients from connecting. For patients low self-reported technology literacy, our impact can be great. Many patients had never downloaded a smartphone application or used videoconferencing software before their first virtual appointment. Wary of hackers and scammers, another patient was strongly opposed to telehealth and wanted to cancel his visit, but after talking about the safety of the process with a student, he downloaded the software and had a successful telemedicine visit with his provider.If a patient cannot connect to the videoconference, the provider is forced to call the patient to troubleshoot over the phone, reschedule the appointment, or simply proceed without video. Prior work has shown that the video component significantly contributes to quality and satisfaction of the visit.3 In addition to the technology itself, patients need to know what to expect for their telehealth appointments. Ideally, a patient will have a medication list and be in a quiet and private location at the time of the visit. Therefore, it is important to communicate these expectations beforehand to avoid a visit that takes place from the grocery store or in the car.With the ability to see patients in their own environments, we also gain insight into their lives. Using videoconferencing, it is possible to see a patient's home, to contextualize their experiences, and to better utilize the biopsychosocial model of health. One patient was blind but wanted to use videoconferencing so that the provider could see him. A volunteer helped the patient and his able-sighted daughter navigate the telehealth process using accessibility features for blindness. As medical students who grew up immersed in technology, we have been humbled by the complexity of teaching others to navigate smartphones, web browsers, and applications, and we have seen the tremendous technology gaps in various patient populations.Outside the context of direct patient care, widespread adoption of telehealth has the potential to improve quality of life and health outcomes through additional synergies. Although many older adults perceive benefits from technology, common barriers include self-efficacy, cost, and privacy concerns.4 Prior research has shown that technology adoption can be improved through education and increasing perceived self-efficacy.5 If patients can better navigate their web browsers and applications, they may feel empowered to message their providers through the patient portal or look up healthy recipes online.Among the drastic changes in health care, we hope that updated regulations and improved insurance coverage will be permanent, improving access for patients by addressing issues related to distance, mobility, or health concerns. Licensure across state lines remains a big question that could drastically impact access for many patients. In addition, it is imperative to further understand and address how to help our patients access and use technology. The transition to telehealth requires time, patience, and resources—an investment that is crucial for patients who are at risk of being left behind.AcknowledgmentsWe thank Drs. Michelle Griffith and Eiman Jahangir for organizational support of this project as well as reviewing and editing drafts.Disclosure StatementNo competing financial interests exist.Funding InformationNo funding was received for this article.References1. Smith A, Thomas E, Snoswell C, Haydon H, Mehrotra A, Clemensen J, Caffery Lj. Telehealth for global emergencies: Implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020. Available at: https://doi.org/10.1177/1357633X20916567 (last accessed May 15, 2020). Google Scholar2. Dorsey ER, Topol EJ. State of telehealth. N Engl J Med 2016;375:154–161. Crossref, Medline, Google Scholar3. McLendon SF. Interactive video telehealth models to improve access to diabetes specialty care and education in the rural setting: A systematic review. Diabetes Spectr 2017;30:124–136. Crossref, Medline, Google Scholar4. Scott Kruse C, Karem P, Shifflett K, Vegi L, Ravi K, Brooks M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecare 2018;24:4–12. Crossref, Medline, Google Scholar5. Gatti FM, Brivio E, Galimberti C. "The future is ours too": A training process to enable the learning perception and increase self-efficacy in the use of tablets in the elderly. Educ Gerontol 2017;43:209–224. 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Triana, Roman E. Gusdorf, Kaustav P. Shah, and Sara N. Horst.Technology Literacy as a Barrier to Telehealth During COVID-19.Telemedicine and e-Health.Sep 2020.1118-1119.http://doi.org/10.1089/tmj.2020.0155Published in Volume: 26 Issue 9: September 10, 2020Online Ahead of Print:May 19, 2020 TopicsCOVID-19e-health and telehealth careTelehealth devices PDF download
Peer-review and publication of research protocols offer several advantages to all parties involved. Among these are the following opportunities for authors: external expert opinion on the methods, demonstration to funding agencies of prior expert review of the protocol, proof of priority of ideas and methods, and solicitation of potential collaborators. We think that review and publication of protocols is an important role for Open Access journals. Because of their electronic form, openness for readers, and author-pays business model, they are better suited than traditional journals to ensure the sustainability and quality of protocol reviews and publications. In this editorial, we describe the workflow for investigators in eHealth research, from protocol submission to a funding agency, to protocol review and (optionally) publication at JMIR, to registration of trials at the International eHealth Study Registry (IESR), and to publication of the report. One innovation at JMIR is that protocol peer reviewers will be paid a honorarium, which will be drawn partly from a new submission fee for protocol reviews. Separating the article processing fee into a submission and a publishing fee will allow authors to opt for "peer-review only" (without subsequent publication) at reduced costs, if they wish to await a funding decision or for other reasons decide not to make the protocol public.
Background: The global targets for HIV testing for achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets are still short. Identifying gaps and opportunities for HIV testing uptake is crucial in fast-tracking the second (initiate people living with HIV on antiretroviral therapy) and third (viral suppression) UNAIDS goals. Machine learning and health technologies can precisely predict high-risk individuals and facilitate more effective and efficient HIV testing methods. Despite this advancement, there exists a research gap regarding the extent to which such technologies are integrated into HIV testing strategies worldwide. Objective: The study aimed to examine the characteristics, citation patterns, and contents of published studies applying machine learning and emerging health technologies in HIV testing from 2000 to 2024. Methods: This bibliometric analysis identified relevant studies using machine learning and emerging health technologies in HIV testing from the Web of Science database using synonymous keywords. The Bibliometrix R package was used to analyze the characteristics, citation patterns, and contents of 266 articles. The VOSviewer software was used to conduct network visualization. The analysis focused on the yearly growth rate, citation analysis, keywords, institutions, countries, authorship, and collaboration patterns. Key themes and topics were driven by the authors' most frequent keywords, which aided the content analysis. Results: The analysis revealed a scientific annual growth rate of 15.68%, with an international coauthorship of 8.22% and an average citation count of 17.47 per document. The most relevant sources were from high-impact journals such as the Journal of Internet Medicine Research, JMIR mHealth and uHealth, JMIR Research Protocols, mHealth, AIDS Care-Psychological and Socio-Medical Aspects of AI, and BMC Public Health, and PLOS One. The United States of America, China, South Africa, the United Kingdom, and Australia produced the highest number of contributions. Collaboration analysis showed significant networks among universities in high-income countries, including the University of North Carolina, Emory University, the University of Michigan, San Diego State University, the University of Pennsylvania, and the London School of Hygiene and Tropical Medicine. The discrepancy highlights missed opportunities in strategic partnerships between high-income and low-income countries. The results further demonstrate that machine learning and health technologies enhance the effective and efficient implementation of innovative HIV testing methods, including HIV self-testing among priority populations. Conclusions: This study identifies trends and hotspots of machine learning and health technology research in relation to HIV testing across various countries, institutions, journals, and authors. The trends are higher in high-income countries with a greater focus on technology applications for HIV self-testing among young people and priority populations. These insights will inform future researchers about the dynamics of research outputs and help them make scholarly decisions to address research gaps in this field.
Inductive content analysis (ICA), or qualitative content analysis, is a method of qualitative data analysis well-suited to use in health-related research, particularly in relatively small-scale, non-complex research done by health professionals undertaking research-focused degree courses. For those new to qualitative research, the methodological literature on ICA can be difficult to navigate, as it employs a wide variety of terminology and gives a number of different descriptions of when and how to carry it out.In this article, we describe in plain language what ICA is, highlight how it differs from deductive content analysis and thematic analysis, and discuss the key aspects to consider when making decisions about employing ICA in qualitative research. Using a study investigating practices and views around genetic testing in children as an example, we provide a clear step-by-step account of analysing text using ICA. Clear guidance on ICA will be useful for beginning researchers, especially those more familiar with quantitative biomedical and behavioural research, and for their academic and professional supervisors.
BACKGROUND: Due to the widespread and unprecedented popularity of mobile phones, the use of digital medicine and mobile health apps has seen significant growth. Mobile health apps have tremendous potential for monitoring and treating diseases, improving patient care, and promoting health. OBJECTIVE: This paper aims to explore research trends, coauthorship networks, and the research hot spots of mobile health app research. METHODS: Publications related to mobile health apps were retrieved and extracted from the Web of Science database with no language restrictions. Bibliographic Item Co-Occurrence Matrix Builder was employed to extract bibliographic information (publication year and journal source) and perform a descriptive analysis. We then used the VOSviewer (Leiden University) tool to construct and visualize the co-occurrence networks of researchers, research institutions, countries/regions, citations, and keywords. RESULTS: We retrieved 2802 research papers on mobile health apps published from 2000 to 2019. The number of annual publications increased over the past 19 years. JMIR mHealth and uHealth (323/2802, 11.53%), Journal of Medical Internet Research (106/2802, 3.78%), and JMIR Research Protocols (82/2802, 2.93%) were the most common journals for these publications. The United States (1186/2802, 42.33%), England (235/2802, 8.39%), Australia (215/2802, 7.67%), and Canada (112/2802, 4.00%) were the most productive countries of origin. The University of California San Francisco, the University of Washington, and the University of Toronto were the most productive institutions. As for the authors' contributions, Schnall R, Kuhn E, Lopez-Coronado M, and Kim J were the most active researchers. The co-occurrence cluster analysis of the top 100 keywords forms 5 clusters: (1) the technology and system development of mobile health apps; (2) mobile health apps for mental health; (3) mobile health apps in telemedicine, chronic disease, and medication adherence management; (4) mobile health apps in health behavior and health promotion; and (5) mobile health apps in disease prevention via the internet. CONCLUSIONS: We summarize the recent advances in mobile health app research and shed light on their research frontier, trends, and hot topics through bibliometric analysis and network visualization. These findings may provide valuable guidance on future research directions and perspectives in this rapidly developing field.
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BACKGROUND: Many implementation efforts fail, even with highly developed plans for execution, because contextual factors can be powerful forces working against implementation in the real world. The Consolidated Framework for Implementation Research (CFIR) is one of the most commonly used determinant frameworks to assess these contextual factors; however, it has been over 10 years since publication and there is a need for updates. The purpose of this project was to elicit feedback from experienced CFIR users to inform updates to the framework. METHODS: User feedback was obtained from two sources: (1) a literature review with a systematic search; and (2) a survey of authors who used the CFIR in a published study. Data were combined across both sources and reviewed to identify themes; a consensus approach was used to finalize all CFIR updates. The VA Ann Arbor Healthcare System IRB declared this study exempt from the requirements of 38 CFR 16 based on category 2. RESULTS: The systematic search yielded 376 articles that contained the CFIR in the title and/or abstract and 334 unique authors with contact information; 59 articles included feedback on the CFIR. Forty percent (n = 134/334) of authors completed the survey. The CFIR received positive ratings on most framework sensibility items (e.g., applicability, usability), but respondents also provided recommendations for changes. Overall, updates to the CFIR include revisions to existing domains and constructs as well as the addition, removal, or relocation of constructs. These changes address important critiques of the CFIR, including better centering innovation recipients and adding determinants to equity in implementation. CONCLUSION: The updates in the CFIR reflect feedback from a growing community of CFIR users. Although there are many updates, constructs can be mapped back to the original CFIR to ensure longitudinal consistency. We encourage users to continue critiquing the CFIR, facilitating the evolution of the framework as implementation science advances.
In the chaotic first moments after the Big Bang, ripples in spacetime may have done more than just echo through the cosmos—they could have helped create dark matter itself。 New research suggests that faint, ancient gravitational waves might have transformed into particles that eventually became the invisible substance shaping galaxies today
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Two of the most dangerous fault systems on the U。 West Coast may be more connected than scientists once thought。 New research suggests the Cascadia subduction zone and the San Andreas fault can “sync up,” triggering earthquakes within minutes or hours of each other