Knowledge is power: improving outcomes for patients, partners, and professionals in the digital age

Purpose The aim of this research was to develop and evaluate methods to address poor knowledge of hearing aids, hearing loss, and communication in patients, partners, and nonaudiologic health and social care professionals. Method An interactive multimedia educational program (C2Hear) has been co-produced with hearing aid users and audiologists to provide high-quality information and demonstrate complex concepts relating to hearing aids and communication. Results A randomized controlled trial showed numerous benefits for first-time hearing aid users that included better knowledge and skill, and increased hearing aid use and satisfaction. Patients reported that C2Hear was highly useful, enjoyable, and preferable to written information. C2Hear Online is now freely available on YouTube and has global reach, well in excess of 150,000 views. Further developments include a version for communication partners, which showed that joint-working between hearing aid users and their communication partners resulted in joint responsibility for communication that facilitated communication behaviors. In addition, a behavior theory-driven version for use with mobile technologies (m2Hear) has been designed to be tailored to the needs of individual hearing aid users. m2Hear includes more activities/interaction to maximize user engagement and learning. Finally, C2Hear has been used to improve hearing-related knowledge in other health and social care professionals, such as carehome assistants. Conclusion This range of educational programs and tools aims to improve knowledge and skills, leading to better outcomes for patients, partners, and health care professionals

Service-Oriented Framework for Developing Interoperable e-Health Systems in a Low-Income Country

e-Health solutions in low-income countries are fragmented, address institution-specific needs, and do little to address the strategic need for inter-institutional exchange of health data. Although various e-health interoperability frameworks exist, contextual factors often hinder their effective adoption in low-income countries. This underlines the need to investigate such factors and to use findings to adapt existing e-health interoperability models. Following a design science approach, this research involved conducting an exploratory survey among 90 medical and Information Technology personnel from 67 health facilities in Uganda. Findings were used to derive requirements for e-health interoperability, and to orchestrate elements of a service oriented framework for developing interoperable e-health systems in a low-income country (SOFIEH). A service-oriented approach yields reusable, flexible, robust, and interoperable services that support communication through well-defined interfaces. SOFIEH was evaluated using structured walkthroughs, and findings indicate that it scored well regarding applicability, usability, and understandability

CorpOperatio: Game-inspired App for Encouraging Outdoor Physical Activity for People with Intellectual Disabilities

This thesis presents a serious mobile exergame for people with intellectual disabilities, to help people with intellectual disability be more physically active. Exergames are games with the purpose of physically engaging the user in the gameplay, and intervenes with sedentariness and repetitive behavior. The game is based around the use of augmented reality, which is described as bringing 3D virtual objects into a 3D real environment in real time. As the field of physical activity in people with intellectual disabilities is a low-research field, the project aims to create a technical solution to them improve their physical health. There are few solutions tailored for people with intellectual disabilities to aid in physical exercise, something we wanted to change. A physical activity mobile game was created using the Unity game engine and augmented reality. Requirements and design choices came through literature review, reference meetings and meetings with professional psychologists. The game was tested by intellectually disabled users in a controlled, randomized trial over the course of four days, with interviews after testing to get results. While evaluation of the application rvealed areas of potential improvement, the application is already usable for people with intellectual disabilities. Augmented reality proved to be challenging to understand initially, but also fun, once the concept was understood. We have created an application for encouraging physical activity for people with intellectual disabilities. The application shows promise, but also improvement points for it to be deployed to the public market

Investigating usability of mobile health applications in Bangladesh

Background Lack of usability can be a major barrier for the rapid adoption of mobile services. Therefore, the purpose of this paper is to investigate the usability of Mobile Health applications in Bangladesh. Method We followed a 3-stage approach in our research. First, we conducted a keyword-based application search in the popular app stores. We followed the affinity diagram approach and clustered the found applications into nine groups. Second, we randomly selected four apps from each group (36 apps in total) and conducted a heuristic evaluation. Finally, we selected the highest downloaded app from each group and conducted user studies with 30 participants. Results We found 61% usability problems are catastrophe or major in nature from heuristic inspection. The most (21%) violated heuristic is aesthetic and minimalist design. The user studies revealed low System Usability Scale (SUS) scores for those apps that had a high number of usability problems based on the heuristic evaluation. Thus, the results of heuristic evaluation and user studies complement each other. Conclusion Overall, the findings suggest that the usability of the mobile health apps in Bangladesh is not satisfactory in general and could be a potential barrier for wider adoption of mobile health services

Leveraging Digital Technologies for Management of Peripartum Depression to Mitigate Health Disparities

Health disparities are adverse, preventable differences in health outcomes that affect disadvantaged populations. Examples of health disparities can be seen in the condition of peripartum depression (PPD), a mood disorder affecting approximately 10-15% of peripartum women. For example, Hispanic and African-American women are less likely to start or continue PPD treatment. Digital health technologies have emerged as practical solutions for PPD care and self-management. However, existing digital solutions lack an incorporation of behavior theory and distinctive information needs based on women’s personal, social, and clinical profiles. Bridging this gap, I adapt Digilego, an integrative digital health development framework consisting of: a) mixed-methods user needs analysis, (b) behavior and health literacy theory mapping, and (c) content and feature engineering specifications for future programmatic development, to address health disparities. This enhanced framework is then used to design and develop a digital platform (MomMind) for PPD prevention among women in their peripartum period. This platform contains a digital journal, social forum, a library repository of PPD patient education materials, and a repository of PPD self-monitoring surveys. In line with the existing Digilego digital health framework, throughout my iterative process of design and development, I gather design insights from my target population (n=19) and their health providers (n=9) using qualitative research methods (e.g., interviews) and secondary analysis of peer interactions in two PPD online forums (n=55,301 posts from 9,364 users spanning years 2008-2022). These multimodal needs gathering efforts allowed me to a) compile women’s information and technology needs, and b) utilize them as a guide for MomMind intervention development and evaluation. One key MomMind strength is its grounding in theory-driven behavior change techniques (e.g., shaping knowledge) and patient engagement features (e.g., electronic questionnaires) as facilitated by Digilego. Also, I extend Digilego by incorporating literacy domains (e.g., health literacy) and cognitive processes (e.g., understanding) from the eHealth literacy framework into my content engineering approach. After an in-house usability assessment, I conducted a pilot acceptability evaluation of MomMind using cross-sectional acceptability surveys and PPD health literacy surveys administered pre-and-post use of MomMind. Interviews were also conducted to assess participant’s personal opinions and feedback. The study sample included n=30 peripartum women, of whom 16 (53.3%) were Hispanic and 17 (56.7%) were in low-income ranges. A total of 29/30 (96.6%) participants approved of MomMind, 28/30 (93.3%) deemed it a good fit, and 29/30 (96.67%) deemed it easy to use. Participants showed statistically significant improvement (

Five key strategic priorities of integrating patient generated health data into United Kingdom electronic health records

The integration of patient/person generated health data into clinical applications is a key strategic priority internationally. However, despite agreement on the overall direction of travel, there are still a range of challenges that inhibit progress in this area. These include technology-related factors (such as interoperability), use-related factors (such as data overload) and characteristics of the strategic environment (such as existing standards). Building on important policy deliberations from the United States that aim to navigate these challenges, we here apply emerging policy frameworks to the United Kingdom and outline five key priority areas that are intended to help policy makers make important strategic decisions in attempting to integrate patient/person generated data into electronic health records

Achieving Adaptive Augmented Reality through Ontological Context-Awareness applied to AAL Scenarios

This paper presents a proposal for supporting daily user needs by simple interactions with the environment through an augmented-reality perspective that applies proactive adaptation through knowledge representation using ontologies. The proposed architecture (i-ARA) uses principles of the Semantic Web that endow context-awareness and user personalization. In addition, these types of services allow the supervision and management of what is happening in the environment and, consequently, improve the information offered to users. The architecture has been used to implement applications using iPhone technology and has been applied to illustrative scenarios, including Ambient Assisted Living.This paper presents a proposal for supporting daily user needs by simple interactions with the environment through an augmented-reality perspective that applies proactive adaptation through knowledge representation using ontologies. The proposed architecture (i-ARA) uses principles of the Semantic Web that endow context-awareness and user personalization. In addition, these types of services allow the supervision and management of what is happening in the environment and, consequently, improve the information offered to users. The architecture has been used to implement applications using iPhone technology and has been applied to illustrative scenarios, including Ambient Assisted Living

Ontological Context-Awareness for Adaptive Augmented Reality

This paper presents a proposal for supporting daily user needs by simple interactions with the environment through an augmented-reality perspective and applying proactive adaptation through knowledge representation using ontologies. The proposed architecture (i-ARA) makes use of principles of Semantic Web that endow context-awareness and user personalization. In addition, this kind of services allows the supervision and management of what is happening at the environment and, in consequence, to improve information offered to users. The architecture has been used to implement applications using iPhone technology and applied to illustrative scenarios.This paper presents a proposal for supporting daily user needs by simple interactions with the environment through an augmented-reality perspective and applying proactive adaptation through knowledge representation using ontologies. The proposed architecture (i-ARA) makes use of principles of Semantic Web that endow context-awareness and user personalization. In addition, this kind of services allows the supervision and management of what is happening at the environment and, in consequence, to improve information offered to users. The architecture has been used to implement applications using iPhone technology and applied to illustrative scenarios

Easing the Creation Process of Mobile Applications for Non-Technical Users

In this day and age, the mobile phone is becoming one of the most indispensable personal computing device. People no longer use it just for communication (i.e. calling, sending messages) but also for other aspects of their lives as well. Because of this rise in demand for different and innovative applications, mobile companies (i.e. mobile handset manufacturers and mobile network providers) and organizations have realized the power of collaborative software development and have changed their business strategy. Instead of hiring specific organizations to do programming, they are now opening up their APIs and tools to allow ordinary people create their own mobile applications either for personal use or for profit. However, the problem with this approach is that there are people who might have nice ideas of their own but do not possess the technical expertise in order to create applications implementing these ideas. The goal of this research is to find ways to simplify the creation of mobile applications for non-technical people by applying model-driven software development particularly domain-specific modeling combined with techniques from the field of human-computer interaction (HCI) particularly iterative, user-centered system design. As proof of concept, we concentrate on the development of applications in the domain of mHealth and use the Android Framework as the target platform for code generation. The iterative user-centered design and development of the front-end tool which is called the Mobia Modeler, led us to eventually create a tool that features a configurable-component based design and integrated modeless environment to simplify the different development tasks of end-users. The Mobia models feature both constructs specialized for specific domains (e.g. sensor component, special component ), and also those that are applicable to any type of domain (e.g. structure component, basic component ). In order to accommodate different needs of end-users, a clear separation between the front-end tools (i.e. Mobia Modeler ) and the underlying code generator (i.e. Mobia Processor ) is recommended as long as there is a consistent model in between, that serves as a bridge between the different tools