Usability and acceptability of a mobile app for behavior change and to improve immunization coverage among children in Pakistan: A mixed-methods study

Background: Pakistan\u27s immunization uptake rates are still significantly lower than anticipated despite several initiatives. Lack of awareness, forgetting about vaccination schedule, and vaccine misconception/misinformation are a few of the major drivers that mitigate the rates of immunization. The current COVID-19 pandemic emphasizes the importance of immunization. The significant reductions in regular childhood vaccination during pandemic have increased the risk of outbreaks of vaccine-preventable diseases. Concerns among parents over possibly exposing their children to COVID-19 during child visits may have contributed to the reported declines. Innovative and cost-effective mHealth interventions must be implemented in order to address the problem of inadequate immunization rates. In addition, it is also critical to understand the end user needs in order to reflect on the highly relevant essence of the customized healthcare experience.Objective: The aim of this study was to learn about caregivers\u27 attitudes toward the usability and acceptability of behavior-change smartphone applications (mobile phones) for improving immunization coverage in Pakistan.Methods: A mixed-method design was employed for this study. The study was conducted at Aga Khan University, Hospital. Parents visiting the Community Health Center for 6-week vaccination of their children were recruited. The study was conducted in two stages. Stage 1 consisted of qualitative interviews that grasped the parent\u27s attitudes and challenges to immunization, as well as their acceptability and accessibility of the smartphone-based behavior-change application to increase vaccine uptake. Stage 1 was followed by stage 2, in which data were collected through a questionnaire designed by using data from qualitative interviews.Results: The majority of participants agreed that immunization serves an important role in protecting their child from illnesses that cause morbidity and mortality. Almost all of them emphasized the importance of using a pre-appointment method at vaccination center in order to reduce the waiting time. Furthermore, participants were also interested in AI-based behavior modification applications related to immunization. They also wanted to have applications in their native language for better understanding and communication of related information. In our study, approximately 95.2 percent of participants agreed to accept SMS immunization updates, which was also reasonably high. Lastly, the majority of them identified forgetfulness as a significant contributor to regular immunization.Conclusion: To enhance the uptake of childhood vaccines, overall vaccination rates, and overcome barriers related to vaccination coverage, cost-effective and user-friendly mHealth AI-based smart phone applications are required to raise awareness regarding the continuation of vaccination service and the importance of timely vaccination. Parents\u27 experiences and attitudes must be considered while designing and evaluating the efficacy of mHealth-based interventions

Relationship between Socioeconomic Inequalities and Oral Hygiene Indicators in Private and Public Schools in Karachi: An Observational Study

Background: The study investigated the relationship between socioeconomic status and oral hygiene indicators in two schools located in Karachi, Pakistan. Oral hygiene indicators of public and private school children were compared. Private schools cater to children of relatively wealthier families compared to public school, whose attendees are generally children from less affluent backgrounds. The aim of this study was to determine whether socio-economic differences and inequalities have an impact on key oral hygiene indicators. Methodology: Primary data for this research was collected from community school visits conducted by the community dentistry department of Jinnah Medical and Dental and Medical College from January to September 2019. A convenience sample of the two schools, comprising 300 school students was selected. Data was collected using modified World Health Organization (WHO) oral health care forms. A pre-tested/customized dental hygiene form based on WHO forms was created by the research team. This form was used to measure DMFT/dmft scores and key oral hygiene indicators in the sample. Results: A total sample size of 300 school-children affiliated with public and private schools was selected. The children’s age ranged from 2 to 18 years. The mean DMFT scores of private and public-school children were not significantly different (private (1.82) vs. public (1.48)). (p = 0.257). The mean of carious teeth was 1.69 in private school children compared to 1.34 in government school children, whereas the mean values of other key indicators of oral hygiene including plaque deposition (p = 0.001), dental stains (p < 0.001) and bleeding gums/gingivitis (p < 0.001), were statistically significant between public and private school children. Conclusion: Oral health inequalities can be reduced with increased awareness and public funding to cater for the oral health needs of children of less affluent families. A dynamic and practical community-oriented program is fundamental for enhancing pediatric oral hygiene status, particularly for children attending government schools

Clinician satisfaction and experience using teleconsultation during the COVID-19 pandemic in Pakistan: A cross-sectional study

Aims: During the pandemic of COVID-19, the sudden change in traditional health-care providing systems, clinicians experience some positive and negative aspects of the approach. This study evaluates the clinician's satisfaction and experience with the use of teleconsultation provided during the pandemic of novel coronavirus and their willingness to continue telehealth after the pandemic. Materials and Methods: A cross-sectional survey was conducted online during the peak pandemic of COVID-19 in Pakistan through Google Forms questionnaire from 115 health consultants on different disciplines and recruited through social media. The questionnaire contains 15 questions regarding clinician's satisfaction, quality of treatment, and intention to continue providing telehealth services after the pandemic. Descriptive and inferential statistics were obtained by analyzing the data using SPSS software version 20, USA. Results: One hundred and fifteen consultants, 28 males and 87 females participated in the study, in which 62% were found to have an average and 34% at a high level of satisfaction. The Kruskal–Wallis test showed a significant difference among different medical specialists in the continuation of telehealth services after the pandemic of COVID-19 (P = 0.003) and its recommendation to friends and family (P = 0.02) with high mean rank in endocrinologist and dermatologist. Conclusions: A great number of participants reported a good response for the continuation in telemedicine services in their daily routine even after the pandemic situation. However, there is an urgent need to find the solution for the difficulties and drawbacks faced by health-care providers

How does artificial intelligence impact digital healthcare initiatives? A review of AI applications in dental healthcare

The use of artificial intelligence (AI) technology in dentistry provides information that aids clinical decision-making by interpreting big data quickly. This study aims to systematically review the current role of AI in dentistry where it has a significant impact on clinical dentistry. Document collection was done from 1990 to 2022 based on the main themes of AI-assisted dentistry. This document extraction was done by utilizing PubMed, Embase, CINAHL, and Google Scholar libraries with different Medical Subject Headings (MeSH). This search result revealed different numbers of publications under the search terms AI in dentistry (N=1289), AI role in the diagnosis of dental caries (N=4), AI in dental diagnostic and treatment planning (N=68), AI and dental caries (N=76), the future of dentistry with AI (N=5), and Machine learning in dentistry (N=668). A fast-emerging technology like AI can certainly replace manual dexterity in dentistry. To reduce errors and oversight, these technologies must also be used with caution and under human supervision. The fastest and most accurate diagnosis of oral diseases leads to better outcomes for patients

The promise of telemedicine in Pakistan: A systematic review

Background: Telemedicine offers the possibility of provision of medical assistance to remote patients, and it has great potential in developing countries like Pakistan. Telemedicine solves logistical barriers, gives support to weak health systems, and helps to establish worldwide networks of healthcare professionals. Because of the high implementation costs, it is not possible yet to adopt telehealth systems for low- and middle-income nations. Objective: To present a revision of region-based telemedical services in Pakistan. Methods: Libraries such as PubMed (Medline), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Scopus (EMBASE), and Google Scholar were used for document search. Newcastle-Ottawa Scale (NOS) was adopted to conduct study quality. Many of the studies (n-8) included in the review were of high quality as assessed through the Newcastle-Ottawa scale. Selected study characteristics were further analyzed based on different parameters such as publication year, sample size, study design, methods, motivation, and outcomes. Results: Search produced 955 articles and 11 items were ultimately selected to conduct the review. These studies were further characterized as region-based telemedicine implementation. Out of 11, eight studies were conducted in the urban region and three studies were conducted in the rural areas of Pakistan. Many studies produced evidence on telehealth interventions by smartphone services such as SMS, apps, and web-based telemedicine. Conclusions: Telehealth interventions such as mHealth, eHealth, telemedicine, and telepharmacy in Pakistan were introduced starting from the last two decades. For obtaining the full benefits of these technologies, it is necessary that they but certainly need to become an integral part of Pakistan\u27s current health infrastructure