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Background: Good preconception health reduces the incidence of preventable morbidity and mortality for women, their babies, and future generations. In Australia, there is a need to increase health literacy and awareness about the importance of good preconception health. Digital health tools are a possible enabler to increase this awareness at a population level. The Healthy Conception Tool (HCT) is an existing web-based, preconception health self-assessment tool, that has been developed by academics and clinicians., Objective: This study aims to optimize the HCT and to seek user feedback to increase the engagement and impact of the tool., Methods: In-depth interviews were held with women and men aged 18-41 years, who spoke and read English and were residing in Australia. Interview transcripts were analyzed, and findings were used to inform an enhanced HCT prototype. This prototype underwent user-experience testing and feedback from users to inform a final round of design changes to the tool., Results: A total of 20 women and 5 men were interviewed; all wanted a tool that was quick and easy to use with personalized results. Almost all participants were unfamiliar with the term "preconception care" and stated they would not have found this tool on the internet with its current title. User-experience testing with 6 women and 5 men identified 11 usability issues. These informed further changes to the tool's title, the information on how to use the tool, and the presentation of results., Conclusions: Web-based self-assessment tools need to be easy to find and should communicate health messages effectively. End users' feedback informed changes to improve the tool's acceptability, engagement, and impact. We expect that the revised tool will have greater reach and prompt more people to prepare well for pregnancy., (© Edwina Dorney, Karin Hammarberg, Raymond Rodgers, Kirsten I Black. Originally published in JMIR Human Factors (https://humanfactors.jmir.org).)

Background: The COVID-19 pandemic has sped up the implementation of telehealth solutions in medicine. A few symptom checkers dedicated for COVID-19 have been described, but it remains unclear whether and how they can affect patients and health systems. Objective: This paper demonstrates our experiences with the COVID-19 risk assessment (CRA) tool. We tried to determine who the user of the web-based COVID-19 triage app is and compare this group with patients in the infectious diseases ward's admission room to evaluate who could benefit from implementing the COVID-19 online symptom checker as a remote triage solution. Methods: We analyzed the answers of 248,862 people interacting with an online World Health Organization-based triage tool for assessing the probability of SARS-CoV-2 infection. These users filled in an online questionnaire between April 7 and August 6, 2020. Based on the presented symptoms, risk factors, and demographics, the tool assessed whether the user's answers were suggestive of COVID-19 and recommended appropriate action. Subsequently, we compared the sociodemographic and clinical characteristics of tool users with patients admitted to the Infectious Diseases Admission Room of J. Gromkowski Hospital in Wrocław. Results: The CRA tool tended to be used by asymptomatic or oligosymptomatic individuals (171,226 [68.80%] of all users). Most users were young (162,432 [65.27%] were below 40 years of age) and without comorbidities. Only 77,645 (31.20%) of the self-assessment app users were suspected of COVID-19 based on their reported symptoms. On the contrary, most admission room patients were symptomatic--symptoms such as fever, cough, and dyspnea were prevalent in both COVID-19-positive and COVID-19-negative patients. COVID-19-suspected patients in the CRA tool group presented similar COVID-19 symptoms as those who presented to the admission room. These were cough (25,062/40,007 [62.64%] in the CRA tool group vs 138/232 [59.48%] in the admission room group), fever (23,123/40,007 [57.80%] in the CRA tool group vs 146/232 [62.93%] in the admission room group), and shortness of breath (15,157/40,007 [37.89%] in the CRA tool group vs 87/232 [37.50%] in the admission room group). Conclusions: The comparison between the symptomatology of the users interacting with the CRA tool and those visiting the admission room revealed 2 major patient groups who could have benefited from the implementation of the self-assessment app in preclinical triage settings. The primary users of the CRA tool were young, oligosymptomatic individuals looking for screening for COVID-19 and reassurance early in the COVID-19 pandemic. The other group were users presenting the typical symptoms suggestive of COVID-19 at that time. The CRA tool recognized these individuals as potentially COVID-19 positive and directed them to the proper level of care. These use cases fulfil the idea of preclinical triage; however, the accuracy and influence on health care must be examined in the clinical setting. [ABSTRACT FROM AUTHOR]