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Purpose: This review aims to examine how the use of voice assistants influences loneliness in older adults., Materials and methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as CINAHL, APA PsycINFO, MEDLINE, PubMed, Web of Science, ScienceDirect, Scopus, SciELO, Google Scholar, and IEEE Xplore were used. We implemented search strategies in English to locate studies published between January 2010 and January 2023, including those examining the impact of voice assistant usage on loneliness in older adults. Descriptive information was examined, assessing its quality with the Mixed Methods Appraisal Tool., Results: A total of 499 studies were yielded from the initial search, with 13 included in the final analysis. Positive outcomes in reducing loneliness were reported in 84.6% of these studies. There was a prevalence of quasi-experimental studies, alongside heterogeneous measurement instruments, scarce use of standardized tests, and small samples predominantly consisting of women. Commercial voice assistants were the most commonly utilized., Conclusions: Voice assistants show potential in mitigating feelings of loneliness in older adults. Adequate training and adaptation to specific needs seem essential to maximize their effectiveness. In particular, voice assistants available in the consumer market hold significant potential in this area. Further research is necessary to comprehend their impact, encompassing potential risks and ethical considerations.

Background: The rise of digital health services, especially following the outbreak of COVID-19, has led to a need for health literacy policies that respond to people's needs. Spain is a country with a highly developed digital health infrastructure, but there are currently no tools available to measure digital health literacy fully. A well-thought-through questionnaire with strong psychometric properties such as the eHealth Literacy Questionnaire (eHLQ) is important to assess people's eHealth literacy levels, especially in the context of a fast-growing field such as digital health., Objective: This study aims to adapt the eHLQ and gather evidence of its psychometric quality in 2 of Spain's official languages: Spanish and Catalan., Methods: A systematic cultural adaptation process was followed. Data from Spanish-speaking (n=400) and Catalan-speaking (n=400) people were collected. Confirmatory factor analysis was used to confirm the previously established factor structure. For reliability, the Cronbach α and categorical ω were obtained for every subscale. Evidence of convergent and discriminant validity was provided through the correlation with the total score of the eHealth Literacy Scale. Evidence based on relations to other variables was evaluated by examining extreme values for educational level, socioeconomic level, and use of technology variables., Results: Regarding the confirmatory factor analysis, the 7-factor correlated model and the 7 one-factor models had adequate goodness-of-fit indexes for both Spanish and Catalan. Moreover, measurement invariance was established between the Spanish and Catalan versions. Reliability estimates were considered adequate as all the scales in both versions had values of >0.80. For convergent and discriminant validity evidence, the eHealth Literacy Scale showed moderate correlation with eHLQ scales in both versions (Spanish: range 0.57-0.76 and P<.001; Catalan: range 0.41-0.64 and P<.001). According to the relationship with external variables, all the eHLQ scales in both languages could discriminate between the maximum and minimum categories in level of education, socioeconomic level, and level of technology use., Conclusions: The Spanish and Catalan versions of the eHLQ appear to be psychometrically sound questionnaires for assessing digital health literacy. They could both be useful tools in Spain and Catalonia for researchers, policy makers, and health service managers to explore people's needs, skills, and competencies and provide interesting insights into their interactions and engagement regarding their own experiences with digital health services, especially in the context of digital health growth in Spain., (©Eulàlia Hernández Encuentra, Noemí Robles, Ariadna Angulo-Brunet, David Cullen, Ignacio del Arco. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 10.05.2024.)

Aim: To describe the development of a mobile health application -mICardiApp- designed by a multidisciplinary professional team and patients with heart failure and to evaluate its content validity., Methods: Critical reviews of the literature, semi-structured interviews with patients, and user stories guided the development of the content of the mobile application. These contents were refined and validated through a modified Delphi process. An expert panel of healthcare and social care professionals together with patients and academics evaluated the content through two content validity indicators, relevance, and adequacy, and provided narrative feedback. The content validity of the app and each screen was determined by calculating the Content Validity Index (CVI). Similarly, the Adequacy Index (AI) was analyzed., Results: The developed app is composed by 8 topics: (1) available resources, (2) cardiac rehabilitation, (3) control of signs and symptoms, (4) emotional support, (5) learning and having fun, (6) medication, (7) nutrition, and (8) physical activity. The results demonstrated high CVI of the screens and the full app. 57 of the 59 screens in the app reached an excellent CVI ≥ 0.70 for both relevance and adequacy, except for 2 screens. The CVI Average Method of the app was 0.851., Conclusions: mICardiApp is presented as an application to improve health literacy and self-management of patients with multimorbidity and heart failure, with proven validation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Despite Catalonia being an advanced region in terms of digital health adoption, the "Forum for Professional Dialogue" identified the need to improve information and communication technology (ICT) competences as one of the present and future challenges for health care professionals (HPs)., Objective: We aimed to validate the digital competence test developed ad hoc for this study and to measure the digital competence level of Catalan HPs to establish their current level as the baseline for designing a strategic training plan., Methods: An exploratory observational study was conducted based on a voluntary survey where sociodemographic, professional and digital tool knowledge, digital tool use, and training needs data were collected and based on the score obtained from a digital competence test developed ad hoc. The digital competence test consisted of 2 "real-life scenarios" with 7 and 11 questions., Results: In total, 803 HPs, of whom 612 (76.2%) were women, completed the survey between June 28 and July 16, 2021. Most participants self-rated their digital competence level as either intermediate (384/803, 47.8%) or basic (357/803, 44.5%). The mean score in the digital competence test was 22.6 (SD 4.3). Therefore, most participants displayed a basic level of digital competence. The internal consistency of the digital competence test was 0.66, and the discrimination index of all questions was ≥0.2 for all items except for 1 question., Conclusions: This exploratory study highlights the need to improve the digital competence of HPs working in Catalonia, with special effort being made to provide training according to the specific needs of the different HP profiles. The results have informed the Health Plan for Catalonia 2021-2025 and lay the foundations for the development and deployment of a framework program for the digital competences of HPs. The developed digital competence test shows acceptable consistency for the objective pursued, although improvements are needed to fine-tune its accuracy., (©Elisenda Reixach, Erik Andrés, Josuè Sallent Ribes, Montserrat Gea-Sánchez, Alícia Àvila López, Bea Cruañas, Anna González Abad, Ricard Faura, Montse Guitert, Teresa Romeu, Eulàlia Hernández-Encuentra, Sandra Bravo-Ramirez, Francesc Saigí-Rubió. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 30.11.2022.)