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The potential of mobile health applications to improve healthcare outcomes and accessibility, particularly among older individuals, is significant. However, challenges such as small fonts, complex navigation, and unintuitive design hinder their effective use by older adults. Addressing these issues is crucial for ensuring equitable access to healthcare. This study aims to identify the unique difficulties older people face with mobile health apps and explore innovative ways to enhance usability and accessibility. Through design analysis and user testing, the research seeks to address these obstacles and propose solutions. The study examines usability issues and suggests a practical framework that integrates assistive technology and dynamic procurement processes to ensure the availability of user-friendly apps. Emphasizing the importance of user testing with older adults, the research offers actionable insights for improving the overall experience of seniors using mobile health apps. The framework provides practical solutions for resolving these problems, ultimately improving seniors' overall experience utilizing the system.

Executive function (EF) is a set of higher order cognitive processes through which learning and everyday goals are realised. They comprise the fundamental building blocks of how we plan, execute, monitor and regulate tasks, and impact our cognitive, socioemotional and behavioural responses. An important question to consider is how we can support children to develop effective EF skills through motivating and age-appropriate training. Virtual reality (VR) offers an interesting avenue to enhance motivation due to the experience of presence and immersion, however, whether children experience presence and immersion similarly to adults is unknown and could impact the educational utility of VR over other media. In order to understand whether VR is suitable for an educational setting we must understand the experience of key stakeholders, such as school-aged children and adults that will be facilitating use in the educational context. Therefore, the current study aims to understand the experience of key stakeholders using EF training delivered in a VR environment, to enable reflection on the feasibility and usability of the technology. This study aimed to explore the qualitative experiences of 8 primary school-aged children, 5 teachers and 13 training teaching assistants, after playing an EF training game, Koji's Quest, on a VR head mounted display. Firstly we found that most teachers and trainee teachers gave good ratings of usability, but in their subjective descriptions of use focused on hedonic experiences, whereas, children focused on pragmatic experiences. Results also indicate that adults may favour ‘being’ definitions of presence, whereas child participants appear to incorporate both ‘being’ and ‘doing’ definitions into their accounts. This research has implications for how VR based EF training can be maximised within an educational setting.

With the increasing expansion of creative computing courses among higher education institutions, there is a growing demand for more objective and efficient assessment frameworks that cater to the multidisciplinary skills that students engage in during the production of such work. This research addresses persistent gaps for a systematic approach of assessing creative content in technical courses. Existing theories are reviewed including creative requirements framework and computing production model, which leads to the establishment of a newly proposed assessment framework. A mixture of research methods is employed combining both inductive and deductive approaches, evidence- based analysis, and case study, based on data collected over three academic years at a British university. The proposed assessment framework incorporates three factors of production (function, usability, and management) and two attributes of creativity (core and optional requirements), which is evaluated to determine its suitability for accurately reflecting the work undertaken by students. Creativity is quantified in the assessment based on technical contribution. The proposed framework can be applied in the delivery of courses involving creative production in the computer science and engineering disciplines in which teaching usually focuses on technical content rather than contextual design, creativity, or aesthetics. The findings reveal positive feedback and a number of pertinent outcomes, including promoting creativity, student satisfaction, and efficient assessments. The framework may be adopted by educators for similar courses that are underpinned by technical skills and creativity.

Objective: The training of dietitians emphasizes the development of strong communication skills. Immersive virtual reality (IVR) has been successfully employed for various healthcare scenarios; however, it is yet understudied in dietetics education. Therefore, we conducted a feasibility study to investigate the usefulness of IVR for the purpose of communication skills training. Methods: We designed a multi-user virtual hospital environment that enabled the training of professional conversations between dietitians and patients. Divided into groups of three, 30 dietetics students participated in a role-play task. Taking a qualitative approach to inquiry, we evaluated how participants assessed the benefits and limitations of the IVR training. Results: Participants appreciated the authenticity of the training environment and mentioned various advantages of IVR (e.g., sense of privacy, better focus on conversation) over traditional modes of instruction. On the other side, participants frequently mentioned that the lack of avatars' facial expressions might present an obstacle for effective communication skills training. Conclusion: IVR enables authentic communication skills trainings for dietitians. Special consideration should be given to providing ample social cues during training. Innovation: The study demonstrates that the promising results from other healthcare professions regarding the usefulness of IVR training also apply to dietetics.

In the contemporary landscape of healthcare, the rapid integration of digital technologies is reshaping traditional practices. As healthcare systems increasingly embrace digitalization, there arises a critical need to comprehend the dynamic and ever-evolving role played by Information and Communication Technologies (ICTs). Amidst the rapid digitization of healthcare systems, understanding the evolving role of Information and Communication Technologies (ICTs) is paramount. This study explores the impact of Information and Communication Technologies (ICTs) on healthcare, with a focus on Health Information Technology (HIT) and its role in enhancing patient-centered care. Specifically, the research centers on Personal Health Records (PHRs), which empower patients to control their health information securely. The study aims to identify key features influencing patients’ behavioral intention to adopt HIT, utilizing a structured questionnaire and a conceptual framework based on the Technology Acceptance Model (TAM). Feature selection analysis, conducted using the Weka tool, employed various classifiers to predict users’ perceptions and behavioral intentions towards HIT adoption. Results highlight the significance of trust, comfort, usefulness, and technophobia in shaping patients’ acceptance of HIT, with Random Forest and Bayes Net classifiers emerging as key predictors. This research provides valuable insights into the critical factors driving patients’ acceptance of HIT, contributing to the ongoing discourse on the adoption of healthcare technologies.

Cassava crop is in the forefront among the arable crops mostly cultivated in Nigeria. It is a crop that International Institute of Tropical Agriculture (IITA) have invested more efforts to develop mobile digital solutions for farmers to address some of the agronomic issues threatening its productivity. The ultimate aim of the digital solution is to bring innovations closer to farmers as well as to bring about the transformation needed to achieve food security in Africa. However, farmers’ (users) quality rating and usability of agricultural mobile apps remains uncertain thereby, creating knowledge gap. Feedbacks of users are critical to inform developers of the apps about necessary modifications. This study therefore examined the usability attributes of Agricultural Mobile Phone Applications (AMPAs) among cassava farmers in South-west Nigeria using users-centered approach. Because of the selected crop, apps evaluated in this study were Akilimo App, Airtel 4-21 call App and IITA herbicide calculator App. Akilimo App is an advisory tool that provides site-specific recommendations to cassava farmers in order to increase their cassava-based cropping systems; Airtel 4-2-1 call App provides a voice-based tutorial on cassava production, weather, education, rice amongst others by simply dialing 4-2-1 on any mobile phone with an Airtel sim card; while IITA herbicide is a mobile application developed to prevent herbicide abuse, such as over-dosing and/or under-dosing. Four hundred and ten (410) cassava farmers were recruited as respondents for the study. Data were analyzed using both descriptive and inferential statistics, including frequency counts, percentages, means and standard deviation. As the major contribution, it was shown for the first time, how users (farmers) rated the three Apps in terms of engagement, functionality, aesthetics, information quality, and subjective quality while usability of the Apps were rated for efficiency, effectiveness, satisfaction, learnability, memorability, cognitive load, accuracy and error. Similarly, pattern of usage, benefits of usage and constraints to usage of the Apps were further investigated.

Background: To promote physical activity in post-treatment cancer survivors, a mobile application WExercise was developed using the Multi-Process Action Control Framework. It contains 10 weekly online lesson to facilitate reflective, regulatory, and reflexive processes to help participants to form and sustain physical activity behavior. Objectives: To test the usability and acceptability of WExercise in post-treatment cancer survivors. Methods: This study involved four phases: (1) preparing application content, (2) expert panel review (comprising oncology healthcare workers, exercise specialists, and behavior change researchers), (3) developing the app, and (4) usability test. The usability test was conducted cross-sectionally using direct observation of application navigation tasks, a quantitative survey, and qualitative interviews among 10 post-treatment cancer survivors. Results: In Phase 2, the expert panel rated the application highly on relevance, accuracy, comprehensiveness, meaningfulness, and easiness to understand (average score = 3.83 out of 4). The application was developed accordingly. In Phase 4, the System Usability Score was 75 %, greater than the cut-off point. Participants gave the items assessing acceptance of the application positive ratings (e.g., satisfaction = 4.30 out of 5). Based on the performance and feedback, the application was modified, including adjusting the font size and improving the visualization of buttons. Conclusion: Overall, experts and potential users considered the application relevant, usable, and acceptable. It has the full potential for further testing in a larger trial for its effectiveness in promoting physical activity in cancer survivors.

This review explores the Metaverse, focusing on user perceptions and emphasizing the critical aspects of usability, social influence, and interoperability within this emerging digital ecosystem. By integrating various academic perspectives, this analysis highlights the Metaverse's significant impact across various sectors, emphasizing its potential to reshape digital interaction paradigms. The investigation reveals usability as a cornerstone for user engagement, demonstrating how social dynamics profoundly influence user behaviors and choices within virtual environments. Furthermore, the study outlines interoperability as a paramount challenge, advocating for establishing unified protocols and technologies to facilitate seamless experiences across disparate Metaverse platforms. It advocates for the adoption of inclusive, ergonomically oriented designs aimed at enhancing user participation. It addresses the ethical and societal challenges posed by the Metaverse, including concerns related to digital harassment, invasive marketing practices, and breaches of privacy. Additionally, the review identifies existing gaps in the literature, particularly regarding the Metaverse's implications for healthcare, its impact on educational outcomes, and the urgent need for empirical data concerning its long-term effects on user psychology and behavior.By providing a comprehensive synthesis of the current understanding of user experiences and challenges within the Metaverse, this paper contributes to the academic dialogue, laying the groundwork for future research initiatives. It aims to steer the development of the Metaverse towards a trajectory that is ethically sound, socially responsible, inclusive, and aligned with societal expectations, thereby fostering a digital realm that upholds the highest standards of integrity and inclusivity.

Background: To reduce the risk of errors, patient safety monitoring in the medical imaging department is crucial. Interventions are required and these can be provided as a framework for documenting, reporting, evaluating, and recognizing events that pose a threat to patient safety. The aim of this study was to develop minimum data set and dashboard for monitoring adverse events in radiology departments. Material and methods: This developmental research was conducted in multiple phases, including content determination using the Delphi technique; database designing using SQL Server; user interface (UI) building using PHP; and dashboard evaluation in three aspects: the accuracy of calculating; UI requirements; and usability. Results: This study identified 26 patient safety (PS) performance metrics and 110 PS-related significant data components organized into 14 major groupings as the system contents. The UI was built with three tabs: pre-procedure, intra-procedure, and post-procedure. The evaluation results proved the technical feasibility of the dashboard. Finally, the dashboard's usability was highly rated (76.3 out of 100). Conclusion: The dashboard can be used to supplement datasets to obtain a more accurate picture of the PS condition and to draw attention to characteristics that professionals might otherwise overlook or undervalue.

Climate change can significantly affect and influence, both positively and negatively, the wine sector. In this context, the adoption of timely, cost-effective adaptation strategies may contribute to reduce such risks, maximise opportunities, and enhancing the sector’s resilience to changing climatic conditions. Climate services involve the production and use of climate information to support decision-makers adapting to climate variability and change. Assessing the value and benefits of using climate services constitutes a critical area of research and can help climate service providers identify any barriers in their development, uptake, and use. The climate service developed in this research benefitted from a co-production approach with a Portuguese Wine company − SOGRAPE. In this paper, we aim to assess the usability and value of the climate service co-developed with SOGRAPE and identify possible barriers that limited the tool’s usability and value. Engagement with SOGRAPE users was pursued based on mixed methods approach throughout the various stages of co-development and testing of the tool. The results show that the data provided in the Dashboard was perceived as reliable and legitimate. However, the saliency of the Dashboard was questioned, and some recommendations proposed to increase its saliency and overall usability. More importantly, SOGRAPE users were not able to use the climate information provided in the tool due to a number of barriers which are also reported in this study. The findings and recommendations from this study will help inform the design, development and usability of other climate services within and beyond the wine sector.

Text-based CAPTCHA is widely used as an online security guard, requiring a user to input letters for classifying human and automated software (known as a bot). However, they are still a problem for usability and robustness. This study investigated the effect of letter spacing, disturbing line orientation and disturbing line color on user test and robustness of text-based CAPTCHA. The 240 CAPTCHAS were tested using Thai undergraduate students. The results show that there were no significant differences in user tests for the three factors. For robustness, disturbing line orientation had no significant difference. However, overlapping letter CAPTCHA was the most significantly robust. CAPTCHA with a disturbing line using the same color as the background was more significantly robust than that using the same color as the foreground. Moreover, if no-spacing letter is used, the effect of disturbing line color is statistically significant in robustness while the effect of that became insignificant when a spacing between letter and overlapping letter are used. We recommend that CAPTCHA with no spacing letter and combined with disturbing line using the same color as the background is suitable for users and its robustness. This can be concluded that letter segmenting technique is not too hard for users (passed 88 %) while it is not too easy for bot attacks (passed 39 %). In terms of security, more studies can still be carried on the CAPTCHA to enabled more robustness against new crime technologies. In terms of usability, on other age groups could be consider.

Background: As smartphone ownership has become common in all demographic groups in the United States, smartphone applications (apps) for smoking cessation have grown in popularity due to their potential for supporting the diverse populations in the United States who are attempting to quit smoking. Usability is commonly assessed in mobile health (mHealth) technology as an important aspect of the user experience that could influence users' adherence to a health app and health outcomes. However, the variation of perceived usability across demographic groups, and the implications of that variation for app success, have not been well studied. Objective: The aims of this study were to characterize variation in the perceived usability of the National Cancer Institute Smokefree.gov Initiative smoking cessation app quitSTART across demographic groups, and to assess the correlation between perceived usability and short-term smoking cessation. Methods: We conducted a secondary analysis of data from a randomized controlled trial conducted from 2020 to 2021, which used a 16-item modified version of the mHealth App Usability Questionnaire (MAUQ) to quantify perceived usability four weeks after app download among 131 smokers attempting to quit. Responses were coded on a 5-point Likert-type scale ranging from strongly disagree (1) to strongly agree (5) and total perceived usability was calculated as the sum of all 16 items (range: 16–80). Associations between participant demographic characteristics (gender, race, education level, age, etc.) and total usability were determined using an ANCOVA model. A multivariable logistic regression model was used to assess the association between usability and smoking cessation, also assessed 4 weeks after app download. Results: The ANCOVA model demonstrated that race was associated with perceived usability, with participants from a racial minority group reporting higher total usability than White participants (p

The Standardized User Experience Percentile Rank Questionnaire (SUPR-Q) is a user experience (UX) measure that is highly appropriate for assessing different transactional websites and mobile applications which have transactional capabilities, such as shopping and e-commerce services. SUPR-Q can also be applicable to websites and applications that have informational purposes such as news sites or Wiki platforms. The aim of this work was to adapt SUPR-Q cross-culturally to the Arabic language and to investigate the reliability and validity of the Arabic version of the SUPR-Q for Arabic-speaking users. The SUPR-Q was translated into Arabic and then back translated into English according to established guidelines. The Arabic adaption of SUPR-Q was evaluated by 147 respondents who were all users of SHEIN e-commerce shopping website. Psychometric evaluation of the translated scale was performed to assess its structure, validity, and reliability. The reliability coefficients of the four subscales ranged from 0.858 to 0.875, indicating high internal consistency. The Partial Least Squares based Confirmatory Factor Analysis (PLS-CFA) provided confirmatory evidence for the construct structure, validity, and the model fit, yielding conclusive results. Therefore, the Arabic version of the SUPR-Q was found to be a valid and reliable tool that can be used to assess user experiences among an Arabic-speaking population.

Wearable robots are increasingly being deployed for use in industrial fields. However, only a few studies have focused on the usability of wearable robots. The present study evaluated the factors affecting the usability of a harness in securing a wearable robot to the body because the harness directly affects the work efficiency, and thus its design and use require careful consideration. A comparative evaluation of the arrangement of the Vest Exoskeleton before and after improvements was conducted, in which participants performed a benchmark assembly task while wearing the robot. Results showed that wearability decreased after the improvements due to the additional straps and buckles used, but the overall wearing satisfaction improved as a result of increased stability. Stability and convenience were the main factors affecting the overall wearing satisfaction, while sub-indicators included wearing comfort and tactile sensation. Therefore, improvements in stability, such as those related to fixation strength and tactile sensation, had a direct positive impact on the overall wearing satisfaction.

Background: Electronic prescribing is vital in healthcare systems, providing an efficient alternative to manual prescriptions and addressing issues like errors in writing. This study evaluates Iran's Computerized Physician Order Entry (CPOE) system due to its significant role in the health system. Method: Conducted as a cross-sectional case study in 2023, this research targeted physicians and outpatient unit users in three hospitals affiliated with Kashan University of Medical Sciences. User satisfaction was assessed using the QUIS Questionnaire for user interaction satisfaction and the System Usability Scale (SUS) for overall usability. Statistical analysis included descriptive statistics, independent-sample t-tests, one-way ANOVA, and SUS questionnaire calculation via SPSS software. Result: The QUIS and SUS questionnaires revealed an overall user satisfaction range of 4.65 out of 9 for physicians and 5.73 out of 9 for outpatient unit users. The SUS questionnaire scored the CPOE system at 72 out of 100 for physicians and 76 out of 100 for outpatient unit users, indicating good usability. Conclusion: Iran's CPOE system received positive feedback, emphasizing ease of use, learnability, control, stimulation, and flexibility to user needs. While the evaluation was generally positive, there are areas for improvement. Future versions should address user demands, incorporate human-computer interaction principles, and rectify identified shortcomings for enhanced competency. Authorities should prioritize user-centric updates in the continuous development of the Iranian CPOE system.

Advances in mixed reality (MR) have led to the extensive use of technological forms in education and training, and there is evidence of MR's pedagogical effectiveness. Owing to its ability to foster learning, research on MR and its application in education are considered technological breakthroughs. Design education requires an environment that supports creative activities to help students improve their learning outcomes, making it an appropriate field to explore the incorporation of MR. This study developed a virtual learning environment based on Microsoft HoloLens 2, creating an MR educational setting that enhances design students' learning experience by combining a physical and a virtual environment. Additionally, the study evaluated the impact of MR environment interventions on the creative process and the effect of design students' creativity on the results. Employing an experimental research design, 24 design students were divided into control and experimental groups, each with an equal number of participants. Both groups completed a creative task, with the control group using a traditional creative environment and the latter using an MR creative environment. The experimental results showed that the MR environment is feasible for use in design education. Additionally, the creative outcomes of the experimental group were better than those of the control group, and the students who used the MR environment rated their creative experience more positively. For example, MR intervention stimulated students' personal engagement and learning motivation by providing them with more intelligent and multisensory 3D interactive information. The study also revealed that students' creative processes and outcomes benefited from the MR environment. We explored the advantages of MR educational environments in terms of expanding the environmental dimension in education and valuing the promotion of learners' capabilities, as well as the application of its future developments in education and beyond.

Exploring the usability of educational virtual reality (VR) is essential. Research in this area can explain the adoption of VR as a new technology, contribute to examining paths toward effective learning, and provide recommendations for effective educational design. This study investigated usability in a sample of N = 64 university students learning about simplified construction engineering topics from an interactive VR field trip. Two research objectives were pursued. First, the level of achieved usability was examined using a mixed-methods approach, including data from semi-structured interviews and a survey on system usability and satisfaction. Second, the relationships between several connected variables (ease of use, usefulness, presence, and cognitive load) and system usability and satisfaction were investigated quantitatively. With respect to the first research objective, system usability and satisfaction were evaluated positively in the interviews and rated highly in the surveys. These results indicate that VR field trips, which are increasingly replacing excursions, are regarded as an appropriate instructional method. Concerning the second research objective, ease of use, usefulness, presence, and extraneous load were found to predict system usability. Further, the factors of usefulness, presence, and intrinsic cognitive load helped explain the variance in satisfaction. These findings highlight that the variables connected to system usability and satisfaction in VR learning vary. In addition to these and other theoretical implications, practical implications and recommendations for educational design are discussed.

Safety training is an effective method to reduce safety issues. Immersive virtual reality (IVR) for safety training has gained attention in high-risk industries, but the trade-off between realism and abstraction in IVR-based training is not fully understood. This study investigated the impact of scenario and interaction fidelity on IVR-based forklift safety training, focusing on presence and usability. Scenario fidelity varied the Level of Development (LOD) in IVR model (high LOD vs. low LOD), while interaction fidelity varied the control interface (steering wheel and pedals vs. keyboard). A 2-by-2 experiment with 120 participants examined high/low scenario and interaction fidelity. Results showed scenario fidelity enhanced presence and usability significantly, while interaction fidelity had no effect. The realism of training scenarios is more influential for presence and immersion than control interface realism. These findings aim to balance IVR simulation fidelity and learning outcomes and help guide the development of cost-efficient IVR-based safety training.

Smart TV is a lean-back and shared device with diverse viewership, cultural acceptance, interaction modalities, input/output characteristics, and contextual use. Researchers, developers, and vendors constantly add new features and functionalities to its user interface (UI) to get higher market shares. However, the current smart TV UIs are static and follow a one-size-fits-all approach, where adding new features makes it cluttered and complex with limited learnability, usability, and greater cognitive overload. Another issue is the limited support for adaptive UIs to customize these features, functions, and services as per user needs. This article fills these gaps in the literature by designing a framework of personalized adaptive UIs for smart TV users capable of changing the UI layout and structure per the user needs and contextual details. The framework was tested on an Android-based smart TV and evaluated using a real-world dataset and an empirical study involving 75 household members in a mixed-mode questionnaire-based survey. The results were analyzed using Cronbach alpha, Kendall's tau-b, and principal component factor analysis. It was observed that personalized adaptive UIs are perceived positively in terms of attitude, usability, user experience, accessibility, learnability, user satisfaction, intension to use, and reduced cognitive overload.

Usability, or the ease with which something can be used, is a key aspect in ensuring end-users can achieve the best possible outcomes from a given educational resource. Ideally usability testing should take place iteratively throughout the design of the resource, and there are several approaches for undertaking usability testing described in the wider literature. Within radiation oncology education, the extent to which usability testing occurs remains unclear. This literature review aimed to assess current practice and provide a practical introduction to usability testing for educational resource design within radiation oncology.Two web databases were searched for articles describing planned or completed usability testing during the design of a radiation oncology educational resource. Fifteen studies were identified. Data was gathered describing the type of usability testing performed, the number of cycles of testing and the number of test subjects. Articles described design of educational resources for both patients and trainees, with the number of test subjects ranging from 8 to 18. Various testing methods were used, including questionnaires, think aloud studies and heuristic evaluation. Usability testing comprised a range of single cycle through to several rounds of testing.Through illustrative examples identified in the literature review, we demonstrate that usability testing is feasible and beneficial for educational resources varying in size and context. In doing so we hope to encourage radiation oncologists to incorporate usability testing into future educational resource design.

Background: Mobile healthcare apps have transformed the healthcare industry and these apps can now be used for educational and preventive purposes, as well as providing valuable information for self-care. Apps related to Parkinson's disease can help from diagnoses to treatment, however the purpose of the app in this study is to inform and to educate. Objective: To describe user appraisal of the refinement of a Parkinson's Disease app through a technical evaluation by researchers in the technological area of Human-computer Interaction HCI and usability from the perspective of the end user. Methods: Technological development research of heuristic evaluation and user experience study carried out for usability testing, where the profile of users were surveyed and usability was evaluated by HCI researchers and end users. Results: Parkinsonians with a recent diagnosis showed the greatest interest in the app. The final version of the app was ready after modifications proposed by experts and users. The app achieved an excellent usability rating, when rated on the Brooke scale in regard to user evaluation. Conclusion: Structured strategies to promote greater adherence contribute to increased usability, and may allow for greater autonomy in care and early identification of symptoms.

The present study aims to determine the importance weights of the subjective and objective usability criteria based on task and user by considering these criteria simultaneously in the usability analysis of web applications. In this context, by proposing a Multi-criteria Decision Making approach including Entropy-Rank Sum (RS) – Technique of Precise Order Preference (TPOP) integration, the Multi-Dimensional Usability Analysis (MDUA) approach was advanced. The proposed analysis approach was applied on MOODLE software selected as a sample web application. The objective criteria in the sample application were measured using the Morae V3 program as a result of users performing their predefined tasks, and the subjective criteria were evaluated by determining the importance orders of the criteria for each user that affect the users' satisfaction. Subsequently, objective criteria weights were calculated by the Entropy method on task basis, and subjective criteria weights were computed by the RS method on user basis. In the last stage, the weights of the objective criteria and the weights of the subjective criteria that change according to the user are combined separately using the TPOP method. Thus, the most important subjective and objective criteria for improving the usability of MOODLE LMS were determined.

Idiopathic Toe Walking is an atypical gait pattern that results in limited mobility, pain, and higher risk of falling. Current therapeutic interventions lack the ability to be implemented outside the clinic or lab. Beyond this, it is unclear if gait analysis and real-time feedback is technologically feasible to attain within a user's natural environment. In our research we aimed to understand the child and parent participants’ experience of an innovative wearable system. We surveyed children and parents after the deployment of a functional prototype with real time vibrotactile feedback for awareness of toe walking via a shoe insert paired with a smartphone for visual feedback. Findings revealed insights into design considerations for wearable technologies for children. Factors such as comfort of using the system (physically and psychologically), child's perception and response to the vibrotactile feedback, and children and parents’ perception of reduced fall risk, pain, and stigma are discussed.

The Internet of things (IoT) integrates heterogeneous computing devices, allowing each node to communicate with one another. However, the connected “things” raise security challenges that need protection for IoT devices from network-based attacks. As an integrated solution, Secure Swarm Toolkit (SST) provides authorization infrastructure that addresses the security requirements of IoT devices. The pre-release version of SST primarily provided the Node.js and JavaScript-based API for programming IoT nodes (network entities) using the SST’s infrastructure. This new release introduces easy-to-use C API functions, making SST more usable on bare-metal platforms such as embedded microcontrollers without middleware, including operating systems. In this paper, we release the first official version (v1.0.0) of SST and propose a new set of C API as a pluggable security solution for the IoT. Our new C API is easy to use and supports resource-constrained IoT systems such as bare-metal embedded computers where middleware or operating systems are unavailable. For evaluation, we present an example IoT system using SST in practical IoT environments with WiFi-connected embedded devices, providing essential security processes, authentication, and authorization, of IoT devices with a minimal execution-time overhead of less than 10% and linear communication overhead, compared to the system without any security. Thanks to the proposed C API, we expect SST to be applied to existing IoT software platforms more easily.

Introduction: The potential of patient symptoms being monitored longitudinally in radiotherapy (RT) is still unexploited. When novel technologies like online adaptive MR-guided radiotherapy (MRgRT) are evaluated, weekly electronic patient-reported outcomes (ePROs) may add knowledge about the symptom trajectory. This study aimed at evaluating feasibility, usability and acceptance of weekly ePRO among patients receiving pelvic radiotherapy. Materials and Methods: In a mixed-methods convergent design, a prospective pilot study enrolled patients referred to pelvic radiotherapy with curative intent. Patients used their own device at home to self-report PRO weekly during and four weeks following radiotherapy and week 8, 12, and 24 (paper-questionnaire as an alternative). Feasibility was extracted from the ePRO software. The Patient Feedback Form and patient interviews were used to explore usability and patient acceptance. Patients were informed that clinicians had no access to PRO responses. Results: In total, 40 patients were included; 32 patients with prostate cancer and 8 with cervical cancer (consent rate 87%), median age 68 (36–76). The majority did digital reporting (93%). 85% of patients responded to ≥80% of the weekly questionnaires with 91% average adherence to weekly completion (60% for follow-up), although lower for patients ≥age 70. Time spent on ePRO (97%) and frequency of reporting (92%) was considered appropriate. Interviews (n = 14) revealed the application was usable and the patients requested real-time feedback from the clinicians. Conclusion: Recruitment for ePRO during radiotherapy was feasible and adherence to weekly self-reporting high. The digital application was usable and weekly frequency and time spent acceptable. Real-time feedback from the clinicians is requested by the patients.

Objective: To examine the data quality and usability of visual acuity (VA) data extracted from an electronic health record (EHR) system during ophthalmology encounters and provide recommendations for consideration of relevant VA end points in retrospective analyses. Design: Retrospective, EHR data analysis. Participants: All patients with eyecare office encounters at any 1 of the 9 locations of a large academic medical center between August 1, 2013, and December 31, 2015. Methods: Data from 13 of the 21 VA fields (accounting for 93% VA data) in EHR encounters were extracted, categorized, recoded, and assessed for conformance and plausibility using an internal data dictionary, a 38-item listing of VA line measurements and observations including 28 line measurements (e.g., 20/30, 20/400) and 10 observations (e.g., no light perception). Entries were classified into usable and unusable data. Usable data were further categorized based on conformance to the internal data dictionary: (1) exact match; (2) conditional conformance, letter count (e.g., 20/30+2-3); (3) convertible conformance (e.g., 5/200 to 20/800); (4) plausible but cannot be conformed (e.g., 5/400). Data were deemed unusable when they were not plausible. Main Outcome Measures: Proportions of usable and unusable VA entries at the overall and subspecialty levels. Results: All VA data from 513 036 encounters representing 166 212 patients were included. Of the 1 573 643 VA entries, 1 438 661 (91.4%) contained usable data. There were 1 196 720 (76.0%) exact match (category 1), 185 692 (11.8%) conditional conformance (category 2), 40 270 (2.6%) convertible conformance (category 3), and 15 979 (1.0%) plausible but not conformed entries (category 4). Visual acuity entries during visits with providers from retina (17.5%), glaucoma (14.0%), neuro-ophthalmology (8.9%), and low vision (8.8%) had the highest rates of unusable data. Documented VA entries with providers from comprehensive eyecare (86.7%), oculoplastics (81.5%), and pediatrics/strabismus (78.6%) yielded the highest proportions of exact match with the data dictionary. Conclusions: Electronic health record VA data quality and usability vary across documented VA measures, observations, and eyecare subspecialty. We proposed a checklist of considerations and recommendations for planning, extracting, analyzing, and reporting retrospective study outcomes using EHR VA data. These are important first steps to standardize analyses enabling comparative research.

Summary: Background: The success of a tuberculosis digital adherence technology relies on patients’ satisfaction with and the usability of the technology. This study aimed to evaluate treatment satisfaction and usability of a digital medication event reminder and monitor (MERM) device for patients with tuberculosis to address the prespecified secondary endpoint of the SELFTB trial. Methods: In this multicenter, randomised controlled trial, adults (≥18 years) with new or previously treated, bacteriologically-confirmed, drug-sensitive pulmonary tuberculosis who were eligible to start anti-tuberculosis therapy were recruited from 10 healthcare facilities in Ethiopia. With a computer-generated random number sequence, participants were randomly assigned 1:1 to receive a 15-day tuberculosis medication supply dispensed with an evriMED500® MERM device to self-administer and return every 15 days or the standard in-person DOT. Both arms were followed throughout the standard two-month intensive treatment phase. Treatment was based on the WHO-recommended two-month fixed-dose-combination of first-line anti-tuberculosis drug delivered as a single daily dose (2RHZE). Treatment Satisfaction Questionnaire for Medication version 4 (TSQM 1.4©) was used to measure and compare treatment satisfaction between arms. Adapted System Usability Scale (SUS) was used to assess the usability of the device, with emphasis on ease of use, challenges, benefits, motivation, popularity, and recommendation. The findings were correlated with adherence and clinical endpoints including sputum smear conversion and IsoScreen urine isoniazid test results. This trial is registered with ClinicalTrials.gov, NCT04216420. Findings: Between June 2, 2020, and June 15, 2021, 337 patients were screened for eligibility, of whom 109 participants enrolled and completed the satisfaction [control (n = 57) and intervention (n = 52) arms] and usability [intervention arm (n = 52)] questionnaires. TSQM 1.4© geometric mean scores were: Effectiveness 73.25 [geometric standard deviation (GSD) 1.28], Side Effects 100, Convenience 63.31 (GSD 1.45), and Global Satisfaction 77.29 (GSD 1.25). TSQM score was significantly higher in the intervention vs the control: Effectiveness [85.78 vs 63.43, 95% CI 1.35 (1.26–1.45), p

Background and objective: Electronic medical records are now essential to patient treatment. A variety of usability evaluation techniques or usability metrics are employed in the evaluation of new technologies. The scope of health information technology (IT) usability for medical students is examined in this study. Method: A thorough literature search was conducted in PubMed, Cochrane Library for Systematic Reviews, Web of Science, and MEDLINE databases following the PRISMA 2020 standards. An additional data source was the PubMed Central search engine. The primary authors created a special term to optimize the resulting literature search. To guarantee that only the most pertinent research was included in the evaluation, a PICOs eligibility criterion was also used. Results: Most medical students agreed that the current curricula on physical activity (PA) are insufficient and expressed a strong need for greater instruction on exercise medicine. Medical students felt the e-learning source filled a knowledge gap in their understanding of PA. Still, they also emphasized that e-learning should not replace in-person instruction and that a blended learning approach would be the most effective way to teach physical exercise. Students believed that using such a strategy would provide them a greater chance to put their physical activity counseling abilities into practice when they were on clinical placement. An attractive design and engaging gamification components like self-assessment tests and visual progress tracking positively affect students' motivation to use the IT resource. There were identified usability attributes; contentment, usefulness, learning performance, ease of use, and learnability were the most often cited. Conclusion: Medical scholars are aware of the essence of PA for health but are dissatisfied with the current medical curriculum's lack of instruction in this area. A practical way to incorporate PA into the undergraduate curriculum is through interactive online learning tools like medic gaming (MEGA), electronic medical records (EMR), electronic health-care records (EHCR), etc. Still, opportunities for in-person PA counseling practice should complement this.

Purpose: Ensuring security of online health records and patients' perceptions of security are concerns in adolescent healthcare. Little is known about adolescents' perceptions about healthcare's ability to protect online health records. This article explores adolescents' perspectives on security and privacy of their online health records, potential differences based on gender and health, attitudes to sharing information, and perceptions of what constitutes sensitive information., Methods: This study included a subset of items from a national online patient survey conducted in Sweden (January-February 2022), focusing on respondents aged 15-19 years. Gender and health status differences were calculated using the Kruskal-Wallis test., Results: Of 218 adolescent respondents (77.1% female), a minority had security and privacy concerns. A notable proportion (41.3%) wished to control who could see their records, and those who reported better perceived health were more likely to want to manage access to their electronic health record (H = 13.569, p = .009). Most had not experienced unauthorized access to their records (75.2%) and had never shared health information on other online applications (85.8%). More than half (56.0%) perceived some information as sensitive, where mental health was the most common (76.0%). Most felt that reading their notes improved their trust for their healthcare professional (65.6%) and supported better communication with healthcare professionals (66.5%)., Discussion: In this national survey, adolescents generally reported few concerns about patient portals. Findings emphasize the need for security and privacy protection and to empower adolescents with greater control over access to their health information housed in electronic health record systems., (Copyright © 2024 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Background: A decade after the Health Information Technology for Economic and Clinical Health (HITECH) Act, electronic health records (EHRs) largely remain poorly designed and contribute to clinician burnout. Objective: The purpose of this study was to understand clinicians’ wants, needs, and perceived barriers imposed by the EHR; implement best practices in user-centered design; and create a clinician-centered EHR framework validated via a functional EHR prototype. Methods: Usability evaluations were performed using a simulated patient with a complex clinical scenario. Convergent parallel mixed methods linked to action research and agile development were used to create an EHR prototype based on clinician-centered design. Prototype functionality was validated via a final usability evaluation. Results: Between 2015 and 2017, 53 clinicians from 8 cardiology practices (4 academic and 4 private) participated in initial evaluations of their installed EHR. In 2019, 25 clinicians participated in final evaluations of their EHR vs our EHR prototype. Initial evaluations documented that clinicians judged the EHRs as poorly designed, scoring a mean of 47.1 on the System Usability Scale. Clinicians expressed that EHRs impeded workflow and communication and prolonged their workday. In the final evaluations, no improvement in installed EHRs was found (mean score 48.1); however, the EHR prototype was assessed as significantly more usable (mean score 77.8; P

The ability of Voice User Interface (VUI) to understand how users will express their commands naturally and intuitively is an essential component of user experience, especially when the user is interacting with the VUI for the first time. Designing an automated method for testing the usability of VUI is a challenge for two reasons. First, there are many different ways for a user to express the same intention, e.g. “play some music”, ””put some music on”, etc., that is difficult to determine in advance. Second, many VUI apps today typically rely on the platform service provider (e.g. Amazon, Google, etc.) to perform many of the speech recognition and natural language processing tasks, and these services are provided as a blackbox. Consequently, it is difficult for the app developer to obtain information about errors and user feedback. In this paper, we propose a framework, VORI, to systematically evaluate the interactability of VUI, as well as a new metric for quantifying the interactability of a VUI. We use VORI to analyze 127 applications on Alexa by sending over 82,931 commands. Our analysis results highlight that 41.7% of apps only accept strict input that has to exactly match the developer’s predefined sample commands with an interactability score of 20% or less. This suggests developers should consider a better interactability strategy in the design of VUIs, and more research is needed to further explore the design space to improve the interactability.

The expeditious development of mobile applications has transformed how travel e-commerce firms enhance customer relationships to implement their business strategies successfully. However, the literature has identified that a major determinant affecting customers' considerations to reject a mobile application is a deficiency of usability. Therefore, unlike the typical spotlight on general usability variables found in the prior literature, this study concentrated on investigating more specific usability factors that drive the continued intention to use and mobile application loyalty of a mobile travel e-commerce application. To achieve this, this study utilized the mobile application usability, which we adapted to form an Indonesian version. The dataset was obtained through a survey of 248 users of an Indonesian mobile travel e-commerce application, Traveloka. The collected data were analyzed using partial least square structural equation modeling (PLS-SEM) to test the hypotheses. The results indicated that application utility and the user interface structure emerge as significant drivers for both outcomes. This study could help travel e-commerce firms to develop their mobile strategies effectively, especially in terms of their usability, which may ensure that their customers continue to use the mobile application.

ClimApp was developed to assist individuals in reducing the risk of exposure to thermal stress and to supply the user with individualized advice and recommendations. The tool integrates several human thermal models and heat indices with the local weather forecast and goes on to provide users with a prediction of their thermal stress based on their activity level, clothing level, and heat acclimatization input. Despite its innovative and interactive functionality, ClimApp’s utility and ease of use should be considered to increase its usability. The usability of ClimApp was evaluated over two iterations: one usability lab test (n = 10) and one field test (n = 38) where first-time users completed tasks in ClimApp related to navigation, perceived ease of use, and perceived usefulness. Activity theory guided the analysis, and a directed qualitative content analysis was applied to evaluate the usability of ClimApp. The results suggest that there is room for improvement when assessing the universal design aspects, navigation, and information complexity, yet the participants perceived the tool as useful in the situated context.

Objective: A system to provide feedback for laparoscopic training using an online conferencing system during the COVID-19 pandemic was developed. The purpose of this study is to evaluate this system from the trainer perspective. Design: A procedural feedback system using an online conferencing system was devised. Setting: Surgical training was observed using an online conferencing system (Zoom). Feedback was provided while viewing suture videos which are, as a feature of this system, pre-recorded. Feedback was then recorded. Trainer comments were then converted into text, summarized as feedback items, and sorted by suture phase which facilitates reflection. Trainers completed a questionnaire concerning the usability of the online feedback session. Results: Eleven trainers were selected. Physicians had an average experience of 21.9 ± 5.9 years (mean ± standard deviation). The total number of feedback items obtained by classifying each phase was 32. Based on questionnaire results, 91% of trainers were accustomed to the use of Zoom, and 100% felt that online procedural education was useful. In questions regarding system effectiveness, more than 70% of trainers answered positively to all questions, and in questions about efficiency, more than 70% of trainers answered positively. Only 55% of the trainers felt that this system was easy to use, but 91% were satisfied as trainers. Conclusions: The results of the questionnaire suggest that this system has high usability for training. This online system could be a useful tool for providing feedback in situations where face-to-face education is difficult.

Interactive machine learning (ML) systems are difficult to design because of the “Two Black Boxes” problem that exists at the interface between human and machine. Many algorithms that are used in interactive ML systems are black boxes that are presented to users, while the human cognition represents a second black box that can be difficult for the algorithm to interpret. These black boxes create cognitive gaps between the user and the interactive ML model. In this paper, we identify several cognitive gaps that exist in a previously-developed interactive visual analytics (VA) system, Andromeda, but are also representative of common problems in other VA systems. Our goal with this work is to open both black boxes and bridge these cognitive gaps by making usability improvements to the original Andromeda system. These include designing new visual features to help people better understand how Andromeda processes and interacts with data, as well as improving the underlying algorithm so that the system can better implement the intent of the user during the data exploration process. We evaluate our designs through both qualitative and quantitative analysis, and the results confirm that the improved Andromeda system outperforms the original version in a series of high-dimensional data analysis tasks.

Objective: To define the current state of peer-reviewed literature demonstrating the usability, acceptability, and implementation of artificial intelligence (AI) and machine learning (ML) techniques in surgical coaching and training., Design: We conducted a literature search with defined inclusion and exclusion criteria. We searched five scholarly databases: MEDLINE via PubMed, Embase via Elsevier, Scopus via Elsevier, Cochrane Central Register of Controlled Trials, and the Healthcare Administration Database via ProQuest. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines., Results: Only 4 articles met the inclusion criteria and used standardized methods for performance evaluation with expert observation. We found no literature examining the impact on performance, user acceptance, or implementation of AI/ML techniques used for surgical coaching and training. We highlight the need for qualitative and quantitative research demonstrating these techniques' effectiveness before broad implementation., Conclusion and Relevance: We emphasize the need for research to specifically evaluate performance, impact, user acceptance, and implementation of AI/ML techniques. Incorporating these facets of research when developing AI/ML techniques for surgical training is crucial to ensure emerging technology meets user needs without increasing cognitive burden or frustrating users., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Background: Health Care Professionals (HCPs) are the main end-users of digital clinical tools such as electronic prescription systems. For this reason, it is of high importance to include HCPs throughout the design, development and evaluation of a newly introduced system to ensure its usefulness, as well as confirm that it tends to their needs and can be integrated in their everyday clinical practice., Methods: In the context of the PrescIT project, an electronic prescription platform with three services was developed (i.e., Prescription Check, Prescription Suggestion, Therapeutic Prescription Monitoring). To allow an iterative process of discovery through user feedback, design and implementation, a two-phase evaluation was carried out, with the participation of HCPs from three hospitals in Northern Greece. The two-phase evaluation included presentations of the platform, followed by think-aloud sessions, individual platform testing and the collection of qualitative as well as quantitative feedback, through standard questionnaires (e.g., SUS, PSSUQ)., Results: Twenty one HCPs (8 in the first, 18 in the second phase, and five present in both) participated in the two-phase evaluation. HCPs comprised clinicians varying in their specialty and one pharmacist. Clinicians' feedback during the first evaluation phase already deemed usability as "excellent" (with SUS scores ranging from 75 to 95/100, showing a mean value of 86.6 and SD of 9.2) but also provided additional user requirements, which further shaped and improved the services. In the second evaluation phase, clinicians explored the system's usability, and identified the services' strengths and weaknesses. Clinicians perceived the platform as useful, as it provides information on potential adverse drug reactions, drug-to-drug interactions and suggests medications that are compatible with patients' comorbidities and current medication., Conclusions: The developed PrescIT platform aims to increase overall safety and effectiveness of healthcare services. Therefore, including clinicians in a two-phase evaluation confirmed that the introduced system is useful, tends to the users' needs, does not create fatigue and can be integrated in their everyday clinical practice to support clinical decision and e-prescribing., Competing Interests: Declaration of competing interest All authors declare no financial or non-financial competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Increasingly, healthcare policies have changed focus from cure and care to behaviour and health. Prevention is becoming more important, which requires a change in the role of healthcare professionals. Healthcare professionals' role is changing from being a therapist to taking on the role of a coach. To prevent chronicity in Medically Unexplained Physical Symptoms (MUPS), an integrated blended care program was developed. To apply this new program in daily practice, it is important to gain insight into the usability. From the healthcare professionals' point of view the concept of usability consists of performance, satisfaction and acceptability. In this qualitative study participants were recruited after participating in the PARASOL program. Demographics were collected. Semi-structured interviews were conducted and analysed using thematic analysis. Ten healthcare professionals (six physical therapists and four mental health nurses) were interviewed. Four themes on usability were identified: (1) Who fits in the program, (2) preparation, (3) experience with the program and (4) interprofessional collaboration. This study gathered healthcare professionals' experiences with and attitudes towards integrating healthcare and offering blended care programs. An integrated blended care program offers the possibility to personalize treatment. Findings show attention should be given to the new responsibilities of healthcare professionals, and their role in integrated and blended care. This new approach of delivering healthcare can facilitate interprofessional collaboration. Achieving sustainable change in patients however still requires instruction and support for healthcare professionals implementing behavioural change techniques.

Climate services have climbed high on the agenda of EU research policy, yet few contributions have reflected on the actual usability of climate services from the perspectives of the intended users, let alone the implications for future EU research and innovation policy. This commentary reflects on four key lessons learnt from engagement in climate services research projects and discusses implications for future EU research policy: i) all end-users have pre-established decision-making processes and tools for their purposes, hence all new information needs to be adapted ii) one size fits none – and tailoring takes time iii) building trust between different actors, processes and confidence in new information is key in the tailoring process – and resource-demanding iv) purveyors and intermediaries can facilitate tailoring processes but need to finance their activities until end-users demonstrate willingness to pay and/or the climate service is readily implemented. The main argument is that more attention needs to be paid to the demand-side of climate services to help viable climate services make it through the innovation “valley of death” – that is, the twilight zone between technical invention and (commercially) successful innovation. EU Research and Innovation (R&I) funding streams and policies for establishing truly transdisciplinary learning loops driven by (actual) user needs can function as vehicles through the valley of death.

Background: eHealth interventions have been explored to provide convenient support and training to informal dementia carers. Design and usability issues may however hinder user acceptance of Web-based interventions. iSupport is an online program developed by World Health Organization (WHO) to support informal dementia carers. Purpose: This study gathers user-feedback and evaluates the usability of the European-Portuguese version of iSupport. Methods: A mixed-methods study was conducted. Two focus groups discussions (n = 15) and 15 usability test sessions were conducted with carers and health/social support professionals to collect data on user satisfaction and requirements on the program's contents and Web interface. The usability testing protocol comprised pre/post-test surveys, a structured interview and observation of task performance in the Web platform. Content analysis of text data was performed by two independent coders. Results: Success rates were superior to 80% for most tasks. An average score of 89.5 on the System Usability Scale demonstrated an excellent perception of the program's usability. The program was perceived as trustworthy, and participants were globally satisfied with its aesthetics and easiness of use. Feedback and personalization were valued functional requirements, while no consensus was found for mood self-assessment or professional/peer interaction features. Lessons were considered culturally fit, thematically pertinent, and comprehensive. Suggestions for improvement were wide-ranging from program's layout to accessibility, usability, functional requirements, content format and lessons' themes. Conclusions: This study derives user requirements for an evidence-based program for dementia carers. Both the study findings and usability assessment methodology can be imported to the development of similar programs worldwide.

Clinical tools involving immersive virtual reality (VR) may bring several advantages to cognitive neuroscience and neuropsychology. However, there are some technical and methodological pitfalls. The American Academy of Clinical Neuropsychology (AACN) and the National Academy of Neuropsychology (NAN) raised 8 key issues pertaining to Computerized Neuropsychological Assessment Devices. These issues pertain to: (1) the safety and effectivity; (2) the identity of the end-user; (3) the technical hardware and software features; (4) privacy and data security; (5) the psychometric properties; (6) examinee issues; (7) the use of reporting services; and (8) the reliability of the responses and results. The VR Everyday Assessment Lab (VR-EAL) is the first immersive VR neuropsychological battery with enhanced ecological validity for the assessment of everyday cognitive functions by offering a pleasant testing experience without inducing cybersickness. The VR-EAL meets the criteria of the NAN and AACN, addresses the methodological pitfalls, and brings advantages for neuropsychological testing. However, there are still shortcomings of the VR-EAL, which should be addressed. Future iterations should strive to improve the embodiment illusion in VR-EAL and the creation of an open access VR software library should be attempted. The discussed studies demonstrate the utility of VR methods in cognitive neuroscience and neuropsychology.

Autonomous driving technology and changes in regulations may create an environment that allows novel vehicle interiors. It is important to consider impact on all types of passengers when contemplating interior design, particularly for vehicles that may be used by families with children. We developed a fixture that enables us to change the orientation of each of 4 car seats and used it to simulate three different vehicle interiors. Ten families with children aged 3 months to 7 years interacted with each of the simulated interiors as part of a usability study. Times to install and remove child restraint systems were not significantly different across the three simulated vehicle interiors, but parents were able to release children fastest when using the “X” configuration, which had all seats on a diagonal facing the middle of the vehicle. While overall experience ratings didn’t differ significantly, seven out of ten parents indicated that they liked the “X” configuration better than the other two configurations tested. Reasons included: ability to interact with other passengers, ability to see the road, and legroom/comfort. However, many participants disliked having some passengers not facing forward. Overall, parents liked facing their children, but several said that they would only be comfortable if they could see out of the front windshield; meanwhile, children liked seeing their parents’ faces but also preferred to face forward. Child restraint system and vehicle manufacturers could benefit from considering this study when designing new products.

Background: The evidence-based Japanese integrative medicine (eJIM) website was launched by the Japanese government in 2014 to provide information on integrative medicine to the general public and physicians. While Japanese physicians discourage the use of traditional, complementary, and integrative medicine (TCIM), there are very few reports that explore this issue. We aimed to understand the attitudes of Japanese physicians towards TCIM and evaluate the usability of the eJIM website according to physicians. Methods: We conducted a two-staged, mixed-method study with interviews and an internet-based survey. Face-to-face interviews were conducted with 12 physicians who worked for large-scale hospitals in two different areas of Japan. We assessed their understanding of TCIM and the usability of the eJIM website. Based on the interviews, the internet survey was developed and was conducted in February 2019. Results: In the interviews, 12 physicians provided their opinion on TCIM and highlighted important areas, such as increasing the resources available for patients, and ensuring more information on TCIM is available. The internet survey of 231 physicians showed that 35% of the physicians used or advised on TCIM in clinical practice. Kampo medicines (87.8%) and dietary supplements (24.7%) were common. The physicians did not use TCIM primarily because of concerns regarding its efficacy, safety, and cost. Most physicians were not aware of which TCIM their patients used. Conclusion: Physicians in Japan may not have comprehensively understood TCIM and do not actively use TCIM. The eJIM website could help physicians to gain a better understanding of TCIM if improvements are made.

This study aimed to summarize available data about health information system evaluation using the ISO 9241–110 (previously 9241–10) standard. A systematic review of literature from January 2000 to November 2020 was conducted in PubMed, Scopus, ScienceDirect, Web of Science, and Google Scholar as well as two Iranian national databases, Scientific Information Database and Magiran. Pooled estimates were calculated using random-effects meta-analysis. Data analyses were conducted using Stata version 14. From total of 179 studies subjected to initial screening, fifteen studies were eligible to enter the meta-analysis. The pooled mean estimates of the health information systems' overall scores (3.11; 95% confidence interval [CI], 2.82–3.41), suitability for individualization (3.82; 95% CI, 2.59–3.04), and controllability (3.82; 95% CI, 2.91–3.47) commonly had better performance compared with other dimensions. High heterogeneity was seen among the seven dimensions (I2 ≥ 98.6%, p .1). Most of the studies used the ISO 9241-110 standard as a summative assessment for evaluation of the usability of the HIS and results indicated the relative success of the evaluated systems based on this standard.

Mental health problems are a major public health concern worldwide. Approximately 50% of the population will experience mental problems during their life. Traditional treatment is based on psychopharmacotherapy or psychotherapy, with face-to-face interaction between the patient and the therapist. New technologies such as Internet-delivered treatments are seen as an opportunity to offer more scalable and cost-efficient treatments in the field of mental health. Despite the growing interest and new evidence supporting the effect of Internet-delivered treatments is it remarkably little research on how the technology and the usability of Internet-delivered treatment programs affects the treatment. In this paper, we propose a set of evaluation criteria for evaluating the usability and the responsive design of Internet-delivered treatment systems. By our knowledge we are the first to include usability and universal design principles in the evaluation of Internet-delivered treatment systems. Our findings indicate that despite the good treatment results and proven clinical effects, the systems in general have several issues regarding usability, universal design and outdated technology. Based on our findings we propose that there should be established guidelines for testing the usability and technology of Internet-delivered treatment systems.

Aim: to evaluate the usability of a comprehensive national health information system by the heuristic method. Introduction: Presently, information systems are widely being used in healthcare settings. Methods: Five independent evaluators assessed the user interface design of this system in terms of its compliance with a set of predetermined standard principles, also known as Jakob Nielsen's 10 general principles. Problems were reassessed in the presence of all evaluators, and similar cases were merged and a single list of unique problems was prepared. After a second assessment, the evaluators determined and categorized problem severity in five domains, including: the absence of a problem (zero point), a cosmetic problem (1 point), a minor problem (2 points), a major problem (3 points) and a catastrophic problem (4 points). Data were then analyzed in a spreadsheet using descriptive statistical tests. Results: The “recognition rather than recall” principle with 13 problems (21.3% of all cases) had the greatest frequency among all problems, while the “match between system and the real world” and “help and documentation” principles with 1 problem (1.6% of all cases) had the least frequency. Moreover, principles such as “help users recognize, diagnose and recover from errors”, “error prevention”, and “help and documentation” had a mean severity of 2.8, 2.8, and 3.4, respectively. Consequently, they were considered as catastrophic and major problems. Conclusions: Based on the viewpoint of evaluation experts, a large portion of problems in this system were classified into major and catastrophic categories, which primarily indicates the poor usability of this system. Therefore, it is highly recommended that authorities be notified of the issues in writing in order to resolve them in a future update. Finally, special consideration should be given to the meticulous evaluation of these systems during preliminary stages of design and development, so as to encounter fewer issues on a national level at the time of implementation.

Objective: The opinions, satisfaction, and expectations of telemedicine can provide essential data for remote health services in individuals with Multiple Sclerosis (MS). The study aimed to demonstrate the views (barriers-benefits), satisfaction, and expectations of individuals with MS about telerehabilitation services., Methods: A prospective cross-sectional was conducted with 82 individuals with MS who received telerehabilitation services for at least one year. The participants have completed SymptoMScreen, Beck Depression Inventory (BDI), Telehealth Usability Questionnaire (TUQ), Telemedicine Satisfaction Questionnaire (TSQ), Telehealth Barriers Questionnaire (TBaQ and Telehealth Benefits Questionnaire (TBeQ)., Results: As the age of individuals with MS increased, TUQ (r: -0.517, p < 0.001) and TBeQ (r: -0.383, p < 0.001) decreased, while TSQ (r: 0.405, p < 0.001) and TBaQ (r: 0.390, p < 0.001) increased. SymptoMScreen score (r: -0.288, p < 0.05) was weakly associated with TUQ. In addition, TUQ, TSQ, TBeQ, and TBaQ were strongly correlated (p < 0.001)., Conclusion: In order to improve usability and satisfaction in telerehabilitation services, the age, symptom severity, and education levels of individuals with MS should be considered. Telehealth methods with high usability should be preferred to increase patient satisfaction., Competing Interests: Declaration of Competing Interest The authors report no conflicts of interest and certify that no funding has been received for this study and/or preparation of this manuscript., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: Examining information presentation strategies that may facilitate patient education through patient portals is important for effective health education., Methods: A randomized exploratory study evaluated information presentation (text or videos) and a chatbot in patient education and examined several performance and outcome variables (e.g., search duration, Decisional Conflict Scale, and eye-tracking measures), along with a simple descriptive qualitative content analysis of the transcript of chatbot., Results: Of the 92 participants, those within the text conditions (n = 46, p < 0.001), had chatbot experiences (B =-74.85, p = 0.046), knew someone with IBD (B =-98.66, p = 0.039), and preferred to engage in medical decision-making (B =102.32, p = 0.006) were more efficient in information-searching. Participants with videos spent longer in information-searching (mean=666.5 (SD=171.6) VS 480.3 (SD=159.5) seconds, p < 0.001) but felt more informed (mean score=18.8 (SD=17.6) VS 27.4 (SD=18.9), p = 0.027). The participants' average eye fixation duration with videos was significantly higher (mean= 473.8 ms, SD=52.9, p < 0.001)., Conclusions: Participants in video conditions were less efficient but more effective in information seeking. Exploring the trade-offs between efficiency and effectiveness for user interface designs is important to appropriately deliver education within patient portals., Practice Implications: This study suggests that user interface designs and chatbots impact health information's efficiency and effectiveness., 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 Elsevier B.V. All rights reserved.)

While the use of electronic methods to collect patient-reported outcome data in clinical trials continues to increase, it remains the case that many patient-reported outcome measures (PROMs) have originally been developed and validated on paper. Careful consideration during the move from paper PROMs to electronic format is required to preserve the integrity of the measure and ensure a "faithful migration." Relevant literature has long called out the importance of following migration best practices during this process; nevertheless, such best practices are distributed across multiple documents. This article consolidates and builds upon existing electronic PROM implementation best practice recommendations to provide a comprehensive, up-to-date, single point of reference. It reflects the current consensus based on the significant advances in technology capabilities and knowledge gleaned from the growing evidence base on electronic migration and implementation, to balance the need for maintaining the integrity of the measure while optimizing respondent usability. It also specifies whether the practice is rooted in evidence or expert consensus, to enable those using these best practices to make informed and considered decisions when conducting migration., Competing Interests: Author Disclosures Links to the individual disclosure forms provided by the authors are available here., (Copyright © 2023. Published by Elsevier Inc.)

Purpose: The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral health IT system focusing on safe, innovative, and pragmatic self-care strategies for lymphedema symptom management. The purpose of this study was to evaluate usability, feasibility, and acceptability of TOLF among the end-user of breast cancer survivors. Methods: Two types of usability testing were completed with 30 breast cancer survivors: heuristic evaluation and end-user testing. Each participant was asked to think aloud while completing a set of specified tasks designed to explicate and freely explore the system features. A heuristic evaluation checklist, the Perceived Ease of Use and Usefulness Questionnaire, and The Post Study System Usability Questionnaire were used to evaluate usability of the system. Open-ended questions were used to gather qualitative data. Quantitative data were analyzed using descriptive statistics and qualitative data were summarized thematically. Results: Breast cancer survivors were very satisfied with the system: 90% (n = 27) rated the system having no usability problems; 10% (n = 3) noted minor cosmetic problems: spelling errors or text font size. The majority of participants 96.6% (n = 29) strongly agreed that the system was easy to use and effective in helping to learn about lymphedema, symptoms and self-care strategies. Themes from the qualitative data included empowerment, high quality information, loving avatar simulation videos, easy accessibility, and user-friendliness. Conclusions: This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.