Evaluation of an Access-Risk-Knowledge (ARK) Platform for Governance of Risk and Change in Complex Socio-Technical Systems

Three key challenges to a whole-system approach to process improvement in health systems are the complexity of socio-technical activity, the capacity to change purposefully, and the consequent capacity to proactively manage and govern the system. The literature on healthcare improvement demonstrates the persistence of these problems. In this project, the Access-Risk-Knowledge (ARK) Platform, which supports the implementation of improvement projects, was deployed across three healthcare organisations to address risk management for the prevention and control of healthcare-associated infections (HCAIs). In each organisation, quality and safety experts initiated an ARK project and participated in a follow-up survey and focus group. The platform was then evaluated against a set of fifteen needs related to complex system transformation. While the results highlighted concerns about the platform’s usability, feedback was generally positive regarding its effectiveness and potential value in supporting HCAI risk management. The ARK Platform addresses the majority of identified needs for system transformation; other needs were validated in the trial or are undergoing development. This trial provided a starting point for a knowledge-based solution to enhance organisational governance and develop shared knowledge through a Community of Practice that will contribute to sustaining and generalising that change.

Implicating Human Values for designing a Digital Government Collaborative Platform for Environmental Issues: A Value Sensitive Design Approach

Digital technology is instrumental in designing e-government services to achieve environmental sustainability. This study aims to implicate essential human values for designing a Digital Government Collaborative Platform (DGCP), which seeks to enhance the collaboration between citizens and government officers to address environmental issues in Sri Lanka. The study adopts a value sensitive design (VSD) approach to identify human values to conceptualize the design. The results reveal 15 human values shared by citizens and officers of environmental authorities: transparency, safety, universal usability, feedback, authenticity, fairness, representativeness, accountability, legitimacy, informed consent, autonomy, awareness, human welfare, attitude, and trust. In addition to the identified human values, four system feature categories have been proposed from interviews. Thus, the study advances knowledge in designing an e-government system for collaboration between citizens and government officers, especially in tackling environmental problems in developing countries. Further, the study contributes knowledge to VSD for digital collaboration for improving environmental sustainability.

Elements of Engagement in Promoting Social Acceptance of Mobile Augmented Reality Application

In a social context, Mobile Augmented Reality is a type of Augmented Reality which enables users to interact with the augmented environment. However, the degree of engagement and non-distraction of Mobile Augmented Reality has been of major concern to scholars. This is because Mobile Augmented Reality should be a focused, movable and engaged augmented environment which allows users to achieve the desired objectives. Therefore, this paper examines the engagement elements of Mobile Augmented Reality that promote social acceptance among users within the vast literature. These elements will enable Mobile Augmented Reality designers and developers to produce apps that will be able to enhance users’ interest and attractiveness in a fun way. Based on the critical and comprehensive review, there are 22 elements of engagement that have been used by previous researchers in the design of Mobile Augmented Reality apps. The 22 elements include; Aesthetics, Novelty, Usability, Feedback, Motivation, Attention, Perceived Control, Curiosity, Enjoyment, Self-efficacy, Friendliness, Social skill, Endurability, Interest, Immersion, Challenge, Satisfaction, User Autonomy, Improvement, Supportive, Trust and Interaction. This paper argues that the 22 elements are critical in producing an engaging Mobile Augmented Reality app. It is recommended for designers to consider these elements in ensuring that the users will be positively engaged with the Mobile Augmented Reality app.

Usability and Acceptability of Home-based Self-testing for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Antibodies for Population Surveillance

Background This study assesses acceptability and usability of home-based self-testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies using lateral flow immunoassays (LFIA). Methods We carried out public involvement and pilot testing in 315 volunteers to improve usability. Feedback was obtained through online discussions, questionnaires, observations, and interviews of people who tried the test at home. This informed the design of a nationally representative survey of adults in England using two LFIAs (LFIA1 and LFIA2) which were sent to 10 600 and 3800 participants, respectively, who provided further feedback. Results Public involvement and pilot testing showed high levels of acceptability, but limitations with the usability of kits. Most people reported completing the test; however, they identified difficulties with practical aspects of the kit, particularly the lancet and pipette, a need for clearer instructions and more guidance on interpretation of results. In the national study, 99.3% (8693/8754) of LFIA1 and 98.4% (2911/2957) of LFIA2 respondents attempted the test and 97.5% and 97.8% of respondents completed it, respectively. Most found the instructions easy to understand, but some reported difficulties using the pipette (LFIA1: 17.7%) and applying the blood drop to the cassette (LFIA2: 31.3%). Most respondents obtained a valid result (LFIA1: 91.5%; LFIA2: 94.4%). Overall there was substantial concordance between participant and clinician interpreted results (kappa: LFIA1 0.72; LFIA2 0.89). Conclusions Impactful public involvement is feasible in a rapid response setting. Home self-testing with LFIAs can be used with a high degree of acceptability and usability by adults, making them a good option for use in seroprevalence surveys.

Dose Tracker Application for Collecting Medication Use Data from International Space Station Crew

INTRODUCTION: There are knowledge gaps in spaceflight pharmacology with insufficient in-flight data to inform future planning. This effort directly addressed in-mission medication use and also informed open questions regarding spaceflight-associated changes in pharmacokinetics (PK) and/or pharmacodynamics (PD).METHODS: An iOS application was designed to collect medication use information relevant for research from volunteer astronaut crewmembers: medication name, dose, dosing frequency, indication, perceived efficacy, and side effects. Leveraging the limited medication choices aboard allowed a streamlined questionnaire. There were 24 subjects approved for participation.RESULTS: Six crewmembers completed flight data collection and five completed ground data collection before NASA’s early study discontinuation. There were 5766 medication use entries, averaging 20.6 ± 8.4 entries per subject per flight week. Types of medications and their indications were similar to previous reports, with sleep disturbances and muscle/joint pain as primary drivers. Two subjects treated prolonged skin problems. Subjects also used the application in unanticipated ways: to note drug tolerance testing or medication holiday per research protocols, and to share data with flight surgeons. Subjects also provided usability feedback on application design and implementation.DISCUSSION: The volume of data collected (20.6 ± 8.4 entries per subject per flight week) is much greater than was collected previously (<12 per person per entire mission), despite user criticisms regarding app usability. It seems likely that improvements in a software-based questionnaire application could result in a robust data collection tool that astronauts find more acceptable, while simultaneously providing researchers and clinicians with useful data.Wotring VE, Smith LK. Dose tracker application for collecting medication use data from International Space Station crew. Aerosp Med Hum Perform. 2020; 91(1):41–45.

Impact of a Web Program to Support the Mental Wellbeing of High School Students: A Quasi Experimental Feasibility Study

Little effort has been made to investigate the potential of web programs aimed to support the mental wellbeing of adolescents in school environments in middle-income countries. A quasi-experimental feasibility study was conducted in Thailand with adolescents (N = 180) in three conveniently sampled high schools and with teachers (N = 12) who acted as program tutors. The web program was used in small groups, independently, or it was not used at all. No statistically significant changes were found between the groups regarding depression, stress, or satisfaction. Differences between program users (n = 61) and non-users (n = 48) were not significant. Acceptance was higher among adolescents who used the program independently (n = 40, 73% vs. n = 21, 39%; p = 0.001). Usability feedback did not differ between the groups. Support should be provided in order for programs to be potentially used. More information is needed regarding factors associated with the use of web programs.

Development of PositiveLinks: A Mobile Phone App to Promote Linkage and Retention in Care for People With HIV (Preprint)

BACKGROUND Linkage to and retention in HIV care are challenging, especially in the Southeastern United States. The rise in mobile phone app use and the potential for an app to deliver just in time messaging provides a new opportunity to improve linkage and retention among people living with HIV (PLWH). OBJECTIVE This study aimed to develop an app to engage, link, and retain people in care. We evaluated the acceptability, feasibility, and impact of the app among users. METHODS App development was informed by principles of chronic disease self-management and formative interviews with PLWH. Once developed, the app was distributed among participants, and usability feedback was incorporated in subsequent iterations. We interviewed app users after 3 weeks to identify usability issues, need for training on the phone or app, and to assess acceptability. We tracked and analyzed usage of app features for the cohort over 2 years. RESULTS A total of 77 participants used the app during the pilot study. The query response rate for the first 2 years was 47.7%. Query response declined at a rate of 0.67% per month. The community message board was the most popular feature, and 77.9% (60/77) of users posted on the board at least once during the 2 years. CONCLUSIONS The PositiveLinks app was feasible and acceptable among nonurban PLWH. High participation on the community message board suggests that social support from peers is important for people recently diagnosed with or returning to care for HIV.

Rendering ICU Data Useful via Formative Evaluations of Trajectory, Tracking, and Trigger (T3TM) Software

We describe formative evaluations of a new software tool which aggregates and displays data about Intensive Care Unit patients. T3TM, which stands for Tracking, Trajectory, and Trigger, not only integrates the data being collected from a variety of devices, but also uses these data to assess the patient’s current state of tissue oxygen perfusion. We performed three different evaluation methods to generate recommendations on ways to improve the usability and utility of this software. First, we organized expert reviews, adapting a proven method of conducting a heuristic evaluation of a medical device so it requires less time for clinical experts to participate, and showed that it produces valuable results. Next we conducted contextual inquiry to help understand how differences among pediatric hospitals’ Cardiac Intensive Care Units including equipment, room layout, staff training, policies, and nursing workflows can impact adoption of physiological data aggregation software. Our approach, which is consistent with user centered design best practices, emphasizes understanding potential interactions between existing equipment and new technology. Finally, we describe how we plan to use simulation both to train nurses who work in different hospitals, with different equipment, different policies and different cultures and to capture additional usability feedback.

Sounds of Time and Place

The author describes various aural techniques developed as part of the origination of the sonic content of compositions themed on palimpsests of time and place. Field-based recordings, authentic and synthetic impulse responses, convolution reverb and the use of third-party sounds retrieved via open programmatic interfaces are considered. The role of usability feedback is also discussed, specifically its beneficial impact on informing the development both of the compositions and the techniques they utilize. An initial mobile phone application is described, together with continuing work to develop additional mobile experiences.