Mental health difficulties are increasing among Canadian postsecondary students, and many face barriers to accessing mental health care. Mobile health smartphone apps for mental health reduce common barriers to care and improve student mental health outcomes. However, students' engagement and use of mental health apps is low. Evaluating the usability and quality of mental health apps is essential not only for user engagement but also for safety and overall utility. Few mental health apps have undergone usability and quality evaluations, especially with measures explicitly designed for these apps. The JoyPop app is a resilience-building mental health app with evidence supporting its effectiveness for student mental health. It has yet to be evaluated using standardized measures of mental health app usability and quality, and the influence of usability and quality on use is unknown. We evaluated the usability and quality of the JoyPop app and the predictive importance of usability and quality, compared to other relevant user characteristics, in predicting intentions to use the app in the future (usage intentions). Participants (N=183) completed preapp measures assessing demographics and personality traits, then used the app for 1 week, and then completed postapp measures assessing the usability, quality, and use of the JoyPop app. Usability (overall; and subscales: ease of use, interface and satisfaction, and usefulness) and quality (objective, subjective, and perceived impact) were assessed with descriptive statistics. Multiple regression analyses tested the predictive importance of usability and quality on usage intentions after controlling for other user characteristics. Participants rated the JoyPop app's overall usability as "very good" (mean 5.63, SD 0.85). Participants rated the JoyPop app's overall objective quality as "excellent" (mean 4.06, SD 0.54). Subjective quality ratings were good, with many participants (135/183, 73.8%) indicating they would recommend the app to others. Participants rated the app as having a moderate and helpful impact on their mental health and coping skills (mean 3.48, SD 0.88). In each regression model, usability (β=.56, P<.001) and quality (β=.52, P<.001) were the strongest predictors and predicted usage intentions over and above other user characteristics. Results align with prior research evaluating the JoyPop app and maintain that it is an engaging and high-quality mental health app that can support students. Findings provide important insight into the optimal design of mental health apps for students and inform adaptations to future iterations of the JoyPop app.

Ireland is ranked among the most disadvantageous European countries in terms of mental health challenges. Contrary to general health services that primarily focus on diagnosis and treatment, the mental health sector in Ireland deals with highly sensitive psychiatric case notes based on patient-doctor conversations. Such data, therefore, must be collected, analyzed, and stored with an approach customized specifically for psychiatry. This study's objective involves examining the state of data handling practices in the Irish Mental Health Services (MHS), identifying the shortcomings regarding privacy, security, and usability of psychiatric case notes, and proposing an innovative technological solution that addresses most of the surfaced challenges. The study was conducted using a comprehensive methodology. Our approach involved a thorough literature review, ethics approval, web-based surveys with mental health professionals as participants, interviews of psychiatrists, interactions with mental health organizations, analysis of inspection reports by the Ireland Mental Health Commission, and comparative evaluation of existing IT solutions. The thoroughness of our adopted research methodology instills confidence in the reliability and validity of our findings. Our study revealed outdated data management, heavy reliance on paperwork resulting in serious repercussions, parallel workload, alarmingly low readability of notes, and a nonviable setup that hinders research and analytical examination. Our survey reported an average score of 4.37 of 10 (SD 1.25) given by participants in terms of technology use. Regarding privacy measures, 75% (n=12) of participants mentioned that staff members are allowed to keep their phones while accessing psychiatric case notes. Similarly, 80% (n=13) of submissions highlighted that multiple staff members can access sensitive notes and patients' contact information. On the other hand, Mental Health Commission reports showed that their inspections are limited to evaluating physical privacy only. Regarding technological comparative analysis, we observed that conventional IT solutions are vulnerable against cyberattacks and fall short in addressing multiple challenges simultaneously. Therefore, an innovative convergence of different technologies is needed. Our research supports speech-to-text transcription for data collection, interactive artificial intelligence for data analysis, and permissioned blockchain for data storage and retrieval. Our survey participants also estimated the proposed solution to optimize their workload by an average of 35%. Irish MHS seem to be handling psychiatric data under polycrisis circumstances; therefore, a single-dimensional digitization of records would not be sufficient in addressing the wide range of concerns. In addition to highlighting intertwined challenges in Irish psychiatry and validating the need for innovation in data handling practices in Irish MHS, this study culminated in the proposal of an innovative technological solution that offers a significant contribution to a considerably improved, efficient, and compliant service delivery in mental health care.

Falls are the leading cause of injury-related death among adults aged 65 and older. The fear of falling can further limit older adults' independence by contributing to activity restriction, social isolation, and physical decline-ironically increasing the risk of mechanical falls. Although home safety assessments have been shown to reduce fall risk by up to 36% and decrease serious injuries such as hip fractures, their adoption remains low. Understanding the barriers to implementing these assessments is critical to improving their uptake and effectiveness. This study aimed to (1) identify specific barriers perceived by older adults in implementing home safety assessments and modifications to reduce the risk of mechanical falls, (2) explore the attitudes of health care professionals and other stakeholders toward these assessments, and (3) identify novel design opportunities to guide the development and implementation of more effective home safety assessment techniques and practices to reduce mechanical fall risk. This explanatory qualitative study drew on the "inspiration" phase of the human-centered design (HCD) research process. We conducted 35 interviews (28 initial and 7 follow-up) with 28 purposefully sampled participants in the San Francisco Bay Area between February and June 2021. Participants included community-dwelling older adults (n=3), geriatricians (n=4), therapists (n=6), product developers (n=2), older health researchers (n=8), and community program leaders (n=5). Interview notes were analyzed inductively by the research team to extract themes and generate insight statements and design opportunities. Analysis yielded three key insights: (1) older adults often experience a conflict between maintaining independence and implementing safety modifications. One participant described living with a "repeating mantra in my head throughout the day saying 'above all, don't fall.'" (2) aesthetic and privacy concerns frequently override safety benefits. Participants rejected modifications that made their homes feel "institutional." (3) access to occupational therapy services-already limited in rural areas-was further constrained by the COVID-19 pandemic, with some providers reporting that travel time "took up the majority of their day just assessing one home." These barriers help explain the low adoption of home safety assessments despite strong supporting evidence. The study identified design opportunities to address these challenges, including customizable, user-friendly safety solutions, dignity-preserving approaches to assessment, and technology-enabled remote alternatives. This study identified specific emotional, aesthetic, logistical, and access-related barriers to the adoption of home safety assessments among older adults. The proposed design solutions offer promising directions to increase uptake, improve user experience, and enhance safety. However, further validation through co-design with a larger and more diverse group of older adults is needed. Future research should pilot test these ideas across varied contexts and evaluate their implementation and impact.

BackgroundDepression is a severe and prevalent mental disorder among youth that requires professional care; however, various barriers hinder access to effective treatments. Chatbots, one of the latest innovations in the research on digital mental health interventions, have shown potential in addressing these barriers. However, most studies on how to design chatbots to treat depression have focused on adult populations or prevention in the general population.ObjectiveThis study aimed to investigate the problems faced by youth with depression and their adaptive coping strategies, as well as attitudes, expectations, and design preferences for chatbots designed to treat depression.MethodsWe conducted a qualitative study, consisting of a semistructured interview and a concurrent think-aloud session, in which participants interacted with a chatbot prototype with 14 youth with a current or remitted depressive episode.ResultsThe participants reported a wide range of problems beyond core depressive symptoms, such as interpersonal challenges, concerns about school and the future, and problems with human therapists. Adaptive coping strategies varied, with most seeking social support or engaging in pleasant activities. Attitudes toward chatbots for depression treatment were predominantly positive, with participants expressing less anxiety about using a chatbot than about seeing a human therapist. Participants showed diverse and partially contradictory design preferences, which included diverse dialogue topics, such as discussing daily life, acute problems, and therapeutic exercises, as well as various preferences for personality, language use, and personalization of the chatbot.ConclusionsOur study provides a comprehensive foundation for designing chatbots that meet the unique needs and design preferences of youth with depression. These findings can inform the design of engaging and effective chatbots tailored to this vulnerable population.

BackgroundThe use of individual wearable devices or internet-based applications to collect biometric data from research participants is popular, but several devices may be needed to replace a full set of research measurements.ObjectiveIn this study, we assessed the feasibility of a “Virtual Home Clinic” within the context of long-term epidemiologic studies.MethodsParticipants from 3 study cohorts were recruited. Devices were sent to the home to measure anthropometrics, resting metabolic rate, blood pressure (BP), heart rate (HR), heart rhythm, oxygen saturation, glucose, total cholesterol, physical activity, diet, sleep duration or quality, and arterial stiffness over the course of 1 week. Stool and saliva were also self-collected for microbiome, DNA, and cotinine. Feasibility and acceptability of collecting measurements using home devices were assessed.ResultsA total of 134 participants were enrolled (87% female, 31% Black; mean age 54.2, SD 8.4 years). Furthermore, 91% (N=122) performed at least one of the home tests. At least two-thirds of participants were able to complete all of the requested readings for glucose, electrocardiogram, BP, diet record, and resting metabolic rate. The scale that measured weight, body composition, and pulse wave velocity (PWV) was more difficult to use (113/134, 84% participants recorded at least one weight and 84/134, 63% recorded a PWV). The device to measure total cholesterol was least successful (32/134, 24% participants completed all readings, 72/134, 54% provided at least one result). Return of biospecimens was highly successful (115/134, 86% returned saliva and 113/134, 84% returned stool). Of 95 who responded to the user acceptability survey, 38 (40%) participants preferred home assessment, 36 (38%) preferred clinic, and 21 (22%) did not have a preference. The mean user acceptability score across devices for ease of use was 4.3 (SD 1.0), for instructions was 4.5 (SD 0.7), and for time to use was 3.9 (SD 1.1; scale of 1‐5, with higher scores indicating greater acceptability). The study team documented several regulatory or IT, connectivity or account, data retrieval, and logistical issues encountered during the study.ConclusionsDespite several complications involved with managing multiple devices and applications, most of the components of the virtual home clinic were reasonably feasible and acceptable to participants.

BackgroundAs the prevalence of mild cognitive impairment (MCI) among older adults increases, so does the need to enhance social participation and cognitive functions through innovative interventions. Digital storytelling in group settings holds potential not only to foster social connections but also to integrate with traditional in-person activities, leveraging both for greater impact.ObjectiveThis study aimed to evaluate the feasibility of the Huiyou app in supporting group-based storytelling activities, aiming to enhance social participation for people with MCI. We focused on the app’s ability to improve storytelling goal attainment, social connectedness, self-efficacy, and subjective happiness, comparing these outcomes between the experimental and control groups.MethodsWe randomly assigned 20 participants with MCI to either an intervention group or a control group, engaging them in the use of the Huiyou digital storytelling app over 4 weekly sessions of 45 minutes each. We measured outcomes through the Assessment of Life Habits questionnaire (77 items), particularly outdoor activities and interpersonal relationships; the Social Connectedness Scale–Revised (20 items); the General Self-Efficacy Scale (10 items), focusing on coping self-efficacy; and the Subjective Well-Being Scale (SWBS; 20 items), with a special emphasis on self-acceptance.ResultsThe sample had an average age of 69.7 (SD 3.21) years, with no significant (P=.23) baseline differences between groups in age, sex, or educational background. Cognitive function, assessed via the Montreal Cognitive Assessment–Chinese questionnaire, also showed no significant differences at baseline (P=.20). Specifically, significant enhancements in the outdoor activity (mean value difference 0.171, SD 0.353; Cohen d=1.046; P=.03) and interpersonal adaptation experience subscales of the SWBS (mean value difference 0.167, SD 0.247; Cohen d=1.290; P=.01) were noted. Notably, storytelling performance improved markedly, evidenced by increases in story sharing duration and complexity. Although overall improvements in Assessment of Life Habits (P=.14), Social Connectedness Scale–Revised (P=.59), and Subjective Well-Being Scale (P=.26) scores were not statistically significant, the large effect sizes observed suggest potential benefits of the Huiyou app that might be obscured by the study’s small sample size.ConclusionsThis study indicates that the Huiyou mobile storytelling app is feasible to enhance social participation and specific aspects of social functioning such as interpersonal adaptation for people with MCI. Despite the lack of significant changes in overall scores for key scales, observed effect sizes highlight a positive trend that merits further investigation. These results advocate for the continuation of digital intervention development to improve quality of life and social integration for individuals with MCI.

Nurses face a higher risk of developing work-related musculoskeletal disorders (WMSDs) due to their primary roles in patient care. Participatory ergonomics (PE), an approach that integrates large-scale interventions performed at organizational and systems levels with small-scale interventions, is widely considered a promising approach to mitigate health problems at the workplace. However, its effectiveness in addressing WMSDs and secondary outcomes such as sickness absence and work performance among nurses is not fully understood. This systematic review assessed the effectiveness of PE interventions in preventing WMSDs and mitigating two related outcomes, sickness absence and work performance, among nurses. A literature search was performed in four electronic databases, PubMed, ScienceDirect, Scopus, and PsycNet, guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to retrieve relevant papers published between 2017 and 2023. Papers fulfilling the eligibility criteria were analyzed and subjected to quality appraisal. Overall, 19 papers were included in the final analysis. Various categories of ergonomic interventions were identified, with the predominant being exercise and physical activities, health promotional activities and training, educational programs, and patient handling devices. Multicomponent interventions, especially those involving physical activities and exercise, demonstrated stronger effects in reducing the risk of WMSDs at 6 months (OR 1.64, 95% CI 1.12-4.54) and 12 months postintervention (OR 2.70, 95% CI 1.52-4.51) compared with single interventions. However, most ergonomic interventions had no statistically significant effect (P>.05) on sickness absence and work performance. More than half (n=13) of the studies demonstrated moderate to high risk of bias, reflecting the need for better quality interventions. Multicomponent interventions, particularly those involving physical activities and exercise, are more effective in reducing the risk of WMSDs among nurses compared with individual interventions. However, their long-term effects in addressing WMSDs, sick absenteeism, and work performance are still unclear. These gaps could be addressed by integrating organizational factors and prevention policies into existing ergonomic interventions, thereby offering opportunities to improve psychological health, job satisfaction, and work dynamics.

BackgroundAnxiety and depression symptoms have been rising among college students, with many increasingly meeting the criteria for 1 or more mental health problems. Due to a rise in internet access and lockdown restrictions associated with the COVID-19 pandemic, online mediums, such as teletherapy, repositories for mental health information, discussion forums, self-help programs, and online screening tools, have become more popular and used by college students to support their mental health. However, there is limited information about individual-level factors that lead college students to use these online tools to support their mental health.ObjectiveThis mixed methods study aimed to examine the associations between demographics, symptom severity, mental health literacy, stigma, attitudes, and self-efficacy and the use of online tools to seek psychological information and services among racially and ethnically diverse college students. This study also aimed to qualitatively characterize types of online tools used, reasons for using tools or lack thereof, and perceived helpfulness of tools.MethodsUndergraduate students (N=123) completed validated measures and provided open-ended descriptions of the types of online tools they used to seek psychological information and services and their reasons for using those tools. Logistic regression analyses were used to test associations of online tool use to seek mental health information and hypothesized predictors. Descriptive statistics were conducted to examine online tool types, reasons for using online tools, and helpfulness explanations.ResultsIn total, 49.6% (61/123) of the participants used online tools (eg, search engines) to seek mental health information, while 30.1% (37/123) used online tools (eg, medical websites) to seek mental health services. Mental health literacy (P=.002; odds ratio 1.14, 95% CI 1.05-1.24) was associated with greater use of online tools to seek mental health information. None of the hypothesized variables predicted online tool use to seek mental health services. In total, 82% (50/61) of participants who sought information found online tools somewhat helpful, while 49% (18/37) of participants who sought services found online tools very helpful. Of the students who did not use online tools to seek information, 19% (12/62) reported it was because they did not know which online tools to use and 31% (19/62) stated they would be encouraged to use online tools if it was recommended by professionals, therapists, family, or friends. Of the students who did not use online tools to seek services, 33% (28/86) reported it was because they did not think mental health help was necessary.ConclusionsThese findings highlight the use of online tools to provide mental health information and connect to professional services, suggesting that online tools are widely used to access mental health support.

BackgroundChatbots, as dialog-based platforms, have the potential to transform health education and behavior-change interventions. Despite the growing use of chatbots, qualitative insights into user and provider experiences remain underexplored, particularly with respect to experiences and perceptions, adoption factors, and the role of theoretical frameworks in design.ObjectiveThis systematic review of qualitative evidence aims to address three key research questions (RQs): (RQ1) user and provider experiences; (RQ2) facilitators and barriers to adoption; and (RQ3) role of theoretical frameworks.MethodsWe systematically searched PubMed, the Cochrane Library, and ScienceDirect from January 1, 2018, to October 1, 2023, for English- or German-language, peer-reviewed qualitative or mixed methods studies. Studies were included if they examined users’ or providers’ experiences with chatbots in health education or behavior-change contexts. Two reviewers independently screened titles, abstracts, and full texts (Cohen κ=0.82). We used the Joanna Briggs Institute Critical Appraisal Checklist for quality assessment and conducted a reflexive thematic analysis following Braun and Clarke’s framework.ResultsAmong the 1754 records identified, 27 studies from 10 countries met the inclusion criteria, encompassing 241 qualitative-only participants and 10,802 mixed method participants (657 contributing qualitative data). For RQ1, users emphasized empathy and emotional connection. For RQ2, accessibility and ease of use emerged as facilitators, whereas trust deficits, technical glitches, and cultural misalignment were key barriers. For RQ3, the integration of behavior-change theories emerged as underutilized despite their potential to increase motivation.ConclusionsChatbots demonstrate strong potential for health education and behavior-change interventions but must address privacy and trust issues, embed robust theoretical underpinnings, and overcome adoption barriers to fully realize their impact. Future directions should include evaluations of cultural adaptability and rigorous ethical considerations in chatbot design.

BackgroundThe perinatal period is one of the most vulnerable times a woman experiences. Multidimensional, interprofessional, and personalized support is needed to improve outcomes in women’s and children’s health while strengthening partner relationships at the same time. Although a vast amount of support services already exist in Germany for psychosocial counseling during the perinatal period, groups who are especially at risk do not take advantage of them.ObjectiveFamily eNav is an app-based intervention developed by experts in the field of medical and psychosocial support to help young parents navigate through primary and secondary care services in Germany according to their needs. It also empowers patient and parenting perspectives through self-education and symptom monitoring for different settings, for example, mental health and preterm birth. While the intervention will be evaluated in a multicenter, randomized, controlled trial, the focus here lies on the conception of the app, demand among patients, and preuse acceptance.MethodsDuring the conception phase, we conducted an explorative study with prospective users and experts in the perinatal psychosocial field to understand the need and preuse acceptance of the intervention. We interviewed 20 participants with a semistructured guide, analyzing their responses using systematic text condensation. Additionally, we conducted a short survey on general questions concerning digitalization within the health care system among the participants.ResultsWe established two main themes: (1) access and barriers to health care and psychosocial services and (2) high preuse acceptance of app-based intervention. Health care and psychosocial providers indicated that there is a high demand for their services, which cannot always be met immediately, and at the same time, they are doubtful of reaching those individuals most in need. Prospective users and health and social care providers alike showed great interest in the perinatal navigator and suggested a variety of needs and content requirements to be included. Regionality, availability, and individualized content were underlined as success factors for high user acceptance. Barriers consisted of data protection concerns, as well as denial of their own needs.ConclusionsOur findings show great acceptance for an app-based intervention on the part of both prospective users and service providers. Feedback on requirements and content, as well as possible barriers, was taken into consideration while developing the app.