App Features Research Articles

An exploration of facilitators and barriers to patient navigator core functions with breast cancer patients: Implications for the development of a human-centered mHealth app

ObjectivesTo understand the barriers to core functions and workflow among patient navigators (PN) who navigate people diagnosed with breast cancer (BC). To identify how a mobile health (mHealth) app could assist PNs in providing care to BC patients. MethodsThis qualitative research study used purposive sampling to recruit stakeholders (N = 33) from January to August 2021. We conducted individual semi-structured interviews with PNs (n = 11), oncology care providers (n = 12), and BC patients (n = 10). We used conventional content analysis to analyze the interview data. ResultsParticipants identified the following sociotechnical systems barriers in PN workflows that negatively impact BC patient care: 1) resources, 2) insurance coverage, 3) communication challenges, and 4) impact of logistical tasks. Participants identified the user experience, app features, and interoperability customizations to enhance PNs' provision of patient care as important design elements to include in a mHealth app. ConclusionFeedback from stakeholders provided valuable insights into key design considerations, functions, and content areas for developing a mHealth app for PN use in BC care delivery. InnovationThis is one of the first studies to incorporate the human-centered design and sociotechnical systems frameworks to understand barriers to PN workflow and provision of BC patient care across the cancer care continuum.

The interplay of app characteristics and smartphone addiction in mobile shopping behaviour

AbstractIn recent years, we have witnessed accelerated digital interactions among new technology users as a means of communication, leading to addictive behaviours owing to the overuse of smartphones and other new technological interfaces that have reshaped our daily routines. Thus, we adopted the social cognitive theory and the attachment theory to explore and understand the users' app adaptations and how mobile app characteristics, through their influence on smartphone addiction, impact mobile shopping behaviour. We designed an online survey to gather responses from 302 mobile app shoppers in India. We analysed the data using the partial least squares structural equation modelling technique. The results indicate that perceived privacy and security, personalization, contextual offers, and retailers' reputations trigger smartphone addiction. Moreover, the interaction between smartphone addiction and app incentives encourages mobile shopping intentions and frequent purchases. These findings would presumably enhance mobile app characteristics as the stimulus of a closer relationship between consumers and retailers. We present valuable avenues for practitioners to strategically manage their businesses' mobile app environment.

User experiences of college students using mental health applications to improve self-care: Implications for improving engagement

The purpose of this study is to evaluate themes on ‘user experiences’ among college students (N = 265) enrolled in an upper-division Psychopathology course who were assigned a project in which they were instructed to identify a self-care goal, choose from a list of six mental health-focused mobile applications (apps) provided by the instructor, and use the app over the course of three weeks to support progress towards their goal. Prior literature on user experiences typically evaluates user reviews, or asks participants to reflect on past app use or anticipate future use. Students reported their experiences using the app during key decision points: app selection, while using the app, and at the conclusion of the assignment. Using thematic analysis, results identified seven central themes and eight subthemes pertaining to the content of the app (e.g., app features) and the context of using the app (e.g., classroom assignment). Content-wise students liked: 1) features with a strong evidence base, namely, thought diaries and guided meditations; 2) progress tracking, because it increased awareness of mood/stressors, motivated students to see improvement, and helped them stay on track. Students appreciated having 3) crisis support resources; 4) app interfaces that allowed for customization (poor app interfaces were sometimes cited as the reason for disengagement); and 5) apps that included varied, comprehensive resources such that it felt like a one-stop shop. In addition to the content of features and design interface, the context in which mental health apps are introduced and used is important. The remaining themes related to the context in which the app was used, including 6) preparation for app usage, such as reviewing scholarly/credible sources, and 7) social support from fellow students completing the same assignment. Future research should evaluate the ‘who, what, when, why, where, and how’ of app utilization during key decision points, such as initial app selection or subscription renewal, to better understand the impact of user experience on engagement.

FinerMe: Examining App-level and Feature-level Interventions to Regulate Mobile Social Media Use

Many digital wellbeing tools help users monitor and control social media use on their smartphones by tracking and setting limits on their usage time. Tracking is typically done at the granularity of phone- or app-level; however, recent social media apps provide various features such as direct messaging, comment reading/posting, and content uploading/viewing. While it is possible to track and analyze within-app feature usage, little is known about the effect of granularity on smartphone interventions. We designed and developed FinerMe to explore how the granularity of interventions (app-level vs. feature-level) affects the usage of popular social media such as Instagram and YouTube on smartphones. We conducted a field study with 56 participants over 16 days that consisted of three phases: baseline collection, self-reflection, and self-reflection with restrictive interventions. The results showed that while both app-level and feature-level interventions similarly reduced social media use, feature-level interventions enabled users to spend less time on passive app features related to content consumption (e.g., following feed on Instagram, and viewing comments on YouTube) than app-level interventions. Moreover, when self-reflection is combined with restrictive interventions at the feature-level, users were more reflective on their usage behavior than when done at the app-level.

Android malware detection method based on graph attention networks and deep fusion of multimodal features

Currently, Android malware detection methods always focus on one kind of app feature, such as structural, semantic, or other statistical features. This paper proposes a novel Android malware detection method that integrates multiple features of Android applications. First, to effectively extract the structural and semantic features, we propose a new type of call graph named the class-set call graph (CSCG) that uses the sets of Java classes as nodes and the call relationships between class sets as edges, and we design a dynamic adaptive CSCG construction method that can automatically determine the node size for applications with different scales. The topic model is used to mine the source code semantics from the class sets as the node features. Then, we use a graph attention network (GAT) with max pooling to extract the CSCG feature that encompass both the semantic and structural features of the Android application. Furthermore, we construct a deep multimodal feature fusion network to fuse the CSCG features with permission features. Experimental results show that our method achieves a detection accuracy of 97.28%–99.54% on the three constructed datasets, which is better than the existing methods.

Feasibility of Implementation of a Mobile Digital Personal Health Record to Coordinate Care for Children and Youth With Special Health Care Needs in Primary Care: Protocol for a Mixed Methods Study.

Electronic health record (EHR)-integrated digital personal health records (PHRs) via Fast Healthcare Interoperability Resources (FHIR) are promising digital health tools to support care coordination (CC) for children and youth with special health care needs but remain widely unadopted; as their adoption grows, mixed methods and implementation research could guide real-world implementation and evaluation. This study (1) evaluates the feasibility of an FHIR-enabled digital PHR app for CC for children and youth with special health care needs, (2) characterizes determinants of implementation, and (3) explores associations between adoption and patient- or family-reported outcomes. This nonrandomized, single-arm, prospective feasibility trial will test an FHIR-enabled digital PHR app's use among families of children and youth with special health care needs in primary care settings. Key app features are FHIR-enabled access to structured data from the child's medical record, families' abilities to longitudinally track patient- or family-centered care goals, and sharing progress toward care goals with the child's primary care provider via a clinician dashboard. We shall enroll 40 parents or caregivers of children and youth with special health care needs to use the app for 6 months. Inclusion criteria for children and youth with special health care needs are age 0-16 years; primary care at a participating site; complex needs benefiting from CC; high hospitalization risk in the next 6 months; English speaking; having requisite technology at home (internet access, Apple iOS mobile device); and an active web-based EHR patient portal account to which a parent or caregiver has full proxy access. Digital prescriptions will be used to disseminate study recruitment materials directly to eligible participants via their existing EHR patient portal accounts. We will apply an intervention mixed methods design to link quantitative and qualitative (semistructured interviews and family engagement panels with parents of children and youth with special health care needs) data and characterize implementation determinants. Two CC frameworks (Pediatric Care Coordination Framework; Patient-Centered Medical Home) and 2 evaluation frameworks (Consolidated Framework for Implementation Research; Technology Acceptance Model) provide theoretical foundations for this study. Participant recruitment began in fall 2022, before which we identified >300 potentially eligible patients in EHR data. A family engagement panel in fall 2021 generated formative feedback from family partners. Integrated analysis of pretrial quantitative and qualitative data informed family-centered enhancements to study procedures. Our findings will inform how to integrate an FHIR-enabled digital PHR app for children and youth with special health care needs into clinical care. Mixed methods and implementation research will help strengthen implementation in diverse clinical settings. The study is positioned to advance knowledge of how to use digital health innovations for improving care and outcomes for children and youth with special health care needs and their families. ClinicalTrials.gov NCT05513235; https://clinicaltrials.gov/study/NCT05513235. DERR1-10.2196/46847.

An mHealth Platform for People With HIV Receiving Care in Washington, District of Columbia: Qualitative Analysis of Stakeholder Feedback.

HIV viral suppression and retention in care continue to be challenging goals for people with HIV in Washington, District of Columbia (DC). The PositiveLinks mobile app is associated with increased retention in care and viral load suppression in nonurban settings. The app includes features such as daily medication reminders, mood and stress check-ins, an anonymized community board for peer-to-peer social support, secure messaging to care teams, and resources for general and clinic-specific information, among other features. PositiveLinks has not been tailored or tested for this distinct urban population of people with HIV. This study aimed to inform the tailoring of a mobile health app to the needs of people with HIV and their providers in Washington, DC. We conducted a 3-part formative study to guide the tailoring of PositiveLinks for patients in the DC Cohort, a longitudinal cohort of >12,000 people with HIV receiving care in Washington, DC. The study included in-depth interviews with providers (n=28) at study clinics, focus groups with people with HIV enrolled in the DC Cohort (n=32), and a focus group with members of the DC Regional Planning Commission on Health and HIV (COHAH; n=35). Qualitative analysis used a constant comparison iterative approach; thematic saturation and intercoder agreement were achieved. Emerging themes were identified and grouped to inform an adaptation of PositiveLinks tailored for patients and providers. Emerging themes for patients, clinic providers, and COHAH providers included population needs and concerns, facilitators and barriers to engagement in care and viral suppression, technology use, anticipated benefits, questions and concerns, and suggestions. DC Cohort clinic and COHAH provider interviews generated an additional theme: clinic processes. For patients, the most commonly discussed potential benefits included improved health knowledge and literacy (mentioned n=10 times), self-monitoring (n=7 times), and connection to peers (n=6 times). For providers, the most common anticipated benefits were improved communication with the clinic team (n=21), connection to peers (n=14), and facilitation of self-monitoring (n=11). Following data review, site principal investigators selected core PositiveLinks features, including daily medication adherence, mood and stress check-ins, resources, frequently asked questions, and the community board. Principal investigators wanted English and Spanish versions depending on the site. Two additional app features (messaging and documents) were selected as optional for each clinic site. Overall, 3 features were not deployed as not all participating clinics supported them. Patient and provider perspectives of PositiveLinks had some overlap, but some themes were unique to each group. Beta testing of the tailored app was conducted (August 2022). This formative work prepared the team for a cluster randomized controlled trial of PositiveLinks' efficacy. Randomization of clinics to PositiveLinks or usual care occurred in August 2022, and the randomized controlled trial launched in November 2022. RR2-10.2196/37748.

Understanding Physical Activity Determinants in an HIV Self-Management Intervention: Qualitative Analysis Guided by the Theory of Planned Behavior.

People living with HIV have long life expectancy and are experiencing more comorbid conditions, being at an increased risk for developing cardiovascular disease (CVD) and diabetes, further exacerbated due to the HIV or inflammatory process. One effective intervention shown to decrease mortality and improve health outcomes related to CVD and diabetes in people living with HIV is increased regular physical activity. However, people living with HIV often fall short of the daily recommended physical activity levels. While studies show that mobile health (mHealth) can potentially help improve people's daily activity levels and reduce mortality rates due to comorbid conditions, these studies do not specifically focus on people living with HIV. As such, it is essential to understand how mHealth interventions, such as wearables, can improve the physical activity of people living with HIV. This study aimed to understand participants' experiences wearing a fitness tracker and an app to improve their physical activity. In total, 6 focus groups were conducted with participants who completed the control arm of a 6-month randomized controlled trial (ClinicalTrials.gov NCT03205982). The control arm received daily walk step reminders to walk at least 5000 steps per day and focused on the overall wellness of the individual. The analysis of the qualitative focus groups used inductive content analysis using the theory of planned behavior as a framework to guide and organize the analysis. In total, 41 people living with HIV participated in the focus groups. The majority (n=26, 63%) of participants reported their race as Black or African American, and 32% (n=13) of them identified their ethnicity as Hispanic or Latino. In total, 9 major themes were identified and organized following the theory of planned behavior constructs. Overall, 2 major themes (positive attitude toward tracking steps and tracking steps is motivating) related to attitudes toward the behavior, 2 major themes (social support or motivation from the fitness tracker and app and encouragement from family and friends) related to participant's subjective norms, 1 theme (you can adjust your daily habits with time) related to perceived behavioral control, 2 themes (reach their step goal and have a healthier lifestyle) related to participant's intention, and 2 themes (continuing to walk actively and regularly wearing the fitness tracker) related to participant's changed behavior. Participants highlighted how the mHealth interface with the avatar and daily step tracking motivated them to both begin and continue to engage in physical activity by adjusting their daily routines. Findings from this study illustrate how features of mHealth apps may motivate people living with HIV to start and continue sustained engagement in physical activities. This sustained increase in physical activity is crucial for reducing the risk of comorbid conditions such as diabetes or CVD. ClinicalTrials.gov NCT03205982; https://classic.clinicaltrials.gov/ct2/show/NCT03205982.

How reliable is assessment of children's sentence comprehension using a self-directed app? A comparison of supported versus independent use.

This study reports on the feasibility of using the Test of Complex Syntax- Electronic (TECS-E), as a self-directed app, to measure sentence comprehension in children aged 4 to 5 ½ years old; how testing apps might be adapted for effective independent use; and agreement levels between face-to-face supported computerized and independent computerized testing with this cohort. A pilot phase was completed with 4 to 4;06-year-old children, to determine the appropriate functional app features required to facilitate independent test completion. Following the integration of identified features, children completed the app independently or with adult support (4-4;05 (n = 22) 4;06-4;11 months (n = 55) and 5 to 5;05 (n = 113)) and test re-test reliability was examined. Independent test completion posed problems for children under 5 years but for those over 5, TECS-E is a reliable method to assess children's understanding of complex sentences, when used independently.

Development of an App for Tracking Family Engagement With Early Intervention Services: Focus Groups and Pilot Evaluation Study.

Expedient access to early intervention (EI) systems has been identified as a priority for children with developmental delays, identified disabilities, and other special health care needs. Despite the mandated availability of EI, it remains challenging for families to navigate referral processes and establish appropriate services. Such challenges disproportionately affect families from traditionally underserved communities. Mobile health apps can improve clinical outcomes, increase accessibility to health services, and promote adherence to health-related interventions. Though promising, the implementation of apps within routine care is in its infancy, with limited research examining the components of what makes an effective app or how to reach families most impacted by inequities in health care delivery. In study 1, we conducted focus groups to access a broad range of perspectives on the process of navigating the EI system, with the dual goals of identifying ways in which a patient-facing app might facilitate this process and identifying barriers to use with traditionally underrepresented and underserved groups. In study 2, focus group findings informed the development of a patient-facing app, which was subsequently tested with a pilot sample of 5 families. In study 1, the focus groups included 29 participants from 4 shareholder groups. Targeted sampling was used to recruit participants from traditionally underrepresented groups. Focus group questions sought information about barriers families experience as they navigate the EI system, ideal features of a patient-facing app designed to track family engagement with the EI system, and potential barriers. Focus group procedures were informed by the Consolidated Framework for Implementation Research framework. In study 2, a pilot app was developed. The app was tested with a sample of 5 families of young children involved in the EI system. Families provided information on app functionality and usability. Qualitative analysis revealed a desire for increased communication and information about the process of accessing EI services, potential utility of an app for communication purposes, and clear recommendations for app features. Insights from focus groups were used to inform the development of the Family on Track app and related implementation supports. App features included survey customization, timing and delivery of prompts, and questions related to barriers and service satisfaction. Implementation supports include a visual guide for app installation, resources related to common family questions, and availability of study personnel to guide families through installation and provide ongoing support. Field testing provided preliminary information about app usability, including identifying future directions. The results of this study could support the development of a new way for the EI system to communicate and connect with families, provide families with a means to communicate satisfaction and frustration, and access the supports they need to be active participants in their child's care.

O.5.1-3 Co-creation of an active transportation promotion intervention: a concept mapping study

Abstract Purpose Active transportation (AT) is an efficient way to increase daily physical activity and reduce pollution from the transportation sector. Mhealth has contributed to behavior change in fields like physical activity and has been explored to encourage AT. Most interventions, however, did not incorporate evidence-based behavior change techniques and were not co-created with potential users. We aim to understand how AT can be promoted via mhealth intervention by using a bottom-up participatory approach. Methods Concept mapping was done online via GroupWisdom platform, with the public of Alpes-Maritimes County, France. Participants were asked to brainstorm, sort, and rate ideas about mobile app features to encourage AT. Multidimensional scaling algorithm and hierarchical cluster analysis were used to create visual cluster maps to illustrate the participants’ conceptual thinking of the topic. We compared the data by participants’ age, education, and typical transportation mode to understand how different groups perceived each idea and clusters. Results Participants generated 44 unique ideas that they believe would encourage AT behaviors. Six themes emerged, from highest to lowest cluster rating: Infrastructure (n = 9 ideas) and Itinerary (n = 9 ideas), which were consistently rated across groups; Contact with government (n = 4 ideas); Data (n = 12 ideas), with the most number of ideas generated; App usability (n = 6 ideas); and Legislation and code of conduct (n = 4 ideas), with the least number of ideas. Conclusions Our findings showed various ways AT can be promoted. Even though the participants were asked about mobile apps features, they quickly pointed out ideas unrelated to mobile apps. The built environment and infrastructure are clearly the most important factors to promote AT, for our participants. However, they have also identified other soft measures like information, participation in decision making, and social aspects that can contribute to behavior change and support sustainable and healthy modes of transportation. Therefore, a systemic and multifaceted approach is recommended to promote AT. Support/Funding Source This work was supported by the French government, managed by the Agence Nationale de la Recherche under the project Investissements d'Avenir UCAJEDI with the reference n° ANR-15-IDEX-01.

Predictors of users' adherence to a fully automated digital intervention to manage insomnia complaints.

Fully automated digital interventions show promise for disseminating evidence-based strategies to manage insomnia complaints. However, an important concept often overlooked concerns the extent to which users adopt the recommendations provided in these programs into their daily lives. Our objectives were evaluating users' adherence to the behavioral recommendations provided by an app, and exploring whether users' perceptions of the app had an impact on their adherence behavior. Case series study of individuals completing a fully automated insomnia management program, conducted by a virtual agent, during December 2020 to September 2022. Primary outcome was self-reported adherence to the behavioral recommendations provided. Perceptions of the app and of the virtual agent were measured with the Acceptability E-Scale and ECA-Trust Questionnaire. Insomnia was evaluated with the Insomnia Severity Index at baseline (phase 1), after 7days of sleep monitoring (phase 2) and post-intervention (phase 3). A total of 824 users were included, 62.7% female, mean age 51.85 (±12.55) years. Of them, 32.7% reported having followed at least one recommendation. Users' trust in the virtual agent and acceptance of the app were related to a pre-intervention effect in insomnia severity (phase 2). In turn, larger pre-intervention improvements predicted better adherence. Mediational analyses showed that higher levels of trust in the virtual agent and better acceptance of the app exerted statistically significant positive effects on adherence (β = 0.007, 95% CI, 0.001-0.017 and β = 0.003, 95% CI 0.0004-0.008, respectively). Users' adherence is motivated by positive perceptions of the app's features and pre-intervention improvements. Determinants of adherence should be assessed, and targeted, to increase the impact of fully automated digital interventions.

Can technology break the invisible wall? Exploring mobile application needs and preferences among North Korean refugees in South Korea

Although the ubiquity of digital technology among refugees inevitably changes resettlement experiences, studies exploring the utility and usability of mobile applications (apps) centered on refugees’ needs and priorities are largely fragmented. Using focus groups with North Korean refugees in South Korea ( N = 40), we explored the utility and usability of mobile apps, examined differences in app preferences among demographic subgroups and proposed recommendations for tailored app features. Six themes emerged under two domains: (a) content needs and priorities, and (b) feature preferences. Study findings highlight refugees as both consumers and producers of knowledge with implications for scaling up digital interventions for refugee resettlement.

U.S. parents' intentions to use anti-bullying apps: Insights from a comprehensive model

Cyberbullying has become a prominent risk for youth and an increasing concern for parents. To help parents reduce their child's cyberbullying risk, anti-bullying apps (ABAs)—mobile applications for identifying and preventing instances of cyberbullying—have been developed in recent years. Given that ABAs are an emerging technology, limited research has been conducted to understand the factors predicting parents' intentions to use them. Drawing on three interdisciplinary theoretical frameworks, a sample of parents in the U.S. recruited through Amazon Mechanical Turk completed an online survey to assess parents' knowledge of, attitudes about, and intentions to use ABAs. Participants also rated the importance of a range of ABA functions and provided information about their child's social media use and bullying history. A series of path analyses revealed that the importance parents placed on an app's ability to provide information about their child's cyberbullying risk predicted more positive attitudes toward ABAs and greater perceived usefulness of them. Stronger intentions to use ABAs were predicted by greater cyberbullying concern, greater importance of social recommendations, greater perceived usefulness, more positive attitudes toward the apps, and lower ratings of the importance of ease of use. These findings shed light on the factors predicting parents' intentions to use ABAs and the app features they view as most important. Crucial directions for future research and implications for anti-bullying efforts are discussed.

Acceptability and Utility of a Smartphone App to Support Adolescent Mental Health (BeMe): Program Evaluation Study.

Adolescents face unprecedented mental health challenges, and technology has the opportunity to facilitate access and support digitally connected generations. The combination of digital tools and live human connection may hold particular promise for resonating with and flexibly supporting young people's mental health. This study aimed to describe the BeMe app-based platform to support adolescents' mental health and well-being and to examine app engagement, usability, and satisfaction. Adolescents in the United States, aged 13 to 20 years, were recruited via the web and enrolled between September 1 and October 31, 2022. App engagement, feature use, clinical functioning, and satisfaction with BeMe were examined for 30 days. BeMe provides content based on cognitive behavioral therapy, dialectical behavior therapy, motivational interviewing, and positive psychology; interactive activities; live text-based coaching; links to clinical services; and crisis support tools (digital and live). The average age of the sample (N=13,421) was 15.04 (SD 1.7) years, and 56.72% (7612/13,421) identified with she/her pronouns. For the subsample that completed the in-app assessments, the mean scores indicated concern for depression (8-item Patient Health Questionnaire mean 15.68/20, SD 5.9; n=239), anxiety (7-item Generalized Anxiety Disorder Questionnaire mean 13.37/17, SD 5.0; n=791), and poor well-being (World Health Organization-Five Well-being Index mean 30.15/100, SD 16.1; n=1923). Overall, the adolescents engaged with BeMe for an average of 2.38 (SD 2.7) days in 7.94 (SD 24.1) sessions and completed 11.26 (SD 19.8) activities. Most adolescents engaged with BeMe's content (12,270/13,421, 91.42%), mood ratings (13,094/13,421, 97.56%), and interactive skills (10,098/13,421, 75.24%), and almost one-fifth of the adolescents engaged with coaching (2539/13,421, 18.92%), clinical resources (2411/13,421, 17.96%), and crisis support resources (2499/13,421, 18.62%). Overall app engagement (total activities) was highest among female and gender-neutral adolescents compared with male adolescents (all P<.001) and was highest among younger adolescents (aged 13-14 years) compared with all other ages (all P<.001). Satisfaction ratings were generally high for content (eg, 158/176, 89.8% rated as helpful and 1044/1139, 91.66% improved coping self-efficacy), activities (5362/8468, 63.32% helpful and 4408/6072, 72.6% useful in coping with big feelings), and coaching (747/894, 83.6% helpful and 747/894, 83.6% improved coping self-efficacy). Engagement (total activities completed) predicted the likelihood of app satisfaction (P<.001). Many adolescents downloaded the BeMe app and completed multiple sessions and activities. Engagement with BeMe was higher among female and younger adolescents. Ratings of BeMe's content, activities, and coaching were very positive for cognitive precursors aimed at reducing depression and anxiety and improving well-being. The findings will inform future app development to promote more sustained engagement, and future evaluations will assess the effects of BeMe on changes in mental health outcomes.

Outcomes of End-User Testing of a Care Coordination Mobile App With Families of Children With Special Health Care Needs: Simulation Study.

Care for children with special health care needs relies on a network of providers who work to address the medical, behavioral, developmental, educational, social, and economic needs of the child and their family. Family-directed, manually created visual depictions of care team composition (ie, care mapping) and detailed note-taking curated by caregivers (eg, care binders) have been shown to enhance care coordination for families of these children, but they are difficult to implement in clinical settings owing to a lack of integration with electronic health records and limited visibility of family-generated insights for care providers. Caremap is an electronic health record-integrated digital personal health record mobile app designed to integrate the benefits of care mapping and care binders. Currently, there is sparse literature describing end-user participation in the co-design of digital health tools. In this paper, we describe a project that evaluated the usability and proof of concept of the Caremap app through end-user simulation. This study aimed to conduct proof-of-concept testing of the Caremap app to coordinate care for children with special health care needs and explore early end-user engagement in simulation testing. The specific aims included engaging end users in app co-design via app simulation, evaluating the usability of the app using validated measures, and exploring user perspectives on how to make further improvements to the app. Caregivers of children with special health care needs were recruited to participate in a simulation exercise using Caremap to coordinate care for a simulated case of a child with complex medical and behavioral needs. Participants completed a postsimulation questionnaire adapted from 2 validated surveys: the Pediatric Integrated Care Survey (PICS) and the user version of the Mobile Application Rating Scale (uMARS). A key informant interview was also conducted with a liaison to Spanish-speaking families regarding app accessibility for non-English-speaking users. A Caremap simulation was successfully developed in partnership with families of children with special health care needs. Overall, 38 families recruited from 19 different US states participated in the simulation exercise and completed the survey. The average rating for the survey adapted from the PICS was 4.1 (SD 0.82) out of 5, and the average rating for the adapted uMARS survey was 4 (SD 0.83) out of 5. The highest-rated app feature was the ability to track progress toward short-term, patient- and family-defined care goals. Internet-based simulation successfully facilitated end-user engagement and feedback for a digital health care coordination app for families of children with special health care needs. The families who completed simulation with Caremap rated it highly across several domains related to care coordination. The simulation study results elucidated key areas for improvement that translated into actionable next steps in app development.

Exploring English newspaper reading of Chinese college English majors in mobile-assisted language learning

Abstract With advances in mobile technology, mobile devices have been widely applied in language learning. English newspaper reading apps are emerging language learning tools for Chinese English majors. However, little has been published on reading in mobile-assisted language learning (MALL) environments. Studies of English newspaper reading are limited to the classroom environment. To explore English newspaper reading in MALL, this study analysed the features of English newspaper reading apps, usage patterns, and users’ language learning strategies by adopting both quantitative and qualitative methods. This research found that (1) apps incorporating multimedia technology mainly provide vocabulary instruction. Most English majors prefer English newspaper reading apps with explanations; (2) Learners tend to use WeChat as the main reading platform instead of utilising apps in combination; and (3) The most frequently used strategies by English majors are affective strategies, while the least frequently used strategies are social strategies, although most English newspaper reading apps support collaborative learning. The study is expected to inspire the design of English newspaper reading apps and the reform of the English newspaper reading course.

Auditing Accessibility of Pavements and Points of Interest in Urban Areas: The ‘Seek &amp; Go’ Tool

In recent years, accessibility has become a topic of great interest on a global scale across the scientific, business, and policy sectors. There are two primary reasons for this growing trend. Firstly, accessibility serves as a vital indicator reflecting the social performance of communities, and the public is increasingly aware of critical social issues such as accessibility. Secondly, accessibility is essential for the sustainable development of regions and civil settings, facilitating inclusion and business growth. In this regard, information and communications technologies can play a crucial role in facilitating the accessibility of spaces by disabled people. Numerous digital tools and smart applications are already available to serve this purpose. This study presents a novel digital tool called ‘Seek &amp; Go’, a comprehensive aid application designed specifically for disabled individuals. The app features a GPS navigation system that caters to pedestrians with disabilities and unique accessibility requirements. The present study documents the models underlying the development of ‘Seek &amp; Go’, discusses technical aspects of the application, and presents user experience insights.

Nutrition and Diet Apps: Brazilian Panorama before and during the COVID-19 Pandemic.

To describe the characteristics of nutrition and diet apps before and after the COVID-19 pandemic available in Brazil. Nutrition and diet apps were identified using the official Apple and Google stores. The search occurred in January 2020 and May 2022 in Brazil. We extracted the nutritional content and standard indicators (e.g., being developed before or after 2020, number of languages, target population, investment, prices, seller, number of reviews and downloads, consumer rating). 280 apps were launched before and 411 during the COVID-19 period. Most apps were available in at least ten languages (96.6%), with no indication of age (95.6%) or partial or full cost (59%). As for the contents, 18.9% addressed personal diet suggestions; 73.4%, nutritional education; 48.8%, revenues; 35.9%, physical activity with a nutritional guide; 2.3%, nutritional recommendation for eating out; 23.9%, grocery shopping with a scan code; 32.4%, food diary; 18.9%, water intake; and 4.6%, nutrition/diseases. The data show an evolution that may have been boosted by the pandemic and that reveals a trend towards the development of apps with educational content. During the pandemic, there was a positive qualitative and quantitative movement in e-health regarding the promotion of education.

Investigating Individuals' Preferences in Determining the Functions of Smartphone Apps for Fighting Pandemics: Best-Worst Scaling Survey Study.

Smartphone apps have been beneficial in controlling and preventing the COVID-19 pandemic. However, there is a gap in research surrounding the importance of smartphone app functions from a user's perspective. Although the insights and opinions of different stakeholders, such as policymakers and medical professionals, can influence the success of a public health policy, any strategy will face difficulty in achieving the expected effect if it is not based on a method that users can accept. This study aimed to assess the importance of a hypothetical smartphone app's functions for managing health during a pandemic based on the perspective of user preferences. A cross-sectional and web-based survey using the best-worst scaling (BWS) method was used to investigate the general population's preferences for important smartphone app functions. Participants were recruited from a professional surveying company's web-based surveying panel. The attributes of the BWS questionnaire were developed based on a robust process, including literature review, interviews, and expert discussion. A balanced incomplete block design was used to construct the choice task to ensure the effectiveness of the research design. Count analysis, conditional logit model analysis, and mixed logit analysis were used to estimate preference heterogeneity among respondents. The responses of 2153 participants were eligible for analysis. Nearly 55% (1192/2153) were female, and the mean age was 31.4 years. Most participants (1765/2153, 81.9%) had completed tertiary or higher education, and approximately 70% (1523/2153) were urban residents. The 3 most vital functions according to their selection were "surveillance and monitoring of infected cases," "quick self-screening," and "early detection of infected cases." The mixed logit regression model identified significant heterogeneity in preferences among respondents, and stratified analysis showed that some heterogeneities varied in respondents by demographics and COVID-19-related characteristics. Participants who preferred to use the app were more likely to assign a high weight to the preventive functions than those who did not prefer to use it. Conversely, participants who showed lower willingness to use the app tended to indicate a higher preference for supportive functions than those who preferred to use it. This study ranks the importance of smartphone app features that provide health care services during a pandemic based on the general population's preferences in China. It provides empirical evidence for decision-makers to develop eHealth policies and strategies that address future public health crises from a person-centered care perspective. Continued use of apps and smart investment in digital health can help improve health outcomes and reduce the burden of disease on individuals and communities.