Health Experts Research Articles

Legal review of the constitutional court decision number 135/PUU-XIII/2015 on the voting rights of people with mental disorders (ODGJ) reviewed from the foundation of positive law

People's participation as citizens in the implementation of government is the main requirement in filling positions. To be able to take part in elections, people must comply with the provisions that have been ratified by law. The KPU "General Election Commission" as the organizer of the democratic party gives the right to vote in elections to People with Mental Disorders (ODGJ). ODGJ are allowed to take part in the 2024 elections as stated in the decision of the MK "Constitutional Court". The aim of this research is to examine juridically "the decision of the Constitutional Court Number 135/PUU-XIII/2015 concerning the voting rights of People with Mental Disorders or ODGJ and the impact that may arise from the participation of ODGJ in taking part in the election". The author chose a normative juridical approach (Legislative Approach). The research carried out by the author used a normative juridical approach (Legislation Approach). The data used in this research uses secondary data, namely data or input sourced from literature and statutory regulations. For this type of research, the author applies qualitative descriptive research. Based on research results, the ruling "Constitutional Court Decision Number 135/PUU-XII/2015" states that people suffering from mental disorders can vote only if they do not experience permanent mental disorders that have prevented them from voting in general elections, according to mental health experts.. Based on this, there is disharmony between the decision of the constitutional court and positive law in Indonesia. Apart from that, the possible impact of ODGJ's participation in the election is the emergence of various frauds in the democratic party process.

Challenges and Alternatives to Evaluation Methods and Regulation Approaches for Medical Apps as Mobile Medical Devices: International and Multidisciplinary Focus Group Discussion.

The rapid proliferation of medical apps has transformed the health care landscape by giving patients and health care providers unprecedented access to personalized health information and services. However, concerns regarding the effectiveness and safety of medical apps have raised questions regarding the efficacy of randomized controlled trials (RCTs) in the evaluation of such apps and as a requirement for their regulation as mobile medical devices. This study aims to address this issue by investigating alternative methods, apart from RCTs, for evaluating and regulating medical apps. Using a qualitative approach, a focus group study with 46 international and multidisciplinary public health experts was conducted at the 17th World Congress on Public Health in May 2023 in Rome, Italy. The group was split into 3 subgroups to gather in-depth insights into alternative approaches for evaluating and regulating medical apps. We conducted a policy analysis on the current regulation of medical apps as mobile medical devices for the 4 most represented countries in the workshop: Italy, Germany, Canada, and Australia. We developed a logic model that combines the evaluation and regulation domains on the basis of these findings. The focus group discussions explored the strengths and limitations of the current evaluation and regulation methods and identified potential alternatives that could enhance the quality and safety of medical apps. Although RCTs were only explicitly mentioned in the German regulatory system as one of many options, an analysis of chosen evaluation methods for German apps on prescription pointed toward a "scientific reflex" where RCTs are always the chosen evaluation method. However, this method has substantial limitations when used to evaluate digital interventions such as medical apps. Comparable results were observed during the focus group discussions, where participants expressed similar experiences with their own evaluation approaches. In addition, the participants highlighted numerous alternatives to RCTs. These alternatives can be used at different points during the life cycle of a digital intervention to assess its efficacy and potential harm to users. It is crucial to recognize that unlike analog tools, digital interventions constantly evolve, posing challenges to inflexible evaluation methods such as RCTs. Potential risks include high dropout rates, decreased adherence, and nonsignificant results. However, existing regulations do not explicitly advocate for other evaluation methodologies. Our research highlighted the necessity of overcoming the gap between regulatory demands to demonstrate safety and efficacy of medical apps and evolving scientific practices, ensuring that digital health innovation is evaluated and regulated in a way that considers the unique characteristics of mobile medical devices.

Risk perceptions of healthcare workers and occupational health experts on psychological distress: a qualitative mental model study

Abstract Background The objectives of this study are to explore healthcare workers’ (HCW) mental models regarding psychological distress and to compare these with that of experts. Methods Semi-structured interviews was conducted (n = 28 HCWs, n = 13 experts). Topic list encompassed risk perception, early stress symptoms, causes, consequences and preventive measures of psychological distress. Interviews were transcribed verbatim and thematically analyzed using MAXQDA. Results Similarities were found in risk perception, symptoms, causes, and consequences. Differences arose in HCWs' reliance on personal experiences and values, versus experts' scientific perspective. Preventive measures also showed discrepancies. Variation within HCWs was found on all aspects of their mental model. Conclusion For effective preventive interventions regarding psychological distress, experts should consider HCWs' personal values and experiences, acknowledging the variation in their mental models. This approach may enhance HCWs' engagement in preventive behaviors.

Surviving in the midst of 'Nowhere': Disrupting the conceptualisation of a maternity care desert.

The conceptualisation of 'care deserts' has gained increased public attention in recent years. This paper engages a reproductive justice framework to investigate the (mis)alignment of a maternity care desert within a predominantly Black rural community in the United States. I draw on a case study of Gadsden County, Florida-a community that is perceived by its members to be a maternity care desert but that is not technically defined as one-to demonstrate how Black birthing people are cultivating a reproductive liberatory consciousness. Semi-structured interviews with birthing persons and reproductive health experts reveal three overarching processes-naming barriers to health equity, resisting health inequity and cultivating health equity-that characterise a reproductive liberatory consciousness, which I identify as an analytical tool to outline how local social actors are identifying structural constraints as well as developing strategies of communal care and resistance. This work contributes to sociological research on reproductive justice and health equity by exploring the limitations of 'desert' frameworks. Pointing to the need to carefully consider the mechanisms that actively disrupt and potentially transform spatial stratifications and inequities, this paper advances a new understanding of birthing space that captures the layered movements of those living within a perceived maternity care desert.

Temporal changes in HIV-related stigma and sexual behaviours: An examination of 22 African countries.

ABSTRACTDespite non-trivial success against the HIV epidemic, health experts in Sub-Saharan Africa (SSA) remain concerned about new infections, stigma attitudes, and increasing rates of higher-risk sexual behaviours (HRSBs). Although this concern has produced voluminous scholarship on the behavioural consequences of belonging to stigmatised populations, scholars have only recently examined the behavioural consequences of holding stigmatising attitudes. Existing work generally finds a positive relationship between stigmatising beliefs and the practice of HRSBs. Yet, it is unknown whether this relationship has changed for countries over the past two decades. We fill this gap using Demographic and Health Survey data from 22 SSA countries. We first find that in most countries, the practice of HRSBs has increased, while stigma beliefs have become more tolerant. Second, the relationship between stigma beliefs and HRSBs changed in only six countries: Nigeria, Kenya, Mozambique, Sierra Leone, Ethiopia, and Lesotho. It changed from non-existent or negative to positive in Nigeria, Kenya, Mozambique, and Ethiopia, but non-existent to negative in Sierra Leone. In Lesotho, the positive association weakened over time. These findings highlight the importance of social and epidemic contexts when considering how stigma impacts sexual behaviours and HIV rates in SSA.

Michael A. (Mick) Smyer (1950-2024).

Memorializes Michael A. (Mick) Smyer (1950-2024). Mick was a clinical psychologist, gerontologist, expert in mental health and aging policy, academic administrator, and climate activist. He contributed importantly to the development of clinical geropsychology from the beginning of its emergence as an organized field. Among many roles and recognitions, Mick was president of Division 20 of the American Psychological Association (APA). He contributed to the founding of the Clinical Geropsychology section of Division 12 and was the section's first president. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parenting strategies to support adolescent mental health during a pandemic: A Delphi consensus study

BackgroundThe COVID-19 pandemic has had ongoing detrimental effects on mental health, especially for young people. Parents can play a crucial role in the prevention of youth depression and anxiety disorders. While parenting guidelines for reducing the risk of adolescent depression and anxiety have been developed, they needed to be adapted for the unique challenges brought by a pandemic. MethodThis study employed the Delphi methodology to establish expert consensus on parenting strategies that are important for preventing adolescent depression or anxiety disorders during a pandemic. Through a literature search and panel recommendations, we identified 304 parenting recommendations. These were presented to an international panel of 35 experts in parenting and youth mental health, who rated the importance of these recommendations in preventing adolescent depression and anxiety over three survey rounds. ResultsThere were 167 parenting strategies endorsed as important or essential in reducing adolescents' risk of developing depression or anxiety disorders during a pandemic by ≥90% of the panel. These strategies were written into a set of specific and actionable guidelines for parenting through the pandemic, and made freely available online for parents. ConclusionsThis study adapted an original set of parenting guidelines for the COVID-19 pandemic, supported by research evidence and/or international experts, which can be promoted in Western English-speaking communities to help parents protect their adolescents from depression and anxiety disorders during pandemic and post-pandemic times.

SMOKING PREVALENCE AMONG DRIVERS OF DHAKA CITY:

Smoking is an increasingly prevalent habit in Bangladesh, particularly among men with low socio-economic status. Tobacco expenditures exacerbate the effects of poverty and cause significant deterioration in living standards among the poor Bangladeshi people. A cross sectional study was carried out from 15th to 26th March, 2013 to determine the prevalence, pattern, socio-economic impact of smoking among bus drivers of Dhaka city. The prevalence of cigarette smoking was 93% and 20% of total income was spent on cigarettes indicating more than twice as much as per capita expenditure on food, clothing, housing, health and education combined, resulting in illiterate, malnourished household members. Though most (32.3%) of the drivers started smoking before involving in driving profession, excessive smoking was promoted by occupational and environmental stress experiencing hectic work schedule. Tobacco can also worsen poverty among users and their families since most of the drivers reported heart disease (26.9%) and other health complications caused by smoking, depriving families of much-needed income and imposing additional costs of health care. Around 70% smokers wished to quit smoking considering its detrimental effect but unknown of quitting strategy. Interventions and preventions by policy makers, public health experts and other stakeholders should be introduced because smoking was more prevalent among bus drivers with detrimental health sequel.

Systematic Literature Review of Disseminating Health Information to BIPOC Communities

Purpose This study aims to systematically review the literature to examine best practices for disseminating health information and strategies useful for advancing equitable health outcomes in communities of Black, Indigenous, and People of Color (BIPOC). Methods Databases such as Science.gov, Education Resources Information Center (ERIC), Social Science Research Network, and CHAT AI were searched using terms like “health promotion,” “information dissemination/methods,” “minority communities,” “urban health,” “health education/methods,” and “health promotion/methods.” The search focused on qualitative, quantitative, and mixed-methods studies conducted between January 1, 2005, and December 31, 2023. An academic expert evaluated the manuscripts for quality. Dissemination methods were categorized based on cultural, linguistic, and sociodemographic characteristics. Results/Expected results Out of 4,726 articles identified, 23 were included in the full review. The study found that the most effective methods for disseminating health information involved direct community interaction using versatile communication strategies. Real-time engagement and accessibility to public health experts increased community trust and participation. Narrative storytelling, focus groups, workshops, and the use of technology for visual representation were particularly effective. Major obstacles included the lack of stakeholder interaction, language barriers, cultural, educational, and generational differences, and limited funding for human resources. The unavailability of information from previous research also caused frustration among decision-makers. Conclusion Effective engagement with BIPOC communities requires diverse communication methods. Involving community members in selecting settings, language, cultural activities, and other specific aspects helps non-community stakeholders understand evidence-based best practices for health information dissemination, thereby improving healthcare outcomes. Implications This comprehensive literature review enhances understanding of evidence-based best practices for disseminating health information to BIPOC communities. The findings provide valuable insights for policymakers, healthcare providers, community organizations, and researchers to develop targeted and effective health communication strategies.

Challenging cases in rheumatic disease pregnancy: management perspectives from reproductive rheumatologists

Pregnant women with rheumatic and musculoskeletal diseases (RMDs) have a higher risk of adverse pregnancy and perinatal outcomes compared to those without RMDs. Although evidence-based guidelines have been developed for the reproductive health care and management of these individuals, multiple areas of uncertainty exist around the diagnosis and treatment of pregnant patients with confirmed or suspected RMDs. We present a series of outpatient cases that address areas of uncertainty in the field of reproductive rheumatology. Expert opinions were elicited from rheumatologists who have expertise in the reproductive health of individuals with RMDs to build new understanding around diagnosis or treatment approaches. The cases focused on the interpretation of antiphospholipid antibodies in various clinical scenarios, diagnosis and management of nephrotic-range proteinuria during pregnancy, and the use of tumor necrosis factor inhibitors during pregnancy. Our objective was not to replace existing guidelines and classification criteria but rather to provide a range of expert opinions that rheumatologists might consider when tailoring treatment and care for patients, particularly in challenging situations with limited data.

Moving from crisis response to a learning health system: Experiences from an Australian regional primary care network

AbstractIntroductionThe COVID‐19 pandemic challenged primary care to rapidly innovate. In response, the Western Victorian Primary Health Network (WVPHN) developed a COVID‐19 online Community of Practice comprising general practitioners (GPs), practice nurses, pharmacists, aged care and disability workers, health administrators, public health experts, medical specialists, and consumers. This Experience Report describes our progress toward a durable organizational learning health system (LHS) model through the COVID‐19 pandemic crisis and beyond.MethodsIn March 2020, we commenced weekly Community of Practice sessions, adopting the Project ECHO (Extension of Community Health Outcomes) model for a virtual information‐sharing network that aims to bring clinicians together to develop collective knowledge. Our work was underpinned by the LHS framework proposed by Menear et al. and aligned with Kotter's eight‐step change model.ResultsThere were four key phases in the development of our LHS: build a Community of Practice; facilitate iterative change; develop supportive organizational infrastructure; and establish a sustainable, ongoing LHS. In total, the Community of Practice supported 83 unique COVID‐19 ECHO sessions involving 3192 h of clinician participation and over 10 000 h of organizational commitment. Six larger sessions were run between March 2020 and September 2022 with 3192 attendances. New models of care and care pathways were codeveloped in sessions and network leaders contributed to the development of guidelines and policy advice. These innovations enabled WVPHN to lead the Australian state of Victoria on rates of COVID vaccine uptake and GP antiviral prescribing.ConclusionThe COVID‐19 pandemic created a sense of urgency that helped stimulate a regional primary care‐based Community of Practice and LHS. A robust theoretical framework and established change management theory supported the purposeful implementation of our LHS. Reflection on challenges and successes may provide insights to support the implementation of LHS models in other primary care settings.

Abstract B074: Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities

Abstract Background: Up to 2.4 million people in the US live with chronic hepatitis B (HBV) infection (Wong et al., 2021). Foreign-born communities are most impacted, particularly those from Asia, the Pacific Islands, the Caribbean, and sub-Saharan Africa (Conners et al., 2023). Individuals with unmanaged HBV have a 15-40% lifetime risk of dying prematurely from cirrhosis or hepatocellular carcinoma (HCC) (McMahon, 2009). Low awareness, cultural norms, and misperceptions about HBV, HCC, and their connection contribute to low screening and care rates in affected communities. A more robust and comprehensive understanding of these barriers is needed to design effective awareness campaigns to improve HBV screening and care and prevent HCC. To this end, this study aimed to learn about existing knowledge and misconceptions about HBV and its relationship to HCC in high-risk communities, identify barriers to screening, and use the findings to develop effective communication strategies that raise awareness and dispel myths. Methods: Fifteen focus groups and two key informant interviews with community members, leaders, and public health experts were conducted to assess beliefs and attitudes about HBV and HCC and to identify preferred communication strategies. Results: The link between HBV and HCC remains poorly understood, and myths persist about the transmission and outcomes of both conditions. Multiple barriers to HBV and HCC screening exist, including concerns about insurance and immigration status, language barriers, cultural and religious beliefs, lack of general health literacy, lack of resources to cope with a positive diagnosis, widespread distrust of Western medicine, and fear of stigma and isolation. Ideas for effective communication methods included employing community health educators, primary care providers, ethnic media outlets and personal testimonials for delivery of information, and tailoring communications by community, age, and gender. These findings were used to create a suite of culturally and linguistically appropriate educational materials for use in each of twelve communities. Conclusions: Many challenges to increasing screening persist in groups most impacted by HBV and HCC, including a need for increased awareness about their connection. Community engagement is essential to overcoming these challenges, as are specific, targeted messaging and dissemination to improve the uptake of HBV screening and management. Behavioral and Social Science: Community-based Participatory Research Citation Format: Beatrice Zovich, Fiona Borondy-Jenkins, Suzanne Block, Kate Moraras, Thomas Chen, Chari Cohen. Qualitative assessment of knowledge gaps and barriers to Hepatitis B and liver cancer screening in high-risk U.S. communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B074.

Sustainable Recovery in Health Tourism: Managerial Insights from a Mediterranean Destination during the COVID-19 Pandemic

Health tourism, a sector that has gained increasing global attention, particularly in the context of sustainable development, is poised for significant growth even in the face of the COVID-19 pandemic. This study investigates the challenges faced by the health tourism sector in a small Mediterranean country, focusing on sustainable recovery strategies. The current study aims to determine managerial implications post-COVID-19, emphasizing sustainability in operational practices and long-term demand growth. We conducted in-depth interviews with 32 health tourism managers and experts, and the qualitative content analysis with Leximancer identified key themes such as sustainable demand management, organizational adaptation, and crisis recovery. This study revealed eight critical themes related to managerial survival and the demand for sustainable practices in health tourism, namely “demand”, “hotel”, “tour operators”, “employees”, “crises”, “social media”, “word of mouth”, and “time”. These findings underscore the importance of integrating sustainability into tourism recovery strategies, ensuring long-term resilience for the industry. This study, which provides theoretical and practical insights into the sustainable growth of health tourism amidst global crises, serves as a valuable reference for stakeholders seeking sustainable development solutions, inspiring them to contribute to the sector’s growth.

A One Health Approach to Public Safety: A Review of Police Canines in the United States.

Working dogs are an essential part of modern society, and police canines (K9s) in the United States are amongst the most recognizable of all working dogs. Given the dearth of published data on active police canines in the U.S. and the calls for police reform, an interdisciplinary effort is necessary to comprehensively understand how these dogs are best used for the benefit of society. This review paper relies on veterinary public health expertise to present a comprehensive overview of police canine use by municipal law enforcement in the United States, including known impacts and gaps in knowledge. The existing literature from animal-assisted interventions (AAI) provides evidence to ensure working dog well-being, while human-animal bond research contributes to officer safety and canine partnership. Lastly, law enforcement and public health agendas (LEPH) assure the team's successful efforts in built environments and local neighborhoods. These frameworks acknowledge the complexity of police dog use, spanning from punitive to public relations, which mirrors the role of law enforcement in U.S. society. This paper proposes the use of a One Health framework to ensure police canine contributions to society, including suggested approaches to partner municipal police with veterinary medicine and public health, and integrate One Health in promoting public safety for local communities.

Rethinking Health Systems Responsiveness in Low- and Middle-Income Countries: Validation Study.

Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by the World Health Organization (WHO) includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. The WHO tool is applied globally to assess HSR in low, middle, and high-income countries. We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for low- and middle-income countries (L&MICs). This study is designed to (1) run the Delphi technique to validate the upgraded conceptual framework of HSR, (2) modify and upgrade the WHO measurement tool for assessing HSR in the context of L&MICs, and (3) determine the validity of the upgraded HSR measurement tool by pilot testing it in Pakistan. The Delphi technique will be run by inviting global public health experts to provide suggestions on the domains and subdomains of HSR specific to L&MICs. Cronbach ɑ will be calculated to determine internal consistency among the participants. The upgraded HSR conceptual framework will serve as a beacon to modify the measurement tool by the research team, which will be reviewed by subject experts for refinement. The modified tool will be pilot-tested by administering it to 1128 participants from primary, secondary, and tertiary care hospitals in Rawalpindi district, Pakistan. Additionally, an "observation checklist" of HSR domains and subdomains will be completed to objectively measure the state of HSR across health care facilities. HSR assessment will be further strengthened by incorporating the perspective of hospital managers, service providers, and policy makers (ie, the supply side) as well as community leaders and representatives (ie, the demand side) through qualitative interviews. The study was started in January 2024 and will continue until February 2025. A multidimensional approach will yield significant quantifiable information on HSR from the demand and supply sides of L&MICs. This study will provide a conceptual understanding of HSR and a corresponding measurement tool specific to L&MICs. It will contribute to global public health literature and provide a snapshot of HSR in Rawalpindi district, Pakistan, with concrete action points for policy makers. DERR1-10.2196/59836.

Validation and usability of SeDAR e-health video for enhancing cervical cancer screening.

The cervical cancer (CC) incidence rate is increasing among young women aged <50 years despite early screening is proven effective. Electronic health (e-health) has great potential for disseminating health education. This study validated a newly developed e-health tool "SeDAR®" and assessed its usability via evaluations by health experts (HE), media experts (ME), and women. The SeDAR® content was developed based on protection motivation theory (PMT) using the nominal group technique and in-depth interviews that involved HE and women, respectively. Content validation was performed among the HE (n = 12) and ME (n = 5) using the content validation index (CVI) to identify their agreement. Subsequently, the Video Engagement Scale (VES®) was used to validate SeDAR® among women of different ethnicities (n = 11) to achieve ecological validity. The experts and women also commented on the presentation of the video. The validation yielded a good CVI among the HE (scale-level CVI-average [SCVI/Ave] = 0.986; scale-level CVI-universal agreement [SCVI/UA] = 0.900) and ME (SCVI/Ave = 0.979, SCVI/UA = 0.897). The highest VES® score [mean (±SD) = 92.90(±3.46)] proved the ecological validity of SeDAR®. The experts' feedback established that SeDAR® conveyed a clear message about awareness of performing CC screening and was suitable for public viewing. The women considered SeDAR® easy to understand, and it advised early exposure for early CC screening. SeDAR® was valid and could constitute an important e-health tool to improve motivation and uptake of CC screening.

Efficacy of internet-based cognitive behavioral and interpersonal treatment for depression in Arabic speaking countries: A randomized controlled trial

BackgroundPolitically and economically unstable contexts have been associated with increased prevalence rates of depression. Despite high demand, the availability of mental health experts and care systems is limited in Arabic-speaking countries. Internet-based interventions might provide an opportunity to treat patients independently of location. Therefore, we investigated the efficacy of internet-based cognitive behavioral treatment (iCBT) and interpersonal treatment (iIPT) for depression in Arabic-speaking countries. MethodsIn total, 743 Arabic-speaking adults with depression were randomly allocated to iCBT (n = 243), iIPT (n = 247), or waitlist (n = 253). Depressive, anxiety, and somatoform symptoms, perceived social support and quality of life (QoL) were assessed at pre-, and post-treatment and at three months follow-up. Multiple imputation was performed for missing data. Changes associated with treatment were analyzed using regression in the completer and intention-to-treat sample. ResultsParticipants in both treatment groups showed lower depressive and anxiety symptom severity, higher QoL, and perceived social support compared to the waitlist group (p < .001). Somatoform symptom severity was significantly lower in participants receiving iIPT compared to waitlist (p < .001). Differences between the two treatments in all outcomes were non-significant (p > .05). Three-month follow-up treatment effects regarding depressive symptoms were indicated. LimitationsThe sample mainly consists of educated, single, female adults. Three-month follow-up results rely on a small subsample and must be interpreted with caution. ConclusionsThis is the first randomized controlled trial to demonstrate the efficacy of iCBT and iIPT for depression in Arabic-speaking countries. It provides first indications that internet-based interventions might help specific individuals in this region.

The Role of Health Belief Model Constructs and Content Creator Characteristics in Social Media Engagement: Insights from COVID-19 Vaccine Tweets.

The Health Belief Model (HBM) has been widely studied, but it is unclear how social media post creators use HBM constructs to influence the public's awareness of health topics, particularly for COVID-19 preventative health behaviors. Moreover, there is limited knowledge about how content creators enhance user engagement with COVID-19 vaccine tweets. A content analysis of COVID-19 vaccine tweets (n = 362) examined how HBM constructs were used in social media posts and their relationship to content creator characteristics (e.g., race, education level) and user engagement behaviors (e.g., number of favorites). Content creators' tweets about COVID-19-related topics generally centered on two HBM constructs-benefits and barriers-while fewer tweets emphasized perceived susceptibility or self-efficacy; tweets containing these constructs were retweeted less often. Findings revealed that tweets from politicians, health experts, and white and Asian sources emphasized the perceived benefits of the COVID-19 vaccine. Individual tweets, especially from Black individuals and celebrities, generated more user engagement. Understanding the factors that contribute to social media user engagement with health-related content is important for designing more focused and impactful health communication campaigns and promoting healthier habits and perspectives. Thus, by demonstrating the possible relevance of the HBM to digital communication strategies or health campaigns, our study provides useful guidance for health promoters and policymakers who use social media to raise public health awareness.

Human centered design of AI-powered Digital Therapeutics for stress prevention: Perspectives from multi-stakeholders' workshops about the SHIVA solution

BackgroundAI-powered Digital Therapeutics (DTx) hold potential for enhancing stress prevention by promoting the scalability of P5 Medicine, which may offer users coping skills and improved self-management of mental wellbeing. However, adoption rates remain low, often due to insufficient user and stakeholder involvement during the design phases. ObjectiveThis study explores the human-centered design potentials of SHIVA, a DTx integrating virtual reality and AI with the SelfHelp+ intervention, aiming to understand stakeholder views and expectations that could influence its adoption. MethodsUsing the SHIVA example, we detail design opportunities involving AI techniques for stress prevention across modeling, personalization, monitoring, and simulation dimensions. Workshops with 12 stakeholders—including target users, digital health designers, and mental health experts—addressed four key adoption aspects through peer interviews: AI data processing, wearable device roles, deployment scenarios, and the model's transparency, explainability, and accuracy. ResultsStakeholders perceived AI-based data processing as beneficial for personalized treatment in a secure, privacy-preserving environment. While wearables were deemed essential, concerns about compulsory use and VR headset costs were noted. Initial human facilitation was favored to enhance engagement and prevent dropouts. Transparency, explainability, and accuracy were highlighted as crucial for the stress detection model. ConclusionStakeholders recognized AI-driven opportunities as crucial for SHIVA's adoption, facilitating personalized solutions tailored to user needs. Nonetheless, challenges persist in developing a transparent, explainable, and accurate stress detection model to ensure user engagement, adherence, and trust.

Repelling Aedes aegypti mosquitoes with electric fields using insulated conductor wires.

The control and prevention of mosquito-borne diseases is mostly achieved with insecticides. However, their use has led to the rapid development and spread of insecticide resistance worldwide. Health experts have called for intensified efforts to find new approaches to reduce mosquito populations and human-mosquito contact. A promising new tool is the use of electrical fields (EFs), whereby mosquitoes are repelled by charged particles in their flight path. Such particles move between two or more conductors, and the use of uninsulated copper or aluminum plates as conductors has been proven to be effective at repelling mosquitoes. Here, for the first time, we assess if EFs generated using a single row of insulated conductor wires (ICWs) can also successfully repel mosquitoes, and whether mosquitoes are equally repelled at the same EF strength when the electrodes are a) orientated differently (horizontal vs. vertical placement), and b) spaced more apart. Over a period of 23 hours, the number of host-seeking female Aedes aegypti mosquitoes that were successfully repelled by EFs, using ICWs, at EF strengths ranging from 0 kV/cm (control) to 9.15 kV/cm were quantified. Mosquitoes were released inside a 220×220×180 cm room and lured into a BG-Pro trap that was equipped with a BG-counter and baited with CO2 using dry ice. Mosquitoes had to pass through an EF window, that contained a single row of ICWs with alternating polarity, to reach the bait. The baseline interaction between EF strength and repellency was assessed first, after which the impact of different ICW orientations and ICW distances on repellency were determined. Over 50% of mosquitoes were repelled at EF strengths of ≥ 3.66 kV/cm. A linear regression model showed that a vertical ICW orientation (vertical vs. horizontal) had a small but insignificant increased impact on mosquito repellency (p = 0.059), and increasing ICW distance (while maintaining the same EF strength) significantly reduced repellency (p = 0.01). ICWs can be used to generate EFs that partially repel host-seeking mosquitoes, which will reduce human-mosquito contact. While future studies need to assess if (i) increased repellency can be achieved, and (ii) a repellency of 50-60% is sufficient to impact disease transmission, it is encouraging that EF repellency using ICWs is higher compared to that of some spatial repellent technologies currently in development. This technology can be used in the housing improvement toolkit (i.e. preventing mosquito entry through eaves, windows, and doors). Moreover, the use of cheap, over-the-counter ICWs will mean that the technology is more accessible worldwide, and easier to manufacture and implement locally.