End-user Involvement Research Articles

Barriers and Facilitators to the Preadoption of a Computer-Aided Diagnosis Tool for Cervical Cancer: Qualitative Study on Health Care Providers' Perspectives in Western Cameroon.

Computer-aided detection and diagnosis (CAD) systems can enhance the objectivity of visual inspection with acetic acid (VIA), which is widely used in low- and middle-income countries (LMICs) for cervical cancer detection. VIA's reliance on subjective health care provider (HCP) interpretation introduces variability in diagnostic accuracy. CAD tools can address some limitations; nonetheless, understanding the contextual factors affecting CAD integration is essential for effective adoption and sustained use, particularly in resource-constrained settings. This study investigated the barriers and facilitators perceived by HCPs in Western Cameroon regarding sustained CAD tool use for cervical cancer detection using VIA. The aim was to guide smooth technology adoption in similar settings by identifying specific barriers and facilitators and optimizing CAD's potential benefits while minimizing obstacles. The perspectives of HCPs on adopting CAD for VIA were explored using a qualitative methodology. The study participants included 8 HCPs (6 midwives and 2 gynecologists) working in the Dschang district, Cameroon. Focus group discussions were conducted with midwives, while individual interviews were conducted with gynecologists to comprehend unique perspectives. Each interview was audio-recorded, transcribed, and independently coded by 2 researchers using the ATLAS.ti (Lumivero, LLC) software. The technology acceptance lifecycle framework guided the content analysis, focusing on the preadoption phases to examine the perceived acceptability and initial acceptance of the CAD tool in clinical workflows. The study findings were reported adhering to the COREQ (Consolidated Criteria for Reporting Qualitative Research) and SRQR (Standards for Reporting Qualitative Research) checklists. Key elements influencing the sustained use of CAD tools for VIA by HCPs were identified, primarily within the technology acceptance lifecycle's preadoption framework. Barriers included the system's ease of use, particularly challenges associated with image acquisition, concerns over confidentiality and data security, limited infrastructure and resources such as the internet and device quality, and potential workflow changes. Facilitators encompassed the perceived improved patient care, the potential for enhanced diagnostic accuracy, and the integration of CAD tools into routine clinical practices, provided that infrastructure and training were adequate. The HCPs emphasized the importance of clinical validation, usability testing, and iterative feedback mechanisms to build trust in the CAD tool's accuracy and utility. This study provides practical insights from HCPs in Western Cameroon regarding the adoption of CAD tools for VIA in clinical settings. CAD technology can aid diagnostic objectivity; however, data management, workflow adaptation, and infrastructure limitations must be addressed to avoid "pilotitis"-the failure of digital health tools to progress beyond the pilot phase. Effective implementation requires comprehensive technology management, including regulatory compliance, infrastructure support, and user-focused training. Involving end users can ensure that CAD tools are fully integrated and embraced in LMICs to aid cervical cancer screening.

Grief, choice and digital technology use: how bereaved people use digital technologies to support their grief

ABSTRACT Despite extensive research into how best to support bereaved people, little empirical evidence is available exploring how bereaved people themselves can shape the technology designed to provide this support. This significant gap highlights the need for both end-user involvement and a user-centred approach in the design and development of digital grief services. In order to do so however, first we need to learn about how bereaved people use digital services when bereaved, which is the focus of this article. Adopting a user-centred approach to understand user needs, interview findings show how immediacy, anonymity, and choice over engagement levels play key roles in bereaved people engaging with digital grief services. Though digital technologies are widely used and perceived as beneficial early on in grief, some participants express concern over text-based communications and social media use, including content type and volume, interactions and accessibility. This paper highlights the variability and limitations of technology use to support grief, providing new insights, through a Choice Theory lens, into understanding the needs of bereaved people to inform bereavement service design, and paving the way for a new generation of user-centred grief support services.

A systematic review of features and content quality of Arabic mental mHealth apps.

Anxiety and depression are major causes of disability in Arab countries, yet resources for mental health services are insufficient. Mobile devices may improve mental health care delivery (mental m-Health), but the Arab region's mental m-Health app landscape remains under-documented. This study aims to systematically assess the features, quality, and digital safety of mental m-Health apps available in the Arab marketplace. We also contrast a set of recommended Australian apps to benchmark current strategies and evidence-based practices and suggest areas for improvement in Arabic apps. Fifteen Arab country-specific iOS Apple Stores and an Android Google Play Store were searched. Apps that met the inclusion criteria were downloaded and evaluated using the Mobile App Rating Scale (MARS) and the Mobile App Development and Assessment Guide (MAG). Twenty-two apps met the inclusion criteria. The majority of apps showed no evidence of mental health experts being involved in the app design processes. Most apps offered real-time communication with specialists through video, text, or audio calls rather than evidence-based self-help techniques. Standardized quality assessment showed low scores for design features related to engagement, information, safety, security, privacy, usability, transparency, and technical support. In comparison to apps available in Australia, Arabic apps did not include evidence-based interventions like CBT, self-help tools and crisis-specific resources, including a suicide support hotline and emergency numbers. In conclusion, dedicated frameworks and strategies are required to facilitate the effective development, validation, and uptake of Arabic mental mHealth apps. Involving end users and healthcare professionals in the design process may help improve app quality, dependability, and efficacy.

Development, Implementation, and Evaluation Methods for Dashboards in Health Care: Scoping Review.

Dashboards have become ubiquitous in health care settings, but to achieve their goals, they must be developed, implemented, and evaluated using methods that help ensure they meet the needs of end users and are suited to the barriers and facilitators of the local context. This scoping review aimed to explore published literature on health care dashboards to characterize the methods used to identify factors affecting uptake, strategies used to increase dashboard uptake, and evaluation methods, as well as dashboard characteristics and context. MEDLINE, Embase, Web of Science, and the Cochrane Library were searched from inception through July 2020. Studies were included if they described the development or evaluation of a health care dashboard with publication from 2018-2020. Clinical setting, purpose (categorized as clinical, administrative, or both), end user, design characteristics, methods used to identify factors affecting uptake, strategies to increase uptake, and evaluation methods were extracted. From 116 publications, we extracted data for 118 dashboards. Inpatient (45/118, 38.1%) and outpatient (42/118, 35.6%) settings were most common. Most dashboards had ≥2 stated purposes (84/118, 71.2%); of these, 54 of 118 (45.8%) were administrative, 43 of 118 (36.4%) were clinical, and 20 of 118 (16.9%) had both purposes. Most dashboards included frontline clinical staff as end users (97/118, 82.2%). To identify factors affecting dashboard uptake, half involved end users in the design process (59/118, 50%); fewer described formative usability testing (26/118, 22%) or use of any theory or framework to guide development, implementation, or evaluation (24/118, 20.3%). The most common strategies used to increase uptake included education (60/118, 50.8%); audit and feedback (59/118, 50%); and advisory boards (54/118, 45.8%). Evaluations of dashboards (84/118, 71.2%) were mostly quantitative (60/118, 50.8%), with fewer using only qualitative methods (6/118, 5.1%) or a combination of quantitative and qualitative methods (18/118, 15.2%). Most dashboards forego steps during development to ensure they suit the needs of end users and the clinical context; qualitative evaluation-which can provide insight into ways to improve dashboard effectiveness-is uncommon. Education and audit and feedback are frequently used to increase uptake. These findings illustrate the need for promulgation of best practices in dashboard development and will be useful to dashboard planners.

Assessment of barriers to the adoption of innovative building materials (IBM) for sustainable construction in the Nigerian construction industry

PurposeWhile innovative building materials (IBM) have emerged as a promising solution for addressing the global construction industry’s environmental, economic and social challenges, their adoption is plagued with increasing challenges in the Nigerian construction industry (NCI). To provide practical strategies to overcome the present IBM challenges in the NCI, the barriers that hinder its successful adoption need detailed investigation. Consequently, this study examines the barriers that affect the adoption of IBM for sustainable construction (SC) in the NCI.Design/methodology/approachA quantitative research approach was used to obtain primary data from 282 construction professionals, viz. architects, builders, engineers and quantity surveyors, via a closed-ended questionnaire survey. Data were analysed using a mean item score (descriptive analysis) and exploratory factor analysis (inferential analysis).FindingsThe study revealed the top five most significant barriers to IBM adoption in the NCI. These barriers include lack of awareness and knowledge, learning/training period, cost and economic viability, lack of qualified staff and lack of end-user involvement. Factor analysis revealed five components of barriers: resource and policy-related barriers, perception and cultural-related barriers, organisational-related barriers, awareness and market-related barriers and resistance and stakeholder engagement-related barriers.Practical implicationsThe findings of this study have several practical implications for construction professionals, policymakers and other stakeholders in Nigeria. The study highlights the need for increased awareness and technical expertise to promote the adoption of IBM in the NCI. The study also recommends several practical strategies for overcoming the barriers to IBM adoption and promoting SC practices in Nigeria, such as fostering a positive perception of sustainable concepts, fostering stakeholder support and involvement and promoting a more conducive environment for adopting sustainable practices. The implication of this study transcends the local context, offering a model for other countries to consider, thereby contributing to a global shift towards sustainable construction practices.Social implicationsThe findings highlight the critical role of societal attitudes and awareness in adopting IBM, suggesting the need for educational and awareness programmes to shift public and organisational perception. This shows the importance of cultural change and societal readiness to embrace sustainable construction practices.Originality/valueThis study contributes significantly to knowledge of the barriers to adopting IBM for SC in NCI. Findings from the study will inform policymakers, industry professionals and other stakeholders about the key barriers that require attention and intervention, facilitating the initiatives to overcome these barriers effectively.

User Requirements and Involvement Methods in the Development of Hand Exoskeletons: A Review

Current hand exoskeleton systems for assistive and rehabilitative purposes pose challenges due to weight, bulk, and size, thus negatively affecting user experience in terms of comfort and wearability. End-user involvement is vital during design and deployment to improve usefulness, usability, and user acceptance. A scoping review was conducted to identify the currently prioritized user requirements and user-centered practices in the development of hand exoskeleton systems. Content analysis was used to identify the user-centered design criteria and user research methodologies in 124 articles. More studies aim for rehabilitation than assistance and the dominant form of assessment is system validation. Wearability, comfort, portability, adaptability, affordability, and safety were the most frequently targeted user-centered criteria. Only 38 articles reported assessment with human subjects, the majority of them being functional tests, followed by usability tests. We offer user-centered design directions and methodological suggestions for user involvement to improve the usability and acceptability of the exoskeleton systems, and discuss the necessity for restructuring the engineering design strategy for better adaptability. This research has direct applications for the design and assessment of assistive and rehabilitative hand exoskeletons by offering user requirements. The findings and suggestions can have wider implications in the field of wearable robotics for developing, evaluating, and refining systems through a user-centered perspective.

A mixed-methods study among adolescents and teachers in Bogotá, Colombia: adapting the OurFutures Alcohol Program.

Early onset of alcohol consumption among Colombian adolescents highlights the need for effective and accessible preventive interventions. This project aimed to conduct formative work to inform the adaptation of an effective eHealth alcohol use prevention program originally developed in Australia, the OurFutures Alcohol Module, to the Bogotá context. Twenty-six adolescents and 10 teachers in Bogotá participated in the study. We used a mixed-methods approach comprising interviews, surveys and semi-structured discussions to evaluate the acceptability of OurFutures. Study materials were translated into Spanish before conducting three 1.5-hour focus groups with adolescents (aged 11-15; n = 26), and 1-hour interviews or online surveys with teachers to assess attitudes towards alcohol use and the acceptability of one lesson from the OurFutures Alcohol Module in the Bogotá context. Qualitative data were analysed thematically, and descriptive analyses of quantitative data reported percentage agreement for survey questions. Overall, 96% of students and 89% of teachers expressed strong satisfaction with the OurFutures Alcohol Module lesson. Most students (96%) liked its storyline and character portrayal, and most teachers (80%) said they would use OurFutures with their students. Participants provided feedback for improving program relatability, including adapting scenarios, character names, clothing and language to align with the Bogotá context and resonate with Colombian adolescents. This study marks the first step in informing the adaptation of the OurFutures Alcohol Module to the Bogotá context and highlights key considerations for cultural adaptations of other substance use prevention interventions. This research underscores the importance of place-based end-user involvement in co-designing adolescent prevention interventions.

Provision of Digital Primary Health Care Services: Overview of Reviews.

Digital health is a growing field, and many digital interventions have been implemented on a large scale since the COVID-19 pandemic, mainly in primary health care (PHC). The development of digital health interventions and their application in PHC are encouraged by the World Health Organization. The increased number of published scientific papers on this topic has resulted in an overwhelming amount of information, but there is no overview of reviews to summarize this evidence. This study aims to provide policy makers, health managers, and researchers with a summary of evidence on digital interventions used in PHC. This overview of reviews searched the Web of Science and MEDLINE databases for systematic and scoping reviews on assessments of digital technologies implemented in PHC published from January 2007 to March 2023. Only reviews that addressed digital interventions whose targets were real patients or health care providers (HCPs) were included. A total of 236 records were identified from the search strategy, of which 42 (17.8%) full-text papers were selected for analysis, and 18 (7.6%) reviews met the eligibility criteria. In total, 61% (11/18) of the reviews focused their analysis on specific digital health interventions (client-to-provider telemedicine, provider-to-provider telemedicine, health worker decision support systems, systems for tracking patients' health status, client participation and self-care platforms, and provision of education and training to health workers), and 39% (7/18) of the reviews focused on specific topics related to PHC (preventive care, chronic disease management, behavioral health disorders, the COVID-19 pandemic, multicomponent PHC interventions, and care coordination). Most studies in the included reviews agreed on barriers to implementation, such as software and apps developed without involving end users, the lack of training of HCPs and patients in digital technology use, and the lack of reimbursement and billing strategies for remote consultations. However, they showed several mixed results related to health service quality and patients' clinical conditions and behavior changes. Research in digital health applied to PHC is still concentrated in high-income countries, mainly in North America and Europe. The mixed results related to health service quality and patients' clinical conditions or behavior changes may have been caused by deficiencies in the process of implementing digital interventions. It is necessary to examine the entire impact pathway and the causal relationship among implementation, health service quality, and clinical condition outcomes to support the spread of digital health in PHC settings.

What the textbooks don’t teach about the reality of running a digitally enabled health study: a phenomenological interview study

BackgroundMost studies do not produce their intended outcomes on time or within budget. However, it is challenging to identify the facilitators and barriers to successful study management when the “behind the scenes action” of especially digitally enabled health research studies are akin to a black box. Therefore, it is necessary to explore first-hand experience of the facilitators and barriers to managing digitally enabled health studies. The goal of such studies is to produce new knowledge and/or develop tools that can be translated to real-world benefits for the health and care sector, individuals, and other stakeholders. These studies now exist in a time that encourages collaborative research activities with interdisciplinary research partnerships, industry collaboration, end-user involvement and insights for policy. These expectations require teams with different work cultures, methodologies, technologies, and approaches to work together, resulting in significant benefits but also challenges.ObjectivesTo explore the relationship between the dynamics and needs of research teams and the technology used to manage digitally enabled studies through the experience of those who worked on such studies.MethodsWe used an interpretive phenomenological approach to explore research team members’ experiences and perceptions of study management in the field of digitally enabled health research. We interviewed 15 research team members from eight studies. A semi-structured interview guide was used to explore concepts related to study activity management, team dynamics, resources and technologies used to manage research activities, and reflections of personal experiences. An adductive thematic analysis was performed on the transcripts.ResultsFive main themes were identified: 1) Project Team, 2) Study management, which included management technologies, 3) Study plan, 4) Intervention, 5) Participants. This paper focuses on the first two main themes. Sub-themes included: Roles and responsibilities, Methods, Changes, Challenges and solutions and Expectations vs. reality. Sub-themes were applicable to all main themes. Therefore, results were presented as knowledge gained from the interaction between sub-themes within each theme, i.e. referred to as “comprehensive insights” in the results section of this paper.ConclusionThis interview study provides new knowledge about the realities of working in collaborative, digitally enabled health research studies and demonstrates several opportunities for improved understanding of study management. More realistic and thorough understanding of the complex system in which digitally enabled health research exists can be applied to better prepare experienced researchers and newly graduated students entering the field, as well as improve existing strategies for management.

Cocreative Development of Robotic Interaction Systems for Health Care: Scoping Review.

Robotic technologies present challenges to health care professionals and are therefore rarely used. Barriers such as lack of controllability and adaptability and complex control functions affect the human-robot relationship. In addition to educational opportunities, the possibility of individual adaptation can improve the usability and practical implementation of robotics. Previous work has focused on developments from a technology-centered perspective and has included user interests too late in the process. This study addresses the following research question: What cocreative research approaches are used in the field of nursing robotics to improve the usability, intended use, and goal-directed application of robotic developments for nurses and to support the nursing process? This scoping review provides an overview of the topic and the research activities taking place within it. Five databases and the reference lists of the identified publications were searched for studies without further restrictions. Studies were included if they developed and evaluated interaction and control platforms for robotic systems in health care in a cocreative way with end users. The search resulted in 419 hits, of which 3 publications were included. All publications were feasibility or user studies that were mainly carried out in the European Union. The 3 interaction and control platforms presented were all prototypes and not commercially available. In addition to those in need of care, all studies also included family carers and health care professionals. Robotic interaction and control platforms in health care are rarely, if ever, developed and evaluated with feasibility or user studies that include prototypes and end users. While the involvement of end users is crucial, this review emphasizes that all stakeholders, including health care professionals, should participate in the development process to ensure a holistic understanding of application needs and a focus on user experiences and practical health care needs. It is emphasized that the active involvement of end users in the development process is critical to effectively meeting the needs of the target group.

Involving Experts by Experience in Craniofacial Research.

Many areas of health research increasingly involve end users of research (typically patients and their families/caregivers) in study design, management, and dissemination. Beyond recruiting patients as research participants, the shift is towards engaging patients, parents and caregivers as active partners on the research team, who are recognised and valued as 'experts-by-experience' (EbyE). Currently, involving EbyE is not routine in global craniofacial research. This paper highlights the value of EbyE involvement, addresses how to incorporate EbyE at all stages of research and discusses key considerations in facilitating positive experiences for EbyE.

Establishing Quality Indicators and Implementation Priorities for Post-Stroke Aphasia Services Through End-User Involvement.

Currently, there are no agreed quality standards for post-stroke aphasia services. Therefore, it is unknown if care reflects best practices or meets the expectations of people living with aphasia. We aimed to (1) shortlist, (2) operationaliseand (3) prioritise best practice recommendations for post-stroke aphasia care. Three phases of research were conducted. In Phase 1, recommendations with strong evidence and/or known to be important to people with lived experience of aphasia were identified. People with lived experience and health professionals rated the importance of each recommendation througha two-round e-Delphi exercise. Recommendations were then ranked for importance and feasibility and analysed using a graph theory-based voting system. In Phase 2,shortlisted recommendations from Phase 1 were converted into quality indicators for appraisal and voting in consensus meetings. In Phase 3,priorities for implementation were established by people with lived experience and health professionals following discussion and anonymous voting. In Phase 1, 23 best practice recommendations were identified and rated by people with lived experience (n = 26) and health professionals (n = 81). Ten recommendations were shortlisted. In Phase 2,people with lived experience (n = 4) and health professionals (n = 17) reached a consensus on 11 quality indicators, relating toassessment (n = 2), information provision (n = 3),communication partner training (n = 3),goal setting (n = 1),person and family-centred care (n = 1)and provision of treatment (n = 1). In Phase 3,people with lived experience (n = 5) and health professionals (n = 7) identified three implementation priorities: assessment of aphasia,provision of aphasia-friendly informationand provision of therapy. Our 11 quality indicators and 3 implementation priorities are the first step to enabling systematic, efficientand person-centred measurement and quality improvement in post-stroke aphasia services. Quality indicators will be embedded in routine data collection systems, and strategies will be developed to address implementation priorities. Protocol development was informed by our previous research, which exploredthe perspectives of 23 people living with aphasia about best practice aphasia services. Individuals with lived experience of aphasia participated as expert panel members in our three consensus meetings. Wereceived support from consumer advisory networks associated with the Centre for Research Excellence in Aphasia Rehabilitation and Recovery and the Queensland Aphasia Research Centre.

The ERMES chatbot: A conversational communication tool for improved emergency management and disaster risk reduction

The increased occurrence and severity of worldwide disasters, exacerbated by the impact of climate change, pose significant challenges to emergency management, calling for novel and more effective Disaster Risk Reduction (DRR) approaches. Despite the phenomenological differences of diverse hazards and the heterogeneity of local policies and governance structures, effective communication systems are needed to better manage the available resources in all phases of the emergency management cycle, especially in the case of cross-border events. In this work, we present the design, implementation, and validation of a novel tool for emergency management, i.e., the ERMES Chatbot: a mobile-based conversational communication system developed to facilitate real-time bidirectional communication between control centres, in-field forces, and citizens. The methodology used to create the ERMES Chatbot is grounded on the user-centred design approach, which entails end-user involvement in all key phases of the development, including the definition of the end-user requirements, the technical design, and the final validation of the proposed solution. The co-design approach involved several organisations belonging to the DRR domain, which includes a gamified experience for citizens and is iteratively validated through four in-field demonstration events based on realistic emergency scenarios with the involvement of emergency practitioners, volunteering organisations, and citizens.

The roadblocks to success – Identifying challenges in implementing a surgery support E-health solution: A qualitative interview study

BackgroundSurgery accounts for 30 % of the global disease burden, but healthcare systems struggle with managing surgical waitlists, optimising operations, and minimising cancellations, leading to poor patient outcomes and financial strain. E-health technologies offer promising solutions to enhance perioperative care and improve surgical outcomes, yet their integration faces significant organisational and structural challenges. This paper aims to explore and analyse the perspectives of decision-making personnel regarding the challenges and opportunities of implementing a surgery support e-health application. MethodsThis study utilised an explorative qualitative approach, employing a rapid cycle qualitative evaluation informed by the NASSS framework. Data were collected through individual semi-structured interviews with decision-making personnel conducted. Framework analysis guided by the NASSS framework was used to analyse the interview transcripts. ResultsA total of 15 participants from public health and external organisations participated in the study. The analysis, framed by the seven domains of the NASSS framework, critical challenges in integrating new health technologies, emphasising the need for compatibility, cybersecurity, and demonstrating clear benefits. Key factors for successful adoption included early and continuous stakeholder engagement, organisational readiness, and ongoing support. Additionally, participants highlighted the importance of centralised information systems and continuous adaptation of health IT solutions to meet evolving needs. ConclusionThis paper reveals that implementing surgical e-health interventions is a complex process fraught with organisational, technical, financial, and political challenges, particularly due to insufficient end-user involvement and the intricate healthcare landscape. Despite the recognised benefits, successful implementation necessitates comprehensive stakeholder engagement and co-design approaches. Additionally, while a partnership between commercial vendors and public health developers presents an attractive solution, significant obstacles such as intellectual property disputes and resource allocation must be overcome.

Editors' Introduction

This issue of the Interdisciplinary Journal of Signage and Wayfinding underscores the significance of involving end users, including the public, in the design and policy development of signage systems. The issue explores the multifaceted roles of signs and symbols in reflecting community character, supporting business branding, aiding wayfinding, and enhancing placemaking. Emphasizing evidence-based design and research, the articles present diverse methodologies, including stakeholder theory, qualitative studies, and shadowing techniques, to inform signage practices.

Pengujian Alpha dan Beta Testing Pada Aplikasi TIJE

This research discusses the software testing process on the TIJE application using the alpha (blackbox) and beta test methods. Alpha testing is carried out to identify and fix internal errors by the development team, while beta testing involves end users to ensure the application meets user needs and expectations. Test results show that various critical bugs were successfully identified and fixed, improving the quality and stability of the application before being released to the public. The conclusion of this research shows the importance of alpha and beta testing in the software development cycle.

What's different about digital? A qualitative interview study exploring experiences of adapting in-person behaviour change interventions for digital delivery.

Digital health behaviour change interventions may be adapted from in-person interventions, without appropriate consideration of how the digital context might differ. Drawing on the wider literature on behaviour change intervention development, this research aims to explore the digital adaptation process of health behaviour change interventions and the specific considerations for digital modes of delivery. A qualitative interview study. Interviews with 15 intervention developers/facilitators were analysed using inductive thematic analysis. Findings highlight a continuum of digitalization, where variation in technology available and human support influences considerations for digital adaptation. 'What vs how: "trying to do the impossible"' describes the balance between retaining the intervention's active ingredients while modifying for digital delivery. Through 'Trial and error', participants described an iterative process based on experience of delivery. 'Creating connection and engagement' emphasizes the importance of social support and the challenges of replicating this. Several considerations for digital adaptations are proposed including the involvement of end-users (facilitators and recipients) during adaptation, the need to understand the original intervention and new context for use, and the different motivational needs of digital intervention recipients.

Facilitating co-design among older adults in a digital setting: methodological challenges and opportunities

ABSTRACT Healthy ageing is a global priority due to a growing older population, which increases the need for preventive measures and tailored technology. In health technology development, co-design is emphasised as a valuable strategy to support a person-centred approach. Co-design, a value-driven and collaborative approach, involves end users in development processes to overcome barriers connected to capability, opportunity, and motivation. While a growing number of older adults are involved in design processes, there is a deficit of suitable methodologies for achieving active involvement. Additionally, the COVID-19 pandemic necessitated a shift to developing methodological skills and tools to facilitate co-design remotely in a digital setting. Here, we draw on experiences of conducting iterative co-design workshops with a Canadian and a Swedish cohort of older adults about technology development to support mobility, balance, and confidence in daily movement. We describe and discuss methodological and ethical challenges and opportunities to provide recommendations for conducting co-design research in a digital setting with older adults (+65 years). Our recommendations include the use of live mind mapping to facilitate participation involvement, and we address the issue of ‘homework’ in co-design and the importance of setting expectations.

Implementing injury prevention training in youth handball (I-PROTECT) in Sweden: study protocol for a cluster randomised trial

IntroductionEfficacy trials show that evidence-based injury prevention training reduces injuries in youth athletes but effectiveness, that is, outside the controlled setting, is lower and, consequently this training has had limited...

Capacity-building during public health emergencies: perceived usefulness and cost savings of an online training on SARS-CoV-2 real-time polymerase chain reaction (qPCR) diagnostics in low- and middle-income settings during the COVID-19 pandemic.

Upon the onset of the COVID-19 pandemic, the Public Health Laboratory Support Unit (ZIG4) at the Robert Koch Institute (RKI), the German National Public Health Institute, developed and delivered an online training on SARS-CoV-2 qPCR diagnostics to 17 partner countries in low- and middle-income countries (LMIC). This article analyses the usefulness and cost savings of this training. The authors performed a concurrent mixed-methodology study based on key informant interviews, interviewer-administered questionnaires, and document reviews. Economic costs were estimated from the perspective of RKI. Responding participants indicated that the course provided good and comprehensive information on up-to-date scientific knowledge and laboratory practice in PCR diagnostics. Respondents appreciated how the technical content of the training enhanced their ability to apply diagnostic methods in their daily work. Interviewees highlighted that the fast implementation and the low threshold of attending an online training had allowed them to quickly build skills that were crucial during, and beyond, the COVID-19 crisis. The total estimated cost of the online SARS-CoV-2 qPCR training was 61,644 euros. The total estimated cost of the equivalent face-to-face training was estimated at 267,592 euros. Programme weaknesses identified included the top-down approaches taken, lack of interactive components and opportunities to directly engage with other course participants and with teachers. An online training was developed and implemented to support RKI partner countries in SARS-CoV-2 qPCR diagnostics during the COVID-19 pandemic, thereby strengthening pandemic response and health system resilience. The training incurred in important cost savings compared to the equivalent face-to-face training. Post-pandemic studies could usefully build on these research findings and explore ways to enhance end user involvement and improve interactive features to build stronger communities of learners and facilitate exchange of information and mutual learning.