Communication Modalities Research Articles

Separability of Motor Imagery Directions Using Subject-Specific Discriminative EEG Features

Electroencephalogram (EEG) based brain–computer interface (BCI) is an augmented communication modality between the brain and computer that exclusively depends on noninvasively recorded neuro-electrical activity. To establish multiple control commands in BCI systems, it is essential to efficiently identify unique EEG activation patterns underlying multiple motor tasks. This article investigates the brain activation modulations elicited by imagined movement directions and the EEG features that characterize them. An experiment was conducted in which ten subjects imagined two-dimensional right-hand movement in the left, right, up, and down directions in the vertical plane. The frequency and phase characteristics of EEG rhythms are explored to identify the features that discriminate movement imagination toward multiple directions. The proposed decoding step consists of Fisher's analysis of instantaneous phase values to identify EEG channels with optimal discriminative information followed by extraction of phase-locking values and temporal-spatial features, which are then used for classification. The proposed approach offers significantly higher ( <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">p</i> < 0.05) performance than the state-of-the-art method while employing subject-specific time segments and channels. Hence, an average accuracy of 69.25% is obtained for binary classification of all pairs of movement directions with a performance increment of 8.33% compared to the conventional approaches using fixed channel-time paradigm. The results illustrate the potential use of noninvasive EEG signals in decoding imagined movement kinematics, and further research is needed to investigate and optimize the separability in multiple directions.

Epistemic Trust and the Emergence of Conduct Problems: Aggression in the Service of Communication

Fonagy and colleagues have recently proposed that deficits in the capacity for epistemic trust (i. e., the expectation that interpersonal communication is relevant to the addressee) are fundamental to psychopathology. In this paper, we consider the implications of this hypothesis for understanding the role of aggression in conduct disorder and conduct problems more generally. Our main proposal is to view conduct problems not only as reflecting dysregulation, but as an adaptation that allows communication with others who are (or are perceived to be) unreliable. Our formulation hinges on two propositions. The first one is to view aggression as a modality of communication adapted to scenarios in which the communicator expects the audience to have low epistemic trust in the communicator. The second idea is to conceptualize the failed “unlearning of aggression” as reflecting a lack of interest in maintaining one's reputation as a communicator, which in turn stems from a lack of epistemic trust in other communicators. In this paper, we discuss these ideas and examine how they may account for the developmental pathways that lead young people to develop conduct problems.

Best Practices for an Equitable Covid-19 Vaccination Program

Summary An array of factors hamper equitable Covid-19 vaccine deployment in the United States along racial, ethnic, age, and geographic lines. The Puget Sound Veterans Affairs facility developed a multidisciplinary vaccine delivery strategy to forestall systematic inequities in receipt of vaccination among veterans using methods that can be used by other health care organizations. The VA Puget Sound Health Care System deployed targeted outreach to individual patients on the basis of a simple score consisting of the sum of risk factors for severe Covid-19 disease and high-risk race or ethnicity. The health system then conducted sequential outreach using multiple communication modalities; worked with trusted community stakeholders to publicize and deploy mobile clinics to underserved areas; and monitored vaccination coverage rates by age, race, sex, and rural status at prespecified intervals and adjusted operations to ensure equity. Vaccination rates were highest in Black, multiracial, and Hispanic veterans compared with white veterans during the vaccine drive, a finding that persisted after the drive.

Volume 51 (2021)

Volume 51 (2021)

Student and tutor perceptions of the pedagogical potential and challenges of design jury as an assessment method

This article examines the pedagogical potential and challenges of the design jury as an assessment method from the perceptions of the tutor/jury member and the design students. It aims to gain an understanding of the factors that create opportunities for, and barriers to, the promotion of learning in the design jury. It inquires the possible contributions of the jury into formative evaluation processes in design education. The results show that (1) the communication modalities, and (2) the evaluation criteria influence the way tutors and students perceive design jury as a pedagogical method. While the hierarchy between the jury member and the student creates a barrier to constructive feedback, a balance between formative and summative evaluations is essential in the design jury. Transparency of evaluation criteria decreases design students’ concern for grade. The design jury could also serve for formative evaluation. A student-centred approach to design jury engenders experiences of deep learning.

Patient and Clinician Characteristics Associated With Secure Message Content: Retrospective Cohort Study.

BackgroundGood communication has been shown to affect patient outcomes; however, the effect varies according to patient and clinician characteristics. To date, no research has explored the differences in the content of secure messages based on these characteristics.ObjectiveThis study aims to explore characteristics of patients and clinic staff associated with the content exchanged in secure messages.MethodsWe coded 18,309 messages that were part of threads initiated by 1031 patients with hypertension, diabetes, or both conditions, in communication with 711 staff members. We conducted four sets of analyses to identify associations between patient characteristics and the types of messages they sent, staff characteristics and the types of messages they sent, staff characteristics and the types of messages patients sent to them, and patient characteristics and the types of messages they received from staff. Logistic regression was used to estimate the strength of the associations.ResultsWe found that younger patients had reduced odds of sharing clinical updates (odds ratio [OR] 0.77, 95% CI 0.65-0.91) and requesting prescription refills (OR 0.77, 95% CI 0.65-0.90). Women had reduced odds of self-reporting biometrics (OR 0.78, 95% CI 0.62-0.98) but greater odds of responding to a clinician (OR 1.20, 95% CI 1.02-1.42) and seeking medical guidance (OR 1.19, 95% CI 1.01-1.40). Compared with White patients, Black patients had greater odds of requesting preventive care (OR 2.68, 95% CI 1.30-5.51) but reduced odds of requesting a new or changed prescription (OR 0.72, 95% CI 0.53-0.98) or laboratory or other diagnostic procedures (OR 0.66, 95% CI 0.46-0.95). Staff had lower odds of sharing medical guidance with younger patients (OR 0.83, 95% CI 0.69-1.00) and uninsured patients (OR 0.21, 95% CI 0.06-0.73) but had greater odds of sharing medical guidance with patients with public payers (OR 2.03, 95% CI 1.26-3.25) compared with patients with private payers. Staff had reduced odds of confirming to women that their requests were fulfilled (OR 0.82, 95% CI 0.69-0.98). Compared with physicians, nurse practitioners had greater odds of sharing medical guidance with patients (OR 2.74, 95% CI 1.12-6.68) and receiving prescription refill requests (OR 3.39, 95% CI 1.49-7.71). Registered nurses had greater odds of deferred information sharing (OR 1.61, 95% CI 1.04-2.49) and receiving responses to messages (OR 3.93, 95% CI 2.18-7.11) than physicians.ConclusionsThe differences we found in content use based on patient characteristics could lead to the exacerbation of health disparities when content is associated with health outcomes. Disparities in the content of secure messages could exacerbate disparities in patient outcomes, such as satisfaction, trust in the system, self-care, and health outcomes. Staff and administrators should evaluate how secure messaging is used to ensure that disparities in care are not perpetuated via this communication modality.

Did You Just Lie to Me?Deception Detection in Face to Face versus Computer Mediated Communication

ABSTRACT Individuals’ deception detection ability during either a face-to-face (FtF) interaction or through computer-mediated communication (CMC) was explored under more naturalistic conditions where they were not forewarned that deception may be involved. Participants discussed a social issue either in a room together or by instant messaging from separate rooms. Prior to discussion, some participants were asked to deceive their partner regarding their actual opinion on the issue. Results showed that mode of communication did not influence participants’ deception detection accuracy rate, nor their truth bias. Regardless of mode of communication, deceptive participants experienced the same level of physiological arousal as the non-deceivers. In contrast, deceivers reported experiencing higher levels of anxiety but only in the FtF condition. Findings highlight how for different communication modalities, a multitude of interactive factors may influence deception detection.

The 3.0 Cell Communication: New Insights in the Usefulness of Tunneling Nanotubes for Glioblastoma Treatment.

Simple SummaryCommunication between cells helps tumors acquire resistance to chemotherapy and makes the struggle against cancer more challenging. Tunneling nanotubes (TNTs) are long channels able to connect both nearby and distant cells, contributing to a more malignant phenotype. This finding might be useful in designing novel strategies of drug delivery exploiting these systems of connection. This would be particularly important to reach tumor niches, where glioblastoma stem cells proliferate and provoke immune escape, thereby increasing metastatic potential and tumor recurrence a few months after surgical resection of the primary mass. Along with the direct inhibition of TNT formation, TNT analysis, and targeting strategies might be useful in providing innovative tools for the treatment of this tumor.Glioblastoma (GBM) is a particularly challenging brain tumor characterized by a heterogeneous, complex, and multicellular microenvironment, which represents a strategic network for treatment escape. Furthermore, the presence of GBM stem cells (GSCs) seems to contribute to GBM recurrence after surgery, and chemo- and/or radiotherapy. In this context, intercellular communication modalities play key roles in driving GBM therapy resistance. The presence of tunneling nanotubes (TNTs), long membranous open-ended channels connecting distant cells, has been observed in several types of cancer, where they emerge to steer a more malignant phenotype. Here, we discuss the current knowledge about the formation of TNTs between different cellular types in the GBM microenvironment and their potential role in tumor progression and recurrence. Particularly, we highlight two prospective strategies targeting TNTs as possible therapeutics: (i) the inhibition of TNT formation and (ii) a boost in drug delivery between cells through these channels. The latter may require future studies to design drug delivery systems that are exchangeable through TNTs, thus allowing for access to distant tumor niches that are involved in tumor immune escape, maintenance of GSC plasticity, and increases in metastatic potential.

‘My journey is to help somebody else’: a qualitative assessment of peer-to-peer gynecologic cancer mentorship during COVID-19

<h3>Objectives:</h3> The Ovarian Cancer Research Alliance's Woman to Woman (W2W) program is a peer mentorship program for women with gynecological cancer that was founded in 2004 and has since expanded to over 40 sites nationwide. An initial program survey was conducted in 2013, but no qualitative studies have investigated patient experiences with peer support programs for gynecologic cancer in the United States. <h3>Methods:</h3> This qualitative study investigated perspectives of both mentor and mentee participants in a W2W program at an academic medical center in the Midwest. Semi-structured interviews averaging 54 minutes were conducted, recorded and transcribed verbatim. Interviews focused on understanding how the relationship was built and the benefits and challenges of giving and receiving peer support. Qualitative inductive analysis of 236 pages of transcripts was conducted and managed with NVivo 12. All authors open-coded a subset of interviews that informed codebook development. This codebook was used to code the remainder of the interviews, with one primary coder and a secondary coder reviewing. <h3>Results:</h3> Seven mentors and nine mentees were interviewed (N=16). Thirteen were non-Hispanic White and three were African-American. Participants in both groups were in varying stages of active treatment, remission, and recurrence. Mentors and mentees communicated over several mediums including Facebook, emailing, texting, or calling. Many reported disappointment over not being able to meet in person due to COVID-19. There was occasional misalignment in mentor and mentee expectations for frequency and intensity of communication. Interestingly, it was more often the mentor who expected more contact. While some mentees did express a desire for mentor concordance (e.g. marital status, parenthood, recurrence status), compatibility of mentor-mentee pairs in our study was positive for pairs even when they were not concordant across all demographics. Compatibility issues arose when participants felt like there was a discordance in coping styles between them and their mentor or mentee. While mentees reported receiving other sources of support, having a mentor who had ‘been in the trenches' was uniquely important, especially when COVID-19 restrictions prevented their families from accompanying them to treatments. Mentors reported numerous psychological benefits of being a mentor including feeling needed after retirement, fulfilling a promise to themselves, and giving hope to others. <h3>Conclusions:</h3> Participants reported benefits of giving and receiving peer mentorship for gynecologic cancer. Mentees accessed valuable insider information and mentors found purpose in their own cancer experiences. Assessing mentees' needs, including preferred modality and frequency of communication, and considering demographic concordance prior to matching is crucial to ensuring a successful match. Future iterations of the program should focus on training mentors to interact with mentees through multiple communication platforms, as well as to address additional mentee vulnerabilities introduced by the pandemic.

The dissemination of mesmerism in Germany (1784–1815): Some patterns of the circulation of knowledge

Franz Anton Mesmer (1734–1815), a physician who graduated from the University of Vienna, invented a therapy based on the concept of a universal fluid, similar to electricity, that flowed through all living things. By restoring the circulation of this fluid in the nerves of human bodies, he believed he could cure illness without resorting to medication. Few medical theories have enjoyed as great success as Mesmer's, first among French high society and then in Germany, Switzerland, the Netherlands, Italy, Sweden, Russia, Britain, and the US. Mesmerism was the circulatory phenomenon par excellence. Its success was founded not only on the hypothesis of the circulation of a fluid common to human physiology and the entire universe, but also on the scientific practices of the time—correspondence, translations, and periodicals—and some ardent and highly active supporters who ensured its spread. However, far from functioning along the lines of direct exportation–importation from one country to another, or a centre to the periphery, mesmerism's dissemination was the work of diffuse institutions and individual mobilities influenced by the modalities of communication. In seeking to reconstitute the wellsprings of these circulations, the first sources that come to mind are printed matter: the many pamphlets and especially the articles and reviews that appeared in periodicals, as well as the Romantic literature that flourished after 1810. Such documents are foundational for authoritative studies of mesmerism in Germany, which proceed from the thesis of successive “waves” of reception. Such sources, however, are somewhat misleading. Rather than taking them as our starting point, it would be better to reconstitute the channels of information by using many sources, both printed and handwritten. The complexity of the circulation of knowledge generated by mesmerism is implicitly testament to the difficulties arising from the institutionalization of this current.

Multicomponent and multisensory communicative acts in orang-utans may serve different functions

From early infancy, human face-to-face communication is multimodal, comprising a plethora of interlinked communicative and sensory modalities. Although there is also growing evidence for this in nonhuman primates, previous research rarely disentangled production from perception of signals. Consequently, the functions of integrating articulators (i.e. production organs involved in multicomponent acts) and sensory channels (i.e. modalities involved in multisensory acts) remain poorly understood. Here, we studied close-range social interactions within and beyond mother-infant pairs of Bornean and Sumatran orang-utans living in wild and captive settings, to examine use of and responses to multicomponent and multisensory communication. From the perspective of production, results showed that multicomponent acts were used more than the respective unicomponent acts when the presumed goal did not match the dominant outcome for a specific communicative act, and were more common among non-mother-infant dyads and Sumatran orang-utans. From the perception perspective, we found that multisensory acts were more effective than the respective unisensory acts, and were used more in wild compared to captive populations. We argue that multisensory acts primarily facilitate effectiveness, whereas multicomponent acts become relevant when interaction outcomes are less predictable. These different functions underscore the importance of distinguishing between production and perception in studies of communication.

English

BACKGROUND Even in the presence of sufficient voluntary blood donors, the need of blood is not met yet. We wanted to evaluate the causes that hinder the smooth functioning of well-maintained blood transfusion services (BTS). METHODS This is a population based cross-sectional study conducted among blood donors from voluntary outreach blood donation camp for period of one year. Total 1536 blood donors from 32 blood donation camps were subjected to study for the sociodemographic characteristic and their knowledge of blood donation. Statistical analysis of data was done using Microsoft Excel, analysed using statistical package for social sciences (SPSS) ver.16 software. RESULTS A total of 32 blood donation camps were conducted during the study period that provided 1536 donors. In most of the camps, male donors (75 %) were more than female donors. Donors of age group of 30 to 39 years (43.9 %) were more when compared to others. Donors those who were married accounted for 79.9 %. Blood donors of Hindu religion (53 %) were more. CONCLUSIONS The main hindrance for blood donor motivation is lack of knowledge. Literacy and chance to mingle in society have a positive effect on blood donor motivation. Targeting of effective donor motivation, recruitment, and retention were attained by conducting awareness classes, seminars, workshops, and visual communication modalities. KEYWORDS World Health Organization, Altruistic Blood Donor, Blood Transfusion Services, Transfusion Transmitted Infections, Blood Components and Plasma Derivatives, Director General of Health Services (DGHS), National Blood Transportation Council (NBTC)

Teacher and school staff perspectives on their role in school-based vision programs

ObjectiveSchool-based vision programs (SBVPs) are one approach to increase access to vision care by providing vision screenings, eye examinations, and eyeglasses directly in schools. Few studies report on the perspectives of teachers and staff, who are important stakeholders, on SBVPs. We examined teacher and staff perspectives on their involvement in SBVPs. DesignQualitative study using focus groups. ParticipantsTeachers and staff at Baltimore and Chicago public schools served by SBVPs between 2016 and 2018. MethodsWe conducted 21 semistructured focus groups with 117 teachers and staff in 10 Baltimore and 11 Chicago public preK–12 schools that participated in SBVPs. Sessions were recorded, transcribed, and coded using inductive thematic analysis. ResultsParticipants identified 2 main themes regarding teacher and staff involvement in SBVPs: (i) program outreach, including using multiple communication modalities to engage parents, explaining program details to families, and helping with program consent form return and (ii) promoting vision health, including identifying vision problems in the classroom, encouraging eyeglasses wear, and supporting eyeglasses maintenance. Participants also discussed limitations in capacity to partake in these activities. ConclusionTeachers interact with parents and students throughout the SBVP process, undertaking important roles in outreach and health promotion to ensure uptake of SBVP services. SBVPs and other school-based health programs should explore strategies to support teachers in the roles they fill to optimize program impact.

Extracellular Vesicles-The Next Frontier in Endocrinology.

Extracellular vesicles (EVs), including exosomes, are emerging as important carriers of signals in normal and pathological physiology. As EVs are a long-range communication or signaling modality-just like hormones are-the field of endocrinology is uniquely poised to offer insight into their functional biology and regulation. EVs are membrane-bound particles secreted by many different cell types and can have local or systemic effects, being transported in body fluids. They express transmembrane proteins, some of which are shared between EVs and some being specific to the tissue of origin, that can interact with target cells directly (much like hormones can). They also contain cargo within them that includes DNA, RNA, miRNA, and various metabolites. They can fuse with target cells to empty their cargo and alter their target cell physiology in this way also. Similar to the endocrine system, the EV system is likely to be under homeostatic control, making the regulation of their biogenesis and secretion important aspects to study. In this review, we briefly highlight select examples of how EVs are implicated in normal physiology and disease states. We also discuss what is known about their biogenesis and regulation of secretion. We hope that this paper inspires the endocrinology field to use our collective expertise to explore these new multimodal "hormones."

Nurse Practitioner Students' Perceptions on Delivering Culturally Congruent Care to Vulnerable Mexican Immigrants: A Qualitative Study.

Increasingly, nurse practitioners serve as vanguards in providing primary health care to vulnerable Mexican immigrants. The aims of this study were to explore the lived experiences of nurse practitioner students in caring for Mexican immigrant patients and to capture their meaning of cultural influences deemed essential to the delivery of culturally congruent care. An exploratory descriptive design was employed. Purposive sampling was used to select 17 nurse practitioner students who volunteered to complete a semistructured face-to-face audio-taped interview and follow-up focus group discussion. Constant comparison was utilized to analyze data. From this process, four distinct themes emerged: Culturally congruent care extends beyond race and ethnicity, understands the importance of therapeutic communication, accepts complementary and alternative medical modalities, and recognizes the importance of eating patterns, food choices, and perceptions of ideal weight and health. These findings build on our understanding of key evidence-based cultural beliefs and practices that are important in delivering culturally congruent care to this subgroup.

Implications of Electronic Consultations for Clinician Communication and Relationships: A Qualitative Study.

Strong relationships and effective communication between clinicians support care coordination and contribute to care quality. As a new mechanism of clinician communication, electronic consultations (e-consults) may have downstream effects on care provision and coordination. The objective of this study was to understand primary care providers' and specialists' perspectives on how e-consults affect communication and relationships between clinicians. Qualitative study using thematic analysis of semistructured interviews. Six of 8 sites in the VISN 1 (Veterans Integrated Service Network) in New England were chosen, based on variation in organization and received e-consult volume. Seventy-three respondents, including 60 clinicians in primary care and 3 high-volume specialties (cardiology, pulmonology, and neurology) and 13 clinical leaders at the site and VISN level, were recruited. Participants' perspectives on the role and impact of e-consults on communication and relationships between clinicians. Clinicians identified 3 types of e-consults' social affordances: (1) e-consults were praised for allowing specialist advice to be more grounded in patient data and well-documented, but concerns about potential legal liability and increased transparency of communication to patients and others were also noted; (2) e-consults were perceived as an imperfect modality for iterative communication, especially for complex conversations requiring shared deliberation; (3) e-consults were understood as a factor influencing clinician relationships, but clinicians disagreed on whether e-consults promote or undermine relationship building. Clinicians have diverse concerns about the implications of e-consults for communication and relationships. Our findings may inform efforts to expand and improve the use of e-consults in diverse health care settings.

Contextual defeasible reasoning framework for heterogeneous knowledge sources

AbstractRecent years have witnessed the rapid advances of smart computing paradigms in a ubiquitous environment. These paradigms make human life much easier, comfortable, secure and hassle free. In a smart computing environment, it is a fact that human users interact with the systems dynamically with or without human intervention using different modalities. The core emphasize is given on the intelligent systems that run in a highly decentralized environment with different communication mechanism. Literature highlighted numerous formalisms to bridge the communication modalities for different knowledge sources. Among others, Multi‐context System (MCS) has been advocated as one of the most suitable formalism to interlink different contexts (domains) dynamically in the distributed environment. However, interaction of these knowledge sources sometime may produce inconsistent and conflicting results. In this work, we presents a contextual defeasible reasoning based multi‐agent formalism to handle the inconsistency issues. This framework relies on the semantic knowledge sources which allow us to model context‐aware non‐monotonic reasoning agents to infer the desired goals using the extracted rules from the ontologies and handles inconsistencies using conflicting contextual information. We illustrate the validity and correctness of the proposed formalism using a simple case study of a smart healthcare system with the prototypal implementation of the system.

CHARITY ORGANIZATIONS ADOPTING VIRTUAL REALITY MODALITY: THEORIZATION AND VALIDATION

ABSTRACT Communicators of charity organizations have begun to adopt virtual reality modality to draw in more donors in recent years. However, there is still a lack of comprehensive theoretical exploration and empirical verification on the avenues that may optimize the function of virtual reality modality for communication conducted by charity organizations. To fill this gap, the current study proposes and validates a framework based on integrative extension of theories pertaining to enactive cognition, media affordances, and personal norm. As the research result suggests, the five immersive affordance attributes of vividness, authenticity, coherence, interactivity, and controllability are primary facilitators of empathy and personal norm activation in the virtual reality context. The type of virtual reality modality, which provides immersive affordance attributes to exercise the transformative change effect, serves to elicit charitable donation intention through evocation of empathy and personal norm activation as the two key mediators. More noteworthy, the positive impact of empathy on charitable donation intention significantly increases due to the partial mediating effect of personal norm activation. Overall, the research result contributes to enhancing the effectiveness of communication conducted by charity organizations.

Analytical review of automatic systems for depression detection by speech

In recent years the interest in automatic depression detection has grown within medical and scientific-technical communities. Depression is one of the most widespread mental illnesses that affects human life. In this review we present and analyze the latest researches devoted to depression detection. Basic notions related to the definition of depression were specified, the review includes both unimodal and multimodal corpora containing records of informants diagnosed with depression and control groups of non-depressed people.&#x0D; Theoretical and practical researches which present automated systems for depression detection were reviewed. The last ones include unimodal as well as multimodal systems. A part of reviewed systems addresses the challenge of regressive classification predicting the degree of depression severity (non-depressed, mild, moderate and severe), and another part solves a problem of binary classification predicting the presence of depression (if a person is depressed or not). An original classification of methods for computing of informative features for three communicative modalities (audio, video, text information) is presented. New methods for depression detection in every modality and all modalities in total are defined. The most popular methods for depression detection in reviewed studies are neural networks. The survey has shown that the main features of depression are psychomotor retardation that affects all communicative modalities and strong correlation with affective values of valency, activation and domination, also there has been observed an inverse correlation between depression and aggression. Discovered correlations confirm interrelation of affective disorders and human emotional states. The trend observed in many reviewed papers is that combining modalities improves the results of depression detection systems.

Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study.

BackgroundPatient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized.ObjectiveThe purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina.MethodsWe conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses.ResultsMost patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload.ConclusionsPatients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients.