Message Reminders Research Articles

A multi-method feasibility trial of a multi-component behaviour change intervention to reduce sedentary behaviour and increase physical activity among ethnically diverse older adults

IntroductionEvidence suggests that sedentary behaviour (SB) and physical activity (PA) are important indicators of well-being and quality of life in older adults (OAs). However, OAs are the least active and...

Embedding a text message recall system to increase the uptake of cardiovascular screening in Australian general practice. Results of the Text to Detect randomised controlled trial

Abstract Background Australian guidelines recommend cardiovascular disease (CVD) risk screening for adults aged 45-74 years, but less than one in three have blood pressure and cholesterol recorded within their general practitioner (GP) records. Medicare subsidised ‘Heart Health Checks’ were introduced in primary care in 2019, however uptake has been suboptimal. Purpose The aims of this study were to; 1) implement a text mediated Heart Health Check recall program within general practice at scale, 2) determine whether uptake can be increased with nudge reminder text messages and 3) evaluate the impact on risk factor measurement and medication prescription. Methods Australian general practices were invited via advertisement and mailing list. Medical record software identified patients eligible for a Heart Health Check. Practices were randomised to one of three arms: 1) standard SMS: 1 SMS inviting patients to see their GP for a Heart Health Check, 2) nudge reminder: standard SMS + nudge reminder two weeks later, 3) control: no SMS. Aggregate, deidentified, practice-level data was extracted at baseline and 3-months. The primary outcome was the proportion of Heart Health Checks delivered at a practice level. Secondary outcomes included updated CVD risk factor assessment and new medication prescriptions. Analyses used ANOVA and Tukey's HSD. Results Between 2022 and 2023, 206 general practices participated, each with 560 median eligible patients (IQR:297-909). A total of 70,679 recall text messages and 34,406 nudge reminder messages were sent. Heart Health Check uptake was 11 and 16 times higher in the standard and nudge arms (respectively) compared to control (0.4 vs 4.5 vs 6.3 per 100 patients, p<0.001), with a 40% statistically significant increase (p=0.02) for 2 SMS vs 1 SMS. Updated cholesterol values were 31.6 and 60.2% higher in standard and nudge arms (respectively) compared to control (13.7 vs 16.8 vs 17.4 per 100 patients, p=0.02). Both active arms were statistically significantly different from control (standard p=0.047, nudge p=<0.001). Updated blood pressure was 23.0 and 26.8% higher in the standard and nudge arms (respectively) compared to control (13.7 vs 16.8 vs 17.4 per 100 participants), however only the nudge arm was statistically significantly different (p=0.38). New medication prescription (lipid or blood pressure-lowering) was 36.8% higher in the nudge arm compared to control (32.1 vs 43.9 patients per practice, p=0.03). Conclusions This study demonstrates the effectiveness of text mediated recall of eligible patients to increase the uptake of cardiovascular risk screening in Australian general practice. The findings will inform the implementation of new Australian guidelines and policy reform.

5099 Capturing the Patient Voice for Diabetes Eye Exams

Abstract Disclosure: S. Du: None. S. Lambrechts: None. M. Freeby: None. M. Han: None. Background: Diabetic retinopathy (DR) is a leading cause of blindness among adults 20-74 years old. Ophthalmic exams are recommended every 1-2 years for type 2 diabetes patients with minimal to no DR. The 50th percentile Integrated Healthcare Association benchmark for DR screening is 49%, but at our academic medical center, the completion rate is 30%. Potential barriers to screening noted in the literature include lower levels of education, lack of knowledge about DR, and financial barriers. Objective: To understand motivating factors and barriers to DR screening among patients in our health system. Methods: We utilized the Patient Voice qualitative research method to uncover themes and identify interventions to improve care delivery. The literature was synthesized to develop a structured interview guide. From our urban academic health system, 15 patients were randomly selected for interview, six of whom had completed the “Diabetes Eye Exam” care gap and nine that had not. Interviews were transcribed and coded for thematic analysis. Results: Six opportunity areas were identified. 1) There are currently only six retinal cameras located across primary and specialty care clinics serving more than 38,000 diabetes patients. 67% of patients felt the current clinic locations were inconvenient, with distant locations and long travel times. 2) 20% of patients expressed that they would like increased flexibility of appointments offered, such as evening, weekend, and same day appointments. 3) Patients were motivated by automated diabetes eye exam specific reminder messages and appreciated the ability to self-schedule within the patient portal. 47% of patients wanted yearly reminder messages, while 40% had no preference. 4) 53% of patients expressed that they did not fully understand DR or were confused about the difference between an optometrist exam and diabetes eye exam. 5) 40% of patients completed their eye exam with their local optometrist and found this to be a more convenient option. One patient expressed that she wished her doctor had informed her that she could complete her diabetes eye exam at a local optometry clinic. 6) If patients do choose to complete their exam with their local optometrist, they would like reminders to send their records to their primary care physician or endocrinologist. A more streamlined processes to upload outside records through the patient portal would decrease this barrier. Conclusion: It is important to engage patient stakeholders and understand their needs to improve overall experience and close care gaps. Through the Patient Voice, we learned that factors such as driving distance, traffic, scheduling, and issues with uploading records are major barriers to care gap completion. Convenient clinic locations, education, and reminder messages are motivating factors. Future work will focus on developing and implementing solutions in each opportunity area. Presentation: 6/1/2024

Caregivers' and nurses' perceptions of the Smart Discharges Program for children with sepsis in Uganda: A qualitative study.

Sepsis arises when the body's response to an infection injures its own tissues and organs. Among children hospitalized with suspected sepsis in low-income country settings, mortality rates following discharge are high, similar to mortality rates in hospital. The Smart Discharges Program uses a mobile health (mHealth) platform to identify children at high risk of post-discharge mortality to receive enhanced post-discharge care. This study sought to explore the perceptions and experiences of the caregivers and nurses of children enrolled into the Smart Discharges Program and the program's effect on post-discharge care. We conducted an exploratory qualitative study, which included in-person focus group discussions (FGDs) with 30 caregivers of pediatric patients enrolled in the Smart Discharges Program and individual, semi-structured interviews with eight Smart Discharges Program nurses. The study was carried out at four hospitals in Uganda in 2019. Following thematic analysis, three key themes pertaining to the Smart Discharges program were identified: (1) Facilitators and barriers to follow-up care after discharge; (2) Changed caregiver behavior following discharge; and (3) Increased involvement of male caregivers. Facilitators included telephone/text message reminders, positive nurse-patient relationship, and the complementary aspects of the program. Barriers included resource constraints and negative experiences during post-discharge care seeking. With regards to behavior, when provided with relevant and well-timed information, caregivers reported increased knowledge about post-discharge care and improvements in their ability to care for their child. Enrolment in the Smart Discharges Program also increased male caregiver involvement, increased provision of resources and improved communication within the family and with the healthcare system. The Smart Discharges approach is an impactful strategy to improve pediatric post-discharge care, and similar approaches should be considered to improve the hospital to home transition in similar low-income country settings.

Putting TB notification into practice among private pharmacies in Mangalore city, India – Did we succeed?

Problem consideredGlobally, tuberculosis (TB) is the second leading infectious killer after Covid-19 with 1.18–1.43 million deaths in 2022. As per the Global TB Report 2023, an estimated 10.6 million people developed TB in 2022. An estimated 3.1 million cases were missed globally, posing a challenge in breaking the chain of transmission. India is one of the major contributors to the missed cases. Almost 50 % of patients are being treated in the Private sector in India, but fewer are notified to the public health system. This study explored the role of sensitization of pharmacies in TB Case Notification in Mangalore city. MethodsIn this study using a before and after intervention design, the programmatic data was utilized to compare the TB case notifications by the private pharmacies using TB reporting formats for mandatory notification. The intervention was sensitization of the pharmacy owners and pharmacists by a trained field assistant and monthly reminder messages using a social media tool. The data was collected for 2 consecutive quarters October 2019–March 2020 in the prescribed formats. ResultsPost Intervention, there was an increase in the number of pharmacies reporting TB cases from 6 to 14, and prescriptions were being maintained and shared with the District TB Office. An increased number of case reporting was also observed post-intervention. ConclusionIntensified sensitization led to improvement in the reporting mechanism of TB case notification by private pharmacies, though it did not translate into a concurrent rise in notification of TB cases in the district.

“Don’t touch your face”---Effectiveness of a health communication intervention on reducing face-touching behaviors

Given the risk of infection through face-touching behaviors, investigators have called for more research into the development of interventions to reduce the frequency of face-touching. The current study aims to test the effectiveness of messages on reducing face-touching behaviors. Nine different messages that highlighted the risk of face-touching were developed. Study 1, an online survey-experiment with a national sample of US adults (N=998), examined message-, risk perceptions, and face-touching-related behavioral intentions. The most promising messages identified in study 1 were then tested in study 2, a follow-up behavioral observation study with a class of undergraduate students. Students' face-touching behaviors were observed during a 4-week period when intervention versus control messages were displayed in the classroom. Four messages performed better in study 1, 2 of which were selected to test the actual message effectiveness in study 2. Study 2 results showed that on average, students touched their faces less frequently when a "Don't touch your face" message was present, although such decrease was not statistically significant. Having reminder messages of "Don't touch your face" in public spaces holdthe potential to be a low-cost, effective strategy to reduce face-touching behaviors.

Enhancing self-care in elderly patients: the impact of WhatsApp reminder messages at the Heart and Vascular Center

The importance of reminder messages lies in improving self-care among heart disease patients. At the Heart and Vascular Center, many patients, both those under ongoing care and those recently treated, do not consistently engage in self-care activities. Reminder messages can encourage adherence to medication regimens. This study aimed to investigate the effectiveness of WhatsApp reminder messages on the self-care of elderly patients at the Heart and Vascular Center. The research employed a quasi-experimental design with a two-group pre- and post-test control design. Using a probability sampling technique with simple random sampling, the study required 16 new patients in each group. The instrument used was the Self-Care Heart Failure Index (SCHFI) questionnaire, consisting of 22 questions. Data analysis was performed using the Mann-Whitney test. The results indicated that WhatsApp reminder messages are effective in enhancing patient self-care at the Heart and Vascular Center at Premier Hospital Surabaya (p-value<0.001). The Mann-Whitney test results post-intervention showed a p-value of 0.013, confirming the effectiveness of WhatsApp reminder messages in improving self-care among patients. This study demonstrated a significant positive influence of WhatsApp reminder messages on the self-care of elderly patients at the Heart and Vascular Center. These messages are an effective tool for improving patient self-care practices at Premier Hospital Surabaya.

The effect of multiple nursing interventions on physical activity and health promotion in the elderly: A randomized controlled trial

Health promotion and physical activity practices for the elderly are important but still not sufficient. This study aimed to determine if the effects of education through home visit, mobile application (Google Fit), group walking, and phone reminder interventions on health promotion and physical activity in the elderly. The study has a randomized controlled design with pretest-posttest interventions and a control group. The study sample consisted of 66 elderly individuals, 33 of whom were assigned to the intervention group and 33 to the control group by randomization. Multiple nursing interventions, including education through home visit, mobile application (Google Fit) use, group walking, and phone reminder messages, were implemented by the researcher in line with Pender's Health Promotion Model. The first month score of the intervention group participants on the healthy lifestyle habits subscale was higher than that of the control group participants (all p-values < 0.05). The effect size was 0.577 (high effect size) and the confidence interval was 0.085-1.07. It can be recommended that interventions with reminders and repetitions regarding healthy lifestyle behaviors to health promotion in the elderly be planned.

Adherence to antihypertensive medication and its associated factors among patients with hypertension attending a tertiary hospital in Kathmandu, Nepal.

Hypertension is a major risk factor for cardiovascular disease, which is the leading cause of premature mortality and morbidity globally. Despite the evidences of the availability of effective treatment for hypertension, its management remains suboptimal. Medication adherence is the most crucial factor for blood pressure control. It is important to identify the factors associated with adherence to antihypertensive treatment for better management. Hence, this study assessed the level of antihypertensive medication adherence and its associated factors among patients with hypertension visiting a tertiary-level hospital in Kathmandu, Nepal. An analytical cross-sectional study was carried out among 308 diagnosed patients with hypertension who were prescribed antihypertensive medication. The Morisky Medication Adherence Scale (MMAS-8) was used to assess medication adherence. Data was collected through face-to-face interviews and analysed using SPSS v26. A bivariate and multivariate logistic regression model was used to assess the factors associated with low medication adherence. More than half (61%) of the study participants had moderate to high levels of medication adherence. Upon bivariate analysis, there was a significant association between presence of side effects, blood pressure status, forgetfulness, high cost, fear of taking medicine lifelong and irregular follow-up with a low level of adherence. Upon multivariate the logistic regression analysis, forgetfulness [Adjusted Odd's Ratio (AOR) 22.5, 95% Confidence Interval(CI) 10.56-47.86], high cost (AOR 3.8, 95%CI 1.25-11.60) and fear of taking medicines lifelong (AOR 6.04, 95%CI 2.96-12.33) were found to be associated factors of low level of adherence. There is an urgency to develop evidence-based strategies to improve the level of adherence to antihypertensive medications among patients with hypertension. Strategies like reminder messaging, setting alarms, expanding the scope of national health insurance and proper counselling to reduce fear could help to improve medication adherence. Hence, the feasibility and effectiveness of such intervention should be explored in future studies.

A Feasibility Study of a Behavioral Intervention to Increase Uptake of Human Papillomavirus (HPV) Vaccination in Envigado, Colombia

PURPOSE The estimated HPV vaccination coverage in Colombia is approximately 39%, falling short of the 90% goal set by the Global Strategy for Cervical Cancer Elimination proposed by the WHO for 2030. The aim of this study was to evaluate the feasibility of a behavioral intervention named Super Protegidas, to increase HPV vaccination of girls aged 9 to 14 years. Following the recommendations of the ORBIT model for behavioral interventions development, the problem was conceptualized, an intervention was designed with stakeholders, and the results of the feasibility phase are presented here. METHODS The protocol, based on the COM-B model, focuses on dyads of girls and caregivers. For the girls, a playful pedagogical workshop was conducted in two schools, addressing primary prevention of cervical cancer through HPV vaccination. For parents, the protocol includes a letter, a series of multimedia messages with text, a video on cervical cancer prevention, and a reminder message the day before vaccination. After conducting this intervention, a feasibility study was carried out through semi-structured telephone interviews with participating caregivers. This aimed to assess acceptability, retention, comprehension, effort required to participate, and suggestions for improvement. RESULTS Fifteen dyads of girls and their caregivers participated, with an 80% sample retention completing both the intervention and the telephonic interview. Of these, 69.2% did not watch the videos, 83.3% read the letter with their daughter, 100% were pleased with the intervention, the clarity of the messages, and the delivery method. Regarding areas for improvement, 41.6% suggested avoiding videos due to the time required to watch them and recommended sending messages in the early hours of the night as this increases the likelihood of reading them. CONCLUSION The intervention was well-received by participants and deemed feasible by researchers. Adjustments are needed to enable participants to access information in a more timely manner.

Promoting Rural-Residing Parents' Receptivity to HPV Vaccination: Targeting Messages and Mobile Clinic Implementation.

Interventions are needed to increase low HPV vaccination rates within rural areas in the United States, particularly in the state of Florida, which has the seventh highest number of HPV-related cancers. Florida also ranks low compared to other states in terms of HPV vaccination. Rural-residing parents may benefit from two evidence-based strategies to increase vaccination rates: reminder messages informing and prompting vaccination appointments and mobile clinics to reduce transportation barriers. We sought to identify parental attitudes towards (1) message features that promote rural-residing parents' receptivity to HPV vaccination; (2) parents' acceptability of three reminder message modalities (text, postcard, phone); and (3) implementation factors that promote parents' acceptability of using a mobile clinic for vaccination. We recruited 28 rural-residing parents of 9- to 12-year-old children (unvaccinated for HPV) for focus group and individual interviews and thematically analyzed transcripts. Three features promoted parents' receptivity to HPV vaccination messages: source credibility, specific information coverage, and personalization (name and birthday wishes). Parents most preferred text messages and identified three factors promoting parents' mobile clinic use: convenience and feasibility, trustworthiness, and detailed information. The findings indicate rural-residing parents' acceptability of reminder messages and mobile clinics as well as the importance of trust and feasibility when implementing these evidence-based strategies for rural-residing parents.

Megastudy shows that reminders boost vaccination but adding free rides does not

Encouraging routine COVID-19 vaccinations is likely to be a crucial policy challenge for decades to come. To avert hundreds of thousands of unnecessary hospitalizations and deaths, adoption will need to be higher than it was in the autumn of 2022 or 2023, when less than one-fifth of Americans received booster vaccines1,2. One approach to encouraging vaccination is to eliminate the friction of transportation hurdles. Previous research has shown that friction can hinder follow-through3 and that individuals who live farther from COVID-19 vaccination sites are less likely to get vaccinated4. However, the value of providing free round-trip transportation to vaccination sites is unknown. Here we show that offering people free round-trip Lyft rides to pharmacies has no benefit over and above sending them behaviourally informed text messages reminding them to get vaccinated. We determined this by running a megastudy with millions of CVS Pharmacy patients in the United States testing the effects of (1) free round-trip Lyft rides to CVS Pharmacies for vaccination appointments and (2) seven different sets of behaviourally informed vaccine reminder messages. Our results suggest that offering previously vaccinated individuals free rides to vaccination sites is not a good investment in the United States, contrary to the high expectations of both expert and lay forecasters. Instead, people in the United States should be sent behaviourally informed COVID-19 vaccination reminders, which increased the 30-day COVID-19 booster uptake by 21% (1.05 percentage points) and spilled over to increase 30-day influenza vaccinations by 8% (0.34 percentage points) in our megastudy. More rigorous testing of interventions to promote vaccination is needed to ensure that evidence-based solutions are deployed widely and that ineffective but intuitively appealing tools are discontinued.

Improving repurchase behaviour based on relationship marketing: evidence from the message framing of airline in China

ABSTRACT Short Message Service (SMS) marketing, as one of mobile marketing, has been a prominent marketing approach in the service business, particularly in airlines. However, for member groups with a social identity, how to send SMS to promote repurchase behaviour of members? This question is what current research tries to explore. A large field experiment involving 200,000 active members of an airlines was conducted to validate the message framing proposed in this study. Specifically, based on the message framing, we applied 2 promotional SMS (With identity vs. Without identity) x 2 Purchase intention (High vs. Low) and 2 promotional SMS (Feasibility vs. Desirability) x 2 Purchase intention (High vs. Low) between-subjects experimental design and a control group with general reminder messages in a ‘Member Day’ promotion. By analyzing 188,627 respondent’s actual repurchase data, the result shows that the framing effect between with-identity or feasibility messages and high purchase intention significantly positively impacts members repurchase behaviour. In contrast, the effect between without-identity or desirability messages and low purchase intention has no influence. Furthermore, the moderation effect of members’ features on the framing effect has also been discussed. This study has theoretical and practical guidance for the research on relationship marketing, membership management, and loyalty programmes.

Improving Accessibility to Outpatient Department Through Reduction of Third Next Available Appointment in Tertiary Hospital in Taif, Saudi Arabia

Background The Outpatient Department (OPD) of Al Hada Armed Forces Hospital - Taif Region (AHAFH) plays a critical role in providing specialized medical services to a diverse population in Taif region, Saudi Arabia. The hospital faces the challenge of ensuring timely access to a comprehensive array of 40 specialized services and subspecialties, supported by 120 rooms in the OPD. This article outlines a significant understanding of the patient flow process and queuing mechanism in the context of the OPD and the dynamics of supply and demand. Local Problem Our project was initiated during the last few weeks of fourth quarter 2020, which revealed a concerning trend of increasing the third next available appointment (TNAA), surpassing the optimal target of &lt;14 days. Methods The study used pre-test and post-test monitoring of the TNAA. Patients’ categories of referral were identified as urgent and routine. We also established a referral and discharge criteria for each clinic specialty and reminder messages on patient appointments 24 hours and 48 hours prior to their actual appointment. Interventions The Plan-Do-Study-Act (PDSA) model for improvement was utilized to implement action plans and interventions to address the increase of TNAA (in days) in the OPD. Weekly huddles were conducted to monitor project progress, action plans, data, and challenges. Results During the intervention phase, notable changes were observed in the control chart, including shifts in TNAA mean decreasing from 9.4 days to 5.6 days after the implementation of four PDSA cycles. Moreover, the average TNAA in each quarter showed consistent reduction in TNAA, with an average of six days in Q1 2022. Conclusions The study sheds light on the complexity of managing the patient flow and access in an outpatient setting. By implementing effective strategies and continuous and vigilant monitoring of the outcomes, outpatient departments can strive to ensure that patients receive specialized care in a timely manner.

Multiple Messaging Strategies for Increasing HPV Vaccination Intentions among English- and Spanish-Speaking Parents in the United States and Mexico.

The reported study compared the impact of four influence strategies (agency assignment, enhanced active choice, deviance regulation marking, and temporal framing) on English- and Spanish-speaking parents' reported intention to vaccinate their children for HPV. An online experiment was conducted to examine the impact of the strategies. In a fractional factorial design, participating parents (N = 1663) were exposed to combinations of influence strategies in text messages presented as reminders they might receive from a healthcare provider about their child's eligibility for the vaccine series. The results indicated small but significant impacts of agency assignment, enhanced active choice, and deviance regulation marking on parents' reported vaccination intentions. The study adds to the research literature on HPV vaccination communication in two important respects. First, it demonstrated how incorporating evidence-based influence strategies into reminder messages can increase parents' vaccination intentions, an important precursor and predictor of actual vaccine uptake. Second, it sets an important precedent by examining the effects of influence strategies on vaccination intentions across different languages.

Implementation of SI-KEPPO Innovation to Increase Return Visits of Hypertension Patients at Public Health Center of Sobo, Banyuwangi

The key to managing hypertension is regular control visits to the community health center or other health facilities. These visits are critical in monitoring response to treatment, adjusting therapy if necessary, and providing education and support to the patient. Low compliance of hypertension patients with re-visits or regular control can hinder the success of hypertension management and increase the risk of complications. The SI-KEPPO (Automatic Reminder Message Group System) innovation aims to provide an effective solution in managing and arranging re-visits or reminding individuals or groups of contact time automatically via text messages or other messages. This activity is a community service aimed at doctors, nurses, administration staff and counter staff. A direct training is carried out on computers owned by the Community Health Center so that deficiencies and advantages are detected in the existing facilities at the Community Health Center. The material presented is an introduction to the program or innovation by explaining the use of the innovation, the preparations made and the procedures for implementing it. There were 1 doctor, 4 nurses, 1 medical center administration staff, 1 operator staff, and 1 counter staff who participate in community service activities. All participants were very enthusiastic about this training and it could increase the number of repeat visits for hypertensive patients.

Intervensi yang Efektif dalam Peningkatan Skrining Kanker Serviks pada Perempuan Usia Subur

This study aims to review the literature on effective interventions to increase the uptake of cervical cancer screening in women of childbearing age. The method used is a systematic review through searching for articles according to the formulation of research questions using the PIO formula in the Proquest, Pubmed, Sage Journal, Science Direct, and Scopus databases. The search keywords used are ((technology[Title/Abstract]) OR (innovation[Title/Abstract])) OR (intervention[Title/Abstract])) OR (method[Title/Abstract])) AND (increase cervical cancer screening[Title/Abstract])) OR (improve cervical cancer screening[Title/Abstract]). The results showed that from 10 articles reviewed, relevant interventions were found to increase screening uptake, including the provision of SMS (education and reminder) and eVouchers, self-sampling of HPV sent by post, FCHV visits to provide education and counseling using flipchart media and booklets as well as talk shows and peer discussions by CHW. CHW conducts education using video clips and brochures, Conclusions, and relevant interventions to increase the uptake of cervical cancer screening are the provision of reminder messages and eVouchers, self-sampling of HPV sent by post, mentoring interventions by FCHV or CHW for education and counseling. Keywords: Technology Intervention, Cervical Cancer Screening, Women of Childbearing Age

Tourism e-commerce marketing following live-streaming: consumer behavior and verification psychology

Purpose Based on social cognitive theory, this study aims to explore the psychological mechanism behind consumer verification behavior following tourism e-commerce live-streaming. Design/methodology/approach Based on grounded theory, data were collected through 20 semi-structured in-depth interviews and analyzed. Findings This study identified that companies commonly use reminder messages and secondary promotions to facilitate the verification of tourism live-streaming products. Throughout this process, consumers undergo various psychologies related to verification. Specifically, they experience four positive verification psychologies: fear of missing out, anticipated emotions, status self-esteem and promotional perception. They also encounter two negative verification psychologies: psychological reactance and invasiveness. In addition, environmental factors such as the type of tourism live-streaming products and tourism destinations, along with individual trait factors like cognitive miserliness, tourism experience, autonomy, regulatory mode and impulsiveness, play significant roles in shaping verification behavior. These factors collectively influence the formation of verification behavior. Originality/value This study can provide recommendations for tourism companies to conduct marketing events following live-streaming. It is one of the earlier comprehensive studies discussing how to promote verification behavior following tourism e-commerce live-streaming. It helps to understand the psychological mechanism underlying the formation of verification behavior.

Application of implementation science for improving the utilization of an international clinical practice guidance on familial hypercholesterolemia

The International Atherosclerosis Society (IAS) published an evidence-informed guidance for familial hypercholesterolemia (FH) that provides both clinical and implementation recommendations. We reference examples of strategies from the literature to explore how these implementation recommendations can be tailored into implementation strategies at the local-level for stakeholders guided by a framework proposed by Sarkies and Jones. Four authors of the IAS guidance selected two published exemplar implementation recommendations for detection, management, and general implementation. Each recommendation was described as an implementation strategy using Proctor's guidance for specifying and reporting implementation strategies. It recommends reporting the actor (who), action (what), action-target (who is impacted), temporality (how often), and dose (how much) for each implementation strategy. Detection: A centralized cascade testing model, mobilized nurses (actor) to relative's homes, after the diagnosis of the proband (temporality), once (dose) to consent, obtain a blood sample and health information (action) on relatives (action-target). A primary care initiative to improve FH management included an educational session (action) with clinicians (action-target), computer-based reminder message and message to patients to have their cholesterol screened once (dose) at a visit or outreach (temporality) by researchers (actor). General: A partnership between a statewide public pathology provider, local public hospital network, primary health network, government health ministry, and an academic university (actors) was established to implement a primary-tertiary shared care model (action) to improve the detection of FH (action-target). We demonstrate that implementation recommendations can be specified and reported for different local contexts with examples on monitoring, evaluation, and sustainability in practice.

Adapting mHealth Interventions (PrEPmate and DOT Diary) to Support PrEP Retention in Care and Adherence Among English and Spanish-Speaking Men Who Have Sex With Men and Transgender Women in the United States: Formative Work and Pilot Randomized Trial.

A growing number of mobile health (mHealth) technologies are being developed to support HIV preexposure prophylaxis (PrEP) adherence and persistence; however, most tools have focused on men who have sex with men (MSM), and few are available in Spanish. To maximize the potential impact of these tools in reducing gender and racial/ethnic disparities and promoting health equity, mHealth tools tailored to Spanish-speaking people and transgender women are critically needed. The aim of this study is to adapt and tailor 2 mHealth technologies, PrEPmate and DOT Diary, to support daily PrEP adherence and persistence among Spanish-speaking MSM and English- and Spanish-speaking transgender women and to evaluate the feasibility and acceptability of these tools. PrEPmate, an interactive, bidirectional, text messaging intervention that promotes personalized communication between PrEP users and providers, and DOT Diary, a mobile app that promotes self-management of PrEP use and sexual health through an integrated electronic pill-taking and sexual activity diary, were previously developed for English-speaking MSM. We conducted 3 focus groups with 15 English- and Spanish-speaking transgender women and MSM in San Francisco and Miami to culturally tailor these tools for these priority populations. We then conducted a 1-month technical pilot among 21 participants to assess the usability and acceptability of the adapted interventions and optimize the functionality of these tools. Participants in focus groups liked the "human touch" of text messages in PrEPmate and thought it would be helpful for scheduling appointments and asking questions. They liked the daily reminder messages, especially the fun facts, gender affirmations, and transgender history topics. Participants recommended changes to tailor the language and messages for Spanish-speaking and transgender populations. For DOT Diary, participants liked the adherence tracking and protection level feedback and thought the calendar functions were easy to use. Based on participant recommendations, we tailored language within the app for Spanish-speaking MSM and transgender women, simplified the sexual diary, and added motivational badges. In the technical pilot of the refined tools, mean System Usability Scale scores were 81.2/100 for PrEPmate and 76.4/100 for DOT Diary (P=.48), falling in the "good" to "excellent" range, and mean Client Satisfaction Questionnaire scores were 28.6 and 28.3 for PrEPmate and DOT Diary, respectively (maximum possible score=32). Use of both tools was high over the 1-month pilot (average of 10.5 messages received from each participant for PrEPmate; average of 17.6 times accessing the DOT Diary app), indicating good feasibility for both tools. Using a user-centered design approach, we culturally tailored PrEPmate and DOT Diary to support daily PrEP use among Spanish-speaking MSM and English- and Spanish-speaking transgender women. Our positive findings in a technical pilot support further testing of these mHealth interventions in an upcoming comparative effectiveness trial.