Override rate of drug-drug interaction alerts in clinical decision support systems: A brief systematic review and meta-analysis.

Primary studies have demonstrated that despite being useful, most of the drug-drug interaction (DDI) alerts generated by clinical decision support systems are overridden by prescribers. To provide more information about this issue, we conducted a systematic review and meta-analysis on the prevalence of DDI alerts generated by CDSS and alert overrides by physicians. The search strategy was implemented by applying the terms and MeSH headings and conducted in the MEDLINE/PubMed, EMBASE, Web of Science, Scopus, LILACS, and Google Scholar databases. Blinded reviewers screened 1873 records and 86 full studies, and 16 articles were included for analysis. The overall prevalence of alert generated by CDSS was 13% (CI95% 5-24%, p-value <0.0001, I^2 = 100%), and the overall prevalence of alert override by physicians was 90% (CI95% 85-95%, p-value <0.0001, I^2 = 100%). This systematic review and meta-analysis presents a high rate of alert overrides, even after CDSS adjustments that significantly reduced the number of alerts. After analyzing the articles included in this review, it was clear that the CDSS alerts physicians about potential DDI should be developed with a focus on the user experience, thus increasing their confidence and satisfaction, which may increase patient clinical safety.

Moniz Game: Usability and User Experience Evaluation of a Musical Game for Motor Coordination.

Purpose: The objective of this research was to develop a musical digital game for rehabilitation of upper limb and to verify its usability and user experience with professionals in the field (physical therapists). Materials and Methods: Thirty working professionals were recruited to evaluate the system. The usability was evaluated with the System Usability Scale (SUS) and the user experience was verified with the Game Flow scale. Results: The overall score of the SUS scale was 88.67 (±9.129); this score is interpreted as "Best Imaginable" (86-100). The user experience rating had most of its domains equal or higher than 4, which indicates that all the requirements for a good user experience were present in the game. Conclusions: The Moniz Game proved to be a game with good usability and can be a tool for application in clinical practice regarding motor coordination. However, further studies are needed to evaluate the effect of the Moniz Game on motor coordination in patients with neurological dysfunctions.

Facilitators and hinderers for designing augmented reality for ecotourism SME's experiences: A service Design approach.

Designing Augmented Reality (AR) throughout service experiences remains under studied in several industries, despite the fact of growing consumer interest and use through different platforms and applications globally. Consequently, there is growing interest in understanding the what, the why and the how for designing AR applications in practice to boost ecotourism experiences, with the purpose of enhancing customer value creation and organizations differentiation. Consequently, the authors conducted an eleven-month practical theoretical study in 10 ecotourism SMEs purposefully recruited in Latin America, adopting service design as a main research framework. Using interviews, contextual analyses, buyer personas, observation, storytelling creation sessions, prototyping sessions and accompaniment sessions as research methods, researchers studied, (1) what were the key facilitators and hinderers for designing AR in practice at the SMEs ecotourism context following a service design lens and, (2) how the inherent principles of service design influence ecotourism SME's for the strategically adoption of AR in their service experiences. The study suggests key elements that can facilitate or hinder designing AR at ecotourism SME's Experiences in practice. Furthermore, the authors suggest a practical protocol for designing AR for ecotourism SMEs from the lens of service design (SD), User Experience (UX), and Augmented Reality (AR). Finally, the study also contributes to shade light on the marketing role and potential adoption of Augmented Reality (AR) in practice in SME's through a service design lens.

Development of a Framework for the Communication System Based on KNX for an Interactive Space for UX Evaluation.

Domotics (Home Automation) aims to improve the quality of life of people by integrating intelligent systems within inhabitable spaces. While traditionally associated with smart home systems, these technologies have potential for User Experience (UX) research. By emulating environments to test products and services, and integrating non-invasive user monitoring tools for emotion recognition, an objective UX evaluation can be performed. To achieve this objective, a testing booth was built and instrumented with devices based on KNX, an international standard for home automation, to conduct experiments and ensure replicability. A framework was designed based on Python to synchronize KNX systems with emotion recognition tools; the synchronization of these data allows finding patterns during the interaction process. To evaluate this framework, an experiment was conducted in a simulated laundry room within the testing booth to analyze the emotional responses of participants while interacting with prototypes of new detergent bottles. Emotional responses were contrasted with traditional questionnaires to determine the viability of using non-invasive methods. Using emulated environments alongside non-invasive monitoring tools allowed an immersive experience for participants. These results indicated that the testing booth can be implemented for a robust UX evaluation methodology.

The long-term user experience of an m-Health application / A experiência do usuário a longo prazo de um aplicativo m-Health / La experiencia a largo plazo del usuario de una aplicación m-Health

Low user engagement in m-Health applications has been driving the use of retention techniques that aim to ensure a satisfactory long-term user experience. The aim was to understand the experience of hypertensive patients interacting with a mobile health application for 12 months. A qualitative/exploratory study was conducted after 12 months, with the same experimental group of participants as the non-randomized con-trolled clinical trial conducted in 2019. The mean age of the 16 participants was 57 years (SD=8), of which11 were female. All had low socioeconomic and educational levels. Content analysis showed no engagement with the m-health app over time. The main factors contributing to the lack of engagement were; inability of the user to use the app, lack of support and technical problems. When designing m-Health interventions, it is important to understand users' behavioral characteristics, motivations for treatment, level of involve-ment in health care, and ability to use technology

O baixo envolvimento dos usuários em aplicativos m-Health vem impulsionando o uso de técnicas de retenção que visam garantir uma experiência do usuário (UX) satisfatória a longo prazo. Objetivou-se compreender a experiência de pacientes hipertensos interagindo com um aplicativo de saúde móvel (m-Health) durante 12 meses. Realizou-se estudo qualitativo/exploratório após 12 meses, com o mesmo grupo experimental de participantes do ensaio-clínico controlado e não-randomizado realizado em 2019. A idade média dos 16 participantes foi de 57 anos (DP=8); 11 eram do sexo feminino, com baixos níveis socioeconômicos e educacionais. A análise de conteúdo não mostrou nenhum envolvimento ao longo do tempo usando o aplicativo m-Health. Os principais fatores que contribuíram para a falta de envolvimento foram: incapacidade do usuário de usar o aplicativo, falta de suporte e problemas técnicos. Ao propor intervenções que utilizem m-Health, é essencial conhecer características comportamentais dos usuários, motivações para o tratamento, nível de envolvimento nos cuidados com a saúde e sua capacidade de usar tecnologias

La baja participación de los usuarios en las aplicaciones de m-Health ha impulsado el uso de técnicas de retención que tienen como objetivo garantizar una experiencia de usuario satisfactoria a largo plazo. Se pretendió comprender la experiencia de pacientes hipertensos interactuando con una aplicación de salud móvil durante 12 meses. Se realizó un estudio cualitativo/exploratorio después de 12 meses, utilizando los participantes del ensayo clínico controlado no aleatorizado que se llevó a cabo en 2019. La edad media de los 16 participantes fue 57 años (SD=8); 11 mujeres, con niveles socioeconómicos y educativos bajos. El análisis de contenido no mostró compromiso a lo largo del tiempo utilizando la aplicación m-Health. Los principales factores contribuyentes fueron: incapacidad del usuario para utilizar la aplicación, falta de apoyo y problemas técnicos. Cuando se proponen intervenciones con m-Health, es esencial conocer las características de comportamiento de los usuarios, sus motivaciones para el tratamiento, nivel de implicación en el cuidado de la salud y capacidad para utilizar tecnologías

Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation.

BACKGROUND: Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient. METHODS: The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience. RESULTS: The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study. CONCLUSIONS: All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.

EEG motor imagery classification using deep learning approaches in naïve BCI users.

Motor Imagery (MI)-Brain Computer-Interfaces (BCI) illiteracy defines that not all subjects can achieve a good performance in MI-BCI systems due to different factors related to the fatigue, substance consumption, concentration, and experience in the use. To reduce the effects of lack of experience in the use of BCI systems (naïve users), this paper presents the implementation of three Deep Learning (DL) methods with the hypothesis that the performance of BCI systems could be improved compared with baseline methods in the evaluation of naïve BCI users. The methods proposed here are based on Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM)/Bidirectional Long Short-Term Memory (BiLSTM), and a combination of CNN and LSTM used for upper limb MI signal discrimination on a dataset of 25 naïve BCI users. The results were compared with three widely used baseline methods based on the Common Spatial Pattern (CSP), Filter Bank Common Spatial Pattern (FBCSP), and Filter Bank Common Spatial-Spectral Pattern (FBCSSP), in different temporal window configurations. As results, the LSTM-BiLSTM-based approach presented the best performance, according to the evaluation metrics of Accuracy, F-score, Recall, Specificity, Precision, and ITR, with a mean performance of 80% (maximum 95%) and ITR of 10 bits/min using a temporal window of 1.5 s. The DL Methods represent a significant increase of 32% compared with the baseline methods (p< 0.05). Thus, with the outcomes of this study, it is expected to increase the controllability, usability, and reliability of the use of robotic devices in naïve BCI users.

Understanding the customer experience in human-computer interaction: a systematic literature review.

Background: In recent years, there has been an increasing interest in customer experience (CX) and its relation to the human-computer interaction (HCI) field. The CX is different depending on the domain in which it is studied, and therefore its dimensions may vary. Methodology: This research presents an extensive review of 122 studies related to CX definitions and dimensions that have been proposed in different domains, including an analysis from an HCI perspective. The guidelines proposed by Kitchenham & Charters (2007) were used, complementing the review with a snowballing approach. Results: We identified 71 CX definitions (where 14 definitions highlight HCI aspects), 81-dimensional proposals (where 24 proposals contain HCI aspects), and 39 application domains (where 18 domains cover topics related to HCI). However, we did not find CX definitions or dimensions directly focused on HCI. Based on the results, a novel CX definition and dimensions-focused on the HCI area-are proposed and activities that the authors should perform when proposing new CX dimensions in domains related to HCI are suggested, i.e., domains that involve the interaction of a user (or customer) with a software product. Conclusions: Implications for future practice focus on facilitating the understanding of the CX concept and its relationship with HCI; recognizing the key CX dimensions for different domains and how they relate to HCI dimensions; and helping in the creation of new CX dimensions by suggesting activities that can be performed. The results show that there are opportunities for HCI/CX researchers and practitioners to propose new dimensions of CX for a domain related to HCI, develop instruments that allow the evaluation of CX from an HCI point of view, and perform reviews on a particular domain relevant to HCI but less studied.

Assessing Spatial User Experience for Design Guidelines: A Comparative Study of Outpatient Waiting Rooms With Conventional Versus Modern Features.

OBJECTIVES: Identify waiting room design features that are most appreciated by outpatients and their companions in conventional and modern waiting rooms. Evaluate if end users evaluate the environment differently from experts and in what aspects. Provide evidence-based design guidelines that orient designers and healthcare managers. BACKGROUND: Built environments are relevant in patients' evaluation of overall healthcare service. For outpatients, waiting frequently consumes the largest amount of time; thus, waiting room interior design has great potential to enhance their experience. METHODS: This study compares perceptions of two types of waiting rooms-conventional and modern-based on the spatial user experience (SUE) model. In the first stage of the study, we compared user evaluations of conventional waiting rooms (n = 137) and modern waiting rooms (n = 426) with respect to the eight SUE model dimensions using multigroup structural equation modeling. In the second stage, an expert ergonomist and two professional interior designers assessed both types of waiting rooms. RESULTS: Results showed that modern waiting rooms were perceived to be significantly better in all SUE dimensions. We also found experts' evaluations were overall consistent with users' perceptions. Discrepancies were only found in temperature perception, signage evaluation, and spatial appreciation. CONCLUSIONS: Participants valued modern style waiting room features such as good quality signage, use of armchairs and sofas, a controlled environment, and decoration. We suggest involving end users in the design process to respond to their needs and promote a positive experience. Finally, we provide easy-to-adopt design guidelines to improve patients' waiting room experience.

Usefulness of machine learning softwares to screen titles of systematic reviews: a methodological study.

OBJECTIVE: To investigate the usefulness and performance metrics of three freely-available softwares (Rayyan®, Abstrackr® and Colandr®) for title screening in systematic reviews. STUDY DESIGN AND SETTING: In this methodological study, the usefulness of softwares to screen titles in systematic reviews was investigated by the comparison between the number of titles identified by software-assisted screening and those by manual screening using a previously published systematic review. To test the performance metrics, sensitivity, specificity, false negative rate, proportion missed, workload and timing savings were calculated. A purposely built survey was used to evaluate the rater's experiences regarding the softwares' performances. RESULTS: Rayyan® was the most sensitive software and raters correctly identified 78% of the true positives. All three softwares were specific and raters correctly identified 99% of the true negatives. They also had similar values for precision, proportion missed, workload and timing savings. Rayyan®, Abstrackr® and Colandr® had 21%, 39% and 34% of false negatives rates, respectively. Rayyan presented the best performance (35/40) according to the raters. CONCLUSION: Rayyan®, Abstrackr® and Colandr® are useful tools and provided good metric performance results for systematic title screening. Rayyan® appears to be the best ranked on the quantitative and on the raters' perspective evaluation. The most important finding of this study is that the use of software to screen titles does not remove any title that would meet the inclusion criteria for the final review, being valuable resources to facilitate the screening process.

Pactolo Bar: An Approach to Mitigate the Midas Touch Problem in Non-Conventional Interaction.

New ways of interacting with computers is driving research, which is motivated mainly by the different types of user profiles. Referred to as non-conventional interactions, these are found with the use of hands, voice, head, mouth, and feet, etc. and these interactions occur in scenarios where the use of mouse and keyboard would be difficult. A constant challenge in the adoption of new forms of interaction, based on the movement of pointers and the selection of interface components, is the Midas Touch (MT) problem, defined as the involuntary action of selection by the user when interacting with the computer system, causing unwanted actions and harming the user experience during the usage process. Thus, this article aims to mitigate the TM problem in interaction with web pages using a solution centered on the Head Tracking (HT) technique. For this purpose, a component in the form of a Bar was developed and inserted on the left side of the web page, called the Pactolo Bar (PB), in order to enable or disable the clicking event during the interaction process. As a way of analyzing the effectiveness of PB in relation to TM, two stages of tests were carried out based on the collaboration of voluntary participants. The first step aims to find the data that would lead to the best configuration of the BP, while the second step aims to carry out a comparative analysis between the PB solution and the eViacam software, whose use is also focused on the HT technique. The results obtained from the use of PB were considered promising, since the analysis of quantitative data points to a significant prevention of involuntary clicks in the iteration interface and the analysis of qualitative data showed the development of a better user experience due to the ease of use, which can be noticed in elements such as the PB size, the triggering mechanism, and its positioning in the graphical interface. This study benefits in the context of the user experience, because, when using non-conventional interactions, basic items such as aspects of the graphic elements, and interaction events raise new studies that seek to mitigate the problem of the Midas Touch.

Evaluating User Experience With a Chatbot Designed as a Public Health Response to the COVID-19 Pandemic in Brazil: Mixed Methods Study.

BACKGROUND: The potential of chatbots for screening and monitoring COVID-19 was envisioned since the outbreak of the disease. Chatbots can help disseminate up-to-date and trustworthy information, promote healthy social behavior, and support the provision of health care services safely and at scale. In this scenario and in view of its far-reaching postpandemic impact, it is important to evaluate user experience with this kind of application. OBJECTIVE: We aimed to evaluate the quality of user experience with a COVID-19 chatbot designed by a large telehealth service in Brazil, focusing on the usability of real users and the exploration of strengths and shortcomings of the chatbot, as revealed in reports by participants in simulated scenarios. METHODS: We examined a chatbot developed by a multidisciplinary team and used it as a component within the workflow of a local public health care service. The chatbot had 2 core functionalities: assisting web-based screening of COVID-19 symptom severity and providing evidence-based information to the population. From October 2020 to January 2021, we conducted a mixed methods approach and performed a 2-fold evaluation of user experience with our chatbot by following 2 methods: a posttask usability Likert-scale survey presented to all users after concluding their interaction with the bot and an interview with volunteer participants who engaged in a simulated interaction with the bot guided by the interviewer. RESULTS: Usability assessment with 63 users revealed very good scores for chatbot usefulness (4.57), likelihood of being recommended (4.48), ease of use (4.44), and user satisfaction (4.38). Interviews with 15 volunteers provided insights into the strengths and shortcomings of our bot. Comments on the positive aspects and problems reported by users were analyzed in terms of recurrent themes. We identified 6 positive aspects and 15 issues organized in 2 categories: usability of the chatbot and health support offered by it, the former referring to usability of the chatbot and how users can interact with it and the latter referring to the chatbot's goal in supporting people during the pandemic through the screening process and education to users through informative content. We found 6 themes accounting for what people liked most about our chatbot and why they found it useful-3 themes pertaining to the usability domain and 3 themes regarding health support. Our findings also identified 15 types of problems producing a negative impact on users-10 of them related to the usability of the chatbot and 5 related to the health support it provides. CONCLUSIONS: Our results indicate that users had an overall positive experience with the chatbot and found the health support relevant. Nonetheless, qualitative evaluation of the chatbot indicated challenges and directions to be pursued in improving not only our COVID-19 chatbot but also health chatbots in general.

User Experience Regarding Digital Primary Health Care in Santarém, Amazon: Evaluation of Patient Satisfaction and Doctor's Feedback.

BACKGROUND: With the arrival of the pandemic, telemedicine has been widely used to provide medical care and can be used to assist patients in regions far from urban centers that are difficult to access, such as riverside communities in the Brazilian Amazon region. A telemedicine project connecting São Paulo, a mega-metropolis, to Paysandú, a riverside district in the Amazon, was built to serve the local population where access to the nearest medical care is 6 hours away by speedboat. OBJECTIVE: This study aims to assess the feedback from patients and doctors regarding the use of telemedicine in outpatient care at Paysandú, a riverside district in the Amazon. METHODS: This is a single-center study following the guidelines "Evaluating digital health products" from Public Health England, with local adaptations for the project and the Brazilian reality, that was conducted between São Paulo and Santarém in Brazil. A survey was carried out with patients who were treated by a doctor in the city of São Paulo, about 2500 km from the local basic health unit, between September 27 to December 15, 2021. At the end of each teleconsultation, the attending physician answered an administrative survey form, and the patient answered a satisfaction survey. RESULTS: A total of 111 patients completed the satisfaction survey from a total of 220 consultations carried out during the period (95% CI margin error 0.22%). According to the survey, more than 95% of patients were satisfied with the service, 87.4% (n=97) had previous experience with videoconferencing, and 76.6% (n=85) reported that their demand was fully solved. Additionally, according to the hired doctor's feedback, the average duration of the consultations was between 15 and 20 minutes. Of the 220 teleconsultations performed, 90.9% (n=200) of the demands were solved with support from the local health team, and 99.1% (n=218) of the appointments had a problem with audio or video. CONCLUSIONS: This teleconsultation project between São Paulo and Paysandú showed that it is possible to offer medical care from more developed locations to communities far from urban centers, as is the case with Paysandú District. Beyond the feasibility of the infrastructure, acceptance and satisfaction among patients were high. This health care supply model has proven to be functional and should be expanded nationally or perhaps internationally to regions lacking medical assistance. Escalation of the project does not seem too difficult once infrastructure issues are solved.

Maternapro®: percepção sobre saúde bucal e usabilidade de aplicativo sobre pré-natal odontológico no serviço público / Maternapro®: perception about oral health and usability of an application about dental prenatal care in public services / Maternapro®: percepción sobre salud bucodental y usabilidad de una aplicación sobre cuidados dentales prenatales en servicios públicos

Este estudo teve como objetivo analisar a percepção de gestantes sobre saúde bucal e testar a usabilidade do MaternaPrO® (aplicativo móvel) desenvolvido como recurso motivacional para adesão de gestantes ao comparecimento do pré-natal odontológico, reforçando sua importância e desmistificando mitos e crendices relacionados ao período gestacional. Trata-se de um estudo observacional descritivo quali-quantitativo com aplicação de questionário de percepção e instrumento de avaliação de usabilidade. Para a avaliação de usabilidade do aplicativo MaternaPro® foi utilizado o instrumento SURE aplicado em dois grupos de participantes (Experts e Gestantes). Para a análise de percepção foi aplicado um questionário sobre a percepção do pré-natal odontológico para o grupo Gestantes, em dois momentos distintos. A pesquisa quali- quantitativa exploratória, foi estruturada em três fases distintas: a) revisão integrativa da literatura com ênfase em testes de usabilidade de aplicativos móveis na área da saúde; b) aplicação do instrumento de mensuração da usabilidade e; c) aplicação de questionário "percepção sobre pré-natal odontológico" de gestantes em diferentes estágios gestacionais. A pesquisa identificou um total de 813 artigos e, após o processo de seleção, 142 artigos foram selecionados de acordo com os critérios de inclusão, sendo que, 07 publicações enquadraram-se como revisão da literatura, 03 artigos de revisão de escopo, 02 artigos de revisão sistemática e 01 artigo sendo revisão integrativa. Os resultados do questionário SURE obtidos a partir da avaliação da usabilidade pelos profissionais de TI e pelos dentistas apresentaram média de usabilidade geral de 91 e, desta forma, a usabilidade foi enquadrada, no nível 80, isto é, concordam totalmente com usabilidade do aplicativo MaternaPrO®. Os resultados do questionário SURE obtidos a partir da avaliação da usabilidade pelas gestantes, apresentaram média de usabilidade geral de 79 e, desta forma, a usabilidade foi enquadrada no nível 70, isto é, concordam com usabilidade do aplicativo MaternaPrO®. O aplicativo MaternaPrO® contemplou seus objetivos educacionais de apoiar a mulher no seu período gestacional, possibilitando-a nas tomadas de decisões conscientes e orientadas, em relação ao acompanhamento odontológico e educação em saúde da gestante e do bebê. Observou-se a melhora significativa na percepção das gestantes, em relação a saúde bucal, gestação e pré-natal odontológico. O MaternaPrO® apresentou média de usabilidade geral de 85 e, desta forma, a usabilidade foi enquadrada, pelos profissionais de TI, dentistas e gestantes no nível 80, isto é, concordam totalmente com a usabilidade do aplicativo.

This study aimed to analyze the perception of pregnant women about oral health and test the usability of MaternaPrO® (a mobile application) developed as a motivational resource for pregnant women to adhere to dental prenatal care, reinforcing its importance and demystifying myths and beliefs related to the gestational period. It is a descriptive qualitative-quantitative observational study with the application of a perception questionnaire and a usability assessment tool. The SURE instrument was used to evaluate the usability of the MaternaPrO® application in two participant groups (Experts and Pregnant women). For perception analysis, a questionnaire about prenatal dental care perception was applied to the Pregnant women group at two different times. The exploratory qualitative-quantitative research was structured in three distinct phases: a) integrative literature review with emphasis on usability testing of mobile applications in the health area; b) application of the usability measurement instrument; and c) application of the "perception of prenatal dental care" questionnaire to pregnant women at different gestational stages. The research identified a total of 813 articles, and after the selection process, 142 articles were selected according to inclusion criteria, with 07 publications being literature reviews, 03 being scope reviews, 02 being systematic reviews, and 01 being an integrative review. The SURE questionnaire results obtained from the usability evaluation by IT professionals and dentists showed an overall usability average of 91, and thus the usability was classified at level 80, i.e., fully agreeing with the usability of the MaternaPrO® application. The SURE questionnaire results obtained from the usability evaluation by pregnant women showed an overall usability average of 79, and thus the usability was classified at level 70, i.e., agreeing with the usability of the MaternaPrO® application. The MaternaPrO® application achieved its educational objectives of supporting women during their gestational period, enabling them to make conscious and informed decisions regarding dental care and health education for the pregnant woman and baby. There was a significant improvement in pregnant women's perception regarding oral health, pregnancy, and prenatal dental care. The MaternaPrO® application showed an overall usability average of 85, and thus the usability was fully agreed upon by IT professionals, dentists, and pregnant women at level 80.

Este estudio tuvo como objetivo analizar la percepción de las mujeres em- barazadas sobre la salud bucodental y probar la usabilidad de MaternaPrO® (una aplica- ción móvil) desarrollada como recurso motivacional para que las mujeres embarazadas se adhieran al control prenatal dental, reforzando su importancia y desmitificando mitos y creencias relacionados con el período gestacional. Se trata de un estudio observacional descriptivo cualitativo-cuantitativo con la aplicación de un cuestionario de percepción y una herramienta de evaluación de la usabilidad. Se utilizó el instrumento SURE para eva- luar la usabilidad de la aplicación MaternaPrO® en dos grupos de participantes (Expertos y Embarazadas). Para el análisis de la percepción, se aplicó un cuestionario sobre la per- cepción de la atención odontológica prenatal al grupo de mujeres embarazadas en dos momentos diferentes. La investigación exploratoria cualitativa-cuantitativa se estructuró en tres fases diferenciadas: a) revisión bibliográfica integradora con énfasis en pruebas de usabilidad de aplicaciones móviles en el área de la salud; b) aplicación del instrumento de medición de usabilidad; y c) aplicación del cuestionario de "percepción de la atención odontológica prenatal" a mujeres embarazadas en diferentes etapas gestacionales. La in- vestigación identificó un total de 813 artículos, y después del proceso de selección, 142 artículos fueron seleccionados de acuerdo con los criterios de inclusión, siendo 07 publi- caciones revisiones bibliográficas, 03 revisiones de alcance, 02 revisiones sistemáticas y 01 revisión integradora. Los resultados del cuestionario SURE obtenidos de la evaluación de usabilidad por profesionales de TI y dentistas mostraron una media global de usabili- dad de 91, por lo que la usabilidad se clasificó en el nivel 80, es decir, totalmente de acuerdo con la usabilidad de la aplicación MaternaPrO®. Los resultados del cuestionario SURE obtenidos de la evaluación de usabilidad por parte de las mujeres embarazadas mostraron una media global de usabilidad de 79, por lo que la usabilidad se clasificó en el nivel 70, es decir, de acuerdo con la usabilidad de la aplicación MaternaPrO®. La apli- cación MaternaPrO® alcanzó sus objetivos educativos de apoyar a las mujeres durante su periodo gestacional, permitiéndoles tomar decisiones conscientes e informadas en re- lación con el cuidado dental y la educación sanitaria de la embarazada y el bebé. Se pro- dujo una mejora significativa en la percepción de las embarazadas con respecto a la salud bucodental, el embarazo y la atención dental prenatal. La aplicación MaternaPrO® mos- tró un promedio general de usabilidad de 85, por lo que los profesionales de TI, los den- tistas y las mujeres embarazadas estuvieron totalmente de acuerdo con la usabilidad en el nivel 80.

Innovation in Orthopaedics: Part 2-How to Translate Ideas and Research into Clinical Practice.

PURPOSE OF REVIEW: This paper presents some approaches and techniques for translating an idea or research into clinical practice, considering the innovation development process. RECENT FINDINGS: Innovative tools have been a key solution for healthcare problems, such as musculoskeletal disorders, which represent a great economic burden and are among the leading causes of disability. There has been an increase in publications on this topic, but there has been no analysis of the process of innovation development. This review describes the innovation phases for translating an idea or research into clinical practice, considering the stages of discovering the opportunity, innovation creation, project specification, technology development, and innovation launch. An analysis of the innovation development process to translate an idea or research into clinical practice, including concepts, approaches, and techniques that shows the "why", "how", and "what" of innovation.

User experience with a parenting chatbot micro intervention.

Background: The use of chatbots to address mental health conditions have become increasingly popular in recent years. However, few studies aimed to teach parenting skills through chatbots, and there are no reports on parental user experience. Aim: This study aimed to assess the user experience of a parenting chatbot micro intervention to teach how to praise children in a Spanish-speaking country. Methods: A sample of 89 parents were assigned to the chatbot micro intervention as part of a randomized controlled trial study. Completion rates, engagement, satisfaction, net promoter score, and acceptability were analyzed. Results: 66.3% of the participants completed the intervention. Participants exchanged an average of 49.8 messages (SD = 1.53), provided an average satisfaction score of 4.19 (SD = .79), and reported that they would recommend the chatbot to other parents (net promoter score = 4.63/5; SD = .66). Acceptability level was high (ease of use = 4.66 [SD = .73]; comfortability = 4.76 [SD = .46]; lack of technical problems = 4.69 [SD = .59]; interactivity = 4.51 [SD = .77]; usefulness for everyday life = 4.75 [SD = .54]). Conclusions: Overall, users completed the intervention at a high rate, engaged with the chatbot, were satisfied, would recommend it to others, and reported a high level of acceptability. Chatbots have the potential to teach parenting skills however research on the efficacy of parenting chatbot interventions is needed.

Understanding UX Better: A New Technique to Go beyond Emotion Assessment.

User experience (UX) is a quality aspect that considers the emotions evoked by the system, extending the usability concept beyond effectiveness, efficiency, and satisfaction. Practitioners and researchers are aware of the importance of evaluating UX. Thus, UX evaluation is a growing field with diverse approaches. Despite various approaches, most of them produce a general indication of the experience as a result and do not seek to capture the problem that gave rise to the bad UX. This information makes it difficult to obtain relevant results to improve the application, making it challenging to identify what caused a negative user experience. To address this gap, we developed a UX evaluation technique called UX-Tips. This paper presents UX-Tips and reports two empirical studies performed in an academic and an industrial setting to evaluate it. Our results show that UX-Tips had good performance in terms of efficiency and effectiveness, making it possible to identify the causes that led to a negative user experience, and it was easy to use. In this sense, we present a new technique suitable for use in both academic and industrial settings, allowing UX evaluation and finding the problems that may lead to a negative experience.

Playful strategies to foster the well-being of pediatric cancer patients in the Brazilian Unified Health System: a design thinking approach.

BACKGROUND: Cancer care can negatively impact children's subjective well-being. In this research, well-being refers to patients' self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments. This study aims to identify how playfulness, whenever applicable, can be used as a strategy to improve the subjective well-being of pediatric cancer patients in the Brazilian Unified Health System. METHODS: Sixteen volunteers with experience in pediatric oncology participated in the study. They were physicians, psychologists, child life specialists, and design thinking professionals. They engaged in design thinking workshops to propose playful strategies to improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Data collection consisted of participatory observations. All activities were video recorded and analyzed through Thematic Analysis. The content generated by the volunteers was classified into two categories: impact of cancer care on children's self-perception and children's perceptions of the hospital and the care delivery. RESULTS: Volunteers developed strategies to help children deal with time at the hospital, hospital structure, and care delivery. Such strategies are not limited to using playfulness as a way of "having fun"; they privilege ludic interfaces, such as toys, to support psychosocial care and health education. They aim to address cancer and develop communication across families and staff in a humanized manner, educate families about the disease, and design children-friendly environments. Volunteers also generated strategies to help children cope with perceptions of death, pain, and their bodies. Such strategies aim to support understanding the meaning of life and death, comprehend pain beyond physicality, help re-signify cancer and children's changing bodies, and give patients active voices during the treatment. CONCLUSIONS: The paper proposes strategies that can improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Such strategies connect children's experiences as inpatients and outpatients and may inform the implementation of similar projects in other developing countries.

Using a mobile health app to improve patients' adherence to hypertension treatment: a non-randomized clinical trial.

Poor adherence to hypertension treatment increases complications of the disease and is characterized by a lack of awareness and acceptance of ongoing treatment. Mobile health (mHealth) apps can optimize processes and facilitate access to health information by combining treatment methods with attractive solutions. In this study, we aimed at verifying the influence of using an mHealth app on patients' adherence to hypertension treatment, also examining how user experience toward the app influenced the outcomes. A total of 49 participants completed the study, men and women, diagnosed with hypertension and ongoing medical treatment. For 12 weeks, the control group continued with conventional monitoring, while the experimental group used an mHealth app. From the experimental group, at baseline, 8% were non-adherent, 64% were partial adherents and 28% were adherent to the treatment. Baseline in the control group indicated 4.2% non-adherents, 58.3% partial adherents, and 37.5% adherents. After follow-up, the experimental group had an increase to 92% adherent, 8% partially adherent, and 0% non-adherent (P < 0.001). In the control group, adherence after follow-up remained virtually the same (P ≥ 0.999). Results of user experience were substantially positive and indicate that the participants in the experimental group had a satisfactory perception of the app. In conclusion, this study suggests that using an mHealth app can empower patients to manage their own health and increase adherence to hypertension treatment, especially when the app provides a positive user experience.

A Lean UX Process Model for Virtual Reality Environments Considering ADHD in Pupils at Elementary School in COVID-19 Contingency.

Today, the world is experiencing the COVID-19 health contingency, which prevents people from being exposed to one another and restricts physical contact. Under this context, the use of technology has become an essential tool to face the challenges of daily life, and virtual reality can be an alternative in the development of solutions that effectively support the acquisition of learning skills and knowledge transmission through the execution of tasks designed by multi-disciplinary groups. In addition, it can encourage the user to continue with the acquisition of learning skills in a friendly and fun way in a health and education context. This work proposes the use of virtual reality environments as an alternative to support the learning process in children with special educational needs such as Attention Deficit Hyperactivity Disorder (ADHD) and other associated disorders that occur in basic education. These proposed reality environments are designed under the Lean UX process model and their contents are designed according to expert therapeutic guidelines. As a result of this proposal, a case study is presented in which the user experience is evaluated through the use of an interactive environment to support the special educational needs of elementary school children attending an educational institution in Mexico.