RESUMEN
BACKGROUND: Video telehealth offers a mechanism to help Veterans Health Administration (VHA) patients overcome health care access barriers; however, many veterans lack a suitable device and sufficient internet connectivity. To address disparities in technology access, VHA established a Connected Device Program that offers veterans loaned video-capable tablets and internet service. In 2020, VHA introduced a national Digital Divide Consult to facilitate and standardize referrals for this resource. OBJECTIVE: We sought to evaluate the reach and impact of VHA's Connected Device Program, leveraging Digital Divide Consult data to determine whether resources are supporting veterans with health care needs and access barriers. METHODS: We examined the reach of VHA's Connected Device Program using national secondary data from VHA's electronic health records among 119,926 tablet recipients who received a tablet (April 1, 2020, to February 28, 2023) and 683,219 veterans from the general VHA population. We assessed changes in tablet recipients' demographic and clinical characteristics before and after implementation of the Digital Divide Consult compared with the general VHA population. We examined the impact of tablets and the consult on adoption of telehealth (ie, video visit use and number of visits) adjusting for differences between tablet recipients and the general VHA population. Finally, we evaluated consult implementation by assessing the use of video-based services by tablet referral reason. RESULTS: Common reasons for tablet referral included mental health diagnoses (50,367/79,230, 63.9%), distance from a VHA facility >30 miles (17,228/79,230, 21.7%), and social isolation (16,161/79,230, 20.4%). Moreover, 63.0% (49,925/79,230) of individuals who received a tablet after implementation of the Digital Divide Consult had a video visit in the first 6 months of tablet receipt. Some consult reasons were associated with a higher-than-average percentage of video telehealth use, including enrollment in evidence-based mental health programs (74.8% [830/1100] with video use), living >30 miles from a VHA facility (68.3% [10,557/17,228] with video use), and having a mental health diagnosis (68.1% [34,301/50,367] with video use). Tablet recipients had nearly 3 times the likelihood of having a video visit within a month once provided a tablet compared to the general VHA population, with an adjusted risk ratio of 2.95 (95% CI 2.91-2.99) before consult implementation and 2.73 (95% CI 2.70-2.76) after consult implementation. Analyses of telehealth adoption suggested that veterans receiving tablets for mental health care and evidence-based programs have higher rates of video visits, while those who are homebound or receiving tablets for hospice have higher rates of nonuse. CONCLUSIONS: This evaluation of VHA's Connected Device Program suggests that tablets are facilitating video-based care among veterans with complex needs. Standardization of referrals through the Digital Divide Consult has created opportunities to identify groups of tablet recipients with lower telehealth adoption rates who might benefit from a targeted intervention.
Asunto(s)
Telemedicina , United States Department of Veterans Affairs , Humanos , Estados Unidos , Telemedicina/estadística & datos numéricos , Femenino , Masculino , Persona de Mediana Edad , Estudios de Cohortes , Brecha Digital , Veteranos/estadística & datos numéricos , Computadoras de Mano/estadística & datos numéricos , Anciano , Adulto , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Derivación y Consulta/estadística & datos numéricosRESUMEN
INTRODUCTION: Parkinson's disease represents a burdensome condition with complex manifestations. A licensed, standardized paper-based questionnaire is completed by both patients and physicians to monitor the progression and state of the disease. However, integrating the obtained scores into digital systems still poses a challenge. METHODS: Paper-based handwriting is intuitive and an efficient mode of human-computer interaction. Accordingly, we transformed a consumer-grade tablet into a device where an exact digital copy of the disease-specific questionnaire can be filled with the supplied pen. Utilizing a small convolutional neural network directly on the device and trained on MNIST data, we translated the handwritten digits to appropriate LOINC codes and made them accessible through a FHIR-compatible HTTP interface. RESULTS: When evaluating the usability from a patient-centric point of view, the System Usability Score revealed an excellent rating (SUS = 83.01) from the participants. However, we identified some challenges associated with the magnetic pen and the flat design of the device. CONCLUSION: In setups where certified medical devices are not required, consumer hardware can be used to map handwritten digits of patients to appropriate medical standards without manual intervention through healthcare professionals.
Asunto(s)
Escritura Manual , Enfermedad de Parkinson , Enfermedad de Parkinson/complicaciones , Humanos , Programas Informáticos , Interfaz Usuario-Computador , Encuestas y Cuestionarios , Computadoras de Mano , Redes Neurales de la ComputaciónRESUMEN
Problem-solving is an important skill that is associated with reasoning abilities, action control and academic success. Nevertheless, empirical evidence on cognitive correlates of problem-solving performance in childhood is limited. Appropriate assessment tools are scarce and existing analog tasks require extensive coding. Thus, we developed and validated new tablet-based versions of existing analog tasks assessing technical problem-solving with gear construction tasks. To validate these tasks, 215 children (6-8 years) performed the problem-solving tasks in both modalities (analog, digital). To investigate whether performances in both modalities were correlated with other cognitive abilities, participants performed three additional tasks assessing language, reasoning and problem-solving. Structural equation modelling showed that performance was substantially correlated across modalities and also correlated with language, reasoning and another problem-solving task, showing the convergent validity of the digital tasks. We also found scalar measurement invariance across task modalities indicating that both task versions can be used interchangeably. We conclude that both versions (analog and digital) draw on similar cognitive resources and abilities. The analog tasks were thus successfully transferred to a digital platform. The new tasks offer the immense benefits of digital data collection, provide a valid measuring tool advancing problem-solving research in childhood and facilitate the application in the field, e.g., in the classroom.
Asunto(s)
Computadoras de Mano , Solución de Problemas , Estudiantes , Humanos , Niño , Femenino , Masculino , Instituciones Académicas , Cognición/fisiologíaRESUMEN
Pediatric patients usually experience high levels of pain and distress due to venipuncture. This randomised study aimed to evaluate the effects of virtual reality-based preprocedural education in comparison with video-based education in terms of pain and distress experienced by children scheduled to undergo venipuncture. Ninety children aged 4-8 years who were scheduled to undergo venipuncture surgery were randomly assigned to either a video or virtual reality group. Children in the video group received preprocedural education on venipuncture via a video displayed on a tablet and those in the virtual reality group received the same education via a head-mounted virtual reality display unit. The educational content for the two groups was identical. An independent assessor blinded to the group assignment observed the children's behavior and determined their Children's Hospital of Eastern Ontario Pain Scale scores, parental satisfaction score, procedure-related outcomes, venipuncture time, number of repeated procedures and difficulty score for the procedure. The virtual reality group experienced less pain and distress, as indicated by their Children's Hospital of Eastern Ontario Pain Scale scores compared with the video group (5.0 [5.0-8.0] vs. 7.0 [5.0-9.0], P = 0.027). There were no significant intergroup differences in parental satisfaction scores or procedure-related outcomes. For pediatric patients scheduled to undergo venipuncture, preprocedural education via a head-mounted display for immersive virtual reality was more effective compared with video-based education via a tablet in terms of reducing pain and distress.
Asunto(s)
Flebotomía , Realidad Virtual , Humanos , Niño , Femenino , Preescolar , Masculino , Educación del Paciente como Asunto/métodos , Grabación en Video , Dimensión del Dolor , Computadoras de Mano , Dolor/prevención & controlRESUMEN
BACKGROUND: Cognitive impairment and dementia are frequently under-recognized. Health system strategies anchored in primary care are essential to address gaps in timely, comprehensive diagnosis. The goal of this paper is to describe the adaptation of a tablet-based brain health assessment (TabCAT-BHA) intervention and the study protocol to test its effectiveness in improving the detection of cognitive impairment, including dementia. METHODS: This mixed-methods, pragmatic, cluster randomized, hybrid effectiveness-implementation trial is being conducted in two 18-month waves with 26 Kaiser Permanente Southern California primary care clinics, with 13 serving as intervention clinics and 13 as usual care clinics. Patients 65 years and older with memory concerns (n ~ 180,000) receiving care at the 26 clinics will be included in the analyses. Primary care clinics are provided the following practice supports as part of the TabCAT-BHA intervention: brief education and training on neurocognitive disorders and study workflows; digital tools to assess cognitive function and support clinician decision making and documentation; and registered nurse support during the work-up and post-diagnosis periods for primary care providers, patients, and families. The intervention was adapted based on engagement with multiple levels of clinical and operational leaders in the healthcare system. Effectiveness outcomes include rates of cognitive impairment diagnosis in primary care and rates of completed standardized cognitive assessments and specialist referrals with incident diagnoses. Implementation outcomes include acceptability-appropriateness-feasibility, adoption, and fidelity. RESULTS: We identified seven themes organized by system-, provider-, and patient-level domains that were used to adapt the TabCAT-BHA intervention. Accordingly, changes were made to the provider education, diagnostic work-up, and post-diagnostic support. Results will be reported in fall of 2027. CONCLUSIONS: Our engagement with multiple primary and specialty care clinical and operational leaders to adapt the TabCAT-BHA intervention to these primary care clinics has informed the protocol to evaluate the intervention's effectiveness for improving the detection of cognitive impairment, including dementia, in an integrated healthcare system. TRIAL REGISTATION: Clinicaltrials.gov: NCT06090578 (registered 10/24/23).
Asunto(s)
Disfunción Cognitiva , Atención Primaria de Salud , Humanos , Disfunción Cognitiva/diagnóstico , Anciano , Demencia/diagnóstico , Participación de los Interesados , Computadoras de Mano , Ensayos Clínicos Pragmáticos como Asunto , California , FemeninoRESUMEN
Background: Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer's disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations. Objective: To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria. Methods: A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT. Results: We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10-15 minutes to complete. More years of education was associated with better test scores across all tests (pâ<â0.001). Living in a rural location was also associated with better performance (pâ<â0.05). Male compared to female sex did not associate with performance on any of the tests (all psâ>â0.05). Conclusions: Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.
Asunto(s)
Computadoras de Mano , Estudios de Factibilidad , Población Rural , Población Urbana , Humanos , Nigeria , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Anciano , Pruebas Neuropsicológicas , Anciano de 80 o más Años , Disfunción Cognitiva/diagnóstico , Cognición/fisiologíaRESUMEN
Background: Assistive technologies (ATs) have the potential to promote the quality of life and independent living of older adults and, further, to relieve the burden of formal and informal caregivers and relatives. Technological developments over the last decades have led to a boost of available ATs. However, evidence on the benefits and satisfaction with ATs in real-world applications remains scarce. Objective: This prospective, real-world, pilot study tested the perceived benefit and satisfaction with different ATs in the real-world environment. Methods: Community-dwelling adults aged ≥65 and their relatives tested a tablet computer with a simplified interface or a smartwatch with programmable emergency contacts for 8 weeks in their everyday life. Perceived benefits and satisfaction with ATs were assessed by all older adults and their relatives using different assessment tools before and after the intervention. Outcome measures included the Technology Usage Inventory, Quebec User Evaluation of Satisfaction with Assistive Technology 2.0, and Canadian Occupational Performance Measure. Results: A total of 17 older adults (tablet computer: n=8, 47% and smartwatch: n=9, 53%) and 16 relatives (tablet computer: n=7, 44% and smartwatch: n=9, 56%) were included in the study. The number of participants that were frail (according to the Clinical Frailty Scale) and received care was higher in the smartwatch group than in the tablet computer group. Older adults of the smartwatch group reported higher technology acceptance (Technology Usage Inventory) and satisfaction (Quebec User Evaluation of Satisfaction with Assistive Technology 2.0) scores than those of the tablet computer group, although the differences were not significant (all P>.05). In the tablet computer group, relatives had significantly higher ratings on the item intention to use than older adults (t12.3=3.3, P=.006). Identified everyday issues with the Canadian Occupational Performance Measure included contact/communication and entertainment/information for the tablet computer, safety and getting help in emergency situations for the smartwatch, and the usability of the AT for both devices. While the performance (t8=3.5, P=.008) and satisfaction (t8=3.2, P=.01) in these domains significantly improved in the smartwatch group, changes in the tablet computer group were inconsistent (all P>.05). Conclusions: This study highlights the remaining obstacles for the widespread and effective application of ATs in the everyday life of older adults and their relatives. While the results do not provide evidence for a positive effect regarding communication deficits, perceived benefits could be shown for the area of safety. Future research and technical developments need to consider not only the preferences, problems, and goals of older adults but also their relatives and caregivers to improve the acceptability and effectiveness of ATs.
Asunto(s)
Computadoras de Mano , Dispositivos de Autoayuda , Humanos , Proyectos Piloto , Anciano , Masculino , Femenino , Estudios Prospectivos , Anciano de 80 o más Años , Familia/psicología , Satisfacción del Paciente , Vida Independiente , Cuidadores/psicologíaRESUMEN
BACKGROUND: Assistive technology is becoming increasingly accessible and affordable for supporting people with dementia and their care partners living at home, with strong potential for technology-based prompting to assist with initiation and tracking of complex, multistep activities of daily living. However, there is limited direct comparison of different prompt features to guide optimal technology design. OBJECTIVE: Across 3 experiments, we investigated the features of tablet-based prompts that best support people with dementia to complete activities of daily living at home, measuring prompt effectiveness and gaining feedback from people with dementia and their care partners about their experiences. METHODS: Across experiments, we developed a specialized iPad app to enable data collection with people with dementia at home over an extended experimental period. In experiment 1, we varied the prompts in a 3 (visual type: text instruction, iconic image, and photographic image) × 3 (audio type: no sound, symbolic sound, and verbal instruction) experimental design using repeated measures across multiple testing sessions involving single-step activities. In experiment 2, we tested the most effective prompt breakdown for complex multistep tasks comparing 3 conditions (1-prompt, 3-prompt, and 7-prompt conditions). In experiment 3, we compared initiation and maintenance alerts that involved either an auditory tone or an auditory tone combined with a verbal instruction. Throughout, we asked people with dementia and their care partners to reflect on the usefulness of prompting technology in their everyday lives and what could be developed to better meet their needs. RESULTS: First, our results showed that audible verbal instructions were more useful for task completion than either tone-based or visual prompts. Second, a more granular breakdown of tasks was generally more useful and increased independent use, but this varied across individuals. Third, while a voice or text maintenance alert enabled people with dementia to persist with a multistep task for longer when it was more frequent, task initiation still frequently required support from a care partner. CONCLUSIONS: These findings can help inform developers of assistive technology about the design features that promote the usefulness of home prompting systems for people with dementia as well as the preferences and insights of people with dementia and their care partners regarding assistive technology design.
Asunto(s)
Actividades Cotidianas , Demencia , Humanos , Demencia/psicología , Demencia/terapia , Actividades Cotidianas/psicología , Femenino , Masculino , Anciano , Dispositivos de Autoayuda , Atención , Anciano de 80 o más Años , Computadoras de Mano , Cuidadores/psicología , Aplicaciones Móviles , Persona de Mediana Edad , Servicios de Atención de Salud a DomicilioRESUMEN
OBJECTIVES: (1) Assess whether health-related social needs (HRSN)/caregiver mental health concerns (CMHC) disclosure rates differ when screening questions are administered on paper versus electronic tablet. (2) Evaluate whether changes in need identification alters referral rates to social work and our medical-legal partnership (MLP). METHODS: We conducted a retrospective review of HRSN/CMHC screening in publicly insured patients 0-18 years presenting for well-child visits in three primary care practices. Our primary outcome was HRSN/CMHC disclosure rate, comparing the proportion of positive HRSN/CMHC screens during the 11 months before and after screening modality change. Generalized estimating equations and interrupted time series (ITS) were used to assess changes over time. Mediation analyses assessed the indirect effect of HRSN/CMHC disclosure during the electronic screening period on changes in referrals to social work/MLP. RESULTS: A total of 16,151 patients had paper-based HRSN/CMHC screens; 13,019 patients had electronic screens. Overall, 11% of paper-based screens identified ≥1 need, compared to 26% of electronic screens (p<0.001). All three practices saw an increase in disclosure rate after transition from paper to electronic screening (odds ratio [OR] range 1.54 to 4.24). Using ITS, two of three practices had significantly increased odds of need disclosure with electronic screens compared to paper (OR 3.0, 95% confidence interval [CI] 2.5, 3.6; and OR 1.7, 95%CI 1.2, 2.4). Increased HRSN/CMHC disclosure rates from transitioning to electronic screening mediated increased referrals to social work/MLP. CONCLUSIONS: Electronic screening was associated with an increased HRSN/CMHC disclosure rate compared to paper, which led to increased referrals to social work/MLP.
Asunto(s)
Computadoras de Mano , Atención Primaria de Salud , Humanos , Niño , Estudios Retrospectivos , Preescolar , Adolescente , Lactante , Femenino , Masculino , Recién Nacido , Derivación y Consulta , Tamizaje Masivo/métodos , Evaluación de Necesidades , Servicio Social , Pediatría/métodosRESUMEN
BACKGROUND: Cerebral palsy is the most frequent condition affecting the central nervous system and causing large disability. OBJECTIVE: To determine the impact of touch screen tablet upon fine motor functions in children with hemiparesis. METHOD: This was a randomized controlled trial involving 60 children, ranging in age from 5 to 7 years old, randomized into two groups: intervention or control group (30 children per group). Both groups were given 12 consecutive weeks of designed fine motor tasks. Additionally, for thirty minutes, the intervention group was given a fine motor exercise program on a touch screen tablet. Upper limb function, finger dexterity and pinch strength were measured pre and post the recommended treatment program using the quality of upper extremity skill test (QUEST), Nine-Hole Peg Test and Jamar hydraulic pinch gauge, respectively. RESULTS: All outcome measures were equivalent between intervention groups at admission (Pâ>â0.05). Significant improvements were found in all assessed variables within the two groups. Meanwhile, the intervention group had significantly higher improvements (Pâ<â0.05) in finger dexterity, pinch strength, and upper limb function when compared with the control groups. CONCLUSION: Including a touch screen smart tablet application with a specially designed fine motor program is an effective method that helps children with U-CP perform more effectively with their fine motor skills.
Asunto(s)
Parálisis Cerebral , Computadoras de Mano , Destreza Motora , Paresia , Humanos , Parálisis Cerebral/fisiopatología , Parálisis Cerebral/rehabilitación , Niño , Masculino , Femenino , Preescolar , Paresia/rehabilitación , Paresia/fisiopatología , Paresia/etiología , Destreza Motora/fisiología , Resultado del Tratamiento , Terapia por Ejercicio/métodos , Extremidad Superior/fisiopatologíaRESUMEN
BACKGROUND: Point-of-care cardiovascular left ventricle ejection fraction (LVEF) quantification is established, but automatic tablet-based stroke volume (SV) quantification with handheld ultrasound (HAND) devices is unexplored. We evaluated a tablet-based monoplane LVEF and LV volume quantification tool (AutoEF) against a computer-based tool (Tomtec) for LVEF and SV quantification. METHODS: Patients underwent HAND scans, and LVEF and SV were quantified using AutoEF and computer-based software that utilized either apical four-chamber views (Auto Strain-monoplane [AS-mono]) or both apical four-chamber and apical two-chamber views (Auto Strain-biplane [AS-bi]). Correlation and Bland-Altman analysis were used to compare AutoEF with AS-mono and AS-bi. RESULTS: Out of 43 participants, eight were excluded. AutoEF showed a correlation of .83 [.69:.91] with AS-mono for LVEF and .68 [.44:.82] for SV. The correlation with AS-bi was .79 [.62:.89] for LVEF and .66 [.42:.81] for SV. The bias between AutoEF and AS-mono was 4.88% [3.15:6.61] for LVEF and 17.46 mL [12.99:21.92] for SV. The limits of agreement (LOA) were [-5.50:15.26]% for LVEF and [-8.02:42.94] mL for SV. The bias between AutoEF and AS-bi was 6.63% [5.31:7.94] for LVEF and 20.62 mL [16.18:25.05] for SV, with LOA of [-1.20:14.47]% for LVEF and [-4.71:45.94] mL for SV. CONCLUSION: LVEF quantification with AutoEF software was accurate and reliable, but SV quantification showed limitations, indicating non-interchangeability with neither AS-mono nor AS-bi. Further refinement of AutoEF is needed for reliable SV quantification at the point of care.
Asunto(s)
Ecocardiografía , Volumen Sistólico , Humanos , Volumen Sistólico/fisiología , Femenino , Masculino , Reproducibilidad de los Resultados , Ecocardiografía/métodos , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/fisiopatología , Persona de Mediana Edad , Función Ventricular Izquierda/fisiología , Interpretación de Imagen Asistida por Computador/métodos , Anciano , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Izquierda/diagnóstico por imagen , Computadoras de Mano , Programas Informáticos , Sistemas de Atención de PuntoRESUMEN
Neurocognitive diseases are diagnosed in specialized centers such as memory clinics, where the waiting time can be long. The reference assessment involves a battery of tests carried out by a specialized team. Facilitating screening in primary care using new technologies could make it possible to appropriately direct care pathways towards specialist care. This work aimed to set up a battery of questionnaires, cognitive and manual dexterity tests on a digital tablet to screen people with cognitive impairment. Three groups of people are recruited from a memory consultation: people with major neurocognitive disorders, people with mild neurocognitive disorders and people with no cognitive impairment. Initial results in geriatric settings show that the digital tablet assessment test is feasible and well accepted, but that manual dexterity assessment needs to be adapted to the bodily particularities of the very old.
Asunto(s)
Computadoras de Mano , Estudios de Factibilidad , Humanos , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Pruebas Neuropsicológicas , Trastornos Neurocognitivos/diagnóstico , Evaluación Geriátrica/métodosRESUMEN
The diagnosis of neurocognitive diseases is an important health issue for patients, families and healthcare professionals. The need to develop rapid, high-performance screening tools would improve access to care. The Clock Drawing Test (CDT) is widely used and validated with the older adults, and its digital version is becoming increasingly widespread. We propose to confirm its validity in a population of old patients hospitalized in a geriatric unit, and secondly to verify its performance in comparison with the reference diagnosis made by a specialized team in a memory consultation. CDTs were collected from older hospitalized patients, both in paper form and digitally on a touchscreen tablet. The results show good agreement between the paper and digital versions (kappa coefficient = 0.81). Sensitivity and specificity of the digital CDT were 0.84 and 0.59 respectively for the diagnosis of major cognitive disorders. The corresponding values were 0.72 and 0.59 for the diagnosis of mild neurocognitive disorders. User questionnaires indicate that older participants find the digital tablet easy to use. However, they prefer to use paper, even if they are open to learning how to use the tablet.
Asunto(s)
Computadoras de Mano , Humanos , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Trastornos Neurocognitivos/diagnóstico , Pruebas Neuropsicológicas , Sensibilidad y Especificidad , Reproducibilidad de los ResultadosRESUMEN
INTRODUCTION: Developing L2 speaking proficiency can be challenging for learners, particularly when it comes to fostering self-regulation and maintaining engagement. Intelligent Personal Assistants (IPAs) offer a potential solution by providing accessible, interactive language learning opportunities. METHODS: This mixed-methods study investigated the effectiveness of using Google Assistant within a learning-oriented feedback (LOA) framework to enhance L2 speaking proficiency, self-regulation, and learner engagement among 54 university-level EFL learners in China. Convenience sampling assigned participants to either an experimental group (n = 27) using Google Assistant with tailored activities or a control group (n = 27) using traditional methods. The Oral Proficiency Interview (OPI) assessed speaking performance. Self-reported questionnaires measured L2 motivation and the Scale of Strategic Self-Regulation for Speaking English as a Foreign Language (S2RS-EFL) evaluated speaking self-regulation. Additionally, semi-structured interviews with a subsample of the experimental group provided qualitative insights. RESULTS: The Google Assistant group demonstrated a statistically significant improvement in speaking performance compared to the control group. While no significant difference in motivation was found, thematic analysis of interviews revealed perceived benefits of Google Assistant, including increased accessibility, interactivity, and immediate pronunciation feedback. These features likely contributed to a more engaging learning experience, potentially fostering self-regulation development in line with the core principles of LOA. CONCLUSION: This study suggests Google Assistant as a promising supplementary tool for enhancing L2 speaking proficiency, learner autonomy, and potentially self-regulation within an LOA framework. Further research is needed to explore its impact on motivation and optimize engagement strategies.
Asunto(s)
Aprendizaje , Motivación , Multilingüismo , Autocontrol , Humanos , Masculino , Femenino , Adulto Joven , Adulto , Computadoras de Mano , China , Habla , RetroalimentaciónRESUMEN
The widespread adoption of smartphones coupled with advancements in artificial intelligence has significantly propelled the use of intelligent personal assistants (IPAs). These digital assistants have become indispensable for many users, particularly during the COVID-19 pandemic. Employing coviance-based structural equation modeling (CB-SEM) and analyzing data from 260 participants, this study explores the key factors influencing IPA usage intensity. Contrary to expectations, affective risk perception showed no significant impact on either IPA usage or parasocial interaction during the pandemic. In stark contrast, cabin fever syndrome significantly influenced both IPA usage and parasocial interaction, underscoring the role of environmental and psychological stressors in shaping technology use. Furthermore, loneliness was found to significantly enhance parasocial interaction with IPAs, though it did not affect usage intensity. The findings highlight a substantial connection between parasocial interaction and IPA usage intensity, suggesting that users who engage in human-like interactions with IPAs tend to use them more extensively. These insights not only deepen our understanding of how IPAs are utilized during health crises but also point to potential directions for developing IPAs that are more responsive to users' emotional and social needs.
Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , COVID-19/psicología , Femenino , Masculino , Adulto , SARS-CoV-2 , Teléfono Inteligente , Pandemias , Computadoras de Mano , Persona de Mediana Edad , Soledad/psicología , Adulto JovenRESUMEN
BACKGROUND: Children and adolescents are exposed to a high volume of unhealthy food marketing across digital media. No previous Canadian data has estimated child exposure to food marketing across digital media platforms. This study aimed to compare the frequency, healthfulness and power of food marketing viewed by children and adolescents across all digital platforms in Canada. METHODS: For this cross-sectional study, a quota sample of 100 youth aged 6-17 years old (50 children, 50 adolescents distributed equally by sex) were recruited online and in-person in Canada in 2022. Each participant completed the WHO screen capture protocol where they were recorded using their smartphone or tablet for 30-min in an online Zoom session. Research assistants identified all instances of food marketing in the captured video footage. A content analysis of each marketing instance was then completed to examine the use of marketing techniques. Nutritional data were collected on each product viewed and healthfulness was determined using Health Canada's 2018 Nutrient Profile Model. Estimated daily and yearly exposure to food marketing was calculated using self-reported device usage data. RESULTS: 51% of youth were exposed to food marketing. On average, we estimated that children are exposed to 1.96 marketing instances/child/30-min (4067 marketing instances/child/year) and adolescents are exposed to 2.56 marketing instances/adolescent/30-min (8301 marketing instances/adolescent/year). Both children and adolescents were most exposed on social media platforms (83%), followed by mobile games (13%). Both age groups were most exposed to fast food (22% of marketing instances) compared to other food categories. Nearly 90% of all marketing instances were considered less healthy according to Health Canada's proposed 2018 Nutrient Profile Model, and youth-appealing marketing techniques such as graphic effects and music were used frequently. CONCLUSIONS: Using the WHO screen capture protocol, we were able to determine that child and adolescent exposure to the marketing of unhealthy foods across digital media platforms is likely high. Government regulation to protect these vulnerable populations from the negative effects of this marketing is warranted.
Asunto(s)
Mercadotecnía , Humanos , Adolescente , Niño , Canadá , Masculino , Femenino , Estudios Transversales , Mercadotecnía/métodos , Mercadotecnía/estadística & datos numéricos , Industria de Alimentos , Teléfono Inteligente/estadística & datos numéricos , Medios de Comunicación Sociales/estadística & datos numéricos , Computadoras de Mano/estadística & datos numéricosRESUMEN
BACKGROUND: Nursing handoff of complete and accurate information is critical for patient safety yet is often difficult to achieve with consistency between nursing departments. OBJECTIVE: This quality improvement project aims to describe the development and piloting of a standardized handoff tool for administration by computer tablet for nursing report. METHODS: This descriptive quality improvement initiative was conducted in an 885-bed Level I trauma center in the Southeast Region of the United States. The study was completed in three phases. First, emergency department and trauma intensive care unit nurses were surveyed to determine handoff barriers and best practices. Second, the survey information was used to develop a standardized handoff tool incorporating tablet technology. Third, staff pilot testing was performed, followed by a final survey to ascertain staff feedback on the tool. RESULTS: A total of n = 120 nurses completed the surveys, and pilot testing was conducted on n = 177 patient handoffs. Ninety-five percent of nurses expressed satisfaction with the tool and 65% with the tablet. CONCLUSION: This study supported using a standardized handoff tool between the emergency department and trauma intensive care unit and substantiated the benefits of using a tablet for face-to-face communication.
Asunto(s)
Computadoras de Mano , Pase de Guardia , Mejoramiento de la Calidad , Humanos , Pase de Guardia/normas , Masculino , Femenino , Centros Traumatológicos/normas , Enfermería de Trauma/normas , Proyectos Piloto , Adulto , Personal de Enfermería en Hospital , Seguridad del Paciente/normas , Encuestas y CuestionariosRESUMEN
Barcode Medication Administration (BCMA) is a proven process for maintaining patient safety during medication administration. However, maintaining compliance with BCMA scanning in the Emergency Department has its challenges. To overcome these challenges handheld devices, enabled with scanning technology, were provided to each nurse. BCMA compliance rates increased by 20% over a 6-month period. Handheld devices work to improve BCMA compliance in the ED environment when using a 1:1 model.
Asunto(s)
Servicio de Urgencia en Hospital , Errores de Medicación , Errores de Medicación/prevención & control , Sistemas de Medicación en Hospital , Humanos , Procesamiento Automatizado de Datos , Adhesión a Directriz , Computadoras de ManoRESUMEN
IMPORTANCE: Visual-motor integration (VMI) is typically examined in children to promote handwriting, but it may also be relevant for adults' capacity for technology use. OBJECTIVE: To examine the reliability and validity of speed of completion of the box clicking test, a web-based test of VMI. DESIGN: Participants in the Understanding America Study completed online surveys on a regular basis, including a very brief (less than 30 s) self-administered box clicking test. For validity testing, we examined whether box clicking speed was associated with constructs relevant to visual-perceptual skills and motor coordination, the skills underlying VMI. Test-retest reliability was examined by computation of intraclass correlation coefficients. PARTICIPANTS: A total of 11,114 adults. MEASURES: Measures included the completion time for the box clicking task and measures relevant to visual perception (e.g., perceptual speed) and motor coordination (e.g., self-reported functional limitation). RESULTS: Results suggested that the box clicking test was a VMI task. Slower test performance was associated with lower visual-perceptual speed and a greater likelihood of reporting difficulties with dressing, a motor coordination relevant task. Box clicking tests taken within at least 2 yr of one another had moderate test-retest stability, but future studies are needed to examine test-retest reliabilities over brief (e.g., 2-wk) time intervals. CONCLUSIONS AND RELEVANCE: The box clicking test may serve both as a tool for research and to clinically observe whether clients have VMI difficulties that interfere with computer, smartphone, or tablet use. Plain-Language Summary: Use of devices such as smartphones and computers is increasingly becoming integral for daily functioning. Visual-motor integration (VMI) has often been addressed by occupational therapists to support handwriting of children, but it may also be important for technology use by adults. Prior literature supports the relevance of VMI to technology use, and adults with various chronic conditions have been found to have decrements in VMI. We tested the psychometric properties of a brief box clicking test of VMI that could be used to examine VMI underlying technology use among adults. Overall, results suggested that the box clicking test was a VMI task. Just as speed of gait has been used as an index of functional mobility, speed on the box clicking task seemed serviceable as an index of VMI ability. The box clicking test may also be used for clinical observation of whether VMI interferes with technology use.
Asunto(s)
Desempeño Psicomotor , Percepción Visual , Humanos , Masculino , Femenino , Adulto , Reproducibilidad de los Resultados , Persona de Mediana Edad , Computadoras de Mano , Destreza Motora , Adulto Joven , Teléfono Inteligente , Adolescente , AncianoRESUMEN
Importance: With personalized touch-screen tablets, young children can choose content and engage in play-like activities. However, tablets may also reduce shared engagement as the action of viewing or touching the screen is often not visible to nearby adults. This may impact communicative gazing and pointing, which is critical to the formation of shared awareness and in turn supports language development. Objective: To assess the association of tablet media content with toddlers' responses to joint attention prompts and behavioral requests. Design, Setting, and Participants: This cohort study took place at a behavioral research laboratory and included toddlers who were aged 18 to 32 months with neurotypical development who were recruited from a volunteer and community sample. Toddlers engaged with a real toy or 3 different types of tablet content (ie, viewing video of toy play, playing with a digital toy, or playing a commercial game) while an experimenter delivered joint attention prompts. Data were acquired from June 2021 November XX 2022, and data analysis occurred from January 2023 to May 2024. Main Outcomes and Measures: Main outcomes included child response to joint attention (number of prompts with joint attention response per number of prompts delivered) and child response to behavioral request (ie, the prompt on which the child responded to the behavioral request). Measures included crossed random effects, Wald tests, and likelihood ratio tests. Results: In this study, 63 toddlers were enrolled, and data from 62 were included (31 female [49%]; mean [SD] age, 26.1 [3.4] months; median [IQR] age, 25.0 [18.6-32.6] months). When toddlers were playing a commercial game on a tablet, they responded to fewer joint attention prompts (crossed random effects model, -0.15; 95% CI, -0.24 to -0.06 prompts) and male toddlers took longer to acknowledge a behavioral request (interaction of content and sex, -0.75; 95% CI, -1.36 to -0.17). The negative impact of the tablet game was larger as child age increased (τ = -2.30; 95% CI, -0.05 to 0; P = .03). Greater media use at home was associated with decreased responding to joint attention prompts during the tablet game (ρ = -0.47; P < .001), while better language skills were associated with more joint attention during play with a real toy (ρ = 0.31; P = .02). Conclusions and Relevance: In this cohort study, a touch-screen tablet game was associated with decreased joint attention among toddlers and they were less likely to respond to a behavioral request. In a laboratory setting, it was difficult for toddlers to engage in social-communicative interactions with adults when using a tablet media device.