Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan. Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization’s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy. Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations’ inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects.
BACKGROUND: Self-monitoring of physical activity (PA) using an accelerometer is a promising intervention to stimulate PA after hospital discharge.OBJECTIVE: This study aimed to evaluate the feasibility of PA self-monitoring after discharge in patients who have undergone gastrointestinal or lung cancer surgery.METHODS: A mixed methods study was conducted in which 41 patients with cancer scheduled for lobectomy, esophageal resection, or hyperthermic intraperitoneal chemotherapy were included. Preoperatively, patients received an ankle-worn accelerometer and the corresponding mobile health app to familiarize themselves with its use. The use was continued for up to 6 weeks after surgery. Feasibility criteria related to the study procedures, the System Usability Scale, and user experiences were established. In addition, 6 patients were selected to participate in semistructured interviews.RESULTS: The percentage of patients willing to participate in the study (68/90, 76%) and the final participation rate (57/90, 63%) were considered good. The retention rate was acceptable (41/57, 72%), whereas the rate of missing accelerometer data was relatively high (31%). The mean System Usability Scale score was good (77.3). Interviewed patients mentioned that the accelerometer and app were easy to use, motivated them to be more physically active, and provided postdischarge support. The technical shortcomings and comfort of the ankle straps should be improved.CONCLUSIONS: Self-monitoring of PA after discharge appears to be feasible based on good system usability and predominantly positive user experiences in patients with cancer after lobectomy, esophageal resection, or hyperthermic intraperitoneal chemotherapy. Solving technical problems and improving the comfort of the ankle strap may reduce the number of dropouts and missing data in clinical use and follow-up studies.
Background:An eHealth tool that coaches employees through the process of reflection has the potential to support employees with moderate levels of stress to increase their capacity for resilience. Most eHealth tools that include self-tracking summarize the collected data for the users. However, users need to gain a deeper understanding of the data and decide upon the next step to take through self-reflection.Objective:In this study, we aimed to examine the perceived effectiveness of the guidance offered by an automated e-Coach during employees’ self-reflection process in gaining insights into their situation and on their perceived stress and resilience capacities and the usefulness of the design elements of the e-Coach during this process.Methods:Of the 28 participants, 14 (50%) completed the 6-week BringBalance program that allowed participants to perform reflection via four phases: identification, strategy generation, experimentation, and evaluation. Data collection consisted of log data, ecological momentary assessment (EMA) questionnaires for reflection provided by the e-Coach, in-depth interviews, and a pre- and posttest survey (including the Brief Resilience Scale and the Perceived Stress Scale). The posttest survey also asked about the utility of the elements of the e-Coach for reflection. A mixed methods approach was followed.Results:Pre- and posttest scores on perceived stress and resilience were not much different among completers (no statistical test performed). The automated e-Coach did enable users to gain an understanding of factors that influenced their stress levels and capacity for resilience (identification phase) and to learn the principles of useful strategies to improve their capacity for resilience (strategy generation phase). Design elements of the e-Coach reduced the reflection process into smaller steps to re-evaluate situations and helped them to observe a trend (identification phase). However, users experienced difficulties integrating the chosen strategies into their daily life (experimentation phase). Moreover, the identified events related to stress and resilience were too specific through the guidance offered by the e-Coach (identification phase), and the events did not recur, which consequently left users unable to sufficiently practice (strategy generation phase), experiment (experimentation phase), and evaluate (evaluation phase) the techniques during meaningful events.Conclusions:Participants were able to perform self-reflection under the guidance of the automated e-Coach, which often led toward gaining new insights. To improve the reflection process, more guidance should be offered by the e-Coach that would aid employees to identify events that recur in daily life. Future research could study the effects of the suggested improvements on the quality of reflection via an automated e-Coach.
Adolescenten brengen steeds meer vrije tijd door met het spelen van games en bevinden zich mede daardoor in een hybride leefwereld. Deze relatief nieuwe wereld brengt nieuwe uitdagingen mee rondom identiteitsontwikkeling en psychosociaal welzijn; voor gamende adolescenten zelf, maar ook hun (professionele) opvoeders. Wij onderzoeken de relatie tussen gamen, identiteitsontwikkeling en psychosociaal welzijn en de rol die (professionele) opvoeders hierin hebben.Doel Op dit moment ontbreekt kennis over de relatie tussen gamen, identiteitsontwikkeling en psychosociaal welzijn van adolescenten en is het onder andere lastig om handvatten voor (professionele) opvoeders te ontwikkelen. Handvatten kunnen helpen om beter aan te sluiten bij de leefwereld en behoeftes van gamende adolescenten. De resultaten van dit onderzoek kunnen bijdragen aan een positieve (sociale) identiteitsontwikkeling van gamende adolescenten in een hybride wereld. Resultaten Het promotieonderzoek gaat verschillende wetenschappelijke publicaties opleveren. We vertalen onze resultaten samen met professionals, opvoeders en adolescenten naar praktische handvatten voor (professionele) opvoeders. De betrokken praktijkpartners en opleidingen geven deze wetenschappelijk onderbouwde inzichten en handvatten een passende plaats in hun curricula en werkwijzen. Looptijd 01 september 2022 - 01 september 2026 Aanpak Dit promotieonderzoek heeft een praktijkgericht, mixed-methods design. Voor de kwantitatieve analyse maken we gebruik van longitudinale data van het Digital Youth project van Universiteit Utrecht. De kwalitatieve data wordt verzameld door symbolic netnography (een digitale variant van etnografisch onderzoek), interviews en participerende observaties met adolescenten en (professionele) opvoeders. In samenspraak met adolescenten en (professionele) opvoeders worden deze inzichten vertaald naar praktische handvatten.
Adolescenten brengen steeds meer vrije tijd door met het spelen van games en bevinden zich mede daardoor in een hybride leefwereld. Deze relatief nieuwe wereld brengt nieuwe uitdagingen mee rondom identiteitsontwikkeling en psychosociaal welzijn; voor gamende adolescenten zelf, maar ook hun (professionele) opvoeders. Wij onderzoeken de relatie tussen gamen, identiteitsontwikkeling en psychosociaal welzijn en de rol die (professionele) opvoeders hierin hebben.
De COVID-19-pandemie heeft het belang duidelijk gemaakt van continuïteit van zorgverlening binnen de GGZ. Online behandeling is een veelbelovende oplossing daarvoor. Vaktherapie is een vaak ingezette behandeling voor psychiatrische aandoeningen. Vaktherapie is ervaringsgericht en bestaat uit beeldende, dans-, drama-, muziek-, psychomotorische en/of speltherapie. Vaktherapie wordt tot dusverre nog niet online aangeboden. Virtual Reality (VR) is een innovatieve manier om vaktherapie online aan te bieden. Eerder is een innovatieve online vaktherapieruimte ontwikkeld, de VR Health Experience (VRhExp). Hierdoor konden cliënten online vanuit huis aan vaktherapie deelnemen. De VRhExp werd door vaktherapeuten als veelbelovend beschouwd. Tegelijkertijd gaven vaktherapeuten aan specifieke interventies te missen. Het ´ARts and psychomotoR Interventions for Virtual rEality (ARRIVE)´ project stelt zich ten doel om vaktherapeutische VR-interventies te ontwikkelen en te bouwen voor de VRhExp. Vervolgens worden de VR-interventies in pilots onderzocht. Dit wordt gedaan door IT-technici, vaktherapeuten en onderzoekers met behulp van de Design Thinking methode. De VR-interventies worden Open Access beschikbaar gesteld. Door het opnemen van VR-interventies in de VRhExp wordt deze daadwerkelijk bruikbaar voor het aanbieden van online vaktherapie. Dit praktijkonderzoek wordt uitgevoerd door de lectoraten ‘Vaktherapie bij Persoonlijkheidsstoornissen’ en ‘Innovatie in de Care’ van de Hogeschool van Arnhem en Nijmegen in samenwerking met twee vaktherapeutische praktijken (MKB) en GGNet (Centrum voor Geestelijke Gezondheid). De onderzoeksresultaten worden geïmplementeerd in het onderwijs en het werkveld.
