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JMIR MHealth and UHealth Jun 2024Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical...
BACKGROUND
Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical services and enhanced accessibility. However, increasing concerns about personal information (PI) and strict legal compliance requirements necessitate privacy assessments for these platforms. Guided by the theory of contextual integrity, this study investigates the regulatory compliance of privacy policies for internet hospital apps in the mainland of China.
OBJECTIVE
In this paper, we aim to evaluate the regulatory compliance of privacy policies of internet hospital apps in the mainland of China and offer recommendations for improvement.
METHODS
We obtained 59 internet hospital apps on November 7, 2023, and reviewed 52 privacy policies available between November 8 and 23, 2023. We developed a 3-level indicator scale based on the information processing activities, as stipulated in relevant regulations. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 70 level-3 indicators.
RESULTS
The mean compliance score of the 52 assessed apps was 73/100 (SD 22.4%), revealing a varied spectrum of compliance. Sensitive PI protection compliance (mean 73.9%, SD 24.2%) lagged behind general PI protection (mean 90.4%, SD 14.7%), with only 12 apps requiring separate consent for processing sensitive PI (mean 73.9%, SD 24.2%). Although most apps (n=41, 79%) committed to supervising subcontractors, only a quarter (n=13, 25%) required users' explicit consent for subcontracting activities. Concerning PI storage security (mean 71.2%, SD 29.3%) and incident management (mean 71.8%, SD 36.6%), half of the assessed apps (n=27, 52%) committed to bear corresponding legal responsibility, whereas fewer than half (n=24, 46%) specified the security level obtained. Most privacy policies stated the PI retention period (n=40, 77%) and instances of PI deletion or anonymization (n=41, 79%), but fewer (n=20, 38.5%) committed to prompt third-party PI deletion. Most apps delineated various individual rights, but only a fraction addressed the rights to obtain copies (n=22, 42%) or to refuse advertisement based on automated decision-making (n=13, 25%). Significant deficiencies remained in regular compliance audits (mean 11.5%, SD 37.8%), impact assessments (mean 13.5%, SD 15.2%), and PI officer disclosure (mean 48.1%, SD 49.3%).
CONCLUSIONS
Our analysis revealed both strengths and significant shortcomings in the compliance of internet hospital apps' privacy policies with relevant regulations. As China continues to implement internet hospital apps, it should ensure the informed consent of users for PI processing activities, enhance compliance levels of relevant privacy policies, and fortify PI protection enforcement across the information processing stages.
Topics: China; Humans; Mobile Applications; Computer Security; COVID-19; Confidentiality; Internet; Pandemics
PubMed: 38904994
DOI: 10.2196/55061 -
Frontiers in Digital Health 2024With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities...
INTRODUCTION
With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities have become more widespread. Introducing these technologies to the classroom aims to offer possibilities of social and educational inclusion. While implementation is still at an experimental level, several of these avatars have already been introduced as a marketable service. However, various obstacles impede widespread acceptance.
METHODS
In our explorative qualitative case study we conducted semi-structured interviews with eight individuals involved in the implementation of the avatar robots AV1 in Germany and eleven participants involved with implementing OriHime in Japan. We analyzed and compared implementation processes, application areas, access and eligibility, and the potential and limitations of avatars at schools.
RESULTS
We identified structural similarities and differences in both countries. In the German cases the target is defined as temporary use for children who cannot attend school in person because of childhood illness, with the clear goal of returning to school. Whereas in Japan OriHime is also implemented for children with physical or developmental disabilities, or who cannot attend school in person for other reasons.
DISCUSSION
Our study suggests that avatar technologies bear high potential for children to stay socially and educationally connected. Yet, structures need establishing that grant equal access to avatar technologies. These include educational board regulations, budgets for funding avatar technologies and making them accessible to the public, and privacy protection standards that are adequate, yet do not create implementation hurdles that are too high. Furthermore, guidelines or training sessions on technical, educational and psychosocial aspects of including avatar technologies in the classroom for teachers are important for successful implementation. Since our Japanese cases suggest that expanding the area of application beyond childhood illness is promising, further research on the benefits for different groups is needed.
PubMed: 38904032
DOI: 10.3389/fdgth.2024.1273415 -
Frontiers in Artificial Intelligence 2024The prevention of crime is a multifaceted challenge with legal, political, and cultural implications. Surveillance technologies play a crucial role in assisting law...
The prevention of crime is a multifaceted challenge with legal, political, and cultural implications. Surveillance technologies play a crucial role in assisting law enforcement and other relevant parties in this mission. Drones, cameras, and wiretaps are examples of such devices. As their use increases, it becomes essential to address related challenges involving various stakeholders and consider cultural, political, and legal aspects. The objective of this study was to analyze the impact of surveillance technologies and identify commonalities and differences in perspectives among social media users and researchers. Data extraction was performed from two platforms: Scopus (for academic research papers) and platform X (formerly known as Twitter). The dataset included 88,989 tweets and 4,874 research papers. Topic modeling, an unsupervised machine learning approach, was applied to analyze the content. The research results revealed that privacy received little attention across the datasets, indicating its relatively low prominence. The military applications and their usage have been documented in academic research articles as well as tweets. Based on the empirical evidence, it seems that contemporary surveillance technology may be accurately described as possessing a bi-directional nature, including both sousveillance and surveillance, which aligns with Deleuzian ideas on the Panopticon. The study's findings also indicate that there was a greater level of interest in actual applications of surveillance technologies as opposed to more abstract concepts like ethics and privacy.
PubMed: 38903156
DOI: 10.3389/frai.2024.1406361 -
BMC Medical Education Jun 2024Most Japanese medical schools likely continue to rely on peer physical examination (PPE) as a tool to for teaching physical examination skills to students. However, the...
BACKGROUND
Most Japanese medical schools likely continue to rely on peer physical examination (PPE) as a tool to for teaching physical examination skills to students. However, the attitudes of medical students in Japan toward PPEs have not be identified. Therefore, we evaluated students' attitudes toward PPE in a Japanese medical school as a preparation for developing a PPE policy tailored to the context of Japanese culture.
METHODS
We conducted a mixed-methods study with an explanatory sequential approach, in which qualitative data were used to interpret the quantitative findings. Surveys and interviews were conducted with medical students and junior residents at a Japanese university. A total of 63 medical students and 50 junior residents responded to the questionnaire. We interviewed 16 participants to reach theoretical saturation and investigated the attitudes of medical students toward PPE and the themes emerging from the interview data, providing detailed descriptions of the quantitative findings.
RESULTS
Female participants were significantly more likely than male participants to report varying degrees of resistance to being a model patient during PPE (male: 59.7%, female: 87%, p < 0.001). Most of the participants who took on the role of patients that involved undressing were males. The participants expected improvements in issues related to the guarantee of freedom to refuse to be a model patient and measures to protect confidentiality. Approximately 22% of the participants reported that they witnessed incidental findings (including variations within the normal range) in front of other students during PPE.
CONCLUSIONS
The findings imply that medical students expect high levels of autonomy and confidentiality when volunteering as model patients during PPE. Thus, developing a PPE policy suitable for Japanese culture may be effective in establishing a student-centered PPE environment.
Topics: Humans; Students, Medical; Japan; Physical Examination; Female; Male; Peer Group; Attitude of Health Personnel; Surveys and Questionnaires; Adult; Young Adult; Education, Medical, Undergraduate
PubMed: 38902752
DOI: 10.1186/s12909-024-05635-4 -
JMIR Human Factors Jun 2024Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated...
BACKGROUND
Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated with a host of acute and chronic health and mental health concerns. Recent advances in ubiquitous technologies have prompted interest and innovation in using technology-based data collection instruments to understand substance use and associated harms. Existing methods for collecting granular, real-world data primarily rely on the use of smartphones to study and understand substance use in young adults. Wearable devices, such as smartwatches, show significant potential as platforms for data collection in this domain but remain underused.
OBJECTIVE
This study aims to describe the design and user evaluation of a smartwatch-based data collection app, which uses ecological momentary assessments to examine young adult substance use in daily life.
METHODS
This study used a 2-phase iterative design and acceptability evaluation process with young adults (aged 18-25 y) reporting recent alcohol or cannabis use. In phase 1, participants (8/15, 53%) used the data collection app for 14 days on their Apple Watches to report their substance use patterns, social contexts of substance use, and psychosocial risk factors (eg, affect). After this 14-day deployment, the participants completed a user experience survey and a semistructured interview to record their perspectives and experiences of using the app. Formative feedback from this phase informed feature modification and refinement of the app. In phase 2, an additional cohort (7/15, 47%) used the modified app for 14 days and provided feedback through surveys and interviews conducted after the app use period.
RESULTS
Analyses of overall app use patterns indicated high, consistent use of the app, with participants using the app for an average of 11.73 (SD 2.60) days out of 14 days of data collection. Participants reported 67 instances of substance use throughout the study, and our analysis indicates that participants were able to respond to ecological momentary assessment prompts in diverse temporal and situational contexts. Our findings from the user experience survey indicate that participants found the app usable and functional. Comparisons of app use metrics and user evaluation scores indicate that the iterative app design had a measurable and positive impact on users' experience. Qualitative data from the participant interviews highlighted the value of recording substance use patterns, low disruption to daily life, minimal overall burden, preference of platforms (smartphones vs smartwatches), and perspectives relating to privacy and app use in social contexts.
CONCLUSIONS
This study demonstrated the acceptability of using a smartwatch-based app to collect intensive, longitudinal substance use data among young adults. The findings document the utility of smartwatches as a novel platform to understand sensitive and often-stigmatized behaviors such as substance use with minimal burden.
Topics: Humans; Male; Feasibility Studies; Mobile Applications; Female; Adult; Young Adult; Adolescent; Substance-Related Disorders; Ecological Momentary Assessment; Smartphone; United States
PubMed: 38901024
DOI: 10.2196/50795 -
Health Informatics Journal 2024Wearables have the potential to transform healthcare by enabling early detection and monitoring of chronic diseases. This study aimed to assess wearables' acceptance,...
Wearables have the potential to transform healthcare by enabling early detection and monitoring of chronic diseases. This study aimed to assess wearables' acceptance, usage, and reasons for non-use. Anonymous questionnaires were used to collect data in Germany on wearable ownership, usage behaviour, acceptance of health monitoring, and willingness to share data. Out of 643 respondents, 550 participants provided wearable acceptance data. The average age was 36.6 years, with 51.3% female and 39.6% residing in rural areas. Overall, 33.8% reported wearing a wearable, primarily smartwatches or fitness wristbands. Men (63.3%) and women (57.8%) expressed willingness to wear a sensor for health monitoring, and 61.5% were open to sharing data with healthcare providers. Concerns included data security, privacy, and perceived lack of need. The study highlights the acceptance and potential of wearables, particularly for health monitoring and data sharing with healthcare providers. Addressing data security and privacy concerns could enhance the adoption of innovative wearables, such as implants, for early detection and monitoring of chronic diseases.
Topics: Humans; Germany; Female; Male; Adult; Cross-Sectional Studies; Wearable Electronic Devices; Surveys and Questionnaires; Middle Aged; Monitoring, Physiologic; Monitoring, Ambulatory
PubMed: 38900846
DOI: 10.1177/14604582241260607 -
Human Brain Mapping Jun 2024With the rise of open data, identifiability of individuals based on 3D renderings obtained from routine structural magnetic resonance imaging (MRI) scans of the head has...
With the rise of open data, identifiability of individuals based on 3D renderings obtained from routine structural magnetic resonance imaging (MRI) scans of the head has become a growing privacy concern. To protect subject privacy, several algorithms have been developed to de-identify imaging data using blurring, defacing or refacing. Completely removing facial structures provides the best re-identification protection but can significantly impact post-processing steps, like brain morphometry. As an alternative, refacing methods that replace individual facial structures with generic templates have a lower effect on the geometry and intensity distribution of original scans, and are able to provide more consistent post-processing results by the price of higher re-identification risk and computational complexity. In the current study, we propose a novel method for anonymized face generation for defaced 3D T1-weighted scans based on a 3D conditional generative adversarial network. To evaluate the performance of the proposed de-identification tool, a comparative study was conducted between several existing defacing and refacing tools, with two different segmentation algorithms (FAST and Morphobox). The aim was to evaluate (i) impact on brain morphometry reproducibility, (ii) re-identification risk, (iii) balance between (i) and (ii), and (iv) the processing time. The proposed method takes 9 s for face generation and is suitable for recovering consistent post-processing results after defacing.
Topics: Humans; Magnetic Resonance Imaging; Adult; Brain; Male; Female; Neural Networks, Computer; Imaging, Three-Dimensional; Neuroimaging; Data Anonymization; Young Adult; Image Processing, Computer-Assisted; Algorithms
PubMed: 38899549
DOI: 10.1002/hbm.26721 -
BMC Public Health Jun 2024Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward...
Working mechanisms of the use and acceptability of ecological momentary interventions: a realist evaluation of a guided self-help ecological momentary intervention targeting self-esteem.
BACKGROUND
Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward intervening in daily life to enhance the generalizability and ecological validity, and to be able to intervene in moments most needed. Identifying working mechanisms of the use of ecological momentary interventions might generate insights to improve interventions.
METHODS
The present study investigates the working mechanisms of the use and acceptability of an ecological momentary intervention, named SELFIE, targeting self-esteem in youth exposed to childhood trauma, and evaluates under what circumstances these mechanisms of use and acceptability do or do not come into play. A realist evaluation approach was used for developing initial program theories (data: expert interviews and a stakeholders focus group), and subsequently testing (data: 15 interviews with participants, a focus group with therapists, debriefing questionnaire), and refining them.
RESULTS
The SELFIE intervention is offered through a smartphone application enabling constant availability of the intervention and thereby increasing accessibility and feasibility. When the intervention was offered on their personal smartphone, this enhanced a sense of privacy and less hesitance in engaging with the app, leading to increased disclosure and active participation. Further, the smartphone application facilitates the practice of skills in daily life, supporting the repeated practice of exercises in different situations leading to the generalizability of the effect. Buffering against technical malfunction seemed important to decrease its possible negative effects.
CONCLUSIONS
This study enhanced our understanding of possible working mechanisms in EMIs, such as the constant availability supporting increased accessibility and feasibility, for which the use of the personal smartphone was experienced as a facilitating context. Hereby, the current study contributes to relatively limited research in this field. For the field to move forward, mechanisms of use, and acceptability of EMIs need to be understood. It is strongly recommended that alongside efficacy trials of an EMI on specific target mechanisms, a process evaluation is conducted investigating the working mechanisms of use.
TRIAL REGISTRATION
The current paper reports on a realist evaluation within the SELFIE trial (Netherlands Trial Register NL7129 (NTR7475)).
Topics: Humans; Self Concept; Female; Male; Adolescent; Ecological Momentary Assessment; Focus Groups; Mobile Applications; Patient Acceptance of Health Care; Smartphone
PubMed: 38898412
DOI: 10.1186/s12889-024-19143-z -
Digital Health 2024Millions of people in the UK have asthma, yet 70% do not access basic care, leading to the largest number of asthma-related deaths in Europe. Chatbots may extend the...
OBJECTIVE
Millions of people in the UK have asthma, yet 70% do not access basic care, leading to the largest number of asthma-related deaths in Europe. Chatbots may extend the reach of asthma support and provide a bridge to traditional healthcare. This study evaluates 'Brisa', a chatbot designed to improve asthma patients' self-assessment and self-management.
METHODS
We recruited 150 adults with an asthma diagnosis to test our chatbot. Participants were recruited over three waves through social media and a research recruitment platform. Eligible participants had access to 'Brisa' via a WhatsApp or website version for 28 days and completed entry and exit questionnaires to evaluate user experience and asthma control. Weekly symptom tracking, user interaction metrics, satisfaction measures, and qualitative feedback were utilised to evaluate the chatbot's usability and potential effectiveness, focusing on changes in asthma control and self-reported behavioural improvements.
RESULTS
74% of participants engaged with 'Brisa' at least once. High task completion rates were observed: asthma attack risk assessment (86%), voice recording submission (83%) and asthma control tracking (95.5%). Post use, an 8% improvement in asthma control was reported. User satisfaction surveys indicated positive feedback on helpfulness (80%), privacy (87%), trustworthiness (80%) and functionality (84%) but highlighted a need for improved conversational depth and personalisation.
CONCLUSIONS
The study indicates that chatbots are effective for asthma support, demonstrated by the high usage of features like risk assessment and control tracking, as well as a statistically significant improvement in asthma control. However, lower satisfaction in conversational flexibility highlights rising expectations for chatbot fluency, influenced by advanced models like ChatGPT. Future health-focused chatbots must balance conversational capability with accuracy and safety to maintain engagement and effectiveness.
PubMed: 38894942
DOI: 10.1177/20552076241258276 -
Sensors (Basel, Switzerland) Jun 2024Monitoring the lifestyles of older adults helps promote independent living and ensure their well-being. The common technologies for home monitoring include wearables,...
BACKGROUND
Monitoring the lifestyles of older adults helps promote independent living and ensure their well-being. The common technologies for home monitoring include wearables, ambient sensors, and smart household meters. While wearables can be intrusive, ambient sensors require extra installation, and smart meters are becoming integral to smart city infrastructure. Research Gap: The previous studies primarily utilized high-resolution smart meter data by applying Non-Intrusive Appliance Load Monitoring (NIALM) techniques, leading to significant privacy concerns. Meanwhile, some Japanese power companies have successfully employed low-resolution data to monitor lifestyle patterns discreetly.
SCOPE AND METHODOLOGY
This study develops a lifestyle monitoring system for older adults using low-resolution smart meter data, mapping electricity consumption to appliance usage. The power consumption data are collected at 15-min intervals, and the background power threshold distinguishes between the active and inactive periods (0/1). The system quantifies activity through an active score and assesses daily routines by comparing these scores against the long-term norms. Key Outcomes/Contributions: The findings reveal that low-resolution data can effectively monitor lifestyle patterns without compromising privacy. The active scores and regularity assessments calculated using correlation coefficients offer a comprehensive view of residents' daily activities and any deviations from the established patterns. This study contributes to the literature by validating the efficacy of low-resolution data in lifestyle monitoring systems and underscores the potential of smart meters in enhancing elderly people's care.
Topics: Humans; Aged; Independent Living; Life Style; Female; Male; Activities of Daily Living; Monitoring, Physiologic; Monitoring, Ambulatory; Aged, 80 and over; Wearable Electronic Devices
PubMed: 38894452
DOI: 10.3390/s24113662