Operationalizing a Rideshare Intervention for Colonoscopy Completion: Barriers, Facilitators, and Process Recommendations

IntroductionTransportation is a common barrier to colonoscopy completion for colorectal cancer (CRC) screening. The study aims to identify the barriers, facilitators, and process recommendations to implement a rideshare non-emergency medical transportation (NEMT) intervention following colonoscopy completion within a safety-net healthcare setting.MethodsWe used informal stakeholder engagement, story boards—a novel user-centered design technique, listening sessions and the nominal group technique to identify the barriers, facilitators, and process to implementing a rideshare NEMT program following colonoscopy completion in a large safety-net healthcare system.ResultsBarriers to implementing a rideshare NEMT intervention for colonoscopy completion included: inability to expand an existing NEMT program beyond Medicaid patients and lack of patient chaperones with rideshare NEMT programs. Facilitators included: commercially available rideshare NEMT platforms that were lower cost and had shorter wait times than the alternative of taxis. Operationalizing and implementing a rideshare NEMT intervention in our healthcare system required the following steps: 1) identifying key stakeholders, 2) engaging stakeholder groups in discussion to identify barriers and solutions, 3) obtaining institutional sign-off, 4) developing a process for reviewing and selecting a rideshare NEMT program, 5) executing contracts, 6) developing a standard operating procedure and 7) training clinic staff to use the rideshare platform.DiscussionRideshare NEMT after procedural sedation is administered may improve colonoscopy completion rates and provide one solution to inadequate CRC screening. If successful, our rideshare model could be broadly applicable to other safety-net health systems, populations with high social needs, and settings where procedural sedation is administered.

Design of Sustainable Modular Wooden Booths Inspired by Revitalization of Croatian Traditional Construction and New User Needs Due to COVID-19 Pandemic

The paper presents the results of the first phase of the student project CROSTAND2, whose main goal is to revitalize the traditional construction techniques of vernacular architecture in the Republic of Croatia by developing modern sustainable prefabricated modular wooden buildings/public booths in accordance with users’ needs and habits. To incorporate conceptual design, the literature on Croatian construction and wood protection, prefabricated modular construction, and public urban spaces was analyzed and field research was conducted. Photo documentation was also collected in the village of Donja Kupčina, Zagreb County, Croatia. An online survey questionnaire on socializing habits in public spaces, before and during the COVID-19 pandemic, additionally analyzed new requirements for user-centered design. The obtained results, as well as results from previous project research, were used as a basis and inspiration for the design of a conceptual modular building inspired by traditional wooden joints, modular construction, and the emerging needs of users to socialize safely in a healthy environment. Conceptual solutions for a sustainable modular prefabricated wooden building for public use, intended for public urban and rural areas, have been proposed. Such constructions would ensure the sustainability of enjoying the natural environment for personal, tourist, and commercial purposes with the perpetuation of Croatian heritage building traditions.

Developing a Web-Based App to Assess Mental Health Difficulties in Secondary School Pupils: Qualitative User-Centered Design Study

Background Secondary schools are an ideal setting to identify young people experiencing mental health difficulties such as anxiety or depression. However, current methods of identification rely on cumbersome paper-based assessments, which are lengthy and time-consuming to complete and resource-intensive for schools to manage. Artemis-A is a prototype web app that uses computerized adaptive testing technology to shorten the length of the assessment and provides schools with a simple and feasible solution for mental health assessment. Objective The objectives of this study are to coproduce the main components of the Artemis-A app with stakeholders to enhance the user interface, to carry out usability testing and finalize the interface design and functionality, and to explore the acceptability and feasibility of using Artemis-A in schools. Methods This study involved 2 iterative design feedback cycles—an initial stakeholder consultation to inform the app design and user testing. Using a user-centered design approach, qualitative data were collected through focus groups and interviews with secondary school pupils, parents, school staff, and mental health professionals (N=48). All transcripts were thematically analyzed. Results Initial stakeholder consultations provided feedback on preferences for the user interface design, school administration of the assessment, and outcome reporting. The findings informed the second iteration of the app design and development. The unmoderated usability assessment indicated that young people found the app easy to use and visually appealing. However, school staff suggested that additional features should be added to the school administration panel, which would provide them with more flexibility for data visualization. The analysis identified four themes relating to the implementation of the Artemis-A in schools, including the anticipated benefits and drawbacks of the app. Actionable suggestions for designing mental health assessment apps are also provided. Conclusions Artemis-A is a potentially useful tool for secondary schools to assess the mental health of their pupils that requires minimal staff input and training. Future research will evaluate the feasibility and effectiveness of Artemis-A in a range of UK secondary schools.

Iterative redesign of a caregiver-mediated intervention for use in educational settings

Teachers endorse disruptive behavior as a considerable concern for autistic students, which is compounded by the lack of adequate resources for behavioral intervention planning in the classroom. The RUBI program is an evidence-based, low-intensity manualized intervention, initially developed for parents of autistic children ages 3–14 and co-occurring disruptive behavior. Utilizing the Discover, Design/Build, Test (DDBT) framework, which combines user-centered design and implementation science, RUBI intervention content was collaboratively and iteratively redesigned with elementary school stakeholders (40 school staff from 28 schools) to ensure the feasibility, acceptability, and appropriateness of the redesigned intervention, RUBI in Educational Settings (RUBIES). Iterative quantitative and qualitative methods were conducted with stakeholders to identify targets for RUBI redesign. Conventional content analysis was used to code qualitative data and identify usability issues. Recommendations were provided for modifications to RUBI sessions to address the needs of the school context and end-users to develop RUBIES. Feasibility scores improved following the redesign. The use of the DDBT framework to redesign the RUBI intervention may promote greater usefulness and usability in school contexts. Lay abstract Teachers often report concerns about behavior challenges in their students with autism spectrum disorder (ASD) in the school setting. Furthermore, teachers often report that they do not have adequate training in how to manage these challenging behaviors effectively. The RUBI program is an intervention initially developed for parents of children with ASD and co-occurring challenging behavior in clinic settings. The present project used school staff input to systematically redesign RUBI to be used with educators in schools. School staff gave input at multiple stages of development to ensure the adapted intervention was appropriate to use in a school setting. Responses were coded and analyzed to identify strengths and weaknesses of the RUBI manual in schools and adaptations were made accordingly. Scores of how appropriate, possible, likable, and usable RUBI would be in schools rose after the intervention was redesigned. The redesigned RUBIES manual may give school staff the tools they need to manage disruptive behaviors. In addition, collaborating with providers over multiple stages to redesign established interventions for new contexts may be a promising way to help bring research tools to practice in the future.

User Centered Design Method for Developing a Mobile-Based Product Distribution Application

Anyelir Cake And Bakery is the largest cake shop in Purwakarta which is engaged in the production of various kinds of cakes. In the process of distributing products from the central store to branch stores, they still use WhatsApp to place orders. This causes frequent discrepancies in the number of products requested and the number of products received due to an error in reading the message. In this study, a mobile-based application will be built that is able to manage order data more accurately. The development of this application uses the User Centered Design (UCD). This is a design method that focuses on user needs so that the final result of this application does not need to change user behavior when using the application. The UCD method consists of four stages, namely plan the human centered design, specify user and organizational requirements, product design solutions, and evaluate design against user requirements. In the development process, application testing was carried out to get feedback from users with good scores, namely an average of 4 (agree) and 5 (strongly agree). This shows that the application is in accordance with the needs of the user.