Introduction: Mental health issues among young people have surged post-COVID-19. Mental health apps can offer accessible preventive support on a large scale, yet the perspective of minoritized youth–such as those from low socioeconomic and ethnic/racial backgrounds–are underexplored. This risks low uptake and effectiveness, and exacerbating health inequities. This study aimed to understand the needs and concerns of minoritized youth in the Netherlands using a participatory approach. Methods: We conducted 3 co-creation sessions with 17 adolescents (16 females, majority Dutch Moroccan background) aged 11–22 years, recruited through community centers in lower-income neighborhoods in The Netherlands, with the help of community workers. We also organized a discussion session with 26 preventive youth workers to explore their perspectives regarding implementation. A subset of youth (n = 10) analyzed the data in 2 co-thematic analysis workshops. We compared youth and researcher themes. Results: Youth saw data-driven mental health apps as useful for short-term stress relief through motivational quotes, social activity suggestions, and homework support, but unable to solve more severe issues. In the co-analysis, youth analyzed based on emotion and functions, whereas researchers employed a more technical lens. Key themes included identity-based (such as religion, gender, and age) and contextual tailoring (to school/home schedules), compassionate communication as opposed to fake support (robots), safety, and the role of social media. Conclusion: These findings highlight the need to examine how app design for young people can prioritize authentic, compassionate communication, safety–including transparency about data–tailoring to identify aspects, adapting the timing and frequency of notifications, and integrating social connections and social media. Participatory approaches are promising to better understand the needs of youth from minoritized backgrounds for digital mental health technologies, with the aim of equitable digital solutions.

Despite the growing potential of artificial intelligence (AI) in improving clinical decision making, patients' perspectives on the use of AI for their care decision making are underexplored. In this paper, we investigate patients' preferences towards the autonomy of AI in assisting healthcare decision making. We conducted interviews and an online survey using an interactive narrative and speculative AI prototypes to elicit participants' preferred choices of using AI in a pregnancy care context. The analysis of the interviews and in-story responses reveals that patients' preferences for AI autonomy vary per person and context, and may change over time. This finding suggests the need for involving patients in defining and reassessing the appropriate level of AI assistance for healthcare decision making. Departing from these varied preferences for AI autonomy, we discuss implications for incorporating patient-centeredness in designing AI-powered healthcare decision making.

Introduction: eHealth seems promising in addressing challenges in the provision of care for Huntington’s disease (HD) across Europe. By harnessing information and communication technologies, eHealth can partially relocate care from specialized centers to the patients’ home, thereby increasing the availability and accessibility of specialty care services beyond regional borders. Previous research on eHealth (development) in HD is however limited, especially when it comes to including eHealth services specifically designed together with HD gene expansion carriers (HDGECs) and their partners to fit their needs and expectations. Methods: This article describes the qualitative human-centered design process and first evaluations of the Huntington Support App prototype: a web-app aimed to support the quality of life (QoL) of HDGECs and their partners in Europe. Prospective end-users, i.e., HDGECs, their partners, and healthcare providers (HCPs), from different countries were involved throughout the development process. Through interviews, we captured people’s experiences with the disease, quality of life (QoL), and eHealth. We translated their stories into design directions that were further co-designed and subsequently evaluated with the user groups. Results: The resulting prototype centralizes clear and reliable information on the disease, HD-related news and events, as well as direct contact possibilities with HCPs via an online walk-in hour or by scheduling an appointment. The app’s prototype was positively received and rated as (very) appealing, pleasant, easy to use and helpful by both HDGECs and partners. Discussion: By involving end-users in every step, we developed a healthcare app that meets relevant needs of individuals affected by HD and therefore may lead to high adoption and retention rates. As a result, the app provides low-threshold access to reliable information and specialized care for HD in Europe. A description of the Huntington Support App as well as implications for further development of the app’s prototype are provided.

Background: Medical procedures can cause considerable stress and anxiety among children. Current interventions mainly diminish stress and anxiety during procedures, while stress and anxiety often build up at home. Moreover, interventions often focus on either distraction or preparation. eHealth can combine multiple strategies and provide a low-cost solution that can be used outside the hospital. Objective: To develop an eHealth solution to diminish preprocedural stress and anxiety, and to evaluate the app on use, usability and user experience in practice. We also aimed to gain in-depth insights in children's and caregivers' opinions and experiences to inform future improvements. Methods: This is a multi-study report on the development (Study 1) and evaluation (Study 2) of a first version of the developed app. In study 1 we adopted a participatory design approach in which children's experiences were central to the design process. We performed an experience journey session with stakeholders (n = 13) to map the child's outpatient journey, identify pains and gains, and formulate the desired experience journey. Iterative development and testing with children (n = 8) and caregivers (n = 6) resulted in a working prototype. The prototype was tested with children, resulting in a first version of the Hospital Hero app. The app was evaluated on use, user-experience and usability during an eight-week pilot study in practice (Study 2). We triangulated data from online interviews with children and caregivers (n = 21) and online questionnaires (n = 46). Results: Multiple stress and anxiety experience touchpoints were identified. The Hospital Hero app supports children in their hospital journey by facilitating preparation at home and providing distraction at the hospital. The pilot study showed that the app was evaluated positively on usability and user-experience and is considered feasible. Qualitative data showed five themes: (1) user-friendliness, (2) coherence and power of storytelling, (3) motivation and reward, (4) fit with real hospital journey, (5) procedural comfort. Discussion: Using participatory design, we developed a child-centered solution that supports children in the entire hospital journey and may diminish preprocedural stress and anxiety. Future efforts should create a more tailored journey, define an optimal engagement window and formulate implementation strategies.

For health and environmental reasons, humanity should reduce the consumption of animal-based products, whereas vegetable consumption should be increased. We created stimuli (drawings with texts) that may be able to increase or decrease the purchasing of mushrooms, cheese, and meat. During the design process, we identified four aspect categories (sensory, health, environment, moral) and we generated positive and negative examples for all products. In Study 1 we determined the familiarity, credibility and relevance of each aspect and measured emotional responses to them. In Study 2, we investigated to what extent four aspects combined in an infographic on a poster lessened or strengthened the emotional responses, purchase intention, and tendency to adapt behavior for the three products. Regression analyses showed that the emotional responses to the posters were well predicted by the responses to the product aspects. Purchase intentions were mainly affected by negative affect, while positive and negative affect seemed equally important for people’s intention to change behavior.

This article describes a user-centered design experiment investigating positive and negative effects of adding game rules to brainstorms. We studied effects on brainstorm output and user experience and behavior. A coin-based gamification was developed with rules intended to improve brainstorm output in relation to quality and quantity of ideas. However, the invasiveness of a gamification can be expected to affect users both positively and negatively. To find an optimum between positive and negative effects of gamification invasiveness, we tested 5 different rule-sets with varying quantity and quality of rules. The results demonstrated that game rules stimulating competitive game behavior improved the quantity and quality of brainstorm output. Yet the invasiveness of the gamification also hindered this positive effect, due to discussions about rules and mandatory game behavior. From these results we deduced 3 types of invasiveness evoked by the rules’ qualities: a) governing rules led to negative cognitive invasiveness, b) forcing rules caused positive as well as negative behavioral invasiveness, and c) adding coins may have led to positive affective invasiveness (i.e., a playful attitude). We conclude our study with recommendations on designing and researching gamification invasiveness in real-life contexts.