Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Patients are increasingly using mobile health applications (“apps”) to monitor their health and educate themselves about medical issues. Despite the increasing popularity of such apps, poor design and usability often lead to suboptimal continue use of these apps, and subsequently to poor adherence to the behavior changes at which they are aimed. One solution to these design problems is for app developers to use user-centered design (UCD) principles to consider the context and needs of users during the development process. Objective: This paper presents a case study on the design and development process for an mHealth app which uses virtual human technology (VHT) to encourage colorectal cancer (CRC) screening among patients over age 50. Methods: We first provide an overview of project and discuss its utilization of VHT. We then review UCD principles and how they can be incorporated into the development of health apps. We describe how we used UCD processes during the app’s development. We then discuss the unique roles played by communications researchers, computer scientists, clinicians, and community participants in creating an mHealth app that is credible, usable, effective, and accessible to its target audience. Results: The principles of user-centered design were woven throughout the project development, with researchers collecting feedback from patients and providers at all stages and using that feedback to improve the credibility, usability, effectiveness, and accessibility of the mHealth app. The app was designed in an iterative process, which encouraged feedback and improvement of the app and allowed teams from different fields to revisit topics and troubleshoot problems. Conclusions: Implementing a user-centered design process contributed to an app which not only reflected cross-disciplinary expertise but reflects the needs, wants, and concerns of patients.

Virtual human (VH) experiences are receiving increased attention for training real-world interpersonal scenarios. Communication in interpersonal scenarios consists of not only speech and gestures, but also relies heavily on haptic interaction–interpersonal touch. By adding haptic interaction to VH experiences, the bandwidth of human-VH communication can be increased to approach that of human-human communication. To afford haptic interaction, a new species of embodied agent is proposed–mixed reality humans (MRHs). A MRH is a virtual human embodied by a tangible interface that shares the same registered space. The tangible interface affords the haptic interaction that is critical to effective simulation of interpersonal scenarios. We applied MRHs to simulate a virtual patient requiring a breast cancer screening (medical interview and physical exam). The design of the MRH patient is presented. This paper also presents the results of a pilot study in which eight (n = 8) physician-assistant students performed a clinical breast exam on the MRH patient. Results show that when afforded haptic interaction with a MRH patient, users demonstrated interpersonal touch and social engagement similarly to interacting with a human patient.

This research investigates how interacting with tangible user interfaces (TUIs) affects spatial cognition. To study the impact of TUIs, a between subjects study was conducted (n=60) in which students learned about the operation of an anesthesia machine. A TUI was compared to two other interfaces commonly used in anesthesia education: (1) a Graphical User Interface (a 2D abstract simulation model of an anesthesia machine) and (2) a Physical User Interface (a real world anesthesia machine). Overall, the TUI was found to significantly compensate for low user spatial cognition in the domain of anesthesia machine training.

In the context of mental wellness support, trust and intimacy between a counselor and a patient are necessary to converge healing processes positively. However, convincing students to trust a virtual human for topics regarding mental wellness is a complex problem that requires understanding students' experiences. Based on research that discusses mental health as a concerning topic regarding Computer Science (CS) students, this paper investigates how undergraduate computing-related students perceive virtual humans' expertise on mental wellness support based on demographic resemblance on spoken accent and gender. Four virtual human counselors were developed to conduct the study, as 58 undergraduate computing-related students from two North American universities were recruited and assessed. Our findings suggest that students were less inclined to interact with a male virtual human than a female one. Also, that spoken accents can impact students' perceptions of expertise under students' multilingualism.

Millions of students worldwide have adopted online learning due to the isolation restrictions imposed by the Covid-19 pandemic. In this context, video conferencing platforms have garnered immense popularity as tools for teaching. However, these tools have several limitations compared to real-world encounters, especially in activities involving collaboration and teamwork. A growing number of researchers and educators have turned to avatar-based communication platforms, such as Mozilla Hubs, as alternatives that can complement video conferencing in social and teaching activities. Several previous research efforts have focused on developing tools that implement avatar-based communication systems or have explored creating activities in these 3D virtual spaces, such as poster sessions in scientific conferences or the classroom environment. In this work, we describe our semester-long efforts to develop Mozilla Hubs rooms toward promoting interaction and communication to help students self-form teams in the context of an introductory virtual reality course at the University of Florida. We describe hands-on activities to prepare students to use Mozilla Hubs effectively, including teaching them skills to customize and create avatars. We describe the implementation of three virtual rooms developed based on researchers' observations and students' survey responses. By observing students' behavior and communication patterns in those rooms, we propose a set of guidelines for building virtual rooms that can promote communication, interaction, and teamwork. We discuss the rooms' design, students' attendance, and avatar choices. Our findings suggest that highly detailed, small, closed spaces are preferred over large, open spaces with few details when promoting interaction and collaboration among students.