Virtual Coaches, also known as e-coaches, are a disruptive technology in healthcare. Indeed, among other usages, they might provide cost-effective solutions for increasing human wellbeing in different domains, such as physical, nutritional, cognitive, social, and emotional. This paper presents a systematic review of virtual coaches specifically aimed at improving or maintaining older adults’ health in the aforementioned domains. Such digital systems assume various forms, from classic apps, to more advanced conversational agents or robots. Fifty-six articles describing a virtual coach for older adults and aimed at improving their wellbeing were identified and further analyzed. In particular, we presented how previous studies defined their virtual coaches, which behavioral change models and techniques they adopted and the overall system architecture, in terms of monitoring solutions, processing methods and modalities for intervention delivery. Our results show that few thorough evaluations of e-coaching systems have been conducted, especially regarding multi-domain coaching approaches. Through our analysis, we identified the wellbeing domains that should be addressed in future studies as well as the most promising behavior change models and techniques and coaching interfaces. Previous work illustrates that older adults often appreciate conversational agents and robots. However, the lack of a multidomain intervention approach in the current literature motivates us to seek to define future solutions.

Background: Receiving a diagnosis that leads to severe disability in childhood can cause a traumatic experience with long-lasting emotional stress for patients and family members. In recent decades, emerging digital technologies have transformed how patients or caregivers of persons with disabilities manage their health conditions. As a result, information (eg, on treatment and resources) has become widely available to patients and their families. Parents and other caregivers can use digital platforms such as websites or social media to derive social support, usually from other patients and caregivers who share their lived experiences, challenges, and successes on these platforms. However, gaps remain in our understanding of platforms that are most frequently used or preferred among parents and caregivers of children with disabilities. In particular, it is not clear what factors primarily drive or discourage engagement with these digital tools and what the main ethical considerations are in relation to these tools. Objective: We aimed to (1) identify prominent digital platforms used by parents or caregivers of children with disabilities; (2) explore the theoretical contexts and reasons for digital platform use, as well as the experiences made with using these platforms reported in the included studies; and (3) identify any privacy and ethical concerns emerging in the available literature in relation to the use of these platforms. Methods: We conducted a scoping review of 5 academic databases of English-language articles published within the last 10 years for diseases with childhood onset disability and self-help or parent/caregiver-led digital platforms. Results: We identified 17 papers in which digital platforms used by parents of affected children predominantly included social media elements but also search engines, health-related apps, and medical websites. Information retrieval and social support were the main reasons for their utilization. Nearly all studies were exploratory and applied either quantitative, qualitative, or mixed methods. The main ethical concerns for digital platform users included hampered access due to language barriers, privacy issues, and perceived suboptimal advice (eg, due to missing empathy of medical professionals). Older and non–college-educated individuals and ethnic minorities appeared less likely to access information online. Conclusions: This review showed that limited scientifically sound knowledge exists on digital platform use and needs in the context of disabling conditions in children, as the evidence consists mostly of exploratory studies. We could highlight that affected families seek information and support from digital platforms, as health care systems seem to be insufficient for satisfying knowledge and support needs through traditional channels.

Natural disasters can have significant consequences for population mental health. Using a digital spatial epidemiologic approach, this study documents emotional changes over space and time in the context of a large-scale disaster. Our aims were to (a) explore the spatial distribution of negative emotional expressions of Twitter users before, during, and after Superstorm Sandy in New York City (NYC) in 2012 and (b) examine potential correlations between socioeconomic status and infrastructural damage with negative emotional expressions across NYC census tracts over time. A total of 984,311 geo-referenced tweets with negative basic emotions (anger, disgust, fear, sadness, shame) were collected and assigned to the census tracts within NYC boroughs between 8 October and 18 November 2012. Global and local univariate and bivariate Moran’s I statistics were used to analyze the data. We found local spatial clusters of all negative emotions over all disaster periods. Socioeconomic status and infrastructural damage were predominantly correlated with disgust, fear, and shame post-disaster. We identified spatial clusters of emotional reactions during and in the aftermath of a large-scale disaster that could help provide guidance about where immediate and long-term relief measures are needed the most, if transferred to similar events and on comparable data worldwide.