The growth of the urban population together with a high concentration of air pollution have important health impacts on citizens who are exposed to them, causing serious risks of the development and evolution of different chronic diseases. This paper presents the design and development of a novel participatory citizen science-based application and data ecosystem model. These developments are imperative and scientifically designed to gather and process perceptual sensing of urban, environmental, and health data. This data acquisition approach allows citizens to gather and generate environment- and health-related data through mobile devices. The sum of all citizens’ data will continuously enrich and increase the volumes of data coming from the city sensors and sources across geographical locations. These scientifically generated data, coupled with data from the city sensors and sources, will enable specialized predictive analytic solutions to empower citizens with urban, environmental, and health recommendations, while enabling new data-driven policies. Although it is difficult for citizens to relate their personal behaviour to large-scale problems such as climate change, pollution, or public health, the developed ecosystem provides the necessary tools to enable a greener and healthier lifestyle, improve quality of life, and contribute towards a more sustainable local environment.

The constructivist approach is interested in creating knowledge through active engagement and encourages students to build their knowledge from their experiences in the world. Learning through digital game making is a constructivist approach that allows students to learn by developing their own games, enhancing problem-solving skills and fostering creativity. In this context two tools, Create@School App and the Project Management Dashboard (PMD), were developed to enable students from different countries to be able to adapt their learning material by programming and designing games for their academic subjects, therefore integrating the game mechanics, dynamics, and aesthetics into the academic curriculum. This paper focuses on presenting the validation context as well as the evaluation of these tools. The Hassenzahl model and AttrakDiff survey were used for measuring users’ experience and satisfaction, and for understanding emotional responses, thus providing information that enables testing of the acceptability and usability of the developed apps. After two years of usage of code-making apps (i.e., Create@School and its pre-design version Pocket Code), the pupils processed knowledge from their academic subjects spontaneously as game-based embedded knowledge. The students demonstrated creativity, a practical approach, and enthusiasm regarding making games focused on academic content that led them to learning, using mobile devices, sensors, images, and contextual information. This approach was widely accepted by students and teachers as part of their everyday class routines.

Objective: Long term behavioural disturbances and interventions in healthy habits (mainly eating and physical activity) are the primary cause of childhood obesity. Current approaches for obesity prevention based on health information extraction lack the integration of multi-modal datasets and the provision of a dedicated Decision Support System (DSS) for health behaviour assessment and coaching of children. Methods: Continuous co-creation process has been applied in the frame of the Design Thinking Methodology, involving children, educators and healthcare professional in the whole process. Such considerations were used to derive the user needs and the technical requirements needed for the conception of the Internet of Things (IoT) platform based on microservices. Results: To promote the adoption of healthy habits and the prevention of the obesity onset for children (9-12 years old), the proposed solution empowers children -including families and educators- in taking control of their health by collecting and following-up real-time information about nutrition, physical activity data coming from IoT devices, and interconnecting healthcare professionals to provide a personalised coaching solution. The validation has two phases involving +400 children (control/intervention group), on four schools in three countries: Spain, Greece and Brazil. The prevalence of obesity decreased in 75.5% from baseline levels in the intervention group. The proposed solution created a positive impression and satisfaction from the technology acceptance perspective. Conclusions: Main findings confirm that this ecosystem can assess behaviours of children, motivating and guiding them towards achieving personal goals.

This paper examines the ethical and legal challenges encountered during the GATEKEEPER Project and how these challenges informed the development of a comprehensive framework for future Large-Scale Pilot (LSP) projects. GATEKEEPER is a LSP Project with 48 partners conducting 30 implementation studies across Europe with 50,000 target participants grouped into 9 Reference Use Cases. The project underscored the complexity of obtaining ethical approval across various jurisdictions with divergent regulations and procedures. Through a detailed analysis of the issues faced and the strategies employed to navigate these challenges, this study proposes an ethical and legal framework. This framework, derived from a comparative analysis of ethical application forms and regulations, aims to streamline the ethical approval process for future LSP research projects. By addressing the hurdles encountered in GATEKEEPER, the proposed framework offers a roadmap for more efficient and effective project management, ensuring smoother implementation of similar projects in the future.

Background: Virtual Health and Wellbeing Living Lab Infrastructure is a Horizon 2020 project that aims to harmonize Living Lab procedures and facilitate access to European health and well-being research infrastructures. In this context, this study presents a joint research activity that will be conducted within Virtual Health and Wellbeing Living Lab Infrastructure in the transitional care domain to test and validate the harmonized Living Lab procedures and infrastructures. The collection of data from various sources (information and communications technology and clinical and patient-reported outcome measures) demonstrated the capacity to assess risk and support decisions during care transitions, but there is no harmonized way of combining this information. Objective: This study primarily aims to evaluate the feasibility and benefit of collecting multichannel data across Living Labs on the topic of transitional care and to harmonize data processes and collection. In addition, the authors aim to investigate the collection and use of digital biomarkers and explore initial patterns in the data that demonstrate the potential to predict transition outcomes, such as readmissions and adverse events. Methods: The current research protocol presents a multicenter, prospective, observational cohort study that will consist of three phases, running consecutively in multiple sites: a cocreation phase, a testing and simulation phase, and a transnational pilot phase. The cocreation phase aims to build a common understanding among different sites, investigate the differences in hospitalization discharge management among countries, and the willingness of different stakeholders to use technological solutions in the transitional care process. The testing and simulation phase aims to explore ways of integrating observation of a patient’s clinical condition, patient involvement, and discharge education in transitional care. The objective of the simulation phase is to evaluate the feasibility and the barriers faced by health care professionals in assessing transition readiness. Results: The cocreation phase will be completed by April 2022. The testing and simulation phase will begin in September 2022 and will partially overlap with the deployment of the transnational pilot phase that will start in the same month. The data collection of the transnational pilots will be finalized by the end of June 2023. Data processing is expected to be completed by March 2024. The results will consist of guidelines and implementation pathways for large-scale studies and an analysis for identifying initial patterns in the acquired data. Conclusions: The knowledge acquired through this research will lead to harmonized procedures and data collection for Living Labs that support transitions in care. International Registered Report Identifier (IRRID): PRR1-10.2196/34573

Objectives: This study aimed to explore healthcare professionals’ views on the use of technology in adult transitional care, identifying challenges, critical procedures, and enabling factors for adoption. Methods: This was a prospective, multisite qualitative study. Data were collected through semi-structured co-creation sessions that explored two main themes, clinical decision-making and technology use in transitional care, through the lenses of current practices, challenges, and future directions. Data were analysed using constant comparison analysis by three independent researchers through iterative open, axial, and selective coding, followed by an impact relationship analysis to explore interconnections between themes. Results: Eleven co-creation sessions were held involving 115 participants. Findings highlight five key transitional care processes, beginning with patient assessment and evaluation, continuing through discharge planning and adherence to protocols, and extending to post-discharge support and follow-up care. The results show how technology can enhance each of these steps by improving digital literacy, user-friendliness, interoperability, and the flow of information. Cross-cutting barriers such as limited resources, privacy concerns, and lack of trust in technology were also identified. Conclusions: Technological tools can support various aspects and processes of transitional care, but their effective adoption requires a distinct set of strategies to address the multiple and complex factors involved.