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ObjectiveStigma has been recognized as a significant issue in sexual health, yet no specific guidelines exist to support digital health development teams in creating stigma-alleviating sexual health digital platforms. The purpose of this study was to develop a set of design guidelines that would serve as a reference point for addressing stigma during the design of sexual health-related digital platforms.Materials and MethodsWe conducted a 3-round Delphi study among 14 researchers in stigma and sexual health. A preliminary list of 28 design guidelines was generated from a literature review. Participants appraised and critiqued the clarity and usefulness of the preliminary list and provided comments for each item and for the overall group of items at each round. At each round, a content validity index and an interquartile range were calculated to determine the level of consensus regarding the clarity and usefulness of each guideline. Items were retained if there was high consensus and discarded if there was no consensus after the three rounds.ResultsNineteen design guidelines achieved consensus. Most of them were content-related guidelines and sought to address the emotional concerns of patients that could potentially aggravate stigma. The findings also reflected modern stigma management strategies of making stigma a societal attribute by challenging, exposing, and normalizing stigma attributes via web platforms.ConclusionTo address stigma via digital platforms, developers should not just concentrate on technical solutions but seriously consider content-related and emotional design components that are likely to result in stigma

BACKGROUND The use of digital health technologies is becoming increasingly common across the globe as they offer immense potential to enhance healthcare delivery by promoting accessibility, flexibility, and personalized care, connecting patients to healthcare professionals and offering more efficient services and treatments to remote residents. At the same time, there is an increasing recognition of how digital health can inadvertently foment psychological trauma. This phenomenon has led to the adoption of trauma-informed care in designing and deploying digital health technologies. However, how trauma-informed care is defined and/or characterized, and the various trauma-informed care strategies employed in designing and/or deploying digital health technologies remain unexplored. OBJECTIVE This scoping review aims to explore and synthesize the literature on how trauma-informed care is defined and characterized in digital health and the various trauma-informed care principles, strategies, or recommendations employed in designing and deploying digital health. METHODS This review will draw on the Joanna Briggs Institute’s updated methodological guidance for scoping reviews. A search will be conducted on CINAHL, PubMed, Embase, Compendex Engineering Village, Web of Science, Scopus, and PsycINFO. This review will consider published research studies and unpublished work (grey literature). Studies will be included if they applied trauma-informed care in designing or deploying digital health for patients across all geographical locations or provide trauma-informed recommendations on how web developers should develop digital health. Studies will be limited to publications within the last 10 years and studies in all languages will be considered. Two independent reviewers will screen the titles, abstracts, and then a full-text review. Data will be extracted into a data extraction tool developed for this study. RESULTS The scoping review was undergoing a full search as of February 2023. The main results will synthesize the peer-reviewed and grey literature on adopting trauma-informed care practices in digital health research and development. The study is expected to be completed by December 2023 and the results published in a peer-reviewed journal. CONCLUSIONS This review is expected to provide the knowledge base on the adoption of trauma-informed care in designing and deploying digital health. This knowledge can lead to a more engaging, and likely, more effective digital health interventions that has less potential for harm. A synthesis of the various trauma-informed care strategies in digital health will also provide a trauma-informed language by enabling researchers and digital health developers to consider trauma as a critical factor in each stage of the design process.

Background We recognized a paucity of accessible, evidence-based, empowering patient-centred resources for those with endometriosis-associated dyspareunia. We aimed to develop a patient-centred educational website for those affected by endometriosis-associated dyspareunia. Methods To develop a functional and meaningful website for endometriosis-associated dyspareunia, we utilized a Knowledge to Action framework, supplemented with a patient-centred research design and technology-enabled knowledge translation. Our patient partners influenced the direction and scope of the project, provided critical feedback throughout the development process, and approved website revisions prior to launch. The website was developed in five phases; 1) needs assessment interviews and focus groups with key stakeholders, 2) landscape analysis of pre-existing websites, 3) development, 4) usability testing, and qualitative interviews, and 5) revisions and launch. Results Phase 1 and 2 emphasized a need for comprehensive yet plain language explanations of pain mechanisms and strategies for pain management. Rigorous consultation with key stakeholders informed the creation of the preliminary website, which was tested in phase 4. User testing identified five main categories of usability problems, of which the majority were considered minor. Qualitative interviews identified users’ overall impressions of the preliminary website, including that the website could help people understand their pain and describe their pain to partners and healthcare providers, as well as feel empowered to seek healthcare and validated in their experiences. User suggestions, combined with usability testing informed revisions. Conclusion We developed an educational website for endometriosis-associated painful sex where people can find evidence-based etiologies for pain, pain management options, and actionable resources. Based on the data collected through qualitative interviews with patients, this website has the potential to empower people to seek health care. The strength of the website development approach used was the inclusion of qualitative user insights in addition to the commonly completed user tests. The patient interviews provided insights into the potential impact of the website and thus, ensured that we not only created a functional website that meets end users’ needs, but a website that is also meaningful to those affected by this condition.

Objective: To review the literature that has examined stigma in relation to the design, impact, and ways web apps can alleviate or aggravate sexual health-related stigma. Methods: Six databases wer...

User interface evaluation has become important in developing usable health care technologies. Although usability engineering methods have been applied in the design and evaluation of health care software, available heuristics focus on task-work aspects and do not address stigma associated with many health conditions. We used a previous set of heuristics and propose a new set of anti-stigma heuristics to evaluate stigmatization in health care websites. The extended set of heuristics were concurrently applied in a heuristic evaluation and a cognitive walkthrough to evaluate an endometriosis and sexual pain website. The walkthrough involved 5 tasks that required 21 actions to execute. Twenty-six usability problems were identified and recommendations for re-design were made to the design team before end-user testing. The anti-stigma heuristics received worse ratings than the traditional heuristics, resulting in several design changes that might otherwise have been missed. Thus, the new anti-stigma heuristics were a valuable contribution.

BACKGROUND Endometriosis is a chronic condition that affects approximately 10% of women worldwide. Despite its wide prevalence, knowledge of endometriosis symptoms, such as pelvic pain, and treatments remains relatively low. This not only leads to a trivialization of symptoms and delayed diagnosis but also fuels myths and misconceptions about pain symptoms. At the same time, the use of web-based platforms for information seeking is particularly common among people with conditions that are perceived as stigmatizing and difficult to discuss. The Sex, Pain, and Endometriosis website is an educational resource designed to provide evidence-based information on endometriosis and sexual pain to help people understand the condition, feel empowered, dispel myths, and destigmatize endometriosis-associated sexual pain. OBJECTIVE The study objective is to evaluate the usability of the website and assess for destigmatizing properties of sexual health–related web-based resources. METHODS We conducted a usability analysis by using a think-aloud observation, a postsystem usability questionnaire, and follow-up interviews with 12 women with endometriosis. The think-aloud data were analyzed using the framework by Kushniruk and Patel for analyzing usability video data, the questionnaire data were analyzed using descriptive statistics, and the follow-up interviews were analyzed using simple content analysis. We conducted a usability assessment by deductively analyzing the interview data via a trauma-informed care framework and a content analysis approach. RESULTS Through usability analysis, we found the website to be simple, uncluttered, satisfying, and easy to use. However, 30 minor usability problems related to navigation; website response; the comprehension of graphics, icons, and tabs; the understanding of content; and mismatch between the website and users’ expectations were reported. In our stigma analysis, we found the web content to be nonstigmatizing. The participants suggested ways in which websites could be designed to address stigma, including ensuring privacy, anonymity, inclusiveness, and factual and nonjudgmental content, as well as providing opportunities for web-based engagement. CONCLUSIONS Overall, the participants found the website to be useful, easy to use, and satisfying. The usability problems identified were largely minor and informed the website redesign process. In the context of the limited literature on stigma and website design, this paper offers useful strategies on how sexual health–related websites can be designed to be acceptable and less stigmatizing to individuals with sensitive health issues. CLINICALTRIAL

Background Endometriosis is a chronic condition that affects approximately 10% of women worldwide. Despite its wide prevalence, knowledge of endometriosis symptoms, such as pelvic pain, and treatments remains relatively low. This not only leads to a trivialization of symptoms and delayed diagnosis but also fuels myths and misconceptions about pain symptoms. At the same time, the use of web-based platforms for information seeking is particularly common among people with conditions that are perceived as stigmatizing and difficult to discuss. The Sex, Pain, and Endometriosis website is an educational resource designed to provide evidence-based information on endometriosis and sexual pain to help people understand the condition, feel empowered, dispel myths, and destigmatize endometriosis-associated sexual pain. Objective The study objective is to evaluate the usability of the website and assess for destigmatizing properties of sexual health–related web-based resources. Methods We conducted a usability analysis by using a think-aloud observation, a postsystem usability questionnaire, and follow-up interviews with 12 women with endometriosis. The think-aloud data were analyzed using the framework by Kushniruk and Patel for analyzing usability video data, the questionnaire data were analyzed using descriptive statistics, and the follow-up interviews were analyzed using simple content analysis. We conducted a usability assessment by deductively analyzing the interview data via a trauma-informed care framework and a content analysis approach. Results Through usability analysis, we found the website to be simple, uncluttered, satisfying, and easy to use. However, 30 minor usability problems related to navigation; website response; the comprehension of graphics, icons, and tabs; the understanding of content; and mismatch between the website and users’ expectations were reported. In our stigma analysis, we found the web content to be nonstigmatizing. The participants suggested ways in which websites could be designed to address stigma, including ensuring privacy, anonymity, inclusiveness, and factual and nonjudgmental content, as well as providing opportunities for web-based engagement. Conclusions Overall, the participants found the website to be useful, easy to use, and satisfying. The usability problems identified were largely minor and informed the website redesign process. In the context of the limited literature on stigma and website design, this paper offers useful strategies on how sexual health–related websites can be designed to be acceptable and less stigmatizing to individuals with sensitive health issues.

Background The internet has become an important source of health information among people across the globe. However, the novel coronavirus outbreak has led to a broader dissemination of fake and misleading health information. While health professionals may be able to critically evaluate internet-based information, the skills at finding, appraising, and using COVID-19-related online information may be problematic for laypeople in low-income countries. The purpose of this study was to examine the digital literacy of lay consumers of online COVID-19-related information in Ghana. Method A cross-sectional survey was conducted among online health consumers across five regions in Ghana. Participants were conveniently recruited through social media, and the survey was based on the eHealth Literacy Scale (eHeals) and administered through Qualtricsxm software. We calculated the overall mean eHeals score to determine the literacy levels and performed descriptive statistics to describe the characteristics of the sample. Linear regression analysis was performed to determine the factors associated with respondents' digital literacy. Result Out of 700 respondents sent with a survey link, 325 responded (46.4 % response rate). The majority of the respondents were: younger than 31 years (M = 28.42, SD = 6.98), males (59.7 %), use the internet daily (94.4 %), engaged in social media activities (65 %), and frequently search the internet for information related to COVID-19. The overall eHealth literacy was quite high (M = 4.01, SD = 0.95), but respondents' scores on items 1 and 6 were relatively low. Sex, age, frequently searching the internet for COVID-19 information, using the internet for educational purposes, and having a little/adequate knowledge of COVID-19 was predictive of digital literacy. Conclusion The study revealed a high overall digital literacy as well as sex and age differences in literacy levels among online health consumers in Ghana. However, respondents’ ability to locate COVID-19 related informaion and their skills in differentiating scientific from unscientific internet-based information remain relatively low. These findings offer useful insight that can inform the design of inclusive internet-based preventive resources that would be accessible and understandable to laypeople across all age groups and sexes in low-income countries.

Introduction Electronic Health Records are receiving considerable attention as a valuable tool for managing clinical information. Despite the prospects of Electronic Health Records in developing countries, many pre-implementation assessments target organizational, managerial, and infrastructural readiness, but barely include a detailed examination of health provider readiness. Meanwhile, health provider readiness is a critical success factor for electronic health records in settings where the majority of the workforce is less likely to have basic computer skills. We sought to assess the readiness of health providers for electronic health records in Ghana. Materials and method An institutional-based cross-sectional study was conducted among 350 health providers in northern Ghana from June-September 2019. Data were collected using a modified questionnaire on provider readiness. The mean overall readiness was calculated for each respondent. Providers with readiness score below the overall mean score were categorized as not being ready while those at or above the mean score were considered ready. Multiple linear regression was conducted to determine the factors that determine provider readiness. Results Two hundred and nine health providers responded to the questionnaire (59.7 response rate). The mean overall readiness was 3.61 (SD = .76), mean core readiness was 3.74 (SD = .80), and mean engagement readiness was 3.47 (SD = .67). Using the average overall readiness score as the cut-off for determining being ready and not ready for electronic health records, overall readiness was 54.9%, core readiness was 67.2%, while engagement readiness was 43.1%. Age, sex, old employees compared to new employees, computer literacy, and knowledge of electronic health records were significant determinants of health providers’ readiness to adopt electronic health records. Conclusion We observed that health providers were marginally ready for electronic health records adoption. While participants might have expressed dissatisfaction with paper-based records and expressed a desire for electronic health records, they expressed fear of the potential impact of computerized records. We proposed a robust informatics curriculum and capacity building workshops for improving provider readiness for electronic health records.