Information Technology Research and Innovation, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, United States.
Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH, United States.
Front Public Health. 2022 Mar 3;10:849322. doi: 10.3389/fpubh.2022.849322. eCollection 2022.
About 23% of households in the United States have at least one child who has special healthcare needs. As most care activities occur at home, there is often a disconnect and lack of communication between families, home care nurses, and healthcare providers. Digital health technologies may help bridge this gap.
We conducted a pre-post study with a voice-enabled medical note taking (diary) app (SpeakHealth) in a real world setting with caregivers (parents, family members) of children with special healthcare needs (CSHCN) to understand feasibility of voice interaction and automatic speech recognition (ASR) for medical note taking at home.
In total, 41 parents of CSHCN were recruited. Participants completed a pre-study survey collecting demographic details, technology and care management preferences. Out of 41, 24 participants completed the study, using the app for 2 weeks and completing an exit survey. The app facilitated caregiver note-taking using voice interaction and ASR. An exit survey was conducted to collect feedback on technology adoption and changes in technology preferences in care management. We assessed the feasibility of the app by descriptively analyzing survey responses and user data following the key focus areas of acceptability, demand, implementation and integration, adaptation and expansion. In addition, perceived effectiveness of the app was assessed by comparing perceived changes in mobile app preferences among participants. In addition, the voice data, notes, and transcriptions were descriptively analyzed for understanding the feasibility of the app.
The majority of the recruited parents were 35-44 years old (22, 53.7%), part of a two-parent household (30, 73.2%), white (37, 90.2%), had more than one child (31, 75.6%), lived in Ohio (37, 90.2%), used mobile health apps, mobile note taking apps or calendar apps (28, 68.3%) and patient portal apps (22, 53.7%) to track symptoms and health events at home. Caregivers had experience with voice technology as well (32, 78%). Among those completed the post-study survey (in Likert Scale 1-5), ~80% of the caregivers agreed or strongly agreed that using the app would enhance their performance in completing tasks (perceived usefulness; mean = 3.4, SD = 0.8), the app is free of effort (perceived ease of use; mean = 3.2, SD = 0.9), and they would use the app in the future (behavioral intention; mean = 3.1, SD = 0.9). In total, 88 voice interactive patient notes were generated with the majority of the voice recordings being less than 20 s in length (66%). Most noted symptoms and conditions, medications, treatment and therapies, and patient behaviors. More than half of the caregivers reported that voice interaction with the app and using transcribed notes positively changed their preference of technology to use and methods for tracking symptoms and health events at home.
Our findings suggested that voice interaction and ASR use in mobile apps are feasible and effective in keeping track of symptoms and health events at home. Future work is suggested toward using integrated and intelligent systems with voice interactions with broader populations.
美国约有 23%的家庭至少有一名有特殊医疗需求的儿童。由于大多数护理活动都在家中进行，因此家庭、家庭护理护士和医疗服务提供者之间经常存在脱节和缺乏沟通。数字健康技术可能有助于弥合这一差距。
我们在真实环境中对有特殊医疗需求儿童（CSHCN）的护理人员（父母、家庭成员）进行了一项具有语音功能的医疗记录（日记）应用程序（SpeakHealth）的预-后研究，以了解在家中使用语音交互和自动语音识别（ASR）进行医疗记录的可行性。
共有 41 名 CSHCN 的父母参与了研究。参与者完成了一项预研究调查，收集人口统计详细信息、技术和护理管理偏好。在 41 名参与者中，有 24 名完成了研究，使用该应用程序 2 周，并完成了退出调查。该应用程序通过语音交互和 ASR 促进了护理人员的记录。退出调查旨在收集有关技术采用和护理管理中技术偏好变化的反馈。我们通过描述性分析调查结果和用户数据来评估应用程序的可行性，重点关注可接受性、需求、实施和整合、适应和扩展等关键领域。此外，通过比较参与者对移动应用偏好的感知变化来评估应用程序的有效性。此外，还对语音数据、笔记和转录本进行了描述性分析，以了解应用程序的可行性。
大多数招募的父母年龄在 35-44 岁（22 人，53.7%），来自双亲家庭（30 人，73.2%），是白人（37 人，90.2%），有不止一个孩子（31 人，75.6%），居住在俄亥俄州（37 人，90.2%），使用移动健康应用程序、移动笔记应用程序或日历应用程序（28 人，68.3%）和患者门户应用程序（22 人，53.7%）在家中跟踪症状和健康事件。护理人员也有语音技术方面的经验（32 人，78%）。在完成后测调查的参与者中（李克特量表 1-5 分），约 80%的护理人员同意或强烈同意使用该应用程序将增强他们完成任务的能力（感知有用性；均值=3.4，标准差=0.8），该应用程序毫不费力（感知易用性；均值=3.2，标准差=0.9），他们将来会使用该应用程序（行为意向；均值=3.1，标准差=0.9）。总共生成了 88 条语音交互患者记录，其中大多数语音记录的长度不到 20 秒（66%）。记录了大多数症状和疾病、药物、治疗和疗法以及患者行为。超过一半的护理人员报告说，应用程序的语音交互和使用转录笔记改变了他们在家中跟踪症状和健康事件的技术偏好和方法。
我们的研究结果表明，移动应用程序中的语音交互和 ASR 使用是可行且有效的，可以在家中跟踪症状和健康事件。建议进一步开展针对更广泛人群的具有语音交互和智能系统的工作。
