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Background: This study concerns the collaboration between a hospital and three municipalities when it comes to allocation of municipal rehabilitation services. In order to make the transitions from the hospital to the municipal health service fast and effective, the professionals has started using electronic  messaging system This study examines how the electronic messaging systemaffected the collaboration between the hospital and the municipal health service. Methods: The researchers conducted group interviews with professionals at the hospital, at the municipal service offices and at the municipal rehabilitation clinic. There were totally 25 participants divided into 7 interviews. Results: The municipalities experienced that with the use of electronic messaging system, they got the information faster than earlier, and some of the content was more precise. Nevertheless, not all of the information was satisfactory. The municipalities experienced that the information lacked sufficient information about the patients functioning level, which they needed to know for decisions about what kind of rehabilitation service the patient should receive. The assessments that the hospital provided was not always satisfactorily explained, or connected to the service offers that the municipality provided. The municipalities therefore had little trust in the hospitals recommendations. After a while, all of the municipalities chose to have a professional of their own at the hospital, in order to meet the patients and professionals in in the hospital in cases where the information was insufficient. Discussion: The results from this study implies that the transfer of actual and accurate information from the hospital to the municipalities improves with the use of electronic messaging system. However, when it comes to professional assessments and judgements, there seems as though the electronic communication not always works optimally. A possible explanation is that the professional assessments often builds on some kind of implicit knowledge that can`t be disseminated in writing. This is a problem because it seems as the hospitals information is rooted in “cure” while the municipalities` information is rooted in “care”. Consequently, the municipality creates a stereotypic picture of the professionals at the hospital as a messenger of information that is not relevant to the situation. An assessment of what is sensible measures in a rehabilitation process is based on the patient's medical situation, motivation, wishes, and also the possibilities and limitations in the patient's environment. This becomes a wicked problem, a problem where there aren`t one possible solution, but through discussions between patient and professional one can come up with concrete suggestions. Theories about wicked problems recommends meetings and teams as arenas for such discussions. This is achievable first when the municipalities meets the patient and the professionals at the hospital. Lessons learned: Electronic medical record systems can improve the information exchange between the hospital and the municipalities, but in situations where one has to collaborate about the solution of wicked problems, it looks as though there still is a need for personal contact.

Declining response proportions in health surveys may lead to increased non-response bias. Multiple reminders are often used to increase response proportions, and, thus, we aimed to determine if the use of reminders decreased the magnitude of non-response bias among web-mode invited in the Danish National Health Survey 2023. In the Danish National Health Survey 2023, a national random sample of 23 467 individuals (aged ≥16 years) with residence in Denmark were invited by a secure electronic mail service. Invited individuals received up to five inquiries: (i) web invitation, (ii) web reminder, (iii) paper invitation including a questionnaire and a prepaid return envelope, (iv) paper reminder, and (v) paper reminder including a questionnaire and a prepaid return envelope. The cumulative response proportions after first-, second-, third-, fourth-, and fifth inquiries were 19.1%, 28.9%, 37.2%, 39.3%, and 42.0%, respectively. In general, third, fourth, and fifth mailing respondents were more often men, at younger ages, with non-Western backgrounds, and unmarried compared to first mailing respondents. Furthermore, third, fourth, and fifth mailing respondents were in general found to have less favorable health behavior than first mailing respondents, but also a lower prevalence of fair or poor self-rated health and long-standing health problems. In conlusion, reminders are an effective way to increase the response proportion. Furthermore, the use of reminders was found to decrease the magnitude of non-response bias; however, the decrease was small due to the low number of individuals responding after fourth and fifth inquiries.

Background Secure digital messaging is a two-way communication channel that gained ground in healthcare over the past decade. While a direct channel between patients and providers may support patients, professionals’ work pressure makes it imperative that patient–provider communication remains efficient. Thus far, there is little insight into how the use of digital messaging between outpatients and professionals varies across medical specialties and how professionals experience effects on their workload and patient empowerment. Methods We conducted a two-stage, cross-specialty study in a Dutch hospital. Stage one analyzed differences in outpatient clinics’ (n = 25) messaging frequencies over a 16-month period. In stage two, across seven outpatient clinics, purposively selected to maximize variation, we interviewed 15 professionals and coded these data for use types and professionals’ experiences, followed by a focus group to check the findings. Results While overall use increased, use frequencies varied across specialties from 228 to 31,319 over the 16-month period. The number of messages per patient ranged between 1 and 274. Eight patient-provider use types emerged: asking and answering administrative questions, asking and answering medical questions, medical updates, sending out information, enquiries about patient updates, and social updates. Most use types were experienced as partial substitutes for phone calls, emails, or both. Only social updates were seen to constitute a complementary form of patient-driven communication. Professionals experienced messaging as inefficient when synchronicity was required and for acute questions. For chronic patient streams of internal medicine specialties, higher frequencies and more use types were reported and greater usefulness was experienced than for surgical patient streams, which was unrelated to patient numbers. The interviewed professionals felt that messaging empowered patients but increased their workload. This increase depended on how messaging use was coordinated and patient expectations managed. Conclusions Professionals may welcome messaging for patient empowerment, but in our study did so less for substitution-based efficiency effects. In chronic care settings—where communication between patients and providers is seen as integral to care delivery—messaging may be valued despite the potential for increased workload. In contrast, in surgical settings, messaging may be viewed as an additional, non-reimbursable service rather than a core care component.

The increasing adoption of product recommendation agents (PRAs) by e-commerce merchants makes it an important area of study for information systems researchers. PRAs are a type of Web personalization technology that provides individual consumers with product recommendations based on their product-related needs and preferences expressed explicitly or implicitly. Whereas extant research mainly assumes that such recommendation technologies are designed to benefit consumers and focuses on the positive impact of PRAs on consumers’ decision quality and decision effort, this study represents an early effort to examine PRAs that are designed to produce their recommendations on the basis of benefiting e-commerce merchants (rather than benefiting consumers) and to investigate how the availability and the design of warning messages (a potential detection support mechanism) can enhance consumers’ performance in detecting such biased PRAs. Drawing on signal detection theory, the literature on warning messages, and the literature on message framing, we identified two content design characteristics of warning messages—the inclusion of risk-handling advice and the framing of risk-handling advice—and investigated how they influence consumers’ detection performance. The results of an online experiment reveal that a simple warning message without accompanying advice on how to detect bias is a double-edged sword, because it increases correct detection of biased PRAs ( hits ) at the cost of increased incorrect detection ( false alarms ). By contrast, including in warning messages risk-handling advice about how to check for bias (particularly when the advice is framed to emphasize the loss from not following the advice) increases correct detection and, more importantly, also decreases incorrect detection. The patterns of findings are in line with the predictions of signal detection theory. With an enriched understanding of how the availability and the content design of warning messages can assist consumers in the context of PRA-assisted online shopping, the results of this study serve as a basis for future theoretical development and yield valuable insights that can guide practice and the design of effective warning messages.

Advances in artificial intelligence algorithms and expansion of straightforward cloud-based platforms have enabled the adoption of conversational assistants by both, medium and large companies, to facilitate interaction between clients and employees. The interactions are possible through the use of ubiquitous devices (e.g., Amazon Echo, Apple HomePod, Google Nest), virtual assistants (e.g., Apple Siri, Google Assistant, Samsung Bixby, or Microsoft Cortana), chat windows on the corporate website, or social network applications (e.g. Facebook Messenger, Telegram, Slack, WeChat). Creating a useful, personalized conversational agent that is also robust and popular is nonetheless challenging work. It requires picking the right algorithm, framework, and/or communication channel, but perhaps more importantly, consideration of the specific task, user needs, environment, available training data, budget, and a thoughtful design. In this paper, we will consider the elements necessary to create a conversational agent for different types of users, environments, and tasks. The elements will account for the limited amount of data available for specific tasks within a company and for non-English languages. We are confident that we can provide a useful resource for the new practitioner developing an agent. We can point out novice problems/traps to avoid, create consciousness that the development of the technology is achievable despite comprehensive and significant challenges, and raise awareness about different ethical issues that may be associated with this technology. We have compiled our experience with deploying conversational systems for daily use in multicultural, multilingual, and intergenerational settings. Additionally, we will give insight on how to scale the proposed solutions.

Today, adolescents can easily make contact with strangers online. The present study examines the relation of online communication with strangers (OCS) and mild delinquency among junior high school students and explores which risk factors are associated with both types of behavior, taking gender differences into account. A total of 1873 Japanese adolescents (aged 12–15) with mobile phones completed online questionnaires assessing internet usage (duration, variability), parental behavior (violence, monitoring), and adolescent characteristics (depression, self-control) as potential predictors of OCS and mild delinquency. Sequential model testing revealed that the duration of internet usage was associated with both dependent variables, whereas its variability was associated with OCS alone. Self-control and parental violence predicted both outcome variables in girls, but only mild delinquency in boys. Depression was related with both behaviors in boys. Parental monitoring was negatively associated with OCS among girls and with mild delinquency among boys. Overall, OCS appeared to have a similar function for girls as mild delinquency did for boys. Implications for future studies and preventive programs will be discussed.

Research indicates that perceived trust affects both behavioral intention to use chatbots and service satisfaction provided by chatbots in customer service contexts. However, it remains unclear whether perceived propensity to trust impacts service satisfaction in this context. Thus, this research aims to explore how customers’ propensity to trust influences trusting beliefs and, subsequently, their satisfaction when using chatbots for customer service. Through purposive sampling, individuals in Hong Kong with prior experience using chatbots were selected to participate in a quantitative survey. The study employed Necessary Condition Analysis, Importance-Performance Map Analysis, and Partial Least Squares Structural Equation Modelling to examine factors influencing users’ trusting beliefs toward chatbots in customer service settings. Findings revealed that trust in chatbot interactions is significantly influenced by propensity to trust technology, social presence, perceived usefulness, and perceived ease of use. Consequently, these factors, along with trusting belief, also influence service satisfaction in this context. Thus, Social Presence, Perceived Ease of Use, Propensity to Trust, Perceived Usefulness, and Trusting Belief are found necessary. By combining Importance-Performance Map Analysis, priority managerial action areas were identified. This research extends the Technology Acceptance Model by incorporating social presence, propensity to trust technology, and trusting belief in the context of AI chatbot use for customer service.

Loneliness is an issue of public health significance. Longitudinal studies indicate that feelings of loneliness are prevalent and were exacerbated by the Coronavirus Disease 2019 (COVID-19) pandemic. With the advent of new media, more people are turning to social media platforms such as Twitter and Reddit as well as online forums, e.g., loneliness forums, to seek advice and solace regarding their health and well-being. The present study therefore aimed to investigate the public messaging on loneliness via an unsupervised machine learning analysis of posts made by organisations on Twitter. We specifically examined tweets put out by organisations (companies, agencies or common interest groups) as the public may view them as more credible information as opposed to individual opinions. A total of 68,345 unique tweets in English were posted by organisations on Twitter from 1 January 2012 to 1 September 2022. These tweets were extracted and analysed using unsupervised machine learning approaches. BERTopic, a topic modelling technique that leverages state-of-the-art natural language processing, was applied to generate interpretable topics around the public messaging of loneliness and highlight the key words in the topic descriptions. The topics and topic labels were then reviewed independently by all study investigators for thematic analysis. Four key themes were uncovered, namely, the experience of loneliness, people who experience loneliness, what exacerbates loneliness and what could alleviate loneliness. Notably, a significant proportion of the tweets centred on the impact of the COVID-19 pandemic on loneliness. While current online interactions are largely descriptive of the complex and multifaceted problem of loneliness, more targeted prosocial messaging appears to be lacking to combat the causes of loneliness brought up in public messaging.

Objective. This trial compared the effectiveness of a web-based only (WO) intervention with web-based supplemented by peer-led discussion (WD) or professional email counseling (WE) across 3 phases to achieve weight loss and weight maintenance in women from underserved rural communities. Methods. 301 women (BMI of 28–45 kg/m2) randomly assigned to groups participated in guided weight loss (baseline to 6 months), guided weight loss and maintenance (6 to 18 months), and self-managed weight maintenance (18 to 30 months). Results. Retention was 88.7%, 76.5%, and 71.8% at 6, 18, and 30 months, respectively. Intent-to-treat analyses demonstrated no group differences in change in weight within any phases. At 6 months, observed mean (SD) weight loss was 5.1 (6.0) kg in WO, 4.1 (5.6) kg in WD, and 6.0 (6.3) kg in WE, with 42%, 38%, and 51%, respectively, meeting ≥ 5% weight loss. These proportions dropped by a third after phase 2 with no further change during phase 3. Conclusion. Web-based interventions assisted women from rural communities in achieving 6-month weight loss, with weight regain by half at 30 months. No group differences were potentially due to the robust nature of the web-based intervention. Trial Registration. This trial is registered with ClinicalTrials.gov NCT01307644.