Talya Porat

Virtual Reality (VR) applications based on real-world contexts, such as training, healthcare, and entertainment, rely on varying degrees of replication of real settings. However, there is a lack of systematic design support for determining which elements of a setting to retain or modify. We propose Behavior Setting Map (BSM), a contextual analysis tool to help VR designers understand and transform real-world settings into virtual ones. In a two-stage study, we piloted and iterated BSM with 30 student designers and 24 individuals in the early stages of content design for real-world VR applications. The evaluation results provide empirical insights into participants’ perceptions of BSM, suggesting that the tool was perceived as easy to use and useful in supporting early-stage VR content design through a structured, guided, and visualized approach, accommodating designers with varying levels of experience. Additionally, we discuss the design opportunities and potentials of BSM in a wide range of Extended Reality applications.

BACKGROUND Self-measured blood pressure (SMBP) monitoring is a low-cost, scalable approach to hypertension management, yet adoption remains limited in rural, low-resource settings. Moving monitoring from clinics into homes redistributes tasks previously supported by healthcare professionals, clinical routines, infrastructure, and information systems. However, little is known about whether home settings provide the conditions needed to support these redistributed roles. OBJECTIVE This study examined how monitoring roles and responsibilities are redistributed as SMBP moves into homes and how their alignment with the home setting shapes adoption and continuation, taking rural Ghana as a case study. METHODS We conducted a 6-month longitudinal qualitative field study in two rural Ghanaian communities involving 42 participants: 29 patients, 10 health care professionals, and 3 community leaders. Data were generated through semi-structured interviews, in-situ observations, SMBP training, situated monitoring enactments, and longitudinal follow-up of 16 households at 1-2 weeks and approximately six months of home monitoring. Guided by Behaviour Settings Theory, we compared how roles, competencies, routines, materials, infrastructure, and care relationships were configured across clinical, community, and household settings and across six interdependent monitoring stages: initiation, measurement, logging, interpretation, sharing, and feedback. RESULTS Blood pressure monitoring was organised differently across settings. In clinical settings, monitoring was sustained by coordinated professional roles, established procedures, infrastructure, documentation systems, and direct pathways to interpretation and clinical response, while community settings retained partial support through local intermediaries. When SMBP moved into homes, these functions remained necessary, but responsibility for performing them became redistributed across patients, caregivers, household members, community actors, and health care professionals. Competencies were frequently distributed across multiple people rather than residing in one individual. Participants adapted monitoring through domestic routines, material improvisation, and informal collaboration, but these adaptations did not always compensate for missing competencies, infrastructure, or clinical connections. We conceptualise this mismatch between required monitoring roles and available setting conditions as Role–Setting Misalignment (RSM). Because monitoring stages were interdependent, misalignment at one stage could constrain subsequent stages, making the overall monitoring pathway fragile. CONCLUSIONS Moving blood pressure monitoring into homes redistributes health care work into settings that may not provide the conditions needed to perform it. Sustainable SMBP therefore requires moving beyond individual behaviour, device usability, and isolated contextual barriers to ensuring that redistributed monitoring roles are adequately supported and coordinated by the social, material, informational, procedural, and clinical conditions available across settings.

Interactive intelligent agents are being integrated across society. Despite achieving human-like capabilities, humans’ responses to these agents remain poorly understood, with research fragmented across disciplines. We conducted a systematic synthesis comparing a range of psychological and behavioural responses in matched human-agent vs. human-human dyadic interactions. A total of 162 eligible studies (146 contributed to the meta-analysis; 468 effect sizes) were included in the systematic review and meta-analysis, which integrated frequentist and Bayesian approaches. Our results indicate that individuals exhibited less prosocial behaviour and moral engagement when interacting with agents vs. humans. They attributed less agency and responsibility to agents, perceiving them as less competent, likeable, and socially present. In contrast, individuals’ social alignment (i.e., alignment or adaptation of internal states and behaviours with partners), trust in partners, personal agency, task performance, and interaction experiences were generally comparable when interacting with agents vs. humans. We observed high effect-size heterogeneity for many subjective responses (i.e., social perceptions of partners, subjective trust, and interaction experiences), suggesting context-dependency of partner effects. By examining the characteristics of studies, participants, partners, interaction scenarios, and response measures, we also identified several moderators shaping partner effects. Overall, functional behaviours and interaction experiences with agents can resemble those with humans, whereas fundamental social attributions and prosocial/moral concerns lag in human-agent interactions. Agents are thus afforded instrumental value on par with humans but lack comparable intrinsic value, providing implications for the development of interactive intelligent agents.

BACKGROUND Patient values play a central role in shaping health-related decisions, yet existing evidence on the breadth, structure, and operationalization of these values remains fragmented. Prior reviews have typically focused on specific conditions, populations, or isolated value constructs, limiting understanding of how patient values are conceptualized and applied across diverse health care decision-making contexts. In addition, there is a lack of integrative, cross-context frameworks that systematically organize patient values to inform research and practice. OBJECTIVE This umbrella review aims to systematically synthesize how patient values have been defined, operationalized, and reported across existing review literature, and to develop a foundational, integrative, and theoretically informed framework of patient values relevant to health decision-making across healthcare settings. METHODS The umbrella review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Three databases (EMBASE, PubMed, and Web of Science) were searched for reviews that examined patient values in relation to health decisions. The Joanna Briggs Institute’s (JBI) critical appraisal tool was applied to assess the quality of included reviews. A mixed synthesis approach combined deductive mapping to established value theories with inductive thematic analysis of extracted value constructs, followed by a best-fit framework synthesis to integrate and interpret the findings. RESULTS A total of 41 reviews were included, spanning diverse patient groups and healthcare contexts. We synthesized 27 value-related themes into 11 higher-order patient values, forming a comprehensive cross-context framework of patient values in healthcare decisions. Key values, such as informed empowerment, treatment feasibility, trust, relational obligations, and cultural or traditional beliefs, were consistently present across conditions and settings. Importantly, this review also identified patient value domains that are largely absent from prior syntheses, including interpersonal dignity and sense of certainty, revealing critical blind spots in how patient values have been conceptualized to date. The resulting framework provides both conceptual clarity and practical relevance for researchers, clinicians, policy makers, and decision-support interventions. CONCLUSIONS This umbrella review is the first to systematically synthesize patient values across diverse healthcare contexts. The resulting initial framework expands prior conceptualizations of patient values and identifies domains not previously captured in condition-specific or fragmented syntheses. These findings offer a robust foundation for operationalizing patient values in decision-making research, value-sensitive design, shared decision-making, patient-centered care initiatives, and digital health and AI-enabled clinical decision support systems. Future work should validate this framework across cultural groups and decision contexts and explore how specific value profiles influence engagement with health information and choices. CLINICALTRIAL PROSPERO (CRD420261279805)

Background: There is increasing recognition of the challenge of representativeness in data, including economic, social, and ethnic diversity, in biological mental health research. This is a particular challenge in adolescence, where brain and body development are impacted by environment. The first step in addressing this is understanding the scale of the challenge. As such, this scoping review aims to explore existing literature to identify and understand the needs, barriers, and facilitators in collecting biological data in adolescent mental health research. Methods: A systematic search identified papers recruiting participants aged 11-18, collecting biological data, and focusing on mental health/related psychopathology. Screening was performed in duplicate, and data charting was iterative. Results: The initial search identified 11,896 papers. After removal of duplicates and screening exclusions, 814 papers were included; 754 were explored for recruitment, retention, and engagement. Sample sizes <99 were most common (53%), and health settings (36%) were the most frequent recruitment source. As labels for ‘barriers’, ‘facilitators’, and ‘needs’ were rarely used, information on recruitment, retention, and engagement (e.g., strategies for stakeholder engagement) were explored as a proxy. Only 9% of papers reported engagement strategies; fewer evaluated their efficacy. Less than half (48%) reported retention data, with reasons for lost data mostly relating to the nature of the data collection. Conclusions: Papers do not adequately report the methods used to ensure sufficient collection of representative data. Limited reporting challenges whether or not facilitators are being implemented. Advancing the field requires detailed guidelines. We present recommendations that serve as a first step towards this development.

This study is among the first to investigate how national origin cues influence visual attention and perception in HPV vaccine advertisements, using eye-tracking technology to provide objective insights into consumer responses. By integrating methods from public health, psychology, and advertising research, this study explores how visual attention is shaped by national affiliation cues. In a controlled experimental setting with a sample of 40 UK university students, we investigated visual attention and effectiveness of HPV vaccination advertisements by comparing ads disclosing the national origin of the vaccine and without any origin information. We assessed total fixation duration and time to first fixation to various elements of the ad, along with intention and attitude measures. Contrary to one of our hypotheses, we did not find significant differences in intention (p = .758) and attitude (p = .620) measures. However, there was significant difference in total fixation duration toward one of the ad images between conditions (p = .043). The qualitative analysis reveals the role of country-of-origin (COO) in HPV vaccination advertising, suggesting a shift in attention from that image to the COO cue. Furthermore, eight out of the 20 participants in the treatment condition did not fixate at the COO cue. Findings provide critical insights for public health communication strategies, suggesting that the use (or omission) of national origin cues in vaccine advertisements could influence vaccine perception and hesitancy. These results highlight the need for strategic messaging approaches to enhance HPV vaccine acceptance and improve public trust in domestic and international vaccines.