Background The traditional informed consent (IC) process rarely emphasizes research participants’ comprehension of medical information, leaving them vulnerable to unknown risks and consequences associated with procedures or studies. Objective This paper explores how we evaluated the feasibility of a digital health tool called Virtual Multimedia Interactive Informed Consent (VIC) for advancing the IC process and compared the results with traditional paper-based methods of IC. Methods Using digital health and web-based coaching, we developed the VIC tool that uses multimedia and other digital features to improve the current IC process. The tool was developed on the basis of the user-centered design process and Mayer’s cognitive theory of multimedia learning. This study is a randomized controlled trial that compares the feasibility of VIC with standard paper consent to understand the impact of interactive digital consent. Participants were recruited from the Winchester Chest Clinic at Yale New Haven Hospital in New Haven, Connecticut, and healthy individuals were recruited from the community using fliers. In this coordinator-assisted trial, participants were randomized to complete the IC process using VIC on the iPad or with traditional paper consent. The study was conducted at the Winchester Chest Clinic, and the outcomes were self-assessed through coordinator-administered questionnaires. Results A total of 50 participants were recruited in the study (VIC, n=25; paper, n=25). The participants in both groups had high comprehension. VIC participants reported higher satisfaction, higher perceived ease of use, higher ability to complete the consent independently, and shorter perceived time to complete the consent process. Conclusions The use of dynamic, interactive audiovisual elements in VIC may improve participants’ satisfaction and facilitate the IC process. We believe that using VIC in an ongoing, real-world study rather than a hypothetical study improved the reliability of our findings, which demonstrates VIC’s potential to improve research participants’ comprehension and the overall process of IC. Trial Registration ClinicalTrials.gov NCT02537886; https://clinicaltrials.gov/ct2/show/NCT02537886

Background/Objectives A major barrier for society in overcoming elder mistreatment is an inability to accurately identify victims. There are several barriers to self‐reporting elder mistreatment, including fear of nursing home placement or losing autonomy or a caregiver. Existing strategies to identify elder mistreatment neglect to empower those who experience it with tools for self‐reporting. In this project, we developed and evaluated the usability of VOICES, a self‐administrated digital health tool that screens, educates, and motivates older adults to self‐report elder mistreatment. Design Cross‐sectional study with User‐Centered Design (UCD) approach. Setting Yale School of Medicine and the Agency on Aging of South‐Central Connecticut. Participants Thirty eight community‐dwelling and cognitively intact older adults aged 60 years and older, caregivers, clinicians, and social workers. Intervention A tablet‐based self‐administrated digital health tool that screens, educates, and motivates older adults to self‐report elder mistreatment. Measurements Qualitative and quantitative data were obtained from: (1) focus groups participants including: feedback from open‐ended discussion, demographics, and a post‐session survey; (2) usability evaluation including: demographics, usability measures, comfortability with technology, emotional state, and open‐ended feedback. Results Focus group participants (n = 24) generally favored using a tablet‐based tool to screen for elder mistreatment and expressed comfort answering questions on elder mistreatment using tablets. Usability evaluation participants (n = 14) overall scored VOICES a mean System Usability Scale (SUS) score of 86.6 (median = 88.8), higher than the benchmark SUS score of 68, indicating excellent ease of use. In addition, 93% stated that they would recommend the VOICES tool to others and 100% indicated understanding of VOICES' information and content. Conclusion Our findings show that older adults are capable, willing, and comfortable with using the innovative and self‐administrated digital tool for elder mistreatment screening. Our future plan is to conduct a feasibility study to evaluate the use of VOICES in identifying suspicion of mistreatment.

Research with individuals with disabilities has demonstrated the utility of intervention approaches to address toy play, also referred to as functional leisure engagement (FLE). Examples include prompting FLE, blocking stereotypy, and differentially reinforcing appropriate FLE with social or automatic (i.e., access to stereotypy) reinforcers. Backward chaining has yet to be evaluated, but may be useful for establishing more complex FLE. The current study employed a treatment package consisting of these components with three school-aged children with autism in a therapeutic classroom. Effects were evaluated during pretest and posttest sessions, which consisted of free access to toys in a novel setting. The percentage of session with FLE was evaluated using a multiple probe design across participants. Results showed all participants demonstrated an increase in FLE and two participants showed decreased stereotypy. Feasibility for classroom implementation is discussed.

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