The following pages provide the PRISMA 2009 Checklist for the paper. We note that the PRISMA website 1 states that it was designed with a focus on the reporting of reviews evaluating randomized trials. The website also states that it can be used as a basis for reporting systematic reviews of other types of research, and hence we have used it in this paper. However, the PRISMA focus on reviews of randomized trials means there are important clarification to note in regard to specific questions. Question 2: Part of question 2 refers to the registration of systematic reviews. We chose not to register the review in this paper as it is qualitative in nature and makes use of grounded theory methods. Question 5: This question again makes reference to advance registration of the study and its protocol. As noted above we did not register the study and protocol in a archival format. Question 13: This question focuses on quantitative measure and as such is not relevant to our qualitative review. Question 14: This question focuses on reviews where data synthesis is done using quantitative / statistical methods. We have answered 'Yes' to this question as our synthesis methods are described in the paper (see page 6). However we note that the methods applied are qualitative rather than quantitative.

Background Existing evidence supports the many benefits of physical activity (PA) in breast cancer survival. However, few breast cancer survivors adhere to the recommended levels of activity. A PA coaching app that provides personalized feedback, guidance, and motivation to the user might have the potential to engage these individuals in a more active lifestyle, in line with the general recommendations. To develop a successful tool, it is important to involve the end users in the design process and to make theoretically grounded design decisions. Objective This study aimed to execute the design process and early prototype evaluation of a personalized PA coaching app for posttreatment breast cancer survivors. In particular, the study explored a design combining behavioral theory and tailored coaching strategies. Methods The design process was led by a multidisciplinary team, including technical and health professionals, and involved input from a total of 22 survivors. The process comprised 3 stages. In stage 1, the literature was reviewed and 14 patients were interviewed to understand the needs and considerations of the target population toward PA apps. In stage 2, the global use case for the tool was defined, the features were ideated and refined based on theory, and a digital interactive prototype was created. In stage 3, the prototype went through usability testing with 8 patients and was subjected to quality and behavior change potential evaluations by 2 human-computer interaction experts. Results The design process has led to the conceptualization of a personalized coaching app for walking activities that addresses the needs of breast cancer survivors. The main features of the tool include a training plan and schedule, adaptive goal setting, real-time feedback and motivation during walking sessions, activity status through the day, activity history, weekly summary reports, and activity challenges. The system was designed to measure users’ cadence during walking, use this measure to infer their training zone, and provide real-time coaching to control the intensity of the walking sessions. The outcomes from user testing and expert evaluation of the digital prototype were very positive, with scores from the system usability scale, mobile app rating scale, and app behavior change scale of 95 out of 100, 4.6 out of 5, and 15 out of 21, respectively. Conclusions Implementing a user-centered design approach for the development and early evaluation of an app brings essential considerations to tailor the solution to the user’s needs and context. In addition, informing the design on behavioral and tailored coaching theories supports the conceptualization of the PA coaching system. This is critical for optimizing the usability, acceptability, and long-term effectiveness of the tool. After successful early in-laboratory testing, the app will be developed and evaluated in a pilot study in a real-world setting.

Following multimedia lectures in mainstream classrooms is challenging for deaf and hard-of-hearing (DHH) students, even when provided with accessibility services. Due to multiple visual sources of information (e.g. teacher, slides, interpreter), these students struggle to divide their attention among several simultaneous sources, which may result in missing important parts of the lecture; as a result, access to information is limited in comparison to their hearing peers, having a negative effect in their academic achievements. In this paper we propose a novel approach to improve classroom accessibility, which focuses on improving the delivery of multimedia lectures. We introduce SlidePacer, a tool that promotes coordination between instructors and sign language interpreters, creating a single instructional unit and synchronizing verbal and visual information sources. We conducted a user study with 60 participants on the effects of SlidePacer in terms of learning performance and gaze behaviors. Results show that SlidePacer is effective in providing increased access to multimedia information; however, we did not find significant improvements in learning performance. We finish by discussing our results and limitations of our user study, and suggest future research avenues that build on these insights.

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Background An acute cardiac incident is a life-changing event that often necessitates surgery. Although surgery has high success rates, rehabilitation, behavioral changes, and self-care are critical to long-term health. Recent systematic reviews have highlighted the potential of technology in this area; however, significant shortcomings have also been identified, particularly with regard to patient experience. Objective This study aims to improve future systems and to explore the experiences of cardiac patients during key phases after hospitalization: recuperation, initial rehabilitation, and long-term self-management. The key objective is to provide a holistic understanding of behavioral factors that impact people across these phases, understand how experiences evolve over time, and provide user-centered recommendations to improve the design of cardiac rehabilitation and self-management technologies. Methods Semistructured interviews were conducted with people who attended rehabilitation programs following hospitalization for acute cardiac events. Interviews were developed and data were analyzed via the Theoretical Domains Framework, a pragmatic framework that synthesizes prior theories of behavioral change. Results Three phases that arise posthospitalization were examined, namely, recuperation, rehabilitation, and long-term self-management. Through these phases, we describe the impact of key factors and important changes that occur in patients’ experiences over time, including the desire for and redefinition of normal life, the need for different types of formal and informal knowledge, the benefits of safe zoning and connectedness, and the need to recognize capability. The use of the Theoretical Domains Framework allows us to show how factors that influence behavior evolve over time and to identify potential sources of tension. Conclusions This study provides empirically grounded recommendations for the design of technology-mediated cardiac rehabilitation and self-management systems. Key recommendations include the use of technology to support a normal life, leveraging social influences to extend participants’ sense of normality, the use of technology to provide a safe zone, the need to support both emotional and physical well-being, and a focus on recognizing capability and providing recommendations that are positive and reinforce this capability.