{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:45:21Z","timestamp":1785545121420,"version":"3.56.0"},"reference-count":41,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Form Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Sex workers face an epidemic of violence around the world. However, violence against sex workers (VASW) is underreported, and sex workers hesitate to report to the police because they are frequently punished; therefore, an alternative for reporting is needed. Sex workers also face stigmatization from health care workers, further discouraging help-seeking behavior or reporting in health care facilities. Sex workers have been recipients of services from nongovernmental organizations, typically related to HIV and sexual transmission of infections, but violence remains underaddressed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to apply human-centered design methods to adapt ReportVASW for use in the Middle East and North Africa and to evaluate the usability of the prototype interface and identify opportunities for improvement.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Evaluation methods included cognitive walkthrough and System Usability Scale by 9 potential end users, and heuristic evaluation by 2 informatics professionals and 2 service providers.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n This study explores ways to improve the trilingual prototype of ReportVASW, with particular attention to ways to improve the data collection tool. Multiple methods identified multiple issues to address. Heuristic analysis revealed 2 serious issues to address, with scores over 2.5 out of 4 in the tool used. The most serious problems identified in heuristic analysis were related to language, particularly the Arabic version. Translation issues were addressed before end user testing. End users were enthusiastic about the idea of a mobile tool to document VASW, provided it led to change. They gave ReportVASW a System Usability Scale of 91.4, above the 68 considered good. Even as end users were enthusiastic, they offered suggestions for improvement.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Many opportunities to improve the interface were identified. Most changes are not overly complex, and the majority involve adapting the language used and improving the translation. Development of the trilingual ReportVASW data collection tool for the Middle East and North Africa region is worth pursuing.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/65210","type":"journal-article","created":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T03:52:11Z","timestamp":1742529131000},"page":"e65210-e65210","source":"Crossref","is-referenced-by-count":0,"title":["Designing and Evaluating a Prototype of a Trilingual Data Collection Tool for the Middle East and North Africa (MENA) Region to Collect Data About Violence Against Sex Workers: Multiple Methods Approach in User-Centered Design"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-5235","authenticated-orcid":false,"given":"Melissa","family":"Ditmore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3820-3018","authenticated-orcid":false,"given":"Amal","family":"El Karouaoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9083-0195","authenticated-orcid":false,"given":"Jose Fernando","family":"Florez-Arango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"issue":"3","key":"R1","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1136\/oemed-2020-106487","article-title":"Incidence and predictors of violence from clients, intimate partners and police in a prospective US-based cohort of women in sex work","volume":"78","author":"Decker","journal-title":"Occup Environ Med"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"e42","DOI":"10.2105\/AJPH.2014.301909","article-title":"A systematic review of the correlates of violence against sex workers","volume":"104","author":"Deering","journal-title":"Am J Public Health"},{"key":"R3","unstructured":"Population size estimation of key populations august 2013. National AIDS program of Sierra Leone. URL: https:\/\/www.nas.gov.sl\/publication\/140-population-size-estimation-of-key-populations-august-2013 [Accessed 05-07-2025]"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1080\/15240657.2014.877726","article-title":"\u201cCaught Between the Tiger and the Crocodile\u201d: Cambodian sex workers\u2019 experiences of structural and physical violence","volume":"15","author":"Ditmore","journal-title":"Stud Gend Sex"},{"key":"R5","unstructured":"Nawara Women\u2019s Network for the Middle East and North Africa. How sex work laws are implemented on the ground and their impact on sex workers: Morocco case study. Global Network of Sex Work Projects. URL: https:\/\/www.nswp.org\/country\/morocco [Accessed 05-07-2025]"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1080\/00918369.2022.2132578","article-title":"Police harassment and violence against transgender & gender diverse sex workers in the United States","volume":"71","author":"Stenersen","journal-title":"J Homosex"},{"issue":"S1","key":"R7","doi-asserted-by":"publisher","first-page":"S152","DOI":"10.2105\/AJPH.2019.305451","article-title":"Exposure to police and client violence among incarcerated female sex workers in Baltimore City, Maryland","volume":"110","author":"Fehrenbacher","journal-title":"Am J Public Health"},{"key":"R8","unstructured":"BC-wide \u201cbad date\u201d reporting system aims to improve sex worker safety. CBC News. URL: https:\/\/www.cbc.ca\/news\/canada\/british-columbia\/b-c-bad-date-database-sex-worker-safety-1.5897871 [Accessed 05-07-2025]"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1093\/her\/cyq087","article-title":"Who Is Helsinki?\u201d: sex workers recommend better communication in clinical trials","volume":"26","author":"Ditmore","journal-title":"Health Educ Rev"},{"issue":"21-22","key":"R10","doi-asserted-by":"publisher","first-page":"10383","DOI":"10.1177\/0886260519884694","article-title":"Cumulative violence and PTSD symptom severity among urban street-based female sex workers","volume":"36","author":"Park","journal-title":"J Interpers Violence"},{"key":"R11","doi-asserted-by":"crossref","unstructured":"Goldenberg SM Morgan Thomas R Forbes A Baral S , editors. Sex Work, Health, and Human Rights: Global Inequities, Challenges, and Opportunities for Action. Springer International Publishing; 2021. [doi: 10.1007\/978-3-030-64171-9]","DOI":"10.1007\/978-3-030-64171-9"},{"issue":"3","key":"R12","doi-asserted-by":"publisher","first-page":"2436","DOI":"10.1177\/15248380231214786","article-title":"Strategies and interventions used to prevent violence against sex workers in the United States: a scoping review using the social-ecological model","volume":"25","author":"Carr","journal-title":"Trauma Violence Abuse"},{"key":"R13","unstructured":"Ditmore M . Aye myanmar association\u2019s community-based intervention to combat violence against sex workers, 2017-2020. United Nations Trust Fund to End Violence Against Women, Asia Pacific Network of Sex Workers, and Aye Myanmar Association; 2020. URL: https:\/\/apnsw.info\/wp-content\/uploads\/2022\/09\/Evaluation-report.pdf [Accessed 01-08-2025]"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.2196\/27696","article-title":"A mobile intervention to link young female entertainment workers in Cambodia to health and gender-based violence services: randomized controlled trial","volume":"24","author":"Brody","journal-title":"J Med Internet Res"},{"key":"R15","unstructured":"SANAC sex worker program. Apple store. 2016. URL: https:\/\/apps.apple.com\/us\/app\/sanac-sex-worker-program\/id1173413049 [Accessed 05-07-2025]"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.2196\/53557","article-title":"User-centered design for designing and evaluating a prototype of a data collection tool to submit information about incidents of violence against sex workers: multiple methods approach","volume":"11","author":"Ditmore","journal-title":"JMIR Hum Factors"},{"key":"R17","unstructured":"Final strategic plan. Nawara Women\u2019s Network for the Middle East and North Africa; 2023."},{"issue":"10","key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/14990","article-title":"Use of human-centered design to improve implementation of evidence-based psychotherapies in low-resource communities: protocol for studies applying a framework to assess usability","volume":"8","author":"Lyon","journal-title":"JMIR Res Protoc"},{"issue":"5","key":"R19","doi-asserted-by":"publisher","DOI":"10.2196\/23809","article-title":"Integrating user-centered design and behavioral science to design a mobile intervention for obesity and binge eating: mixed methods analysis","volume":"5","author":"Graham","journal-title":"JMIR Form Res"},{"issue":"5","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/resprot.7084","article-title":"Development of a web-based health care intervention for patients with heart disease: lessons learned from a participatory design study","volume":"6","author":"Noergaard","journal-title":"JMIR Res Protoc"},{"issue":"7","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/17703","article-title":"Untold stories in user-centered design of mobile health: practical challenges and strategies learned from the design and evaluation of an app for older adults with heart failure","volume":"8","author":"Cornet","journal-title":"JMIR Mhealth Uhealth"},{"issue":"3","key":"R22","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1006\/ijhc.1994.1065","article-title":"Estimating the number of subjects needed for a thinking aloud test","volume":"41","author":"Nielsen","journal-title":"Int J Hum Comput Stud"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2016.02.002","article-title":"A user-centered model for designing consumer mobile health (mHealth) applications (apps)","volume":"60","author":"Schnall","journal-title":"J Biomed Inform"},{"issue":"3","key":"R24","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1097\/NCN.0b013e31819f7c7c","article-title":"User-centered design and interactive health technologies for patients","volume":"27","author":"De Vito Dabbs","journal-title":"Comput Inform Nurs"},{"key":"R25","unstructured":"10 usability heuristics for user interface design. Nielsen Norman Group. URL: https:\/\/www.nngroup.com\/articles\/ten-usability-heuristics\/ [Accessed 05-07-2025]"},{"key":"R26","doi-asserted-by":"publisher","DOI":"10.3233\/SHTI190753","article-title":"SIM-CIG: a serious game to practice and improve clinical guidelines adoption based on computer-interpretable guidelines","author":"Uribe-Ocampo","journal-title":"Stud Health Technol Inform"},{"issue":"6","key":"R27","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/j.jbi.2011.08.005","article-title":"TURF: toward a unified framework of EHR usability","volume":"44","author":"Zhang","journal-title":"J Biomed Inform"},{"key":"R28","unstructured":"Thukral J Ditmore MH . Revolving door. sex workers project. Sex Workers Project of the Urban Justice Center; 2003."},{"key":"R29","unstructured":"New Mexico (2009): Qualtrics. Qualtrics. 2020. URL: https:\/\/www.qualtrics.com [Accessed 05-07-2025]"},{"key":"R30","unstructured":"Ditmore MH Maternick A Zapert K . The road north: the role of gender, poverty and violence in trafficking from Mexico to the US. Urban Justice Center Sex Workers Project; 2012."},{"key":"R31","unstructured":"Brooke J . Usability. Digital.gov. URL: https:\/\/www.usability.gov\/how-to-and-tools\/methods\/system-usability-scale.html [Accessed 30-03-2023]"},{"issue":"20","key":"R32","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1080\/10447318.2020.1801173","article-title":"Multi-language toolkit for the system usability scale","volume":"36","author":"Gao","journal-title":"Int J Hum Comput Interact"},{"key":"R33","unstructured":"Ditmore M . Making international mechanisms work for MENA communities. Global Fund MENA Platform, ITPC MENA, Nawara Women\u2019s Network, UNDP; 2019. URL: https:\/\/nawara.org\/downloads\/2019\/report-gf-platform-november-2019-en.pdf [Accessed 01-08-2025]"},{"key":"R34","unstructured":"Al Rasheed A . Action plan on gender-based violence in sudan. UNDP; 2022."},{"issue":"6","key":"R35","doi-asserted-by":"publisher","DOI":"10.2196\/26085","article-title":"The use of information and communication technologies by sex workers to manage occupational health and safety: scoping review","volume":"23","author":"Bernier","journal-title":"J Med Internet Res"},{"key":"R36","unstructured":"Smart service provider\u2019s guide to ICT and sex work. Global Network of Sex Work Projects. 2017. URL: https:\/\/www.nswp.org\/resource\/nswp-smart-guides\/smart-service-providers-guide-ict-and-sex-work [Accessed 20-09-2024]"},{"issue":"1-2","key":"R37","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1080\/09718524.2017.1385318","article-title":"What\u2019s technology got to do with it? exploring the impact of mobile phones on female sex workers\u2019 lives and livelihood in India","volume":"21","author":"Panchanadeswaran","journal-title":"Gend Technol Dev"},{"key":"R38","volume":"2","author":"Kraidy","journal-title":"J Mass Commun"},{"issue":"2","key":"R39","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.5297","article-title":"Are text messages a feasible and acceptable way to reach female entertainment workers in Cambodia with health messages? a cross-sectional phone survey","volume":"4","author":"Brody","journal-title":"JMIR Mhealth Uhealth"},{"issue":"4","key":"R40","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1007\/s10508-015-0665-3","article-title":"Development and open pilot trial of an HIV-prevention intervention integrating mobile-phone technology for male sex workers in Chennai, India","volume":"46","author":"Thomas","journal-title":"Arch Sex Behav"},{"issue":"5","key":"R41","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1136\/sextrans-2015-052216","article-title":"\u201cIt\u2019s all in the message\u201d: the utility of personalised short message service (SMS) texts to remind patients at higher risk of STIs and HIV to reattend for testing-a repeat before and after study","volume":"92","author":"Nyatsanza","journal-title":"Sex Transm Infect"}],"container-title":["JMIR Formative Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e65210","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:29:52Z","timestamp":1785536992000},"score":1,"resource":{"primary":{"URL":"https:\/\/formative.jmir.org\/2025\/1\/e65210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":41,"URL":"https:\/\/doi.org\/10.2196\/65210","relation":{},"ISSN":["2561-326X"],"issn-type":[{"value":"2561-326X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,22]]},"article-number":"v9i3e65210"}}