{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:44:08Z","timestamp":1785545048506,"version":"3.56.0"},"reference-count":70,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Skin neglected tropical diseases (NTDs) pose significant diagnostic and management challenges in resource-limited settings due to constrained dermatological expertise, frontline health worker (FHW) training, and limited access to diagnostic resources. Mobile health apps with artificial intelligence (AI)\u2013enabled diagnostic imaging capabilities have the potential to enhance clinical decision-making and professional development at the primary care level. The World Health Organization (WHO) skin NTD mobile app uses convolutional neural networks to analyze images of skin lesions and generate differential diagnoses, intended to be used alongside clinical history and examination, to support FHWs in identifying 12 skin NTDs and 24 common skin conditions. Beyond clinical decision support, the app also aims to upskill FHWs in the recognition and management of these diseases. However, the success of such tools depends on understanding users\u2019 needs and the realities of implementation in diverse clinical contexts.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to explore FHWs\u2019 perspectives on the real-world use and impact of the AI-embedded WHO Skin NTDs app on diagnostic workflows, dermatological understanding, clinical decision-making, and FHW-patient interactions across diverse health care delivery settings in Kenya.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This qualitative study involved 36 FHWs from 5 skin NTD-endemic counties in Kenya. Following a training workshop, FHWs integrated the app into routine clinical workflows from June to October 2024. Data were collected through 15 semistructured interviews (each 30\u201045 minutes) and 4 focus group discussions (1\u20101.5 hours) exploring FHW experiences across diverse health care delivery contexts. All sessions were audio-recorded, transcribed verbatim, and thematically analyzed using NVivo (QSR International), using a bottom-up inductive coding approach.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n FHWs reported that the app facilitated a shift from habitual referral to more proactive case management at the local-level facility, reinforcing clinical ownership and positioning them as local dermatology reference points. It was perceived to enhance diagnostic confidence, strengthen patient trust, and encourage community engagement. Some FHWs described how the app helped mitigate situations for patient stigma due to decreased reliance on public colleague consultations. However, technical limitations (eg, internet dependency and algorithmic errors) constrained consistent use. While most FHWs used the app in line with its intended role as an assistive tool, a minority reported situations of diagnostic deferral to the AI output, highlighting potential considerations of clinical autonomy.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The WHO Skin NTDs app shows strong potential to strengthen frontline dermatological capacity that aligns with WHO strategies to decentralize NTD care and promote \u201cskin health for all.\u201d Our findings underscore the importance of embedding such tools within ethical and pedagogical frameworks that protect clinical autonomy and foster sustainable capacity building. Further research will examine real-world use in situ to guide context-specific governance, ensuring that this AI-embedded tool enhances\u2014rather than displaces\u2014clinical reasoning and epistemic authority.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/81829","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T01:00:10Z","timestamp":1781571610000},"page":"e81829-e81829","source":"Crossref","is-referenced-by-count":0,"title":["Frontline Health Workers\u2019 Perspectives of the World Health Organization Skin Neglected Tropical Diseases App in Kenya: Qualitative Study on AI-Embedded mHealth Implementation"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1302-9059","authenticated-orcid":false,"given":"Emily E V","family":"Quilter","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7459-8621","authenticated-orcid":false,"given":"Ruth","family":"Nyangacha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8764-4620","authenticated-orcid":false,"given":"Esther","family":"Kinyeru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9128-9580","authenticated-orcid":false,"given":"A\u00efna","family":"Fuster Casanovas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7958-7881","authenticated-orcid":false,"given":"Amberly","family":"Brigden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8915-4572","authenticated-orcid":false,"given":"Kenton","family":"O'Hara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5011-8640","authenticated-orcid":false,"given":"Diana","family":"Atieno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-8358","authenticated-orcid":false,"given":"Jos\u00e9 A","family":"Ruiz-Postigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1479-7551","authenticated-orcid":false,"given":"Carme","family":"Carrion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"R1","unstructured":"Ending the neglect to attain the sustainable development goals: a road map for neglected tropical diseases 2021-2030. World Health Organization. URL: https:\/\/www.who.int\/publications\/i\/item\/9789240010352 [Accessed 03-09-2024]"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0011357","article-title":"A global call for action to tackle skin-related neglected tropical diseases (skin NTDs) through integration: an ambitious step change","volume":"17","author":"Yotsu","journal-title":"PLoS Negl Trop Dis"},{"issue":"9","key":"R3","doi-asserted-by":"publisher","first-page":"1755","DOI":"10.3201\/eid2809.212126","article-title":"Quantifying population burden and effectiveness of decentralized surveillance strategies for skin-presenting neglected tropical diseases, Liberia","volume":"28","author":"Timothy","journal-title":"Emerg Infect Dis"},{"issue":"8","key":"R4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012391","article-title":"The psychosocial impacts of skin-neglected tropical diseases (SNTDs) as perceived by the affected persons: a systematic review","volume":"18","author":"Alderton","journal-title":"PLoS Negl Trop Dis"},{"key":"R5","unstructured":"Recognizing neglected tropical diseases through changes on the skin: a training guide for frontline health workers. World Health Organization. URL: https:\/\/www.who.int\/publications\/i\/item\/9789241513531 [Accessed 18-09-2024]"},{"issue":"1","key":"R6","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1271-3","article-title":"The health stigma and discrimination framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas","volume":"17","author":"Stangl","journal-title":"BMC Med"},{"issue":"Suppl 1","key":"R7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-008317","article-title":"The health workforce status in the WHO African Region: findings of a cross-sectional study","volume":"7","author":"Ahmat","journal-title":"BMJ Glob Health"},{"issue":"3","key":"R8","doi-asserted-by":"publisher","first-page":"88","DOI":"10.3390\/tropicalmed3030088","article-title":"A teledermatology pilot programme for the management of skin diseases in primary health care centres: experiences from a resource-limited country (Mali, West Africa)","volume":"3","author":"Faye","journal-title":"Trop Med Infect Dis"},{"issue":"8","key":"R9","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1111\/tmi.12525","article-title":"Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review","volume":"20","author":"Agarwal","journal-title":"Trop Med Int Health"},{"key":"R10","unstructured":"Community health worker programmes in the WHO African region: evidence and options-policy brief. World Health Organization. URL: https:\/\/www.afro.who.int\/publications\/community-health-worker-programmes-who-african-region-policy-brief [Accessed 04-09-2024]"},{"key":"R11","unstructured":"WHO expert committee on leprosy: eighth report. World Health Organization. URL: https:\/\/iris.who.int\/items\/da598737-ff32-4d11-b679-e5033641cacd [Accessed 18-09-2024]"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3390\/tropicalmed4010004","article-title":"Skin-related neglected tropical diseases (skin NTDs)\u2014a new challenge","volume":"4","author":"Hay","journal-title":"Trop Med Infect Dis"},{"issue":"6","key":"R13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0009405","article-title":"Diagnosing point-of-care diagnostics for neglected tropical diseases","volume":"15","author":"Bharadwaj","journal-title":"PLoS Negl Trop Dis"},{"key":"R14","unstructured":"Seventy-eighth World Health Assembly\u2014 daily update: 24 May 2025. World Health Organization. URL: https:\/\/www.who.int\/news\/item\/24-05-2025-seventy-eighth-world-health-assembly---daily-update--24-may-2025 [Accessed 16-06-2025]"},{"issue":"1645","key":"R15","doi-asserted-by":"publisher","DOI":"10.1098\/rstb.2013.0434","article-title":"The contribution of mass drug administration to global health: past, present and future","volume":"369","author":"Webster","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1177\/20552076231198702","article-title":"The facilitators and barriers of mHealth adoption and use among people with a low socio-economic position: a scoping review","volume":"9","author":"Hengst","journal-title":"Digit Health"},{"key":"R17","unstructured":"WHO Global Observatory for eHealth. MHealth: new horizons for health through mobile technologies: second global survey on eHealth. World Health Organization; 2011. URL: https:\/\/iris.who.int\/handle\/10665\/44607 [Accessed 04-07-2026]"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.8873","article-title":"The impact of mHealth interventions: systematic review of systematic reviews","volume":"6","author":"Marcolino","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-022-00700-y","article-title":"Artificial intelligence for strengthening healthcare systems in low- and middle-income countries: a systematic scoping review","volume":"5","author":"Ciecierski-Holmes","journal-title":"NPJ Digit Med"},{"issue":"12","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/39393","article-title":"Assessing the quality of the World Health Organization\u2019s Skin NTDs App as a training tool in Ghana and Kenya: protocol for a cross-sectional study","volume":"11","author":"Frej","journal-title":"JMIR Res Protoc"},{"issue":"1","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/51628","article-title":"Evaluating the World Health Organization\u2019s SkinNTDs app as a training tool for skin neglected tropical diseases in Ghana and Kenya: cross-sectional study","volume":"26","author":"Cano","journal-title":"J Med Internet Res"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.47276\/lr.95.2.2024030","article-title":"The WHO Skin NTD mobile application \u2013 a paradigm shift in leprosy diagnosis through Artificial Intelligence?","volume":"95","author":"Quilter","journal-title":"LEPROSY"},{"issue":"7","key":"R23","doi-asserted-by":"publisher","first-page":"5439","DOI":"10.1007\/s00146-025-02276-z","article-title":"Developing professional ethical guidance for healthcare AI use (PEG-AI): an attitudinal survey pilot","volume":"40","author":"Smith","journal-title":"AI Soc"},{"key":"R24","unstructured":"Muga R Kizito P Mbayah MM Gakuruh T . Overview of the health system in Kenya. In: Kenya Service Provision Assessment Survey 2004. National Coordinating Agency for Population and Development, Ministry of Health (Nairobi, Kenya), ORC Macro; 2005. URL: https:\/\/dhsprogram.com\/pubs\/pdf\/spa8\/02chapter2.pdf [Accessed 04-07-2026]"},{"issue":"1","key":"R25","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-023-01131-x","article-title":"National prevalence and risk factors for tungiasis in Kenya","volume":"12","author":"Elson","journal-title":"Infect Dis Poverty"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227697","article-title":"Burden and risk factors of cutaneous leishmaniasis in a peri-urban settlement in Kenya, 2016","volume":"15","author":"Ngere","journal-title":"PLoS One"},{"issue":"2","key":"R27","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1080\/21501203.2023.2204112","article-title":"Burden of fungal infections in Kenya","volume":"14","author":"Ratemo","journal-title":"Mycology"},{"key":"R28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2024.04.011","article-title":"Skin care habits of patients with eczema at Kiambu Level 5 Hospital, Kiambu county, Kenya: a retrospective cross-sectional study","volume":"16","author":"Njenga","journal-title":"JAAD Int"},{"issue":"6","key":"R29","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated Criteria for Reporting Qualitative Research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"Tong","journal-title":"Int J Qual Health Care"},{"key":"R30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2026.03.043","article-title":"The World Health Organization skin neglected tropical diseases app: a dynamic capacity building training tool enhanced with artificial intelligence","author":"Serrano Pons","journal-title":"J Invest Dermatol"},{"issue":"6","key":"R31","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.1038\/jid.2013.446","article-title":"The global burden of skin disease in 2010: an analysis of the prevalence and impact of skin conditions","volume":"134","author":"Hay","journal-title":"J Invest Dermatol"},{"key":"R32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2024.108044","article-title":"Understanding skin color bias in deep learning-based skin lesion segmentation computer methods and programs in biomedicine","volume":"245","author":"Ben\u010devi\u0107","journal-title":"Comput Methods Programs Biomed"},{"issue":"2","key":"R33","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","journal-title":"Qual Res Psychol"},{"key":"R34","doi-asserted-by":"crossref","unstructured":"Barbrook-Johnson P Penn AS . Causal loop diagrams. In: Systems Mapping: How to Build and Use Causal Models of Systems. Springer; 2022. URL: https:\/\/link.springer.com\/book\/10.1007\/978-3-031-01919-7 [Accessed 26-06-2026] [doi: 10.1007\/978-3-031-01919-7]","DOI":"10.1007\/978-3-031-01919-7"},{"key":"R35","unstructured":"County statistical abstract Nakuru County. Kenya National Bureau of Statistics; 2015. URL: https:\/\/www.knbs.or.ke\/wp-content\/uploads\/2023\/09\/2015-County-Statistical-Abstracts-Nakuru.pdf [Accessed 23-06-2026]"},{"key":"R36","unstructured":"County statistical abstract Baringo County. Kenya National Bureau of Statistics; 2015. URL: https:\/\/www.knbs.or.ke\/wp-content\/uploads\/2023\/09\/2015-County-Statistical-Abstracts-Baringo.pdf [Accessed 23-06-2026]"},{"key":"R37","unstructured":"County statistical abstract Kajiado County. Kenya National Bureau of Statistics; 2015. URL: https:\/\/www.knbs.or.ke\/wp-content\/uploads\/2023\/09\/2015-County-Statistical-Abstracts-Kajiado.pdf [Accessed 23-06-2026]"},{"key":"R38","unstructured":"Statistical abstract 2021. Kenya National Bureau of Statistics; 2021. URL: https:\/\/www.knbs.or.ke\/wp-content\/uploads\/2023\/09\/2021-Statistical-Abstract.pdf [Accessed 23-06-2026]"},{"key":"R39","unstructured":"County statistical abstract Kwale County. Kenya National Bureau of Statistics; 2015. URL: https:\/\/www.knbs.or.ke\/wp-content\/uploads\/2023\/09\/2015-County-Statistical-Abstracts-Kwale.pdf [Accessed 23-06-2026]"},{"issue":"7","key":"R40","doi-asserted-by":"publisher","DOI":"10.2196\/19552","article-title":"Implementing mHealth interventions in a resource-constrained setting: case study from Uganda","volume":"8","author":"Meyer","journal-title":"JMIR Mhealth Uhealth"},{"key":"R41","doi-asserted-by":"crossref","unstructured":"Livingston J . Improvising Medicine. Duke University Press; 2013. [Accessed 09-07-2026] [doi: 10.1215\/9780822395768]","DOI":"10.1515\/9780822395768"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/HMR.0b013e31823ea9c7","article-title":"The role of improvising in patient care","volume":"38","author":"McKenna","journal-title":"Health Care Manage Rev"},{"key":"R43","doi-asserted-by":"publisher","DOI":"10.1016\/j.procs.2025.02.182","article-title":"WhatsApp as an improvisation of health information systems in Southern African public hospitals: a socio-technical perspective","volume":"256","author":"Kapepo","journal-title":"Procedia Comput Sci"},{"issue":"4","key":"R44","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1080\/20421338.2021.1899556","article-title":"Unintended consequences of technology-enabled work activities experienced by healthcare professionals in tertiary hospitals of sub-Saharan Africa","volume":"14","author":"Ogundaini","journal-title":"Afr J Sci Technol Innov Dev"},{"issue":"4","key":"R45","doi-asserted-by":"publisher","DOI":"10.2196\/26964","article-title":"Clinician preimplementation perspectives of a decision-support tool for the prediction of cardiac arrhythmia based on machine learning: near-live feasibility and qualitative study","volume":"8","author":"Matthiesen","journal-title":"JMIR Hum Factors"},{"issue":"1","key":"R46","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-023-00990-1","article-title":"AI-driven decision support systems and epistemic reliance: a qualitative study on obstetricians\u2019 and midwives\u2019 perspectives on integrating AI-driven CTG into clinical decision making","volume":"25","author":"Dlugatch","journal-title":"BMC Med Ethics"},{"issue":"2","key":"R47","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/0146-6402(78)90002-4","article-title":"Self-efficacy: toward a unifying theory of behavioral change","volume":"84","author":"Bandura","journal-title":"Pshycol Rev"},{"key":"R48","doi-asserted-by":"publisher","DOI":"10.1016\/j.glmedi.2024.100140","article-title":"From scalpels to algorithms: the risk of dependence on artificial intelligence in surgery","volume":"3","author":"Adegbesan","journal-title":"J Med Surg Public Health"},{"issue":"1","key":"R49","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1007\/s00146-025-02422-7","article-title":"Exploring automation bias in human\u2013AI collaboration: a review and implications for explainable AI","volume":"41","author":"Romeo","journal-title":"AI & Soc"},{"issue":"7","key":"R50","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1136\/medethics-2019-105935","article-title":"Limits of trust in medical AI","volume":"46","author":"Hatherley","journal-title":"J Med Ethics"},{"key":"R51","doi-asserted-by":"crossref","unstructured":"Jeon Y Hwang C Chen XA . Empowering medical data labeling for non-experts with DANNY: enhancing accuracy and mitigating over-reliance on AI. Presented at: Proceedings of the 30th International Conference on Intelligent User Interfaces; Mar 24-27, 2025:624-640; Cagliari, Italy. 2025.[doi: 10.1145\/3708359.3712161]","DOI":"10.1145\/3708359.3712161"},{"issue":"C","key":"R52","doi-asserted-by":"publisher","first-page":"108352","DOI":"10.1016\/j.chb.2024.108352","article-title":"Trust and reliance on AI \u2014 An experimental study on the extent and costs of overreliance on AI","volume":"160","author":"Klingbeil","journal-title":"Comput Human Behav"},{"issue":"CSCW2","key":"R53","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3610218","article-title":"Understanding the effect of counterfactual explanations on trust and reliance on AI for human-AI collaborative clinical decision making","volume":"7","author":"Lee","journal-title":"Proc ACM Hum-Comput Interact"},{"issue":"1","key":"R54","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12911-020-01332-6","article-title":"Explainability for artificial intelligence in healthcare: a multidisciplinary perspective","volume":"20","author":"Amann","journal-title":"BMC Med Inform Decis Mak"},{"key":"R55","unstructured":"Tonekaboni S Joshi S McCradden MD Goldenberg A . What clinicians want: contextualizing explainable machine learning for clinical end use. arXiv. Preprint posted online on May 13, 2019. [doi: 10.48550\/arXiv.1905.05134]"},{"issue":"21","key":"R56","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.1001\/jama.2018.17163","article-title":"Clinical decision support in the era of artificial intelligence","volume":"320","author":"Shortliffe","journal-title":"JAMA"},{"issue":"5","key":"R57","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1145\/3589953","article-title":"Framing machine learning opportunities for hypotension prediction in perioperative care: a socio-technical perspective","volume":"30","author":"Ghosh","journal-title":"ACM Trans Comput Hum Interact"},{"key":"R58","doi-asserted-by":"crossref","unstructured":"Zhang M Ehrmann D Mazwi M Eytan D Ghassemi M Chevalier F . Get to the point! Problem-based curated data views to augment care for critically ill patients. Presented at: Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems; Apr 29 to May 5, 2022:1-13; New Orleans, LA USA. Apr 29, 2022.[doi: 10.1145\/3491102.3501887]","DOI":"10.1145\/3491102.3501887"},{"key":"R59","doi-asserted-by":"crossref","unstructured":"Giles AK Pitonyak JS George-Paschal L Piernik-Yoder B Taff SD . Situated learning. In: Ikiugu M Taff SD Kantartzis S Pollard N , editors. Routledge Companion to Occupational Therapy: Theories, Concepts and Models. Routledge; 2025. [doi: 10.4324\/9781003526766]","DOI":"10.4324\/9781003526766-53"},{"key":"R60","doi-asserted-by":"crossref","unstructured":"Jeng YL Hong ML Lu HT . The development of the mobile situated learning application based on microlocation technology. Presented at: 2017 6th IIAI International Congress on Advanced Applied Informatics (IIAI-AAI); Jul 9-13, 2017; Hamamatsu, Shizuoka, Japan. [doi: 10.1109\/IIAI-AAI.2017.108]","DOI":"10.1109\/IIAI-AAI.2017.108"},{"issue":"3","key":"R61","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1080\/09687760903247666","article-title":"Situated learning in the mobile age: mobile devices on a field trip to the sea","volume":"17","author":"Pfeiffer","journal-title":"Res Learn Technol"},{"issue":"2","key":"R62","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1007\/s10459-019-09900-w","article-title":"Situated learning theory in health professions education research: a scoping review","volume":"25","author":"O\u2019Brien","journal-title":"Adv Health Sci Educ Theory Pract"},{"key":"R63","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1258","article-title":"Process evaluation of complex interventions: medical research council guidance","volume":"350","author":"Moore","journal-title":"BMJ"},{"issue":"2","key":"R64","doi-asserted-by":"publisher","first-page":"160","DOI":"10.9745\/GHSP-D-13-00031","article-title":"mHealth innovations as health system strengthening tools: 12 common applications and a visual framework","volume":"1","author":"Labrique","journal-title":"Glob Health Sci Pract"},{"issue":"4","key":"R65","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.7044","article-title":"A framework for the study of complex mHealth interventions in diverse cultural settings","volume":"5","author":"Maar","journal-title":"JMIR Mhealth Uhealth"},{"issue":"3","key":"R66","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed3030101","article-title":"The skin-a common pathway for integrating diagnosis and management of NTDs","volume":"3","author":"Chandler","journal-title":"Trop Med Infect Dis"},{"key":"R67","unstructured":"WHO academy. World Health Organization. URL: https:\/\/www.who.int\/about\/who-academy [Accessed 05-06-2025]"},{"key":"R68","doi-asserted-by":"crossref","unstructured":"Grimm P . Social desirability bias. Wiley International Encyclopedia of Marketing. Dec 15, 2010. URL: https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1002\/9781444316568.wiem02057 [Accessed 05-06-2025]","DOI":"10.1002\/9781444316568.wiem02057"},{"key":"R69","doi-asserted-by":"crossref","unstructured":"Mathieu C . Performance appraisal. In: Dark Personalities in the Workplace. Academic Press; 2021:71-96. ISBN: 978-0-12-815827-2","DOI":"10.1016\/B978-0-12-815827-2.00004-1"},{"issue":"3","key":"R70","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1080\/0305569900160305","article-title":"The Hawthorne Effect: a fresh examination","volume":"16","author":"Diaper","journal-title":"Educ Stud"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e81829","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:26:26Z","timestamp":1785536786000},"score":1,"resource":{"primary":{"URL":"https:\/\/mhealth.jmir.org\/2026\/1\/e81829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,14]]},"references-count":70,"URL":"https:\/\/doi.org\/10.2196\/81829","relation":{},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,14]]},"article-number":"v14i6e81829"}}