{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:09:11Z","timestamp":1760123351268,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian National Recovery and Resilience Plan (PNRR)","award":["352\/2022"],"award-info":[{"award-number":["352\/2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Computers"],"abstract":"<jats:p>Integrating blockchain into healthcare devices offers the potential for improved data control but faces significant usability and acceptance challenges. This study addresses this gap by evaluating CipherPal, an improved blockchain-enabled Smart Fidget Toy prototype, using a multi-framework approach to understand the interplay between technology, design, and user experience. We synthesized insights from three complementary frameworks: an expert review assessing adherence to Web3 Design Guidelines, a User Acceptance Toolkit assessment with professionals based on UTAUT2, and an extended three-day user testing study. The findings revealed that users valued CipherPal\u2019s satisfying tactile interaction and perceived benefits for well-being, such as stress relief. However, significant usability barriers emerged, primarily related to challenging device\u2013application connectivity and data synchronization. The multi-framework approach proved valuable in revealing these core tensions. While the device was conceptually accepted, the blockchain integration added significant interaction friction that overshadowed its potential benefits during the study. This research underscores the critical need for user-centered design in health-related blockchain applications, emphasizing that seamless usability and abstracting technical complexity are paramount for adoption.<\/jats:p>","DOI":"10.3390\/computers14080300","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T16:04:51Z","timestamp":1753286691000},"page":"300","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing Blockchain Health Devices: A Multi-Framework Method for Integrating Usability and User Acceptance"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4052-0285","authenticated-orcid":false,"given":"Polina","family":"Bobrova","sequence":"first","affiliation":[{"name":"Department of Design, Politecnico di Milano, Via Candiani 72, 20158 Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-8888","authenticated-orcid":false,"given":"Paolo","family":"Perego","sequence":"additional","affiliation":[{"name":"Department of Design, Politecnico di Milano, Via Candiani 72, 20158 Milan, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kumar, R., Marchang, N., and Tripathi, R. (2020, January 7\u201311). Distributed Off-Chain Storage of Patient Diagnostic Reports in Healthcare System Using IPFS and Blockchain. Proceedings of the 2020 International Conference on COMmunication Systems & NETworkS (COMSNETS), Bengaluru, India.","DOI":"10.1109\/COMSNETS48256.2020.9027313"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e18619","DOI":"10.2196\/18619","article-title":"The Current State of Research, Challenges, and Future Research Directions of Blockchain Technology in Patient Care: Systematic Review","volume":"22","author":"Durneva","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Mackey, T.K., Kuo, T.-T., Gummadi, B., Clauson, K.A., Church, G., Grishin, D., Obbad, K., Barkovich, R., and Palombini, M. (2019). \u2018Fit-for-Purpose?\u2019\u2014Challenges and Opportunities for Applications of Blockchain Technology in the Future of Healthcare. BMC Med., 17.","DOI":"10.1186\/s12916-019-1296-7"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Dwivedi, A.D., Srivastava, G., Dhar, S., and Singh, R. (2019). A Decentralized Privacy-Preserving Healthcare Blockchain for IoT. Sensors, 19.","DOI":"10.3390\/s19020326"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"8770","DOI":"10.1109\/JIOT.2019.2923525","article-title":"Healthchain: A Blockchain-Based Privacy Preserving Scheme for Large-Scale Health Data","volume":"6","author":"Xu","year":"2019","journal-title":"IEEE Internet Things J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3512","DOI":"10.1080\/00207543.2021.2013560","article-title":"Prioritizing Adoption Barriers of Platforms Based on Blockchain Technology from Balanced Scorecard Perspectives in Healthcare Industry: A Structural Approach","volume":"61","author":"Govindan","year":"2023","journal-title":"Int. J. Prod. Res."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Al-rawashdeh, M., Keikhosrokiani, P., Belaton, B., Alawida, M., and Zwiri, A. (2022). IoT Adoption and Application for Smart Healthcare: A Systematic Review. Sensors, 22.","DOI":"10.3390\/s22145377"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jnca.2019.02.027","article-title":"Blockchain in Healthcare Applications: Research Challenges and Opportunities","volume":"135","author":"McGhin","year":"2019","journal-title":"J. Netw. Comput. Appl."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"104040","DOI":"10.1016\/j.ijmedinf.2019.104040","article-title":"Blockchain in Healthcare and Health Sciences\u2014A Scoping Review","volume":"134","author":"Hasselgren","year":"2020","journal-title":"Int. J. Med. Inform."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"21196","DOI":"10.1109\/ACCESS.2020.2969881","article-title":"A Systematic Review of Blockchain in Healthcare: Frameworks, Prototypes, and Implementations","volume":"8","author":"Chukwu","year":"2020","journal-title":"IEEE Access"},{"key":"ref_11","first-page":"102407","article-title":"Blockchain-Based Electronic Healthcare Record System for Healthcare 4.0 Applications","volume":"50","author":"Tanwar","year":"2020","journal-title":"J. Inf. Secur. Appl."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bobrova, P., Perego, P., and Boiano, R. (2024). Design and Development of a Smart Fidget Toy Using Blockchain Technology to Improve Health Data Control. Sensors, 24.","DOI":"10.3390\/s24206582"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Bobrova, P., and Perego, P. (2025). The Development of User-Centric Design Guidelines for Web3 Applications: An Empirical Study. Computers, 14.","DOI":"10.3390\/computers14020046"},{"key":"ref_14","first-page":"657","article-title":"Designing Blockchain-Based Wearables for Health Monitoring","volume":"28","author":"Bobrova","year":"2025","journal-title":"Des. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"101966","DOI":"10.1016\/j.cose.2020.101966","article-title":"Applications of Blockchain in Ensuring the Security and Privacy of Electronic Health Record Systems: A Survey","volume":"97","author":"Shi","year":"2020","journal-title":"Comput. Secur."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4258\/hir.2019.25.1.51","article-title":"Blockchain Applications for Healthcare Data Management","volume":"25","author":"Dimitrov","year":"2019","journal-title":"Healthc. Inf. Res."},{"key":"ref_17","unstructured":"Dempsey, C., Wang, A., and Mart, J. (2025, March 28). A Simple Guide to the Web3 Stack. Available online: https:\/\/www.coinbase.com\/blog\/a-simple-guide-to-the-web3-stack."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"11475","DOI":"10.1007\/s00521-020-05519-w","article-title":"Blockchain for Healthcare Data Management: Opportunities, Challenges, and Future Recommendations","volume":"34","author":"Yaqoob","year":"2022","journal-title":"Neural Comput. Appl."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1109\/TEM.2020.3013507","article-title":"Technical, Temporal, and Spatial Research Challenges and Opportunities in Blockchain-Based Healthcare: A Systematic Literature Review","volume":"70","author":"Soltanisehat","year":"2023","journal-title":"IEEE Trans. Eng. Manag."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1093\/jamia\/ocae084","article-title":"Biomedical Blockchain with Practical Implementations and Quantitative Evaluations: A Systematic Review","volume":"31","author":"Lacson","year":"2024","journal-title":"J. Am. Med. Inform. Assoc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e003800","DOI":"10.1161\/CIRCOUTCOMES.117.003800","article-title":"Blockchain Technology: Blockchain Technology: Applications in Health Care","volume":"10","author":"Angraal","year":"2017","journal-title":"Circ. Cardiovasc. Qual. Outcomes"},{"key":"ref_22","unstructured":"(2025, March 28). 7 Heuristics for Web3 Interface Design. Available online: https:\/\/ethereum.org\/en\/developers\/docs\/design-and-ux\/heuristics-for-web3\/."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Froehlich, M., Waltenberger, F., Trotter, L., Alt, F., and Schmidt, A. (2022, January 13\u201317). Blockchain and Cryptocurrency in Human Computer Interaction: A Systematic Literature Review and Research Agenda. Proceedings of the 2022 ACM Designing Interactive Systems Conference, Online.","DOI":"10.1145\/3532106.3533478"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Bhuiyan, T., Rahman, M.M., and Ali, M.A. (2020). Examining Usability Issues in Blockchain-Based Cryptocurrency Wallets. Cyber Security and Computer Science, Springer International Publishing.","DOI":"10.1007\/978-3-030-52856-0"},{"key":"ref_25","unstructured":"Ahram, T. (2020). Improving the Blockchain User Experience\u2014An Approach to Address Blockchain Mass Adoption Issues from a Human-Centred Perspective. Advances in Artificial Intelligence, Software and Systems Engineering, Springer International Publishing."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"111","DOI":"10.3390\/blockchains1020008","article-title":"Web3: Exploring Decentralized Technologies and Applications for the Future of Empowerment and Ownership","volume":"1","author":"Lai","year":"2023","journal-title":"Blockchains"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"114182","DOI":"10.1016\/j.dss.2024.114182","article-title":"Designing Trust-Enabling Blockchain Systems for the Inter-Organizational Exchange of Capacity","volume":"179","author":"Schoormann","year":"2024","journal-title":"Decis. Support Syst."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1109\/TETC.2019.2949510","article-title":"Blockchain Mutability: Challenges and Proposed Solutions","volume":"9","author":"Politou","year":"2021","journal-title":"IEEE Trans. Emerg. Top. Comput."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gabrielli, S., Rizzi, S., Mayora, O., More, S., P\u00e9rez Baun, J.C., and Vandevelde, W. (2022). Multidimensional Study on Users\u2019 Evaluation of the KRAKEN Personal Data Sharing Platform. Appl. Sci., 12.","DOI":"10.3390\/app12073270"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Gan, W., Ye, Z., Wan, S., and Yu, P.S. (May, January 30). Web 3.0: The Future of Internet. Proceedings of the WWW \u201823 Companion: Proceedings of the ACM Web Conference 2023, Austin, TX, USA.","DOI":"10.1145\/3543873.3587583"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1287\/mnsc.35.8.982","article-title":"User Acceptance of Computer Technology: A Comparison of Two Theoretical Models","volume":"35","author":"Davis","year":"1989","journal-title":"Manag. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101320","DOI":"10.1016\/j.techsoc.2020.101320","article-title":"Accepting Financial Transactions Using Blockchain Technology and Cryptocurrency: A Customer Perspective Approach","volume":"62","author":"Albayati","year":"2020","journal-title":"Technol. Soc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4835896","DOI":"10.1155\/2023\/4835896","article-title":"Extending the Technology Acceptance Model: A New Perspective on the Adoption of Blockchain Technology","volume":"2023","author":"Chen","year":"2023","journal-title":"Hum. Behav. Emerg. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"425","DOI":"10.2307\/30036540","article-title":"User Acceptance of Information Technology: Toward a Unified View","volume":"27","author":"Venkatesh","year":"2003","journal-title":"MIS Q."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"157","DOI":"10.2307\/41410412","article-title":"Consumer Acceptance and Use of Information Technology: Extending the Unified Theory of Acceptance and Use of Technology","volume":"36","author":"Venkatesh","year":"2012","journal-title":"MIS Q."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s10586-020-03200-4","article-title":"Blockchain Technology in Supply Chain Management: An Empirical Study of the Factors Affecting User Adoption\/Acceptance","volume":"24","author":"Alazab","year":"2021","journal-title":"Clust. Comput"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"21","DOI":"10.25300\/MISQ\/2013\/37.1.02","article-title":"Bridging the Qualitative-Quantitative Divide: Guidelines for Conducting Mixed Methods Research in Information Systems","volume":"37","author":"Venkatesh","year":"2013","journal-title":"MIS Q."},{"key":"ref_38","unstructured":"Creswell, J.W., and Clark, V.L.P. (2018). Designing and Conducting Mixed Methods Research, SAGE Publications."},{"key":"ref_39","unstructured":"Bobrova, P., and Perego, P. (2025, June 10). Assessment of CipherPal\u2014User Acceptance Design Toolkit [PUBLIC]. Available online: https:\/\/www.figma.com\/file\/vFKydmKmPMupQ2J9Dc70My\/Assessment-of-CipherPal-%E2%80%93-User-Acceptance-Design-Toolkit-PUBLIC."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bobrova, P., and Perego, P. (2025, January 5\u20139). CipherPal: A Privacy-Preserving Smart Fidget Device for Mindful Data Collection and Storage. Proceedings of the Companion Publication of the 2025 ACM Designing Interactive Systems Conference, Funchal, Portugal.","DOI":"10.1145\/3715668.3735594"},{"key":"ref_41","unstructured":"(2024, November 06). Polygon PoS and Polygon zkEVM: New Testnets for Polygon Protocols. Available online: https:\/\/polygon.technology\/blog\/polygon-pos-and-polygon-zkevm-new-testnets-for-polygon-protocols."},{"key":"ref_42","unstructured":"Bobrova, P. (2025, June 10). Cipherpal v1.2-beta.0. Available online: https:\/\/github.com\/pbdes\/cipherpal."},{"key":"ref_43","unstructured":"Bobrova, P. (2025, June 10). Cipherpal-Device v1.2-beta.0. Available online: https:\/\/github.com\/pbdes\/cipherpal-device."},{"key":"ref_44","unstructured":"(2025, April 03). IPFS: Building Blocks for a Better Web. Available online: https:\/\/ipfs.tech."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Nielsen, J. (1994). Usability Inspection Methods, John Wiley & Sons.","DOI":"10.1145\/259963.260531"},{"key":"ref_46","unstructured":"(2024, July 12). Figma FigJam. Available online: https:\/\/www.figma.com\/figjam\/."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Nielsen, J., and Landauer, T.K. (1993, January 24\u201329). A Mathematical Model of the Finding of Usability Problems. Proceedings of the INTERACT \u201993 and CHI \u201993 Conference on Human Factors in Computing Systems, Amsterdam The Netherlands.","DOI":"10.1145\/169059.169166"},{"key":"ref_48","unstructured":"(2024, June 10). MetaMask Wallet. Available online: https:\/\/metamask.io."},{"key":"ref_49","unstructured":"(2025, April 03). Microsoft Clarity\u2014Free Heatmaps & Session Recordings. Available online: https:\/\/clarity.microsoft.com."}],"container-title":["Computers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-431X\/14\/8\/300\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:14:57Z","timestamp":1760033697000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-431X\/14\/8\/300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":49,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["computers14080300"],"URL":"https:\/\/doi.org\/10.3390\/computers14080300","relation":{},"ISSN":["2073-431X"],"issn-type":[{"type":"electronic","value":"2073-431X"}],"subject":[],"published":{"date-parts":[[2025,7,23]]}}}