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Auger C, Guay C, Pysklywec A, Bier N, Demers L, Miller WC, Gélinas-Bronsard D, Ahmed S. What's behind the Dashboard? Intervention Mapping of a Mobility Outcomes Monitoring System for Rehabilitation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13303. [PMID: 36293885 PMCID: PMC9602496 DOI: 10.3390/ijerph192013303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Training and follow-up for older adults who received new assistive technology can improve device use adoption and function, but there is a lack of systematic and coordinated services. To address this gap, the Internet-based MOvIT+™ was designed to provide remote monitoring and support for assistive technology users and their caregivers. This paper presents the intervention mapping approach that was used. In step 1, we established a project governance structure and a logic model emerged from interviews with stakeholders and a systematic review of literature. In step 2, a modified TRIAGE consensus process led to the prioritization of thirty-six intervention components. In step 3, we created use cases for all intervention end users. In step 4, the intervention interface was created through iterative lab testing, and we gathered training resources. In step 5, a two-stage implementation plan was devised with the recruited rehabilitation sites. In step 6, we proposed an evaluation protocol. This detailed account of the development of MOvIT+™ demonstrates how the combined use of an intervention mapping approach and participatory processes with end users can help linking evidence-based, user-centered, and pragmatic reasoning. It makes visible the complexities behind the development of Internet-based interventions, while guiding future program developers.
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Affiliation(s)
- Claudine Auger
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Cassioppée Guay
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Alex Pysklywec
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Nathalie Bier
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - Louise Demers
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W5, Canada
| | - William C. Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Dominique Gélinas-Bronsard
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
| | - Sara Ahmed
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC H3S 1M9, Canada
- School of Physical and Occupational Therapy, McGill University, Montréal, QC H3A 0G4, Canada
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The Use Intention of Hospital Report Cards among Patients in the Presence or Absence of Patient-Reported Outcomes. Health Policy 2022; 126:541-548. [DOI: 10.1016/j.healthpol.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/14/2022] [Accepted: 03/26/2022] [Indexed: 11/17/2022]
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Hentati A, Forsell E, Ljótsson B, Lindefors N, Kraepelien M. A self-guided and monitored digital problem-solving intervention for patients with symptoms of depression or anxiety on the waiting list for treatment in routine psychiatric care: feasibility study. BJPsych Open 2022; 8:e43. [PMID: 35130998 PMCID: PMC8867893 DOI: 10.1192/bjo.2022.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND There is often a waiting period for people who seek psychiatric treatment for depression or anxiety. As this delay risks worsening symptoms, an alternative could be to provide an intervention that requires minimal resources during the waiting period. AIMS The aim was to investigate if a digital problem-solving intervention delivered in a self-guided format with automated features is feasible to provide for patients on the waiting list in routine psychiatric care. METHOD A total of 12 patients with symptoms of depression or anxiety on the waiting list for treatment in routine psychiatric care were given access to a self-guided and monitored digital problem-solving intervention over 4 weeks. Primary outcome measures were treatment credibility and usability. Secondary outcome measures were behavioural engagement, symptoms of depression and anxiety, and negative effects. RESULTS A majority of participants rated the intervention as both credible and usable. The intervention was used at least once by nine out of 12 individuals, with an average of 11 logins. The participants did, on average, initiate 2.8 problem-solving attempts and 10.1 solutions. A few participants reached a clinically relevant symptom improvement of depression and anxiety. No serious negative effects were reported. CONCLUSIONS The credibility and usability of the intervention was perceived as good, and the behavioural engagement with the intervention was deemed sufficient compared with similar self-guided interventions. A self-guided and monitored digital problem-solving intervention may be a beneficial option for patients waiting for or receiving treatment in routine psychiatric care, and should be further evaluated.
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Affiliation(s)
- Amira Hentati
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Erik Forsell
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Nils Lindefors
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Martin Kraepelien
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden; and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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Kip H, Keizer J, da Silva MC, Beerlage-de Jong N, Köhle N, Kelders SM. Methods for Human-Centered eHealth Development: Narrative Scoping Review. J Med Internet Res 2022; 24:e31858. [PMID: 35084359 PMCID: PMC8832261 DOI: 10.2196/31858] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/29/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022] Open
Abstract
Background Thorough holistic development of eHealth can contribute to a good fit among the technology, its users, and the context. However, despite the availability of frameworks, not much is known about specific research activities for different aims, phases, and settings. This results in researchers having to reinvent the wheel. Consequently, there is a need to synthesize existing knowledge on research activities for participatory eHealth development processes. Objective The 3 main goals of this review are to create an overview of the development strategies used in studies based on the CeHRes (Center for eHealth Research) Roadmap, create an overview of the goals for which these methods can be used, and provide insight into the lessons learned about these methods. Methods We included eHealth development studies that were based on the phases and/or principles of the CeHRes Roadmap. This framework was selected because of its focus on participatory, iterative eHealth design in context and to limit the scope of this review. Data were extracted about the type of strategy used, rationale for using the strategy, research questions, and reported information on lessons learned. The most frequently mentioned lessons learned were summarized using a narrative, inductive approach. Results In the included 160 papers, a distinction was made between overarching development methods (n=10) and products (n=7). Methods are used to gather new data, whereas products can be used to synthesize previously collected data and support the collection of new data. The identified methods were focus groups, interviews, questionnaires, usability tests, literature studies, desk research, log data analyses, card sorting, Delphi studies, and experience sampling. The identified products were prototypes, requirements, stakeholder maps, values, behavior change strategies, personas, and business models. Examples of how these methods and products were applied in the development process and information about lessons learned were provided. Conclusions This study shows that there is a plethora of methods and products that can be used at different points in the development process and in different settings. To do justice to the complexity of eHealth development, it seems that multiple strategies should be combined. In addition, we found no evidence for an optimal single step-by-step approach to develop eHealth. Rather, researchers need to select the most suitable research methods for their research objectives, the context in which data are collected, and the characteristics of the participants. This study serves as a first step toward creating a toolkit to support researchers in applying the CeHRes Roadmap to practice. In this way, they can shape the most suitable and efficient eHealth development process.
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Affiliation(s)
- Hanneke Kip
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Department of Research, Transfore, Deventer, Netherlands
| | - Julia Keizer
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Marcia C da Silva
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Nienke Beerlage-de Jong
- Department of Health Technology & Services Research, University of Twente, Enschede, Netherlands
| | - Nadine Köhle
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Saskia M Kelders
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands.,Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
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de Looper M, Smets EMA, Schouten BC, Bolle S, Belgers EHJ, Eddes EH, Leijtens JWA, van Weert JCM. The Patient Navigator: Can a systematically developed online health information tool improve patient participation and outcomes related to the consultation in older patients newly diagnosed with colorectal cancer? BMC Cancer 2022; 22:109. [PMID: 35078438 PMCID: PMC8788912 DOI: 10.1186/s12885-021-09096-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 09/23/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Older cancer patients may search for health information online to prepare for their consultations. However, seeking information online can have negative effects, for instance increased anxiety due to finding incorrect or unclear information. In addition, existing online cancer information is not necessarily adapted to the needs of older patients, even though cancer is a disease often found in older individuals. OBJECTIVE The aim of this study was to systematically develop, implement and evaluate an online health information tool for older cancer patients, the Patient Navigator, providing information that complements the consultation with healthcare providers. METHOD For the development and evaluation of the Patient Navigator, the four phases of the MRC framework were used. In the first and second phase the Patient Navigator was developed and pilot tested based on previous research and sub-studies. During the third phase the Patient Navigator was implemented in four Dutch hospitals. In the last phase, a pilot RCT was conducted to evaluate the Patient Navigator in terms of usage (observational tracking data), user experience (self-reported satisfaction, involvement, cognitive load, active control, perceived relevance of the tool), patient participation (observational data during consultation), and patient outcomes related to the consultation (questionnaire data regarding anxiety, satisfaction, and information recall). Recently diagnosed colorectal cancer patients (N = 45) were randomly assigned to the control condition (usual care) or the experimental condition (usual care + Patient Navigator). RESULTS The Patient Navigator was well used and evaluated positively. Patients who received the Patient Navigator contributed less during the consultation by using less words than patients in the control condition and experienced less anxiety two days after the consultation than patients in the control condition. CONCLUSION Since the Patient Navigator was evaluated positively and decreased anxiety after the consultation, this tool is potentially a valuable addition to the consultation for patients. Usage of the Patient Navigator resulted in patients using less words during consultations, without impairing patients' satisfaction, possibly because information needs might be fulfilled by usage of the Patient Navigator. This could create the possibility to personalize communication during consultations and respond to other patient needs.
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Affiliation(s)
- Melanie de Looper
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, 1018, Amsterdam, WV, Netherlands.
| | - Ellen M A Smets
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Barbara C Schouten
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, 1018, Amsterdam, WV, Netherlands
| | - Sifra Bolle
- Centre for Health and Society, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Eric H Eddes
- Department of Surgery, Deventer Hospital, Deventer, The Netherlands
- Dutch Institute of Clinical Auditing, Leiden, The Netherlands
| | | | - Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR, University of Amsterdam, 1018, Amsterdam, WV, Netherlands
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Hentati A, Forsell E, Ljótsson B, Kaldo V, Lindefors N, Kraepelien M. The effect of user interface on treatment engagement in a self-guided digital problem-solving intervention: A randomized controlled trial. Internet Interv 2021; 26:100448. [PMID: 34471610 PMCID: PMC8387893 DOI: 10.1016/j.invent.2021.100448] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/11/2021] [Accepted: 08/17/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Resources are spent worldwide on the development of digital platforms and their user interfaces (UIs) for digital mental health services (DMHS). However, studies investigating the potential benefits of different UIs for DMHS are currently lacking. To fill this knowledge gap, the aim of this study was to investigate differences in treatment engagement between two different UIs for DMHS. METHODS A total of 397 participants from the Swedish general public were randomized (1:1) to use a self-guided digital problem-solving intervention during one week, either with an optimized UI (N = 198), based on user experience (UX) design principles and with automated features, or a basic UI (N = 199), analogous with a UI used in Swedish regular health care comprising elementary UI features and less automation. Primary outcome measures were self-rated usability, on the System Usability Scale, and treatment credibility, on the Credibility/Expectancy Questionnaire. Secondary outcome measures included behavioral engagement with the intervention. FINDINGS There were no significant differences between the UIs in ratings of usability or treatment credibility. However, participants who used the optimized UI were significantly more engaged with the intervention as measured by usage of the intervention at least once (odds ratio 2.54, 95% CI [1.67, 3.85]), total number of generated solutions (mean difference 1.41, 95% CI [0.72, 2.11]), and mean number of generated solutions per initiated problem-solving attempt (mean difference 1.45, 95% CI [1.06, 1.85]). Other findings included participants using the optimized UI rating the intervention as easier to understand, while feeling more overwhelmed, than those using the basic UI. INTERPRETATION Our findings indicate that an optimized UI based on UX design principles, in comparison to a basic UI comprising elementary UI features, do not affect overall self-rated usability or treatment credibility but increases some measures of behavioral engagement with a digital intervention. FUNDING Funded by the Government of Sweden, Ministry of Health and Social Affairs.
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Affiliation(s)
- Amira Hentati
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Corresponding author at: Center for Psychiatry Research, Norra Stationsgatan 69, 113 64 Stockholm, Sweden.
| | - Erik Forsell
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Viktor Kaldo
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Nils Lindefors
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Martin Kraepelien
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Gartrell K, Han K, Trinkoff A, Cho H. Three-factor structure of the eHealth Literacy Scale and its relationship with nurses' health-promoting behaviours and performance quality. J Adv Nurs 2021; 76:2522-2530. [PMID: 33463741 DOI: 10.1111/jan.14490] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/02/2020] [Accepted: 06/19/2020] [Indexed: 12/19/2022]
Abstract
AIMS To examine the factorial validity of the eHealth Literacy Scale among hospital nurses and to investigate the associations of its components with health-promoting behaviours and nursing performance quality. DESIGN This cross-sectional study used survey data of 484 Korean hospital nurses, which were collected between March-May 2016. METHODS The three-factor structure was tested using confirmatory factor analyses. Multiple linear regression was conducted to test associations of the three components' scores with health-promoting behaviours and self-rated nursing performance quality. RESULTS The eHealth Literacy Scale supported a three-factor structure: awareness of internet health resources (awareness), having skills needed to access resources (skills), and the ability to evaluate the quality of internet health resources (evaluation). All the three components were significantly associated with higher quality of nursing performance and better interpersonal relations. Stress management, spiritual growth, and health responsibility were linked with evaluation or skills but physical activity and nutrition were not. CONCLUSION Strategies to enhance eHealth literacy among nurses could improve nurses' health and further patient care. Training to build nurses' self-efficacy to evaluate internet health information could improve eHealth literacy and should be developed and examined. IMPACT To improve nurses' health and patient care, training programs to build nurses' self-efficacy to access and evaluate internet health information should be developed.
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Affiliation(s)
| | - Kihye Han
- Chung-Ang University College of Nursing, Seoul, Republic of Korea
| | - Alison Trinkoff
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Hyeonmi Cho
- University of Wisconsin-Madison School of Nursing, Madison, WI, USA
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Wangler J, Stachwitz P, Jansky M. [Can a National Health Portal Support Primary Care? - A Survey of General Practitioners]. DAS GESUNDHEITSWESEN 2020; 83:596-603. [PMID: 32610356 PMCID: PMC8426037 DOI: 10.1055/a-1195-2312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Hintergrund
Das Bundesministerium für Gesundheit (BMG) plant
die Einrichtung eines unabhängigen nationalen Gesundheitsportals,
das evidenzbasierte Gesundheitsinformationen zur Verfügung stellen
soll. Eine wünschenswerte Eigenschaft soll darin bestehen,
Ärzte bei ihrer informierenden und beratenden Tätigkeit zu
unterstützen. Gerade Hausärzte, die mit einer großen
Bandbreite an Symptomen, Erkrankungen und Patienten zu tun haben,
könnten hiervon profitieren. In Kooperation mit dem health
innovation hub (hih) des BMG wurde ein Forschungsprojekt initiiert, bei dem
hausärztliche Positionen, Bedürfnisse und Anforderungen mit
Blick auf ein nationales Gesundheitsportal ermittelt wurden.
Methoden
Auf Basis einer qualitativen Vorstudie wurden Anfang 2020
insgesamt 745 Hausärzte in Rheinland-Pfalz und im Saarland
schriftlich befragt. Neben der deskriptiven Analyse kam zur Feststellung von
signifikanten Unterschieden zwischen 2 Gruppen ein T-Test bei
unabhängigen Stichproben zum Einsatz.
Ergebnisse
Hausärzte artikulieren einen Bedarf nach einem
nationalen Gesundheitsportal. 54% stehen diesem positiv
gegenüber; 49% sehen große
Unterstützungspotenziale. Angeführt wird v. a. eine
Entlastung bei ärztlicher Beratung (68%), eine Optimierung
der Arzt-Patient-Kommunikation (56%), eine Stabilisierung von
ängstlichen Patienten (42%) und eine bessere
‚Schulung‘ im Umgang mit dem Gesundheitssystem
(41%). Zudem sollen Versorgungssettings längerfristig
stabilisiert werden (38%). Wichtig ist den Befragten ein
Präventionsschwerpunkt (91%) und eine symptomorientierte
Darstellung (62%). Für einen Teil ist vorstellbar,
über eine solche Plattform Informationen für ihre Patienten
zusammenzustellen (45%) und den Austausch mit Fachkollegen zu suchen
(44%).
Schlussfolgerung
Allgemeinärzte sehen in der Schaffung eines
nationalen Gesundheitsportals klare Chancen für eine bessere
Information und Beratung von Patienten. Dabei sollte das Portal so
ausgestaltet werden, dass zum einen leitlinienkonforme,
verständliche Informationen symptomorientiert vermittelt werden, zum
anderen das Arzt-Patient-Verhältnis unterstützt und die
Orientierung im Gesundheitswesen verbessert wird. Offene Fragen bleiben,
z. B. mit Blick auf die Sicherstellung einer ausreichenden
Auffindbarkeit des Portals.
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Affiliation(s)
- Julian Wangler
- Zentrum für Allgemeinmedizin und Geriatrie, Universitätsmedizin Mainz, Mainz
| | | | - Michael Jansky
- Abteilung Allgemeinmedizin, Universitätsmedizin Mainz, Mainz
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Branscum P, Patricio-Agosto N. How Children Search for Health Information Online: An Observational Study. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2020; 52:522-527. [PMID: 32389242 DOI: 10.1016/j.jneb.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To evaluate whether children could find the correct answers to obesity-related health questions on the Internet and observe the search strategies children use when searching for such information. METHODS Twenty-five parent-child dyads, from a southwestern US summer day camp, participated in this cross-sectional study. Parents' health literacy skills were evaluated. Children searched the Internet for 6 questions related to nutrition and physical activity. Search activities were recorded via Camtasia. Quantitative (ie, time spent per question) and qualitative data (ie, themes related to difficulties searching) were extracted by rewatching the recordings. RESULTS All parents had either proficient or basic levels of health literacy. The question that had the highest rating for being correctly answered pertained to physical activity recommendations, whereas none of the children were able to find recommended servings of food groups. CONCLUSIONS AND IMPLICATIONS Children were not successful in finding correct answers to most of the questions and used ineffective search strategies. Interventions that teach children effective search strategies for health information are needed.
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Affiliation(s)
- Paul Branscum
- Department of Kinesiology and Health, Miami University, Oxford, OH.
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Wiegers TA, Hendriks M, Malanda U, de Boer D. Users' Experiences With Web-Based Health Care Information: Qualitative Study About Diabetes and Dementia Information Presented on a Governmental Website. J Med Internet Res 2019; 21:e11340. [PMID: 31287066 PMCID: PMC6643759 DOI: 10.2196/11340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/29/2019] [Accepted: 04/07/2019] [Indexed: 01/17/2023] Open
Abstract
Background Information on health and health care is abundant on the internet. To make informed choices, patients need reliable and easy-to-understand information about quality and availability of care providers and treatment options. However, the reliability of such Web-based information is difficult to assess. Objective This study aimed to test Web-based information about diabetes and dementia and specifically a new presentation format of care routes to see if people are able to understand and use the information. Methods Overall, 38 cognitive interviews were held; 20 people viewed the information about diabetes and 18 viewed the dementia information. Participants were asked what they would want to know about either diabetes or dementia, what choices they would want to make concerning their preferred care provider and treatment, and what information they would like to find to make these choices. They were then asked to view the relevant pages and comment on them. The interview was focused on general information about the condition, the care route, and the quality information for choosing a hospital. The interviews were transcribed verbatim and then systematically coded and ordered into themes. Results The themes that were developed for both Web pages during the analysis were information needs, findability, usability, comprehension and readability, recognizability, care route, quality information, and usefulness. Information needs were found to be very diverse and dependent on the personal situation and condition of the participant. Several participants were unable to find specific items because they were not where they expected them to be. Most participants were positive about the layout, font, and color scheme of the test pages. However, options of clicking through to another website and indications where information can be expanded and collapsed could be made clearer. Participants generally found the information easy to understand but felt a need for a more detailed explanation of the medical terms. Recognition of the information played an important role: participants assessed whether the information they found matched their experiences. The term care route meant little to most of the participants, but the layout of the care route itself was found to be clear. Not many respondents spontaneously went to the quality information, and a number of participants had difficulty understanding it. Overall, the participants thought the information on the website was useful and helpful. Conclusions The cognitive interviews gave numerous insights into how Web-based information is processed and understood. The care route offers a clear overview of the various stages as the condition progresses, but the name care route is not clear to everyone. We gained insight into differences between subgroups of people in terms of information needs, comprehension, and use of the information because the diversity within the group of participants was lower than expected.
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Hewitt J, Pennington A, Smith A, Gething S, Price M, White J, Dewar R, Carter B. A multi-centre, UK-based, non-inferiority randomised controlled trial of 4 follow-up assessment methods in stroke survivors. BMC Med 2019; 17:111. [PMID: 31262317 PMCID: PMC6604353 DOI: 10.1186/s12916-019-1350-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 05/24/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Recovery following a stroke is a long and ongoing process. Post-stroke follow-up after leaving the hospital is recommended. Methods for follow-up patients include face-to-face, via the telephone, post or online (internet). However, there is a debate which method is preferred by patients. This study aimed to determine whether telephone interview, online questionnaire and postal questionnaire were as acceptable as face-to-face follow-up. METHODS In a blinded, UK-wide, multi-centre, Zelen's designed, 4-arm (postal, online, telephone, compared to face-to-face), pragmatic non-inferiority randomised controlled trial of the mode of administration, stroke survivors were randomised to postal, online, telephone and face-to-face assessment, in an equal ratio (1:1:1:1). The primary outcome was the proportion of participants that responded to the three allocation groups, compared to the face-to-face group. Subgroup analyses for age, aphasia and type and severity of stroke were carried out. A non-inferiority margin of 0.025 was used, and Holm-Bonferroni multiplicity adjustment was made. RESULTS Of the 2074 eligible patients randomised, 55% were male (1142/2074), with an average age of 73.0 years old (SD = 13.2). Of those randomised, 22% (116/525), 9% (47/515) and 20% (101/513) responded in postal, online and telephone, respectively, compared to 17% (89/521) in the face-to-face group. The reduction in the online response rate compared to face-to-face was found to be both inferior and not non-inferior and estimated as an 8% reduction (95% CI 3.9 to 12.0%; p < 0.001). The association with lower online completion was present regardless of age, stroke type (haemorrhage or infarct) and stroke severity. In haemorrhagic stroke, the reduction in response online, compared to face-to-face, was 21% (95% CI 10 to 32%; p value = 0.002). A secondary analysis found non-aphasic stroke survivors preferred postal completion adjusted odds ratio of 1.43 (95% CI 1.04 to 1.95; p = 0.026). CONCLUSIONS The study found that fewer stroke survivors completed follow-up assessment using an online method, compared to face-to-face. This finding was present in all age groups. Caution should be employed when considering online follow-up methods in stroke survivors, particularly in those who have experienced a cerebrovascular haemorrhage. TRIALS REGISTRATION ClinicalTrials.gov, NCT03177161 . Registered on 6 June 2017.
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Affiliation(s)
- Jonathan Hewitt
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK.
| | - Anna Pennington
- Aneurin Bevan University Health Board, Newport, South Wales, UK
| | - Alexander Smith
- Aneurin Bevan University Health Board, Newport, South Wales, UK
| | | | | | - James White
- Prince Charles Hospital, Cwm Taf NHS Trust, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT, UK
| | - Richard Dewar
- Prince Charles Hospital, Cwm Taf NHS Trust, Prince Charles Hospital, Merthyr Tydfil, CF47 9DT, UK
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Huhta AM, Hirvonen N, Huotari ML. Health Literacy in Web-Based Health Information Environments: Systematic Review of Concepts, Definitions, and Operationalization for Measurement. J Med Internet Res 2018; 20:e10273. [PMID: 30567690 PMCID: PMC6315258 DOI: 10.2196/10273] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 09/07/2018] [Accepted: 09/25/2018] [Indexed: 12/20/2022] Open
Abstract
Background Health literacy research seems to lack a consensus on what aspects to include into literacy in the context of health and on how to operationalize these concepts for measurement purposes. In addition to health literacy, several other concepts, such as electronic health (eHealth) literacy and mental health literacy, have been developed across disciplines. This study examines how these different concepts are used when studying health-related competencies in Web contexts. Objective This study systematically reviews health literacy concepts and definitions and their operationalization in studies focused on Web-based health information environments. Methods A systematic literature search was conducted in April 2016 in 6 electronic databases with a limitation to articles in English published between January 2011 and April 2016. Altogether, 1289 unique records were identified and screened according to the predefined inclusion criteria: (1) original, peer-reviewed research articles written in English; (2) the topic of the article concerned literacy in the context of health; (3) informants of the study were lay people, not health professionals or students of the field; and (4) the focus of the study was placed on an Web-based information environment. In total, 180 full texts were screened, of which 68 were included in the review. The studies were analyzed with an emphasis on the used health literacy concepts and measures. Results On the basis of the included studies, several concepts are in use when studying health-related literacy in Web environments, eHealth literacy and health literacy being the most common ones. The reviewed studies represent a variety of disciplines, but mostly medical sciences. Typically, quantitative research methods are used. On the basis of the definitions for health literacy, 3 thematic categories were identified: general and skill-based, multidimensional, and domain-specific health literacy. Most studies adopted a domain-specific concept, followed by the ones that used a general and skill-based concept. Multidimensional concepts occurred least frequently. The general health literacy concepts were usually operationalized with reading comprehension measures, the domain-specific concepts with self-efficacy measures, and multidimensional concepts with several types of measures. However, inconsistencies in operationalization were identified. Conclusions The results show that in studies conducted in Web-based information environments, several different health literacy concepts are in use, and there is no clear consensus on the definitions for these concepts. Future studies should place emphasis on the conceptual development of health literacy in Web contexts to gain better results on operationalization for measurement. Researchers are encouraged to provide clear operational definitions for the concepts they use to ensure transparency in reporting.
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Affiliation(s)
- Anna-Maija Huhta
- Department of Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Noora Hirvonen
- Department of Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Information Studies, Faculty of Social Sciences, Business and Economics, Åbo Akademi University, Turku, Finland
| | - Maija-Leena Huotari
- Department of Information Studies, Faculty of Humanities, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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13
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Andrenucci A, Dalianis H, Velupillai S. Knowledge patterns for online health portal development. Health Informatics J 2018; 25:1779-1799. [PMID: 30232926 DOI: 10.1177/1460458218796601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the development and evaluation of a set of knowledge patterns that provide guidelines and implications of design for developers of mental health portals. The knowledge patterns were based on three foundations: (1) knowledge integration of language technology approaches; (2) experiments with language technology applications and (3) user studies of portal interaction. A mixed-methods approach was employed for the evaluation of the knowledge patterns: formative workshops with knowledge pattern experts and summative surveys with experts in specific domains. The formative evaluation improved the cohesion of the patterns. The results of the summative evaluation showed that the problems discussed in the patterns were relevant for the domain, and that the knowledge embedded was useful to solve them. Ten patterns out of thirteen achieved an average score above 4.0, which is a positive result that leads us to conclude that they can be used as guidelines for developing health portals.
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14
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Griebel L, Enwald H, Gilstad H, Pohl AL, Moreland J, Sedlmayr M. eHealth literacy research-Quo vadis? Inform Health Soc Care 2017; 43:427-442. [PMID: 29045164 DOI: 10.1080/17538157.2017.1364247] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The concept of electronic health (eHealth) literacy evolved from the social and information sciences and describes competencies necessary to use electronic health services. As it is a rather new topic, and as there is no current overview of the state of the art in research, it is not possible to identify research gaps. Therefore, the objective of this viewpoint article is to increase knowledge on the current state of the art of research in eHealth literacy and to identify gaps in scientific research which should be focused on by the research community in the future. The article provides a current viewpoint of the concept of eHealth literacy and related research. Gaps can be found in terms of a missing "gold standard" regarding both the definition and the measurement of eHealth literacy. Furthermore, there is a need for identifying the implications on eHealth developers, which evolve from the measurement of eHealth literacy in eHealth users. Finally, a stronger inclusion of health professionals, both in the evolving concept and in the measurement of eHealth literacy, is needed in the future.
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Affiliation(s)
- Lena Griebel
- a Chair of Medical Informatics , Friedrich-Alexander University Erlangen-Nürnberg , Erlangen, Germany
| | - Heidi Enwald
- b Information Studies , University of Oulu , Oulu, Finland.,c Information Studies , Åbo Akademi University , Turku, Finland
| | - Heidi Gilstad
- d Health Informatics Research Group, Faculty of Medicine , NTNU The Norwegian University of Science and Technology , Trondheim, Norway
| | - Anna-Lena Pohl
- e Institute for eHealth and Management in HealthCare , Flensburg University of Applied Sciences , Flensburg, Germany
| | - Julia Moreland
- f Social Sciences , University of the Highlands and Islands, Moray College UHI , Elgin, Scotland
| | - Martin Sedlmayr
- a Chair of Medical Informatics , Friedrich-Alexander University Erlangen-Nürnberg , Erlangen, Germany
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15
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Papadakos J, Trang A, Cyr AB, Abdelmutti N, Giuliani ME, Snow M, McCurdie T, Pulandiran M, Urowitz S, Wiljer D. Deconstructing Cancer Patient Information Seeking in a Consumer Health Library Toward Developing a Virtual Information Consult for Cancer Patients and Their Caregivers: A Qualitative, Instrumental Case Study. JMIR Cancer 2017; 3:e6. [PMID: 28539305 PMCID: PMC5463052 DOI: 10.2196/cancer.6933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/19/2017] [Accepted: 02/28/2017] [Indexed: 11/30/2022] Open
Abstract
Background Cancer patients and their caregivers want information about their disease and are interested in finding health information online. Despite the abundance of cancer information online, it is often fragmented, its quality is highly variable, and it can be difficult to navigate without expert-level knowledge of the cancer system. The Patient & Family Library at the Princess Margaret Cancer Centre offers a broad collection of high-quality cancer health information and staff are available to help patrons refine their questions and explore information needs that they may not have considered. Objective The purpose of this research study was to deconstruct patrons’ information-seeking behaviors in the library to assess the feasibility of replicating the services provided in the library through a Web app, extending the service beyond the walls of the cancer centre. The specific aims of this research were to understand (1) how patrons approach information seeking in the library (interface design), (2) how patrons communicate their informational needs (information categorization and metadata requirements), and (3) what resources are provided to address the patrons’ information needs (collection development). Methods We employed a qualitative, instrumental case study to deconstruct patrons’ health information-seeking behavior. The study population included patients, the librarian, and library volunteers. Ethnographic observation was conducted at the library over 3 days and key informant interviews with library staff were conducted to address the first aim. A closed card-sorting activity was conducted to address the second aim and the library shift logs and Search Request Forms (SRFs) were reviewed to address the third aim. Results A total of 55 interactions were recorded during the ethnographic observation and nine semistructured interviews were conducted during the key informant interviews. Seven library patron personas were identified: (1) Newbie, (2) Seasoned, (3) Direct, (4) Window Shopper, (5) Collector, (6) Information Seeker, and (7) Distressed. A total of 83 participants completed the closed card-sorting exercise. The participants’ conceptual clusters within the similarity matrix overlapped with the groupings created by the librarian, with a few differences. A total of 161 entries in the library shift log and 65 SRFs were analyzed to determine what resources were given to patrons. Most resources that patrons received were available online (61%), although almost half of these required special access (47%). Conclusions The study findings suggest it is possible to replicate library functions in a Web app with a few exceptions that cannot be replicated online. These elements include access to journal articles or other content behind paywalls and the librarian’s ability to encourage further discussion through empathy and active listening. Discussion with the librarian could serve to refine and predict needs through observing information seekers and to provide immediate connection to spiritual care and psychosocial support for patrons in distress.
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Affiliation(s)
- Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Aileen Trang
- Cancer Education Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Alaina B Cyr
- Cancer Education Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Nazek Abdelmutti
- Cancer Education Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Meredith E Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Michelle Snow
- Cancer Education Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Tara McCurdie
- Health Care Human Factors, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Menaka Pulandiran
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Sara Urowitz
- Canadian Cancer Research Alliance, Toronto, ON, Canada
| | - David Wiljer
- Education, Technology & Innovation, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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16
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Sudbury-Riley L, FitzPatrick M, Schulz PJ. Exploring the Measurement Properties of the eHealth Literacy Scale (eHEALS) Among Baby Boomers: A Multinational Test of Measurement Invariance. J Med Internet Res 2017; 19:e53. [PMID: 28242590 PMCID: PMC5348620 DOI: 10.2196/jmir.5998] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 10/23/2016] [Accepted: 01/30/2017] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The eHealth Literacy Scale (eHEALS) is one of only a few available measurement scales to assess eHealth literacy. Perhaps due to the relative paucity of such measures and the rising importance of eHealth literacy, the eHEALS is increasingly a choice for inclusion in a range of studies across different groups, cultures, and nations. However, despite its growing popularity, questions have been raised over its theoretical foundations, and the factorial validity and multigroup measurement properties of the scale are yet to be investigated fully. OBJECTIVE The objective of our study was to examine the factorial validity and measurement invariance of the eHEALS among baby boomers (born between 1946 and 1964) in the United States, United Kingdom, and New Zealand who had used the Internet to search for health information in the last 6 months. METHODS Online questionnaires collected data from a random sample of baby boomers from the 3 countries of interest. The theoretical underpinning to eHEALS comprises social cognitive theory and self-efficacy theory. Close scrutiny of eHEALS with analysis of these theories suggests a 3-factor structure to be worth investigating, which has never before been explored. Structural equation modeling tested a 3-factor structure based on the theoretical underpinning to eHEALS and investigated multinational measurement invariance of the eHEALS. RESULTS We collected responses (N=996) to the questionnaires using random samples from the 3 countries. Results suggest that the eHEALS comprises a 3-factor structure with a measurement model that falls within all relevant fit indices (root mean square error of approximation, RMSEA=.041, comparative fit index, CFI=.986). Additionally, the scale demonstrates metric invariance (RMSEA=.040, CFI=.984, ΔCFI=.002) and even scalar invariance (RMSEA=.042, CFI=.978, ΔCFI=.008). CONCLUSIONS To our knowledge, this is the first study to demonstrate multigroup factorial equivalence of the eHEALS, and did so based on data from 3 diverse nations and random samples drawn from an increasingly important cohort. The results give increased confidence to researchers using the scale in a range of eHealth assessment applications from primary care to health promotions.
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Affiliation(s)
| | - Mary FitzPatrick
- Waikato Management School, University of Waikato, Hamilton, New Zealand
| | - Peter J Schulz
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano, Lugano, Switzerland
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17
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An Iterative, Mixed Usability Approach Applied to the Telekit System from the Danish TeleCare North Trial. Int J Telemed Appl 2016; 2016:6351734. [PMID: 27974888 PMCID: PMC5128708 DOI: 10.1155/2016/6351734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 09/19/2016] [Indexed: 12/05/2022] Open
Abstract
Objective. The aim of the present study is to evaluate the usability of the telehealth system, coined Telekit, by using an iterative, mixed usability approach. Materials and Methods. Ten double experts participated in two heuristic evaluations (HE1, HE2), and 11 COPD patients attended two think-aloud tests. The double experts identified usability violations and classified them into Jakob Nielsen's heuristics. These violations were then translated into measurable values on a scale of 0 to 4 indicating degree of severity. In the think-aloud tests, COPD participants were invited to verbalise their thoughts. Results. The double experts identified 86 usability violations in HE1 and 101 usability violations in HE2. The majority of the violations were rated in the 0–2 range. The findings from the think-aloud tests resulted in 12 themes and associated examples regarding the usability of the Telekit system. The use of the iterative, mixed usability approach produced both quantitative and qualitative results. Conclusion. The iterative, mixed usability approach yields a strong result owing to the high number of problems identified in the tests because the double experts and the COPD participants focus on different aspects of Telekit's usability. This trial is registered with Clinicaltrials.gov, NCT01984840, November 14, 2013.
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18
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Peute LW, Knijnenburg SL, Kremer LC, Jaspers MWM. A Concise and Practical Framework for the Development and Usability Evaluation of Patient Information Websites. Appl Clin Inform 2015; 6:383-99. [PMID: 26171083 DOI: 10.4338/aci-2014-11-ra-0109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 04/09/2015] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Website Developmental Model for the Healthcare Consumer (WDMHC) is an extensive and successfully evaluated framework that incorporates user-centered design principles. However, due to its extensiveness its application is limited. In the current study we apply a subset of the WDMHC framework in a case study concerning the development and evaluation of a website aimed at childhood cancer survivors (CCS). OBJECTIVE To assess whether the implementation of a limited subset of the WDMHC-framework is sufficient to deliver a high-quality website with few usability problems, aimed at a specific patient population. METHODS The website was developed using a six-step approach divided into three phases derived from the WDMHC: 1) information needs analysis, mock-up creation and focus group discussion; 2) website prototype development; and 3) heuristic evaluation (HE) and think aloud analysis (TA). The HE was performed by three double experts (knowledgeable both in usability engineering and childhood cancer survivorship), who assessed the site using the Nielsen heuristics. Eight end-users were invited to complete three scenarios covering all functionality of the website by TA. RESULTS The HE and TA were performed concurrently on the website prototype. The HE resulted in 29 unique usability issues; the end-users performing the TA encountered eleven unique problems. Four issues specifically revealed by HE concerned cosmetic design flaws, whereas two problems revealed by TA were related to website content. CONCLUSION Based on the subset of the WDMHC framework we were able to deliver a website that closely matched the expectancy of the end-users and resulted in relatively few usability problems during end-user testing. With the successful application of this subset of the WDMHC, we provide developers with a clear and easily applicable framework for the development of healthcare websites with high usability aimed at specific medical populations.
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Affiliation(s)
- L W Peute
- Center for Human Factors Engineering of Health Information Technology (HIT-Lab), Academic Medical Center, University of Amsterdam , The Netherlands ; Dept. of Medical Informatics, Academic Medical Center , Amsterdam, the Netherlands
| | - S L Knijnenburg
- Center for Human Factors Engineering of Health Information Technology (HIT-Lab), Academic Medical Center, University of Amsterdam , The Netherlands ; Dept. of Medical Informatics, Academic Medical Center , Amsterdam, the Netherlands ; Dept. of Pediatric Oncology, Emma's Children Hospital/Academic Medical Center , Amsterdam, The Netherlands
| | - L C Kremer
- Dept. of Pediatric Oncology, Emma's Children Hospital/Academic Medical Center , Amsterdam, The Netherlands
| | - M W M Jaspers
- Center for Human Factors Engineering of Health Information Technology (HIT-Lab), Academic Medical Center, University of Amsterdam , The Netherlands ; Dept. of Medical Informatics, Academic Medical Center , Amsterdam, the Netherlands
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19
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The Technological Growth in eHealth Services. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2015; 2015:894171. [PMID: 26146515 PMCID: PMC4469784 DOI: 10.1155/2015/894171] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/27/2015] [Indexed: 12/31/2022]
Abstract
The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.
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20
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Stellefson M, Chaney B, Chaney D, Paige S, Payne-Purvis C, Tennant B, Walsh-Childers K, Sriram P, Alber J. Engaging community stakeholders to evaluate the design, usability, and acceptability of a chronic obstructive pulmonary disease social media resource center. JMIR Res Protoc 2015; 4:e17. [PMID: 25630449 PMCID: PMC4336200 DOI: 10.2196/resprot.3959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Revised: 12/05/2014] [Accepted: 01/05/2015] [Indexed: 12/31/2022] Open
Abstract
Background Patients with chronic obstructive pulmonary disease (COPD) often report inadequate access to comprehensive patient education resources. Objective The purpose of this study was to incorporate community-engagement principles within a mixed-method research design to evaluate the usability and acceptability of a self-tailored social media resource center for medically underserved patients with COPD. Methods A multiphase sequential design (qual → QUANT → quant + QUAL) was incorporated into the current study, whereby a small-scale qualitative (qual) study informed the design of a social media website prototype that was tested with patients during a computer-based usability study (QUANT). To identify usability violations and determine whether or not patients found the website prototype acceptable for use, each patient was asked to complete an 18-item website usability and acceptability questionnaire, as well as a retrospective, in-depth, semistructured interview (quant + QUAL). Results The majority of medically underserved patients with COPD (n=8, mean 56 years, SD 7) found the social media website prototype to be easy to navigate and relevant to their self-management information needs. Mean responses on the 18-item website usability and acceptability questionnaire were very high on a scale of 1 (strongly disagree) to 5 (strongly agree) (mean 4.72, SD 0.33). However, the majority of patients identified several usability violations related to the prototype’s information design, interactive capabilities, and navigational structure. Specifically, 6 out of 8 (75%) patients struggled to create a log-in account to access the prototype, and 7 out of 8 patients (88%) experienced difficulty posting and replying to comments on an interactive discussion forum. Conclusions Patient perceptions of most social media website prototype features (eg, clickable picture-based screenshots of videos, comment tools) were largely positive. Mixed-method stakeholder feedback was used to make design recommendations, categorize usability violations, and prioritize potential solutions for improving the usability of a social media resource center for COPD patient education.
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Affiliation(s)
- Michael Stellefson
- Center for Digital Health and Wellness, Department of Health Education and Behavior, University of Florida, Gainesville, FL, United States.
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Lyles CR, Sarkar U, Osborn CY. Getting a technology-based diabetes intervention ready for prime time: a review of usability testing studies. Curr Diab Rep 2014; 14:534. [PMID: 25173689 PMCID: PMC4164626 DOI: 10.1007/s11892-014-0534-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Consumer health technologies can educate patients about diabetes and support their self-management, yet usability evidence is rarely published even though it determines patient engagement, optimal benefit of any intervention, and an understanding of generalizability. Therefore, we conducted a narrative review of peer-reviewed articles published from 2009 to 2013 that tested the usability of a web- or mobile-delivered system/application designed to educate and support patients with diabetes. Overall, the 23 papers included in our review used mixed (n = 11), descriptive quantitative (n = 9), and qualitative methods (n = 3) to assess usability, such as documenting which features performed as intended and how patients rated their experiences. More sophisticated usability evaluations combined several complementary approaches to elucidate more aspects of functionality. Future work pertaining to the design and evaluation of technology-delivered diabetes education/support interventions should aim to standardize the usability testing processes and publish usability findings to inform interpretation of why an intervention succeeded or failed and for whom.
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Affiliation(s)
- Courtney R Lyles
- UCSF Center for Vulnerable Populations at San Francisco General Hospital, San Francisco, CA, USA,
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22
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Stellefson M, Chaney B, Barry AE, Chavarria E, Tennant B, Walsh-Childers K, Sriram PS, Zagora J. Web 2.0 chronic disease self-management for older adults: a systematic review. J Med Internet Res 2013; 15:e35. [PMID: 23410671 PMCID: PMC3636299 DOI: 10.2196/jmir.2439] [Citation(s) in RCA: 181] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 12/30/2012] [Accepted: 01/26/2013] [Indexed: 11/16/2022] Open
Abstract
Background Participatory Web 2.0 interventions promote collaboration to support chronic disease self-management. Growth in Web 2.0 interventions has led to the emergence of e-patient communication tools that enable older adults to (1) locate and share disease management information and (2) receive interactive healthcare advice. The evolution of older e-patients contributing to Web 2.0 health and medical forums has led to greater opportunities for achieving better chronic disease outcomes. To date, there are no review articles investigating the planning, implementation, and evaluation of Web 2.0 chronic disease self-management interventions for older adults. Objective To review the planning, implementation, and overall effectiveness of Web 2.0 self-management interventions for older adults (mean age ≥ 50) with one or more chronic disease(s). Methods A systematic literature search was conducted using six popular health science databases. The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and compute a study quality score (SQS) for 15 reviewed articles. Results Most interventions were adopted for delivery by multidisciplinary healthcare teams and tested among small samples of white females with diabetes. Studies indicated that Web 2.0 participants felt greater self-efficacy for managing their disease(s) and benefitted from communicating with health care providers and/or website moderators to receive feedback and social support. Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication adherence, biological outcomes, or health care utilization. Mean SQS scores were notably low (mean=63%, SD 18%). Studies were judged to be weakest on the Maintenance dimension of RE-AIM; 13 reviewed studies (87%) did not describe any measures taken to sustain Web 2.0 effects past designated study time periods. Detailed process and impact evaluation frameworks were also missing in almost half (n=7) of the reviewed interventions. Conclusions There is need for a greater understanding of the costs and benefits associated with using patient-centered Web 2.0 technologies for chronic disease self-management. More research is needed to determine whether the long-term effectiveness of these programs is sustainable among larger, more diverse samples of chronically ill patients. The effective translation of new knowledge, social technologies, and engagement techniques will likely result in novel approaches for empowering, engaging, and educating older adults with chronic disease.
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Affiliation(s)
- Michael Stellefson
- Center for Digital Health and Wellness, Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA.
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Knijnenburg SL, Kremer LC, Versluys AB, Braam KI, Mud MS, van der Pal HJ, Caron HN, Jaspers MW. Evaluation of a patient information website for childhood cancer survivors. Support Care Cancer 2012; 21:919-26. [PMID: 23007883 DOI: 10.1007/s00520-012-1604-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Accepted: 09/10/2012] [Indexed: 12/01/2022]
Abstract
PURPOSE Childhood cancer survivors (CCS) are in need of specialized information about late effects of treatment. In the current study, we assessed the perceived usability and satisfaction with the content of a national website with information on late effects and analyzed possible determinants related to website usability and content satisfaction. METHODS CCS and their parents were contacted through our local follow-up program and via online media to complete an online questionnaire regarding their baseline characteristics, medical decision style, and the usability and content of the website. Usability was evaluated using the System Usability Scale (SUS), a validated questionnaire resulting in a score from 0 to 100. For the content rating, we constructed a six-item scale resulting in a score from 1 to 5 (Cronbach's α, 0.83). Comments were analyzed qualitatively. RESULTS Fifty-five survivors and forty-three parents of survivors completed the questionnaire. Median age of respondents was 41 years (range, 17-58). Respondents rated the website's usability with a mean SUS score of 72.5 (95 % CI, 69.2-74.9). The mean content rating was 3.7 (95 % CI, 3.5-3.8). No determinants were significantly related to the perceived usability or content satisfaction in multivariate analyses. Qualitative analysis revealed respondents' preference for more detailed and even scientific information on late effects. CONCLUSION Respondents were satisfied with the usability and the contents of a website that targeted at their information needs. As knowledge about late effects is still limited among survivors, a website can be a valuable resource to improve their knowledge, promote healthy behavior, and in the end, improve their quality of life.
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Affiliation(s)
- Sebastiaan L Knijnenburg
- Department of Medical Informatics, Academic Medical Center, Room J1B-113.2, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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