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Veerhuis N, Merizzi A, Papoulias S, Bradbury C, Sheret K, Traynor V. 'It is empowering and gives people dignity in a very difficult process': A multistage, multimethod qualitative study to understand the views of end users in the cultural adaptation of a dementia and driving decision aid. Health Expect 2024; 27:e14006. [PMID: 38497286 PMCID: PMC10945392 DOI: 10.1111/hex.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND Decisions about driving for individuals living with dementia (ILWD) can be challenging. There are limited evidence-based person-centred interventions in the United Kingdom that support decisions about transitioning to not driving or guidelines for developing decision aids for ILWD. This study aimed to understand the important features of a decision aid through the cultural adaptation of Australian dementia and driving decision aid (DDDA) for ILWD residing in the United Kingdom. METHODS This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid. RESULTS Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options. CONCLUSIONS Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics. PATIENT AND PUBLIC INVOLVEMENT Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.
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Affiliation(s)
- Nadine Veerhuis
- Aged, Dementia, Health Education and Research Centre, Faculty of Science Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Alessandra Merizzi
- Memory Assessment and Treatment Service, Pennine Care National Health Service Foundation Trust, Oldham, UK
| | - Stephanie Papoulias
- Memory Assessment and Treatment Service, Pennine Care National Health Service Foundation Trust, Oldham, UK
| | - Claire Bradbury
- Memory Assessment Service, Dorset Healthcare University Foundation Trust, Alderney Hospital, Poole, UK
| | - Kathy Sheret
- Memory Assessment Service, Dorset Healthcare University Foundation Trust, Alderney Hospital, Poole, UK
| | - Victoria Traynor
- Aged, Dementia, Health Education and Research Centre, Faculty of Science Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
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2
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Riboldi I, Calabrese A, Piacenti S, Capogrosso CA, Paioni SL, Bartoli F, Carrà G, Armes J, Taylor C, Crocamo C. Understanding University Students' Perspectives towards Digital Tools for Mental Health Support: A Cross-country Study. Clin Pract Epidemiol Ment Health 2024; 20:e17450179271467. [PMID: 38660572 PMCID: PMC11037510 DOI: 10.2174/0117450179271467231231060255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/06/2023] [Accepted: 12/20/2023] [Indexed: 04/26/2024]
Abstract
Background Organisational and individual barriers often prevent university students from seeking mental health support. Digital technologies are recognised as effective in managing psychological distress and as a source of health-related information, thus representing useful options to address mental health needs in terms of accessibility and cost-effectiveness. However, university students' experiences and perspectives towards such interventions are little known. Objectives We thus aimed to expand the existing base of scientific knowledge, focusing on this special population. Methods Data were from the qualitative component of "the CAMPUS study", longitudinally assessing the mental health of students at the University of Milano-Bicocca (Italy) and the University of Surrey (UK). We conducted in-depth interviews and thematically analysed the transcripts using the framework approach. Results An explanatory model was derived from five themes identified across 33 interviews (15 for Italy, 18 for the UK). Students perceived that social media, apps, and podcasts could deliver relevant mental health content, ranging from primary to tertiary prevention. Wide availability and anonymity were perceived as advantages that make tools suitable for preventive interventions, to reduce mental health stigma, and as an extension of standard treatment. These goals can be hindered by disadvantages, namely lower efficacy compared to face-to-face contact, lack of personalisation, and problematic engagement. Individual and cultural specificities might influence awareness and perspectives on the use of digital technologies for mental health support. Conclusion Although considering some specific features, digital tools could be a useful instrument to support the mental health needs of students. Since personal contact remains crucial, digital tools should be integrated with face-to-face interventions through a multi-modal approach.
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Affiliation(s)
- Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Angela Calabrese
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Susanna Piacenti
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | | | - Susanna Lucini Paioni
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
- Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, UK
| | - Jo Armes
- Faculty of Health and Medical Sciences, School of Health and Sciences, University of Surrey, Stag Hill, Guildford GU2 7XH, UK
| | - Cath Taylor
- Faculty of Health and Medical Sciences, School of Health and Sciences, University of Surrey, Stag Hill, Guildford GU2 7XH, UK
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy
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Slade M, Rennick-Egglestone S, Elliott RA, Newby C, Robinson C, Gavan SP, Paterson L, Ali Y, Yeo C, Glover T, Pollock K, Callard F, Priebe S, Thornicroft G, Repper J, Keppens J, Smuk M, Franklin D, Walcott R, Harrison J, Smith R, Robotham D, Bradstreet S, Gillard S, Cuijpers P, Farkas M, Zeev DB, Davidson L, Kotera Y, Roe J, Ng F, Llewellyn-Beardsley J. Effectiveness and cost-effectiveness of online recorded recovery narratives in improving quality of life for people with non-psychotic mental health problems: a pragmatic randomized controlled trial. World Psychiatry 2024; 23:101-112. [PMID: 38214639 PMCID: PMC10785987 DOI: 10.1002/wps.21176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2024] Open
Abstract
Narratives describing first-hand experiences of recovery from mental health problems are widely available. Emerging evidence suggests that engaging with mental health recovery narratives can benefit people experiencing mental health problems, but no randomized controlled trial has been conducted as yet. We developed the Narrative Experiences Online (NEON) Intervention, a web application providing self-guided and recommender systems access to a collection of recorded mental health recovery narratives (n=659). We investigated whether NEON Intervention access benefited adults experiencing non-psychotic mental health problems by conducting a pragmatic parallel-group randomized trial, with usual care as control condition. The primary endpoint was quality of life at week 52 assessed by the Manchester Short Assessment (MANSA). Secondary outcomes were psychological distress, hope, self-efficacy, and meaning in life at week 52. Between March 9, 2020 and March 26, 2021, we recruited 1,023 participants from across England (the target based on power analysis was 994), of whom 827 (80.8%) identified as White British, 811 (79.3%) were female, 586 (57.3%) were employed, and 272 (26.6%) were unemployed. Their mean age was 38.4±13.6 years. Mood and/or anxiety disorders (N=626, 61.2%) and stress-related disorders (N=152, 14.9%) were the most common mental health problems. At week 52, our intention-to-treat analysis found a significant baseline-adjusted difference of 0.13 (95% CI: 0.01-0.26, p=0.041) in the MANSA score between the intervention and control groups, corresponding to a mean change of 1.56 scale points per participant, which indicates that the intervention increased quality of life. We also detected a significant baseline-adjusted difference of 0.22 (95% CI: 0.05-0.40, p=0.014) between the groups in the score on the "presence of meaning" subscale of the Meaning in Life Questionnaire, corresponding to a mean change of 1.1 scale points per participant. We found an incremental gain of 0.0142 quality-adjusted life years (QALYs) (95% credible interval: 0.0059 to 0.0226) and a £178 incremental increase in cost (95% credible interval: -£154 to £455) per participant, generating an incremental cost-effectiveness ratio of £12,526 per QALY compared with usual care. This was lower than the £20,000 per QALY threshold used by the National Health Service in England, indicating that the intervention would be a cost-effective use of health service resources. In the subgroup analysis including participants who had used specialist mental health services at baseline, the intervention both reduced cost (-£98, 95% credible interval: -£606 to £309) and improved QALYs (0.0165, 95% credible interval: 0.0057 to 0.0273) per participant as compared to usual care. We conclude that the NEON Intervention is an effective and cost-effective new intervention for people experiencing non-psychotic mental health problems.
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Affiliation(s)
- Mike Slade
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Faculty of Nursing and Health Sciences, Health and Community Participation Division, Nord University, Namsos, Norway
| | | | - Rachel A Elliott
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Chris Newby
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Clare Robinson
- Centre for Evaluation and Methods, Wolfson Institute of Population Health, Pragmatic Clinical Trials Unit, Queen Mary University of London, London, UK
| | - Sean P Gavan
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Luke Paterson
- Manchester Centre for Health Economics, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
| | - Yasmin Ali
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Caroline Yeo
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Department of Architecture and Built Environment, Faculty of Engineering, University of Nottingham, Nottingham, UK
| | | | - Kristian Pollock
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Felicity Callard
- School of Geographical & Earth Sciences, University of Glasgow, Glasgow, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, East London NHS Foundation Trust, London, UK
| | - Graham Thornicroft
- Centre for Implementation Science and Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Jeroen Keppens
- Department of Informatics, King's College London, London, UK
| | - Melanie Smuk
- Centre for Genomics and Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | | | - Rianna Walcott
- Black Communication and Technology Lab, Department of Communication, University of Maryland, College Park, MD, USA
| | | | - Roger Smith
- NEON Lived Experience Advisory Panel, Nottingham, UK
| | | | - Simon Bradstreet
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Steve Gillard
- School of Health Sciences, City, University of London, London, UK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- International Institute for Psychotherapy, Babes¸-Bolyai University, Cluj-Napoca, Romania
| | - Marianne Farkas
- Center for Psychiatric Rehabilitation, College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - Dror Ben Zeev
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Larry Davidson
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Yasuhiro Kotera
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
- Center for Infectious Disease Education and Research, Osaka University, Osaka, Japan
| | - James Roe
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration East Midlands, University of Nottingham, Nottingham, UK
| | - Fiona Ng
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Joy Llewellyn-Beardsley
- School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, UK
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Nittas V, Daniore P, Chavez SJ, Wray TB. Challenges in implementing cultural adaptations of digital health interventions. COMMUNICATIONS MEDICINE 2024; 4:7. [PMID: 38182750 PMCID: PMC10770150 DOI: 10.1038/s43856-023-00426-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 12/08/2023] [Indexed: 01/07/2024] Open
Abstract
Differences in the access and use of digital health interventions are driven by culture, in addition to economic and physical factors. To avoid the systematic exclusion of traditionally underserved cultural groups, creating inclusive digital health interventions is essential. One way to achieve this is through cultural adaptations, defined as the systematic modification of an existing intervention that aligns with a target audience's cultural norms, beliefs, and values. In theory, cultural adaptations can potentially increase the reach and engagement of digital health interventions. However, the evidence of whether and how that is achieved is limited. Justifying, planning, and implementing an adaptation comes with various challenges and takes time and money. This perspective provides a critical overview of the field's current state and emphasizes the need for technology-specific frameworks that address when and how to culturally adapt digital health interventions.
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Affiliation(s)
- Vasileios Nittas
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, 02912, Providence, RI, USA.
| | - Paola Daniore
- Institute for Implementation Science in Health Care, University of Zurich Faculty of Medicine, Universitaetstrasse 84, 8006, Zurich, Switzerland
| | - Sarah J Chavez
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, 121 South Main Street, 02912, Providence, RI, USA
| | - Tyler B Wray
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, 02912, Providence, RI, USA
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Goel V, Mathew S, Gudi N, Jacob A, John O. A scoping review on laboratory surveillance in the WHO Southeast Asia Region: Past, present and the future. J Glob Health 2023; 13:04028. [PMID: 37083001 PMCID: PMC10119808 DOI: 10.7189/jogh.13.04028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Background The South-East Asia (SEA) region bears a significant proportion of the world's communicable disease burden. The onset of the COVID-19 pandemic has further affected the situation. A well-established laboratory-based surveillance (LBS) can reduce the burden of infectious diseases. In light of this, the review collated the existing literature on LBS system in the region and the modifications adopted by the surveillance systems during the pandemic. Methodology We followed the guidelines for scoping review as prescribed by Arskey and O'Malley. We comprehensively searched three databases (PubMed, Scopus and CINAHL) and supplemented it with grey literature search. The screening of the articles was conducted at the title and abstract followed by full-text screening. This was followed by data extraction using a pre-tested data extraction tool by two independent reviewers. The results were presented narratively. Results Including 75 relevant articles and documents, we compiled a list of surveillance systems. A shift from paper to dual (paper and electronic) modalities was identified across the countries. This largely low- and middle-income countries (LMIC) area face challenges in reporting, resources, and collaboration-related issues. While some countries have well-established National Reference Laboratories; others have more private than public-owned laboratories. Given the COVID-19 pandemic, modifications to the existing laboratory capacities to enable real-time surveillance was identified. Laboratory capacity complemented with genomic surveillance can indubitably aid in disease detection and control. Limitations due to inaccessible government portals, and language barriers are acknowledged. This review identified a comprehensive list of surveillance systems in the region, challenges faced in using these surveillance systems and inform the decision makers about the benefits of integrating fragmented surveillance systems. Conclusion Regionally and nationally integrated genomic and laboratory surveillance systems justify capital investments, as their payoffs rationalise such costs owing to economies of scale over time. Further, as data flows are harmonized and standardized, algorithm- and computing-based pattern recognition methods allow for targeted and accurate disease prediction when integrated with, potentially, climate and weather systems data. Trained human resources are a sine qua non to optimize such investments, but in the medium to long run, such investments will buttress initiatives in other arenas at the regional level.
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Affiliation(s)
- Vidushi Goel
- The George Institute for Global Health, New Delhi, India
| | - Silvy Mathew
- The George Institute for Global Health, New Delhi, India
| | - Nachiket Gudi
- Public Health Evidence South Asia, Department of Health Information, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anil Jacob
- The George Institute Services, New Delhi, India
| | - Oommen John
- The George Institute for Global Health, New Delhi, India
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Apers H, Van Praag L, Nöstlinger C, Agyemang C. Interventions to improve the mental health or mental well-being of migrants and ethnic minority groups in Europe: A scoping review. Glob Ment Health (Camb) 2023; 10:e23. [PMID: 37854435 PMCID: PMC10579672 DOI: 10.1017/gmh.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/21/2023] [Accepted: 04/11/2023] [Indexed: 10/20/2023] Open
Abstract
In Europe, migrants and ethnic minority groups are at greater risk for mental disorders compared to the general population. However, little is known about which interventions improve their mental health and well-being and about their underlying mechanisms that reduce existing mental health inequities. To fill this gap, the aim of this scoping review was to synthesise the available evidence on health promotion, prevention, and non-medical treatment interventions targeting migrants and ethnic minority populations. By mapping and synthesising the findings, including facilitators and barriers for intervention uptake, this scoping review provides valuable insights for developing future interventions. We used the PICo strategy and PRISMA guidelines to select peer-reviewed articles assessing studies on interventions. In total, we included 27 studies and synthesised the results based on the type of intervention, intervention mechanisms and outcomes, and barriers and facilitators to intervention uptake. We found that the selected studies implemented tailored interventions to reach these specific populations who are at risk due to structural inequities such as discrimination and racism, stigma associated with mental health, language barriers, and problems in accessing health care. The majority of interventions showed a positive effect on participants' mental health, indicating the importance of using a tailored approach. We identified three main successful mechanisms for intervention development and implementation: a sound theory-base, systematic adaption to make interventions culturally sensitive and participatory approaches. Moreover, this review indicates the need to holistically address social determinants of health through intersectoral programming to promote and improve mental health among migrants and ethnic minority populations. We identified current shortcomings and knowledge gaps within this field: rigorous intervention studies were scarce, there was a large diversity regarding migrant population groups and few studies evaluated the interventions' (cost-)effectiveness.
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Affiliation(s)
- Hanne Apers
- Centre for Migration and Intercultural Studies/Centre for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Lore Van Praag
- Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Christiana Nöstlinger
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Bounds DT, Stiles-Shields C, Schueller SM, Odgers CL, Karnik NS. Ethical considerations for developing pediatric mhealth interventions for teens with socially complex needs. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:7-16. [PMID: 36134754 PMCID: PMC9898213 DOI: 10.1111/jcap.12396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/03/2022] [Accepted: 09/11/2022] [Indexed: 02/06/2023]
Abstract
TOPIC Mobile Health (mHealth) stands as a potential means to better reach, assess, and intervene with teens with socially complex needs. These youth often face overlapping adversities including medical illness and a history of experiencing adverse childhood experiences (ACEs). Clinicians are faced with navigating ethical decisions when developing mHealth tools for teens who have socially complex needs. Many tools have been developed for adults from the general population. However, despite the development of thousands of mHealth interventions, developers tend to focus on designing for usability, engagement, and efficacy, with less attention on the ethical considerations of making such tools. PURPOSE To safely move mHealth interventions from research into clinical practice, ethical standards must be met during the design phase. In this paper we adapt the Four Box Model (i.e., medical indications, preferences of patients, quality of life, and contextual features) to guide mHealth developers through ethical considerations when designing mHealth interventions for teens who present with a medical diagnosis and a history of ACEs. SOURCES A review of language, inclusive features, data sharing, and usability is presented using both the Four Box Model and potential scenarios to guide each consideration. CONCLUSIONS To better support designers of mHealth tools we present a framework for evaluating applications to determine overlap with ethical design and are well suited for use in clinical practice with underserved pediatric patients.
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Affiliation(s)
- Dawn T Bounds
- Irvine, Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
| | - Candice L Odgers
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
- Social Science Research Institute, Duke University, Durham, North Carolina, USA
| | - Niranjan S Karnik
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
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Daniore P, Nittas V, Gille F, von Wyl V. Promoting participation in remote digital health studies: An expert interview study. Digit Health 2023; 9:20552076231212063. [PMID: 38025101 PMCID: PMC10644759 DOI: 10.1177/20552076231212063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Remote digital health studies are on the rise and promise to reduce the operational inefficiencies of in-person research. However, they encounter specific challenges in maintaining participation (enrollment and retention) due to their exclusive reliance on technology across all study phases. Objective The goal of this study was to collect experts' opinions on how to facilitate participation in remote digital health studies. Method We conducted 13 semi-structured interviews with principal investigators, researchers, and software developers who had recent experiences with remote digital health studies. Informed by the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, we performed a thematic analysis and mapped various approaches to successful study participation. Results Our analyses revealed four themes: (1) study planning to increase participation, where experts suggest that remote digital health studies should be planned based on adequate knowledge of what motivates, engages, and disengages a target population; (2) participant enrollment, highlighting that enrollment strategies should be selected carefully, attached to adequate support, and focused on inclusivity; (3) participant retention, with strategies that minimize the effort and complexity of study tasks and ensure that technology is adapted and responsive to participant needs, and (4) requirements for study planning focused on the development of relevant guidelines to foster participation in future studies. Conclusions Our findings highlight the significant requirements for seamless technology and researcher involvement in enabling high remote digital health study participation. Future studies can benefit from collected experiences and the development of guidelines to inform planning that balances participant and scientific requirements.
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Affiliation(s)
- Paola Daniore
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - Vasileios Nittas
- Department of Behavioral and Social Sciences, Brown University, Providence, USA
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Felix Gille
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Tang A, Woldemariam S, Roger J, Sirota M. Translational Bioinformatics to Enable Precision Medicine for All: Elevating Equity across Molecular, Clinical, and Digital Realms. Yearb Med Inform 2022; 31:106-115. [PMID: 36463867 PMCID: PMC9719766 DOI: 10.1055/s-0042-1742513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
OBJECTIVES Over the past few years, challenges from the pandemic have led to an explosion of data sharing and algorithmic development efforts in the areas of molecular measurements, clinical data, and digital health. We aim to characterize and describe recent advanced computational approaches in translational bioinformatics across these domains in the context of issues or progress related to equity and inclusion. METHODS We conducted a literature assessment of the trends and approaches in translational bioinformatics in the past few years. RESULTS We present a review of recent computational approaches across molecular, clinical, and digital realms. We discuss applications of phenotyping, disease subtype characterization, predictive modeling, biomarker discovery, and treatment selection. We consider these methods and applications through the lens of equity and inclusion in biomedicine. CONCLUSION Equity and inclusion should be incorporated at every step of translational bioinformatics projects, including project design, data collection, model creation, and clinical implementation. These considerations, coupled with the exciting breakthroughs in big data and machine learning, are pivotal to reach the goals of precision medicine for all.
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Affiliation(s)
- Alice Tang
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, USA
- Graduate Program in Bioengineering, UCSF, San Francisco, CA, USA
- School of Medicine, UCSF, San Francisco, CA, USA
| | - Sarah Woldemariam
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, USA
- School of Medicine, UCSF, San Francisco, CA, USA
| | - Jacquelyn Roger
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, USA
- Graduate Program in Biological and Medical Informatics, UCSF, San Francisco, CA, USA
| | - Marina Sirota
- Bakar Computational Health Sciences Institute, UCSF, San Francisco, CA, USA
- Department of Pediatrics, UCSF, San Francisco, CA, USA
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Maddula R, MacLeod J, Painter S, McLeish T, Steward A, Rossman A, Hamid A, Ashwath M, Martinez HR, Guha A, Patel B, Addison D, Blaes A, Choudhuri I, Brown SA. Connected Health Innovation Research Program (C.H.I.R.P.): A bridge for digital health and wellness in cardiology and oncology. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 20:100192. [PMID: 37800118 PMCID: PMC10552440 DOI: 10.1016/j.ahjo.2022.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Study objective Cancer and heart disease are leading causes of mortality, and cardio-oncology is emerging as a new field addressing the cardiovascular toxicities related to cancer and cancer therapy. Interdisciplinary research platforms that incorporate digital health to optimize cardiovascular health and wellness in cancer survivors are therefore needed as we advance in the digital era. Our goal was to develop the Connected Health Innovation Research Program (C.H.I.R.P.) to serve as a foundation for future integration and assessments of adoption and clinical efficacy of digital health tools for cardiovascular health and wellness in the general population and in oncology patients. Design/setting/participants Partner companies were identified through the American Medical Association innovation platform, as well as LinkedIn and direct contact by our team. Company leaders met with our team to discuss features of their technology or software. Non-disclosure agreements were signed and data were discussed and obtained for descriptive or statistical analysis. Results A suite of companies with technologies focused on wellness, biometrics tracking, audio companions, oxygen saturation, weight trends, sleep patterns, heart rate variability, electrocardiogram patterns, blood pressure patterns, real-time metabolism tracking, instructional video modules, or integration of these technologies into electronic health records was collated. We formed an interdisciplinary research team and established an academia-industry collaborative foundation for connecting patients with wellness digital health technologies. Conclusions A suite of software and device technologies accessible to the cardiology and oncology population has been established and will facilitate retrospective, prospective, and case research studies assessing adoption and clinical efficacy of digital health tools in cardiology/oncology.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Hugo R. Martinez
- The Heart Institute at Le Bonheur Children’s Hospital, Memphis, TN, USA
- St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Avirup Guha
- Cardio-Oncology Program, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | | | - Daniel Addison
- Cardio-Oncology Program, Ohio State University, Columbus, OH, USA
| | - Anne Blaes
- Division of Hematology, Oncology and Transplantation, University of Minnesota Medical School, MN, USA
| | | | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
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Barua S, Sabharwal A, Glantz N, Conneely C, Larez A, Bevier W, Kerr D. The northeast glucose drift: Stratification of post-breakfast dysglycemia among predominantly Hispanic/Latino adults at-risk or with type 2 diabetes. EClinicalMedicine 2022; 43:101241. [PMID: 34988413 PMCID: PMC8703234 DOI: 10.1016/j.eclinm.2021.101241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is minimal experience in continuous glucose monitoring (CGM) among underserved racial/ethnic minority populations with or at risk of type 2 diabetes (T2D), and therefore a lack of CGM-driven insight for these individuals. We analyzed breakfast-related CGM profiles of free-living, predominantly Hispanic/Latino individuals at-risk of T2D, with pre-T2D, or with non-insulin treated T2D. METHODS Starting February 2019, 119 participants in Santa Barbara, CA, USA, (93 female, 87% Hispanic/Latino [predominantly Mexican-American], age 54·4 [±12·1] years), stratified by HbA1c levels into (i) at-risk of T2D, (ii) with pre-T2D, and (iii) with non-insulin treated T2D, wore blinded CGMs for two weeks. We compared valid CGM profiles from 106 of these participants representing glucose response to breakfast using four parameters. FINDINGS A "northeast drift" was observed in breakfast glucose responses comparing at-risk to pre-T2D to T2D participants. T2D participants had a significantly higher pre-breakfast glucose level, glucose rise, glucose incremental area under the curve (all p < 0·0001), and time to glucose peak (p < 0·05) compared to pre-T2D and at-risk participants. After adjusting for demographic and clinical covariates, pre-breakfast glucose and time to peak (p < 0·0001) were significantly associated with HbA1c. The model predicted HbA1c within (0·55 ± 0·67)% of true laboratory HbA1c values. INTERPRETATION For predominantly Hispanic/Latino adults, the average two-week breakfast glucose response shows a progression of dysglycemia from at-risk of T2D to pre-T2D to T2D. CGM-based breakfast metrics have the potential to predict HbA1c levels and monitor diabetes progression. FUNDING US Department of Agriculture (Grant #2018-33800-28404), a seed grant from the industry board fees of the NSF Engineering Research Center for Precise Advanced Technologies and Health Systems for Underserved Populations (PATHS-UP) (Award #1648451), and the Elsevier foundation.
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Affiliation(s)
- Souptik Barua
- Electrical and Computer Engineering, Rice University, Houston, TX, United States
| | - Ashutosh Sabharwal
- Electrical and Computer Engineering, Rice University, Houston, TX, United States
| | - Namino Glantz
- Sansum Diabetes Research Institute, Santa Barbara, California, United States
| | - Casey Conneely
- Sansum Diabetes Research Institute, Santa Barbara, California, United States
| | - Arianna Larez
- Sansum Diabetes Research Institute, Santa Barbara, California, United States
| | - Wendy Bevier
- Sansum Diabetes Research Institute, Santa Barbara, California, United States
| | - David Kerr
- Sansum Diabetes Research Institute, Santa Barbara, California, United States
- Corresponding author.
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