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Obilor HN, Veryha O, Weisz T, Botros M, Wilson R, Tranmer J, Woo K. The feasibility of a social media-based foot self-management education and support program for adults with diabetes: A partially randomized preference trial. PEC INNOVATION 2024; 5:100307. [PMID: 39027228 PMCID: PMC11254740 DOI: 10.1016/j.pecinn.2024.100307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 05/27/2024] [Accepted: 06/17/2024] [Indexed: 07/20/2024]
Abstract
Aim To assess the feasibility of Diabetic Foot Care Group (DFCG), a social media-based self-management education and support intervention, for people with diabetes (PWD) empowerment in diabetes-related foot ulceration prevention. Methods A partially randomized preference trial was conducted among 32 PWD. DFCG was implemented through Facebook. Participants in the intervention group joined the DFCG in addition to their usual care, while the control group received usual care. Data were collected online using questionnaires on participants' DFCG acceptance, engagement and preliminary efficacy on nine diabetes foot care-related outcomes at baseline, one, and three months post-intervention. Results The participants' study intervention acceptability and engagement rates were 84.2% and 55.2%, respectively. DFCG efficacy rate compared to usual care was 88.9% to 22.2%. Three diabetes foot care-related outcomes increased significantly in the intervention group three-month post-intervention: foot self-care adherence (p = 0.001, ηp 2 = 0.35), preventive foot self-care practice (p = 0.002, ηp 2 = 0.33), and physical health status (p < 0.02, ηp 2 = 0.23). Conclusion DFCG is feasible and could effectively improve diabetes foot care-related outcomes. Innovation Social media is an innovative approach healthcare professionals could utilize to virtually support PWD in ongoing learning and engagement in optimal foot self-care activities. Trial registration ClinicalTrials.gov, Identifier: NCT04395521.
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Affiliation(s)
- Helen Ngozichukwuka Obilor
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
- Department of Nursing, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Olena Veryha
- Wounds Canada (Canadian Association of Wound Care), Ontario, Canada
| | - Tom Weisz
- Wounds Canada (Canadian Association of Wound Care), Ontario, Canada
| | - Mariam Botros
- Wounds Canada (Canadian Association of Wound Care), Ontario, Canada
| | - Rosemary Wilson
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Joan Tranmer
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Kevin Woo
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
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Veerman LK, Fjermestad KW, Vatne TM, Sterkenburg PS, Derks SD, Brouwer-van Dijken AA, Willemen AM. Cultural applicability and desirability of 'Broodles': The first serious game intervention for siblings of children with disabilities. PEC INNOVATION 2024; 4:100277. [PMID: 38590338 PMCID: PMC11000116 DOI: 10.1016/j.pecinn.2024.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/21/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
Objective Serious games can serve as easily accessible interventions to support siblings of children with disabilities, who are at risk of developing mental health problems. The Dutch serious game 'Broodles' was developed for siblings aged 6-9 years. The current study aims to assess the cultural applicability, desirability, feasibility, and acceptability of 'Broodles' in Norway. Methods Norwegian siblings (N = 16) aged 6-13 years and parents (N = 12) of children with intellectual disabilities assessed the game. Their feedback data from interviews and questionnaires were sorted using a model of engagement factors in serious games. Results At pre-use, participants showed interest in the game, and after initial use the participants were overall positive about the format, content and objectives, including validation of emotions and recognition. The participants had suggestions for improved engagement and feasibility. Conclusion The game was found to be culturally applicable, desirable and acceptable, although Norwegian translation is necessary for further evaluation. Recommendations to enhance engagement were provided, including suggestions to play the game with parents or in a group. Innovation This initial assessment of the serious game Broodles in a non-Dutch setting shows promise for an innovative way of supporting siblings of children with disabilities.
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Affiliation(s)
- Linda K.M. Veerman
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
| | - Krister W. Fjermestad
- University of Oslo, Boks 1072 Blindern, 0316, Oslo, Norway
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, 1404, Siggerud, Norway
| | - Torun M. Vatne
- University of Oslo, Boks 1072 Blindern, 0316, Oslo, Norway
- Frambu Resource Center for Rare Disorders, Sandbakkveien 18, 1404, Siggerud, Norway
| | - Paula S. Sterkenburg
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
- Bartiméus, Oude Arnhemse Bovenweg 3, 3941 XM, Doorn, the Netherlands
| | - Suzanne D.M. Derks
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
| | | | - Agnes M. Willemen
- Vrije Universiteit Amsterdam, Amsterdam Public Health, LEARN!, De Boelelaan 1105, 1081 HV, Amsterdam, the Netherlands
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Wathne H, May C, Morken IM, Storm M, Husebø AML. Acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illness: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100229. [PMID: 39166216 PMCID: PMC11334779 DOI: 10.1016/j.ijnsa.2024.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
Background Patients living with long-term chronic illnesses often need ongoing medical attention, lifestyle adjustments, and psychosocial support beyond the initial diagnosis and treatment phases. Many experience illness deterioration and subsequently require hospitalisation, especially in the transition period after hospital discharge. A promising strategy for managing long-term conditions is promoting self-management. eHealth interventions involving remote patient monitoring have the potential to promote self-management and offer a more seamless bridge between the hospital and the patient´s home environment. However, such interventions can only significantly impact health and health care if they are effective, accepted and adopted by users, normalised into routine practice and everyday life, and able to be widely implemented. Feasibility studies are used to determine whether an intervention is suitable for the target population and effective in achieving its intended goal. They may also provide critical information about an intervention´s acceptability and usability. Objectives We aimed to evaluate the acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illnesses by use of the core constructs of normalisation process theory. Design A descriptive and explanatory qualitative approach was used, with patients observed during training and semi-structured interviews conducted with patients and nurses after study completion. Settings Participants were recruited from two university hospitals in Norway between December 2021 and February 2023. Participants Ten patients were observed during training, and 27 patients and eight nurses were interviewed after study completion. Methods Structured and overt observations were made while the patients received training to operate the remote patient monitoring service, guided by an observation guide. Semi-structured interviews were conducted with patients and nurse navigators about their experiences of remote follow-up care, guided by open ended questions. Data analysis followed a stepwise deductive inductive method. Results `Achieving acceptance and usability through digital social interaction´ emerged as a unifying theme that bridged the experiences of patients with long-term illnesses and the nurse navigators. This overarching theme was illustrated by four sub-themes, which all reflected the usability and acceptability of the nurse-assisted remote patient monitoring service in various ways. Conclusion Acceptability and usability are critical factors to consider when evaluating remote patient monitoring interventions. In this study, the most important feature for promoting acceptability and usability was the interaction between patients and nurse navigators. Therefore, the intervention´s feasibility and implementation potential rested upon the relationship between its deliverer and receiver.
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Affiliation(s)
- Hege Wathne
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ingvild Margreta Morken
- Department of Quality and Health Technologies, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
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Borsoi L, Listorti E, Ciani O. Artificial-Intelligence Cloud-Based Platform to Support Shared Decision-Making in the Locoregional Treatment of Breast Cancer: Protocol for a Multidimensional Evaluation Embedded in the CINDERELLA Clinical Trial. PHARMACOECONOMICS - OPEN 2024:10.1007/s41669-024-00519-1. [PMID: 39264499 DOI: 10.1007/s41669-024-00519-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/05/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Shared decision-making (SDM) plays a crucial role in breast cancer care by empowering patients and reducing decision regret. Patient decision aids (PtDAs) are valuable tools for facilitating SDM, now available in digital and artificial intelligence (AI)-powered formats to offer increasingly personalized contents. The ongoing CINDERELLA clinical trial (ClinicalTrials.gov: NCT05196269) evaluates an innovative AI cloud-based approach using a web platform and a mobile application (CINDERELLA APProach) versus the conventional approach to support SDM in breast cancer patients undergoing locoregional treatment. This protocol outlines a trial-based multidimensional evaluation, encompassing economic, financial, implementability, and environmental considerations associated with the CINDERELLA APProach. METHODS A within-trial cost-consequence and cost-utility analysis from a societal perspective will be performed using patient-level data on outcomes and resource use. The latter will be valued in monetary terms using country-specific unit costs or patient valuations. A budget impact analysis will be performed over 1 and 5 years from the budget holder perspectives. The CINDERELLA APProach implementability will be assessed through an evaluation of its usability, acceptability, organizational impact, and overall feasibility. The environmental impact will be quantitatively assessed across several dimensions, such as quantity, appropriateness, and emissions, supplemented by qualitative insights. Overall, data for the evaluation will be gathered from patient questionnaires, interviews with patients and managers, focus groups with healthcare professionals, and app electronic data. DISCUSSION A thorough understanding of the broad consequences of the CINDERELLA APProach may foster its successful translation into real-world settings, hopefully benefiting breast cancer patients and clinical practice.
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Affiliation(s)
- Ludovica Borsoi
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy.
| | - Elisabetta Listorti
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
| | - Oriana Ciani
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
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LaMontagne LG, Diehl DC, Gage NA, Leon SP, Doty JL, Nesbit T, Kumbkarni N. Acceptability, usage, and efficacy of mindfulness apps for college student mental health: A systematic review and meta-analysis of RCTs. J Affect Disord 2024:S0165-0327(24)01493-9. [PMID: 39260578 DOI: 10.1016/j.jad.2024.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 07/19/2024] [Accepted: 09/03/2024] [Indexed: 09/13/2024]
Abstract
BACKGROUND Preventing anxiety and depression among college students is a pressing public health need. Recent meta-analyses have examined mobile mindfulness interventions in adult populations; however, college students are in a unique developmental stage and institutional setting. METHODS We conducted a systematic literature review and meta-analysis of published and unpublished studies in English language on the acceptability, usage, and efficacy of mindfulness training apps on mental health among non-clinical samples of college students. Out of 167 reviewed studies, 47 were included in the narrative review. Additionally, we summarized effects from 19 stress, 12 anxiety, 13 depression, and 8 emotional well-being trials (total N = 2974) using robust variance estimation meta-regression and evaluated certainty of evidence with the GRADE approach. RESULTS Apps were acceptable, with usage levels varying. They reduced stress by 0.435 standard deviation units, 95 % CI (-0.615,-0.255), and increased emotional well-being by 0.431 (0.162,0.7) approaching medium effect sizes. The apps had small effects on depression (B = -0.219 (-0.374, -0.065)) and anxiety (B = -0.218 (-0.42, -0.016)). Certainty of evidence was moderate for stress, depression, and well-being; and low-to-moderate for anxiety. Distressed participants had larger improvements in all outcomes except depression. LIMITATIONS Small sample sizes in the original studies and small numbers of studies limit the precision of our effect estimates. The small number of studies with objective usage data impedes our ability to characterize the optimal dose. CONCLUSIONS With moderate certainty of evidence, mindfulness training apps may improve student mental health with similar or larger effect sizes than in the general adult population. However, sustained usage may be a challenge, and more research is needed on the optimal implementation strategy, dose, and equity.
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Affiliation(s)
- Liva G LaMontagne
- Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL 32610, USA.
| | - David C Diehl
- Family, Youth and Community Sciences, Institute for Food and Agricultural Sciences, University of Florida, Gainesville, FL 32611, USA.
| | | | - Sophia P Leon
- Clinical Psychology, Xavier University, Cincinnati, OH 45207, USA.
| | - Jennifer L Doty
- Counseling Psychology and Human Services, College of Education, University of Oregon, Eugene, OR 97403, USA.
| | - Tyler Nesbit
- Family, Youth and Community Sciences, Institute for Food and Agricultural Sciences, University of Florida, Gainesville, FL 32611, USA.
| | - Nayha Kumbkarni
- Psychology, College of Liberal Arts & Sciences, University of Florida, Gainesville, FL 32611, USA.
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Wanless B, Hassan N, McClellan C, Sothinathan C, Abelleyra Lastoria DA, Herweijer T, Thorpe J, Noblet T, Berry A. How Do We Better Serve Excluded Populations When Delivering Digital Health Technology? Inclusion Evaluation of a Digital Musculoskeletal Self-Management Solution. Musculoskeletal Care 2024; 22:e1925. [PMID: 39180193 DOI: 10.1002/msc.1925] [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: 06/18/2024] [Revised: 07/12/2024] [Accepted: 07/22/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Digital self-management platforms have been proposed as a solution to better support people manage their musculoskeletal (MSK) condition. However, research studies often explicitly exclude people who can't access internet connected devices. An important consideration is that digital exclusion (for people without access to an internet connected device) from these new digital options will worsen already existing inequality and inequity in healthcare. AIM To evaluate the acceptability and potential causes of digital exclusion of the South West London (SWL) MSK self-management app. OBJECTIVES (1) Explore why some patients are not using the app and any barriers they have. Explore why some clinicians are not prescribing the app. (2) Make recommendations, based on these findings, to improve digital inclusion. METHODS/DESIGN An explanatory sequential mixed method service evaluation that consisted of initial questionnaires to identify suitable collaborators, followed by structured interviews of patients and clinicians. RESULTS Following a comprehensive data analysis, 10 sub-themes were grouped into four main themes: (1) Beliefs: Importance of understanding the role of digital; face to face consultation is still valued and needed. (2) Barriers: Lack of digital literacy; lack of physical examination/contact with a clinician. (3) Enablers: Immediate access to advice and information; perceived better control over health; ease of use; no appointment needed. (4) Solutions: Support and training; greater awareness. CONCLUSIONS As digital health technology develops, strategies must change, requiring deliberate work and investments to improve inclusion. Our findings highlight how digital technology design and delivery can be adapted to address the causes of digital exclusion.
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Affiliation(s)
- Ben Wanless
- Department of Musculoskeletal Therapy, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Nawal Hassan
- Innovation and Transformation Team, NHS South West London Integrated Care Board, London, UK
| | | | | | | | - Thomas Herweijer
- Innovation and Transformation Team, NHS South West London Integrated Care Board, London, UK
| | - Jayne Thorpe
- Innovation and Transformation Team, NHS South West London Integrated Care Board, London, UK
| | - Tim Noblet
- Department of Musculoskeletal Therapy, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Alice Berry
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
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Schol CMA, van Mol MMC, Berger E, Leerentveld C, Gommers DAMPJ, Ista E. Implementation of a digital diary in the intensive care unit; understanding the facilitators and barriers: A qualitative exploration. Aust Crit Care 2024; 37:672-679. [PMID: 38719673 DOI: 10.1016/j.aucc.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/28/2024] [Accepted: 04/05/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND In the recent years, digital intensive care unit (ICU) diaries have emerged as more advantageous than paper diaries. Despite the advantages of digital diaries, the successful implementation and maintenance of this digital intervention present significant challenges in clinical practice. Therefore, understanding the facilitators and barriers among stakeholders influencing this process becomes imperative for devising a tailored strategy to integrate digital diaries effectively within ICU settings. AIM/OBJECTIVE The aim of this study was to explore facilitators and barriers for implementation of a digital ICU diary from the perspectives of ICU professionals, ICU survivors, and their relatives. METHODS A qualitative design was used, incorporating focus-group interviews with professionals from four Dutch ICUs, along with individual interviews with ICU survivors and relatives. The study spanned from October 2022 to April 2023. Data analysis utilised a mixed inductive-deductive approach, particularly through directed content analysis. The Consolidated Framework for Implementation Research 2.0 guided both data collection and analysis processes. FINDINGS We conducted five focus-group interviews among ICU professionals (n = 32) and 10 individual or dual interviews involving five ICU survivors and nine relatives. Key facilitators for implementing a digital diary according to ICU professionals encompassed a user-friendly interface accessible independent of time and place, with a seamless login process requiring minimal steps, comprehensive training covering all aspects of its use, and feedback from the experiences of both patients and relatives. Barriers for ICU professionals included many steps required to access the digital diary, as well as resistance to (co)writing diary entries. In contrast, professionals' involvement in writing diary entries was highly appreciated among ICU survivors and relatives. An ambiguous factor arose regarding sharing the digital diary with others; both ICU survivors and relatives found it valuable, yet it also raised privacy concerns. CONCLUSIONS This study offers insights into the most important factors influencing the implementation of a digital ICU diary. Strikingly, some factors serve as both barriers and facilitators. When developing the implementation strategy, the identified facilitators can be used to overcome the barriers faced by ICU professionals, ICU survivors, and their relatives in adopting a digital diary.
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Affiliation(s)
- Carola M A Schol
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
| | - Margo M C van Mol
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Elke Berger
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Department of Intensive Care, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands
| | | | - Diederik A M P J Gommers
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Erwin Ista
- Department of Internal Medicine, Section Nursing Science, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, University Medical Centre Rotterdam, Rotterdam, the Netherlands
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Talana ALE, Guirguis KB, Matthews JA, Chojecka PA, Chapman S, Koenig MA. A Rural Community Readiness Assessment of Prehospital Telestroke Services in the Ambulance. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:250-256. [PMID: 39290533 PMCID: PMC11402793 DOI: 10.62547/vzqv6670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
The research team assessed community acceptability of prehospital stroke telemedicine services in rural O'ahu communities. Tools were developed to evaluate patient-centered goals about implementing ambulance-based telemedicine which aimed to retain appropriate patients in community hospitals and improve thrombolytic treatment times. Using a mixed methods approach, the team surveyed well-appearing adults (ie, able to complete survey and interview) at O'ahu community events. Participants were asked to complete a short Likert-scale questionnaire (n=263) followed by a semi-structured interview (n=29). Data were summarized by descriptive and inferential statistics. Comparisons between rural and urban groups were made by chi-square analysis and Wilcoxon rank-sum 2-tailed test. Interviews were transcribed, coded, and analyzed using inductive and deductive methods. The findings suggest that use of prehospital telemedicine for specialty care is viewed favorably by both rural and urban respondents. Additionally, most respondents felt comfortable staying at their local hospital if they had access to a specialist by telemedicine. However, mistrust in rural hospitals may be a potential barrier to implementation. Compared to urban respondents, rural respondents were less confident in their local hospital's resources and capabilities for stroke care. The findings identified a potential misalignment of the project's goal with some patients' goal to use emergency medical services (EMS) to bypass rural hospitals for stroke care. Future community outreach efforts are needed to encourage activation of EMS and highlight the advantages of utilizing prehospital telemedicine for accessing specialty care thereby improving treatment times.
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Affiliation(s)
| | | | - J Aaron Matthews
- The Queen's Medical Center, Honolulu, HI (ALET, KBG, AM, PAC, MAK)
| | - Pola A Chojecka
- The Queen's Medical Center, Honolulu, HI (ALET, KBG, AM, PAC, MAK)
| | - Sherita Chapman
- Richmond VA Medical Center, Richmond, VA (SC)
- University of Virginia School of Medicine, Charlottesville, VA (SC)
| | - Matthew A Koenig
- The Queen's Medical Center, Honolulu, HI (ALET, KBG, AM, PAC, MAK)
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Chen W, Graham ID, Hu J, Lewis KB, Gifford W. Nurse managers' perceptions of the prospective acceptability of an implementation leadership training programme: A qualitative descriptive study. J Adv Nurs 2024; 80:3721-3733. [PMID: 38186229 DOI: 10.1111/jan.16047] [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: 08/10/2023] [Revised: 11/19/2023] [Accepted: 12/17/2023] [Indexed: 01/09/2024]
Abstract
AIM To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence-based practices, from the perspectives of potential programme participants and deliverers. DESIGN A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. METHODS We conducted individual semi-structured interviews with unit-level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. RESULTS After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi-modal training activities such as group work, experience-sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID-19 pandemic, and support from senior organizational leadership. CONCLUSIONS The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. IMPACT The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally.
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Affiliation(s)
- Wenjun Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian D Graham
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Jiale Hu
- Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Krystina B Lewis
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
| | - Wendy Gifford
- School of Nursing, Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
- Center for Research on Health and Nursing, University of Ottawa, Ottawa, Ontario, Canada
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Alves B, Mota PR, Sineiro D, Carmo R, Santos P, Macedo P, Carreira JC, Madeira RN, Dias SB, Pereira CM. MoveONParkinson: developing a personalized motivational solution for Parkinson's disease management. Front Public Health 2024; 12:1420171. [PMID: 39224558 PMCID: PMC11366595 DOI: 10.3389/fpubh.2024.1420171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
Introduction Despite the effectiveness of exercise-based interventions on symptom management and disease progression, many people with Parkinson's Disease (PwPD) do not exercise regularly. In line with the ubiquitous use of digital health technology, the MoveONParkinson digital solution was developed, comprising a Web Platform and a Mobile App with a Conversational Agent (CA). The interface features were designed based on the principles of Social Cognitive Theory with the goal of fostering behavior change in PwPD for sustained exercise participation and improved disease management. Methods Using a mixed methods approach, this study aimed to collect feedback, assess the acceptability of the Mobile App and the Web Platform, and evaluate the usability of the latter. Quantitative data, which included questionnaire responses and the System Usability Scale (SUS) scores, were analyzed using descriptive statistics, heatmaps, and correlation matrices. Qualitative data, comprising semi-structured and thinking-aloud interview transcripts, were subjected to an inductive thematic analysis. A total of 28 participants were involved in the study, comprising 20 physiotherapists (average age: 34.50 ± 10.4), and eight PwPD (average age: 65.75 ± 8.63; mean Hoehn & Yahr: 2.0 (± 0.76)). Results Three main themes emerged from the thematic analysis of the interviews, namely: Self-management (Theme 1), User Engagement (Theme 2), and Recommendations (Theme 3). The assessment of the Mobile App and the CA (mean score: 4.42/5.0 ± 0.79) suggests that PwPD were able to navigate this interface without notable difficulties. The mean SUS score of 79.50 (± 12.40%) with a 95% confidence interval ranging from 73.70 to 85.30, reveal good usability. Discussion These findings indicate a high level of acceptability of the MoveONParkinson digital solution, serving as a foundation for assessing its impact on exercise engagement and, subsequently, its influence on symptom management and quality of life of PwPD.
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Affiliation(s)
- Beatriz Alves
- Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Pedro R. Mota
- Escola Superior de Tecnologia, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Daniela Sineiro
- Escola Superior de Tecnologia, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Ricardo Carmo
- Escola Superior de Tecnologia, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Pedro Santos
- Research Center for Engineering and Sustainable Development (SUSTAIN), Setúbal, Portugal
- NOVA Laboratory for Computer Science and Informatics (NOVA LINCS), NOVA University Lisbon, Lisbon, Portugal
| | - Patrícia Macedo
- Research Center for Engineering and Sustainable Development (SUSTAIN), Setúbal, Portugal
- NOVA School of Science and Technology, Center of Technology and Systems (UNINOVA-CTS) and Associated Lab of Intelligent Systems (LASI), NOVA University Lisbon, Lisbon, Portugal
| | - João Casaca Carreira
- Comprehensive Health Research Centre (CHRC), NOVA University Lisbon, Lisbon, Portugal
| | - Rui Neves Madeira
- Research Center for Engineering and Sustainable Development (SUSTAIN), Setúbal, Portugal
- NOVA Laboratory for Computer Science and Informatics (NOVA LINCS), NOVA University Lisbon, Lisbon, Portugal
| | - Sofia Balula Dias
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Carla Mendes Pereira
- Comprehensive Health Research Centre (CHRC), NOVA University Lisbon, Lisbon, Portugal
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11
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Blake HB, Njah M, Babey MM, Asongwe E, Junkins A, Dionne JA, Montgomery AE, Washington T, Ivankova N, Smith T, Jolly PE. Understanding female sex workers' acceptance of secret Facebook group for HIV prevention in Cameroon. PLOS DIGITAL HEALTH 2024; 3:e0000562. [PMID: 39141653 PMCID: PMC11324143 DOI: 10.1371/journal.pdig.0000562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 06/27/2024] [Indexed: 08/16/2024]
Abstract
Despite the widespread utilization of social media in HIV prevention interventions, little is known about the acceptance of social media in the dissemination of HIV prevention information among key at-risk groups like female sex workers (FSWs). This study has investigated FSWs' acceptance of Secret Facebook Group (SFG) in learning about HIV prevention. During June 2022, a quantitative study was conducted using a 5-star point Likert scale survey among 40 FSWs aged 18 years and older who took part in a Secret Facebook Group (SFG) HIV intervention. Descriptive statistics described demographics, social media accessibility, perceived usefulness (PU), perceived ease of use (PEOU), and acceptance among survey participants using SPSS and SAS. Most study participants found SFG utilized in HIV prevention intervention acceptable. Seventy-five percent (75%) of participants selected 5 stars for the acceptance of SFG. The majority of participants used social media, spent more than 90 minutes on social media per day, and could participate in the SFG HIV prevention intervention if airtime was not provided by study investigators, despite experiencing times when the internet was interrupted. The results also showed the PU and PEOU mean scores of SFG in the HIV prevention intervention were slightly lower than the acceptance scores (4.70 and 4.50 vs. 4.74). The data suggested future research should focus on explaining FSWs acceptance of social media and identifying social media platform alternatives for HIV prevention intervention. This study provided useful insights into social media acceptance, use, and importance in HIV prevention education among FSWs. The findings also indicate the need for further research on the reasons for acceptance of social media and relevant social media platforms supporting HIV prevention education among FSWs.
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Affiliation(s)
- Hassanatu B. Blake
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Mercy Njah
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Mary Mah Babey
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Eveline Asongwe
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Anna Junkins
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Jodie A. Dionne
- Department of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Ann E. Montgomery
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Teneasha Washington
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Nataliya Ivankova
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Tamika Smith
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Pauline E. Jolly
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Morgan RM, Trejo C, Trager BM, Boyle SC, Koning IM, LaBrie JW. Process Evaluation and Investigation of Cultural Adaptations for an Online Parent-Based Intervention Using a Mixed-Method Approach. JOURNAL OF PREVENTION (2022) 2024; 45:557-577. [PMID: 38678484 PMCID: PMC11271356 DOI: 10.1007/s10935-024-00781-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/01/2024]
Abstract
Most alcohol intervention research focuses on program efficacy, yet few studies have investigated the acceptability of a program's design and implementation to the target population or adapting existing alcohol interventions to different populations. To address these gaps in the literature, we (1) examined participant responsiveness to and implementation quality of FITSTART+, a web-app delivered parent-based alcohol intervention designed for incoming first-year college students in the United States, and (2) gathered feedback on how this intervention could be adapted to other populations of parents. A sample of U.S. parents of 17-20-year-old first-year college students (N = 109) participated in FITSTART+ during their child's first year of college and completed a survey about parents' responsiveness to the app and its quality. Next, a sample of non-U.S. parents of adolescents aged 13 to 19 (N = 44) participated in one of 11 focus groups in which they briefly explored the app and then discussed how it could be adapted to be applicable and culturally relevant for them and their context. Results revealed that U.S. parents rated the intervention's quality as high and parents were responsive to the web-app's content, but some did not visit one of the most critical aspects of the intervention (i.e., alcohol-related parenting resources). Non-U.S. participants provided a range of suggestions for adapting the intervention to their context, which varied by culture. Results identify areas for improvement, particularly regarding the use of alcohol-related parenting resources, in this intervention and for web-delivered PBIs more broadly.
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Affiliation(s)
- Reed M Morgan
- Department of Psychology, Fordham University, New York, USA
- Department of Psychological Science, Loyola Marymount University, 1 LMU Drive Suite 4700, Los Angeles, CA, 90045, USA
| | - Constanza Trejo
- Psychology Department of Health and Student Welfare, Pontifical Catholic University of Chile, Santiago, Chile
| | - Bradley M Trager
- Department of Psychological Science, Loyola Marymount University, 1 LMU Drive Suite 4700, Los Angeles, CA, 90045, USA.
| | - Sarah C Boyle
- Department of Psychological Science, Loyola Marymount University, 1 LMU Drive Suite 4700, Los Angeles, CA, 90045, USA
| | - Ina M Koning
- Department of Clinical Child and Family Studies, VU University Amsterdam, Amsterdam, Netherlands
| | - Joseph W LaBrie
- Department of Psychological Science, Loyola Marymount University, 1 LMU Drive Suite 4700, Los Angeles, CA, 90045, USA
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Oldham M, Dina LM, Loebenberg G, Perski O, Brown J, Angus C, Beard E, Burton R, Field M, Greaves F, Hickman M, Kaner E, Michie S, Munafò MR, Pizzo E, Garnett C. Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page: Qualitative Interview Process Evaluation. J Med Internet Res 2024; 26:e42319. [PMID: 39024575 PMCID: PMC11294780 DOI: 10.2196/42319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 03/08/2024] [Accepted: 05/14/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy. OBJECTIVE In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app. METHODS A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews. The interview questions were mapped on to the 7 facets of acceptability according to the Theoretical Framework of Acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Alongside these constructs, we also included a question on perceived personal relevance, which previous research has linked to acceptability and engagement. Framework and thematic analysis of data was undertaken. RESULTS The Drink Less app was perceived as being ethical, easy, user-friendly, and effective for the period the app was used. Participants reported particularly liking the tracking and feedback sections of the app, which they reported increased personal relevance and which resulted in positive affect when achieving their goals. They reported no opportunity cost. Factors such as negative affect when not meeting goals and boredom led to disengagement in the longer term for some participants. The NHS alcohol advice web page was rated as being easy and user-friendly with no opportunity costs. However, the information presented was not perceived as being personally relevant or effective in changing drinking behavior. Most participants reported neutral or negative affect, most participants thought the alcohol advice web page was accessible, and some participants reported ethical concerns around the availability of suggested resources. Some participants reported that it had acted as a starting point or a signpost to other resources. Participants in both groups discussed motivation to change and contextual factors such as COVID-19 lockdowns, which influenced their perceived self-efficacy regardless of their assigned intervention. CONCLUSIONS Drink Less appears to be an acceptable digital intervention among the recruited sample. The NHS alcohol advice web page was generally considered unacceptable as a stand-alone intervention among the recruited sample, although it may signpost and help people access other resources and interventions.
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Affiliation(s)
- Melissa Oldham
- Behavioural Science and Health, University College London, London, United Kingdom
| | - Larisa-Maria Dina
- Behavioural Science and Health, University College London, London, United Kingdom
| | - Gemma Loebenberg
- Behavioural Science and Health, University College London, London, United Kingdom
| | - Olga Perski
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, United States
| | - Jamie Brown
- Behavioural Science and Health, University College London, London, United Kingdom
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Emma Beard
- Behavioural Science and Health, University College London, London, United Kingdom
| | - Robyn Burton
- Addictions Directorate, Office for Health Improvement and Disparities, London, United Kingdom
- Institute of Psychiatry, Psychology and Neuroscience, Kings College, London, United Kingdom
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Felix Greaves
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
- National Institute for Health and Care Excellence, London, United Kingdom
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Eileen Kaner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, United Kingdom
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Elena Pizzo
- Department of Applied Health Research, University College London, London, United Kingdom
| | - Claire Garnett
- Behavioural Science and Health, University College London, London, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
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Rinne J, Leino-Kilpi H, Koskinen S, Saaranen T, Pasanen M, Vauhkonen A, Salminen L. An intervention to address nurse educators' occupational well-being: A process evaluation. NURSE EDUCATION TODAY 2024; 138:106219. [PMID: 38636189 DOI: 10.1016/j.nedt.2024.106219] [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: 10/10/2023] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND There is a global need for more support for the occupational well-being of educators working in nurse education, where nurse educators experience challenges when managing their own occupational well-being. However, there is a lack of research studies into occupational well-being interventions. Aim To evaluate the usability and utility of the Self-Help INtervention for Educators in nurse education. DESIGN A process evaluation was conducted after the intervention in Spring 2022. SETTINGS Educational organisations providing national regulated practical nurse education in Finland. PARTICIPANTS Nurse educators (n = 37), completing the 8-workweek intervention. METHODS Data were collected with the self-reported electronic feedback questionnaire consisting of three sections: 1) 10-item System Usability Scale, 2) 7-item Utility scale developed for this study and 3) 4 open ended questions. The data were analysed statistically and with content analysis. RESULTS The intervention was found to be usable; especially the easy learnability and usage of the digital Smart Break-SHINE program and the applicable exercises. It was estimated to be moderately useful as a well-being and break promoter at work. The utility of the intervention to promote physical activity and recovery during working hours was statistically more positive for educators with <5 years of work experience than those with over 15 years. Usability and utility barriers were found especially regarding workload issues. CONCLUSIONS The Self-Help INtervention for Educators supports the occupational well-being of nurse educators and includes well-being actions suitable for different work surroundings (e.g., remote working) without the need for constant facilitating. The intervention was found to be most beneficial for early career nurse educators. The Self-Help INtervention for Educators needs more development to overcome the usability and utility barriers related to workload issues.
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Affiliation(s)
- Jenni Rinne
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland.
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland; Turku University Hospital, Finland.
| | - Sanna Koskinen
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland.
| | - Terhi Saaranen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
| | - Miko Pasanen
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland.
| | - Anneli Vauhkonen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
| | - Leena Salminen
- Department of Nursing Science, University of Turku, 20014 Turun Yliopisto, Finland; Turku University Hospital, Finland.
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15
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Spoladore D, Colombo V, Fumagalli A, Tosi M, Lorenzini EC, Sacco M. An Ontology-Based Decision Support System for Tailored Clinical Nutrition Recommendations for Patients With Chronic Obstructive Pulmonary Disease: Development and Acceptability Study. JMIR Med Inform 2024; 12:e50980. [PMID: 38922666 PMCID: PMC11237782 DOI: 10.2196/50980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 02/01/2024] [Accepted: 04/23/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic condition among the main causes of morbidity and mortality worldwide, representing a burden on health care systems. Scientific literature highlights that nutrition is pivotal in respiratory inflammatory processes connected to COPD, including exacerbations. Patients with COPD have an increased risk of developing nutrition-related comorbidities, such as diabetes, cardiovascular diseases, and malnutrition. Moreover, these patients often manifest sarcopenia and cachexia. Therefore, an adequate nutritional assessment and therapy are essential to help individuals with COPD in managing the progress of the disease. However, the role of nutrition in pulmonary rehabilitation (PR) programs is often underestimated due to a lack of resources and dedicated services, mostly because pneumologists may lack the specialized training for such a discipline. OBJECTIVE This work proposes a novel knowledge-based decision support system to support pneumologists in considering nutritional aspects in PR. The system provides clinicians with patient-tailored dietary recommendations leveraging expert knowledge. METHODS The expert knowledge-acquired from experts and clinical literature-was formalized in domain ontologies and rules, which were developed leveraging the support of Italian clinicians with expertise in the rehabilitation of patients with COPD. Thus, by following an agile ontology engineering methodology, the relevant formal ontologies were developed to act as a backbone for an application targeted at pneumologists. The recommendations provided by the decision support system were validated by a group of nutrition experts, whereas the acceptability of such an application in the context of PR was evaluated by pneumologists. RESULTS A total of 7 dieticians (mean age 46.60, SD 13.35 years) were interviewed to assess their level of agreement with the decision support system's recommendations by evaluating 5 patients' health conditions. The preliminary results indicate that the system performed more than adequately (with an overall average score of 4.23, SD 0.52 out of 5 points), providing meaningful and safe recommendations in compliance with clinical practice. With regard to the acceptability of the system by lung specialists (mean age 44.71, SD 11.94 years), the usefulness and relevance of the proposed solution were extremely positive-the scores on each of the perceived usefulness subscales of the technology acceptance model 3 were 4.86 (SD 0.38) out of 5 points, whereas the score on the intention to use subscale was 4.14 (SD 0.38) out of 5 points. CONCLUSIONS Although designed for the Italian clinical context, the proposed system can be adapted for any other national clinical context by modifying the domain ontologies, thus providing a multidisciplinary approach to the management of patients with COPD.
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Affiliation(s)
- Daniele Spoladore
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council of Italy, Lecco, Italy
- Department of Pure and Applied Sciences, Computer Science Division, Insubria University, Varese, Italy
| | - Vera Colombo
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council of Italy, Lecco, Italy
| | - Alessia Fumagalli
- Unit of Pulmonary Rehabilitation, IRCCS, Italian National Research Center on Aging, Casatenovo, Italy
| | - Martina Tosi
- Institute of Agricultural Biology and Biotechnology, National Research Council of Italy, Milan, Italy
- Department of Health Science, University of Milan, Milan, Italy
| | - Erna Cecilia Lorenzini
- Institute of Agricultural Biology and Biotechnology, National Research Council of Italy, Milan, Italy
- Department of Biomedical Sciences for Health, Chair of Clinical Pathology, University of Milan, Milan, Italy
| | - Marco Sacco
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council of Italy, Lecco, Italy
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16
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Milne-Ives M, Homer S, Andrade J, Meinert E. The conceptualisation and measurement of engagement in digital health. Internet Interv 2024; 36:100735. [PMID: 38558760 PMCID: PMC10979253 DOI: 10.1016/j.invent.2024.100735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/12/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Digital tools are an increasingly important component of healthcare, but their potential impact is commonly limited by a lack of user engagement. Digital health evaluations of engagement are often restricted to system usage metrics, which cannot capture a full understanding of how and why users engage with an intervention. This study aimed to examine how theory-based, multifaceted measures of engagement with digital health interventions capture different components of engagement (affective, cognitive, behavioural, micro, and macro) and to consider areas that are unclear or missing in their measurement. We identified and compared two recently developed measures that met these criteria (the Digital Behaviour Change Intervention Engagement Scale and the TWente Engagement with Ehealth Technologies Scale). Despite having similar theoretical bases and being relatively strongly correlated, there are key differences in how these scales aim to capture engagement. We discuss the implications of our analysis for how affective, cognitive, and behavioural components of engagement can be conceptualised and whether there is value in distinguishing between them. We conclude with recommendations for the circumstances in which each scale may be most useful and for how future measure development could supplement existing scales.
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Affiliation(s)
- Madison Milne-Ives
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Health Technology, University of Plymouth, Plymouth, UK
| | - Sophie Homer
- School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Jackie Andrade
- School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Edward Meinert
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Health Technology, University of Plymouth, Plymouth, UK
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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17
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Pehlivan MJ, Sherman KA, Wuthrich V, Gandhi E, Zagic D, Kopp E, Perica V. The effectiveness of psychological interventions for reducing poor body image in endometriosis, PCOS and other gynaecological conditions: a systematic review and meta-analysis. Health Psychol Rev 2024; 18:341-368. [PMID: 37675797 DOI: 10.1080/17437199.2023.2245020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/01/2023] [Indexed: 09/08/2023]
Abstract
Gynaecological conditions (e.g., endometriosis, PCOS) result in bodily changes that negatively impact body image. Psychological interventions (e.g., CBT, psychoeducation) have shown promise in reviews with the general population for alleviating body image concerns. This systematic review and meta-analysis aims to provide asynthesis of the impact of psychological interventions for reducing body image concerns for individuals with gynaecological conditions. Electronic databases were searched for relevant psychological intervention studies with body image outcomes. Twenty-one eligible studies were included in the systematic review (ten were included in a random-effects meta-analysis). Studies included participants (N = 1483, M = 71.85, SD = 52.79) with a range of gynaecological conditions, ages (Mage = 35.08, SD = 12.17) and cultural backgrounds. Most included studies reported at least one positive effect with the meta-analysis indicating psychological interventions were moderately superior to control conditions for reducing body image concerns (SMD -.41, 95% CI [-0.20 -0.62]). However, there was a high risk of bias and moderate heterogeneity. Results suggest psychological interventions may hold promise for reducing body image concerns among individuals gynaecological conditions in the short term. Further, preliminary support was found for the use of theory-guided psychological interventions delivered in group settings in particular, with further research needed on optimal intervention length and particular psychotherapeutic approach.
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Affiliation(s)
- Melissa J Pehlivan
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Kerry A Sherman
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Viviana Wuthrich
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Esther Gandhi
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Dino Zagic
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Emily Kopp
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Valentina Perica
- Lifespan, Health and Wellbeing Research Centre, School of Psychological Sciences, Macquarie University, Sydney, Australia
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18
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Cavuoto MG, Markusevska S, Stevens C, Reyes P, Renshaw G, Peters MDJ, Dow B, Feldman P, Gilbert A, Manias E, Mortimer D, Enticott J, Cooper C, Antoniades J, Appleton B, Nakrem S, O'Brien M, Ostaszkiewicz J, Eckert M, Durston C, Brijnath B. The impact of elder abuse training on subacute health providers and older adults: study protocol for a randomized control trial. Trials 2024; 25:338. [PMID: 38778386 PMCID: PMC11110438 DOI: 10.1186/s13063-024-08160-3] [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: 01/22/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse. METHODS This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. DISCUSSION This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. TRIAL REGISTRATION ANZCTR, ACTRN12623000676617p . Registered 22 June 2023.
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Affiliation(s)
- Marina G Cavuoto
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Simona Markusevska
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
| | | | - Patricia Reyes
- . Vincent's Health Sydney, Darlinghurst, NSW, Australia
- University of New South Wales, Kensington, NSW, Australia
- Uniting War Memorial Hospital, Waverley, NSW, Australia
| | - Gianna Renshaw
- Sir Charles Gairdner Osborne Park Health Care Group, Stirling and Nedlands, WA, Australia
| | - Micah D J Peters
- Rosemary Bryant AO Research Centre, Clinical Health Science, University of South Australia, Adelaide, South Australia, Australia
- Australian Nursing and Midwifery Federation (Federal Office), Melbourne, VIC, Australia
- Adelaide Nursing School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Health Evidence Synthesis, Recommendations, and Impact (HERSI), School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Briony Dow
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- The University of Melbourne, Parkville, VIC, Australia
- Deakin University, Waurn Ponds, Victoria, Australia
| | - Peter Feldman
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
| | - Andrew Gilbert
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- La Trobe University, Bundoora, VIC, Australia
| | - Elizabeth Manias
- Deakin University, Waurn Ponds, Victoria, Australia
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
- Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Duncan Mortimer
- Centre for Health Economics, Monash University, Caulfield East, VIC, Australia
| | - Joanne Enticott
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Claudia Cooper
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Josefine Antoniades
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
- School of Media, Creative Arts and Social Inquiry, Curtin University, Bentley, WA, Australia
| | | | - Sigrid Nakrem
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Joan Ostaszkiewicz
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia
- The University of Melbourne, Parkville, VIC, Australia
- Health and Innovation Transformation Centre, Federation University, Ballarat, VIC, Australia
| | - Marion Eckert
- Rosemary Bryant AO Research Centre, Clinical Health Science, University of South Australia, Adelaide, South Australia, Australia
- College of Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | | | - Bianca Brijnath
- Social Gerontology, National Ageing Research Institute, PO Box 2127, Parkville, VIC, 3050, Australia.
- The University of Melbourne, Parkville, VIC, Australia.
- The School of Social Sciences, The University of Western Australia, Perth, WA, Australia.
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Amiot O, Sauvaget A, Alamome I, Bulteau S, Charpeaud T, Clair AH, Courtet P, Drapier D, Haffen E, Fakra E, Gaudeau-Bosma C, Gaillard A, Mouchabac S, Pineau F, Narboni V, Duburcq A, Lecardeur L. Prospective Acceptability of Digital Therapy for Major Depressive Disorder in France: Multicentric Real-Life Study. JMIR Form Res 2024; 8:e53204. [PMID: 38568139 PMCID: PMC11148517 DOI: 10.2196/53204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/26/2024] [Accepted: 04/03/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND Major depressive disorder is one of the leading causes of disability worldwide. Although most international guidelines recommend psychological and psychosocial interventions as first-line treatment for mild to moderate depression, access remains limited in France due to the limited availability of trained clinicians, high costs for patients in the context of nonreimbursement, and the fear of stigmatization. Therefore, online blended psychological treatment such as Deprexis could improve access to care for people with depression. It has several advantages, such as easy accessibility and scalability, and it is supported by evidence. OBJECTIVE This study aims to evaluate the real-life acceptability of Deprexis for people with depression in France outside of a reimbursement pathway. METHODS Deprexis Acceptability Study Measure in Real Life (DARE) was designed as a multicenter cross-sectional study in which Deprexis was offered to any patient meeting the inclusion criteria during the fixed inclusion period (June 2022-March 2023). Inclusion criteria were (1) depression, (2) age between 18 and 65 years, (3) sufficient French language skills, and (4) access to the internet with a device to connect to the Deprexis platform. Exclusion criteria were previous or current diagnoses of bipolar disorder, psychotic symptoms, and suicidal thoughts during the current episode. The primary objective was to measure the prospective acceptability of Deprexis, a new digital therapy. Secondary objectives were to examine differences in acceptability according to patient and clinician characteristics and to identify reasons for refusal. All investigators received video-based training on Deprexis before enrollment to ensure that they all had the same level of information and understanding of the program. RESULTS A total of 245 patients were eligible (n=159, 64.9% were women and n=138, 56.3% were single). The mean age was 40.7 (SD 14.1) years. A total of 78% (n=191) of the patients had moderate to severe depression (according to the Patient Health Questionnaire-9 [PHQ-9]). More than half of the population had another psychiatric comorbidity (excluding bipolar disorder, psychotic disorders, and suicidal ideation). A total of 33.9% (n=83) of patients accepted the idea of using Deprexis; the main reason for refusal was financial at 83.3% (n=135). Multivariate logistic regression identified factors that might favor the acceptability of Deprexis. Among these, being a couple, being treated with an antidepressant, or having a low severity level favored the acceptance of Deprexis. CONCLUSIONS DARE is the first French study aiming at evaluating the prospective acceptability of digital therapy in the treatment of depression. The main reason for the refusal of Deprexis was financial. DARE will allow better identification of factors influencing acceptability in a natural setting. This study highlights the importance of investigating factors that may be associated with the acceptability of digital interventions, such as marital status, medication use, and severity of depression.
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Affiliation(s)
- Odile Amiot
- Groupe Hospitalier Paul Guiraud, Boulogne Billancourt, France
| | - Anne Sauvaget
- Movement - Interactions - Performance, Centre Hospitalier Universitaire Nantes, Nantes Université, Nantes, France
| | | | - Samuel Bulteau
- Institut national de la santé et de la recherche médicale 1246, MethodS in Patient-Centered Outcomes and HEalth ResEarch, Centre Hospitalier Universitaire de Nantes, Department of Addictology, Psychiatry and Old Age Psychiatry, University of Nantes, Nantes, France
- Department of Addictology, Psychiatry and Old Age Psychiatry, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | | | | | - Philippe Courtet
- Neuropsychiatrie: Recherche Epidemiologique et Clinique, Institut national de la sante et de la recherche medicale, Centre Hospitalier Universitaire de Montpellier, University of Montpellier, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Dominique Drapier
- Centre Hospitalier Guillaume Régnier, Pôle hospitalo universitaire de psychiatrie adulte, Rennes, France
- Centre d'Investigation Clinique Institut national de la sante et de la recherche medicale 1414 équipe neuropsychiatrie du développement et du comportement, Université de Rennes, Rennes, France
| | - Emmanuel Haffen
- Service de Psychiatrie de l'Adulte, Centre d'Investigation Clinique 1431-Institut national de la sante et de la recherche medicale, Centre Hospitalier Universitaire de Besançon, Université de Franche-Comté, Besançon, France
| | - Eric Fakra
- Pôle Universitaire de Psychiatrie, Centre Hospitalier Universitaire de Saint-Etienne, Université Jean Monnet, Equipe Troubles psychiatriques, Recherche en Neurosciences et Recherche Clinique- InInstitut national de la sante et de la recherche medicaleserm, Centre National de la Recherche Scientifique 5292, Université Lyon 1, Université Jean Monnet, Saint-Etienne, France
| | - Christian Gaudeau-Bosma
- Espace Territoriale d'Accompagnement Psychosociale, Groupe Hospitaliser Territorial Val de Marne-Est, Saint-Maurice, France
| | | | - Stéphane Mouchabac
- Department of Psychiatry, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - Fanny Pineau
- Cabinet de psychologie, Bureaux du Polygone, Montpellier, France
| | | | - Anne Duburcq
- CEMKA - 43, boulevard du Maréchal Joffre, Bourg-La-Reine, France
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Kepper M, Walsh-Bailey C, Miller ZM, Zhao M, Zucker K, Gacad A, Herrick C, White NH, Brownson RC, Foraker RE. The Impact of Behavior Change Counseling Delivered via a Digital Health Tool Versus Routine Care Among Adolescents With Obesity: Pilot Randomized Feasibility Study. JMIR Form Res 2024; 8:e55731. [PMID: 38758581 PMCID: PMC11143394 DOI: 10.2196/55731] [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: 12/21/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Youth overweight and obesity is a public health crisis and increases the risk of poor cardiovascular health (CVH) and chronic disease. Health care providers play a key role in weight management, yet few tools exist to support providers in delivering tailored evidence-based behavior change interventions to patients. OBJECTIVE The goal of this pilot randomized feasibility study was to determine the feasibility of implementing the Patient-Centered Real-Time Intervention (PREVENT) tool in clinical settings, generate implementation data to inform scale-up, and gather preliminary effectiveness data. METHODS A pilot randomized clinical trial was conducted to examine the feasibility, implementation, and preliminary impact of PREVENT on patient knowledge, motivation, behaviors, and CVH outcomes. The study took place in a multidisciplinary obesity management clinic at a children's hospital within an academic medical center. A total of 36 patients aged 12 to 18 years were randomized to use PREVENT during their routine visit (n=18, 50%) or usual care control (n=18, 50%). PREVENT is a digital health tool designed for use by providers to engage patients in behavior change education and goal setting and provides resources to support change. Patient electronic health record and self-report behavior data were collected at baseline and 3 months after the intervention. Implementation data were collected via PREVENT, direct observation, surveys, and interviews. We conducted quantitative, qualitative, and mixed methods analyses to evaluate pretest-posttest patient changes and implementation data. RESULTS PREVENT was feasible, acceptable, easy to understand, and helpful to patients. Although not statistically significant, only PREVENT patients increased their motivation to change their behaviors as well as their knowledge of ways to improve heart health and of resources. Compared to the control group, PREVENT patients significantly improved their overall CVH and blood pressure (P<.05). CONCLUSIONS Digital tools can support the delivery of behavior change counseling in clinical settings to increase knowledge and motivate patients to change their behaviors. An appropriately powered trial is necessary to determine the impact of PREVENT on CVH behaviors and outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT06121193; https://www.clinicaltrials.gov/study/NCT06121193.
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Affiliation(s)
- Maura Kepper
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Callie Walsh-Bailey
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Zoe M Miller
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Min Zhao
- Institute for Informatics, Washington University School of Medicine, St. Louis, MO, United States
| | - Kianna Zucker
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Angeline Gacad
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Cynthia Herrick
- Division of Endocrinology, Washington University School of Medicine, St. Louis, MO, United States
| | - Neil H White
- Division of Pediatric Endocrinology & Diabetes, Washington University School of Medicine, St. Louis, MO, United States
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Randi E Foraker
- Institute for Informatics, Washington University School of Medicine, St. Louis, MO, United States
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21
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Abouzeid N, Lal S. The role of sociodemographic factors on the acceptability of digital mental health care: A scoping review protocol. PLoS One 2024; 19:e0301886. [PMID: 38669278 PMCID: PMC11051634 DOI: 10.1371/journal.pone.0301886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Many individuals experiencing mental health complications face barriers when attempting to access services. To bridge this care gap, digital mental health innovations (DMHI) have proven to be valuable additions to in-person care by enhancing access to care. An important aspect to consider when evaluating the utility of DMHI is perceived acceptability. However, it is unclear whether diverse sociodemographic groups differ in their degree of perceived acceptability of DMHI. OBJECTIVE This scoping review aims to synthesize evidence on the role of sociodemographic factors (e.g., age, gender) in the perceived acceptability of DMHI among individuals seeking mental health care. METHODS Guided by the JBI Manual of Evidence Synthesis, chapter on Scoping Review, a search strategy developed according to the PCC framework will be implemented in MEDLINE and then adapted to four electronic databases (i.e., CINAHL, MEDLINE, PsycINFO, and EMBASE). The study selection strategy will be piloted by two reviewers on subsets of 30 articles until agreement among reviewers reaches 90%, after which one reviewer will complete the remaining screening of titles and abstracts. The full-text screening, data extraction strategy, and charting tool will be completed by one reviewer and then validated by a second member of the team. Main findings will be presented using tables and figures. EXPECTED CONTRIBUTIONS This scoping review will examine the extent to which sociodemographic factors have been considered in the digital mental health literature. Also, the proposed review may help determine whether certain populations have been associated with a lower level of acceptability within the context of digital mental health care. This investigation aims to favor equitable access to DMHI among diverse populations.
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Affiliation(s)
- Nagi Abouzeid
- School of Rehabilitation, University of Montréal, Montréal, Québec, Canada
- Youth Mental Health and Technology Lab, University of Montréal Hospital Research Centre, Montréal, Québec, Canada
| | - Shalini Lal
- School of Rehabilitation, University of Montréal, Montréal, Québec, Canada
- Youth Mental Health and Technology Lab, University of Montréal Hospital Research Centre, Montréal, Québec, Canada
- Douglas Research Centre, Montréal, Québec, Canada
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22
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Materia FT, Smyth JM. Acceptability and concerns about innovative wearable health sensors in persons with and without chronic disease diagnosis. Internet Interv 2024; 35:100702. [PMID: 38221944 PMCID: PMC10787257 DOI: 10.1016/j.invent.2023.100702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/19/2023] [Accepted: 12/17/2023] [Indexed: 01/16/2024] Open
Abstract
Advances in biomedical engineering continue to produce innovative wearable health sensors capable of real-time ambulatory assessments (e.g., of physiology, the environment), holding great potential for advancing precision monitoring and interventions through the integration of such devices and data into eHealth systems. As with any novel device, however, user views on acceptability and concerns about the technology must be evaluated to facilitate widespread implementation and user adoption of such devices. One factor that may strongly influence user views is the potential relevance to, and need for, self-care for chronic disease management. We examined if acceptability and concerns regarding innovative wearable devices differed between individuals living with or without chronic disease. A U.S. adult sample (N = 448; 20-70 yrs.; 34 % Female; 60 % White, 35 % Hispanic) completed a web-based survey regarding their thoughts/opinions related to innovative wearable sensors. Two-thirds (67 %, N = 298) reported at least one chronic disease; one-third (33 %, N = 150) reported no chronic health conditions. Participants viewed learning modules about two innovative devices: a watch to detect environmental gases for respiratory health, and a chest-patch monitoring real-time ECG. For each device, participants rated acceptability across multiple dimensions, and then rated potential concerns (including general concerns and specific worries about negative health impacts). Respondents with and without chronic disease differed in education, race, and ethnicity. Controlling for these differences, individuals with chronic disease reported significantly higher acceptability for the watch and for the chest-patch. Healthy participants reported significantly higher general concerns about technology. However, when concern questions were asked specifically about the potential negative impacts of the two study devices on physical health and well-being, participants with chronic disease reported significantly higher concerns. Overall, results show that living with chronic disease influences acceptability and concerns associated with adoption of innovative sensors. These findings suggest it is essential to take potential users' health status into account when studying the design and implementation of innovative wearable sensors. Dissemination strategies may benefit from emphasizing the beneficial features of these devices, addressing hesitations, and customizing implementation approaches by user group.
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Affiliation(s)
- Frank T. Materia
- Departments of Otolaryngology and Population Health, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Joshua M. Smyth
- Department of Psychology, The Ohio State University, Columbus, OH, United States of America
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23
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Evans RP, Bryant LD, Russell G, Absolom K. Trust and acceptability of data-driven clinical recommendations in everyday practice: A scoping review. Int J Med Inform 2024; 183:105342. [PMID: 38266426 DOI: 10.1016/j.ijmedinf.2024.105342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/08/2023] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Increasing attention is being given to the analysis of large health datasets to derive new clinical decision support systems (CDSS). However, few data-driven CDSS are being adopted into clinical practice. Trust in these tools is believed to be fundamental for acceptance and uptake but to date little attention has been given to defining or evaluating trust in clinical settings. OBJECTIVES A scoping review was conducted to explore how and where acceptability and trustworthiness of data-driven CDSS have been assessed from the health professional's perspective. METHODS Medline, Embase, PsycInfo, Web of Science, Scopus, ACM Digital, IEEE Xplore and Google Scholar were searched in March 2022 using terms expanded from: "data-driven" AND "clinical decision support" AND "acceptability". Included studies focused on healthcare practitioner-facing data-driven CDSS, relating directly to clinical care. They included trust or a proxy as an outcome, or in the discussion. The preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) is followed in the reporting of this review. RESULTS 3291 papers were screened, with 85 primary research studies eligible for inclusion. Studies covered a diverse range of clinical specialisms and intended contexts, but hypothetical systems (24) outnumbered those in clinical use (18). Twenty-five studies measured trust, via a wide variety of quantitative, qualitative and mixed methods. A further 24 discussed themes of trust without it being explicitly evaluated, and from these, themes of transparency, explainability, and supporting evidence were identified as factors influencing healthcare practitioner trust in data-driven CDSS. CONCLUSION There is a growing body of research on data-driven CDSS, but few studies have explored stakeholder perceptions in depth, with limited focused research on trustworthiness. Further research on healthcare practitioner acceptance, including requirements for transparency and explainability, should inform clinical implementation.
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Affiliation(s)
- Ruth P Evans
- University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
| | | | - Gregor Russell
- Bradford District Care Trust, Bradford, New Mill, Victoria Rd, BD18 3LD, UK.
| | - Kate Absolom
- University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
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24
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Gannamani R, Castela Forte J, Folkertsma P, Hermans S, Kumaraswamy S, van Dam S, Chavannes N, van Os H, Pijl H, Wolffenbuttel BHR. A Digitally Enabled Combined Lifestyle Intervention for Weight Loss: Pilot Study in a Dutch General Population Cohort. JMIR Form Res 2024; 8:e38891. [PMID: 38329792 PMCID: PMC10884913 DOI: 10.2196/38891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 05/04/2023] [Accepted: 09/25/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Overweight and obesity rates among the general population of the Netherlands keep increasing. Combined lifestyle interventions (CLIs) focused on physical activity, nutrition, sleep, and stress management can be effective in reducing weight and improving health behaviors. Currently available CLIs for weight loss (CLI-WLs) in the Netherlands consist of face-to-face and community-based sessions, which face scalability challenges. A digitally enabled CLI-WL with digital and human components may provide a solution for this challenge; however, the feasibility of such an intervention has not yet been assessed in the Netherlands. OBJECTIVE The aim of this study was two-fold: (1) to determine how weight and other secondary cardiometabolic outcomes (lipids and blood pressure) change over time in a Dutch population with overweight or obesity and cardiometabolic risk participating in a pilot digitally enabled CLI-WL and (2) to collect feedback from participants to guide the further development of future iterations of the intervention. METHODS Participants followed a 16-week digitally enabled lifestyle coaching program rooted in the Fogg Behavior Model, focused on nutrition, physical activity, and other health behaviors, from January 2020 to December 2021. Participants could access the digital app to register and track health behaviors, weight, and anthropometrics data at any time. We retrospectively analyzed changes in weight, blood pressure, and lipids for remeasured users. Surveys and semistructured interviews were conducted to assess critical positive and improvement points reported by participants and health care professionals. RESULTS Of the 420 participants evaluated at baseline, 53 participated in the pilot. Of these, 37 (70%) were classified as overweight and 16 (30%) had obesity. Mean weight loss of 4.2% occurred at a median of 10 months postintervention. The subpopulation with obesity (n=16) showed a 5.6% weight loss on average. Total cholesterol decreased by 10.2% and low-density lipoprotein cholesterol decreased by 12.9% on average. Systolic and diastolic blood pressure decreased by 3.5% and 7.5%, respectively. Participants identified the possibility of setting clear action plans to work toward and the multiple weekly touch points with coaches as two of the most positive and distinctive components of the digitally enabled intervention. Surveys and interviews demonstrated that the digital implementation of a CLI-WL is feasible and well-received by both participants and health care professionals. CONCLUSIONS Albeit preliminary, these findings suggest that a behavioral lifestyle program with a digital component can achieve greater weight loss than reported for currently available offline CLI-WLs. Thus, a digitally enabled CLI-WL is feasible and may be a scalable alternative to offline CLI-WL programs. Evidence from future studies in a Dutch population may help elucidate the mechanisms behind the effectiveness of a digitally enabled CLI-WL.
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Affiliation(s)
- Rahul Gannamani
- Ancora Health BV, Groningen, Netherlands
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - José Castela Forte
- Ancora Health BV, Groningen, Netherlands
- Department of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Pytrik Folkertsma
- Ancora Health BV, Groningen, Netherlands
- Department of Endocrinology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | | | | | - Sipko van Dam
- Ancora Health BV, Groningen, Netherlands
- Department of Endocrinology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Hendrikus van Os
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden University, Leiden, Netherlands
- National eHealth Living Lab, Leiden, Netherlands
| | - Hanno Pijl
- Department of Endocrinology, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Schäfer SK, von Boros L, Schaubruch LM, Kunzler AM, Lindner S, Koehler F, Werner T, Zappalà F, Helmreich I, Wessa M, Lieb K, Tüscher O. Digital interventions to promote psychological resilience: a systematic review and meta-analysis. NPJ Digit Med 2024; 7:30. [PMID: 38332030 PMCID: PMC10853230 DOI: 10.1038/s41746-024-01017-8] [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: 07/19/2023] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
Societies are exposed to major challenges at an increasing pace. This underscores the need for preventive measures such as resilience promotion that should be available in time and without access barriers. Our systematic review summarizes evidence on digital resilience interventions, which have the potential to meet these demands. We searched five databases for randomized-controlled trials in non-clinical adult populations. Primary outcomes were mental distress, positive mental health, and resilience factors. Multilevel meta-analyses were performed to compare intervention and control groups at post-intervention and follow-up assessments. We identified 101 studies comprising 20,010 participants. Meta-analyses showed small favorable effects on mental distress, SMD = -0.24, 95% CI [-0.31, -0.18], positive mental health, SMD = 0.27, 95% CI [0.13, 0.40], and resilience factors, SMD = 0.31, 95% CI [0.21, 0.41]. Among middle-aged samples, older age was associated with more beneficial effects at follow-up, and effects were smaller for active control groups. Effects were comparable to those of face-to-face interventions and underline the potential of digital resilience interventions to prepare for future challenges.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany.
- Department of Clinical Psychology, Psychotherapy and Diagnostics - Child and Adolescent Psychology and Psychotherapy, Technische Universität Braunschweig, Braunschweig, Germany.
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | | | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Friederike Koehler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä, Jyväskylä, Finland
| | - Tabea Werner
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
- Institute for Molecular Biology, Johannes Gutenberg University Mainz, Mainz, Germany
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Mendes Pereira C, Matos M, Carvalho D, Macedo P, Calheiros JM, Alves J, Paulino Ferreira L, Dias TL, Neves Madeira R, Jones F. Building Bridges between People with Stroke, Families, and Health Professionals: Development of a Blended Care Program for Self-Management. J Clin Med 2024; 13:300. [PMID: 38202307 PMCID: PMC10779663 DOI: 10.3390/jcm13010300] [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: 12/18/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024] Open
Abstract
Evidence-informed interventions for stroke self-management support can influence functional capability and social participation. People with stroke should be offered self-management support after hospital discharge. However, in Portugal, there are no known programs of this nature. This study aimed to develop a person-centered and tailored blended care program for post-stroke self-management, taking into account the existing evidence-informed interventions and the perspectives of Portuguese people with stroke, caregivers, and health professionals. An exploratory sequential mixed methods approach was used, including qualitative methods during stakeholder consultation (stage 1) and co-production (stage 2) and quantitative assessment during prototyping (stage 3). After ethical approval, recruitment occurred in three health units. Results from a literature search led to the adaptation of the Bridges Stroke Self-Management Program. In stage one, 47 participants were interviewed, with two themes emerging: (i) Personalized support and (ii) Building Bridges through small steps. In stage two, the ComVida program was developed, combining in-person and digital approaches, supported by a workbook and a mobile app. In stage three, 56 participants evaluated prototypes, demonstrating a strong level of quality. Understandability and actionability of the developed tools obtained high scores (91-100%). The app also showed good usability (A-grade) and high levels of recommendation (5 stars).
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Affiliation(s)
- Carla Mendes Pereira
- Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (M.M.); (T.L.D.)
- Comprehensive Health Research Centre (CHRC), NOVA University of Lisbon, 1150-082 Lisbon, Portugal
| | - Mara Matos
- Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (M.M.); (T.L.D.)
| | - Daniel Carvalho
- Local Health Unit Litoral Alentejano (ULSLA), 7540-230 Santiago do Cacém, Portugal;
| | - Patricia Macedo
- Research Center for Engineering a Sustainable Development (Sustain.RD), Setúbal School of Technology, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (P.M.); (R.N.M.)
- Center of Technology and Systems (UNINOVA-CTS), NOVA School of Science and Technology, 2829-516 Caparica, Portugal
| | - José M. Calheiros
- Institute for Research, Innovation and Development (FP-I3ID), University Fernando Pessoa, 4249-004 Porto, Portugal;
| | - Janice Alves
- Neurology Department, Setúbal Hospital Centre, 2910-446 Setúbal, Portugal;
| | - Luís Paulino Ferreira
- Department of Psychiatry and Mental Health, Setúbal Hospital Centre, 2910-446 Setúbal, Portugal;
| | - Teresa L. Dias
- Department of Physiotherapy, School of Health, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (M.M.); (T.L.D.)
| | - Rui Neves Madeira
- Research Center for Engineering a Sustainable Development (Sustain.RD), Setúbal School of Technology, Polytechnic University of Setúbal, 2910-761 Setúbal, Portugal; (P.M.); (R.N.M.)
- NOVA Laboratory of Computer Science and Informatics (NOVA LINCS), NOVA School of Science and Technology, NOVA University of Lisbon, 2829-516 Caparica, Portugal
| | - Fiona Jones
- Population Health Research Institute, St George’s, University of London, London SW17 ORE, UK;
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Hua D, Petrina N, Young N, Cho JG, Poon SK. Understanding the factors influencing acceptability of AI in medical imaging domains among healthcare professionals: A scoping review. Artif Intell Med 2024; 147:102698. [PMID: 38184343 DOI: 10.1016/j.artmed.2023.102698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/29/2023] [Accepted: 10/29/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Artificial intelligence (AI) technology has the potential to transform medical practice within the medical imaging industry and materially improve productivity and patient outcomes. However, low acceptability of AI as a digital healthcare intervention among medical professionals threatens to undermine user uptake levels, hinder meaningful and optimal value-added engagement, and ultimately prevent these promising benefits from being realised. Understanding the factors underpinning AI acceptability will be vital for medical institutions to pinpoint areas of deficiency and improvement within their AI implementation strategies. This scoping review aims to survey the literature to provide a comprehensive summary of the key factors influencing AI acceptability among healthcare professionals in medical imaging domains and the different approaches which have been taken to investigate them. METHODS A systematic literature search was performed across five academic databases including Medline, Cochrane Library, Web of Science, Compendex, and Scopus from January 2013 to September 2023. This was done in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Overall, 31 articles were deemed appropriate for inclusion in the scoping review. RESULTS The literature has converged towards three overarching categories of factors underpinning AI acceptability including: user factors involving trust, system understanding, AI literacy, and technology receptiveness; system usage factors entailing value proposition, self-efficacy, burden, and workflow integration; and socio-organisational-cultural factors encompassing social influence, organisational readiness, ethicality, and perceived threat to professional identity. Yet, numerous studies have overlooked a meaningful subset of these factors that are integral to the use of medical AI systems such as the impact on clinical workflow practices, trust based on perceived risk and safety, and compatibility with the norms of medical professions. This is attributable to reliance on theoretical frameworks or ad-hoc approaches which do not explicitly account for healthcare-specific factors, the novelties of AI as software as a medical device (SaMD), and the nuances of human-AI interaction from the perspective of medical professionals rather than lay consumer or business end users. CONCLUSION This is the first scoping review to survey the health informatics literature around the key factors influencing the acceptability of AI as a digital healthcare intervention in medical imaging contexts. The factors identified in this review suggest that existing theoretical frameworks used to study AI acceptability need to be modified to better capture the nuances of AI deployment in healthcare contexts where the user is a healthcare professional influenced by expert knowledge and disciplinary norms. Increasing AI acceptability among medical professionals will critically require designing human-centred AI systems which go beyond high algorithmic performance to consider accessibility to users with varying degrees of AI literacy, clinical workflow practices, the institutional and deployment context, and the cultural, ethical, and safety norms of healthcare professions. As investment into AI for healthcare increases, it would be valuable to conduct a systematic review and meta-analysis of the causal contribution of these factors to achieving high levels of AI acceptability among medical professionals.
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Affiliation(s)
- David Hua
- School of Computer Science, The University of Sydney, Australia; Sydney Law School, The University of Sydney, Australia
| | - Neysa Petrina
- School of Computer Science, The University of Sydney, Australia
| | - Noel Young
- Sydney Medical School, The University of Sydney, Australia; Lumus Imaging, Australia
| | - Jin-Gun Cho
- Sydney Medical School, The University of Sydney, Australia; Western Sydney Local Health District, Australia; Lumus Imaging, Australia
| | - Simon K Poon
- School of Computer Science, The University of Sydney, Australia; Western Sydney Local Health District, Australia.
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Young K, Xiong T, Lee R, Banerjee AT, Leslie M, Ko WY, Pham Q. User-Centered Design and Usability of a Culturally Adapted Virtual Survivorship Care App for Chinese Canadian Prostate Cancer Survivors: Qualitative Descriptive Study. JMIR Hum Factors 2024; 11:e49353. [PMID: 38163295 PMCID: PMC10790201 DOI: 10.2196/49353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/05/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Cultural adaptations of digital health innovations are a growing field. However, digital health innovations can increase health inequities. While completing exploratory work for the cultural adaptation of the Ned Clinic virtual survivorship app, we identified structural considerations that provided a space to design digitally connected and collective care. OBJECTIVE This study used a community-based participatory research and user-centered design process to develop a cultural adaptation of the Ned Clinic app while designing to intervene in structural inequities. METHODS The design process included primary data collection and qualitative analysis to explore and distill design principles, an iterative design phase with a multidisciplinary team, and a final evaluation phase with participants throughout the design process as a form of member checking and validation. RESULTS Participants indicated that they found the final adapted prototype to be acceptable, appropriate, and feasible for their use. The changes made to adapt the prototype were not specifically culturally Chinese. Instead, we identified ways to strengthen connections between the survivor and their providers; improve accessibility to resources; and honor participants' desires for relationality, accountability, and care. CONCLUSIONS We grounded the use of user-centered design to develop a prototype design that supports the acts of caring through digital technology by identifying and designing to resist structures that create health inequities in the lives of this community of survivors. By designing for collective justice, we can provide accessible, feasible, and relational care with digital health through the application of Indigenous and Black feminist ways of being and knowing.
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Affiliation(s)
- Karen Young
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ting Xiong
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rachel Lee
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Ananya Tina Banerjee
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Myles Leslie
- School of Public Policy, University of Calgary, Calgary, AB, Canada
| | - Wellam Yu Ko
- Men's Health Research Program, University of British Columbia, Vancouver, BC, Canada
| | - Quynh Pham
- Centre for Digital Therapeutics, Techna Institute, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Dale CM, Ambreen M, Kang S, Buchanan F, Pizzuti R, Gershon AS, Rose L, Amin R. Acceptability of the Long-Term In-Home Ventilator Engagement virtual intervention for home mechanical ventilation patients during the COVID-19 pandemic: A qualitative evaluation. Digit Health 2024; 10:20552076241228417. [PMID: 38282921 PMCID: PMC10822085 DOI: 10.1177/20552076241228417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024] Open
Abstract
Background Clinical management of ventilator-assisted individuals (VAIs) was challenged by social distancing rules during the COVID-19 pandemic. In May 2020, the Long-Term In-Home Ventilator Engagement (LIVE) Program was launched in Ontario, Canada to provide intensive digital care case management to VAIs. The purpose of this qualitative study was to explore the acceptability of the LIVE Program hosted via a digital platform during the COVID-19 pandemic from diverse perspectives. Methods We conducted a qualitative descriptive study (May 2020-April 2021) comprising semi-structured interviews with participants from eight home ventilation specialty centers in Ontario, Canada. We purposively recruited patients, family caregivers, and providers enrolled in LIVE. Content analysis and the theoretical concepts of acceptability, feasibility, and appropriateness were used to interpret findings. Results A total of 40 individuals (2 VAIs, 18 family caregivers, 20 healthcare providers) participated. Participants described LIVE as acceptable as it addressed a longstanding imperative to improve care access, ease of use, and training provided; feasible for triaging problems and sharing information; and appropriate for timeliness of provider responses, workflows, and perceived value. Negative perceptions of acceptability among healthcare providers concerned digital workload and fit with existing clinical workflows. Perceived benefits accorded to LIVE included enhanced physical and psychological safety in the home, patient-provider relations, and VAI engagement in their own care. Conclusions Study findings identify factors influencing the LIVE Program's acceptability by patients, family caregivers, and healthcare providers during pandemic conditions including enhanced access to care, ease of case management triage, and VAI safety. Findings may inform the implementation of digital health services to VAIs in non-pandemic circumstances.
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Affiliation(s)
- Craig M. Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Munazzah Ambreen
- Medical Surgical Intensive Care Unit, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sohee Kang
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
- Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Francine Buchanan
- Medical Surgical Intensive Care Unit, The Hospital for Sick Children, Toronto, ON, Canada
| | - Regina Pizzuti
- Live Program, Ontario Ventilator Equipment Pool, Kingston, ON, Canada
| | - Andrea S. Gershon
- Division of Respirology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Louise Rose
- Faculty of Nursing, Midwifery and Palliative Care, Kings College London, London, UK
- Department of Critical Care and Lane Fox Unit, Guy's & St Thomas’ NHS Foundation Trust, London, UK
| | - Reshma Amin
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
- Clinical Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
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Békés V, Ménard CG, Schmitz N, Aafjes-van Doorn K. Therapist-Reported Differences between Teletherapy via Phone and via Videoconferencing. Brain Sci 2023; 13:1714. [PMID: 38137162 PMCID: PMC10742214 DOI: 10.3390/brainsci13121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/03/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
When therapists provide teletherapy they can choose between teletherapy via phone and teletherapy via videoconferencing, however, little is known about differences between using these two teletherapy formats. We aimed to compare therapists' attitudes, level of professional self-doubt, and experience of the therapeutic relationship in sessions conducted via phone versus via videoconferencing. We administered an online survey to 117 therapists who had experience with sessions both via phone and videoconferencing. The results suggested that therapists' attitudes and perceptions of the therapeutic relationship were similar. However, therapists' level of professional self-doubt was higher in sessions conducted via videoconferencing. Therapists with previous experience of conducting teletherapy via phone perceived phone sessions more positively. Thus, familiarity with videoconferencing technology might be more important in shaping therapists' attitudes and confidence than the type of technology per se. This highlights the importance of practicing with new technologies.
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Affiliation(s)
- Vera Békés
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA; (V.B.); (N.S.)
| | | | - Natale Schmitz
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA; (V.B.); (N.S.)
| | - Katie Aafjes-van Doorn
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Ave, Bronx, NY 10461, USA; (V.B.); (N.S.)
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31
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Fournier V, Duprez C, Grynberg D, Antoine P, Lamore K. Are digital health interventions valuable to support patients with cancer and caregivers? An umbrella review of web-based and app-based supportive care interventions. Cancer Med 2023; 12:21436-21451. [PMID: 37937812 PMCID: PMC10726780 DOI: 10.1002/cam4.6695] [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: 08/02/2023] [Revised: 09/28/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Digital health technologies have expanded tremendously in the last two decades, creating an emerging research and clinical field. They are regarded as cost-effective, and their use in healthcare is prioritized by many countries. However, the constant evolution of these technologies has led to an abundance of related literature. Thus, we conducted an umbrella review to identify and characterize digital supportive care interventions for patients with cancer and their relatives. METHODS A preregistered umbrella review was conducted (PROSPERO registration number CRD42022333110). Five databases were searched (Embase, PsycINFO, PubMed, CINAHL, and the Cochrane Library). To be considered, studies had to be systematic reviews or meta-analyses, be performed on pediatric or adult patients with cancer or survivors or their relatives, report results on web-based or app-based supportive care interventions, and measure psychological, functional, or behavioral variables or quality of life related to cancer. The methodological quality of the studies was assessed using the AMSTAR-2 tool. FINDINGS Twenty eligible studies were identified. Most of the included studies reported results from adult patients with cancer. Globally, digital interventions were shown to be effective for physical activity in patients with cancer but had mixed results regarding emotional outcomes and quality of life. Additionally, a lack of methodological quality was noted for most of the included reviews. DISCUSSION Digital supportive care interventions could be an effective tool in cancer care for some outcomes. Recommendations have been formulated for further research in this field using adapted methodologies for the development of digital health interventions.
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Affiliation(s)
- Valentyn Fournier
- Universite de Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences AffectivesLilleFrance
| | - Christelle Duprez
- Universite de Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences AffectivesLilleFrance
| | - Delphine Grynberg
- Universite de Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences AffectivesLilleFrance
- Institut Universitaire de FranceParisFrance
| | - Pascal Antoine
- Universite de Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences AffectivesLilleFrance
| | - Kristopher Lamore
- Universite de Lille, CNRS, UMR 9193—SCALab—Sciences Cognitives et Sciences AffectivesLilleFrance
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Holtrop K, Casaburo G, Hickman T, Yzaguirre MM, Young D. The acceptability and preliminary effectiveness of a brief, online parenting program: Expanding access to Evidence-Based parenting intervention content. FAMILY PROCESS 2023; 62:1506-1523. [PMID: 37039325 DOI: 10.1111/famp.12883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
Parenting interventions are a promising means for preventing and treating a variety of child behavior and conduct problems; yet, many families lack access to such services. Online parenting programs offer an opportunity to mitigate many barriers to intervention access by extending service delivery options. The purpose of the present study was to evaluate the acceptability and preliminary effectiveness of a brief, online parenting program. We developed a new online parenting program based on foundational content from the evidence-based GenerationPMTO intervention and used a mixed-methods, single-arm open trial (pre-post) design to perform a preliminary evaluation. The combined results from the quantitative and qualitative data provide initial support for the acceptability and preliminary effectiveness of the online program, based on participant self-report data from program completers. Participants indicated high levels of acceptability for the program topics and videos. They also reported statistically significant improvements from baseline to 4 weeks postintervention in parental efficacy, parenting practices, and child behavior problems. The qualitative data corroborated and expanded these findings. We go on to discuss important accessibility and sustainability considerations addressed by this online parenting program as well as to suggest implications for intervention research and mental health practice.
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Affiliation(s)
| | | | | | | | - Deja Young
- Michigan State University, East Lansing, Michigan, USA
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Anderson AM, McHugh GA, Comer C, Joseph J, Smith TO, Yardley L, Redmond AC. Supporting patients to prepare for total knee replacement: Evidence-, theory- and person-based development of a 'Virtual Knee School' digital intervention. Health Expect 2023; 26:2549-2570. [PMID: 37606150 PMCID: PMC10632615 DOI: 10.1111/hex.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
INTRODUCTION Digital delivery of pre-operative total knee replacement (TKR) education and prehabilitation could improve patient outcomes pre- and post-operatively. Rigorously developing digital interventions is vital to help ensure they achieve their intended outcomes whilst mitigating their potential drawbacks. OBJECTIVE To develop a pre-operative TKR education and prehabilitation digital intervention, the 'Virtual Knee School' (VKS). METHODS The VKS was developed using an evidence-, theory- and person-based approach. This involved a mixed methods design with four phases. The first three focused on planning the VKS. The final phase involved creating a VKS prototype and iteratively refining it through concurrent think-aloud interviews with nine patients who were awaiting/had undergone TKR. Meta-inferences were generated by integrating findings from all the phases. ISRCTN registration of the overall project was obtained on 24 April 2020 (ISRCTN11759773). RESULTS Most participants found the VKS prototype acceptable overall and considered it a valuable resource. Conversely, a minority of participants felt the prototype's digital format or content did not meet their individual needs. Participants' feedback was used to refine the prototype's information architecture, design and content. Two meta-inferences were generated and recommend: 1. Comprehensive pre-operative TKR education and prehabilitation support should be rapidly accessible in digital and non-digital formats. 2. Pre-operative TKR digital interventions should employ computer- and self-tailoring to account for patients' individual needs and preferences. CONCLUSIONS Integrating evidence, theory and stakeholders' perspectives enabled the development of a promising VKS digital intervention for patients awaiting TKR. The findings suggest future research evaluating the VKS is warranted and provide recommendations for optimising pre-operative TKR care. PATIENT OR PUBLIC CONTRIBUTION Patient and Public Involvement (PPI) was central throughout the project. For example, PPI representatives contributed to the project planning, were valued members of the Project Advisory Group, had key roles in developing the VKS prototype and helped disseminate the project findings.
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Affiliation(s)
- Anna M. Anderson
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeedsUK
- Present address:
Leeds Institute of Health SciencesUniversity of LeedsLeedsUK
| | | | - Christine Comer
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- Musculoskeletal and Rehabilitation ServicesLeeds Community Healthcare NHS TrustLeedsUK
| | - Judith Joseph
- Centre for Clinical and Community Applications of Health PsychologyUniversity of SouthamptonSouthamptonUK
| | - Toby O. Smith
- School of Health SciencesUniversity of East AngliaNorwichUK
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK
- Present address:
Warwick Medical SchoolUniversity of WarwickWarwickUK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health PsychologyUniversity of SouthamptonSouthamptonUK
- School of Psychological ScienceUniversity of BristolBristolUK
| | - Anthony C. Redmond
- Leeds Institute of Rheumatic and Musculoskeletal MedicineUniversity of LeedsLeedsUK
- NIHR Leeds Biomedical Research CentreLeedsUK
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Haydon HM, Major T, Kelly JT, Catapan SDC, Caffery LJ, Smith AC, Gallegos-Rejas V, Thomas EE, Banbury A, Snoswell CL. Development and validation of the Digital Health Acceptability Questionnaire. J Telemed Telecare 2023; 29:8S-15S. [PMID: 38007698 DOI: 10.1177/1357633x231202279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
Acceptability (of healthcare services) is an important construct that lacks a consistent definition within research. Addressing this issue, a systematic review led to the Theoretical Framework of Acceptability. In this study, we describe the development (based on the Theoretical Framework of Acceptability) and validation of the Digital Health Acceptability Questionnaire. Nineteen items aligning with the Theoretical Framework of Acceptability were developed. Two versions of the questionnaire measuring telehealth acceptability by telephone (N = 644) and videoconference appointment (N = 425), were administered to a nationally representative survey of consumers in Australia. Two exploratory factor analyses (Oblimin rotation) were conducted for each scale (telephone/videoconference). Two-factor solutions (5 items each) were found for both (telephone/videoconference) acceptability questionnaires: (a) attitude toward the service as a means to address healthcare needs and affective attitude and (b) individual capacity and effort to use telehealth. Before rotation, Factor 1 of the telephone scale (α = 0.92) measured 56.18% of the variance and Factor 2 (α = 0.86) measured 14.17%. Factor 1 of the videoconference scale (α = 0.90) measured 56.68% of the variance and Factor 2 (α = 0.85) measured 10.63%. The full10-item acceptability questionnaire showed excellent internal consistency (telephone: α = 0.91 and videoconference: α = 0.92). The 2-dimensional Digital Health Acceptability Questionnaire is a brief survey based on research evidence and validated in a large Australian sample.
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Affiliation(s)
- Helen M Haydon
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Taylor Major
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Soraia de C Catapan
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Liam J Caffery
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark
| | - Victor Gallegos-Rejas
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Emma E Thomas
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Annie Banbury
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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Fowler JA, Buckley L, Muir M, Viskovich S, Paradisis C, Zanganeh P, Dean JA. Digital mental health interventions: A narrative review of what is important from the perspective of LGBTQIA+ people. J Clin Psychol 2023; 79:2685-2713. [PMID: 37528773 DOI: 10.1002/jclp.23571] [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: 04/27/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES Digital mental health interventions are a promising therapeutic modality to provide psychological support to LGBTQIA+ (lesbian, gay, bisexual, trans, Queer, intersex, asexual, plus other gender, sexual, and romantic minority identities) people. The aim of this narrative review is to explore how the LGBTQIA+ community has been engaged in the design of digital mental health interventions, how content has been tailored to the LGBTQIA+ community, and features identified as important by LGBTQIA+ participants. METHODS A total of 33 studies were included in this review from a larger yield of 1933 identified from systematic searches of five databases (PsycINFO, PubMed, Scopus, CINAHAL, and Medline). Data were analyzed narratively and using content analysis. RESULTS Only half of the studies reported engaging the LGBTQIA+ community in intervention designs. Interventions have been tailored in a variety of ways to support LGBTQIA+ individuals-such as through affirming imagery, recruitment through LGBTQIA+ networks, and designing content to focus specifically on LGBTQIA+ issues. A range of features were identified as important for participants, namely how content was tailored to LGBTQIA+ experiences, providing connection to community, and links to other relevant LGBTQIA+ resources. While not a primary aim, results also showed that a wide range of digital modalities can significantly improve a range of mental health problems. CONCLUSION Digital interventions are an acceptable and effective form of therapeutic intervention, but future research needs to focus on meaningful engagement of community members to inform design and implementation.
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Affiliation(s)
- James A Fowler
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Buckley
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Miranda Muir
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Shelley Viskovich
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Chris Paradisis
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Parnian Zanganeh
- Faculty of Health and Behavioral Sciences, School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Judith A Dean
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Poche Centre for Indigenous Health, The University of Queensland, Brisbane, Queensland, Australia
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Piché A, Santa Mina D, Lambert S, Doré I. Assessing real-world implementability of a multimodal group-based tele-prehabilitation program in cancer care: a pragmatic feasibility study. Front Oncol 2023; 13:1271812. [PMID: 37965450 PMCID: PMC10641394 DOI: 10.3389/fonc.2023.1271812] [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: 08/02/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Multimodal prehabilitation is intended to optimize a patient's mental and physical health prior to surgery. Most multimodal prehabilitation interventions are delivered on a one-on-one format, which may limit benefits associated with social interactions that can be achieved in a group context, and are delivered in-person, which may limit the accessibility. The purpose of this study was to develop a group-based, multimodal, tele-prehabilitation intervention for individuals diagnosed with cancer (iACTIF) and assess its implementability in a "real-world" clinical setting by measuring feasibility, acceptability, fidelity, and preliminary effects. Methods A prospective, single-group, pragmatic feasibility study was conducted with assessments at baseline, pre-surgery, and 12-weeks post-surgery. iACTIF consisted of three 90-min live videoconference sessions per week, including exercise and educational components. Descriptive statistics were used to document feasibility, acceptability, and fidelity indicators. Paired t-test, Wilcoxon test, and Cohen's D-test were conducted to assess changes in health-related outcomes. Results A total of 25 participants (mean age ± SD= 60.2 ± 14.0) were recruited. The feasibility assessment revealed a low referral rate (31.4%) and a high study retention (98%) and program attendance [session attended/possible session] (70.2%), with a prehabilitation window of 32.7 days (SD= 20.9, median= 28). Acceptability was high (84%-100%) according to satisfaction, utility and safety, delivery modality, and intention to continue physical activity and to recommend iACTIF to a relative. Pre-post-intervention assessments suggest positive changes on physical functional capacity based on the 2-min step test (mean difference= +18.9 steps, p=0.005), the 30-s sit-to-stand (mean difference= +1.1 repetition, p=0.011), and volume of moderate intensity physical activity per week (mean difference= +104.8 min, p<0.001). Fidelity was supported by conformity and coherence, with only minimal adjustments required to meet participants' needs. Discussion iACTIF implementability in a "real-world" clinical setting is promising, and preliminary outcomes suggest moderate benefits on physical health and small increase in mental health indicators.
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Affiliation(s)
- Alexia Piché
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, University Health Network, Toronto, ON, Canada
| | - Sylvie Lambert
- St. Mary’s Research Centre, Montréal, QC, Canada
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
| | - Isabelle Doré
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montréal, QC, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, QC, Canada
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Lowe C, Erby L, Joseph G, Biesecker B, Roter DL. Acceptability of an online communication training intervention for genetic counseling students. J Genet Couns 2023. [PMID: 37795757 DOI: 10.1002/jgc4.1790] [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: 06/12/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023]
Abstract
Technology provides opportunities to enhance communication skills training for genetic counseling graduate students. We assessed the acceptability of an online communication training program. Graduate student volunteers completed five online training modules on basic communication skills with opportunities to practice the skills within three simulated/standardized patient (SP) sessions. Participants completed online questionnaires reporting on acceptability, perceived usefulness, and realism of the modules and SP sessions. They also reported on the ease of transferring skills from the modules to clinical practice. Out of the 60 students who completed the baseline session, 35 (58%) completed all five training modules. Out of these 35 students, most found the modules to be useful (94%) and agreed that they were relevant to clinical practice (97%). At least 88% of participants found the genetic counselors, patient, and case scenarios to be realistic. Twenty-eight students had participated in clinical rotations since completing the intervention. Of these, 17 (61%) reported that it was at least slightly easy to use the skills in actual clinical cases. Most students also reported being able to transfer the skills they had learned into clinical practice. While the training was well-received, the relatively low completion rate of 58% raises concern that the intervention may need formal integration into the program curriculum to succeed due to the time and effort demands on students.
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Affiliation(s)
- Chenery Lowe
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lori Erby
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, Maryland, USA
| | - Galen Joseph
- Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, California, USA
| | - Barbara Biesecker
- RTI International, Analytics, Research Triangle Park, North Carolina, USA
| | - Debra L Roter
- Department of Health, Behavior and Society, Johns Hopkins University, Baltimore, Maryland, USA
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LeStourgeon L, Bergner E, Datye K, Streisand R, Jaser S. Evaluation of Study Engagement With an mHealth Intervention (THR1VE) to Treat Diabetes Distress in Teens With Type 1 Diabetes: Randomized Clinical Trial. JMIR Pediatr Parent 2023; 6:e47089. [PMID: 37800881 PMCID: PMC10594399 DOI: 10.2196/47089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/06/2023] [Accepted: 07/13/2023] [Indexed: 10/07/2023] Open
Abstract
Background Positive psychology interventions demonstrate improvements in diabetes self-management and quality of life among adults with chronic health conditions, but few interventions for adolescents use this approach. Objective This study describes engagement with a positive psychology intervention delivered via automated SMS text messages aimed at treating diabetes distress and improving diabetes outcomes. In addition, demographic and clinical predictors of intervention engagement were examined. Methods Adolescents with type 1 diabetes (ages 13-17 years) who reported at least moderate diabetes distress were randomized to receive either the education or positive affect + education intervention, comprising 8 weeks of automated SMS text messages. Engagement was assessed as the response to the SMS text messages. Adolescents completed satisfaction surveys 3 months post intervention, and a subset of participants from both intervention groups completed exit interviews. Results Adolescents in both groups reported high levels of satisfaction with the study, with 95% (163/172) reporting that they would participate again. Engagement with the SMS text messages was high; on average, adolescents in the positive affect + education group responded to 92.5% of intervention messages, and their caregivers responded to 88.5% of messages. There were no significant differences in rates of engagement related to adolescents' sex, age, device use, or race/ethnicity. Conclusions A positive psychology intervention for adolescents delivered via automated SMS text messages was feasible and acceptable across genders, ages, and racial/ethnic groups, suggesting potential for wider dissemination.
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Affiliation(s)
- Lauren LeStourgeon
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Erin Bergner
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Karishma Datye
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
| | - Randi Streisand
- Department of Pyschology and Behavioral Health, Children's National Hospital, WashingtonDC, United States
- Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, WashingtonDC, United States
| | - Sarah Jaser
- Department of Pediatrics, Vanderbilt University Medical Center, NashvilleTN, United States
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Kaplan DM, Greenleaf M, Lam WA. Wear With Care: A Call for Empirical Investigations of Adverse Outcomes of Consumer Health Wearables. MAYO CLINIC PROCEEDINGS. DIGITAL HEALTH 2023; 1:413-418. [PMID: 38143554 PMCID: PMC10745206 DOI: 10.1016/j.mcpdig.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Affiliation(s)
- Deanna M Kaplan
- Center for the Advancement of Diagnostics for a Just Society (ADJUST Center) (D.M.K., M.G., W.A.L.), and Department of Spiritual Health, Woodruff Health Sciences Center (D.M.K.), Emory University, Atlanta, GA; Department of Family and Preventive Medicine (D.M.K), and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Department of Pediatrics (W.A.L.), Emory University School of Medicine, Atlanta, GA; Emory University School of Medicine, Atlanta, GA (M.G.); and Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA (W.A.L.)
| | - Morgan Greenleaf
- Center for the Advancement of Diagnostics for a Just Society (ADJUST Center) (D.M.K., M.G., W.A.L.), and Department of Spiritual Health, Woodruff Health Sciences Center (D.M.K.), Emory University, Atlanta, GA; Department of Family and Preventive Medicine (D.M.K), and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Department of Pediatrics (W.A.L.), Emory University School of Medicine, Atlanta, GA; Emory University School of Medicine, Atlanta, GA (M.G.); and Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA (W.A.L.)
| | - Wilbur A Lam
- Center for the Advancement of Diagnostics for a Just Society (ADJUST Center) (D.M.K., M.G., W.A.L.), and Department of Spiritual Health, Woodruff Health Sciences Center (D.M.K.), Emory University, Atlanta, GA; Department of Family and Preventive Medicine (D.M.K), and Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta and Department of Pediatrics (W.A.L.), Emory University School of Medicine, Atlanta, GA; Emory University School of Medicine, Atlanta, GA (M.G.); and Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA (W.A.L.)
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Louart S, Hedible GB, Ridde V. Assessing the acceptability of technological health innovations in sub-Saharan Africa: a scoping review and a best fit framework synthesis. BMC Health Serv Res 2023; 23:930. [PMID: 37649024 PMCID: PMC10469465 DOI: 10.1186/s12913-023-09897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
Acceptability is a key concept used to analyze the introduction of a health innovation in a specific setting. However, there seems to be a lack of clarity in this notion, both conceptually and practically. In low and middle-income countries, programs to support the diffusion of new technological tools are multiplying. They face challenges and difficulties that need to be understood with an in-depth analysis of the acceptability of these innovations. We performed a scoping review to explore the theories, methods and conceptual frameworks that have been used to measure and understand the acceptability of technological health innovations in sub-Saharan Africa. The review confirmed the lack of common definitions, conceptualizations and practical tools addressing the acceptability of health innovations. To synthesize and combine evidence, both theoretically and empirically, we then used the "best fit framework synthesis" method. Based on five conceptual and theoretical frameworks from scientific literature and evidence from 33 empirical studies, we built a conceptual framework in order to understand the acceptability of technological health innovations. This framework comprises 6 determinants (compatibility, social influence, personal emotions, perceived disadvantages, perceived advantages and perceived complexity) and two moderating factors (intervention and context). This knowledge synthesis work has also enabled us to propose a chronology of the different stages of acceptability.
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Affiliation(s)
- Sarah Louart
- Univ. Lille, CNRS, UMR 8019 - CLERSE - Centre Lillois d'Etudes Et de Recherches Sociologiques Et Economiques, 59000, Lille, France.
- ALIMA, the Alliance for International Medical Action, Dakar, Senegal.
| | | | - Valéry Ridde
- Université Paris Cité, IRD, INSERM, Ceped, 75006, Paris, France
- Institut de Santé Et Développement, Université Cheikh Anta Diop, Dakar, Sénégal
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Forbes A, Keleher MR, Venditto M, DiBiasi F. Assessing Patient Adherence to and Engagement With Digital Interventions for Depression in Clinical Trials: Systematic Literature Review. J Med Internet Res 2023; 25:e43727. [PMID: 37566447 PMCID: PMC10457707 DOI: 10.2196/43727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/24/2023] [Accepted: 06/28/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND New approaches to the treatment of depression are necessary for patients who do not respond to current treatments or lack access to them because of barriers such as cost, stigma, and provider shortage. Digital interventions for depression are promising; however, low patient engagement could limit their effectiveness. OBJECTIVE This systematic literature review (SLR) assessed how participant adherence to and engagement with digital interventions for depression have been measured in the published literature, what levels of adherence and engagement have been reported, and whether higher adherence and increased engagement are linked to increased efficacy. METHODS We focused on a participant population of adults (aged ≥18 years) with depression or major depressive disorder as the primary diagnosis and included clinical trials, feasibility studies, and pilot studies of digital interventions for treating depression, such as digital therapeutics. We screened 756 unique records from Ovid MEDLINE, Embase, and Cochrane published between January 1, 2000, and April 15, 2022; extracted data from and appraised the 94 studies meeting the inclusion criteria; and performed a primarily descriptive analysis. Otsuka Pharmaceutical Development & Commercialization, Inc (Princeton, New Jersey, United States) funded this study. RESULTS This SLR encompassed results from 20,111 participants in studies using 47 unique web-based interventions (an additional 10 web-based interventions were not described by name), 15 mobile app interventions, 5 app-based interventions that are also accessible via the web, and 1 CD-ROM. Adherence was most often measured as the percentage of participants who completed all available modules. Less than half (44.2%) of the participants completed all the modules; however, the average dose received was 60.7% of the available modules. Although engagement with digital interventions was measured differently in different studies, it was most commonly measured as the number of modules completed, the mean of which was 6.4 (means ranged from 1.0 to 19.7) modules. The mean amount of time participants engaged with the interventions was 3.9 (means ranged from 0.7 to 8.4) hours. Most studies of web-based (34/45, 76%) and app-based (8/9, 89%) interventions found that the intervention group had substantially greater improvement for at least 1 outcome than the control group (eg, care as usual, waitlist, or active control). Of the 14 studies that investigated the relationship between engagement and efficacy, 9 (64%) found that increased engagement with digital interventions was significantly associated with improved participant outcomes. The limitations of this SLR include publication bias, which may overstate engagement and efficacy, and low participant diversity, which reduces the generalizability. CONCLUSIONS Patient adherence to and engagement with digital interventions for depression have been reported in the literature using various metrics. Arriving at more standardized ways of reporting adherence and engagement would enable more effective comparisons across different digital interventions, studies, and populations.
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Affiliation(s)
- Ainslie Forbes
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
| | | | | | - Faith DiBiasi
- Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, United States
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Glenn SD, Turrisi R, Hecht ML, Russell MA, Ray AE. Examining engagement with and acceptability and usability of REAL Parenting: A brief online parent-based intervention to reduce alcohol use and consequences among high school students. Addict Behav 2023; 143:107673. [PMID: 36893515 PMCID: PMC10131174 DOI: 10.1016/j.addbeh.2023.107673] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/19/2022] [Accepted: 02/23/2023] [Indexed: 03/03/2023]
Abstract
This study is a formative assessment of REAL Parenting (RP): a brief, digital intervention for parents of high school students that encourages parent-teen communication about alcohol and, in turn, aims to prevent teen alcohol use. The aims of this study were to describe engagement with, and acceptability and usability of RP; and to explore the relationship of these measures with each other and with short-term outcomes. Participants were 160 parents randomly assigned to the treatment group who received RP as part of a randomized pilot trial (Mage = 45.43[SD = 7.26], 59.3% female, 56% White, 19% Hispanic). App-based program analytics captured real-time engagement with RP. Parents completed self-report measures of acceptability, usability, perceived communication effectiveness, perceived self-efficacy to communicate, and frequency of communication post-intervention. Descriptive statistics were calculated to describe engagement, acceptability and usability, and zero-order correlations were calculated to examine associations between these and self-report variables. About 75% (n = 118) of parents accessed the intervention and two-thirds (n = 110) accessed at least one module. Self-report ratings of acceptability and usability were neutral to positive, and mothers liked RP more than fathers. Self-report, but not program analytic indicators were associated with short-term outcomes. Findings suggest that, with little incentive, most parents will access an app focused on parent-teen communication about alcohol. While parent feedback was positive, it also highlighted areas for improvement with app content and design. Correlations suggest that analytic metrics of engagement are useful to discern who is and is not using interventions, and self-report measures are important for understanding pathways by which interventions are associated with short-term outcomes.
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Affiliation(s)
- Shannon D Glenn
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, United States; Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA, 16802, United States
| | - Robert Turrisi
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, United States; Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA, 16802, United States
| | | | - Michael A Russell
- Department of Biobehavioral Health, The Pennsylvania State University, 219 Biobehavioral Health Building, University Park, PA, 16802, United States; Edna Bennett Pierce Prevention Research Center, The Pennsylvania State University, 314 Biobehavioral Health Building, University Park, PA, 16802, United States
| | - Anne E Ray
- Department of Health, Behavior & Society, University of Kentucky, 151 Washington Avenue, Lexington, KY, 40536, United States.
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Abell B, Naicker S, Rodwell D, Donovan T, Tariq A, Baysari M, Blythe R, Parsons R, McPhail SM. Identifying barriers and facilitators to successful implementation of computerized clinical decision support systems in hospitals: a NASSS framework-informed scoping review. Implement Sci 2023; 18:32. [PMID: 37495997 PMCID: PMC10373265 DOI: 10.1186/s13012-023-01287-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Successful implementation and utilization of Computerized Clinical Decision Support Systems (CDSS) in hospitals is complex and challenging. Implementation science, and in particular the Nonadoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework, may offer a systematic approach for identifying and addressing these challenges. This review aimed to identify, categorize, and describe barriers and facilitators to CDSS implementation in hospital settings and map them to the NASSS framework. Exploring the applicability of the NASSS framework to CDSS implementation was a secondary aim. METHODS Electronic database searches were conducted (21 July 2020; updated 5 April 2022) in Ovid MEDLINE, Embase, Scopus, PyscInfo, and CINAHL. Original research studies reporting on measured or perceived barriers and/or facilitators to implementation and adoption of CDSS in hospital settings, or attitudes of healthcare professionals towards CDSS were included. Articles with a primary focus on CDSS development were excluded. No language or date restrictions were applied. We used qualitative content analysis to identify determinants and organize them into higher-order themes, which were then reflexively mapped to the NASSS framework. RESULTS Forty-four publications were included. These comprised a range of study designs, geographic locations, participants, technology types, CDSS functions, and clinical contexts of implementation. A total of 227 individual barriers and 130 individual facilitators were identified across the included studies. The most commonly reported influences on implementation were fit of CDSS with workflows (19 studies), the usefulness of the CDSS output in practice (17 studies), CDSS technical dependencies and design (16 studies), trust of users in the CDSS input data and evidence base (15 studies), and the contextual fit of the CDSS with the user's role or clinical setting (14 studies). Most determinants could be appropriately categorized into domains of the NASSS framework with barriers and facilitators in the "Technology," "Organization," and "Adopters" domains most frequently reported. No determinants were assigned to the "Embedding and Adaptation Over Time" domain. CONCLUSIONS This review identified the most common determinants which could be targeted for modification to either remove barriers or facilitate the adoption and use of CDSS within hospitals. Greater adoption of implementation theory should be encouraged to support CDSS implementation.
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Affiliation(s)
- Bridget Abell
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Sundresan Naicker
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
| | - David Rodwell
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Thomasina Donovan
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Amina Tariq
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Melissa Baysari
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Robin Blythe
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Rex Parsons
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Steven M McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Roesler A, Butten K, Calyx C, Holmes-Truscott E, Taylor P. Use and Preferences of Health Apps among Women and Healthcare Professionals Regarding GDM Postpartum Care Related to Diet, Physical Activity, and Weight Management: A Cross-Sectional Survey. Nutrients 2023; 15:3304. [PMID: 37571242 PMCID: PMC10420904 DOI: 10.3390/nu15153304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/19/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
Gestational Diabetes Mellitus (GDM) is a common medical complication of pregnancy, which is associated with increased risk of future diabetes. mHealth (mobile health, in this paper applications abbreviated to apps) can facilitate health modifications to decrease future risks. This study aims to understand mHealth app use and preferences among women with past GDM and healthcare professionals (HCP) in Australia. An explorative cross-sectional online survey was disseminated via social media, a national diabetes registry, and professional networks. Descriptive analyses were conducted on valid responses (women with prior GDM: n = 1475; HCP: n = 75). One third (33%) of women with prior GDM have used health apps, and a further 80% of non-app users were open to using a health app if recommended by their HCP. Over half (53%) of HCPs supported health information delivery via mHealth, although only 14% had recommended a health app to women post-GDM, and lack of knowledge about mHealth apps was common. Health app users reported that they preferred tracking features, while non-users desired credible health and dietary information and plans. Expanding mHealth app use could facilitate healthy behaviours, but endorsement by HCPs is important to women and is still currently lacking.
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Affiliation(s)
- Anna Roesler
- The Australian e-Health Research Centre, CSIRO, Herston, QLD 4006, Australia; (K.B.); (P.T.)
| | - Kaley Butten
- The Australian e-Health Research Centre, CSIRO, Herston, QLD 4006, Australia; (K.B.); (P.T.)
| | - Cobi Calyx
- School of Humanities and Languages, UNSW Sydney, Sydney, NSW 1466, Australia
| | - Elizabeth Holmes-Truscott
- School of Psychology, Institute for Health Transformation, Deakin University, 1 Gheringhap St., Geelong, VIC 3220, Australia;
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, 15-31 Pelham Street, Carlton, VIC 3053, Australia
| | - Pennie Taylor
- The Australian e-Health Research Centre, CSIRO, Herston, QLD 4006, Australia; (K.B.); (P.T.)
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Dostie R, Gaboury I, Trottier N, Hurtubise K, Camden C. Acceptability of a Multimodal Telerehabilitation Intervention for Children Ages 3-8 Years with Motor Difficulties: Results of a Qualitative Study. Dev Neurorehabil 2023; 26:287-301. [PMID: 37403439 DOI: 10.1080/17518423.2023.2233020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE The purpose of this study is to explore the acceptability of a telerehabilitation intervention provided to parents of children with motor difficulties. MATERIAL AND METHODS Sixteen parents of children were purposefully recruited to participate in semi-structured interviews aimed at assessing the acceptability of the telerehabilitation intervention. Interviews were analyzed thematically. RESULTS All participants described evolving acceptability associated with their interactions with the web platform. The opportunities generated, suitability in relation to families' values and perceived effects positively impacted acceptability. The understanding and consistency of intervention delivery, the child's level of involvement, the associated parental burden of the intervention and the therapeutic alliances created also affected acceptability. CONCLUSION Our study findings support the acceptability of a telerehabilitation intervention for families of children with motor difficulties. Telerehabilitation seems to be more acceptable to families with children without suspected or confirmed diagnoses.
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Godana Boynito W, Tessema GY, Temesgen K, De Henauw S, Abbeddou S. Acceptability and feasibility of video-based health education for maternal and infant health in Dirashe District, South Ethiopia: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000821. [PMID: 37384600 DOI: 10.1371/journal.pgph.0000821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 05/08/2023] [Indexed: 07/01/2023]
Abstract
Evidence about innovative methods to facilitate nutrition education counseling and promote the intended behavior change at scale is limited. We assessed the acceptability and feasibility of a video-based health education intervention aiming to promote community care for pregnant women, mothers, and infants in the Dirashe District, Ethiopia. Using a phenomenological study design, the experiences of study participants in a trial testing the effectiveness of video-based health education on birth outcomes and nutritional status of mothers and their infants six months postpartum were assessed. Focus group discussions (FGDs) and key informant interviews (KIIs) were used to collect the data. The study was conducted in the Dirashe District, South Ethiopia. Five FGDs and 41 KII were conducted among video implementers, mothers, nurses, and health extension workers (HEWs) in eight intervention villages. All data were collected with a tape recorder. The tape-recorded data were transcribed and then translated into English. Data were analyzed using thematic content analysis. The videos delivered messages about nine themes on health, nutrition, and hygiene related to mothers and infants. Overall, the video-based health education interventions was acceptable and feasible. Messages delivered were found to be clear, easily understandable, culturally acceptable, and relevant to the needs of the mothers. Feasibility was affected by the nature of the work, lack of help, and overlapping duties of the HEWs. The video-based health education intervention was acceptable and feasible. It was suggested that determining a common location/venue to show the videos, involving husbands, and involving HEWs could improve the intervention. Trial registration: The effectiveness "parent" study was registered as a clinical trial with the U.S. National Institute of Health (www.ClinicalTrials.gov; NCT04414527). The qualitative study included recipients from the same cohort (participating mothers from the intervention group), in addition to video implementers, health extension workers the Health Development Army, and nurses from the intervention communities.
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Affiliation(s)
- Wanzahun Godana Boynito
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Godana Yaya Tessema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kidus Temesgen
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Stefaan De Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Souheila Abbeddou
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Mair JL, Castro O, Salamanca-Sanabria A, Frese BF, von Wangenheim F, Tai ES, Kowatsch T, Müller-Riemenschneider F. Exploring the potential of mobile health interventions to address behavioural risk factors for the prevention of non-communicable diseases in Asian populations: a qualitative study. BMC Public Health 2023; 23:753. [PMID: 37095486 PMCID: PMC10123969 DOI: 10.1186/s12889-023-15598-8] [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: 10/06/2022] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Changing lifestyle patterns over the last decades have seen growing numbers of people in Asia affected by non-communicable diseases and common mental health disorders, including diabetes, cancer, and/or depression. Interventions targeting healthy lifestyle behaviours through mobile technologies, including new approaches such as chatbots, may be an effective, low-cost approach to prevent these conditions. To ensure uptake and engagement with mobile health interventions, however, it is essential to understand the end-users' perspectives on using such interventions. The aim of this study was to explore perceptions, barriers, and facilitators to the use of mobile health interventions for lifestyle behaviour change in Singapore. METHODS Six virtual focus group discussions were conducted with a total of 34 participants (mean ± SD; aged 45 ± 3.6 years; 64.7% females). Focus group recordings were transcribed verbatim and analysed using an inductive thematic analysis approach, followed by deductive mapping according to perceptions, barriers, facilitators, mixed factors, or strategies. RESULTS Five themes were identified: (i) holistic wellbeing is central to healthy living (i.e., the importance of both physical and mental health); (ii) encouraging uptake of a mobile health intervention is influenced by factors such as incentives and government backing; (iii) trying out a mobile health intervention is one thing, sticking to it long term is another and there are key factors, such as personalisation and ease of use that influence sustained engagement with mobile health interventions; (iv) perceptions of chatbots as a tool to support healthy lifestyle behaviour are influenced by previous negative experiences with chatbots, which might hamper uptake; and (v) sharing health-related data is OK, but with conditions such as clarity on who will have access to the data, how it will be stored, and for what purpose it will be used. CONCLUSIONS Findings highlight several factors that are relevant for the development and implementation of mobile health interventions in Singapore and other Asian countries. Recommendations include: (i) targeting holistic wellbeing, (ii) tailoring content to address environment-specific barriers, (iii) partnering with government and/or local (non-profit) institutions in the development and/or promotion of mobile health interventions, (iv) managing expectations regarding the use of incentives, and (iv) identifying potential alternatives or complementary approaches to the use of chatbots, particularly for mental health.
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Affiliation(s)
- Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
| | - Florian von Wangenheim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - E Shyong Tai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St.Gallen, Switzerland
| | - Falk Müller-Riemenschneider
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Casale M, Somefun O, Haupt Ronnie G, Desmond C, Sherr L, Cluver L. A conceptual framework and exploratory model for health and social intervention acceptability among African adolescents and youth. Soc Sci Med 2023; 326:115899. [PMID: 37087974 DOI: 10.1016/j.socscimed.2023.115899] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Intervention acceptability has become an increasingly key consideration in the development, evaluation and implementation of health and social interventions. However, to date this area of investigation has been constrained by the absence of a consistent definition of acceptability, comprehensive conceptual frameworks disaggregating its components, and few reliable assessment measures. This paper aims to contribute to this gap, by proposing a conceptual framework and exploratory model for acceptability with a specific priority population for health and developmental interventions: adolescents and youth in Africa. We document our multi-staged approach to model development, comprising both inductive and deductive components, and both systematic and interpretative review methods. This included thematic analyses of respective acceptability definitions and findings, from 55 studies assessing acceptability of 60 interventions conducted with young people aged 10-24 in (mainly Southern and Eastern) Africa over a decade; a consideration of these findings in relation to Sekhon et al.'s Theoretical Framework of Acceptability (TFA); a cross-disciplinary review of acceptability definitions and models; a review of key health behavioural change models; and expert consultation with interdisciplinary researchers. Our proposed framework incorporates nine component constructs: affective attitude, intervention understanding, perceived positive effects, relevance, perceived social acceptability, burden, ethicality, perceived negative effects and self-efficacy. We discuss the rationale for the inclusion and definition of each component, highlighting key behavioural models that adopt similar constructs. We then extend this framework to develop an exploratory model for acceptability with young people, that links the framework components to each other and to intervention engagement. Acceptability is represented as an emergent property of a complex, adaptive system of interacting components, which can influence user engagement directly and indirectly, and in turn be influenced by user engagement. We discuss opportunities for applying and further refining or developing these models, and their value as a point of reference for the development of acceptability assessment tools.
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Affiliation(s)
- Marisa Casale
- School of Public Health, University of the Western Cape, Cape Town, South Africa; Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom.
| | - Oluwaseyi Somefun
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | | | - Chris Desmond
- Centre for Rural Health, University of KwaZulu-Natal, South Africa
| | | | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Barnett House, Oxford, United Kingdom; Dept of Psychiatry and Mental Health, University of Cape Town, South Africa
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Keightley S, Duncan M, Gardner B. An intervention to promote positive homeworker health and wellbeing through effective home-working practices: a feasibility and acceptability study. BMC Public Health 2023; 23:614. [PMID: 36997955 PMCID: PMC10063430 DOI: 10.1186/s12889-023-15347-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/28/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND In the wake of Covid-19, the prevalence of working from home ('home-working') is expected to rise. Yet, working from home can have negative health and wellbeing impacts. Interventions are needed to promote effective ways of working that also protect workers' health and wellbeing. This study explored the feasibility and acceptability of an intervention intended to promote home-working practices that would protect and promote health behaviour and wellbeing. METHODS An uncontrolled, single-arm mixed-methods trial design was employed. Forty-two normally-office-based UK workers, working from home between January-February 2021 (during the Covid pandemic), consented to receive the intervention. The intervention: a digital document offering evidence-based recommendations for home-working in ways conducive to health behaviour and wellbeing. Feasibility and acceptability were quantitatively indexed by: expressions of interest within 1 week (target threshold ≥ 35); attrition across the one-week study period (threshold ≤ 20%); and the absence of any apparent detriments in self-reported physical activity, sedentary behaviour, snacking, and work-related wellbeing prior to and one week after receiving the intervention. Qualitative think-aloud data, obtained while participants read through the intervention, and analysed using reflexive thematic analysis, explored acceptability. Semi-structured interviews conducted one week after intervention exposure were content-analysed to identify whether and which behaviour changes were adopted. RESULTS Two feasibility criteria were met: 85 expressions of interest indicated satisfactory intervention demand, and no detriments were observed in health behaviours or wellbeing. Forty-two participants (i.e., maximum capacity for the study; 26 females, 16 males, aged 22-63) consented to take part. 31% dropped out over the one-week study period leaving a final sample of 29 (18 females, 11 males, aged 22-63), exceeding identified attrition thresholds. Think-aloud data showed that participants concurred with intervention guidance, but felt it lacked novelty and practicality. Follow-up interviews produced 18 (62%) participant reports of intervention adherence, where nine recommendations reportedly prompted behaviour change in at least one participant. CONCLUSIONS Mixed evidence was found for intervention feasibility and acceptability. Whilst the information was deemed relevant and of value, further development is required to increase its novelty. It may also be more fruitful to provide this information via employers, to encourage and emphasise employer endorsement.
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Affiliation(s)
- Samuel Keightley
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Myanna Duncan
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Benjamin Gardner
- Department of Psychology, University of Surrey, Guildford, GU2 7XH, Surrey, UK
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Day S, Ncube V, Maja L, Wasunna B, Pienaar J, Setswe G, Waweru E, Feldacker C. Centering Frontline Health Care Workers in Digital Innovation Design to Inform the Optimization of an App for Improved Male Circumcision Follow-up in South Africa: Qualitative Usability Study. JMIR Form Res 2023; 7:e44122. [PMID: 36947127 PMCID: PMC10131628 DOI: 10.2196/44122] [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: 11/08/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Voluntary medical male circumcision (VMMC) is a safe and effective HIV prevention strategy. However, adherence to recommended in-person, postoperative follow-up is inefficient for procedures with few adverse events. Two-way texting (2wT)-based follow-up appears to be a safe and an efficient alternative to scheduled clinic visits for low-risk patients who underwent VMMC. To ensure that 2wT responds to the needs of health care workers (HCWs) and patients, HCWs were closely involved in app design using a human-centered design (HCD) approach. OBJECTIVE Embedded within an ongoing randomized controlled trial of 2wT in South Africa and complementary HCD processes of 2wT app optimization, this qualitative study aimed to use key informant interviews (KIIs) to explore the thoughts, suggestions, and opinions on and perceptions of 2wT's usability and acceptability among HCWs involved in 2wT implementation in both urban and rural South Africa. METHODS A total of 7 HCWs using 2wT in Gauteng and the North West province participated in KIIs regarding the usability and acceptability of 2wT. HCWs were asked for their opinions on 2wT as a viable, useful, appropriate, and accessible method of postoperative VMMC care. They were also asked about 2wT-related working, exploring areas where 2wT could add to or reduce their daily tasks. The KII data were explored, coded, and analyzed by 3 qualitative researchers using thematic content analysis and the ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) software. RESULTS Most HCWs felt confident, comfortable, satisfied, and well supported using a 2wT-based follow-up as an alternative to in-person clinical reviews. They felt that 2wT was easy to use and required little technical support after initial mentoring on how to use the 2wT system. Few noted safety concerns, as men can receive clinical guidance, reassurance, and referral via 2wT. Although fewer in-person visits reduced the in-person review workload and eased clinical flow, HCWs noted the added burden of having to interact with clients via SMS text messages on evenings or weekends. HCWs reinforced the need for enhanced postoperative counseling to ensure that 2wT patients could recognize and understood how to respond to early signs of complications. HCWs suggested a rotation to spread the evening and weekend workload and ensure swift patient responses. CONCLUSIONS In this formative qualitative study focused on HCWs, 2wT was a highly usable alternative to in-person postoperative reviews for patients who underwent VMMC in South Africa. The HCD processes likely improved the usability and acceptability of 2wT for HCWs. HCWs supported the scale-up of 2wT given the distance from the clinic to the men's homes and the potential for reducing workload. To ensure success, providers urged sensitizing patients to the fact that 2wT augments, but does not replace, the existing after-hours and emergency care services.
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Affiliation(s)
- Sarah Day
- Division of Social and Behavioural Sciences, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- The Centre for HIV-AIDS Prevention Studies, Johannesburg, South Africa
| | | | | | | | - Jacqueline Pienaar
- The Centre for HIV-AIDS Prevention Studies, Johannesburg, South Africa
- The Aurum Institute, Johannesburg, South Africa
| | | | | | - Caryl Feldacker
- International Training and Education Center for Health, University of Washington, Seattle, WA, United States
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