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Bertolazzi A, Quaglia V, Bongelli R. Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review. BMC Public Health 2024; 24:506. [PMID: 38365698 PMCID: PMC10873991 DOI: 10.1186/s12889-024-18036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging. METHODS This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors. CONCLUSION The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.
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Affiliation(s)
- Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy.
| | - Valeria Quaglia
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
| | - Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
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Gorman JR, Drizin JH, Smith E, Corey S, Temple M, Rendle KA. Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship. J Sex Med 2022; 19:1131-1146. [PMID: 35523716 DOI: 10.1016/j.jsxm.2022.03.618] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/21/2022] [Accepted: 03/31/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) are increasingly recognized as an effective strategy for supporting female cancer survivors experiencing sexual health concerns. AIM To examine the feasibility of a sexual health MBI, Mindful After Cancer, which was adapted to meet the needs of breast and gynecologic cancer survivors in a community setting and for delivery via videoconference. METHODS A mixed-methods approach was used to evaluate the acceptability, feasibility, and appropriateness of the 8-week virtual MBI. Weekly sessions were 1.5-2 hours in duration and included guided meditations and group discussion about sexuality after cancer and mindfulness in daily life. Home practice activities related to both mindfulness practice and sexual health. Participants completed online surveys at baseline and 1-month post-intervention. A purposive sample of 10 participants were invited to complete a follow-up interview 2-3 months post-intervention. OUTCOMES Primary outcomes included both qualitative and quantitative assessments of acceptability, appropriateness, and feasibility of the Mindful After Cancer intervention for sexual health in cancer survivorship. RESULTS Twenty-two women completed the intervention (Mean age 53.2 years, SD = 9.4, Range= 39-73), with time since diagnosis ranging from 1 to 27 years (Mean 6.0 years, SD = 5.9). Participants completed 6.8 sessions on average (Range = 2 - 8) and 77% reported that the time commitment was manageable. Both qualitative and quantitative findings support the feasibility, acceptability, and appropriateness of the intervention. CLINICAL IMPLICATIONS Many cancer survivors experience sexual dysfunction and related distress after diagnosis and well after treatment ends, yet there are few interventions available. Improved access to effective interventions can improve the delivery of survivorship care and patient outcomes. STRENGTHS & LIMITATIONS The sample size is small for this pilot study, and a control group was not included. The intervention was offered over two time periods, one prior to COVID-19 pandemic and one during the pandemic, resulting in both limitations associated with potential differences between the experiences of participants and the opportunity to learn more about the feasibility of the intervention during times of crisis. CONCLUSION Results suggest that virtual delivery of the MBI is feasible, acceptable, and appropriate for breast and gynecologic cancer survivors. Gorman JR, Drizin JH, Smith E, et al. Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship. J Sex Med 2022;19:1131-1146.
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Affiliation(s)
- Jessica R Gorman
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA.
| | - Julia H Drizin
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Ellie Smith
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Stephanie Corey
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Madison Temple
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Katharine A Rendle
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Cancer Care Innovation, Philadelphia, PA, USA
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Jiang Y, Sun P, Chen Z, Guo J, Wang S, Liu F, Li J. Patients' and healthcare providers' perceptions and experiences of telehealth use and online health information use in chronic disease management for older patients with chronic obstructive pulmonary disease: a qualitative study. BMC Geriatr 2022; 22:9. [PMID: 34979967 PMCID: PMC8721473 DOI: 10.1186/s12877-021-02702-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Telehealth and online health information provide patients with increased access to healthcare services and health information in chronic disease management of older patients with chronic diseases, addressing the challenge of inadequate health resources and promoting active and informed participation of older patients in chronic disease management. There are few qualitative studies on the application of telehealth and online health information to chronic disease management in older patients. Chronic obstructive pulmonary disease is one of the most common chronic diseases in older adults. Telehealth is widely used in the management of chronic obstructive pulmonary disease. The purpose of this study was to explore the perceptions and experiences of older patients and healthcare providers in the application of telehealth and online health information to chronic disease management of chronic obstructive pulmonary disease. METHODS A qualitative descriptive study with data generated from 52 individual semi-structured interviews with 29 patients [Law of the People's Republic of China on the protection of the rights and interests of older people (2018 Revised Version) = >60 years old] with chronic obstructive pulmonary disease and 23 healthcare providers. The inductive thematic analysis method was used for data analysis. RESULTS Four themes and 16 sub-themes were identified in this study. Four themes included: faced with a vast amount of online health information, essential competencies and personality traits ensuring older patients' participation and sustained use, user experience with the use of technology, being in a complex social context. CONCLUSION The ability of patients to understand health information should be fully considered while facilitating access to online health information for older patients. The role of health responsibility and user experience in older patients' participation and sustained use of telehealth and online health information needs to be emphasised. In addition, the complex social context is a determining factor to be considered, particularly the complex impact of a reliance on offspring and social prejudice on the behaviour of older adults using telehealth and online health information.
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Affiliation(s)
- Yuyu Jiang
- Research office of chronic disease management and rehabilitation, Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Wuxi, 214122, Jiangsu Province, China.
| | - Pingping Sun
- Research office of chronic disease management and rehabilitation, Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Wuxi, 214122, Jiangsu Province, China
| | - Zhongyi Chen
- Research office of chronic disease management and rehabilitation, Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Wuxi, 214122, Jiangsu Province, China
| | - Jianlan Guo
- Research office of chronic disease management and rehabilitation, Wuxi School of Medicine, Jiangnan University, No. 1800 Lihu Avenue, Wuxi, 214122, Jiangsu Province, China
| | - Shanshan Wang
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu Province, China
| | - Fenglan Liu
- School of Medicine, Liaocheng University, Liaocheng, 252000, Shandong Province, China
| | - Jinping Li
- Department of Public Health, Wuxi School of Medicine, Jiangnan University, Wuxi, 214122, Jiangsu Province, China
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Oshni Alvandi A, Bain C, Burstein F. Understanding digital health ecosystem from Australian citizens' perspective: A scoping review. PLoS One 2021; 16:e0260058. [PMID: 34780547 PMCID: PMC8592460 DOI: 10.1371/journal.pone.0260058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/30/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. MATERIALS AND METHODS A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. RESULTS Of 3811 articles, 98 articles met the inclusion criteria with research-based articles-as opposed to review articles or white papers- comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were "consumer/user", "health care", "technology", "use and usability", "data and information". These elements were further found to be associated with 127 subcategories. CONCLUSIONS This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens' perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens' experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.
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Affiliation(s)
| | - Chris Bain
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Frada Burstein
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
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Banbury A, Pedell S, Parkinson L, Byrne L. Using the Double Diamond model to co-design a dementia caregivers telehealth peer support program. J Telemed Telecare 2021; 27:667-673. [PMID: 34726994 DOI: 10.1177/1357633x211048980] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to develop a telehealth peer support program for isolated dementia caregivers. This paper reports the co-design process by telehealth and the impact and experiences of participants. The Double Diamond model guided the co-design process, which has four phases, with participants reflecting on their caregiving experiences. Group meetings were recorded, notes compiled with inductive thematic analysis undertaken for phases one to three. Each phase findings were presented to the group for verification and refinement. Semi-structured interviews with participants were completed at the end of the project. Six dementia caregivers were recruited from dispersed locations with diverse characteristics. The process identified eight key topics to be included in a program to be delivered by telehealth. Participants reported the technology did not detract from the co-design and at times aided it, despite some technical problems. All reported high levels of group connectedness, feeling supported and transfer of knowledge and skills. One participant would have liked more understanding of the process. The group continued to meet without professional input for 2.5 years following the completion of the project. Telehealth can be a mechanism to support diverse populations in participating in co-design projects.
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Affiliation(s)
- Annie Banbury
- Centre for Online Health, The University of Queensland, Australia.,Centre for Health Services Research, The University of Queensland, Australia.,School of Nursing, Midwifery & Social Sciences, 6939Central Queensland University, Australia
| | - Sonja Pedell
- Future Self and Design Living Lab, 3783Swinburne University of Technology, Australia
| | - Lynne Parkinson
- School of Nursing, Midwifery & Social Sciences, 6939Central Queensland University, Australia
| | - Louise Byrne
- School of Management, 5376RMIT University, Australia
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Marhefka S, Lockhart E, Chen H, Meng H, Reina Ortiz M, Powell B, Shuter J. A tailored telehealth group tobacco cessation treatment program for people with HIV: Study protocol for a randomized controlled trial. Contemp Clin Trials 2021; 110:106475. [PMID: 34116206 DOI: 10.1016/j.cct.2021.106475] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Smoking-related illnesses are the leading cause of death among people with HIV (PWH). Yet, there are few effective evidence-based interventions that help PWH quit smoking. The group-based program Positively Smoke Free is a biobehavioral cessation intervention for PWH with a growing evidence base. This study builds on prior work of Positively Smoke Free and addresses numerous weaknesses of prior trials for this population. We describe the Positively Quit Trial, a randomized controlled trial comparing a videoconferencing delivered Positively Smoke Free intervention to an attention-matched condition, assessing cessation over a 1-year period. METHODS This attention-matched, randomized (1:1) controlled trial compares Positively Smoke Free Video-Groups to an updated version of Healthy Relationship Video-Groups. Participants are PWH, aged 18 years and older, who smoke at least one cigarette per day. All are offered nicotine replacement therapy patches and given brief advice to quit. Participants are enrolled in 12 group sessions focusing on either smoking cessation for PWH or broader topics regarding living healthy with HIV; in both conditions, Social Cognitive Theory is the guiding theoretical framework. Participants complete assessments at baseline, days 42, 90, 180, and 360; self-reported abstinence is verified with a video-observed cheek swab sent to a lab and tested for cotinine. PRIMARY OUTCOMES Biochemically confirmed 7-day point prevalence smoking abstinence at day 360 is the primary outcome. Cost per quit, sustained abstinence at various timepoints, and biochemical confirmed abstinence at three and six months are secondary outcomes. Effects of smoking cessation on CD4 and virologic suppression are also explored.
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Affiliation(s)
- Stephanie Marhefka
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612, United States of America.
| | - Elizabeth Lockhart
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612, United States of America.
| | - Henian Chen
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612, United States of America.
| | - Hongdao Meng
- College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL 33612, United States of America.
| | - Miguel Reina Ortiz
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612, United States of America.
| | - Brittani Powell
- College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612, United States of America.
| | - Jonathan Shuter
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, United States of America.
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Wallace LM, Falla D, Rushton A, Heneghan NR. Group and individual telehealth for chronic musculoskeletal pain: A scoping review. Musculoskeletal Care 2021; 20:245-258. [PMID: 34668312 DOI: 10.1002/msc.1594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND CONTEXT Musculoskeletal (MSK) pain presents a global challenge. Individual and group pain management programmes (PMPs) are recommended approaches for patients with chronic MSK disorders. With advances in remote healthcare capability, telehealth, and the recent COVID-19 pandemic, the importance of telehealth PMPs has become even more evident. Nevertheless, it is not known how patients perceive PMPs for their MSK complaint when delivered via telehealth. OBJECTIVE To synthesise the evidence of patients' experiences of group and individual telehealth PMPs for chronic MSK pain. DESIGN A scoping review informed by the PRISMA extension for scoping reviews. DATA SOURCES Based on a planned search strategy, modified following initial searches, an electronic search was conducted of key databases: Cochrane Library, Medline, CINAHL, EMBASE, AMED, SportDiscus and APA PsychInfo from 2010 until 11 May 2021. STUDY SELECTION Any qualitative or mixed methods study reporting patient experiences of telehealth PMPs for patients with MSK disorders. DATA EXTRACTION AND DATA SYNTHESIS Data were extracted and synthesised using thematic analysis. RESULTS From 446 identified studies, 10 were included. Just two studies investigated group telehealth PMPs for patients with MSK disorders, with eight delivered individually. Four main themes emerged: (1) Usability of the technology, (2) Tailored care, (3) Therapeutic alliance and (4) Managing behaviour. The findings highlight patient acceptability of telehealth to support self-management for chronic MSK disorders, with appropriate clinical and technical support. Group telehealth has the potential to empower patients with peer support. Remote delivery of PMPs also impacts on how patients and providers interact, communicate and develop a therapeutic relationship. CONCLUSIONS AND IMPLICATIONS Barriers and enablers to engagement in telehealth PMPs for patients with chronic MSK disorders have been identified. Peer support and group cohesiveness can be achieved remotely to enhance the patient experience. There is a critical need for further research in this area.
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Affiliation(s)
- L M Wallace
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - D Falla
- Chair in Rehabilitation Science and Physiotherapy, Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - A Rushton
- School of Physical Therapy, Western University, Elborn College, London, Ontario, Canada
| | - N R Heneghan
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
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Ogrin R, Aylen T, Thurgood L, Neoh SL, Audehm R, Steel P, Churilov L, Zajac J, Ekinci EI. Older People With Type 2 Diabetes-Individualising Management With a Specialised Community Team (OPTIMISE): Perspectives of Participants on Care. Clin Diabetes 2021; 39:397-410. [PMID: 34866781 PMCID: PMC8603327 DOI: 10.2337/cd20-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite the high prevalence of diabetes in older people, there is limited information on optimal methods to support their diabetes management, including how to incorporate technology. This article reports on the results of semi-structured interviews with 41 adult participants with type 2 diabetes (mean age 74 ± 7 years) on their perspectives of a new model of care (the Older People With Type 2 Diabetes-Individualising Management With a Specialised Community Team [OPTIMISE] program) for older people with type 2 diabetes. The OPTIMISE program involved telemedicine consultations, home visits by a credentialed diabetes educator, and intermittent flash glucose monitoring. Human connection and relationships were key to the positive perspectives expressed by participants in this program that used technology to enhance the care of older people in their homes.
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Affiliation(s)
- Rajna Ogrin
- Bolton Clarke, Forest Hill, Victoria, Australia
| | - Tracy Aylen
- Bolton Clarke, Forest Hill, Victoria, Australia
| | | | | | - Ralph Audehm
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia
| | - Paul Steel
- Bolton Clarke, Forest Hill, Victoria, Australia
| | - Leonid Churilov
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
| | - Jeffrey Zajac
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia
- Austin Health Clinical School, Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia
| | - Elif I. Ekinci
- Department of General Practice, University of Melbourne, Parkville, Victoria, Australia
- Austin Health Clinical School, Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia
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Zayde A, Kilbride A, Kucer A, Willis HA, Nikitiades A, Alpert J, Gabbay V. Connection During COVID-19: Pilot Study of a Telehealth Group Parenting Intervention. Am J Psychother 2021; 75:67-74. [PMID: 34525847 PMCID: PMC9490759 DOI: 10.1176/appi.psychotherapy.20210005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has resulted in considerable stress for families, placing parents at risk for heightened psychological distress, while prompting widespread changes in mental health service delivery. This study evaluated treatment engagement, acceptability, and psychiatric distress among participants in the telehealth adaptation of the Connecting and Reflecting Experience (CARE) program after the onset of COVID-19. METHODS CARE is a transdiagnostic, bigenerational, mentalizing-focused group parenting intervention based out of an outpatient child mental health clinic in an underserved urban community. Individuals participating in CARE during the clinic's transition to telehealth services were recruited for participation in this pre-post design pilot study. Participants (N=12) completed self-report surveys before and after their first telehealth group session and at their 20-week follow-up. Quantitative and qualitative measures were used to evaluate psychiatric symptoms, treatment engagement, and preliminary acceptability of the adaptation. RESULTS Self-reported mood and anxiety symptoms decreased significantly after 20 weeks of telehealth therapy. Participants reported high levels of therapeutic alliance and group cohesion in the telehealth format. Results also showed minimal participant-reported privacy concerns and a trend toward increased treatment engagement. CONCLUSIONS These findings have implications regarding the acceptability of teletherapy interventions for caregivers of children during this period of heightened vulnerability and limited access to social support and health services. They also are relevant to establishing the preliminary acceptability of mentalizing-focused parenting inventions delivered via telehealth.
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Affiliation(s)
- Amanda Zayde
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Anna Kilbride
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Audrey Kucer
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Henry A Willis
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Adella Nikitiades
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Jonathan Alpert
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
| | - Vilma Gabbay
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York City (all authors); Division of Clinical Research, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York (Gabbay)
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Shapira S, Yeshua-Katz D, Goren G, Aharonson-Daniel L, Clarfield AM, Sarid O. Evaluation of a Short-Term Digital Group Intervention to Relieve Mental Distress and Promote Well-Being Among Community-Dwelling Older Individuals During the COVID-19 Outbreak: A Study Protocol. Front Public Health 2021; 9:577079. [PMID: 33898369 PMCID: PMC8062707 DOI: 10.3389/fpubh.2021.577079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022] Open
Abstract
Older individuals are at an increased risk of experiencing adverse social and health consequences due to both the COVID-19 pandemic and the measures taken to manage it, such as social distancing. To promote community-dwelling older individuals' well-being during this time, the aims of the current project are to develop effective strategies in order (a) to increase older individuals' digital literacy, and (b) to help them acquire behavioral and cognitive skills that will improve their coping abilities with the stressful situation created as a result of the pandemic, as well as reducing adverse mental health effects. The project comprises an intervention arm that includes digital group sessions for older individuals meant to improve their digital literacy, promote their effective coping, and relieve their mental distress and loneliness. Subjects receive a short-term (seven sessions), twice-weekly, digitally guided group intervention through Zoom (a video conferencing app), and WhatsApp (instant messaging app). The wait list control-group participants receive twice-weekly telephone calls from a research assistant during a parallel period. Web-based questionnaires are filled in pre- and post-participation. The effectiveness of the intervention will be analyzed by comparing pre- and post-measures, between intervention and control groups. This protocol offers a model for helping to support vulnerable populations during the COVID-19 pandemic. However, it is applicable regardless of the outbreak of a global health crisis or the imposition of lockdown rules; in fact, it has the potential to contribute to the social inclusion of vulnerable populations during routine times as well as during emergencies. Furthermore, ideas for future expansion include the integration of multilingual facilitators in order to reach seniors from underserved minority groups in various social contexts, even across borders.
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Affiliation(s)
- Stav Shapira
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- PREPARED Center for Emergency Response Research, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Daphna Yeshua-Katz
- Department of Communication Studies, Faculty of Humanities and Social Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ganit Goren
- The Spitzer Department of Social Work, Faculty of Humanities and Social Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Limor Aharonson-Daniel
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- PREPARED Center for Emergency Response Research, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - A. Mark Clarfield
- Faculty of Health Sciences, Medical School for International Health, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The Department of Geriatrics, McGill University, Montreal, QC, Canada
| | - Orly Sarid
- The Spitzer Department of Social Work, Faculty of Humanities and Social Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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Choi J, Cody JL, Fiske S. Usability testing of tablet-based cognitive behavioral intervention application to improve a simple walking activity for older adults with arthritis fatigue. Geriatr Nurs 2021; 42:473-478. [PMID: 33714905 DOI: 10.1016/j.gerinurse.2021.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to test usability of a tablet-based cognitive behavioral intervention ("Tab-CBI") application. Tab-CBI was designed to improve a simple walking activity for older adults with arthritis fatigue. Two phases of usability evaluation were conducted: phase I with 5 older adults to identify any initial design issues and phase II with 10 older adults to examine if Tab-CBI was seamlessly integrated into their daily living. Participants perceived that Tab-CBI was easy, light, and intuitive to use and helped them walking. They reported two key benefit as a motivator to make more active in walking and improved confidence of self-management of fatigue. They referred video recordings and videoconferencing communications as two preferable features. There were also comments for improvement, for example, a challenge for holding a tablet when videoconferencing communications. Participants comments were incorporated into a final version of Tab-CBI to prepare for a future pilot study.
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Affiliation(s)
- Jeungok Choi
- College of Nursing, University of Massachusetts, Amherst, 120 Skinner Hall, 651 North Pleasant Street, Amherst, MA 01003 USA.
| | - Jean Lemieux Cody
- Nurse Quality Management Administrator, Vermont Veterans Home, 325 North Street, Bennington, Vermont 05201 USA
| | - Sarah Fiske
- College of Nursing, University of Massachusetts, Amherst, 020 Skinner Hall, 651 North Pleasant Street, Amherst, MA 01003 USA
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12
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Ros-DeMarize R, Chung P, Stewart R. Pediatric behavioral telehealth in the age of COVID-19: Brief evidence review and practice considerations. Curr Probl Pediatr Adolesc Health Care 2021; 51:100949. [PMID: 33436319 PMCID: PMC8049735 DOI: 10.1016/j.cppeds.2021.100949] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Considerable efforts over the last decade have been placed on harnessing technology to improve access to behavioral health services. These efforts have exponentially risen since the outbreak of the Coronavirus disease 2019 (COVID-19), which has prompted a move to novel systems of care, largely based on telehealth delivery. This article aims to provide a broad review of evidence for telehealth assessment and treatment of externalizing disorders and internalizing disorders in children and discuss practice considerations and established guidelines for telehealth delivery. Existing literature supports the promise of behavioral health interventions including behavioral parent training and combination approaches for externalizing disorders as well as cognitive-behavioral based interventions for internalizing disorders. There is a scarcity of work on assessment via telehealth compared with the available treatment literature. While treatment may be most pressing given the COVID-19 circumstances to continue delivery of care, movement toward establishing evidence-based assessment via telehealth will be of increased importance. Lastly, practice guidelines have been set forth by national associations, professional societies, and supported by the development of national Telehealth Centers of Excellence. These guidelines and practice considerations are discussed within the context of COVID-19.
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Affiliation(s)
| | - Peter Chung
- University of California, Irvine, United States
| | - Regan Stewart
- Medical University of South Carolina, Charleston, SC, United States
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13
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Sorinmade OA, Kossoff L, Peisah C. COVID-19 and Telehealth in older adult psychiatry-opportunities for now and the future. Int J Geriatr Psychiatry 2020; 35:1427-1430. [PMID: 32729632 DOI: 10.1002/gps.5383] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/24/2020] [Accepted: 07/21/2020] [Indexed: 11/09/2022]
Affiliation(s)
| | - Lana Kossoff
- Faculty Old Age Psychiatry, Royal Australian and New Zealand College of Psychiatrists, Sydney, Australia
| | - Carmelle Peisah
- School of Psychiatry, University of New South Wales, Kensington, Australia
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14
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Lodder A, Papadopoulos C, Randhawa G. Using a blended format (videoconference and face to face) to deliver a group psychosocial intervention to parents of autistic children. Internet Interv 2020; 21:100336. [PMID: 32939343 PMCID: PMC7479349 DOI: 10.1016/j.invent.2020.100336] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/28/2020] [Accepted: 07/31/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Parents and carers of autistic children report poor mental health. Autism stigma is a strong contributing factor to poor parental mental health, yet there are currently no interventions available that are evidenced to improve parents' mental health in part through increasing resilience to stigma. Childcare and travel are well known barriers to attendance and attrition rates for this population are high. METHODS A blended format psychosocial group support intervention was developed with the aim to improve parental mental health. Three sessions were delivered face to face, and five sessions via videoconference. A secret Facebook group was set up to support the intervention and increase retention rates. Mixed methods were used to assess the feasibility and acceptability of this mode of delivery for both the facilitator and service users. Attendance rates, fidelity and implementation issues are discussed. A qualitative focus group was conducted (n = 9) to explore the acceptability to the participants. Framework analysis was used to analyse the findings. RESULTS Attendance rates were high with the online sessions having significantly higher attendance rates than the face to face sessions. The findings of the qualitative evaluation suggest that participants are positive about videoconferencing for a group support intervention. The facilitator reported sound quality, background distractions and late arrivals as challenges; the participants on the other hand, reported that the benefits far outweighed the negatives. Suggestions for improvement are made. CONCLUSIONS The results suggest that videoconference is a well-received method to provide a group support intervention to parents. Only preliminary conclusions can be drawn, owing to the small sample size.
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15
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Does Telehealth Delivery of a Dyadic Dementia Care Program Provide a Noninferior Alternative to Face-To-Face Delivery of the Same Program? A Randomized, Controlled Trial. Am J Geriatr Psychiatry 2020; 28:673-682. [PMID: 32234275 DOI: 10.1016/j.jagp.2020.02.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study aimed to determine whether delivery of a dyadic intervention using telehealth was noninferior to delivery of the same program using traditional face-to-face delivery through home visits. DESIGN We conducted a noninferiority randomized controlled trial. PARTICIPANTS Participants had a diagnosis of dementia, were living in the community, and had an informal caregiver who reported difficulties in managing activities of daily living or behavioral symptoms. INTERVENTION Participants were randomized to receive either telehealth or home visit delivery of the same intervention program. MEASUREMENTS The primary outcome was the Caregiving Mastery Index, secondary outcomes included caregiver's perceptions of change, activities of daily living function, and type and frequency of behavioral symptoms of persons living with dementia. Therapists delivering the intervention recorded the time spent delivering the intervention as well as travel time. RESULTS Sixty-three dyads were recruited and randomized. Both groups reported improvements for the primary outcome, however, these were not statistically significant. There were no significant differences between groups for the primary outcome (mean difference 0.09 (95% confidence interval -1.26 to 1.45) or the secondary outcomes at 4 months. Both groups reported significant improvements in caregiver's perceptions of change. The amount of time spent delivering the content of the program was similar between groups, however offering the intervention via telehealth significantly reduced travel time (mean 255.9 minutes versus mean 77.2 minutes, p <0.0001). CONCLUSION It is feasible to offer dyadic interventions via telehealth and doing so reduces travel time and results in similar benefits for families.
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16
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Høye H, Jahnsen RB, Løvstad M, Hartveit JF, Sørli H, Tornås S, Månum G. A Mindfulness-Based Stress Reduction Program via Group Video Conferencing for Adults With Cerebral Palsy - A Pilot Study. Front Neurol 2020; 11:195. [PMID: 32318010 PMCID: PMC7146892 DOI: 10.3389/fneur.2020.00195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/04/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose: Adults with cerebral palsy experience challenges related to lifelong disability, such as stress, fatigue, pain and emotional issues. E-health services can be delivered regardless of residence and level of functioning. The aim of this pilot study was to explore the potential benefits and feasibility of a mindfulness-based program delivered to adults with cerebral palsy via group video conferencing. Methods: Six adults with cerebral palsy received an 8 week mindfulness group-based program via video conferencing. A multiple single-case study design was applied, including quantitative and qualitative elements. Pain was assessed 16 times through the study period. Questionnaires were administered to gather data on pain catastrophizing, stress, fatigue, emotional distress, positive and negative affect, and quality of life. A focus group interview addressed experiences with the intervention and the mode of delivery. Results: The participants' pain levels showed varied trajectories. Pain catastrophizing and negative affect were statistically significant decreased. Qualitative data indicated benefits from mindfulness in coping and stress management. The video conferencing delivery was evaluated as feasible, with no major adverse effects. Conclusion: Since the pilot study had a small sample size, potential treatment benefits should be interpreted with caution. However, this pilot study provides important information in the planning of future larger and controlled studies on mindfulness-based interventions programs via video conferencing for adults with cerebral palsy and other persons living with long-term disability.
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Affiliation(s)
- Helene Høye
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Reidun Birgitta Jahnsen
- Department of Clinical Neurosciences for Children and Research, Oslo University Hospital, Oslo, Norway.,Center of Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | | | - Hilde Sørli
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Sveinung Tornås
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
| | - Grethe Månum
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
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17
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Parkinson L, Banbury A, Hillman W, Lee J. What are older people and their families looking for in an aged care services provider? Australas J Ageing 2019; 39:244-253. [DOI: 10.1111/ajag.12738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 09/14/2019] [Accepted: 09/16/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Annie Banbury
- Central Queensland University Rockhampton Qld Australia
| | - Wendy Hillman
- Central Queensland University Rockhampton Qld Australia
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18
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Renfro T, Johnson E, Lambert DN, Wingood G, DiClemente RJ. The MEDIA model: An innovative method for digitizing and training community members to facilitate an HIV prevention intervention. Transl Behav Med 2019; 8:815-823. [PMID: 29471535 DOI: 10.1093/tbm/iby012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As human immunodeficiency virus (HIV) continues to disproportionately affect African American women, practitioners remain committed to developing innovative strategies to reduce HIV prevalence. These strategies include training community organizations, such as churches, and utilizing digital media to make intervention dissemination more sustainable. This article describes one such effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV prevention intervention. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. Formative evaluations, consultation with experts in the digital platform of choice, and the experience of two P4 for Women Master Trainers informed our translation. The model guided the translation process as our research team worked alongside topical experts and a production company to develop storyboards for core curriculum activities, which were later scripted and filmed with mock participants. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. Lessons learned from this study indicate future attempts at digitizing TOFs should keep in mind that digitization can be a time-consuming process, pilot testing in the new format is necessary even for a previously tested intervention, and the structure provided by facilitators in face-to-face training must be embedded into the format of digitized trainings.
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Affiliation(s)
- Tiffaney Renfro
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Erin Johnson
- Emory University Rollins School of Public Health, Atlanta, GA, USA.,American Institutes for Research (AIR), Washington, DC, USA
| | | | - Gina Wingood
- Emory University Rollins School of Public Health, Atlanta, GA, USA.,Mailman School of Public Health, Columbia University, New York, NY, USA.,Center for AIDS Research, Emory University, Atlanta, GA, USA
| | - Ralph J DiClemente
- Emory University Rollins School of Public Health, Atlanta, GA, USA.,Center for AIDS Research, Emory University, Atlanta, GA, USA
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19
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Jakobsson E, Nygård L, Kottorp A, Malinowsky C. Experiences from using eHealth in contact with health care among older adults with cognitive impairment. Scand J Caring Sci 2019; 33:380-389. [PMID: 30628736 DOI: 10.1111/scs.12634] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/07/2018] [Indexed: 12/31/2022]
Abstract
RATIONALE Since health care is facing challenges, with fewer caregivers providing care to more clients, eHealth plays a crucial role. Through eHealth, people are expected to be more involved in their own care. On the part of health care users, eHealth requires use of everyday technology such as telephones and computers, and services through the Internet which might be challenging for older adults with cognitive impairment. AIM To investigate experiences of using eHealth in contact with health care among older adults with cognitive impairment. METHOD Individual, semi-structured interviews were conducted with nine participants, aged 65-84 years, with cognitive impairments of varying origins. A constructivist Grounded Theory approach was used. Data collection and analysis were performed simultaneously using a constant comparative method. ETHICAL ISSUES Ethical approval (Dnr: 2014/906-32) was obtained from the regional ethical committee, Stockholm. RESULTS The core category, the eHealth staircase supported by habits, is presented as a model that visualises the result. The model includes three steps showing different ways of being in contact with health care through the use of technological devices and services that mirrors different levels of complexity of eHealth use as follows: (i) Analogue use, (ii) One-way-use and (iii) Interactive use. The participants' location on the eHealth staircase was affected by several aspects described in three categories united by habits; A stable relationship with technology: a prerequisite for use; The importance of interpersonal relationships within health care and Being supported by significant others: a prerequisite in contact with health care. CONCLUSIONS Older adults with cognitive impairments seemed to prefer common and less complex eHealth when contacting health care. Therefore, it is necessary that health care providers offer different possibilities for patients to contact them, that is, both through the Internet and by personal telephone service.
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Affiliation(s)
- Elin Jakobsson
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Louise Nygård
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Camilla Malinowsky
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
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20
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Leafman JS, Mathieson K. Perceptions of telemedicine for patient education among online support group patients with chronic or rare conditions. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1525148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Joan S Leafman
- College of Graduate Health Studies, Still Research Institute Scientist, A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206
| | - Kathleen Mathieson
- College of Graduate Health Studies, Still Research Institute Scientist, A.T. Still University, 5850 E. Still Circle, Mesa, AZ 85206
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21
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Hawkins M, Elsworth GR, Osborne RH. Application of validity theory and methodology to patient-reported outcome measures (PROMs): building an argument for validity. Qual Life Res 2018; 27:1695-1710. [PMID: 29464456 PMCID: PMC5997725 DOI: 10.1007/s11136-018-1815-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Data from subjective patient-reported outcome measures (PROMs) are now being used in the health sector to make or support decisions about individuals, groups and populations. Contemporary validity theorists define validity not as a statistical property of the test but as the extent to which empirical evidence supports the interpretation of test scores for an intended use. However, validity testing theory and methodology are rarely evident in the PROM validation literature. Application of this theory and methodology would provide structure for comprehensive validation planning to support improved PROM development and sound arguments for the validity of PROM score interpretation and use in each new context. OBJECTIVE This paper proposes the application of contemporary validity theory and methodology to PROM validity testing. ILLUSTRATIVE EXAMPLE The validity testing principles will be applied to a hypothetical case study with a focus on the interpretation and use of scores from a translated PROM that measures health literacy (the Health Literacy Questionnaire or HLQ). DISCUSSION Although robust psychometric properties of a PROM are a pre-condition to its use, a PROM's validity lies in the sound argument that a network of empirical evidence supports the intended interpretation and use of PROM scores for decision making in a particular context. The health sector is yet to apply contemporary theory and methodology to PROM development and validation. The theoretical and methodological processes in this paper are offered as an advancement of the theory and practice of PROM validity testing in the health sector.
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Affiliation(s)
- Melanie Hawkins
- Health Systems Improvement Unit, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia.
| | - Gerald R Elsworth
- Health Systems Improvement Unit, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Richard H Osborne
- Health Systems Improvement Unit, Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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22
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Gentry MT, Lapid MI, Clark MM, Rummans TA. Evidence for telehealth group-based treatment: A systematic review. J Telemed Telecare 2018; 25:327-342. [DOI: 10.1177/1357633x18775855] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Interest in the use of telehealth interventions to increase access to healthcare services is growing. Group-based interventions have the potential to increase patient access to highly needed services. The aim of this study was to systematically review the available literature on group-based video teleconference services. Methods The English-language literature was searched using Ovid MEDLINE, PubMed, PsycINFO and CINAHL for terms related to telehealth, group therapy and support groups. Abstracts were reviewed for relevance based on inclusion criteria. Multiple study types were reviewed, including open-label, qualitative and randomised controlled trial study designs. Data were compiled regarding participants, study intervention and outcomes. Specific areas of interest were the feasibility of and satisfaction with telehealth technology, as well as the effect of video teleconference delivery on group dynamics, including therapeutic alliance. Results Forty published studies met the inclusion criteria and were included in the review. Six were randomised controlled trials. Among the studies, there was a broad range of study designs, participants, group interventions and outcome measures. Video teleconference groups were found to be feasible and resulted in similar treatment outcomes to in-person groups. However, few studies were designed to demonstrate noninferiority of video teleconference groups compared with in-person groups. Studies that examined group process factors showed small decreases in therapeutic alliance in the video teleconference participants. Conclusions Video teleconference groups are feasible and produce outcomes similar to in-person treatment, with high participant satisfaction despite technical challenges. Additional research is needed to identify optimal methods of video teleconference group delivery to maximise clinical benefit and treatment outcomes.
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Affiliation(s)
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, USA
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23
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Kandola DK, Banner D, Araki Y, Bates J, Hadi H, Lear SA. The Participant Recruitment Outcomes (PRO) study: Exploring contemporary perspectives of telehealth trial non-participation through insights from patients, clinicians, study investigators, and study staff. Contemp Clin Trials Commun 2018; 11:75-82. [PMID: 29998203 PMCID: PMC6008707 DOI: 10.1016/j.conctc.2018.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 04/13/2018] [Accepted: 05/03/2018] [Indexed: 11/23/2022] Open
Abstract
Background Telehealth has been proposed as an alternative means to providing traditional modes of care while alleviating the need for participant travel and reducing overall healthcare costs. The purpose of this study was to explore contemporary perspectives of patients and stakeholders regarding non-participation in telehealth trials. Methods We undertook a two-phase exploratory qualitative study to understand the reasons behind patient non-participation in telehealth. Data were collected through semi-structured interviews with non-participating patient participants (n = 8) and stakeholders (n = 27) including clinicians, study investigators, and study staff. An analysis of interview data were undertaken and guided by a qualitative descriptive approach. Findings Patients and stakeholders reported many barriers to telehealth participation including technological barriers, limited understanding of disease, and an understated need for services. Both groups had some overlap in their concerns but also provided unique insights. Conclusion The analysis of study findings revealed perspectives of patients and stakeholders including barriers to participation as well as suggestions for future telehealth initiatives. Further research is needed to explore non-participation including patient readiness to assist in the development of future telehealth programs.
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Affiliation(s)
- Damanpreet K Kandola
- School of Nursing, University of Northern British Columbia, Prince George, British Columbia, V2N 4Z9, Canada.,School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, V2N 4Z9, Canada
| | - Davina Banner
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, V2N 4Z9, Canada
| | - Yuriko Araki
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, V5A 1S6, Canada
| | - Joanna Bates
- Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Haidar Hadi
- Northern Medical Program, Department of Medicine, University of Northern British Columbia, V2N 4Z9, Canada.,Northern Health Authority, Prince George, British Columbia, V2L 5B8, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, V5A 1S6, Canada.,Division of Cardiology, Providence Healthcare, Vancouver, British Columbia, V6Z 1Y6, Canada
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24
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Banbury A, Nancarrow S, Dart J, Gray L, Parkinson L. Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review. J Med Internet Res 2018; 20:e25. [PMID: 29396387 PMCID: PMC5816261 DOI: 10.2196/jmir.8090] [Citation(s) in RCA: 152] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/10/2017] [Accepted: 11/02/2017] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Group therapy and education and support sessions are used within health care across a range of disciplines such as chronic disease self-management and psychotherapy interventions. However, there are barriers that constrain group attendance, such as mobility, time, and distance. Using videoconferencing may overcome known barriers and improve the accessibility of group-based interventions. OBJECTIVE The aim of this study was to review the literature to determine the feasibility, acceptability, effectiveness, and implementation of health professional-led group videoconferencing to provide education or social support or both, into the home setting. METHODS Electronic databases were searched using predefined search terms for primary interventions for patient education and/or social support. The quality of studies was assessed using the Mixed Methods Appraisal Tool. We developed an analysis framework using hierarchical terms feasibility, acceptability, effectiveness, and implementation, which were informed by subheadings. RESULTS Of the 1634 records identified, 17 were included in this review. Home-based groups by videoconferencing are feasible even for those with limited digital literacy. Overall acceptability was high with access from the home highly valued and little concern of privacy issues. Some participants reported preferring face-to-face groups. Good information technology (IT) support and training is required for facilitators and participants. Communication can be adapted for the Web environment and would be enhanced by clear communication strategies and protocols. A range of improved outcomes were reported but because of the heterogeneity of studies, comparison of these across studies was not possible. There was a trend for improvement in mental health outcomes. Benefits highlighted in the qualitative data included engaging with others with similar problems; improved accessibility to groups; and development of health knowledge, insights, and skills. Videoconference groups were able to replicate group processes such as bonding and cohesiveness. Similar outcomes were reported for those comparing face-to-face groups and videoconference groups. CONCLUSIONS Groups delivered by videoconference are feasible and potentially can improve the accessibility of group interventions. This may be particularly useful for those who live in rural areas, have limited mobility, are socially isolated, or fear meeting new people. Outcomes are similar to in-person groups, but future research on facilitation process in videoconferencing-mediated groups and large-scale studies are required to develop the evidence base.
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Affiliation(s)
- Annie Banbury
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - Susan Nancarrow
- Office of the Deputy Vice Chancellor (Research), Southern Cross University, Lismore, Australia
| | - Jared Dart
- Faculty of Health Sciences, Bond University, Gold Coast, Australia
| | - Leonard Gray
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Lynne Parkinson
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Australia
- School of Medicine and Public Health, Newcastle University, Newcastle, Australia
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25
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Duan-Porter W, Van Houtven CH, Mahanna EP, Chapman JG, Stechuchak KM, Coffman CJ, Hastings SN. Internet Use and Technology-Related Attitudes of Veterans and Informal Caregivers of Veterans. Telemed J E Health 2017; 24:471-480. [PMID: 29252110 DOI: 10.1089/tmj.2017.0015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Healthcare systems are interested in technology-enhanced interventions to improve patient access and outcomes. However, there is uncertainty about feasibility and acceptability for groups who may benefit but are at risk for disparities in technology use. Thus, we sought to describe characteristics of Internet use and technology-related attitudes for two such groups: (1) Veterans with multi-morbidity and high acute care utilization and (2) informal caregivers of Veterans with substantial care needs at home. MATERIALS AND METHODS We used survey data from two ongoing trials, for 423 Veteran and 169 caregiver participants, respectively. Questions examined Internet use in the past year, willingness to communicate via videoconferencing, and comfort with new technology devices. RESULTS Most participants used Internet in the past year (81% of Veterans, 82% of caregivers); the majority of users (83% of Veterans, 92% of caregivers) accessed Internet at least a few times a week, and used a private laptop or computer (81% of Veterans, 89% of caregivers). Most were willing to use videoconferencing via private devices (77-83%). A majority of participants were comfortable attempting to use new devices with in-person assistance (80% of Veterans, 85% of caregivers), whereas lower proportions were comfortable "on your own" (58-59% for Veterans and caregivers). Internet use was associated with comfort with new technology devices (odds ratio 2.76, 95% confidence interval 1.70-4.53). CONCLUSIONS Findings suggest that technology-enhanced healthcare interventions are feasible and acceptable for Veterans with multi-morbidity and high healthcare utilization, and informal caregivers of Veterans. In-person assistance may be important for those with no recent Internet use.
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Affiliation(s)
- Wei Duan-Porter
- 1 Center for Chronic Disease Outcomes Research and Section of General Internal Medicine , Minneapolis VA Health Care System, Minneapolis, Minnesota.,2 Department of Medicine, University of Minnesota , Minneapolis, Minnesota
| | - Courtney H Van Houtven
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina.,4 Department of Medicine, Duke University School of Medicine , Durham, North Carolina.,5 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina
| | - Elizabeth P Mahanna
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina
| | - Jennifer G Chapman
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina
| | - Karen M Stechuchak
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina
| | - Cynthia J Coffman
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina.,6 Department of Biostatistics and Bioinformatics, Duke University Medical Center , Durham, North Carolina
| | - Susan Nicole Hastings
- 3 Center for Health Services Research in Primary Care , Durham VA Health Care System, Durham, North Carolina.,4 Department of Medicine, Duke University School of Medicine , Durham, North Carolina.,5 Center for the Study of Aging and Human Development, Duke University , Durham, North Carolina.,7 Geriatrics Research, Education and Clinical Center , Durham VA Health Care System, Durham, North Carolina
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Banbury A, Parkinson L, Nancarrow S, Dart J, Gray LC, Buckley J. Delivering patient education by group videoconferencing into the home: Lessons learnt from the Telehealth Literacy Project. J Telemed Telecare 2017; 22:483-488. [PMID: 27799452 DOI: 10.1177/1357633x16674359] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/31/2016] [Indexed: 11/16/2022]
Abstract
We examined the procedures for implementing group videoconference (VC) education for older people delivered into the home environment to identify the most common themes affecting the optimum delivery of VC home-based groups to older people. Participants (n = 52) were involved in a six-week group VC patient education program. There were a total of 44 sessions, undertaken by nine groups, with an average of four participants (range 1-7) and the facilitator. Participants could see and hear each other in real-time whilst in their homes with customised tablets or a desktop computer. The data presented here are based on a program log maintained by the facilitator throughout the implementation phase of the project and post intervention. The VC group experience is influenced by factors including the VC device location, connection processes, meeting times, use of visual aids and test calls. Social presence can be improved by communication protocols and strategies. Robust information technology (IT) support is essential in mitigating technical problems to enhance users' experience. Group patient education can be delivered by VC into homes of older people. However, careful pre-program planning, training and support should be considered when implementing such programs.
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Affiliation(s)
- Annie Banbury
- Human Health and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Lynne Parkinson
- Human Health and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Susan Nancarrow
- Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Jared Dart
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Leonard C Gray
- Centre for Online Health, University of Queensland, Brisbane, Queensland, Australia
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Lindberg I, Torbjørnsen A, Söderberg S, Ribu L. Telemonitoring and Health Counseling for Self-Management Support of Patients With Type 2 Diabetes: A Randomized Controlled Trial. JMIR Diabetes 2017; 2:e10. [PMID: 30291058 PMCID: PMC6238841 DOI: 10.2196/diabetes.6884] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 05/03/2017] [Accepted: 05/25/2017] [Indexed: 12/28/2022] Open
Abstract
Background The prevalence of diabetes is increasing among adults globally, and there is a need for new models of health care delivery. Research has shown that self-management approaches encourage persons with chronic conditions to take a primary role in managing their daily care. Objective The objective of this study was to investigate whether the introduction of a health technology-supported self-management program involving telemonitoring and health counseling had beneficial effects on glycated hemoglobin (HbA1c), other clinical variables (height, weight, body mass index, blood pressure, blood lipid profile), and health-related quality of life (HRQoL), as measured using the Short Form Health Survey (SF-36) version 2 in patients with type 2 diabetes. Methods This was a pragmatic randomized controlled trial of patients with type 2 diabetes. Both the control and intervention groups received usual care. The intervention group also participated in additional health promotion activities with the use of the Prescribed Healthcare Web application for self-monitoring of blood glucose and blood pressure. About every second month or when needed, the general practitioner or the diabetes nurse reviewed the results and the health care activity plan. Results A total of 166 patients with type 2 diabetes were randomly assigned to the intervention (n=87) or control (n=79) groups. From the baseline to follow-up, 36 patients in the intervention group and 5 patients in the control group were lost to follow-up, and 2 patients died. Additionally, HbA1c was not available at baseline in one patient in the intervention group. A total of 122 patients were included in the final analysis after 19 months. There were no significant differences between the groups in the primary outcome HbA1c level (P=.33), and in the secondary outcome HRQoL as measured using SF-36. A total of 80% (67/87) of the patients in the intervention group at the baseline, and 98% (47/50) of the responders after 19-month intervention were familiar with using a personal computer (P=.001). After 19 months, nonresponders (ie, data from baseline) reported significantly poorer mental health in social functioning and role emotional subscales on the SF-36 (P=.03, and P=.01, respectively). Conclusions The primary outcome HbA1c level and the secondary outcome HRQoL did not differ between groups after the 19-month follow-up. Those lost to follow-up reported significantly poorer mental health than did the responders in the intervention group. Trial Registration Clinicaltrials.gov NCT01478672; https://clinicaltrials.gov/ct2/show/NCT01478672 (Archived by WebCite at http://www.webcitation.org/6r4eILeyu)
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Affiliation(s)
- Inger Lindberg
- Division of Nursing, Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Astrid Torbjørnsen
- Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Siv Söderberg
- Department of Nursing Sciences, Mid Sweden University, Östersund, Sweden
| | - Lis Ribu
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
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Banbury A, Chamberlain D, Nancarrow S, Dart J, Gray L, Parkinson L. Can videoconferencing affect older people's engagement and perception of their social support in long-term conditions management: a social network analysis from the Telehealth Literacy Project. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:938-950. [PMID: 27573127 DOI: 10.1111/hsc.12382] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 06/06/2023]
Abstract
Social support is a key component in managing long-term conditions. As people age in their homes, there is a greater risk of social isolation, which can be ameliorated by informal support networks. This study examined the relationship between changes in social support networks for older people living in a regional area following weekly videoconference groups delivered to the home. Between February and June 2014, we delivered 44 weekly group meetings via videoconference to participants in a regional town in Australia. The meetings provided participants with education and an opportunity to discuss health issues and connect with others in similar circumstances. An uncontrolled, pre-post-test methodology was employed. A social network tool was completed by 45 (87%) participants either pre- or post-intervention, of which 24 (46%) participants completed the tool pre- and post-intervention. In addition, 14 semi-structured interviews and 4 focus groups were conducted. Following the intervention, participants identified increased membership of their social networks, although they did not identify individuals from the weekly videoconference groups. The most important social support networks remained the same pre- and post-intervention namely, health professionals, close family and partners. However, post-intervention participants identified friends and wider family as more important to managing their chronic condition compared to pre-intervention. Participants derived social support, in particular, companionship, emotional and informational support as well as feeling more engaged with life, from the weekly videoconference meetings. Videoconference education groups delivered into the home can provide social support and enhance self-management for older people with chronic conditions. They provide the opportunity to develop a virtual social support network containing new and diverse social connections.
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Affiliation(s)
- Annie Banbury
- Human Health and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Daniel Chamberlain
- School of Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Susan Nancarrow
- School of Health and Human Sciences, Southern Cross University, Lismore, New South Wales, Australia
| | - Jared Dart
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Len Gray
- Centre for Online Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Lynne Parkinson
- Human Health and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
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Nutbeam D, McGill B, Premkumar P. Improving health literacy in community populations: a review of progress. Health Promot Int 2017; 33:901-911. [DOI: 10.1093/heapro/dax015] [Citation(s) in RCA: 160] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Don Nutbeam
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Bronwyn McGill
- Prevention Research Collaboration, Sydney School of Public Health, Charles Perkins Centre, University of Sydney, NSW, Australia
| | - Pav Premkumar
- Southampton Education School, University of Southampton, Southampton, UK
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Cultural adaptation and validation of the Health Literacy Questionnaire (HLQ): robust nine-dimension Danish language confirmatory factor model. SPRINGERPLUS 2016; 5:1232. [PMID: 27536516 PMCID: PMC4971008 DOI: 10.1186/s40064-016-2887-9] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 07/20/2016] [Indexed: 11/16/2022]
Abstract
Health literacy is an important construct in population health and healthcare requiring rigorous measurement. The Health Literacy Questionnaire (HLQ), with nine scales, measures a broad perception of health literacy. This study aimed to adapt the HLQ to the Danish setting, and to examine the factor structure, homogeneity, reliability and discriminant validity. The HLQ was adapted using forward–backward translation, consensus conference and cognitive interviews (n = 15). Psychometric properties were examined based on data collected by face-to-face interview (n = 481). Tests included difficulty level, composite scale reliability and confirmatory factor analysis (CFA). Cognitive testing revealed that only minor re-wording was required. The easiest scale to respond to positively was ‘Social support for health’, and the hardest were ‘Navigating the healthcare system’ and ‘Appraisal of health information’. CFA of the individual scales showed acceptably high loadings (range 0.49–0.93). CFA fit statistics after including correlated residuals were good for seven scales, acceptable for one. Composite reliability and Cronbach’s α were >0.8 for all but one scale. A nine-factor CFA model was fitted to items with no cross-loadings or correlated residuals allowed. Given this restricted model, the fit was satisfactory. The HLQ appears robust for its intended application of assessing health literacy in a range of settings. Further work is required to demonstrate sensitivity to measure changes.
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Nancarrow S, Banbury A, Buckley J. Evaluation of a National Broadband Network-enabled Telehealth trial for older people with chronic disease. AUST HEALTH REV 2016; 40:641-648. [DOI: 10.1071/ah15201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 12/16/2015] [Indexed: 01/08/2023]
Abstract
Objective
The aim of the present study was to evaluate the effect of a high-speed telemonitoring project for older people with chronic disease in a regional Australian town. Participants’ vital signs were monitored and triaged daily by a telehealth nurse.
Methods
A prospective, uncontrolled study design evaluated the effect of home-based telemonitoring on older people with chronic disease. Evaluation included surveys (including the Stanford Chronic Disease Self-Efficacy tool and the Self-Rated Health Questionnaire), self-reported health service use and interviews and focus groups exploring client experiences.
Results
Participants reported an improved understanding of their vital signs monitoring (48%) and consequently better self-management of health (48%) and that they were better informed (44%) and more confident (25%) to discuss health with their doctor. Patients also reported making medication changes (17%), positive dietary changes (34%) and increasing their physical activity (33%). Overall, patients’ self-rated general health improved (mean (± s.d.) improvement 0.30 ± 0.80; 95% confidence interval (CI) 0.16–0.45; 118 d.f.; P < 0.001), with more participants reporting that their health is ‘excellent’ or ‘very good’ at the end of the trial. Patients also reported fewer doctor visits (P < 0.001), fewer visits to the local hospital emergency department (P = 0.021) and fewer non-local hospital admissions (P < 0.001) compared with the preceding year. There was no significant reduction in local hospital admissions (P = 0.171).
Conclusions
The findings of the present study suggest that telemonitoring with videoconferencing empowers older people to better understand and manage their own health, and is associated with improved health outcomes and reduced service use. Having regular, daily access to a Telehealth nurse reassured participants, and triggered changes to services and behaviour that are likely to have positively affected patient outcomes.
What is known about this topic?
Telehealth is increasingly being used in the care of older people with chronic conditions and can reduce health service use. Previous research has indicated that telehealth has the potential to provide patients with greater knowledge and understanding of their condition.
What this paper adds?
Our research demonstrates that older people with limited experience of technology can be taught to successfully use telehealth equipment. We observed regular contact with telehealth nurses enables health promoting behaviour messages to be tailored to patients’ needs.
What are the implications for practitioners?
Providing older people with tailored health support alongside an understanding of vital signs readings can enhance self-efficacy.
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Taylor A, Morris G, Pech J, Rechter S, Carati C, Kidd MR. Home Telehealth Video Conferencing: Perceptions and Performance. JMIR Mhealth Uhealth 2015; 3:e90. [PMID: 26381104 PMCID: PMC4704976 DOI: 10.2196/mhealth.4666] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/28/2015] [Accepted: 08/05/2015] [Indexed: 11/17/2022] Open
Abstract
Background The Flinders Telehealth in the Home trial (FTH trial), conducted in South Australia, was an action research initiative to test and evaluate the inclusion of telehealth services and broadband access technologies for palliative care patients living in the community and home-based rehabilitation services for the elderly at home. Telehealth services at home were supported by video conferencing between a therapist, nurse or doctor, and a patient using the iPad tablet. Objective The aims of this study are to identify which technical factors influence the quality of video conferencing in the home setting and to assess the impact of these factors on the clinical perceptions and acceptance of video conferencing for health care delivery into the home. Finally, we aim to identify any relationships between technical factors and clinical acceptance of this technology. Methods An action research process developed several quantitative and qualitative procedures during the FTH trial to investigate technology performance and users perceptions of the technology including measurements of signal power, data transmission throughput, objective assessment of user perceptions of videoconference quality, and questionnaires administered to clinical users. Results The effectiveness of telehealth was judged by clinicians as equivalent to or better than a home visit on 192 (71.6%, 192/268) occasions, and clinicians rated the experience of conducting a telehealth session compared with a home visit as equivalent or better in 90.3% (489/540) of the sessions. It was found that the quality of video conferencing when using a third generation mobile data service (3G) in comparison to broadband fiber-based services was concerning as 23.5% (220/936) of the calls failed during the telehealth sessions. The experimental field tests indicated that video conferencing audio and video quality was worse when using mobile data services compared with fiber to the home services. As well, statistically significant associations were found between audio/video quality and patient comfort with the technology as well as the clinician ratings for effectiveness of telehealth. Conclusions These results showed that the quality of video conferencing when using 3G-based mobile data services instead of broadband fiber-based services was less due to failed calls, audio/ video jitter, and video pixilation during the telehealth sessions. Nevertheless, clinicians felt able to deliver effective services to patients at home using 3G-based mobile data services.
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Affiliation(s)
- Alan Taylor
- Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, Australia.
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