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Lassar W, Hertelendy AJ. Investigating drivers of telecare acceptance to improve healthcare quality for independently living older adults. Int J Qual Health Care 2024; 36:mzae039. [PMID: 38722034 DOI: 10.1093/intqhc/mzae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 03/24/2024] [Accepted: 04/27/2024] [Indexed: 05/18/2024] Open
Abstract
Contemporary telecare systems facilitate the ability for older adults to age in place, keeping them out of residential care facilities and providing numerous quality-of-life advantages for both care receivers (CRs) and caregivers (CGs). However, despite the acceptance of digital health interventions among older adults and their CGs, telecare adoption has been slower than expected. This paper aimed to compare attitudes toward adopting telecare systems between CRs (aging adults) and their CGs (family/friends). Data were collected via an online survey. Respondents included aging adults concerned about their care (CRs) and older adults who cared for an aging loved one (CGs). Analysis of covariance and partial-least-squares techniques were used to examine the relationships between healthcare concerns for older adults, functional telecare benefits, and telecare acceptance. Concerns for healthcare status, mainly driven by CRs, positively impacted telecare acceptance. However, concerns for mental and physical stimulation had a negative relationship with telecare acceptance, while CGs showed a neutral relationship. Telecare's ability to improve healthcare quality and cognitive stimulation positively impacted its acceptance. CGs mainly drove the impact of healthcare quality on telecare acceptance, while the relationship was not significant for CRs. CRs' age reduced telecare acceptance, and higher educational levels of CGs increased telecare acceptance. We found significant differences in telecare acceptance and its drivers between CGs and CRs in the USA. In addition, we discerned that not all healthcare concerns or functional telecare characteristics influenced telecare acceptance equally between the two. Consequently, telecare providers must consider the different needs of constituencies interested in telecare to support the life quality of older adults.
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Affiliation(s)
- Walfried Lassar
- Department of Marketing and Logistics, College of Business, Florida International University, Miami, FL 33199, United States
| | - Attila J Hertelendy
- Department of Information Systems and Business Analytics, College of Business & Herbert Wertheim College of Medicine, Florida International University, Miami, FL 33199, United States
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Lee S, Ory MG, Vollmer Dahlke D, Smith ML. Technology Use Among Older Adults and Their Caregivers: Cross-Sectional Survey Study. JMIR Aging 2024; 7:e50759. [PMID: 38717339 PMCID: PMC11084119 DOI: 10.2196/50759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 02/18/2024] [Accepted: 02/18/2024] [Indexed: 05/12/2024] Open
Abstract
Background Informal caregivers are called upon to provide substantial care, but more needs to be known about technology use among older adult and caregiver dyads. Objective This study described technology use among older adults and their caregivers, explored potential correlates of technology use, and highlighted implications for practice. Methods A cross-sectional survey was conducted among unpaid caregivers of older adults (n=486). Primary outcomes were self-reported technology (devices and functions) use among caregivers and their oldest care recipient. The concordance of technology use among caregivers and care recipients was also examined. Multivariable regression models were conducted separately for caregivers and care recipients. Results Greater proportions of caregivers used all examined technologies, except for the medication alerts or tracking function, than care recipients. Caregivers used an average of 3.4 devices and 4.2 functions, compared to 1.8 devices and 1.6 functions used by their care recipients. Among caregivers, younger age, higher income, and higher education were associated with more technology use (P<.05). Among care recipients, younger age, not having cognitive dysfunction, and caregiver's technology use were associated with more technology use (P<.05). Conclusions Understanding technology use patterns and device adoption across diverse caregiver and care recipient populations is increasingly important for enhancing geriatric care. Findings can guide recommendations about appropriate technology interventions and help providers communicate and share information more effectively with patients and their caregivers.
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Affiliation(s)
- Shinduk Lee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Marcia G Ory
- Department of Environmental and Occupational Health, Texas A&M University, College Station, TX, United States
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
| | - Deborah Vollmer Dahlke
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
- DVD Associates, LLC, Austin, TX, United States
| | - Matthew Lee Smith
- Center for Community Health and Aging, Texas A&M University, College Station, TX, United States
- Department of Health Behavior, Texas A&M University, College Station, TX, United States
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Bogulski CA, Andersen JA, Eswaran S, Willis DE, Edem D, McElfish PA. Factors Associated with Online Patient Portal Utilization Experience in an Arkansas Phone Survey. Telemed J E Health 2024; 30:e1148-e1156. [PMID: 38011711 PMCID: PMC11035923 DOI: 10.1089/tmj.2023.0490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 11/29/2023] Open
Abstract
Introduction: Accessing electronic health record information through a patient portal is associated with numerous benefits to both health care providers and patients. However, patient portal utilization remains low. Little is known about the factors associated with patient portal utilization following the onset of the COVID-19 pandemic. Methods: In March 2022, we conducted a random digit dial phone survey of both cell phones and landlines of adults living in Arkansas that asked numerous demographic and health-related measures, including patient portal utilization in the past 12 months. A total of 2,201 adult Arkansans completed the survey between March 1 and March 28, 2022. Weighted estimates were generated using rank ratio estimation to approximate the 2019 American Community Survey 1-year Arkansas estimates for race/ethnicity (72% White, 15% Black/African American, 7.8% Hispanic, 4.9% other race/ethnicity), age (73% 18-39, 32% 40-59, and 31% 60+), and gender (49% male, 51% female). We fit the data to a logistic regression model. Results: We found that education, employment, prior telehealth experience, having a check-up in the past 2 years, and having a primary care provider were all positively associated with patient portal utilization. We also found that non-Hispanic Black/African-American respondents were less likely to access a patient portal relative to non-Hispanic White respondents. Discussion: Patient portal utilization is related to several demographic and health-related factors among an adult population in Arkansas. Given that the documented benefits of patient portal utilization are broad, under-utilization by groups that already experience relatively worse health outcomes could reproduce or even exacerbate existing health disparities. Additional research is needed to further investigate what barriers to patient portal utilization remain for these populations.
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Affiliation(s)
- Cari A. Bogulski
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Jennifer A. Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Surabhee Eswaran
- Department of Environmental Studies, Tulane University, New Orleans, Louisiana, USA
| | - Don E. Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Dinesh Edem
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Pearl A. McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
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Gordon NP, Zhang S, Lo JC, Li CF. The Digital Transition: Are Adults Aged 65 Years or Older Willing to Complete Online Forms and Questionnaires in Patient Portals? Perm J 2024; 28:68-75. [PMID: 38317596 PMCID: PMC10940229 DOI: 10.7812/tpp/23.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
INTRODUCTION Patients are being encouraged to complete forms electronically using patient portals rather than on paper, but willingness of older adults to make this transition is uncertain. METHODS The authors analyzed data for 4105 Kaiser Permanente Northern California 2020 Member Health Survey respondents aged 65-85 years who answered a question about willingness to complete online forms and questionnaires using a patient portal. Data weighted to the Kaiser Permanente Northern California membership were used to estimate percentages of older adults willing to complete patient portal forms and questionnaires. Chi-square tests and log-Poisson regression models that included sociodemographic, internet use, and patient portal variables were used to identify factors predictive of willingness. RESULTS Overall, 59.6% of older adults were willing to complete patient portal forms, 17.6% were not willing, and 22.8% were not sure. Adults aged 75-85 (49.5%) vs 65-74 years (64.8%) and Black (51.9%) and Latino (46.5%) vs White (62.8%) adults were less likely to indicate willingness. In addition to racial and ethnic differences and younger age, higher educational attainment, use of the internet alone (vs internet use with help or not at all), having an internet-enabled computer or tablet, and having sent at least 1 message through the patient portal increased likelihood of being willing. CONCLUSIONS Health care teams should assess older adults' capabilities and comfort related to completion of patient portal-based forms and support those willing to make the digital transition. Paper forms and oral collection of information should remain available for those unable or unwilling to make this digital transition.
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Affiliation(s)
- Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- The Permanente Medical Group, Oakland, CA, USA
| | - Sherry Zhang
- Department of Adult and Family Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- The Permanente Medical Group, Oakland, CA, USA
| | - Christina F Li
- Department of Adult and Family Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
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Allen RJ, Nakonechnyi A, Phan T, Moore C, Drury E, Grewal R, Liebman SE, Levy D, Saeed F. Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study. Kidney360 2024; 5:344-351. [PMID: 38270895 PMCID: PMC11000739 DOI: 10.34067/kid.0000000000000369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/12/2024] [Indexed: 01/26/2024]
Abstract
Key Points This largest to date patient survey study explores what patients with kidney disease want to know about treatments, such as dialysis or conservative management. A surprising number of patients want extensive doctor-like education, but are willing to spend only several hours on education. Patients are notably open to online and digital educational modalities—technology may allow for individualized and ongoing patient education. Background Despite efforts to educate individuals with CKD and thereby improve outcomes, studies have shown that a significant number of patients still report poor CKD knowledge. Thus, understanding patient needs and preferences is crucial for the development and implementation of an effective CKD educational program. Methods A paper survey was distributed to patients with CKD 21 years and older at a tertiary care hospital's outpatient nephrology clinic in Rochester, NY. Data on patient demographics; print and technological literacies; and preferences regarding topics, instructors, class formats, session frequency, duration, and peer support were gathered. Results The mean age of 337 patients was 65 years (±12.33 years), and the self-identified races were American Indian or Alaska Native (<1%), Asian (3%), Black (12.17%), Native Hawaiian or other Pacific Islander (<1%), White (83%), and Other (2%). Most of the patients (69%) never needed help with health instructions, and 68% of patients used a smartphone or computer every day. Key topics identified by patients included the definitions of CKD, creatinine, and GFR and information on kidney diet. Seventy-three percent of patients desired more than basic CKD information, with one in five even wanting to know everything a doctor knows. Forty-six percent were willing to attend classes, and 33% preferred using digital (video, computer, or smartphone) modalities. Patients were willing to attend an average of 3.6 classes, and most preferred hour-long classes. Most of the patients (46%) preferred a doctor as the educator, and 53% expressed interest in connecting with fellow patients for peer support. Conclusions Most patients with CKD are interested in comprehensive education about their disease. This research may offer insights into the optimal content and delivery of CKD educational programs by elaborating on patients' needs and the integration of online modalities to deliver content. Future person-centered educational programs for people with CKD are needed.
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Affiliation(s)
- Rebecca J. Allen
- Center for IT Engagement (cITe), Mount St. Joseph University, Cincinnati, Ohio
| | - Alex Nakonechnyi
- Center for IT Engagement (cITe), Mount St. Joseph University, Cincinnati, Ohio
| | - TramAnh Phan
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Catherine Moore
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Erika Drury
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Rickinder Grewal
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Scott E. Liebman
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - David Levy
- Division of Nephrology, Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Fahad Saeed
- Division of Nephrology, Division of Palliative Care, Departments of Medicine and Public Health, University of Rochester School of Medicine and Dentistry, Rochester, New York
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Krenn C, Semlitsch T, Zipp C, Lengauer S, Shao L, Schreck T, Bedek M, Kupfer C, Albert D, Kubicek B, Siebenhofer A, Jeitler K. Customization options in consumer health information materials on type-2 diabetes mellitus-an analysis of modifiable features in different types of media. Front Public Health 2024; 12:1252244. [PMID: 38450136 PMCID: PMC10915235 DOI: 10.3389/fpubh.2024.1252244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction The understanding of health-related information is essential for making informed decisions. However, providing health information in an understandable format for everyone is challenging due to differences in consumers' health status, disease knowledge, skills, and preferences. Tailoring health information to individual needs can improve comprehension and increase health literacy. Objective The aim of our research was to analyze the extent to which consumers can customize consumer health information materials (CHIMs) for type-2 diabetes mellitus through various media types. Methods We conducted a comprehensive search for various CHIMs across various media types, such as websites, apps, videos, and printed or printable forms. A representative sample of CHIMs was obtained for analysis through blocked randomization across the various media types. We conducted a quantitative content analysis to determine the frequency of user-centered customization options. Cross-comparisons were made to identify trends and variations in modifiable features among the media. Results In our representative sample of 114 CHIMs, we identified a total of 24 modifiable features, which we grouped into five main categories: (i) language, (ii) text, (iii) audiovisual, (iv) presentation, and (v) medical content. Videos offered the most customization opportunities (95%), while 47% of websites and 26% of apps did not allow users to tailor health information. None of the printed or printable materials provided the option to customize the information. Overall, 65% of analyzed CHIMs did not allow users to tailor health information according to their needs. Conclusion Our results show that CHIMs for type-2 diabetes mellitus could be significantly improved by providing more customization options for users. Further research is needed to investigate the effectiveness and usability of these options to enhance the development and appropriate provision of modifiable features in health information.
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Affiliation(s)
- Cornelia Krenn
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Thomas Semlitsch
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Carolin Zipp
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Stefan Lengauer
- Institute of Computer Graphics and Knowledge Visualization, Graz University of Technology, Graz, Austria
| | - Lin Shao
- Institute of Computer Graphics and Knowledge Visualization, Graz University of Technology, Graz, Austria
- Fraunhofer Austria Center for Data Driven Design, Graz, Austria
| | - Tobias Schreck
- Institute of Computer Graphics and Knowledge Visualization, Graz University of Technology, Graz, Austria
| | - Michael Bedek
- Institute of Psychology, University of Graz, Graz, Austria
| | - Cordula Kupfer
- Institute of Psychology, University of Graz, Graz, Austria
| | | | | | - Andrea Siebenhofer
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
- Institute of General Practice, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Klaus Jeitler
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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McCarthy B, Sabharwal JK, Chawla S. Old age or cognitive decline? Examining the usability of a mobile health app for older Australians. Inform Health Soc Care 2024; 49:83-97. [PMID: 38529731 DOI: 10.1080/17538157.2024.2332691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
There is a growing literature on the role of mobile health applications (mHealth apps) in supporting older adults and the self-management of personal health. The purpose of this pilot study is to assess the usability of a government-funded mobile health app amongst older Australians and to evaluate whether cognitive function and demographic characteristics (i.e. age, gender, education) are associated with usability. A total of 28 older adults living in a regional city in Australia took part in the study. The participants were recruited using purposive sampling. Data collection instruments consisted of validated cognitive tests, task-based usability tests, and a questionnaire. The data was analyzed using non-parametric strategies. The findings of this study demonstrated that a government-funded, mHealth app was usable by older adults. Users were able to perform basic tasks in an effective and efficient manner. The hypothesis that elderly age would be significantly associated with performance on cognitive tests, as well as usability, was not supported. Performance on some cognitive tests was significantly and positively related to usability. Education and gender were not related to usability. The results suggest that traditional stereotypes surrounding aging and cognitive decline need to be reexamined.
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Affiliation(s)
- Breda McCarthy
- Psychology, School of Social and Health Sciences, James Cook University, Townsville, Singapore
- Information Technology, James Cook University, Singapore, Singapore
| | - Jagdeep Kaur Sabharwal
- Psychology, School of Social and Health Sciences, James Cook University, Townsville, Singapore
| | - Shailey Chawla
- Information Technology, James Cook University, Singapore, Singapore
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Purvis S, Gion T. Fluid Status Vulnerability in Older Adults. J Infus Nurs 2024; 47:49-53. [PMID: 38211615 DOI: 10.1097/nan.0000000000000534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
There is a growing body of evidence about physiological changes with age that impact fluid and electrolyte balance. It is important that infusion nurses have knowledge in managing care for geriatric patients so they can identify these changes when they are exhibited. Knowing how to minimize the effect of these changes on the health of older adults is critical. The infusion nurse with knowledge of geriatric-focused care can avoid complications and critical illness in older adults. In addition, it is important to provide specific patient education that is grounded in geriatric best practices. This information will assist older adults to better protect themselves from dehydration, kidney injury, and other complications associated with fluid balance, such as delirium. This article reviews the literature on specific changes with aging that predispose older adults to adverse complications with fluid imbalance. New technology in geriatrics that can improve management of fluid status, such as dehydration and electrolyte monitors, are also discussed. This review included searches of the Medline®/PubMed® Database using MeSH terms (National Library of Medicine). Search terms included the following: aging-biological; aging kidney; water-electrolyte imbalance; dehydration; hypo-hypernatremia; hypo-hyperkalemia; delirium; wearable technology; and hydration monitors.
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Affiliation(s)
- Suzanne Purvis
- Confidence in Aging, LLC, Alexandria, Virginia (Purvis); Confidence in Aging, LLC, Madison, Wisconsin (Gion)
- Suzanne Purvis, DNP, APRN, GCNS-BC, FCNS, brings over 20 years' experience working in health care systems as a clinical nurse specialist in geriatrics to her current business, Confidence in Aging, LLC. The primary mission of Confidence in Aging is to help individuals, schools, communities, and businesses to better understand and manage aging. Suzanne has a doctorate in nursing from the University of Minnesota. She has won several awards in clinical excellence and in health care education and has achieved fellowship in the National Association of Clinical Nurse Specialists. Additionally, she is published on a variety of health care topics, including as contributing author in the current edition of the Adult-Gerontology Certification Review (ANCC, Springer Publishing, 2021). Suzanne's passion is to help everyone embrace and manage aging as a unique life phase
- Terry Gion, DNP, RN, CRRN, NE-BC, has over 40 years of experience working in the health care system. She has been a clinical nurse specialist in acute rehabilitation, nurse leader in medical and procedural nursing, and a consultant in various health care-related businesses. Terry has a doctorate of nursing from Concordia University. She has won various awards in clinical excellence and nursing leadership and has held board positions for professional organizations. She is published on clinical and leadership health care topics. Terry's passion is to provide evidence-based educational materials that can help others understand and manage their health and health care needs
| | - Terry Gion
- Confidence in Aging, LLC, Alexandria, Virginia (Purvis); Confidence in Aging, LLC, Madison, Wisconsin (Gion)
- Suzanne Purvis, DNP, APRN, GCNS-BC, FCNS, brings over 20 years' experience working in health care systems as a clinical nurse specialist in geriatrics to her current business, Confidence in Aging, LLC. The primary mission of Confidence in Aging is to help individuals, schools, communities, and businesses to better understand and manage aging. Suzanne has a doctorate in nursing from the University of Minnesota. She has won several awards in clinical excellence and in health care education and has achieved fellowship in the National Association of Clinical Nurse Specialists. Additionally, she is published on a variety of health care topics, including as contributing author in the current edition of the Adult-Gerontology Certification Review (ANCC, Springer Publishing, 2021). Suzanne's passion is to help everyone embrace and manage aging as a unique life phase
- Terry Gion, DNP, RN, CRRN, NE-BC, has over 40 years of experience working in the health care system. She has been a clinical nurse specialist in acute rehabilitation, nurse leader in medical and procedural nursing, and a consultant in various health care-related businesses. Terry has a doctorate of nursing from Concordia University. She has won various awards in clinical excellence and nursing leadership and has held board positions for professional organizations. She is published on clinical and leadership health care topics. Terry's passion is to provide evidence-based educational materials that can help others understand and manage their health and health care needs
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Lee S. Internet Use and Well-Being of Older Adults Before and During the COVID-19 Pandemic: Findings from European Social Survey. J Gerontol Soc Work 2024; 67:96-113. [PMID: 37246398 DOI: 10.1080/01634372.2023.2217682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/21/2023] [Indexed: 05/30/2023]
Abstract
The present study examined older adults' use of digital technology and its relation to perceived well-being before and during the COVID-19 pandemic in Europe. Three cross-sectional survey data from the European Social Survey (ESS) were employed including ESS8-2016 (n = 10,618, Mean age = 73.59 ± 6.76 years; 54.4% female), ESS9-2018 (n = 13,532, Mean age = 73.85 ± 6.58 years; 55.9% female), and ESS10-2020 (n = 4,894, Mean age = 73.49 ± 6.40 years; 59.0% female). Results showed that there was a tendency to increase Internet use on a daily basis across different European countries before and during the COVID-19 pandemic. Old age, low education, being widowed, and living in a household with more than five household members were salient factors that are correlated with lower levels of Internet use. Internet use was positively associated with happiness and life satisfaction, and negatively associated with poor general health.
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Affiliation(s)
- Sunwoo Lee
- The Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
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Wu Q, Ngien A, Jiang S. Descriptive Norms and eHealth Use Among Older Adults: A Cross-Country Comparative Study. Health Commun 2023:1-12. [PMID: 38148390 DOI: 10.1080/10410236.2023.2297120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
eHealth use enables older adults to access and manage healthcare resources, and benefits their health; however, older adults' uptake of eHealth remains low across societies. Social influences such as descriptive norms may be of critical importance in promoting the elderly's usage of eHealth. Based on the Integrative Model of Behavioral Prediction, this study investigates how descriptive norms relate to eHealth use among the elderly in China and the United States. Analysis of the combined sample (N = 1,070) showed that descriptive norms were positively related to eHealth use. Also, descriptive norms were indirectly associated with eHealth use via injunctive norms, attitudes and self-efficacy. Moderated mediation analysis indicated that these direct and indirect relationships differed across the two countries. This study highlights the important role of descriptive norms in promoting older adults' eHealth use behavior and addresses potential country differences in how the elderly respond to descriptive norms. Several important theoretical and practical implications are also discussed.
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Affiliation(s)
- Qiaofei Wu
- Department of Communications and New Media, National University of Singapore
| | - Annabel Ngien
- Department of Communications and New Media, National University of Singapore
| | - Shaohai Jiang
- Department of Communications and New Media, National University of Singapore
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Turner A, Flood VM, LaMonica HM. Older adults' needs and preferences for a nutrition education digital health solution: A participatory design study. Health Expect 2023; 27:e13923. [PMID: 38014900 PMCID: PMC10734207 DOI: 10.1111/hex.13923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The global population is ageing rapidly and there is a need for strategies to promote health and wellbeing among older adults. Nutrition knowledge is a key predictor of dietary intake; therefore, effective educational programmes are urgently required to rectify poor dietary patterns. Digital health technologies provide a viable option for delivering nutrition education that is cost-effective and widely accessible. However, few technologies have been developed to meet the unique needs and preferences of older adults. OBJECTIVE The aim of this study was to explore technology use among older adults and qualitatively determine the content needs and design preferences for an online nutrition education resource tailored to older adult consumers in Australia. METHODS Twenty adult participants aged 55 years and older (95% female) participated in one of four 2-h participatory design workshops. In each workshop, prompted discussion questions were used to explore participants' technology use and preferences and to explore content needs and design preferences for an online nutrition education resource specific to older adults. RESULTS All participants were regularly using a range of different devices (e.g., smartphones, tablets and computers) and reported being comfortable doing so. Participants wanted a website that provided general nutrition information, practical advice and recipes. To enhance engagement, they sought a personalised resource that could be adjusted to suit their needs, included up-to-date information and allowed for easy sharing with others by exporting information as a PDF. CONCLUSIONS Participatory design methods generate new knowledge for designing and tailoring digital health technologies to be appropriate and useful for the target audience. Specifically, older adults seek an online resource that has large and simple fonts with clear categories, providing them with practical advice and general nutrition information that can be personalised to suit their own needs and health concerns, with the option to export and print information into a paper-based format. PATIENT OR PUBLIC CONTRIBUTION Older adults actively participated in the development and evaluation process to generate ideas about potential features, functionalities, uses and practicalities of an online nutrition education resource.
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Affiliation(s)
- Ashlee Turner
- Sydney School of Health Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Victoria M. Flood
- Sydney School of Health Sciences, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- University Centre for Rural Health (Northern Rivers), Faculty of Medicine and HealthThe University of SydneyLismoreNew South WalesAustralia
| | - Haley M. LaMonica
- Translational Research Collective, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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Mcintyre D, Chiang J, Thiagalingam A, Tong A, Chow CK. Engagement and fidelity of a cardiovascular disease prevention-focused digital health intervention in cardiology outpatient waiting rooms: a mixed-methods study. BMJ Qual Saf 2023; 32:655-664. [PMID: 35803709 DOI: 10.1136/bmjqs-2021-014664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/20/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION We delivered a video-based, cardiovascular disease prevention focused intervention in cardiology waiting rooms that increased motivation to improve cardiovascular risk behaviours and satisfaction with clinic services. To better understand the potential generalisability and scalability of such waiting room interventions, this study evaluated the fidelity of intervention delivery and barriers and enablers to implementation. METHODS Mixed-methods process evaluation conducted among intervention participants in a randomised clinical trial. Data sources included (1) Participant screening logs, (2) Intervention delivery platform data and (3) Semi structured interviews performed with participants. Qualitative data were described using inductive thematic analysis. RESULTS The tablet-based intervention was delivered to 220 patients (112 (50.9%) male, mean age 54.2 (SD 15.4) years). Of 765 videos opened, 636 (83.1%) were watched to completion. Most videos opened were rated (738/765, 96.5%) and video ratings were predominantly positive (661/738, (89.6%) satisfied or highly satisfied). Younger and more educated participants were more likely to rate videos highly (relative risk (RR) 1.73 (95% CI 1.28 to 2.32) and RR 1.26 (95% CI 1.07 to 1.49)) but less likely to watch videos to completion (younger: RR 0.27 (95% CI 0.17 to 0.43), more educated: RR 0.90 (95% CI 0.85 to 0.96)). Of 39 invited, 21 (53.8%) participated in semistructured interviews. Thematic analysis of responses suggested reported behaviour change post intervention may be due to increased awareness of cardiovascular risk, reduced anxiety and intrinsic motivation from delivery within a cardiology waiting room. Lack of reinforcement and limited personalisation were barriers. CONCLUSION The current analysis demonstrates that engagement with a digitally delivered clinic waiting room educational intervention was high, providing explanation for its efficacy in improving motivation to change cardiovascular risk behaviours. The high fidelity of delivery demonstrates potential for scaling of such interventions across waiting rooms. Recall bias and low response rate may bias self-reported engagement measures. TRIAL REGISTRATION NUMBER ANZCTR12618001725257.
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Affiliation(s)
- Daniel Mcintyre
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
| | - Jason Chiang
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
- Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Clara Kayei Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
- Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
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Hoffmann S, Beissner J, Hieber R, Jacoby J, Engler T, Walter CB. Demand-oriented design of telemedical services in gynecologic oncology. BMC Health Serv Res 2023; 23:1168. [PMID: 37891588 PMCID: PMC10604842 DOI: 10.1186/s12913-023-10176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 10/18/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The medical field is in the midst of a massive expansion in telemedical services. However, it is not possible to say to what extent telemedical offerings can be designed to meet needs in the German healthcare system. This study provides insights into demand-oriented care using telemedical services for gynecological patients. METHODS A total of 262 patients who received systemic therapy for gynecological oncology were surveyed anonymously using a questionnaire regarding their acceptance of telemedicine from February 2021 to April 2021. RESULTS Insufficient computer skills were associated with less acceptance of telemedicine treatment by gynecological oncology patients and presented a barrier. However, the patient's level of education was not related to the level of acceptance. Long travel distances from medical facilities and some types of patient occupations significantly increased the acceptance of telemedicine services. A high level of education, on the other hand, was not associated with the approval of telemedical approaches. Long journeys and work commitments increased the acceptance of telemedical visits. CONCLUSIONS The results of this study show that the factors investigated have an influence on the acceptance of telemedical offerings by patients. Barriers such as insufficient computer skills must be taken into account when implementing telemedicine services. Telemedicine can provide physical and economic relief for patients if telemedical planning is tailored to their needs.
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Affiliation(s)
- Sascha Hoffmann
- Department of Women's Health, University Women's Hospital Tübingen, Calwerstr. 7, 72076, Tübingen, Germany.
| | - Julia Beissner
- Department of Women's Health, University Women's Hospital Tübingen, Calwerstr. 7, 72076, Tübingen, Germany
| | - Rebekka Hieber
- Department of Women's Health, University Women's Hospital Tübingen, Calwerstr. 7, 72076, Tübingen, Germany
| | - Johann Jacoby
- Institute for Clinical Epidemiology and Applied Biometry, University of Tübingen, Silcherstr. 5, 72076, Tübingen, Germany
| | - Tobias Engler
- Department of Women's Health, University Women's Hospital Tübingen, Calwerstr. 7, 72076, Tübingen, Germany
| | - Christina Barbara Walter
- Department of Women's Health, University Women's Hospital Tübingen, Calwerstr. 7, 72076, Tübingen, Germany
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Hamaguchi R, Hirokawa Y, Takahashi H, Hachiya T, Kawano H, Isotani S, Ito E, Handa N, Saito R, Horie S, Ide H. Retrospective observational study of a novel smartphone app on the management of patients with mild cognitive impairment or mild dementia. Front Digit Health 2023; 5:1243253. [PMID: 37767524 PMCID: PMC10520957 DOI: 10.3389/fdgth.2023.1243253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction In this study, we aimed to evaluate the feasibility, utility, and potential effects of LQ-M/D App, a smartphone application developed by Life Quest Inc., Tokyo, Japan, for patients with mild cognitive impairment (MCI) and mild dementia. The app incorporates cognitive and physical exercise training, lifestyle habit acquisition features, and a continuity improvement feature added in the post-update version to enhance user engagement. The continuity improvement feature includes the optimization of training content, and disease education, and enables family monitoring via a family app. Methods A retrospective analysis was conducted on app usage, cognitive and exercise training implementation and interruptions, questionnaire response rates, and cognitive assessments in a single institution. A total of 20 patients used the app, with 10 patients using the pre-update version without the continuity improvement feature, and the other 10 patients using the post-update version with the continuity improvement feature. Results and Conclusion The results demonstrated that the LQ-M/D App could be effectively used by the study population, and the continuity improvement feature positively influenced app usage in several aspects. Although a potential association between app usage and cognitive ability was suggested, the scatter in the data points warrants cautious interpretation. Limitations of the study included a small sample size, a single institution setting, and the retrospective nature of the study. In the future, a randomized controlled trial design using a larger sample size and multiple institutions to further evaluate the effectiveness of LQ-M/D App in managing MCI and mild dementia should be performed.
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Affiliation(s)
- Reo Hamaguchi
- Department of Digital Therapeutics, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | | | - Hirotsugu Takahashi
- Department of Digital Therapeutics, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Tsuyoshi Hachiya
- Department of Advanced Informatics for Genetic Disease, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Haruna Kawano
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Shuji Isotani
- Department of Urology, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Emi Ito
- Department of Digital Therapeutics, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Nobuhiro Handa
- Department of Digital Therapeutics, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | | | - Shigeo Horie
- Department of Digital Therapeutics, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hisamitsu Ide
- Department of Digital Therapeutics, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Brinkhof LP, Ridderinkhof KR, Murre JMJ, Krugers HJ, de Wit S. Improving goal striving and resilience in older adults through a personalized metacognitive self-help intervention: a protocol paper. BMC Psychol 2023; 11:223. [PMID: 37542308 PMCID: PMC10403928 DOI: 10.1186/s40359-023-01259-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/21/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Successful aging is often linked to individual's ability to demonstrate resilience: the maintenance or quick recovery of functional ability, well-being, and quality of life despite losses or adversity. A crucial element of resilience is behavioral adaptability, which refers to the adaptive changes in behavior in accordance with internal or external demands. Age-related degradation of executive functions can, however, lead to volition problems that compromise flexible adjustment of behavior. In contrast, the reliance on habitual control has been shown to remain relatively intact in later life and may therefore provide an expedient route to goal attainment among older adults. In the current study, we examine whether a metacognitive self-help intervention (MCSI), aimed at facilitating goal striving through the gradual automatization of efficient routines, could effectively support behavioral adaptability in favor of resilience among older adults with and without (sub-clinical) mental health problems. METHODS This metacognitive strategy draws on principles from health and social psychology, as well as clinical psychology, and incorporates elements of established behavioral change and activation techniques from both fields. Additionally, the intervention will be tailored to personal needs and challenges, recognizing the significant diversity that exist among aging individuals. DISCUSSION Despite some challenges that may limit the generalizability of the results, our MCSI program offers a promising means to empower older adults with tools and strategies to take control of their goals and challenges. This can promote autonomy and independent functioning, and thereby contribute to adaptability and resilience in later life. TRIAL REGISTRATION Pre-registered, partly retrospectively. This study was pre-registered before the major part of the data was collected, created, and realized. Only a small part of the data of some participants (comprising the baseline and other pre-intervention measures), and the full dataset of the first few participants, was collected prior to registration, but it was not accessed yet. See: https://osf.io/5b9xz.
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Affiliation(s)
- Lotte P Brinkhof
- Department of Psychology, Faculty of Behavioral and Social Sciences, University of Amsterdam, Amsterdam, Netherlands.
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands.
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands.
| | - K Richard Ridderinkhof
- Department of Psychology, Faculty of Behavioral and Social Sciences, University of Amsterdam, Amsterdam, Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands
| | - Jaap M J Murre
- Department of Psychology, Faculty of Behavioral and Social Sciences, University of Amsterdam, Amsterdam, Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands
| | - Harm J Krugers
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands
- Faculty of Science, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Sanne de Wit
- Department of Psychology, Faculty of Behavioral and Social Sciences, University of Amsterdam, Amsterdam, Netherlands
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain & Cognition (ABC), University of Amsterdam, Amsterdam, Netherlands
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Pedersen K, Schlichter BR. Improving Predictability and Effectiveness in Preventive Digital Health Interventions: Scoping Review. Interact J Med Res 2023; 12:e40205. [PMID: 37471129 PMCID: PMC10401197 DOI: 10.2196/40205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/01/2022] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Lifestyle-related diseases caused by inadequate diet and physical activity cause premature death, loss of healthy life years, and increased health care costs. Randomized controlled trial (RCT) studies indicate that preventive digital health interventions (P-DHIs) can be effective in preventing these health problems, but the results of these studies are mixed. Adoption studies have identified multiple factors related to individuals and the context in which they live that complicate the transfer of positive results from RCT studies to practical use. Implementation studies have revealed barriers to the large-scale implementation of mobile health (mHealth) solutions in general. Consequently, there is no clear path to delivering predictable outcomes from P-DHIs and achieving effectiveness when scaling up interventions to reduce health problems in society. OBJECTIVE This research aimed to expand our understanding of how to increase the outcome predictability of P-DHIs by focusing on physical activity and diet behaviors and amplify our understanding of how to improve effectiveness in large-scale implementations. METHODS The research objective was pursued through a multidisciplinary scoping review. This scoping review used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) as a guide. A comprehensive search of Web of Science and PubMed limited to English-language journal articles published before January 2022 was conducted. Google Scholar was used for hand searches. Information systems theory was used to identify key constructs influencing outcomes of IT in general. Public health and mHealth literature were used to identify factors influencing the adoption of, outcomes from, and implementation of P-DHIs. Finally, the P-DHI investment model was developed based on information systems constructs and factors from the public health and mHealth literature. RESULTS In total, 203 articles met the eligibility criteria. The included studies used a variety of methodologies, including literature reviews, interviews, surveys, and RCT studies. The P-DHI investment model suggests which constructs and related factors should be emphasized to increase the predictability of P-DHI outcomes and improve the effectiveness of large-scale implementations. CONCLUSIONS The research suggests that outcome predictability could be improved by including descriptions of the constructs and factors in the P-DHI investment model when reporting from empirical studies. Doing so would increase our understanding of when and why P-DHIs succeed or fail. The effectiveness of large-scale implementations may be improved by using the P-DHI investment model to evaluate potential difficulties and possibilities in implementing P-DHIs to create better environments for their use before investing in them and when designing and implementing them. The cost-effectiveness of large-scale implementations is unknown; implementations are far more complicated than just downloading and using apps, and there is uncertainty accompanying implementations given the lack of coordinated control over the constructs and factors that influence the outcome.
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Affiliation(s)
- Keld Pedersen
- Information Systems, Department of Management, Aarhus University, Aarhus C, Denmark
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Morgan G, Briollais L, Clausen M, Casalino S, Mighton C, Chowdhary S, Frangione E, Yiu Jordan Fung C, Arnoldo S, Bearss E, Binnie A, Borgundvaag B, Dagher M, Devine L, Friedman SM, Khan Z, McGeer A, McLeod SL, Richardson D, Stern S, Taher A, Wong I, Zarei N, Bombard Y, Lerner-Ellis J, Taher J. Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey. Clin Biochem 2023:110607. [PMID: 37406717 DOI: 10.1016/j.clinbiochem.2023.110607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES Concepts related to SARS-CoV-2 laboratory testing and result interpretation can be challenging to understand. A cross-sectional survey of COVID-19 positive adults residing in Ontario, Canada was conducted to explore how well people understand SARS-CoV-2 laboratory tests and their associated results. DESIGN AND METHODS Participants were recruited through fliers or by prospective recruitment of outpatients and hospitalized inpatients with COVID-19. Enrolled participants included consenting adults with a positive SARS-CoV-2 polymerase chain reaction test result. An 11-item questionnaire was developed by researchers, nurses, and physicians in the study team and was administered online between April 2021 to May 2022 upon enrolment into the study. RESULTS Responses were obtained from 940 of 1106 eligible participants (85% participation rate). Most respondents understood 1) that antibody results should not influence adherence to social distancing measures (n=602/888, 68%), 2) asymptomatic SARS-CoV-2 infection following test positivity (n=698/888, 79%), 3) serological test sensitivity in relation to post-infection timeline (n=540/891, 61%), and 4) limitations of experts' knowledge related to SARS-CoV-2 serology (n=693/887, 78%). Conversely, respondents demonstrated challenges understanding 1) conflicting molecular and serological test results and their relationship with immune protection (n=162/893, 18%) and 2) the impact of SARS-CoV-2 variants on vaccine effectiveness (n=235/891, 26%). Analysis of responses stratified by sociodemographic variables identified that respondents who were either: 1) female, 2) more educated, 3) aged 18-44, 4) from a high-income household, or 5) healthcare workers responded expectedly more often. CONCLUSIONS We have highlighted concepts related to SARS-CoV-2 laboratory tests and associated results which may be challenging to understand. The findings of this study enable us to identify 1) misconceptions related to various SARS-CoV-2 test results, 2) groups of individuals at risk, and 3) strategies to improve people's understanding of their test results.
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Affiliation(s)
- Gregory Morgan
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | | | - Marc Clausen
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Selina Casalino
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chloe Mighton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sunakshi Chowdhary
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Erika Frangione
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Chun Yiu Jordan Fung
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Saranya Arnoldo
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; William Osler Health System, Brampton, ON, Canada
| | - Erin Bearss
- Mount Sinai Academic Family Health Team, Mount Sinai Hospital, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Bjug Borgundvaag
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Department of Emergency Medicine, Mount Sinai Hospital, Toronto, ON, Canada
| | - Marc Dagher
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Women's College Hospital, Toronto, ON, Canada
| | - Luke Devine
- Division of General Internal Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Steven M Friedman
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Emergency Medicine, University Health Network, Toronto, ON, Canada
| | | | - Allison McGeer
- Department of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Shelley L McLeod
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON, Canada
| | | | - Seth Stern
- Mackenzie Health, Richmond Hill, ON, Canada
| | - Ahmed Taher
- Mackenzie Health, Richmond Hill, ON, Canada; Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Iris Wong
- Mackenzie Health, Richmond Hill, ON, Canada
| | | | - Yvonne Bombard
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Jordan Lerner-Ellis
- Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada; Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Taher
- Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.
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Xu Z, de Melo Ghisi GL, Liu X, Cui L, Grace SL. Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions. Open Med (Wars) 2023; 18:20230674. [PMID: 37009051 PMCID: PMC10052381 DOI: 10.1515/med-2023-0674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/19/2023] [Accepted: 02/06/2023] [Indexed: 03/30/2023] Open
Abstract
The objective of this cross-sectional study was to investigate health management, well-being, and pandemic-related perspectives of chronic disease patients in the context of stringent measures, and associated correlates. A self-report survey was administered during the Omicron wave lockdown in Shanghai, China. Items from the Somatic Symptom Scale (SSS) and Symptom Checklist-90 were administered, as well as pandemic-related items. Overall, 1,775 patients (mostly married females with hypertension) were recruited through a community family physician group. Mean SSS scores were 36.1 ± 10.5/80, with 41.5% scoring in the elevated range (i.e., >36). In an adjusted model, being female, diagnosis of coronary artery disease and arrhythmia, perceived impact of pandemic on life, health condition, change to exercise routine, tolerance of control measures, as well as perception of future and control measures were significantly associated with greater distress. One-quarter perceived the pandemic had a permanent impact on their life, and 44.1% perceived at least a minor impact. One-third discontinued exercise due to the pandemic. While 47.6% stocked up on their medications before the lockdown, their supply was only enough for two weeks; 17.5% of participants discontinued use. Chief among their fears were inability to access healthcare (83.2%), and what they stated they most needed to manage their condition was medication access (65.6%). Since 2020 when we assessed a similar cohort, distress and perceived impact of the pandemic have worsened. Greater access to cardiac rehabilitation in China could address these issues.
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Affiliation(s)
- Zhimin Xu
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200082, China
| | - Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, M4G 2R6, Canada
| | - Xia Liu
- Chengdu Wanda UPMC Hospital, Chengdu, 610218, Sichuan Province, China
| | - Lixian Cui
- Division of Arts and Sciences, NYU Shanghai, 200122, Shanghai, China
| | - Sherry L. Grace
- Faculty of Health, York University, 4700 Keele St, North York, M3J 1P3, Canada
- KITE-Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
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Garcia Reyes EP, Kelly R, Buchanan G, Waycott J. Understanding Older Adults' Experiences With Technologies for Health Self-management: Interview Study. JMIR Aging 2023; 6:e43197. [PMID: 36943333 PMCID: PMC10131633 DOI: 10.2196/43197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Many older adults now use technologies such as wearable devices and telehealth services to support their health and well-being while living independently at home. However, older adults vary in how they use these technologies, and there is a lack of knowledge regarding the motivations that influence their acceptance and use of health-related technologies in home environments. OBJECTIVE This study aimed to understand the types of technologies that older adults use to support their health and the factors that motivate them to use their chosen technologies to support their health. In addition, we aimed to understand the factors that enable the effective use of technologies for health self-management and to identify the barriers that can negatively affect the adoption of technologies. METHODS A total of 22 older adults participated in semistructured interviews regarding their experiences of using technologies for health self-management. Interview transcripts were analyzed through an in-depth thematic analysis. RESULTS The interviews revealed that a range of technologies, such as videoconferencing software, fitness trackers, and other devices, were being used by older adults to support their health. Interviews showed that participants were motivated to use technologies to monitor health issues, to stay active and connected, and to record and change their behavior in the light of foreseen risks related to their future health status. Enablers that facilitated the effective use of technologies include social and organizational influence, convenient access to health care and safety provided by the technology, and easy setup and low cost of the technology. Barriers include information overload and a sense of futility about future health decline; telehealth being an inadequate substitute for in-person consultation; concerns about trust related to privacy and accuracy; and technologies being stigmatizing, uncomfortable to use, expensive, and unfamiliar. CONCLUSIONS This study suggested that older adults were using a variety of technologies to prevent or prepare for future health decline, evidencing a resilient attitude toward health and aging. In addition, older adults were willing to continue using the technology when there was a perceived need. The enabler mentioned by most participants was the social and organizational influence that included health care staff, family, friends, and organizations. This analysis provides a better understanding of how older adults use technologies to support their health and can guide the provision of appropriate health technologies for them.
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Affiliation(s)
- Elsy Paola Garcia Reyes
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Ryan Kelly
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Jenny Waycott
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
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Park-Clinton E, Renda S, Wang F. A Targeted Discharge Planning for High-Risk Readmissions: Focus on Patients and Caregivers. Prof Case Manag 2023; 28:60-73. [PMID: 36662660 DOI: 10.1097/NCM.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE OF STUDY Racial and ethnic minorities with socioeconomic disadvantages are vulnerable to 30-day hospital readmissions. A 16-week quality improvement (QI) project aimed to decrease readmissions of the vulnerable patient populations through tailored discharge planning. The project evaluated the effectiveness of using a 25-item checklist to increase patients' and caregivers' health knowledge, skills, and willingness for self-care and decrease readmissions. PRIMARY PRACTICE SETTING The project took place in an inner-city teaching hospital in the Mid-Atlantic region. METHODOLOGY AND PARTICIPANTS A casual comparative design compared readmissions of the before-intervention group (May 1-July 31, 2021) and the after-intervention group (August 1-October 31, 2021). A pre- and postintervention design evaluated the effectiveness of a 25-item checklist by analyzing the differences of Patient Activation Measure (PAM) pre- and postintervention survey scores and levels in the after-intervention group. Participants were General Medicine Unit patients 18 years or older who had Medicare Fee-for-Service, resided in 10 zip codes near the hospital, and were discharged home. RESULTS Of 30 patients who received the intervention, one patient was readmitted compared with 11 readmissions from 58 patients who did not receive the intervention. The readmission rate was decreased from 19% to 4% during the 16-week project: 11 (19%) versus 1 (4%), p = .038. After receiving the intervention, patients' PAM scores were increased by 8.55, t(22) = 2.67, p < .014. Three patients had a lower postintervention survey level, whereas 12 patients obtained a higher postintervention survey level (p = .01). The increase in scores and levels supported that the intervention effectively improved patients' self-management knowledge, skill, and willingness for self-care. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE The QI project showed that the hospital could partner with patients at high risk for readmission and their caregivers. Accurate evaluation of patients' health knowledge, skills, and willingness for self-care was essential for sufficient discharge planning. Tailored use of the checklist improved patients' self-activation and functionally facilitated patients' and caregivers' care needs and capabilities. The checklist was statistically and clinically effective in decreasing 30-day hospital readmissions of vulnerable patient populations.
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Goodman C, Lambert K. Scoping review of the preferences of older adults for patient education materials. Patient Educ Couns 2023; 108:107591. [PMID: 36584555 DOI: 10.1016/j.pec.2022.107591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To provide an overview of studies that describe the preferred mode and format of delivery of patient education materials to older adults. METHODS A scoping review was used to identify relevant literature published between January 2010 and June 2021, with specific attention given to studies conducted in high income countries with similar health systems. RESULTS A total of 3245 titles were identified, and 20 met the inclusion criteria and were included in this scoping review. Older adults preferred written information that could be accessed via health professionals or downloaded online. Other key features were identified including logical layout, signposted information, larger text size, labelled visual aids, and use of images appropriate and relevant to the target group were preferred. Audio visual resources were also considered valuable when well designed. Formats for patient education such as apps, group classes and online courses were less popular with older adults. CONCLUSIONS Patient education materials for older adults should be carefully designed, with attention to layout and content. Older adults indicated a preference for hard copy handouts or in a format that can be downloaded. PRACTICE IMPLICATIONS Regular engagement with older consumers about their preferences is important as technology for delivery of patient education materials evolve. Key features for specific attention during the design process include a logical layout (tested with consumers), signposted information, text size, labelled visual aids and appropriate images. The perspectives of other key groups of older adults such as those from minority populations or other disadvantaged groups are largely unexplored.
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Affiliation(s)
- Claudia Goodman
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia.
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Moreno O, Garcia-Rodriguez I, Fuentes L, Hernandez C, Munoz G, Fluellen K, Hobgood S, Sargent L. Non-Latinx Healthcare Provider's Knowledge and Awareness of Latinx Geriatric Clinical Health Needs. Clin Gerontol 2023; 46:168-179. [PMID: 35482008 DOI: 10.1080/07317115.2022.2065943] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Due to the exponential growth in the Latinx older adult population, culturally responsive services are needed, especially since most healthcare providers are non-Latinx with limited Spanish or bilingual skills. One place to start is by drawing a formative assessment of the healthcare providers' knowledge and awareness of the healthcare needs of Latinx older adults. METHODS Focus groups were conducted to explore the healthcare providers' knowledge and awareness of cultural and structural barriers and facilitators to accessing health care services for Latinx older adults. RESULTS Results note that healthcare providers perceived the healthcare needs for Latinx older adults to be underutilized for healthcare services, preventive interventions for healthy diet/lifestyle, and healthcare knowledge. Providers reported Latinx family over-involvement, religiosity, immigration, and language/lack of interpreters as barriers to seeking timely healthcare. Finally, healthcare providers said that family support, the location of healthcare services, and community-based partnerships were all facilitators for seeking healthcare. CONCLUSIONS Findings suggest providers' conflicting perspectives toward the Latinx communities. CLINICAL IMPLICATIONS Healthcare services can consider implementing trainings for non-Latinx providers to recognize conflicting perspectives and reduce implicit bias toward the Latinx communities.
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Affiliation(s)
- Oswaldo Moreno
- Psychology Department, La Esperanza Research, Virginia Commonwealth University, Richmond, Virginia, USA
- VCU Institute for Inclusion, Inquiry and Innovation (iCubed), Richmond, Virginia, USA
| | | | - Lisa Fuentes
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Cindy Hernandez
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Geovani Munoz
- Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Kenya Fluellen
- School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Sarah Hobgood
- School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lana Sargent
- VCU Institute for Inclusion, Inquiry and Innovation (iCubed), Richmond, Virginia, USA
- School of Nursing, Virginia Commonwealth University, Richmond, Virginia, USA
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Faleiros F, de Oliveira Braga DC, Schoeller SD, Henriques SH, Cunha NBF, Videira LGN, da Silva Grillo ACL. Surveying people with spinal cord injuries in Brazil to ascertain research priorities. Sci Rep 2023; 13:654. [PMID: 36635338 PMCID: PMC9837118 DOI: 10.1038/s41598-022-26733-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023] Open
Abstract
Scientists are concerned that the research they conduct accurately portrays the needs of people living with spinal cord injuries (SCI). As such, this study set out to investigate the main problems faced by people with SCI and their expectations for research. This quantitative, exploratory, analytical, and cross-sectional study was carried out online, with a non-probabilistic sample of 618 Brazilian adults with SCI who had registered voluntarily to participate in the research of the Neurorehab group. The virtual questionnaire consisted of 22 questions based on ISCOS Data Sets. The majority (68.9%) of participants were male, with higher education or a post-graduate qualification (49.5%). Most injuries had experienced traumatic injuries (78.5%) and 58.7% were paraplegic. The mean age was 38.04 years (SD = 9.85). The main difficulties faced after SCI were locomotion/accessibility (70.9%), neurogenic bladder (68.8%), neurogenic bowel (48.2%), and sexuality (36.1%). The highest demand was for experimental studies on stem cells (22.5%), rehabilitation (14.2%), and cures (13.9%). Most (84.3%) of those who reported sexuality problems after SCI were men (p = 0.013). The findings obtained empower people with SCI by enabling them to influence the agenda of scientific research based on their expectations and difficulties. This survey will also aid organizations to engage stakeholders to implement a comprehensive SCI management program.
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Affiliation(s)
- Fabiana Faleiros
- Ribeirão Preto College of Nursing, University of Sao Paulo, Ribeirão Preto, Brazil.
| | | | | | - Sílvia Helena Henriques
- grid.11899.380000 0004 1937 0722Ribeirão Preto College of Nursing, University of Sao Paulo, Ribeirão Preto, Brazil
| | | | - Lorena Gomes Neves Videira
- grid.11899.380000 0004 1937 0722Ribeirão Preto College of Nursing, University of Sao Paulo, Ribeirão Preto, Brazil
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Lowndes AM, Connelly DM. User experiences of older adults navigating an online database of community-based physical activity programs. Digit Health 2023; 9:20552076231167004. [PMID: 37051565 PMCID: PMC10084572 DOI: 10.1177/20552076231167004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 03/15/2023] [Indexed: 04/09/2023] Open
Abstract
Objectives This study aimed to (1) explore older adult user experiences navigating an online health database of local physical activity programs; (2) compare navigational feedback with age-friendly website design guidelines; (3) assess online database completeness. Methods Focus groups, including guided tasks and a semi-structured interview script, gathered navigational user experiences of fifteen older adults. A review of the literature sought age-friendly best practice website design guidelines and a website search for local physical activity programs was completed. Results The design of the online database website was challenging for older adult participants to navigate and was not ‘intuitive’. Based on focus group feedback, there were multiple discrepancies between the evaluated online database and the established guidelines for designing age-friendly websites. A total of 187 physical activity programs were missing from the database. Conclusions Findings provide novel insight into user experiences of older adults navigating online health and physical activity program sites. Redesigning the following age-friendly website recommendations would empower older adults in the use of online databases and promote awareness of local physical activity programs. Health care providers need reliable and age-friendly online resources to link their patients with local physical activity programs to promote healthy aging.
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Affiliation(s)
- Ashley M Lowndes
- Health & Rehabilitation Sciences Department, University of Western Ontario, London, ON, Canada
| | - Denise M Connelly
- School of Physical Therapy, University of Western Ontario, London, ON, Canada
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LaVine N, Emmert K, Itty J, Martins-Welch D, Carney M, Block A, Burgess L, Volandes AE, Zupanc SN, Jacome S, Gromova V, Davis AD, Schwartz P, Alvarez-Suarez A, Burns E. Reaching Ambulatory Older Adults with Educational Tools: Comparative Efficacy and Cost of Varied Outreach Modalities in Primary Care. J Gen Intern Med 2023; 38:125-130. [PMID: 36217070 PMCID: PMC9550308 DOI: 10.1007/s11606-022-07808-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/13/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Providing patients with access to health information that can be obtained outside of an office visit is an important part of education, yet little is known about the effectiveness of outreach modalities to connect older adults to online educational tools. The objective was to identify the effectiveness and cost of outreach modalities providing online information about advance care planning (ACP) for older adults. METHODS Six different outreach modalities were utilized to connect patients to online educational tools (ACP video decision aids). Participants were 13,582 patients aged 65 and older of 185 primary care providers with appointments over a 30-month period within a large health system in the greater New York City area. Main outcome measures were number of online video views and costs per outreach for each modality. KEY RESULTS There were 1150 video views for 21,407 remote outreach events. Text messages, sent to the largest volume of patients (8869), had the highest outcome rate (9.6%) and were the most economical ($0.09). Characterization of phone calls demonstrated 21.7% engagement in the topic of ACP but resulted in minimal video views (<1%) and incurred the highest cost per outreach ($2.88). In-office handouts had negligible results (<1%). CONCLUSIONS Text was the most cost-effective modality to connect older adults to an online educational tool in this pragmatic trial, though overall efficacy of all modalities was low.
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Affiliation(s)
- N LaVine
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - K Emmert
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - J Itty
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - D Martins-Welch
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA
| | - M Carney
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA.,Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - A Block
- New York Medical College School of Health Sciences and Practice, Westchester, NY, USA
| | - L Burgess
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - A E Volandes
- Harvard Medical School, Boston, MA, USA.,Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.,ACP Decisions, Boston, MA, USA
| | - S N Zupanc
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - S Jacome
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - V Gromova
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | | | | | - A Alvarez-Suarez
- Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
| | - Edith Burns
- Department of Medicine, Zucker School of Medicine at Hofstra Northwell, Hempstead, NY, USA. .,Institute for Health Systems Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
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Lu PJ, Srivastav A, Vashist K, Black CL, Kriss JL, Hung MC, Meng L, Zhou T, Yankey D, Masters NB, Fast HE, Razzaghi H, Singleton JA. COVID-19 Booster Dose Vaccination Coverage and Factors Associated with Booster Vaccination among Adults, United States, March 2022. Emerg Infect Dis 2023; 29:133-140. [PMID: 36480674 PMCID: PMC9796208 DOI: 10.3201/eid2901.221151] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The Centers for Disease Control and Prevention recommends a COVID-19 vaccine booster dose for all persons >18 years of age. We analyzed data from the National Immunization Survey-Adult COVID Module collected during February 27-March 26, 2022 to assess COVID-19 booster dose vaccination coverage among adults. We used multivariable logistic regression analysis to assess factors associated with vaccination. COVID-19 booster dose coverage among fully vaccinated adults increased from 25.7% in November 2021 to 63.4% in March 2022. Coverage was lower among non-Hispanic Black (52.7%), and Hispanic (55.5%) than non-Hispanic White adults (67.7%). Coverage was 67.4% among essential healthcare personnel, 62.2% among adults who had a disability, and 69.9% among adults who had medical conditions. Booster dose coverage was not optimal, and disparities by race/ethnicity and other factors are apparent in coverage uptake. Tailored strategies are needed to educate the public and reduce disparities in COVID-19 vaccination coverage.
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Zhao C, Liang S, Wang X, Gao L, Lai Y, Huang Y, Li J, Chen L, Cai W. User experience of a self-management WeChat applet for patients with neurogenic bladder: A qualitative approach. Int J Nurs Sci 2023; 10:89-96. [PMID: 36860717 DOI: 10.1016/j.ijnss.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/03/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives This study aimed to determine patients' perceived benefits of a WeChat applet for self-management of patients with neurogenic bladder (NGB) and identify the key factors hindering their adoption. Methods In the qualitative study, 19 NGB patients were invited for semi-structured interviews. They were hospitalized in the rehabilitation departments of two tertiary hospitals in Shenzhen and tried out the self-management applet for two weeks. Data were analyzed using the content analysis method. Results The results indicated that the WeChat applet of self-management was helpful and embraced by the NGB patients. Three perceived benefits were identified 1) being accessible, flexible, and intuitive to users, 2) driving bladder self-management, and 3) directing the way for care partners and family members. Challenges hindering the adoption of the applet included 1) negative attitudes of patients towards bladder self-management and patient characteristics, 2) concerns about the risks of mHealth, and 3) the necessity of applet upgrading. Conclusion This study showed feasibility of the WeChat applet for self-management among NGB patients to meet their needs for access to information during hospitalization and after discharge. The study also identified facilitators and barriers to patient use, providing valuable information for healthcare providers to implement mHealth interventions to promote self-management among NGB patients.
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Eysenbach G, Leung T, Holst H, Galvin K. Digital Engagement of Older Adults: Scoping Review. J Med Internet Res 2022; 24:e40192. [PMID: 36477006 PMCID: PMC9773036 DOI: 10.2196/40192] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/21/2022] [Accepted: 10/23/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Digital technologies facilitate everyday life, social connectedness, aging at home, well-being, and dignified care. However, older adults are disproportionately excluded from these benefits. Equal digital opportunities, access, and meaningful engagement require an understanding of older adults' experience across different stages of the technological engagement life cycle from nonuse and initial adoption to sustained use, factors influencing their decisions, and how the experience changes over time. OBJECTIVE Our objectives were to identify the extent and breadth of existing literature on older adults' perspective on digital engagement and summarize the barriers to and facilitators for technological nonuse, initial adoption, and sustained digital technology engagement. METHODS We used the Arksey and O'Malley framework for the scoping review process. We searched MEDLINE, PsycINFO, CINAHL, Web of Science, and ACM digital library for primary studies published between 2005 and 2021. The inclusion and exclusion criteria were developed based on the Joanna Briggs Institute (participants, content, and context) framework. Studies that investigated the digital engagement experience as well as barriers to and facilitators of older adults' digital technology engagement were included. The characteristics of the study, types of digital technology, and digital engagement levels were analyzed descriptively. Content analysis was used to generate tentative elements using a congruent theme, and barriers and facilitators were mapped over the capability, opportunity, and motivation behavior change model (COM-B) and the theoretical domain framework. The findings were reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). RESULTS In total, 96 publications were eligible for the final charting and synthesis. Most of the studies were published over the past 5 years, investigated the initial adoption stage of digital engagement, and focused on everyday technologies. The most cited barriers and facilitators across the engagement stages from each COM-B component were capability (eg, physical and psychological changes and lack of skill), opportunity (eg, technological features, environmental context, and resources), and motivation (eg, optimism from perceived usefulness and beliefs about capability). CONCLUSIONS The COM-B model and theoretical domain framework provide a guide for identifying multiple and intertwined barriers and facilitators at each stage of digital engagement. There are limited studies looking into the whole spectrum of older adults' digital technology experience; in particular, studies on technological nonuse and sustained use stages are rare. Future research and practice should focus on tailored interventions accounting for the barriers to older adults' digital engagement and addressing capabilities, motivation, and opportunities; affordable, usable, and useful digital technologies, which address the changes and capability requirements of older adults and are cocreated with a value framework; and lifelong learning and empowerment to develop older adults' knowledge and skills to cope with digital technology development. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/25616.
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Affiliation(s)
| | | | - Hanna Holst
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Kathleen Galvin
- School of Sport and Health Sciences, University of Brighton, Brighton, United Kingdom
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Cao J, Kurata K, Lim Y, Sengoku S, Kodama K. Social Acceptance of Mobile Health among Young Adults in Japan: An Extension of the UTAUT Model. Int J Environ Res Public Health 2022; 19:15156. [PMID: 36429875 PMCID: PMC9690921 DOI: 10.3390/ijerph192215156] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
The unprecedented development of information and communication technologies has opened up immense possibilities in the field of health care. Mobile health (mHealth) is gaining increasing attention as an important technology for solving health-related problems. Although a high rate of smartphone usage among young people in Japan has been identified, smartphone usage for health management is not high. As Japanese youth are important potential users of mHealth, it is necessary to explore theories that influence the behavioral intention of Japanese youth to adopt mHealth. This study conducted a questionnaire survey in a Japanese university and collected 233 valuable responses. This study was adapted and extended from the unified theory of acceptance and use of technology (UTAUT) model to measure eight constructs: health consciousness, social influence, facilitation conditions, perceived risk, trust, performance expectancy, effort expectancy, and behavioral intention. Structural equation modeling was used for hypothesis testing. We found that trust, performance expectancy, and effort expectancy directly influenced the behavioral intention to use mHealth. Health consciousness and social influence indirectly influence behavioral intention through trust and performance expectancy. Facilitation conditions indirectly influenced behavioral intention through effort expectancy. This study makes a vital theoretical contribution to policymakers and product developers for the further diffusion of mHealth among young people in Japan.
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Affiliation(s)
- Jianfei Cao
- Graduate School of Technology Management, Ritsumeikan University, Ibaraki 567-8570, Japan
| | - Karin Kurata
- Graduate School of Corporate Business, Ritsumeikan University, Ibaraki 567-8570, Japan
| | - Yeongjoo Lim
- Graduate School of Corporate Business, Ritsumeikan University, Ibaraki 567-8570, Japan
| | - Shintaro Sengoku
- School of Environment and Society, Tokyo Institute of Technology, Tokyo 152-8550, Japan
| | - Kota Kodama
- Graduate School of Technology Management, Ritsumeikan University, Ibaraki 567-8570, Japan
- Center for Research and Education on Drug Discovery, The Graduate School of Pharmaceutical Sciences, Hokkaido University, Sapporo 060-0812, Japan
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AboMoslim M, Babili A, Ghaseminejad-Tafreshi N, Manson M, Fattah F, El Joueidi S, Staples JA, Tam P, Lester RT. Mobile phone access and preferences among medical inpatients at an urban Canadian hospital for post-discharge planning: A pre-COVID-19 cross-sectional survey. Front Digit Health 2022; 4:928602. [PMID: 36440462 PMCID: PMC9692091 DOI: 10.3389/fdgth.2022.928602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Digital health interventions are increasingly used for patient care, yet little data is available on the phone access type and usage preferences amongst medical ward inpatients to inform the most appropriate digital interventions post-discharge. Methods To identify mobile phone ownership, internet access, and cellular use preferences among medical inpatients, we conducted a researcher-administered survey of patients admitted to five internal medicine units at Vancouver General Hospital (VGH) in January 2020. The survey was administered over 2 days separated by a 2-week period. Results A total of 81 inpatients completed the questionnaire. Survey found that 85.2% of survey respondents had mobile phone access where 63.0% owned their own mobile phone, and 22.2% had access to a mobile phone via a proxy (or an authorized third-party) such as a family member. All participants with mobile phone access had cellular plans (i.e., phone and text); however, a quarter of respondents did not have data plans with internet access. Survey showed that 71.1% of males owned a mobile phone compared to only 52.8% of females. All participants at a “high” risk of readmission had access to a mobile phone, either as phone-owners or proxy-dependent users. Conclusion Access to mobile phones among medical ward inpatients, 85.2%, was comparable to smartphone penetration rates amongst Canadians in 2019, 85.1%. More patients had cellular than data plans (i.e., internet and applications). Understanding patient-specific access is key to informing potential uptake of digital health interventions aimed at using patients' mobile phones (mHealth) from an effectiveness and equity lens.
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Affiliation(s)
- Maryam AboMoslim
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Correspondence: Maryam AboMoslim
| | - Abdulaa Babili
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Matthew Manson
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Fanan Fattah
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Samia El Joueidi
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - John A. Staples
- Division of Vancouver Costal Health Research Institutute, Centre for Clinical Epidemiology & Evaluation, Vancouver, BC, Canada
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Penny Tam
- Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Richard T. Lester
- Division of Infectious Disease, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Zhang X, Gao S, Cheng Y, Meng F. Encouraging physicians' continuous knowledge-sharing in online health communities: A motivational perspective. Front Public Health 2022; 10:1036366. [PMID: 36420014 PMCID: PMC9676448 DOI: 10.3389/fpubh.2022.1036366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
Online health communities (OHCs) as an essential means of patient education can significantly improve patients' health literacy and treatment outcomes. However, sustaining these social benefits brought by OHCs establishes the prerequisite that physicians can continuously share their knowledge on OHCs. Although previous studies have explored physicians' knowledge-sharing in OHCs, scholarly knowledge related to the means of motivating physicians to continue sharing their knowledge remains limited. Therefore, this study developed a research model based on motivation theory to explore the influence of practical benefits, psychological rewards, and perceived connectedness with OHCs on physicians' continuous knowledge-sharing behaviors and the contingent role of physicians' online seniority status. The research model and relevant hypotheses were examined using objective data from one of the leading OHCs in China. The empirical results reveal that both practical benefits and psychological rewards positively affect physicians' continuous knowledge-sharing behaviors. However, an unexpected finding is that perceived connectedness is negatively associated with physicians' continuous knowledge-sharing behaviors. In addition, physicians' online seniority status strengthens the relationship between practical benefits and continuous knowledge-sharing behaviors but weaken the role of psychological rewards and perceived connectedness on continuous knowledge-sharing behaviors. This study contributes to the understanding of the motivational mechanisms underlying physicians' continuous knowledge-sharing behaviors in OHCs and provides significant practical implications for practitioners of OHCs.
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Affiliation(s)
- Xin Zhang
- Management School, Tianjin Normal University, Tianjin, China
| | - Shanzhen Gao
- Management School, Tianjin Normal University, Tianjin, China
| | - Yanyan Cheng
- Management School, Tianjin Normal University, Tianjin, China
| | - Fanbo Meng
- School of Business, Jiangnan University, Wuxi, China,*Correspondence: Fanbo Meng
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Chen K, Davoodi NM, Strauss DH, Li M, Jiménez FN, Guthrie KM, Goldberg EM. Strategies to Ensure Continuity of Care Using Telemedicine with Older Adults during COVID-19: A Qualitative Study of Physicians in Primary Care and Geriatrics. J Appl Gerontol 2022; 41:2282-2295. [PMID: 35711106 PMCID: PMC9207584 DOI: 10.1177/07334648221109728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives: Our objective was to interview primary care physicians (PCPs) and geriatricians on their experiences using telemedicine during the COVID-19 pandemic to examine strategies used to maintain continuity of care with their patients, ages 65 and older. Methods: Using purposive sampling, we selected physicians based on community size (metro/suburban/rural) and practice setting (academic/community) and conducted semi-structured interviews via Zoom (mean: 30 minutes). Interviews were recorded, transcribed, coded, and analyzed using framework analysis. Results: We enrolled 33 physicians (15 PCPs and 18 geriatricians) from July to November 2020. Findings indicate that many physicians successfully bridged the digital divide by: assessing patients' technological readiness in advance, being flexible with telehealth modes, using available home or facility-based staff, educating patients on telehealth privacy and usefulness, making accommodations for disabilities, and involving caregivers. Discussion: These findings can inform future policy and practice and assist physicians in resolving addressable barriers to telehealth use among older patients.
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Affiliation(s)
- Kevin Chen
- The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Natalie M. Davoodi
- Department of Emergency Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Daniel H. Strauss
- The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | | | | | - Kate M. Guthrie
- Department of Psychiatry and Human
Behavior, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
| | - Elizabeth M. Goldberg
- Department of Emergency Medicine, The Warren Alpert Medical School of
Brown University, Providence, RI, USA
- Department of Health Services,
Policy and Practice, Brown University School of Public
Health, Providence, RI, USA
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Du Y, Patel N, Hernandez A, Zamudio-Samano M, Li S, Zhang T, Fernandez R, Choi BY, Land WM, Ullevig S, Estrada Coats V, Moussavou JMM, Parra-Medina D, Yin Z. Examining the Delivery of a Tailored Chinese Mind-Body Exercise to Low-Income Community-Dwelling Older Latino Individuals for Healthy Aging: Feasibility and Acceptability Study. JMIR Form Res 2022; 6:e40046. [PMID: 35997685 PMCID: PMC9516366 DOI: 10.2196/40046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/28/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Older Latino individuals are disproportionally affected by various chronic conditions including impairments in physical and cognitive functions, which are essential for healthy aging and independent living. Objective This study aimed to evaluate the feasibility and acceptability of FITxOlder, a 12-week mind-body exercise program, in community-dwelling low-income, predominantly older Latino individuals, and assess its preliminary effects on health parameters relevant to healthy aging and independent living. Methods This 12-week, single-arm, stage 1B feasibility study had a pre- and poststudy design. A total of 13 older adults (mean age 76.4, SD 7.9 years; 11/13, 85% Latino) of a congregate meal program in a senior center were enrolled. FITxOlder was a tailored Chinese mind-body exercise program using Five Animal Frolics led by a bilingual community health worker (CHW) participating twice a week at the senior center and facilitated by mobile health technology for practice at home, with incrementally increasing goals moving from once a week to at least 3 times a week. The feasibility and acceptability of the study were examined using both quantitative and qualitative data. Healthy aging–related outcomes (eg, physical and cognitive function) were assessed using paired 2-tailed t tests. Qualitative interview data were analyzed using thematic analysis. Results The attendance rate for the 24 exercise sessions was high (22.7/24, 95%), ranging from 93% (1.8/2) to 97% (1.9/2) over the 12 weeks. Participants were compliant with the incremental weekly exercise goals, with 69.2% (9/13) and 75.0% (9/12) meeting the home and program goals in the last 4 weeks, respectively. Approximately 83% (10/12) to 92% (11/12) of the participants provided favorable feedback on survey questions regarding the study and program implementation, such as program content and support, delivery by the CHW, enjoyment and appeal of the Five Animal Frolics, study burden and incentives, and safety concerns. The qualitative interview data revealed that FITxOlder was well accepted; participants reported enjoyment and health benefits and the desire to continue to practice and share it with others. The 5-time sit-to-stand test (mean change at posttest assessment=−1.62; P<.001; Cohen d=0.97) and 12-Item Short Form Health Survey physical component scores (mean change at post intervention=5.71; P=.01; Cohen d=0.88) exhibited changes with large effect sizes from baseline to 12 weeks; the other parameters showed small or medium effect sizes. Conclusions The research findings indicated that the CHW-led and mobile health–facilitated Chinese qigong exercise program is feasible and acceptable among low-income Latino older adults. The trending health benefits of the 12-week FITxOlder program suggest it is promising to promote physical activity engagement in underserved older populations to improve health outcomes for healthy aging and independent living. Future research with larger samples and longer interventions is warranted to assess the health benefits and suitability of FITxOlder.
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Affiliation(s)
- Yan Du
- Center on Smart and Connected Health Technology, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Neela Patel
- Department of Family and Community Medicine, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Arthur Hernandez
- Dreeben School of Education, University of the Incarnate Word, San Antonio, TX, United States
| | | | - Shiyu Li
- Center on Smart and Connected Health Technology, School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Tianou Zhang
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Roman Fernandez
- Department of Population Health Science, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Byeong Yeob Choi
- Department of Population Health Science, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - William M Land
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, TX, United States
| | - Sarah Ullevig
- College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Vanessa Estrada Coats
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, United States
| | | | - Deborah Parra-Medina
- Latino Research Institute, Latino Studies, University of Texas at Austin, Austin, TX, United States
| | - Zenong Yin
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, United States
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He W, Cao L, Liu R, Wu Y, Zhang W. Factors associated with internet use and health information technology use among older people with multi-morbidity in the United States: findings from the National Health Interview Survey 2018. BMC Geriatr 2022; 22:733. [PMID: 36068502 PMCID: PMC9446732 DOI: 10.1186/s12877-022-03410-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The number of older adults with physical multi-morbidity is increasing. As Internet-based eHealth and mHealth increasingly require patients to use technology, it is important to examine the use of Internet/health information technology (HIT) among older adults with physical multi-morbidity. Here we examine the distribution of physical multi-morbidity, Internet use, and HIT use, and further explored the factors associated with Internet use and HIT use among older adults with physical multi-morbidity. Methods One wave of data from the 2018 US National Health Interview Survey (NHIS) was analysed. We included respondents aged 65 years and older. We used 13 physical non-communicable diseases to measure physical multi-morbidity. Descriptive statistics and logistic regression models, with sociodemographic factors, health status, health insurance, health care service use, and satisfaction with health care as covariates, were used to examine the research questions. Results Of 72,746 respondents in NHIS, 7060 were eligible for our analysis. 5380 (76.2%) eligible respondents had physical multi-morbidity in this study. Overall, 60% of older adults reported using the Internet, with 38.9% using eHealth services (defined as looking up health information online, filling a prescription, scheduling an appointment with a health care provider, or communicating with a health care provider via email). Gender, age, marital status, region, race, education, and family income were significant factors associated with the Internet and HIT use among people with multi-morbidity. The study also showed that after adjusting for confounders, good health status, having Medicare, receiving home care from a health professional, and low satisfaction with health care were positive predictors of the Internet and HIT use. Conclusions In summary, our study found that Internet and HIT use among older patients with chronic diseases is far from the Healthy People 2030 target. Internet and HIT use vary depending on a number of sociodemographic factors. Relevant influencing factors should be fully considered in health education interventions promoted.
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Affiliation(s)
- Wenbo He
- Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, Sichuan, China.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Liujiao Cao
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Rui Liu
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China
| | - Yi Wu
- Department of Epidemiology, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
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Pook CJ, Thomas K, Bultitude MF. Assessing the quality and readability of NHS urology webpages in England. Journal of Clinical Urology 2022. [DOI: 10.1177/20514158211011904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To examine the readability of urology webpages to assess their suitability for the general population and their inclusivity for varied levels of health literacy. Methods: We accessed all urology department websites from NHS trusts in England. A standard framework was used to assess these for ease of navigation, availability and quality of urology-specific information. Text was analysed using Flesch–Kincaid Grade Level and Ease Score to measure readability. Results: From the 132 NHS trust websites investigated, 117 (88.6%) had a urology-specific webpage, a considerable increase from 98 trusts (68%) in 2010. However, a smaller proportion of websites explained their services and procedures, and only 23.9% explained common urological conditions. Websites still appeared outdated, 23.9% had spelling errors, and 75.2% made none or poor use of images. The mean reading grade level was 13.40, equivalent to a UK reading age above 18 years, and the mean reading ease score was 30.35, in the range of ‘difficult’ text. Conclusion: Our data suggest that urology-specific webpages are not providing useful content for patients and are too complex for the general population to understand. Improvement would allow patients to be able to utilise such resources to aid decision making and to navigate complex NHS pathways. Level of evidence: Not applicable
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Affiliation(s)
- Celina J Pook
- Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, UK
- GKT School of Medical Education, King’s College, UK
| | - Kay Thomas
- Department of Urology, Guy’s and St Thomas’ NHS Foundation Trust, UK
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Choi M. Factors associated with eHealth use among community dwelling older adults. Int J Nurs Pract 2022; 28:e13092. [PMID: 35977421 DOI: 10.1111/ijn.13092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/18/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND With the proliferation of the internet and the development of internet-based healthcare interventions, eHealth is expected to be an effective complement to traditional healthcare services. However, without understanding the characteristics of the user population, eHealth itself can isolate older adults. AIM This study aims to identify the characteristics of internet use and the factors associated with eHealth use among older adults. METHODS A secondary data analysis was conducted from a cross-sectional descriptive study. A convenience sample of 186 community dwelling older adults was recruited at two senior welfare centres in Korea. The data collected included demographic characteristics, health related characteristics, internet use, eHealth use and eHealth literacy. Multiple linear regression was utilized to determine factors related to eHealth use. RESULTS Among 186 respondents, 98 reported that they used the internet. Internet usage was associated with educational attainment, marital status, cognitive function and possession of internet-enabled devices. The results of multiple regression analysis showed that greater eHealth usage was related to more positive perception of eHealth usability and better eHealth literacy among older adults. CONCLUSION Educational programmes for older adults should be developed to facilitate digital capability and eHealth literacy. Useful and effective online health resources that are easy to use should be also developed.
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Affiliation(s)
- MoonKi Choi
- Department of Nursing, College of Nursing, Kangwon National University, Chuncheon, Gangwon, Republic of Korea
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Kim S, Eom J, Shim J. A Comparative Study on Intention to Use Digital Therapeutics: MZ Generation and Baby Boomers’ Digital Therapeutics Use Intention in Korea. IJERPH 2022; 19:ijerph19159556. [PMID: 35954906 PMCID: PMC9368623 DOI: 10.3390/ijerph19159556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/24/2022] [Accepted: 08/02/2022] [Indexed: 12/10/2022]
Abstract
Purpose: The aim of this study lies in articulating the relationship between digital literacy and private concern as a predictor of intention to use digital therapeutics. Materials and Methods: An online survey was conducted through a research company among 600 panels. The survey questionnaire consists of items of digital literacy, privacy concern, perceptions, and intention to use digital therapeutics, and the participants were asked to fill out the questions online. A structural equation model was established, and the difference in paths between the MZ generation and the baby boomers were examined. Results: Public perception of digital therapeutics was categorized into seven factors and the dimension of digital literacy as categorized into three factors. For the MZ generation, digital literacy and privacy concern both directly and indirectly affect the digital therapeutics use intention, in that higher the level of digital literacy and the lower the privacy concern, digital therapeutics perception and digital therapeutics use intention becomes intensified. For the baby boomers, digital literacy and privacy concern positively affect digital therapeutics perception, and as digital therapeutics perception becomes more positive, digital therapeutics use intention also increases. Direct effects of digital literacy and privacy concern to digital therapeutics use intention were not found for the baby boomers. Conclusion: In order to promote the use of digital therapeutics, it is common for the MZ generation and baby boomers to develop a positive perception toward digital therapeutics by cultivating digital literacy. For the MZ generation, privacy concerns need to be cautiously considered as they negatively affect the intention to use digital therapeutics.
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Affiliation(s)
- Soojin Kim
- Division of Communication & Media, Ewha Womans University, Seoul 03760, Korea;
| | - Juhee Eom
- Department of Law, Konkuk University, Chungju 05029, Korea;
| | - Jiwon Shim
- Department of Philosophy, Dongguk University, Seoul 04620, Korea
- Correspondence: ; Tel.: +82-2-2290-1719
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Mistry SK, Shaw M, Raffan F, Johnson G, Perren K, Shoko S, Harris-roxas B, Haigh F. Inequity in Access and Delivery of Virtual Care Interventions: A Scoping Review. IJERPH 2022; 19:9411. [PMID: 35954768 PMCID: PMC9367842 DOI: 10.3390/ijerph19159411] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/27/2023]
Abstract
The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched MEDLINE, EMBASE, and CINAHL using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barriers identified in the review included having digitally literate caregivers present during virtual care appointments, conducting virtual care appointments in culturally sensitive manner, and having a focus on enhancing patients’ digital literacy. We identified evidence-based practices for virtual care interventions to ensure equity in access and delivery for their virtual care patients.
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Narcisse MR, Andersen JA, Felix HC, Hayes CJ, Eswaran H, McElfish PA. Factors associated with telehealth use among adults in the United States: Findings from the 2020 National Health Interview Survey. J Telemed Telecare 2022:1357633X221113192. [PMID: 35892167 DOI: 10.1177/1357633x221113192] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION During the COVID-19 pandemic, health care shifted to virtual interactions with health professionals. The aim of this study was to examine the determinants of telehealth use in a nationally representative sample of the United States adult population. METHODS The study used data from the 2020 National Health Interview Survey of 17,582 respondents aged ≥18. Andersen's model of health services utilization was employed to examine predisposing, enabling, and needs factors associated with past-year telehealth use. Multivariable logistic regression was conducted to examine statistical associations. RESULTS 32.5% of adults (n = 6402; mean age 51.6, SE = 0.4) reported telehealth use. Predisposing factors: Women and married/partnered adults and those with higher levels of education had greater odds of using telehealth. Adults living in Midwest and South and adults living in medium-small and non-metropolitan areas had decreased odds of using telehealth. Enabling factors: Income and having a usual source of care were positively associated with telehealth use. A negative association was found for those with no insurance and telehealth use, whereas a positive association was found for military insurance. Needs factors: Odds of using telehealth were increased for adults who had well-visits and ER visits in the past 12 months. Mental health services quadrupled the odds of telehealth use. Odds of using telehealth increased with each additional chronic disease, including COVID-19. CONCLUSION There are disparities in telehealth use according to sex, education, rurality, access to care, and health needs. Tackling these disparities is pivotal to ensure barriers to telehealth use are not exacerbated post-pandemic.
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Affiliation(s)
- Marie-Rachelle Narcisse
- College of Medicine, 37323University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Jennifer A Andersen
- College of Medicine, 37323University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Corey J Hayes
- College of Medicine, College of Pharmacy, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Hari Eswaran
- Institute of Digital Health and Innovation, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, 37323University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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Zhao Y, Zhang T, Dasgupta RK, Xia R. Narrowing the age‐based digital divide: Developing digital capability through social activities. Information Systems Journal 2022. [DOI: 10.1111/isj.12400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yang Zhao
- Aston Business School Aston University Birmingham United Kingdom
| | - Tao Zhang
- Institute for Innovation and Entrepreneurship Loughborough University London London United Kingdom
| | - Rohit K. Dasgupta
- School of Culture & Creative Arts University of Glasgow Glasgow United Kingdom
| | - Renpin Xia
- Department of Organ Transplantation First Affiliated Hospital of Kunming Medical University Kunming City China
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Andersen JA, Felix HC, Su D, Selig JP, Ratcliff S, McElfish PA. Factors Associated with Arkansans' First Use of Telehealth during the COVID-19 Pandemic. Int J Telemed Appl 2022; 2022:5953027. [PMID: 35775023 DOI: 10.1155/2022/5953027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To examine the factors associated with the first use of telehealth during the COVID-19 pandemic using Andersen's Model of Healthcare Utilization. Andersen's Model of Healthcare Utilization allowed the categorization of the independent variables into the following: (1) predisposing factors, including sociodemographic variables and health beliefs; (2) enabling factors, including socioeconomic status and access to care; and (3) need for care, including preexisting or newly diagnosed conditions and reasons to seek out care or to utilize a new mode of care. Methods Potential respondents (n = 4,077) were identified for recruitment from a volunteer registry in Arkansas. Recruitment emails provided a study description, the opportunity to verify meeting the study's inclusion criteria and to consent for participation, and a link to follow to complete the survey online. The online survey responses were collected between July and August of 2020 (n = 1,137). Results Telehealth utilization included two categories: (1) utilizers reported the first use of telehealth services during the pandemic, and (2) nonutilizers reported they had never used telehealth. Lower odds of reporting telehealth utilization during the pandemic were associated with race (Black; OR = 0.57, CI [0.33, 0.96]) and education (high School or less; OR = 0.45, CI [0.25, 0.83]). Higher odds of reporting telehealth utilization included having more than one provider (OR = 2.33, CI [1.30, 4.18]), more physical (OR = 1.12, CI [1.00, 1.25]) and mental (OR 1.53, CI [1.24, 1.88]) health conditions, and changes in healthcare delivery during the pandemic (OR = 3.49, CI [2.78, 4.38]). Conclusions The results illustrate that disparities exist in Arkansans' utilization of telehealth services during the pandemic. Future research should explore the disparities in telehealth utilization and how telehealth may be used to address disparities in care for Black Arkansans and those with low socioeconomic status.
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Nurhasanah N, Asmawita H, Khairani K, Hadi N, Nurhidayah I, Febriana D, Putra A. How is the Elderly’s Capability to Use Smartphones in Banda Aceh. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Smartphone is one form of technology that is increasing that provides many benefits for the elderly such as the many applications adapted to improve the quality of life of the elderly; one of them is the existence of health applications.
AIM: The purpose of this study was to determine how the ability to use smartphones in the elderly in Banda Aceh, which includes the ability to use the basics of the software, communication, data and file storage, internet, calendar, entertainment, privacy, and security, and software troubleshooting and management.
MATERIALS AND METHODS: This study used a descriptive exploratory with a cross-sectional study design. The sampling technique is non-probability sampling using the snowball sampling method with as many as 400 older people. The research data were analyzed using descriptive statistics, namely, the distribution of frequencies and percentages.
RESULTS: The results of the research in the capable component contained the primary use of mobile devices (99.5%), entertainment (95.3%), and the internet (86.3%). While the part that respondent is less capable, there are privacy and security (94.5%), data and file storage (81.7%), communication (79.5%), calendar (59.7%), as well as troubleshooting and device management soft (50.5%).
CONCLUSION: From the study finding, it is expected that nursing services can improve the ability of the elderly in fulfilling the IADL. One of them is utilizing existing smartphone applications and providing nursing interventions for the elderly using smartphones.
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Gates JR, Wilson-Menzfeld G. What Role Does Geragogy Play in the Delivery of Digital Skills Programs for Middle and Older Age Adults? A Systematic Narrative Review. J Appl Gerontol 2022; 41:1971-1980. [PMID: 35543169 PMCID: PMC9364233 DOI: 10.1177/07334648221091236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This systematic narrative review aimed to explore the implementation and delivery of
digital skills programs for middle and older age adults; and understand the presence of
adult learning theory (namely, geragogy/critical geragogy) in their delivery. A database
search was undertaken to examine international literature, published between 2010 and
2020. From 1,713 papers identified during the database searches, 17 papers were included.
Thematic synthesis was used to analyze the papers in this review. Themes were generated
relating to the implementation and delivery of digital skills programs: negative
perceptions of aging; the learning environment; and value of technology. The role of
geragogy/critical geragogy is not explicit in the delivery of digital skills programs in
this review but has an underlying thread of empowerment and embodies the ethos of these
learning theories to some extent. The findings of this review have been used to develop
recommendations for delivering digital skills to older adults.
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Affiliation(s)
- Jessica R Gates
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Gemma Wilson-Menzfeld
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Jacob C, Sezgin E, Sanchez-Vazquez A, Ivory C. Sociotechnical Factors Affecting Patients' Adoption of Mobile Health Tools: Systematic Literature Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10:e36284. [PMID: 35318189 PMCID: PMC9121221 DOI: 10.2196/36284] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Mobile health (mHealth) tools have emerged as a promising health care technology that may contribute to cost savings, better access to care, and enhanced clinical outcomes; however, it is important to ensure their acceptance and adoption to harness this potential. Patient adoption has been recognized as a key challenge that requires further exploration. Objective The aim of this review was to systematically investigate the literature to understand the factors affecting patients’ adoption of mHealth tools by considering sociotechnical factors (from technical, social, and health perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the MEDLINE, PubMed, Cochrane Library, and SAGE databases for studies published between January 2011 and July 2021 in the English language, yielding 5873 results, of which 147 studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with thematic analysis and narrative synthesis of emergent themes. Results The technical factors affecting patients’ adoption of mHealth tools were categorized into six key themes, which in turn were divided into 20 subthemes: usefulness, ease of use, data-related, monetary factors, technical issues, and user experience. Health-related factors were categorized into six key themes: the disease or health condition, the care team’s role, health consciousness and literacy, health behavior, relation to other therapies, integration into patient journey, and the patients’ insurance status. Social and personal factors were divided into three key clusters: demographic factors, personal characteristics, and social and cultural aspects; these were divided into 19 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions This review builds on the growing body of research that investigates patients’ adoption of mHealth services and highlights the complexity of the factors affecting adoption, including personal, social, technical, organizational, and health care aspects. We recommend a more patient-centered approach by ensuring the tools’ fit into the overall patient journey and treatment plan, emphasizing inclusive design, and warranting comprehensive patient education and support. Moreover, empowering and mobilizing clinicians and care teams, addressing ethical data management issues, and focusing on health care policies may facilitate adoption.
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Affiliation(s)
- Christine Jacob
- University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
| | - Emre Sezgin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States.,NORC at the University of Chicago, Chicago, IL, United States
| | - Antonio Sanchez-Vazquez
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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Wilson-Menzfeld G, Naisby J, Baker K, Morris R, Robinson J, Barry G. Yoga provision for individuals living with Multiple Sclerosis: Is the future online? PLoS One 2022; 17:e0266786. [PMID: 35486611 PMCID: PMC9053771 DOI: 10.1371/journal.pone.0266786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Yoga has multiple benefits for individuals living with Multiple Sclerosis (MS), including reduced pain, depression, fatigue, strength, and improved quality of life. During the COVID-19 pandemic, home-based delivery of yoga increased. However, no studies to date have explored online home-based yoga for individuals living with MS, more specifically the motivations, experiences, or the sustainability of home-based yoga practice for individuals living with MS.
Aim
This study aimed to explore the facilitators and barriers of online yoga provision for individuals living with MS.
Methods
One focus group and three semi-structured interviews were carried out online via Zoom with one yoga instructor and seven yoga participants living with MS. Thematic Analysis was used to analyse this data.
Findings
Two themes were generated from the interviews, the environment and future provision, each with their own sub-themes. The themes reflect various facilitators and barriers of home-based yoga provision which differed depending upon the individuals home environment, social connections, physical ability, and confidence practising yoga. Furthermore, preferences of home provision fluctuated over time depending upon symptoms of MS.
Conclusions
Home-based yoga practice is a viable and enjoyable option for individuals living with MS. It is recommended that yoga studios offering home-based yoga provision consider individual differences in preference, as well as fluctuations in symptoms that may create inequitable access to services and may prevent participation for some.
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Affiliation(s)
- Gemma Wilson-Menzfeld
- Department of Nursing, Midwifery and Health, Northumbria University, Newcastle upon Tyne, United Kingdom
- * E-mail:
| | - Jenni Naisby
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Katherine Baker
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Robinson
- School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
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Heng H, Kiegaldie D, Slade SC, Jazayeri D, Shaw L, Knight M, Jones C, Hill A, Morris ME. Healthcare professional perspectives on barriers and enablers to falls prevention education: A qualitative study. PLoS One 2022; 17:e0266797. [PMID: 35476840 PMCID: PMC9045665 DOI: 10.1371/journal.pone.0266797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/28/2022] [Indexed: 11/19/2022] Open
Abstract
In hospitals, patient falls prevention education is frequently delivered by nurses and allied health professionals. Hospital falls rates remain high globally, despite the many systems and approaches that attempt to mitigate falling. The aim of this study was to investigate health professional views on the enablers and barriers to providing patient falls education in hospitals. Four focus groups with 23 nursing and allied health professionals were conducted at 3 hospitals. Three researchers independently coded the data and findings were analysed thematically with a descriptive qualitative approach to identify and develop themes according to barriers and enablers. Barriers included (i) limited interprofessional communication about patient falls; (ii) sub-optimal systems for falls education for patients and health professionals, and (iii) perceived patient-related barriers to falls education. Enablers to providing patient falls education included: (i) implementing strategies to increase patient empowerment; (ii) ensuring that health professionals had access to effective modes of patient education; and (iii) facilitating interprofessional collaboration. Health professionals identified the need to overcome organisational, patient and clinician-related barriers to falls education. Fostering collective responsibility amongst health professionals for evidence-based falls prevention was also highlighted.
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Borda M, Grishchenko N, Kowalczyk-Rólczyńska P. Patient Readiness for Remote Healthcare Services in the Context of the COVID-19 Pandemic: Evidence From European Countries. Front Public Health 2022; 10:846641. [PMID: 35372199 PMCID: PMC8964525 DOI: 10.3389/fpubh.2022.846641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the fact that remote services were successfully implemented in most European social and health systems before 2020, the COVID-19 pandemic has led to an unprecedented development of health and social care services provided in this form. This paper compares the readiness of patients to use the digital solutions in healthcare systems implemented in EU countries, in response to the current pandemic situation. In the study, technological, health insurance, and demographic variables were selected on the basis of substantive criteria. Next, the linear ordering method was applied to make a ranking of the analyzed countries according to the level of patients' readiness to use digital healthcare services. The main findings show that the Netherlands and Ireland are characterized by the highest level of patients' readiness for using remote healthcare services. On the other hand, Romania and Bulgaria are among the countries with the lowest readiness. The study also made it possible to group European countries according to the level of patients' preparedness.
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Affiliation(s)
- Marta Borda
- Department of Insurance, Wroclaw University of Economics and Business, Wroclaw, Poland
| | - Natalia Grishchenko
- Institute of Social Policy, National Research University Higher School of Economics, Moscow, Russia
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Lawrence K, Chong S, Krelle H, Roberts T, Thorpe L, Trinh-Shevrin C, Yi S, Kwon S. Chinese Americans' Use of Patient Portal Systems: Scoping Review. JMIR Hum Factors 2022; 9:e27924. [PMID: 35363153 PMCID: PMC9015766 DOI: 10.2196/27924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/23/2021] [Accepted: 11/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Electronic patient portals are increasingly used in health care systems as communication and information-sharing tools and show promise in addressing health care access, quality, and outcomes. However, limited research exists on portal use patterns and practices among diverse patient populations, resulting in the lack of culturally and contextually tailored portal systems for these patients. Objective This study aimed to summarize existing evidence on the access and use patterns, barriers, and facilitators of patient portals among Chinese Americans, who represent a growing patient population in the United States with unique health care and health technology needs. Methods The authors conducted a literature search using the PRISMA Protocol for Scoping Reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses-ScR) for extracting articles published in major databases (MEDLINE, Embase, and PsycINFO) on patient portals and Chinese Americans. Authors independently reviewed the papers during initial screening and full-text review. The studies were analyzed and coded for the study method type, sample population, and main outcomes of interest. Results In total, 17 articles were selected for inclusion in the review. The included articles were heterogenous and varied in their study aims, methodologies, sample populations, and outcomes. Major findings identified from the articles include variable patterns of portal access and use among Chinese Americans compared to other racial or ethnic groups, with limited evidence on the specific barriers and facilitators for this group; a preference for cross-sectional quantitative tools such as patient surveys and electronic health record–based data over qualitative or other methodologies; and a pattern of aggregating Chinese American–related data into a larger Asian or Asian American designation. Conclusions There is limited research evaluating the use patterns, experiences, and needs of Chinese Americans who access and use patient portal systems. Existing research is heterogeneous, largely cross-sectional, and does not disaggregate Chinese Americans from larger Asian demographics. Future research should be devoted to the specific portal use patterns, preferences, and needs of Chinese Americans to help ensure contextually appropriate and acceptable design and implementation of these digital health tools.
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Affiliation(s)
- Katharine Lawrence
- Healthcare Innovation Bridging Research, Informatics, and Design (HiBRID) Lab, Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Stella Chong
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Holly Krelle
- Division of Healthcare Delivery Services, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Timothy Roberts
- NYU Health Sciences Library, NYU Grossman School of Medicine, New York, NY, United States
| | - Lorna Thorpe
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Chau Trinh-Shevrin
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Stella Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Simona Kwon
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States
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Md Fadzil NH, Shahar S, Rajikan R, Singh DKA, Mat Ludin AF, Subramaniam P, Ibrahim N, Vanoh D, Mohamad Ali N. A Scoping Review for Usage of Telerehabilitation among Older Adults with Mild Cognitive Impairment or Cognitive Frailty. Int J Environ Res Public Health 2022; 19:4000. [PMID: 35409683 DOI: 10.3390/ijerph19074000] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 12/12/2022]
Abstract
Older adults are vulnerable towards cognitive frailty that can lead to adverse health outcomes and telerehabilitation appears to be a potential platform to reverse cognitive frailty among older adults. The aim of this coping review is to identify the usage of telerehabilitation and its common platform of delivery among older adults with mild cognitive impairment (MCI) or cognitive frailty (CF). Articles published from January 2015 until October 2020 were selected. Out of the 1738 articles retrieved, six studies were identified. Two articles were randomized controlled trials, one was a pilot study and three were qualitative studies. The outcome suggests that telerehabilitation may improve the quality of life among participants as well as it can be a useful and supportive digital platform for health care. Some types of technologies commonly used were smartphones or telephones with internet, television-based assistive integrated technology, mobile application and videoconference. Telerehabilitation utilization in managing cognitive frailty among older adults is still limited and more research is required to evaluate its feasibility and acceptability. Although telerehabilitation appears to be implemented among older adults with MCI and CF, some social support is still required to improve the adherence and effectiveness of telerehabilitation. Future research should focus on the evaluation of acceptance and participants’ existing knowledge towards telerehabilitation to achieve its target.
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Kouvonen A, Kemppainen T, Taipale S, Olakivi A, Wrede S, Kemppainen L. Health and self-perceived barriers to internet use among older migrants: a population-based study. BMC Public Health 2022; 22:574. [PMID: 35321678 PMCID: PMC8941300 DOI: 10.1186/s12889-022-12874-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/28/2022] [Indexed: 12/12/2022] Open
Abstract
Background In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants. Methods We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥50 years living in Finland (N=1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response. Results After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p<0.0005) were associated with higher level of overall barriers to internet use. In addition, a number of health conditions were associated with individual barriers, albeit some health conditions appeared protective. Conclusions In general, older migrants with declining health experience more barriers to internet use than their counterparts with better health. To provide better access to healthcare for older adults, including older migrants, rapidly changing devices, software and apps need to be modified and adapted for those with specific health-related needs.
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Affiliation(s)
- Anne Kouvonen
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland. .,Centre for Public Health, Queen's University Belfast, Institute of Clinical Science, Block A, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
| | - Teemu Kemppainen
- Department of Geosciences and Geography, University of Helsinki, PO Box 64, 00014, Helsinki, Finland.,Centre Maurice Halbwachs (CNRS/EHESS/ENS), École Normale Supérieure 48, boulevard Jourdan, 75014, Paris, France
| | - Sakari Taipale
- Department of Social Sciences and Philosophy, University of Jyvaskyla, PO Box 35, 40014, Jyvaskyla, Finland.,Faculty of Social Sciences, University of Ljubljana, Kardeljeva ploščad 5, 1000, Ljubljana, Slovenia
| | - Antero Olakivi
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland
| | - Sirpa Wrede
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland.,Swedish School of Social Science, University of Helsinki, PO Box 16, 00014, Helsinki, Finland
| | - Laura Kemppainen
- Faculty of Social Sciences, University of Helsinki, PO Box 54, 00014, Helsinki, Finland
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