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Louart S, Hedible GB, Ridde V. Assessing the acceptability of technological health innovations in sub-Saharan Africa: a scoping review and a best fit framework synthesis. BMC Health Serv Res 2023; 23:930. [PMID: 37649024 PMCID: PMC10469465 DOI: 10.1186/s12913-023-09897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
Acceptability is a key concept used to analyze the introduction of a health innovation in a specific setting. However, there seems to be a lack of clarity in this notion, both conceptually and practically. In low and middle-income countries, programs to support the diffusion of new technological tools are multiplying. They face challenges and difficulties that need to be understood with an in-depth analysis of the acceptability of these innovations. We performed a scoping review to explore the theories, methods and conceptual frameworks that have been used to measure and understand the acceptability of technological health innovations in sub-Saharan Africa. The review confirmed the lack of common definitions, conceptualizations and practical tools addressing the acceptability of health innovations. To synthesize and combine evidence, both theoretically and empirically, we then used the "best fit framework synthesis" method. Based on five conceptual and theoretical frameworks from scientific literature and evidence from 33 empirical studies, we built a conceptual framework in order to understand the acceptability of technological health innovations. This framework comprises 6 determinants (compatibility, social influence, personal emotions, perceived disadvantages, perceived advantages and perceived complexity) and two moderating factors (intervention and context). This knowledge synthesis work has also enabled us to propose a chronology of the different stages of acceptability.
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Affiliation(s)
- Sarah Louart
- Univ. Lille, CNRS, UMR 8019 - CLERSE - Centre Lillois d'Etudes Et de Recherches Sociologiques Et Economiques, 59000, Lille, France.
- ALIMA, the Alliance for International Medical Action, Dakar, Senegal.
| | | | - Valéry Ridde
- Université Paris Cité, IRD, INSERM, Ceped, 75006, Paris, France
- Institut de Santé Et Développement, Université Cheikh Anta Diop, Dakar, Sénégal
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Public Trust in Dentists among Arabic Populations. Int J Dent 2023; 2023:8359780. [PMID: 36874982 PMCID: PMC9984256 DOI: 10.1155/2023/8359780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 02/03/2023] [Accepted: 02/15/2023] [Indexed: 03/07/2023] Open
Abstract
Objective To investigate public trust in dentists, fear of dentists, factors related to trust, and the impact of the COVID-19 pandemic on the trust in dentists. Materials and Methods We used an Arabic online anonymous survey to collect data from a random population of 838 adults to investigate public trust in dentists, the factors they perceive to affect trust, their perception of key factors in the dentist-patient relationship, fear of dentists, and the impact of the COVID-19 pandemic on the level of their trust in the dentists. Results Eight hundred thirty-eight subjects with a mean age of 28.5 responded to the survey (595 (71%) females, 235 (28%) males, and 8 (1%) did not specify their gender). More than half trust their dentist. The COVID-19 pandemic did not decrease trust in dentists according to 62.2%. There were significant gender differences in reporting fear of dentists (p < 0.001) and in the perception of factors affecting trust (p=0.028). Honesty was chosen by 583 (69.6%), competence by 549 (65.5), and dentist's reputation by 443 (52.9%). Conclusions The findings of this study show that the majority of the public trust dentists, more females reported fear of dentists, and the majority perceived honesty, competence, and reputation as key factors affecting trust in the dentist-patient relationship. The majority reported that the COVID-19 pandemic did not have a negative impact on their trust in dentists.
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Coombs NC, Campbell DG, Caringi J. A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access. BMC Health Serv Res 2022; 22:438. [PMID: 35366860 PMCID: PMC8976509 DOI: 10.1186/s12913-022-07829-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Ensuring access to healthcare is a complex, multi-dimensional health challenge. Since the inception of the coronavirus pandemic, this challenge is more pressing. Some dimensions of access are difficult to quantify, namely characteristics that influence healthcare services to be both acceptable and appropriate. These link to a patient’s acceptance of services that they are to receive and ensuring appropriate fit between services and a patient’s specific healthcare needs. These dimensions of access are particularly evident in rural health systems where additional structural barriers make accessing healthcare more difficult. Thus, it is important to examine healthcare access barriers in rural-specific areas to understand their origin and implications for resolution. Methods We used qualitative methods and a convenience sample of healthcare providers who currently practice in the rural US state of Montana. Our sample included 12 healthcare providers from diverse training backgrounds and specialties. All were decision-makers in the development or revision of patients’ treatment plans. Semi-structured interviews and content analysis were used to explore barriers–appropriateness and acceptability–to healthcare access in their patient populations. Our analysis was both deductive and inductive and focused on three analytic domains: cultural considerations, patient-provider communication, and provider-provider communication. Member checks ensured credibility and trustworthiness of our findings. Results Five key themes emerged from analysis: 1) a friction exists between aspects of patients’ rural identities and healthcare systems; 2) facilitating access to healthcare requires application of and respect for cultural differences; 3) communication between healthcare providers is systematically fragmented; 4) time and resource constraints disproportionately harm rural health systems; and 5) profits are prioritized over addressing barriers to healthcare access in the US. Conclusions Inadequate access to healthcare is an issue in the US, particularly in rural areas. Rural healthcare consumers compose a hard-to-reach patient population. Too few providers exist to meet population health needs, and fragmented communication impairs rural health systems’ ability to function. These issues exacerbate the difficulty of ensuring acceptable and appropriate delivery of healthcare services, which compound all other barriers to healthcare access for rural residents. Each dimension of access must be monitored to improve patient experiences and outcomes for rural Americans.
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Sanıl M, Eminer F. An integrative model of patients' perceived value of healthcare service quality in North Cyprus. Arch Public Health 2021; 79:227. [PMID: 34930446 PMCID: PMC8685307 DOI: 10.1186/s13690-021-00738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Improving healthcare quality has become an essential objective for all health institutions worldwide to address the need to improve services, manage costs and satisfy patient expectations about the quality of care. As health is one of the leading service sectors of the North Cyprus economy, analysing patients’ perceived value of healthcare service quality is crucial. In this research, a comparative analysis of existing models revealed affordability, acceptability and accessibility as the leading modern service quality indicators affecting patients’ perceived value of healthcare service quality. The quality of services is a leading factor impacting business competition and retention dictated by the current market. This study aimed to investigate the factors that influence patient perceptions of healthcare service quality in North Cyprus. Methods A self-administered questionnaire was carried out among 388 patients of public and private hospitals in North Cyprus, and the data were analysed using partial least squares-structural equation modelling. Results Empirical results highlight that the acceptability of healthcare services is a prerequisite for perceiving a high value of service quality. The affordability and accessibility of services, respectively, were less effective. Results concerning mediating effects confirm that acceptability could fully mediate the relationship between affordability and perceived value and could partially mediate the impact of accessibility on the perceived quality of healthcare services. Conclusion This study contributes to healthcare theory and practice by developing a conceptual framework to provide policymakers and managers with a practical understanding of factors that affect healthcare service quality.
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Affiliation(s)
- Mert Sanıl
- Faculty of Health Sciences, European University of Lefke, Gemikonagı-Lefke, North Cyprus, TR-10, Mersin, Turkey.
| | - Fehiman Eminer
- Faculty of Economics and Administrative Sciences, European University of Lefke, Gemikonagı-Lefke, North Cyprus, TR-10, Mersin, Turkey
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Cunningham LD, Salgado EF, Aalsma MC, Garabrant JM, Staples JK, Gordon JS, Salyers MP. Do adolescents consider mind-body skills groups an acceptable treatment for depression: results from a pilot study. BMC Pediatr 2021; 21:475. [PMID: 34706710 PMCID: PMC8549145 DOI: 10.1186/s12887-021-02942-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/13/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Mind-Body Skills Groups (MBSGs) have shown promise in reducing adolescent depression symptoms; however, little is known about adolescents' perspectives on this treatment. The objective of this study was to understand the acceptability of a new treatment for depressed adolescents in primary care settings. METHODS Adolescents participating in a 10-week MBSG treatment were interviewed to understand their perspectives on the acceptability and effectiveness of the treatment. Interviews were collected at post-intervention and at a 3-month follow-up visit. RESULTS A total of 39 adolescents completed both the post-intervention and 3-month follow-up interview. At post-intervention and follow-up, 84% of adolescents stated the MBSGs helped them. When asked how the MBSGs helped them, 3 areas were identified: learning new MBSG activities and skills, social connection with others within the group, and outcomes related to the group. Many adolescents reported no concerns with the MBSGs (49% at post- intervention; 62% at follow-up). Those with concerns identified certain activities as not being useful, wanting the group to be longer, and the time of group (after school) being inconvenient. Most adolescents reported that their life had changed because of the group (72% at post-intervention; 61% at follow-up), and when asked how, common responses included feeling less isolated and more hopeful. CONCLUSIONS Adolescents found the MBSGs to be helpful and acceptable as a treatment option for depression in primary care. Given the strong emphasis on treatment preference autonomy and the social activities within the group, MBSGs appear well-suited for this age group. TRIAL REGISTRATION NCT03363750 ; December 6th, 2017.
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Affiliation(s)
- Lindsey D. Cunningham
- Department of Psychology, Florida International University, 11200 SW 8th St, AHC5, Miami, FL 33199 USA
| | - Eduardo F. Salgado
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford Street, LD 120B, Indianapolis, IN 46202 USA
| | - Matthew C. Aalsma
- Department of Pediatrics – Adolescent Behavioral Health Research Program, Indiana University School of Medicine, 410 W. 10th Street, Suite 2025, Indianapolis, IN 46202 USA
| | - Jennifer M. Garabrant
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford Street, LD 120B, Indianapolis, IN 46202 USA
| | - Julie K. Staples
- The Center for Mind-Body Medicine, 5225 Connecticut Avenue NW, Suite 414, Washington, DC 20015 USA
| | - James S. Gordon
- The Center for Mind-Body Medicine, 5225 Connecticut Avenue NW, Suite 414, Washington, DC 20015 USA
| | - Michelle P. Salyers
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 N. Blackford Street, LD 120B, Indianapolis, IN 46202 USA
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Alaqra AS, Kane B, Fischer-Hübner S. Machine Learning-Based Analysis of Encrypted Medical Data in the Cloud: Qualitative Study of Expert Stakeholders' Perspectives. JMIR Hum Factors 2021; 8:e21810. [PMID: 34528892 PMCID: PMC8485196 DOI: 10.2196/21810] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/04/2020] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Third-party cloud-based data analysis applications are proliferating in electronic health (eHealth) because of the expertise offered and their monetary advantage. However, privacy and security are critical concerns when handling sensitive medical data in the cloud. Technical advances based on "crypto magic" in privacy-preserving machine learning (ML) enable data analysis in encrypted form for maintaining confidentiality. Such privacy-enhancing technologies (PETs) could be counterintuitive to relevant stakeholders in eHealth, which could in turn hinder adoption; thus, more attention is needed on human factors for establishing trust and transparency. OBJECTIVE The aim of this study was to analyze eHealth expert stakeholders' perspectives and the perceived tradeoffs in regard to data analysis on encrypted medical data in the cloud, and to derive user requirements for development of a privacy-preserving data analysis tool. METHODS We used semistructured interviews and report on 14 interviews with individuals having medical, technical, or research expertise in eHealth. We used thematic analysis for analyzing interview data. In addition, we conducted a workshop for eliciting requirements. RESULTS Our results show differences in the understanding of and in trusting the technology; caution is advised by technical experts, whereas patient safety assurances are required by medical experts. Themes were identified with general perspectives on data privacy and practices (eg, acceptance of using external services), as well as themes highlighting specific perspectives (eg, data protection drawbacks and concerns of the data analysis on encrypted data). The latter themes result in requiring assurances and conformance testing for trusting tools such as the proposed ML-based tool. Communicating privacy, and utility benefits and tradeoffs with stakeholders is essential for trust. Furthermore, stakeholders and their organizations share accountability of patient data. Finally, stakeholders stressed the importance of informing patients about the privacy of their data. CONCLUSIONS Understanding the benefits and risks of using eHealth PETs is crucial, and collaboration among diverse stakeholders is essential. Assurances of the tool's privacy, accuracy, and patient safety should be in place for establishing trust of ML-based PETs, especially if used in the cloud.
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Affiliation(s)
- Ala Sarah Alaqra
- Computer Science and Information Systems, Karlstad University, Karlstad, Sweden
| | - Bridget Kane
- Information Systems, Karlstad University Business School, Karlstad, Sweden
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Lawrence S, Namusanya D, Hamuza A, Huwa C, Chasweka D, Kelley M, Molyneux S, Voskuijl W, Denno DM, Desmond N. Hypothetical acceptability of hospital-based post-mortem pediatric minimally invasive tissue sampling in Malawi: The role of complex social relationships. PLoS One 2021; 16:e0246369. [PMID: 33539411 PMCID: PMC7861399 DOI: 10.1371/journal.pone.0246369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Child mortality rates remain unacceptably high in low-resource settings. Cause of death (CoD) is often unknown. Minimally invasive tissue sampling (MITS)-using biopsy needles to obtain post-mortem samples-for histopathological and microbiologic investigation is increasingly being promoted to improve child and adult CoD attribution. "MITS in Malawi" is a sub-study of the Childhood Acute Illness & Nutrition (CHAIN) Network, which aims to identify biological and socioeconomic mortality risk factors among young children hospitalized for acute illness or undernutrition. MITS in Malawi employs standard MITS and a novel post-mortem endoscopic intestinal sampling approach to better understand CoD among children with acute illness and/or malnutrition who die during hospitalization. AIM To understand factors that may impact MITS acceptability and inform introduction of the procedure to ascertain CoD among children with acute illness or malnutrition who die during hospitalization in Malawi. METHODS We conducted eight focus group discussions with key hospital staff and community members (religious leaders and parents of children under 5) to explore attitudes towards MITS and inform consent processes prior to commencing the MITS in Malawi study. We used thematic content analysis drawing on a conceptual framework developed from emergent themes and MITS acceptability literature. RESULTS Feelings of power over decision-making within the hospital and household, trust in health systems, and open and respectful health worker communication with parents were important dimensions of MITS acceptability. Other facilitating factors included the potential for MITS to add CoD information to aid sense-making of death and contribute to medical knowledge and new interventions. Potential barriers to acceptability included fears of organ and blood harvesting, disfigurement to the body, and disruption to transportation and burial plans. CONCLUSION Social relationships and power dynamics within healthcare systems and households are a critical component of MITS acceptability, especially given the sensitivity of death and autopsy.
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Affiliation(s)
- Sarah Lawrence
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - Dave Namusanya
- Behaviour and Health Research Group, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | - Andrew Hamuza
- Behaviour and Health Research Group, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | - Cornelius Huwa
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Dennis Chasweka
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Maureen Kelley
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Wellcome Centre for Ethics & Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sassy Molyneux
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Wellcome Centre for Ethics & Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Wieger Voskuijl
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Amsterdam Centre for Global Child Health, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Donna M. Denno
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Nicola Desmond
- Behaviour and Health Research Group, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Hybrid System of Emotion Evaluation in Physiotherapeutic Procedures. SENSORS 2020; 20:s20216343. [PMID: 33172146 PMCID: PMC7664429 DOI: 10.3390/s20216343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 11/29/2022]
Abstract
Nowadays, the dynamic development of technology allows for the design of systems based on various information sources and their integration into hybrid expert systems. One of the areas of research where such systems are especially helpful is emotion analysis. The sympathetic nervous system controls emotions, while its function is directly reflected by the electrodermal activity (EDA) signal. The presented study aimed to develop a tool and propose a physiological data set to complement the psychological data. The study group consisted of 41 students aged from 19 to 26 years. The presented research protocol was based on the acquisition of the electrodermal activity signal using the Empatica E4 device during three exercises performed in a prototype Disc4Spine system and using the psychological research methods. Different methods (hierarchical and non-hierarchical) of subsequent data clustering and optimisation in the context of emotions experienced were analysed. The best results were obtained for the k-means classifier during Exercise 3 (80.49%) and for the combination of the EDA signal with negative emotions (80.48%). A comparison of accuracy of the k-means classification with the independent division made by a psychologist revealed again the best results for negative emotions (78.05%).
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USTA D, KORKMAZ F. Türkiye'deki üçüncü basamak bakım kurumlarından hizmet alan hastaların sağlık sistemine güven düzeyleri. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.647412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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