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Jabeen S, Chandrima RM, Hasan M, Rahman MM, Rahman QSU, AKM TH, Dewan F, Alim A, Nadia N, Mahmud M, Sarker MH, Islam J, Islam MS, Ashrafee S, Haider MS, Chisti MJ, Sheikh MZH, Miah MS, Al-Mahmud M, Ameen S, Ahmed A, El Arifeen S, Rahman AE. A context-driven approach through stakeholder engagement to introduce a digital emergency obstetric and newborn care register into routine obstetric health care services in Bangladesh. J Glob Health 2024; 14:04098. [PMID: 38721686 PMCID: PMC11079701 DOI: 10.7189/jogh.14.04098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background Emergency obstetric and newborn care (EmONC) in Bangladesh focusses on maternal health, whereby it addresses childbirth and postpartum complications to ensure women's health and well-being. It was transitioned to a digital platform to overcome challenges with the paper-based EmONC register and we conducted implementation research to assess the outcome. Here we outline the stakeholder engagement process integral to the implementation research process. Methods We adopted a four-step stakeholder engagement model based on the identification, sensitisation, involvement, and engagement of stakeholders. The approach was informed by previous experience, desk reviews, and expert consultations to ensure comprehensive engagement with stakeholders at multiple levels. Led by the Maternal Health Programme of the Government of Bangladesh, we involved high-power and high-interest stakeholders in developing a joint action plan for digitisation of the paper-based EmONC register. Finally, we demonstrated this digital EmONC register in real-life settings to stakeholders at different levels. Results The successful demonstration process fostered government ownership and collaboration with multiple stakeholders, while laying the foundation for scalability and sustainability. Nevertheless, our experience highlighted that the stakeholder engagement process is context-driven, time-consuming, resource-intensive, iterative, and dynamic, and it requires involving stakeholders with varied expertise. Effective strategic planning, facilitation, and the allocation of sufficient time and resources are essential components for successful stakeholder engagement. Conclusions Our experience demonstrates the potential of adopting the 'identification, sensitisation, involvement, and engagement' stakeholder engagement model. Success in implementing this model in diverse settings depends on leveraging knowledge gained during implementation, maintaining robust communication with stakeholders, and harnessing the patience and determination of the facilitating organisation.
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Affiliation(s)
- Sabrina Jabeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mehedi Hasan
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md Mahiur Rahman
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Tanvir Hossain AKM
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Farhana Dewan
- Obstetrical and Gynaecological Society of Bangladesh (OGSB), Dhaka, Bangladesh
| | - Azizul Alim
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Nuzhat Nadia
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mustufa Mahmud
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Moazzem Hossain Sarker
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Sabina Ashrafee
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mohammad Sabbir Haider
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | | | | | | | - Md Al-Mahmud
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shafiqul Ameen
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anisuddin Ahmed
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shams El Arifeen
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- icddr,b (International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Jabeen S, Rahman M, Siddique AB, Hasan M, Matin R, Rahman QSU, AKM TH, Alim A, Nadia N, Mahmud M, Islam J, Islam MS, Haider MS, Dewan F, Begum F, Barua U, Anam MT, Islam A, Razzak KSB, Ameen S, Hossain AT, Nahar Q, Ahmed A, El Arifeen S, Rahman AE. Introducing a digital emergency obstetric and newborn care register for indoor obstetric patient management: An implementation research in selected public health care facilities of Bangladesh. J Glob Health 2024; 14:04075. [PMID: 38722093 PMCID: PMC11082830 DOI: 10.7189/jogh.14.04075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background Digital health records have emerged as vital tools for improving health care delivery and patient data management. Acknowledging the gaps in data recording by a paper-based register, the emergency obstetric and newborn care (EmONC) register used in the labour ward was digitised. In this study, we aimed to assess the implementation outcome of the digital register in selected public health care facilities in Bangladesh. Methods Extensive collaboration with stakeholders facilitated the development of an android-based electronic register from the paper-based register in the labour rooms of the selected district and sub-district level public health facilities of Bangladesh. We conducted a study to assess the implementation outcome of introducing the digital EmONC register in the labour ward. Results The digital register demonstrated high usability with a score of 83.7 according to the system usability scale, and health care providers found it highly acceptable, with an average score exceeding 95% using the technology acceptance model. The adoption rate reached an impressive 98% (95% confidence interval (CI) = 98-99), and fidelity stood at 90% (95% CI = 88-91) in the digital register, encompassing more than 80% of data elements. Notably, fidelity increased significantly over the implementation period of six months. The digital system proved a high utility rate of 89% (95% CI = 88-91), and all outcome variables exceeded the predefined benchmark. Conclusions The implementation outcome assessment underscores the potential of the digital register to enhance maternal and newborn health care in Bangladesh. Its user-friendliness, improved data completeness, and high adoption rates indicate its capacity to streamline health care data management and improve the quality of care.
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Affiliation(s)
- Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahiur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mehedi Hasan
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rubaiya Matin
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | - Azizul Alim
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Nuzhat Nadia
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mustufa Mahmud
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mohammad Sabbir Haider
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Farhana Dewan
- Obstetrical and Gynaecological Society of Bangladesh, Dhaka, Bangladesh
| | - Ferdousi Begum
- Obstetrical and Gynaecological Society of Bangladesh, Dhaka, Bangladesh
| | - Uchchash Barua
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Abirul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Shafiqul Ameen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Quamrun Nahar
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
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Tilahun KN, Adem JB, Atinafu WT, Walle AD, Mengestie ND, Birhanu AY. Intention to Use Mobile-Based Partograph and Its Predictors Among Obstetric Health Care Providers Working at Public Referral Hospitals in the Oromia Region of Ethiopia in 2022: Cross-Sectional Questionnaire Study. Online J Public Health Inform 2024; 16:e51601. [PMID: 38728079 PMCID: PMC11127132 DOI: 10.2196/51601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND A partograph is a pictorial representation of the relationship between cervical dilatation and the time used to diagnose prolonged and obstructed labor. However, the utilization of paper-based partograph is low and it is prone to documentation errors, which can be avoided with the use of electronic partographs. There is only limited information on the proportion of intention to use mobile-based partographs and its predictors. OBJECTIVE The objective of this study was to determine the proportion of obstetric health care providers at public referral hospitals in Oromia, Ethiopia, in 2022 who had the intention to use mobile-based partographs and to determine the predictors of their intention to use mobile-based partographs. METHODS We performed an institution-based cross-sectional study from June 1 to July 1, 2022. Census was conducted on 649 participants. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into EpiData version 4.6 and exported to SPSS version 25 for descriptive analysis and AMOS (analysis of moment structure; version 23) for structural and measurement model assessment. Descriptive and structural equation modeling analyses were performed. The hypotheses developed based on a modified Technology Acceptance Model were tested using path coefficients and P values <.05. RESULTS About 65.7% (414/630; 95% CI 61.9%-69.4%) of the participants intended to use mobile-based electronic partographs, with a 97% (630/649) response rate. Perceived usefulness had a positive influence on intention to use (β=.184; P=.02) and attitude (β=.521; P=.002). Perceived ease of use had a positive influence on attitude (β=.382; P=.003), perceived usefulness (β=.503; P=.002), and intention to use (β=.369; P=.001). Job relevance had a positive influence on perceived usefulness (β=.408; P=.001) and intention to use (β=.185; P=.008). Attitude positively influenced intention to use (β=.309; P=.002). Subjective norms did not have a significant influence on perceived usefulness (β=.020; P=.61) and intention to use (β=-.066; P=.07). CONCLUSIONS Two-thirds of the obstetric health care providers in our study intended to use mobile-based partographs. Perceived usefulness, perceived ease of use, job relevance, and attitude positively and significantly influenced their intention to use mobile-based electronic partographs. The development of a user-friendly mobile-based partograph that meets job and user expectations can enhance the intention to use.
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Affiliation(s)
| | | | | | | | - Nebyu Demeke Mengestie
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Abraham Yeneneh Birhanu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Nigatu AM, Yilma TM, Gezie LD, Gebrewold Y, Gullslett MK, Mengiste SA, Tilahun B. Health professionals' technology readiness on the acceptance of teleradiology in the Amhara regional state public hospitals, northwest Ethiopia: Using technology readiness acceptance model (TRAM). PLoS One 2024; 19:e0301021. [PMID: 38547241 PMCID: PMC10977896 DOI: 10.1371/journal.pone.0301021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 03/08/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Considering individual differences caused by personality differences is crucial for end users' technology acceptance. However, previous studies overlooked the influence of users' technology readiness on technology acceptance. This study, therefore, aimed to evaluate the influence of technology readiness on teleradiology acceptance in the Amhara Regional State Public Hospitals using a technology readiness acceptance model. METHODS An institutional-based cross-sectional mixed study design was conducted in September 2021 among 547 health professionals working at sixteen public hospitals in the Amhara region of northwest Ethiopia. Eight key informants were interviewed to explore organizational-related factors. Face-to-face and Google Meet approaches were used to collect the data. We applied structural equation modeling to investigate the influence of technology readiness on health professionals' teleradiology acceptance using Analysis of Moment Structures Version 23 software. RESULTS Of the total participants, 70.2% and 85.7% were ready and intended to use teleradiology, respectively. According to technology readiness measuring constructs, optimism and innovativeness positively influenced health professionals' technology acceptance. Perceived ease of use and perceived usefulness showed a statistically positive significant effect on health professionals' intention to use teleradiology. In addition, a statistically significant mediation effect was observed between technology readiness measuring constructs and behavioral intention to use. Furthermore, a shortage of budget, inadequate infrastructure, and users' lack of adequate skills were reported as critical organizational challenges. CONCLUSIONS We found a higher proportion of readiness and intention to use teleradiology among health professionals. Personality difference measuring constructs and organizational factors played considerable influence on teleradiology acceptance. Therefore, before the actual implementation of teleradiology, ensuring the system's user-friendliness, improving infrastructure, allocating an adequate budget, and availing of capacity-building opportunities are recommended.
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Affiliation(s)
- Araya Mesfin Nigatu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Yonathan Gebrewold
- Department of Radiology, School of Medicine, University of Gondar, Gondar, Ethiopia
| | | | | | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Dai L, Wu Z, Pan X, Zheng D, Kang M, Zhou M, Chen G, Liu H, Tian X. Design and implementation of an automatic nursing assessment system based on CDSS technology. Int J Med Inform 2024; 183:105323. [PMID: 38141563 DOI: 10.1016/j.ijmedinf.2023.105323] [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: 07/30/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Various quantitative and quality assessment tools are currently used in nursing to evaluate a patient's physiological, psychological, and socioeconomic status. The results play important roles in evaluating the efficiency of healthcare, improving the treatment plans, and lowing relevant clinical risks. However, the manual process of the assessment imposes a substantial burden and can lead to errors in digitalization. To fill these gaps, we proposed an automatic nursing assessment system based on clinical decision support system (CDSS). The framework underlying the CDSS included experts, evaluation criteria, and voting roles for selecting electronic assessment sheets over paper ones. METHODS We developed the framework based on an expert voting flow to choose electronic assessment sheets. The CDSS was constructed based on a nursing process workflow model. A multilayer architecture with independent modules was used. The performance of the proposed system was evaluated by comparing the adverse events' incidence and the average time for regular daily assessment before and after the implementation. RESULTS After implementation of the system, the adverse nursing events' incidence decreased significantly from 0.43 % to 0.37 % in the first year and further to 0.27 % in the second year (p-value: 0.04). Meanwhile, the median time for regular daily assessments further decreased from 63 s to 51 s. CONCLUSIONS The automatic assessment system helps to reduce nurses' workload and the incidence of adverse nursing events.
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Affiliation(s)
- Ling Dai
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Zhijun Wu
- ZhongWei Institute of Nursing Information, Beijing, China
| | - Xiaocheng Pan
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Dingchang Zheng
- Research Centre for Intelligent Healthcare Coventry University, Coventry, UK
| | - Mengli Kang
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Mingming Zhou
- Hangzhou Children's Hospital, Hangzhou, Zhejiang, China
| | - Guanyu Chen
- Ewell Technology Co., Ltd, Hangzhou, Zhejiang, China
| | - Haipeng Liu
- Research Centre for Intelligent Healthcare Coventry University, Coventry, UK.
| | - Xin Tian
- The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang, China
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Kumar D, Mathur M, Sarkar A, Chauhan M. E-classroom as a Blended Learning Tool: A Structural Equation Modelling Analysis Using Modified Technology Acceptance Model. Cureus 2024; 16:e56925. [PMID: 38665756 PMCID: PMC11043220 DOI: 10.7759/cureus.56925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND E-classrooms help teachers save time, keep classes organized, and improve communication with students. This study aims to assess Google Classroom's usefulness in enhancing medical students' knowledge and acceptance of new technology for in-depth learning. MATERIAL AND METHOD This educational interventional study was carried out on 100 students in the 3rd year of the M.B.B.S., Part 1. After a briefing about Google Classroom and educational topics, enrolled students and faculty were allowed to discuss the topic for two months. Following this, the descriptive approach was utilized to describe the respondents' technology acceptance through the administration of the technology acceptance model (TAM) survey questionnaire. RESULTS Students were actively involved in discussion, with a 67% response rate. Nearly 85% of students agreed that Google Classroom is a satisfactory way for in-depth knowledge acquisition. On factor analysis, it was observed that the goodness of fit was 0.985, suggesting that the model is acceptable. It was also found that perceived usefulness (PU) had a significant positive effect on motivation towards self-directed learning (SDL), and perceived ease of use (PEOU) had a positive effect on both behavioural intention and actual use. CONCLUSION Google Classroom is a valuable tool for learning that can enhance active self-learning and increase behavioural intention and actual use. It should be incorporated into day-to-day teaching activities to overcome time constraints.
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Affiliation(s)
- Dilip Kumar
- Community Medicine, Pacific Institute of Medical Sciences (PIMS), Udaipur, IND
| | - Medha Mathur
- Community Medicine, Geetanjali Medical College and Hospital (GMCH), Udaipur, IND
| | - Amrita Sarkar
- Community Medicine, Tomo Riba Institute of Health and Medical Sciences (TRIHMS), Naharlagun, IND
| | - Meet Chauhan
- Community Medicine, Shantabaa Medical College, Amreli, IND
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Altes GC, Ong AKS, German JD. Determining factors affecting Filipino consumers' behavioral intention to use cloud storage services: An extended technology acceptance model integrating valence framework. Heliyon 2024; 10:e26447. [PMID: 38404810 PMCID: PMC10884492 DOI: 10.1016/j.heliyon.2024.e26447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Cloud Storage (CS) is a service that digitally stores, remotely manages, backs up, and renders internet-accessible data. However, despite its known benefits compared to traditional storage devices, this service is not widely used in developing nations such as the Philippines. This study integrated the Valence Theoretical Framework into the Extended Technology Acceptance Model (ETAM) to evaluate the influence of twelve variables on Filipino consumers' behavioral intention (BI) toward adopting CS services. The data is gathered through an online survey. Structural Equation Modeling was employed to examine the responses of 431 cloud users, mainly students and working professionals. Results showed that Perceived Benefit and Perceived Usefulness were the strongest determinants of BI. The Job Relevance was also found to be a significant factor. Therefore, CS providers should find additional ways to make their offerings more beneficial for the daily tasks of students and working individuals. Furthermore, considering the substantial influence of Perceived Risk and Subjective Norms on BI, CS providers must strengthen their security measures to boost users' trust in their services. Consumers who receive excellent service are likely to give positive reviews, which can be helpful to individuals who might also be considering purchasing CS for their data. Although the focus of this study is CS services, this can also serve as a reference when analyzing the BI of consumers concerning the adoption of other novel technologies applied in various sectors, including education, e-commerce, healthcare, and more.
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Affiliation(s)
- Gerlyn C. Altes
- School of Industrial Engineering and Engineering Management, Mapúa University, Manila, Philippines. 658 Muralla St., Intramuros, Manila, 1002, Philippines
- School of Graduate Studies, Mapúa University, Manila, Philippines. 658 Muralla St., Intramuros, Manila, 1002, Philippines
| | - Ardvin Kester S. Ong
- School of Industrial Engineering and Engineering Management, Mapúa University, Manila, Philippines. 658 Muralla St., Intramuros, Manila, 1002, Philippines
- E.T. Yuchengo School of Business, Mapúa University. 1191 Pablo Ocampo Sr. Ext., Makati, Metro Manila, 1205, Philippines
| | - Josephine D. German
- School of Industrial Engineering and Engineering Management, Mapúa University, Manila, Philippines. 658 Muralla St., Intramuros, Manila, 1002, Philippines
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Tsatsos M, Rodafinos A, Athanasiadis IK, Mavropoulou D. Patients' Intentions to Use Telemedicine for Ophthalmic Medical Care During the COVID-19 Pandemic. Cureus 2024; 16:e54709. [PMID: 38524077 PMCID: PMC10960638 DOI: 10.7759/cureus.54709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
Background This study aimed to examine the factors predicting participants' intention to use telemedicine during the COVID-19 pandemic. Interest in health information technologies (HITs) has increased due to COVID-19. Most studies have focused on the acceptance of HIT by physicians and nurses, while there is a lack of studies on patients' perception and acceptance of such systems in ophthalmology. Methodology In the first year of the COVID-19 pandemic, a survey comprising 19 items was conducted at an ophthalmic center in Greece. The participants included 77 patients diagnosed with various eye diseases. The survey aimed to evaluate variables related to the Technology Acceptance Model (TAM), such as perceived usefulness, perceived ease of use, facilitating conditions, and intention to use telemedicine. The statistical analyses included intercorrelations, internal consistency reliability tests, and multiple linear regression analysis to examine the predictors of intention to use telemedicine. Results The multiple linear regression analysis revealed that perceived usefulness and facilitating conditions emerged as significant predictors of eye patients' intentions to use HIT. Interestingly, while perceived ease of use did not exhibit a significant predictive relationship with use intentions, the influence of perceived usefulness and facilitating conditions within the healthcare context underscores the pivotal role of perceived utility and external support in shaping patients' willingness to engage with HIT for eye care. Conclusions Empirical data on patient acceptance offer a better understanding of the limiting factors and the variables that facilitate intentions to use services that may improve medical diagnoses, patient communication, and treatment adherence processes. Related interventions and communication efforts should highlight the benefits of HIT in ophthalmology and provide the appropriate support and means to facilitate its use during and after the pandemic.
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Affiliation(s)
- Michael Tsatsos
- Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, GRC
- Ophthalmology, Modern Ophthalmic Practice, Thessaloniki, GRC
| | - Angelos Rodafinos
- Psychology and Behavioural Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Dafni Mavropoulou
- Internal Medicine, Hippokration General Hospital of Thessaloniki, Thessaloniki, GRC
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Walle AD, Hunde MK, Demsash AW. Healthcare professionals' intention to adopt mobile phone-based SMS and its predictors for adherence support and care of TB patients in a resource-limited setting: a structural equation modelling analysis. BMJ Open 2023; 13:e070813. [PMID: 38149411 PMCID: PMC10711927 DOI: 10.1136/bmjopen-2022-070813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 11/08/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVE To assess healthcare providers' intentions and the associated factors to use mobile phone-based short message service (SMS) to support adherence and care of tuberculosis (TB) patients in the Oromia region of southwest Ethiopia. STUDY DESIGN An institutional-based cross-sectional study was conducted from October to November 2022. STUDY SETTING The study was conducted in public hospitals which include Mettu Karl referral hospital, Dembi Hospital, Bedelle Hospital, Darimu Hospital and Chora Hospital in Ilu Aba Bor and Buno Bedelle zones. PARTICIPANTS A total of 625 (54.9% male and 45.1% female) health professionals participated in the study. The study participants were selected using a simple random sampling technique. All health professionals permanently working in Ilu Aba Bor and Buno Bedelle zone hospitals were included in this study. However, health professionals with less than 6 months of experience and those who were not present during the data collection period were excluded from this study. OUTCOME MEASURE The intention to use mobile phone-based SMS to support TB patients. RESULTS Healthcare professionals' intention to use mobile SMS was 54.4%. Effort expectancy had a significant direct effect on attitude (β=0.162, p<0.01) and intention towards using mobile phone SMS (β=0.329, p<0.001). The intention to use mobile phone SMS was directly influenced by facilitating conditions (β=0.104, p<0.01) and attitude (β=0.26, p<0.001). The relationship between effort expectancy and intention to use SMS was mediated by attitude (β=0.043, p<0.01). CONCLUSIONS Overall, intention to use of mobile-based SMS was high. Effort expectancy, attitude and facilitating conditions were significant factors that determined healthcare professionals' behavioural intention to use mobile phone SMS. Effort expectancy had a more significant prediction power than others. As a result, system forms that are easily interactive and applicable should be implemented to improve capacity building and support the adherence and care of TB patients.
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Affiliation(s)
- Agmasie Damtew Walle
- Department of Health Informatics, College of Health Sciences, Mattu University, Mettu, Ethiopia
| | - Mekonnen Kenate Hunde
- Department of Lifelong Learning and Community Development, College of Education and Behavioral sciences, Mettu University, Mettu, Ethiopia
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Atinafu WT, Tilahun KN, Yilma TM, Mekonnen ZA, Walle AD, Adem JB. Intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, West Shoa zone, Ethiopia 2022. BMC Health Serv Res 2023; 23:1368. [PMID: 38057856 DOI: 10.1186/s12913-023-10392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Mental health problems are the most common morbidities of women during the prenatal period. In LMICs mobile phones have been identified as a good vehicle for monitoring individuals with a high risk of mental health conditions. However, evidence is scarce and the purpose of this study was to assess the intention to use a mobile phone to receive mental health support and its predicting factors among women attending antenatal care at public health facilities in Ambo town, Ethiopia 2022. METHODS AND MATERIALS An institutional-based cross-sectional study design was conducted from May 20th to June 20th, 2022. A total of 715 prenatal women were included and a systematic random sampling technique was employed. An interviewer-administered structured questionnaire was used. Collected data was exported to SPSS version 25 for the descriptive part, and AMOS 26 structural equation modeling was also used to describe and assess the degree and significance of relationships between variables. RESULTS A total of 699 (97.8% response rate) responded to complete all the questionnaires. About 530 (77.3%) 95% CI (74%-80.3%) of women intended to use a mobile phone to receive mental health support. The perceived usefulness has a positive effect on attitude (β = 0.391, p < 0.001) and intention to use (β = 0.253, p < 0.001). The perceived ease of use influences perceived usefulness (β = 0.253, p < 0.001) and attitude β = 0.579, p < 0.001). The intention to use is positively affected by attitude (β = 0.662, p < 0.001).Trust has a positive effect on perceived usefulness (β = 0.580, p < 0.001) and intention to use (β = 0.113, p = 0.005). Subjective norm has a direct positive effect on perceived usefulness (β = 0.248, p < 0.001). Attitude serves as a partial mediator between perceived usefulness and intention to use and a complete mediating role between perceived ease of use and intention to use. CONCLUSION The level of intention to use a mobile phone among prenatal women is relatively high and attitude, perceived usefulness, and trust had direct positive effects on intention to use a mobile phone. Therefore, hospitals and healthcare providers should take proactive measures to implement the strategies and policies for providing mobile phone-based mental health support to prenatal women in remote areas.
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Affiliation(s)
- Wabi Temesgen Atinafu
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
| | - Kefyalew Naniye Tilahun
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Zeleke Abebaw Mekonnen
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Agmasie Damtew Walle
- Department of Health Informatics, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Jibril Bashir Adem
- Department of Public Health, College of Medicine and Health Sciences, Arsi University, Asella, Ethiopia
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Sekandi JN, McDonald A, Nakkonde D, Zalwango S, Kasiita V, Kaggwa P, Kakaire R, Atuyambe L, Buregyeya E. Acceptability, Usefulness, and Ease of Use of an Enhanced Video Directly Observed Treatment System for Supporting Patients With Tuberculosis in Kampala, Uganda: Explanatory Qualitative Study. JMIR Form Res 2023; 7:e46203. [PMID: 37948121 PMCID: PMC10674141 DOI: 10.2196/46203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 10/12/2023] [Accepted: 10/14/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND In tuberculosis (TB) control, nonadherence to treatment persists as a barrier. The traditional method of ensuring adherence, that is, directly observed therapy, faces significant challenges that hinder its widespread adoption. Digital adherence technologies such as video directly observed therapy (VDOT) are emerging as promising solutions. However, as these novel technologies gain momentum, a critical gap is the lack of comprehensive studies evaluating their efficacy and the unique experiences of patients in Africa. OBJECTIVE The aim of this study was to assess patients' experiences that affected acceptability, usefulness, and ease of use with an enhanced VDOT system during monitoring of TB treatment. METHODS We conducted individual open-ended interviews in a cross-sectional exit qualitative study in Kampala, Uganda. Thirty participants aged 18-65 years who had completed the VDOT randomized trial were purposively selected to represent variability in sex, adherence level, and HIV status. We used a hybrid process of deductive and inductive coding to identify content related to the experience of study participation with VDOT. Codes were organized into themes and subthemes, which were used to develop overarching categories guided by constructs adapted from the modified Technology Acceptance Model for Resource-Limited Settings. We explored participants' experiences regarding the ease of use and usefulness of VDOT, thereby identifying the facilitators and barriers to its acceptability. Perceived usefulness refers to the benefits users expect from the technology, while perceived ease of use refers to how easily users navigate its various features. We adapted by shifting from assessing perceived to experienced constructs. RESULTS The participants' mean age was 35.3 (SD 12) years. Of the 30 participants, 15 (50%) were females, 13 (43%) had low education levels, and 22 (73%) owned cellphones, of which 10 (45%) had smartphones. Nine (28%) were TB/HIV-coinfected, receiving antiretroviral therapy. Emergent subthemes for facilitators of experienced usefulness and ease of VDOT use were SMS text message reminders, technology training support to patients by health care providers, timely patient-provider communication, family social support, and financial incentives. TB/HIV-coinfected patients reported the added benefit of adherence support for their antiretroviral medication. The external barriers to VDOT's usefulness and ease of use were unstable electricity, technological malfunctions in the app, and lack of cellular network coverage in rural areas. Concerns about stigma, disease disclosure, and fear of breach in privacy and confidentiality affected the ease of VDOT use. CONCLUSIONS Overall, participants had positive experiences with the enhanced VDOT. They found the enhanced VDOT system user-friendly, beneficial, and acceptable, particularly due to the supportive features such as SMS text message reminders, incentives, technology training by health care providers, and family support. However, it is crucial to address the barriers related to technological infrastructure as well as the privacy, confidentiality, and stigma concerns related to VDOT.
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Affiliation(s)
- Juliet Nabbuye Sekandi
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
- Global Health Institute, University of Georgia, Athens, GA, United States
| | - Adenike McDonald
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
- Global Health Institute, University of Georgia, Athens, GA, United States
| | | | - Sarah Zalwango
- School of Public Health, Makerere University, Kampala, Uganda
- Directorate of Public Health Services and Environment, Kampala Capital City Authority, Kampala, Uganda
| | - Vicent Kasiita
- Infectious Disease Institute, Makerere University, Kampala, Uganda
| | - Patrick Kaggwa
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, United States
- Global Health Institute, University of Georgia, Athens, GA, United States
| | - Robert Kakaire
- Global Health Institute, University of Georgia, Athens, GA, United States
| | - Lynn Atuyambe
- School of Public Health, Makerere University, Kampala, Uganda
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Cho Y, Lavoie Smith EM, Zahrieh D, Chow SL, Williams DA, Saint Arnault D, Jiang Y. Electronic Patient-Reported Outcome Data Collection Systems in Oncology Clinical Trials: A Survey of Clinical Research Professionals (an Alliance Study). JCO Clin Cancer Inform 2023; 7:e2300007. [PMID: 37677111 PMCID: PMC10545018 DOI: 10.1200/cci.23.00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/20/2023] [Accepted: 07/02/2023] [Indexed: 09/09/2023] Open
Abstract
PURPOSE To describe clinical research professionals (CRPs)' experiences with electronic patient-reported outcome (ePRO) data collection systems in oncology clinical trials and identify correlates of CRPs' attitude toward technology. METHODS An online survey was conducted among 210 CRPs from 125 National Cancer Institute-funded research sites. Measures included CRPs' demographic characteristics, working years, employment locations, and previous experiences with various types of ePROs. Their attitude toward technology was measured by the Technology Attitude Scale-Adapted. The Wilcoxon signed-rank test was used to compare two subdomains of attitude (perceived usefulness [PU] and perceived ease of use [PEU]). Multiple linear regression was used to explore correlates of (1) overall attitude, (2) PU, and (3) PEU. The significance level was 5%. RESULTS Participants' median age was 41 years (range, 21-67). Most were female (90%) and White (82%). More than half of the participants had previous experiences with web-based ePROs using patients' own devices (72%) or site-/sponsor-provided on-site devices (eg, kiosks or tablets; 64%). CRPs who were 60 years or older (β = -0.32, P < .05) or worked for 10-20 years (β = -0.11, P < .05) had relatively negative attitudes, controlling for other factors. Previous experiences with more ePRO types were associated with more positive attitudes (β = 0.08, P = .02). Similar correlates were found with PU but not with PEU. CONCLUSION This study revealed that CRPs had various experiences with ePRO systems and attitudes toward technology. Age, working years, and previous experiences with ePROs were correlates of overall attitude toward technology and PU. These findings suggest necessary targeted training to facilitate ePRO use in oncology clinical trials by improving CRPs' awareness and attitude toward technology.
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Affiliation(s)
- Youmin Cho
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX
| | | | - David Zahrieh
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN
| | - Selina L. Chow
- Alliance Protocol Operations Office, University of Chicago, Chicago, IL
| | | | | | - Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI
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Walle AD, Demsash AW, Adem JB, Wubante SM, Shibabaw AA, Mamo DN, Kebede SD, Muluneh AA, Mengiste MB, Gebeyew AS, Butta FW, Chereka AA, Dubale AT, Kassie SY, Ferede TA. Exploring facilitators and barriers of the sustainable acceptance of e-health system solutions in Ethiopia: A systematic review. PLoS One 2023; 18:e0287991. [PMID: 37561684 PMCID: PMC10414679 DOI: 10.1371/journal.pone.0287991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/17/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND eHealth is the use of information and communications technologies in support of health and health-related fields, including healthcare services, health surveillance, health literature, and health education knowledge and research, has the potential to improve the delivery and support of healthcare services by promoting information sharing and evidence-based health practice. Acceptance of e-health in Ethiopia using systematic review is uncertain. As a result, this study aimed to assess barriers and facilitators of the sustainable acceptance of e-health system adoption in Ethiopia through a systematic review of the literature. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist was used to conduct this study. Relevant articles have been searched in Google Scholar, Medline, PubMed, Embrace, Web of Science, Scopus, Cochrane Library, and empirical research done in Ethiopia is the main emphasis of the search strategy. The total number of studies that satisfied the criteria for inclusion was ten. In this research, empirical data related to e-health acceptance factors were retrieved, examined, and summarized by the authors. RESULTS This systematic review identified a total of 25 predictors that have been found in the ten studies. The identified facilitators were effort expectancy, performance expectancy, facilitating conditions, social influences, attitude, computer literacy, participant age, perceived enjoyment, and educational status, duration of mobile device use, organizational culture, and habit. Moreover, technology anxiety was the most barrier to sustainable acceptance of e-health systems in Ethiopia. CONCLUSIONS The most common facilitator identified from the predictors was effort expectancy, which played a major role in the adoption of the e-health system in Ethiopia. Therefore, eHealth implementers and managers in those settings should give users of the system priority in improving the technical infrastructure by regularly providing them with basic facilitating conditions. They should also pay attention to the system they want to implement because doing so will improve the users' perception of the system's value and attitude.
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Affiliation(s)
- Agmasie Damtew Walle
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | | | - Jibril Bashir Adem
- Department of Public Health, College of Medicine and Health Sciences, Arsi University, Asella, Ethiopia
| | - Sisay Maru Wubante
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adamu Ambachew Shibabaw
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | - Daniel Niguse Mamo
- Department of Health Informatics, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Shimels Derso Kebede
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Ayana Alebachew Muluneh
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Muluken Belachew Mengiste
- Department of Health Informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Ayenew Sisay Gebeyew
- Department of Health Informatics, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Fikadu Wake Butta
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | - Alex Ayenew Chereka
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | - Abiy Tasew Dubale
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | - Sisay Yitayih Kassie
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | - Tigist Andargie Ferede
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tsarfati B, Cojocaru D. Introducing Computerized Technology to Nurses: A Model Based on Cognitive Instrumental and Social Influence Processes. Healthcare (Basel) 2023; 11:1788. [PMID: 37372906 DOI: 10.3390/healthcare11121788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/07/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
The use of computerized technologies as an integral part of nursing has become a reality in the health care system. Studies present different approaches that range from accepting technology as a health promoter to an approach that opposes computerization. This study, which examined social and instrumental processes that influence nurses' attitudes toward computer technology, will present a model for the optimal assimilation of computer technology in the nurses' work environment. The study, which included 224 participants, was designed as a mixed method and included questionnaires and semi-structured interviews of participants. The data were analyzed to understand the factors that influenced nurses' attitudes toward the use of computer technology. The research findings show that the more clearly nurses understand the positive impact of using technology on the quality of care, the more positive their response to changes in registration and reporting methods. It is not surprising that the research findings found that cognitive instrumental processes and social influence processes have a positive effect on the perceived usefulness of using computer technologies. The unusual finding was the fact that cognitive instrumental processes were the main factor influencing the assimilation of computer technology even though nursing is a social profession.
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Affiliation(s)
- Becky Tsarfati
- Department of Sociology and Social Work, "Alexandru Ioan Cuza" University of Iasi, 700506 Iasi, Romania
| | - Daniela Cojocaru
- Department of Sociology and Social Work, "Alexandru Ioan Cuza" University of Iasi, 700506 Iasi, Romania
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Hailemariam T, Atnafu A, Gezie LD, Kaasbøll JJ, Klein J, Tilahun B. Individual and contextual level enablers and barriers determining electronic community health information system implementation in northwest Ethiopia. BMC Health Serv Res 2023; 23:644. [PMID: 37328840 DOI: 10.1186/s12913-023-09629-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND The government of Ethiopia has envisioned digitalizing primary healthcare units through the electronic community health information system (eCHIS) program as a re-engineering strategy aiming to improve healthcare data quality, use, and service provision. The eCHIS is intended as a community-wide initiative to integrate lower health structure with higher administrative health and service delivery unit with the ultimate goal of improving community health. However, the success or failure of the program depends on the level of identifying enablers and barriers of the implementation. Therefore, this study aimed to explore individual and contextual-level enablers and barriers determining eCHIS implementation. METHOD We conducted an exploratory study to determine the enablers and barriers to successfully implementing eCHIS in rural Wogera district, northwest Ethiopia. In-depth interviews and key informant interviews were applied at participants from multiple sites. A thematic content analysis was conducted based on the key themes reported. We applied the five components of consolidated framework for implementation research to interpret the findings. RESULTS First, based on the intervention's characteristics, implementers valued the eCHIS program. However, its implementation was impacted by the heavy workload, limited or absent network and electricity. Outer-setting challenges were staff turnover, presence of competing projects, and lack of incentive mechanisms. In terms of the inner setting, lack of institutionalization and ownership were mentioned as barriers to the implementation. Resource allocation, community mobilization, leaders' engagement, and availability of help desk need emphasis for a better achievement. With regard to characteristics of the individuals, limited digital literacy, older age, lack of peer-to-peer support, and limited self-expectancy posed challenges to the implementation. Finally, the importance of mentoring and engaging community and religious leaders, volunteers, having defined plan and regular meetings were identified elements of the implementation process and need emphasis. CONCLUSION The findings underlined the potential enablers and barriers of eCHIS program for quality health data generation, use, and service provision and highlighted areas that require emphasis for further scale-up. The success and sustainability of the eCHIS require ongoing government commitment, sufficient resource allocation, institutionalization, capacity building, communication, planning, monitoring, and evaluation.
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Affiliation(s)
- Tesfahun Hailemariam
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
- Department of Health Informatics, College of Health Sciences, Hawassa, Ethiopia.
| | - Asmamaw Atnafu
- Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Jörn Klein
- Department of Nursing and Health Sciences Campus Porsgrunn, University of South-Eastern Norway, Porsgrunn, Norway
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Day S, Ncube V, Maja L, Wasunna B, Pienaar J, Setswe G, Waweru E, Feldacker C. Centering Frontline Health Care Workers in Digital Innovation Design to Inform the Optimization of an App for Improved Male Circumcision Follow-up in South Africa: Qualitative Usability Study. JMIR Form Res 2023; 7:e44122. [PMID: 36947127 PMCID: PMC10131628 DOI: 10.2196/44122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Voluntary medical male circumcision (VMMC) is a safe and effective HIV prevention strategy. However, adherence to recommended in-person, postoperative follow-up is inefficient for procedures with few adverse events. Two-way texting (2wT)-based follow-up appears to be a safe and an efficient alternative to scheduled clinic visits for low-risk patients who underwent VMMC. To ensure that 2wT responds to the needs of health care workers (HCWs) and patients, HCWs were closely involved in app design using a human-centered design (HCD) approach. OBJECTIVE Embedded within an ongoing randomized controlled trial of 2wT in South Africa and complementary HCD processes of 2wT app optimization, this qualitative study aimed to use key informant interviews (KIIs) to explore the thoughts, suggestions, and opinions on and perceptions of 2wT's usability and acceptability among HCWs involved in 2wT implementation in both urban and rural South Africa. METHODS A total of 7 HCWs using 2wT in Gauteng and the North West province participated in KIIs regarding the usability and acceptability of 2wT. HCWs were asked for their opinions on 2wT as a viable, useful, appropriate, and accessible method of postoperative VMMC care. They were also asked about 2wT-related working, exploring areas where 2wT could add to or reduce their daily tasks. The KII data were explored, coded, and analyzed by 3 qualitative researchers using thematic content analysis and the ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) software. RESULTS Most HCWs felt confident, comfortable, satisfied, and well supported using a 2wT-based follow-up as an alternative to in-person clinical reviews. They felt that 2wT was easy to use and required little technical support after initial mentoring on how to use the 2wT system. Few noted safety concerns, as men can receive clinical guidance, reassurance, and referral via 2wT. Although fewer in-person visits reduced the in-person review workload and eased clinical flow, HCWs noted the added burden of having to interact with clients via SMS text messages on evenings or weekends. HCWs reinforced the need for enhanced postoperative counseling to ensure that 2wT patients could recognize and understood how to respond to early signs of complications. HCWs suggested a rotation to spread the evening and weekend workload and ensure swift patient responses. CONCLUSIONS In this formative qualitative study focused on HCWs, 2wT was a highly usable alternative to in-person postoperative reviews for patients who underwent VMMC in South Africa. The HCD processes likely improved the usability and acceptability of 2wT for HCWs. HCWs supported the scale-up of 2wT given the distance from the clinic to the men's homes and the potential for reducing workload. To ensure success, providers urged sensitizing patients to the fact that 2wT augments, but does not replace, the existing after-hours and emergency care services.
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Affiliation(s)
- Sarah Day
- Division of Social and Behavioural Sciences, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- The Centre for HIV-AIDS Prevention Studies, Johannesburg, South Africa
| | | | | | | | - Jacqueline Pienaar
- The Centre for HIV-AIDS Prevention Studies, Johannesburg, South Africa
- The Aurum Institute, Johannesburg, South Africa
| | | | | | - Caryl Feldacker
- International Training and Education Center for Health, University of Washington, Seattle, WA, United States
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Towards Inclusive Diagnostics for Neglected Tropical Diseases: User Experience of a New Digital Diagnostic Device in Low-Income Settings. Trop Med Infect Dis 2023; 8:tropicalmed8030176. [PMID: 36977176 PMCID: PMC10056790 DOI: 10.3390/tropicalmed8030176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 03/19/2023] Open
Abstract
Designing new and inclusive diagnostic tools to detect Neglected Tropical Diseases (NTDs) to achieve rational disease control requires a co-design process where end-users’ input is important. Failure to involve all potential end-users in new diagnostics for NTDs can result in low use and adoption failure, leading to persistent infection hot spots and ineffective disease control. There are different categories of potential end-users of new diagnostic tools for NTD control, and it is unclear if there are differences between the user efficiency, effectiveness, perception, and acceptability across these end-user categories. This study evaluated the usability, user perception, contextual factors affecting the user’s experience, and acceptability of a new digital optical diagnostic device for NTDs across three types of potential end users. A total of 21 participants were tested. Laboratory scientists, technicians, and Community Health Extension Workers (CHEWs) in training achieved similar scores on the usability and user perception questionnaires with no statistically significant difference between end-user categories. All participants also have high scores for the user perception domains which strongly correlate with the acceptability of the AiDx NTDx Assist device. This study indicates that, by providing digital diagnostic tools in combination with minimal training and support, CHEWs undergoing training and, by extension, CHEWs post-training, can be involved in the diagnoses of NTDs, potentially enhancing a community’s capabilities to diagnose, treat, and control NTDs.
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Walle AD, Ferede TA, Baykemagn ND, Shimie AW, Kebede SD, Tegegne MD, Wubante SM, Yehula CM, Demsash AW, Melaku MS, Mengistie MB. Predicting healthcare professionals' acceptance towards electronic personal health record systems in a resource-limited setting: using modified technology acceptance model. BMJ Health Care Inform 2023; 30:bmjhci-2022-100707. [PMID: 36878620 PMCID: PMC9990677 DOI: 10.1136/bmjhci-2022-100707] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2023] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES Personal health record systems allow users to manage their health information in a confidential manner. However, there is little evidence about healthcare providers' intentions to use such technologies in resource-limited settings. Therefore, this study aimed to assess predicting healthcare providers' acceptance of electronic personal health record systems. METHODS An institutional-based cross-sectional study was conducted from 19 July to 23 August 2022 at teaching hospitals in the Amhara regional state of Ethiopia. A total of 638 health professionals participated in the study. Simple random sampling techniques were used to select the study participants. Structural equation modelling analysis was employed using AMOS V.26 software. RESULT Perceived ease of use had a significant effect on the intention to use electronic personal health records (β=0. 377, p<0.01), perceived usefulness (β=0.104, p<0.05) and attitude (β=0.204, p<0.01); perceived ease of use and information technology experience had a significant effect on perceived usefulness (β=0.077, p<0.05); and digital literacy (β=0.087, p<0.05) and attitude had also a strong effect on intention to use electronic personal health records (β=0.361, p<0.01). The relationship between perceived ease of use and the intention to use was mediated by attitude (β=0.076, p<0.01). CONCLUSION Perceived ease of use, attitude and digital literacy had a significant effect on the intention to use electronic personal health records. The perceived ease of use had a greater influence on the intention to use electronic personal health record systems. Thus, capacity building and technical support could enhance health providers' acceptance of using electronic personal health records in Ethiopia.
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Affiliation(s)
| | | | | | - Aynadis Worku Shimie
- Department of Health Informatics, Debre Markos University College of Health Science, Debre Markos, Ethiopia
| | | | | | - Sisay Maru Wubante
- Department of Health Informatics, University of Gondar, Gondar, Ethiopia
| | | | | | | | - Muluken Belachew Mengistie
- Department of Health Informatics, Debre Markos University College of Health Science, Debre Markos, Ethiopia
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Health Information Technologies in a Resource-Limited Setting: Knowledge, Attitude, and Practice of Health Professionals. BIOMED RESEARCH INTERNATIONAL 2023; 2023:4980391. [PMID: 36778058 PMCID: PMC9908339 DOI: 10.1155/2023/4980391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 01/11/2023] [Accepted: 01/20/2023] [Indexed: 02/04/2023]
Abstract
The use of health information technology significantly enhances patient outcomes. As a result, policymakers from developing countries have placed strong emphasis on formulating eHealth policies and initiatives. However, there have not been many successful deployments to show for. The role of individual factors in the successful implementation of these technologies is indispensable. Therefore, this study assesses healthcare professionals' knowledge, attitudes, and practice of health information technology. An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from November 15 to December 29, 2020. A structured, self-administered questionnaire was used to collect data. Student's t-test was used to learn if there were any significant differences in practice habits between participants with and without previous information technology-related training. In addition, first-order partial correlation was conducted to identify the relationship of knowledge and attitude with practice. A total of 347 health professionals responded to the questionnaire, yielding an 87.2% response rate. Most health professionals are not aware of how to use health information technologies. Notably, practice levels were low and needed prompt action from responsible authorities. Previous training did not work very well to improve the practice levels of health professionals. However, the positive attitude of these professionals encourages policymakers and implementers to engage closely.
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Addotey-Delove M, Scott RE, Mars M. Healthcare Workers' Perspectives of mHealth Adoption Factors in the Developing World: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1244. [PMID: 36673995 PMCID: PMC9858911 DOI: 10.3390/ijerph20021244] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND mHealth applications provide health practitioners with platforms that enable disease management, facilitate drug adherence, facilitate drug adherence, speed up diagnosis, monitor outbreaks, take and transfer medical images, and provide advice. Many developing economies are investing more in mobile telecommunication infrastructure than in road transport and electric power generation. Despite this, mHealth has not seen widespread adoption by healthcare workers in the developing world. This study reports a scoping review of factors that impact the adoption of mHealth by healthcare workers in the developing world, and based on these findings, a framework is developed for enhancing mHealth adoption by healthcare workers in the developing world. METHODS A structured literature search was performed using PubMed and Scopus, supplemented by hand searching. The searches were restricted to articles in English during the period January 2009 to December 2019 and relevant to the developing world that addressed: mobile phone use by healthcare workers and identified factors impacting the adoption of mHealth implementations. All authors reviewed selected papers, with final inclusion by consensus. Data abstraction was performed by all authors. The results were used to develop the conceptual framework using inductive iterative content analysis. RESULTS AND DISCUSSION Of 919 articles, 181 met the inclusion criteria and, following a review of full papers, 85 reported factors that impact (promote or impede) healthcare worker adoption of mHealth applications. These factors were categorised into 18 themes and, after continued iterative review and discussion were reduced to 7 primary categories (engagement/funding, infrastructure, training/technical support, healthcare workers' mobile-cost/ownership, system utility, motivation/staffing, patients' mobile-cost/ownership), with 17 sub-categories. These were used to design the proposed framework. CONCLUSIONS Successful adoption of mHealth by healthcare workers in the developing world will depend on addressing the factors identified in the proposed framework. They must be assessed in each specific setting prior to mHealth implementation. Application of the proposed framework will help shape future policy and practice of mHealth implementation in the developing world and increase adoption by health workers.
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Affiliation(s)
- Michael Addotey-Delove
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
| | - Richard E. Scott
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Maurice Mars
- Department of TeleHealth, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4041, South Africa
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia
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Walle AD, Jemere AT, Tilahun B, Endehabtu BF, Wubante SM, Melaku MS, Tegegne MD, Gashu KD. Intention to use wearable health devices and its predictors among diabetes mellitus patients in Amhara region referral hospitals, Ethiopia: Using modified UTAUT-2 model. INFORMATICS IN MEDICINE UNLOCKED 2023. [DOI: 10.1016/j.imu.2022.101157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Navarro Martínez O, Igual García J, Salcedo VT. Nurses' view of benefits, enablers and constraints to the use of digital health tools with patients: A cross-sectional study. Digit Health 2023; 9:20552076231197339. [PMID: 37675060 PMCID: PMC10478564 DOI: 10.1177/20552076231197339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 09/08/2023] Open
Abstract
Introduction Digital literacy helps patients to be more informed in order to make decisions about their health. Patient empowerment in the digital realm is a duty for all healthcare professionals, but nurses are the most numerous professionals in all healthcare systems worldwide. In addition, they have an important role in health education and patient follow-up. Therefore, the use of digital tools, by nurses to empower and help patients know more about their health, is crucial. Objective This study was conducted to identify nurses' views on the benefits as well as constraints nurses encounter when using digital resources to empower and educate their patients. We sought to identify enablers that could help nurses use technology with their patients as a means to reinforce the care and advice they offer them. Methods An online ad hoc questionnaire was answered by 848 currently employed Spanish nurses on the benefits of using digital media with their patients, as well as on the constraints and enablers during implementation. Results The majority of the nurses considered that reliable digital information would reduce unnecessary consultations. In addition, they think that at least 50% of their patients could benefit from consulting information online. Among the constraints, nurses mainly pointed out the older age and low educational level of their patients. Younger nurses are the most likely nurses to see patient age as a problem. As for enablers, nurses pointed out the training offered to patients as well as digital tools being user-friendly for patients. Conclusions It is crucial to work while following a lifelong learning strategy, with training from university education as well as training from healthcare institutions to reduce the digital gap that affects patients' digital empowerment.
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Affiliation(s)
| | - Jorge Igual García
- Higher Technical School of Telecommunication Engineering, Universitat Politècnica de València, Valencia, Spain
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Alfuqaha O, Rabay'ah M, Al. khashashneh O, Alsalaht M. Technology acceptance model among nurses and other healthcare providers during the 2019 Coronavirus pandemic: a comparative cross-sectional study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2022.13.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Hunde MK, Demsash AW, Walle AD. Behavioral intention to use e-learning and its associated factors among health science students in Mettu university, southwest Ethiopia: Using modified UTAUT model. INFORMATICS IN MEDICINE UNLOCKED 2022. [DOI: 10.1016/j.imu.2022.101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Bramo SS, Desta A, Syedda M. Acceptance of information communication technology-based health information services: Exploring the culture in primary-level health care of South Ethiopia, using Utaut Model, Ethnographic Study. Digit Health 2022; 8:20552076221131144. [PMID: 36276184 PMCID: PMC9585563 DOI: 10.1177/20552076221131144] [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: 05/04/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction In sub-Saharan African countries including Ethiopia, the acceptance of Information Communication Technology (ICT) in health is at the proof-of-concept level with a few unsustainable piecemeal of pilot projects. Thus, a desirable willingness of acceptance among healthcare providers is a paramount. Material and Methods Eight months elapsed ethnographic study design was conducted using participant observation and key informant interviews. The data were entered on Qualitative Data Analysis mine software version 1.4. The quotes and field notes were thematized. The Unified Technology Acceptance and Use Theory (UTAUT) is validated and used to generate new meanings. Results This study highlighted the different instances of technology acceptance. Although the primary-level healthcare (PLHC) providers displayed tendencies to accept ICTs-based health information services consistent with the UTAUT dimensions such as the degree of simplicity associated with performance expectancy, use/effort expectancy, facilitating conditions, social issue, individual variation, and organization culture there are instances that disputed acceptance. For instance, the gains in data quality and reporting secondary to the use of District Health Information System Two (DHIS-II) are not influenced by acceptance. Rather PLHC providers are burnt-out of additional clerical duties of filling data on the DHIS-2. Furthermore, ICT acceptance is influenced by individual variations and the unique culture of primary level facilities such as leadership commitment. Conclusions On this basis, we conclude that the willingness to accept ICT-based health information services at the primary level is not limited to those factors discussed in the UTAUT model.
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Affiliation(s)
- Senait Samuel Bramo
- Department of Information Science, Institute of Technology, Jimma University, Jimma, Ethiopia,Senait Samuel Bramo, Department of Information science, institute of technology, Jimma University, Jimma, Ethiopia.
Emails: ,
| | - Amare Desta
- Department of Business Studies, Faculty of Business, University of Wales Trinity Saint David, London, UK
| | - Munavvar Syedda
- Department of Business and Information Systems, Faculty of Business, Cardiff Metropolitan University, Cardiff, UK
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Walczak R, Kludacz-Alessandri M, Hawrysz L. Use of Telemedicine Technology among General Practitioners during COVID-19: A Modified Technology Acceptance Model Study in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710937. [PMID: 36078650 PMCID: PMC9518366 DOI: 10.3390/ijerph191710937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 05/31/2023]
Abstract
During the COVID-19 pandemic, telehealth became a popular solution for the remote provision of primary care by General Practitioners (GPs) in Poland. This study aimed to assess the GPs' acceptance of telehealth during the COVID-19 pandemic in Poland and to explain the factors that drive GPs' need to implement a telehealth system in primary care using the modified Technology Acceptance Model (TAM). In Poland, 361 GPs from a representative sample of 361 clinics drawn from 21,500 outpatient institutions in Poland participated in the empirical study. Structural equation modelling (SEM) was used to evaluate the causal relationships that were formulated in the proposed model. Research has shown that Polish GPs reported a positive perception and high acceptance of the telehealth system during the COVID-19 pandemic. Overall, the results show that the social factors (image, decision autonomy, perception of patient interaction) significantly positively influence the technological factors (perceived ease of use and perceived usefulness) that influence the need to implement a telehealth system. The proposed socio-technological model can serve as a theoretical basis for future research and offer empirical predictions for practitioners and researchers in health departments, governments, and primary care settings.
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Affiliation(s)
- Renata Walczak
- Faculty of Civil Engineering, Mechanics and Petrochemistry, Warsaw University of Technology, 09-400 Plock, Poland
| | | | - Liliana Hawrysz
- Faculty of Management, Wrocław University of Science and Technology, 50-370 Wrocław, Poland
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Exploring Usability and Patient Attitude towards a Smart Hospital Service with the Technology Acceptance Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106059. [PMID: 35627595 PMCID: PMC9141123 DOI: 10.3390/ijerph19106059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/29/2022] [Accepted: 05/13/2022] [Indexed: 01/18/2023]
Abstract
The demand for health care has increased with the development of global technology and the rise of public health awareness, and smart service systems have also been introduced to medical care to relieve the pressure on hospital staff. However, the survey found that patients’ willingness to use smart services at the time of consultation has not improved. The main research purpose of this study was to understand the willingness of patients from various groups to use smart medical service systems and to explore the influencing factors on patients’ use of smart service systems in hospitals through the technology acceptance model. This study distributed questionnaires in the outpatient area of National Taiwan University Hospital Yunlin Branch, and a total of 202 valid questionnaires were obtained. After related research and regression analysis, it was found that patients paid more attention to the benefits and convenience brought by smart services. If patients believed that smart services were trustworthy and beneficial to themselves, their usage intention and attitude would be positive. The results of this study are summarized by the following four points: (1) Designed according to the cultural conditions of different regions; (2) think about design from the patient’s perspective; (3) strengthen the explanation and promotion of smart services; and (4) add humanized care and design. This study could be used as a reference for hospitals to improve their service quality and systems in the future.
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Nahar S. Decoding the Role of Gender in the Relationship Between the Online Payment System and SME Performance: A Case Study Investigating an Emerging Economy—Bangladesh. Front Res Metr Anal 2022; 7:842670. [PMID: 35392107 PMCID: PMC8981142 DOI: 10.3389/frma.2022.842670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
This research examines the moderating role of gender on the adoption of online payment systems (OPS). It also explores the impact of using OPS on the performance of SMEs in an emerging economy, using the Technology Acceptance Model (TAM) and Resource-Based View (RBV). The results indicate that male SME owners (entrepreneurs) are more likely to focus on perceived usefulness, whereas female SME entrepreneurs are more likely to focus on perceived ease of use while adopting OPS, according to data obtained from 302 SMEs in Bangladesh through face-to-face surveys. The results also report that the use of OPS has a considerable positive effect on SMEs' performance. The study's findings will add to the scarce research on the impact of using OPS on business performance in the context of SMEs in emerging economies, in addition to enhancing the OPS adoption literature from a gendered lens.
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Ngusie HS, Kassie SY, Chereka AA, Enyew EB. Healthcare providers' readiness for electronic health record adoption: a cross-sectional study during pre-implementation phase. BMC Health Serv Res 2022; 22:282. [PMID: 35232436 PMCID: PMC8889777 DOI: 10.1186/s12913-022-07688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/25/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The adoption of an electronic health record (EHR) in the healthcare system has the potential to make healthcare service delivery effective and efficient by providing accurate, up-to-date, and complete information. Despite its great importance, the adoptions of EHR in low-income country settings, like Ethiopia, were lagging and increasingly failed. Assessing the readiness of stakeholders before the actual adoption of EHR is considered the prominent solution to tackle the problem. However, little is known about healthcare providers' EHR readiness in this study setting. Accordingly, this research was conducted aiming at examining healthcare providers' readiness for EHR adoption and associated factors in southwestern Ethiopia. METHODS An institutional-based cross-sectional study was conducted from September 1 to October 30, 2021. A total of 423 healthcare providers working in public hospitals were selected using a simple random sampling technique. Multivariable logistic regression was fitted to identify determinant factors of overall healthcare providers' readiness after the other covariates were controlled. RESULT In this study, the overall good readiness level of EHR adoption was 52.8% (n = 204) [95% CI of 47.9% to 56.6%]. Age, computer literacy, computer access at health facilities, attitude towards EHRs, awareness about EHRs, perceived benefit, and perceived technology self-efficacy were significantly associated with the overall health care providers' readiness for the adoption of EHR using a cut point of P-value less than 0.05. CONCLUSION Around half of the respondents had a good level of overall healthcare providers' readiness for the adoption of EHR which was considered inadequate. This finding implied that a huge effort is required to improve readiness before the actual implementation of EHRs. The finding implied that younger-aged groups were more ready for such technology which in turn implied; the older one needs more concern. Enhancing computer literacy, confidence building to raise self-efficacy of such technology, addressing the issue of computer availability at health facilities, building a positive attitude, awareness campaign of EHR, and recognizing the usefulness of such systems were the necessary measures to improve EHR readiness in this setting. Additionally, further studies are recommended to encompass all types of EHR readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed by future works.
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Affiliation(s)
- Habtamu Setegn Ngusie
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Sisay Yitayih Kassie
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Alex Ayenew Chereka
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Ermias Bekele Enyew
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
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Xu Q, Hou X, Xiao T, Zhao W. Factors Affecting Medical Students’ Continuance Intention to Use Mobile Health Applications. J Multidiscip Healthc 2022; 15:471-484. [PMID: 35300179 PMCID: PMC8921670 DOI: 10.2147/jmdh.s327347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background With the dramatic growth in smartphones, mobile health applications (apps) in the field of healthcare or medicine, which are characterized by strong operability, flexibility and interactivity, provide a supplementary approach to medical learning. The aims of this study were to awaken medical students to pay more attention to the learning function of mobile health app and gain deeper insight into our understanding of the factors influencing medical students’ mobile health apps continuance intention for enhancing practical utilization. Methods A cross-sectional survey was conducted with a self-designed questionnaire administered to medical students at Chongqing Medical University. Data were collected from 450 participants from March to April 2019. SPSS V.25 was used for the descriptive statistical analysis of the results. Smart PLS 3.2.7 was used to construct a structural equation modelling framework to estimate the influencing factors of medical students’ continuance intention to use mobile health apps. Results The external characteristics of mobile health apps had a positive influence on perceived ease of use (β = 0.378, P < 0.001). Perceived ease of use had a positive impact on perceived usefulness (β = 0.573, P < 0.001). Perceived ease of use (β = 0.195, P = 0.011), perceived usefulness (β = 0.450, P < 0.001) and subjective norms (β = 0.255, P < 0.001) had a positive impact on attitude towards using mobile health apps. Additionally, perceived usefulness (β = 0.202, P < 0.001) and attitude (β = 0.730, P < 0.001) had a remarkable influence on continuance intention. Furthermore, the mediating effect of attitude between perceived usefulness and continuance intention was significant (β = 0.329, P < 0.001). Conclusion Both perceived usefulness and attitude have a significant effect on medical students’ mobile health apps continuance intention. So, we suggest apps providers and developers evoking and maintaining users’ interest in mobile health apps and perfecting apps’ features from various aspect. Also, more attention should be paid on social relationship to introduce medical students to familiarize mobile health apps and strengthen adhesiveness of medical students.
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Affiliation(s)
- Qian Xu
- College of Medical Informatics, Chongqing Medical University, Chongqing, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, People’s Republic of China
- Department of Medical Informatics Library, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiaorong Hou
- College of Medical Informatics, Chongqing Medical University, Chongqing, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Tingchao Xiao
- Department of Medical Informatics Library, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Wenlong Zhao
- College of Medical Informatics, Chongqing Medical University, Chongqing, People’s Republic of China
- Medical Data Science Academy, Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Wenlong Zhao, College of Medical Informatics Chongqing Medical University, Chongqing, People’s Republic of China, Tel +86 23 6571 4682, Email
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Cheung YT, Lam PH, Lam TTN, Lam HHW, Li CK. Technology Acceptance Among Patients With Hemophilia in Hong Kong and Their Expectations of a Mobile Health App to Promote Self-management: Survey Study. JMIR Form Res 2021; 5:e27985. [PMID: 34499034 PMCID: PMC8461536 DOI: 10.2196/27985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 08/02/2021] [Accepted: 08/16/2021] [Indexed: 01/05/2023] Open
Abstract
Background The lifelong management of hemophilia is demanding and complex. In July 2019, we published a review in the Journal of Medical Internet Research, summarizing telehealth interventions that facilitate monitoring of bleeding events and promoting the appropriate use of clotting factors among patients with hemophilia. This work has led to the development of a community program that aims to harness technology to promote self-management among patients with hemophilia in Hong Kong. Objective Before the inception of this program, we conducted a cross-sectional survey to evaluate the patients’ level of technology acceptance and identify their expectations of the use of mobile technology for self-management of hemophilia. Methods In total, 56 participants (75% adult patients and 25% parents of pediatric patients; 87.5% with moderate to severe disease) were recruited from a local nongovernmental organization that serves patients with hemophilia. They rated their perceived confidence and acceptance in using the new mobile technology (score 1 to 5 for each item, with a higher score indicating better acceptance) using a structured questionnaire (adapted from the Technology Acceptance Model). They also identified the top features that they perceived to be the most important components of a mobile app for the self-management of hemophilia. The Mann–Whitney U test was used to compare technology acceptance scores across subgroups of different clinical and socioeconomic characteristics. Results In general, the participants considered themselves skilled in using mobile apps (mean 4.3, 95% CI 4.1-4.5). They were willing to learn to use the new mobile app to organize their bleeding records (mean 4.0, 95% CI 3.7-4.3) and to manage their health (mean 4.2, 95% CI 4.1-4.5). Participants who lived in public housing (a surrogate marker for lower socioeconomic status in Hong Kong) reported lower technology acceptance than those who lived in private housing (P=.04). The most important features identified by the participants concerned documenting of infusion logs (n=49, 87.5%), bleeding events (n=48, 85.7%), and the secure delivery of the bleeding information to health care professionals (n=40, 71.4%). Conclusions It is encouraging to infer that patients with hemophilia in Hong Kong are receptive to the use of mobile health technology. The findings of this survey are applicable in designing the key features of a patient-centered, multimodal program harnessing mobile technology to promote self-management among patients with hemophilia. Future studies should evaluate participants’ acceptability and perceived usability of the mobile app via user metrics and assess clinical and humanistic outcomes of this program.
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Affiliation(s)
- Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Pok Hong Lam
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Teddy Tai-Ning Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
| | | | - Chi Kong Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.,Department of Paediatrics & Adolescent Medicine, Hong Kong SAR, Hong Kong.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong
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The potential use of digital health technologies in the African context: a systematic review of evidence from Ethiopia. NPJ Digit Med 2021; 4:125. [PMID: 34404895 PMCID: PMC8371011 DOI: 10.1038/s41746-021-00487-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 06/24/2021] [Indexed: 02/08/2023] Open
Abstract
The World Health Organization (WHO) recently put forth a Global Strategy on Digital Health 2020–2025 with several countries having already achieved key milestones. We aimed to understand whether and how digital health technologies (DHTs) are absorbed in Africa, tracking Ethiopia as a key node. We conducted a systematic review, searching PubMed-MEDLINE, Embase, ScienceDirect, African Journals Online, Cochrane Central Registry of Controlled Trials, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform databases from inception to 02 February 2021 for studies of any design that investigated the potential of DHTs in clinical or public health practices in Ethiopia. This review was registered with PROSPERO (CRD42021240645) and it was designed to inform our ongoing DHT-enabled randomized controlled trial (RCT) (ClinicalTrials.gov ID: NCT04216420). We found 27,493 potentially relevant citations, among which 52 studies met the inclusion criteria, comprising a total of 596,128 patients, healthy individuals, and healthcare professionals. The studies involved six DHTs: mHealth (29 studies, 574,649 participants); electronic health records (13 studies, 4534 participants); telemedicine (4 studies, 465 participants); cloud-based application (2 studies, 2382 participants); information communication technology (3 studies, 681 participants), and artificial intelligence (1 study, 13,417 participants). The studies targeted six health conditions: maternal and child health (15), infectious diseases (14), non-communicable diseases (3), dermatitis (1), surgery (4), and general health conditions (15). The outcomes of interest were feasibility, usability, willingness or readiness, effectiveness, quality improvement, and knowledge or attitude toward DHTs. Five studies involved RCTs. The analysis showed that although DHTs are a relatively recent phenomenon in Ethiopia, their potential harnessing clinical and public health practices are highly visible. Their adoption and implementation in full capacity require more training, access to better devices such as smartphones, and infrastructure. DHTs hold much promise tackling major clinical and public health backlogs and strengthening the healthcare ecosystem in Ethiopia. More RCTs are needed on emerging DHTs including artificial intelligence, big data, cloud, cybersecurity, telemedicine, and wearable devices to provide robust evidence of their potential use in such settings and to materialize the WHO’s Global Strategy on Digital Health.
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Saigí-Rubió F, Vidal-Alaball J, Torrent-Sellens J, Jiménez-Zarco A, López Segui F, Carrasco Hernandez M, Alzaga Reig X, Bonet Simó JM, Abizanda González M, Piera-Jimenez J, Solans O. Determinants of Catalan public primary care professionals' intention to use digital clinical consultations (eConsulta) in the post-COVID-19 context: optical illusion or permanent transformation? J Med Internet Res 2021; 23:e28944. [PMID: 34097638 PMCID: PMC8386368 DOI: 10.2196/28944] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND During lockdown due to the COVID-19 pandemic, telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care, and it has been used to support the healthcare needs of COVID-19 patients and routine primary care patients alike. However, this change has not been fully consolidated. OBJECTIVE The objective of this study was to analyse the determinants of healthcare professionals' intention to use the eConsulta digital clinical consultations tool in the post-COVID-19 context. METHODS A literature review of the Technology Acceptance Model (TAM) allowed us to construct a theoretical model and establish a set of hypotheses derived from it about the influence that a variety of different factors relating to both healthcare professionals and the institutions where they work had on those professionals' intention to use eConsulta. In order to confirm the proposed model, a mixed qualitative and quantitative methodology was used, and a questionnaire was designed to serve as the data collection instrument. The data were analysed using univariate and bivariate analysis techniques. To confirm the theoretical model, exploratory factor analysis and binary logistic regression were applied. RESULTS The most important variables were those referring to perceived benefits (B=2.408) and the type of use that individuals habitually made of eConsulta (B=0.715). Environmental pressure (B=0.678), experience of technology (B=0.542), gender (B=0.639) and the degree of eConsulta implementation (B=0.266) were other variables influencing the intention to use the tool in the post-COVID-19 context. When replicating the previous analysis by professional group, experience of technology and gender in the physician group, and experience of the tool's use and the centre where a professional works in the nurse group, were found to be of considerable importance. CONCLUSIONS The implementation and use of eConsulta had increased significantly as a consequence of the COVID-19 pandemic, and the majority of the healthcare professionals were satisfied with its use in practice and planned to incorporate it into their practices in the post-COVID-19 context. Perceived benefits and environmental pressure were determining factors in the attitude towards and intention to use eConsulta. CLINICALTRIAL
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Affiliation(s)
- Francesc Saigí-Rubió
- Universitat Oberta de Catalunya, Faculty of Health Sciences, Barcelona, ES
- Interdisciplinary Research Group on ICTs, Barcelona,, ES
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerencia Territorial de la Catalunya Central, Institut Catala de la Salut, Carrer Pica d'Estats, 36,, Sant Fruitos de Bages, ES
- Unitat de Suport a la Recerca de la Catalunya Central, Fundacio Institut Universitari per a la Recerca a l'Atencio Primaria de Salut Jordi Gol i Gurina, Sant Fruitos de Bages, ES
- Faculty of Medicine, University of Vic - Central University of Catalonia, Vic, ES
| | - Joan Torrent-Sellens
- Interdisciplinary Research Group on ICTs, Barcelona,, ES
- Universitat Oberta de Catalunya, Faculty of Economics and Business, Barcelona, ES
| | - Ana Jiménez-Zarco
- Interdisciplinary Research Group on ICTs, Barcelona,, ES
- Universitat Oberta de Catalunya, Faculty of Economics and Business, Barcelona, ES
| | - Francesc López Segui
- Centre de Recerca en Economia i Salut, Pompeu Fabra University, Barcelona, ES
- Northern Metropolitan Primary Care Directorate, Institut Català de la Salut, Badalona, ES
| | | | | | - Josep Maria Bonet Simó
- Northern Metropolitan Primary Care Directorate, Institut Català de la Salut, Badalona, ES
| | - Mercedes Abizanda González
- Health Department, eHealth Unit, Barcelona, ES
- Pere Virgili Health Park, Primary Care Management Control, Barcelona, ES
| | - Jordi Piera-Jimenez
- Digitalization for the Sustainability of the Healthcare System, Sistema de Salut de Catalunya, Barcelona, ES
- Servei Català de la Salut, Barcelona, ES
- Universitat Oberta de Catalunya, Open Evidence Research Group, Barcelona, ES
| | - Oscar Solans
- Health Department, eHealth Unit, Barcelona, ES
- Digitalization for the Sustainability of the Healthcare System, Sistema de Salut de Catalunya, Barcelona, ES
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