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Chen Y, Shu Y, Zheng H, Sun C, Fu C. The 2 nd China Vaccinology Integrated Innovation & Teaching Development Conference: Promoting the construction of vaccinology discipline system. Hum Vaccin Immunother 2024; 20:2300157. [PMID: 38198292 DOI: 10.1080/21645515.2023.2300157] [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: 12/07/2023] [Accepted: 12/25/2023] [Indexed: 01/12/2024] Open
Abstract
The 2nd China Vaccinology Integrated Innovation & Teaching Development Conference was held in Sun Yat-sen University, Shenzhen, 18-19, November 2023. Over 200 participants in the field of Vaccinology gathered together to address challenges and issues relevant to vaccine education and training courses, research, and public health programs in China. The conference themed "Promoting the Integrated and Innovative Development of Vaccinology through Collective Efforts." The conference was organized by the China Association of Vaccine (CAV) and hosted by Vaccinology Education Professional Committee of CAV, and School of Public Health (Shenzhen), Sun Yat-sen University. Other partners included the Medical Virology Branch of the Chinese Medical Association, the editorial committee of the Chinese Journal of Preventive Medicine, Human Vaccines & Immunotherapeutics, and the People's Medical Publishing House. The 1st conference was held in Hangzhou, in October 2020.
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Affiliation(s)
- Yingqi Chen
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuelong Shu
- National Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Zheng
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Caijun Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Chuanxi Fu
- Institute of Infectious Disease and Vaccine, School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
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Elgamal R. Meta-analysis: eHealth literacy and attitudes towards internet/computer technology. PATIENT EDUCATION AND COUNSELING 2024; 123:108196. [PMID: 38364573 DOI: 10.1016/j.pec.2024.108196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To explore the relationship between eHealth literacy and attitudes towards internet/computer (I/C) technology use in healthcare. METHODS Analysis of data from 16 cross-sectional studies, involving literature search from databases like PubMed, EBSCO, JMIR, up to April 2023. Studies were selected based on a quantitative cross-sectional design, with no restrictions on participant characteristics. RESULTS A significant positive correlation (0.36; 95% CI 0.37-0.38, p < 0.05) was found between eHealth literacy and positive attitudes towards I/C technology use. Age and regional differences, especially in participants over 50 and from Asian and Middle Eastern countries, were notable. CONCLUSION Lower eHealth literacy is associated with more negative attitudes towards I/C technology in healthcare. This trend is consistent across diverse demographics and regions.
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Affiliation(s)
- Raghad Elgamal
- DeGroote School of Business, McMaster University, Hamilton, Ontario, Canada.
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Comer L, Donelle L, Hiebert B, Smith MJ, Kothari A, Stranges S, Gilliland J, Long J, Burkell J, Shelley JJ, Hall J, Shelley J, Cooke T, Ngole Dione M, Facca D. Short- and Long-Term Predicted and Witnessed Consequences of Digital Surveillance During the COVID-19 Pandemic: Scoping Review. JMIR Public Health Surveill 2024; 10:e47154. [PMID: 38788212 PMCID: PMC11129783 DOI: 10.2196/47154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/23/2023] [Accepted: 03/20/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has prompted the deployment of digital technologies for public health surveillance globally. The rapid development and use of these technologies have curtailed opportunities to fully consider their potential impacts (eg, for human rights, civil liberties, privacy, and marginalization of vulnerable groups). OBJECTIVE We conducted a scoping review of peer-reviewed and gray literature to identify the types and applications of digital technologies used for surveillance during the COVID-19 pandemic and the predicted and witnessed consequences of digital surveillance. METHODS Our methodology was informed by the 5-stage methodological framework to guide scoping reviews: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the findings. We conducted a search of peer-reviewed and gray literature published between December 1, 2019, and December 31, 2020. We focused on the first year of the pandemic to provide a snapshot of the questions, concerns, findings, and discussions emerging from peer-reviewed and gray literature during this pivotal first year of the pandemic. Our review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines. RESULTS We reviewed a total of 147 peer-reviewed and 79 gray literature publications. Based on our analysis of these publications, we identified a total of 90 countries and regions where digital technologies were used for public health surveillance during the COVID-19 pandemic. Some of the most frequently used technologies included mobile phone apps, location-tracking technologies, drones, temperature-scanning technologies, and wearable devices. We also found that the literature raised concerns regarding the implications of digital surveillance in relation to data security and privacy, function creep and mission creep, private sector involvement in surveillance, human rights, civil liberties, and impacts on marginalized groups. Finally, we identified recommendations for ethical digital technology design and use, including proportionality, transparency, purpose limitation, protecting privacy and security, and accountability. CONCLUSIONS A wide range of digital technologies was used worldwide to support public health surveillance during the COVID-19 pandemic. The findings of our analysis highlight the importance of considering short- and long-term consequences of digital surveillance not only during the COVID-19 pandemic but also for future public health crises. These findings also demonstrate the ways in which digital surveillance has rendered visible the shifting and blurred boundaries between public health surveillance and other forms of surveillance, particularly given the ubiquitous nature of digital surveillance. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-https://doi.org/10.1136/bmjopen-2021-053962.
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Affiliation(s)
- Leigha Comer
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
- School of Nursing, University of South Carolina, Columbia, SC, United States
| | - Bradley Hiebert
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Maxwell J Smith
- School of Health Studies, Western University, London, ON, Canada
| | - Anita Kothari
- School of Health Studies, Western University, London, ON, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Departments of Family Medicine and Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- The Africa Institute, Western University, London, ON, Canada
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Jason Gilliland
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Jed Long
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Jacquelyn Burkell
- Faculty of Information and Media Studies, Western University, London, ON, Canada
| | | | - Jodi Hall
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - James Shelley
- Faculty of Health Sciences, Western University, London, ON, Canada
| | - Tommy Cooke
- Surveillance Studies Centre, Queen's University, Kingston, ON, Canada
| | | | - Danica Facca
- Faculty of Information and Media Studies, Western University, London, ON, Canada
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Alhammad N, Alajlani M, Abd-Alrazaq A, Arvanitis T, Epiphaniou G. Patients and Stakeholders' Perspectives Regarding the Privacy, Security, and Confidentiality of Data Collected via Mobile Health Apps in Saudi Arabia: Protocol for a Mixed Method Study. JMIR Res Protoc 2024; 13:e54933. [PMID: 38776540 DOI: 10.2196/54933] [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: 11/28/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND There is data paucity regarding users' awareness of privacy concerns and the resulting impact on the acceptance of mobile health (mHealth) apps, especially in the Saudi context. Such information is pertinent in addressing users' needs in the Kingdom of Saudi Arabia (KSA). OBJECTIVE This article presents a study protocol for a mixed method study to assess the perspectives of patients and stakeholders regarding the privacy, security, and confidentiality of data collected via mHealth apps in the KSA and the factors affecting the adoption of mHealth apps. METHODS A mixed method study design will be used. In the quantitative phase, patients and end users of mHealth apps will be randomly recruited from various provinces in Saudi Arabia with a high population of mHealth users. The research instrument will be developed based on the emerging themes and findings from the interview conducted among stakeholders, app developers, health care professionals, and users of mHealth apps (n=25). The survey will focus on (1) how to improve patients' awareness of data security, privacy, and confidentiality; (2) feedback on the current mHealth apps in terms of data security, privacy, and confidentiality; and (3) the features that might improve data security, privacy, and confidentiality of mHealth apps. Meanwhile, specific sections of the questionnaire will focus on patients' awareness, privacy concerns, confidentiality concerns, security concerns, perceived usefulness, perceived ease of use, and behavioral intention. Qualitative data will be analyzed thematically using NVivo version 12. Descriptive statistics, regression analysis, and structural equation modeling will be performed using SPSS and partial least squares structural equation modeling. RESULTS The ethical approval for this research has been obtained from the Biomedical and Scientific Research Ethics Committee, University of Warwick, and the Medical Research and Ethics Committee Ministry of Health in the KSA. The qualitative phase is ongoing and 15 participants have been interviewed. The interviews for the remaining 10 participants will be completed by November 25, 2023. Preliminary thematic analysis is still ongoing. Meanwhile, the quantitative phase will commence by December 10, 2023, with 150 participants providing signed and informed consent to participate in the study. CONCLUSIONS The mixed methods study will elucidate the antecedents of patients' awareness and concerns regarding the privacy, security, and confidentiality of data collected via mHealth apps in the KSA. Furthermore, pertinent findings on the perspectives of stakeholders and health care professionals toward the aforementioned issues will be gleaned. The results will assist policy makers in developing strategies to improve Saudi users'/patients' adoption of mHealth apps and addressing the concerns raised to benefit significantly from these advanced health care modalities. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54933.
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Affiliation(s)
- Nasser Alhammad
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
- Health Informatics, Saudi Electronic University, Jeddah, Saudi Arabia
| | - Mohannad Alajlani
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine, Doha, Qatar
| | | | - Gregory Epiphaniou
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, United Kingdom
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Walldorf JA, Chiu De Vazquez C, Barbosa De Lima AC, Struminger B, Groom A, Burke L, Mayigane LN, Chang Blanc D, Vedrasco L. Sharing lessons learned from COVID-19 vaccine introductions: a global community forum for countries. Front Public Health 2024; 12:1376113. [PMID: 38807989 PMCID: PMC11130350 DOI: 10.3389/fpubh.2024.1376113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/04/2024] [Indexed: 05/30/2024] Open
Abstract
To optimize the efficient introduction and deployment of COVID-19 vaccines across the globe during the COVID-19 pandemic, in April 2021 WHO launched a new process and tools for countries to rapidly review the early phase of countries' COVID-19 vaccine introduction. This methodology is called the COVID-19 vaccination intra-action review, also known as mini COVID-19 vaccine post-introduction evaluation (mini-cPIE). As of November 2022, 46 mini-cPIEs had been conducted. In collaboration with Project ECHO, WHO convened and facilitated real-time experience sharing and peer-learning among countries following their mini-cPIEs through a virtual global real-time learning forum. This five-session clinic series was attended by 736 participants from 129 countries. Based on post-session feedback surveys, when asked about the utility of the sessions, half of the participants said that sessions led them to review national guidelines and protocols or make other changes to their health systems. The post-series survey sent following the end of the clinic series showed that at least eight countries subsequently conducted a mini-cPIE after participating in the clinics, and participants from at least nine countries indicated the experience shared by peer countries on the clinic largely benefited their COVID-19 vaccine introduction and deployment. In this article, we highlight the benefits and importance of creating a global experience-sharing forum for countries to connect and share pertinent learnings in real-time during an international public health emergency. Moving forward, it is critical to foster a culture of individual and collective learning within and between countries during public health emergencies, with WHO playing an important convening role.
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Affiliation(s)
- Jenny Anne Walldorf
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Cindy Chiu De Vazquez
- Department of Health Security Preparedness, World Health Organization, Geneva, Switzerland
| | | | - Bruce Struminger
- ECHO Institute, University of New Mexico, Albuquerque, NM, United States
| | - Amy Groom
- ECHO Institute, University of New Mexico, Albuquerque, NM, United States
| | - Lauren Burke
- ECHO Institute, University of New Mexico, Albuquerque, NM, United States
| | - Landry Ndriko Mayigane
- Department of Health Security Preparedness, World Health Organization, Geneva, Switzerland
| | - Diana Chang Blanc
- Department of Immunization, Vaccines, and Biologicals, World Health Organization, Geneva, Switzerland
| | - Liviu Vedrasco
- Department of Health Security Preparedness, World Health Organization, Geneva, Switzerland
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O'Connor S, Cave L, Philips N. Informing nursing policy: An exploration of digital health research by nurses in England. Int J Med Inform 2024; 185:105381. [PMID: 38402804 DOI: 10.1016/j.ijmedinf.2024.105381] [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: 11/05/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/27/2024]
Abstract
AIMS Digital health technologies are designed, implemented, and evaluated to support clinical practice, enable patients to self-manage illness, and further public and global health. Nursing and health policies often emphasise the importance of evidence-based digital health services to deliver better care. However, the contribution nurses make to digital health research in many countries is unknown. Hence, this study aims to examine digital health research conducted by nurses in England. DESIGN A bibliometric analysis. METHODS The CINAHL, MEDLINE, and Scopus databases were searched between 2000 and 2022, and supplemented with a hand search of nurses' research profiles. Results were screened by title, abstract, and full text against eligibility criteria. Data were extracted and bibliometric analysis used to summarise the findings. RESULTS Mental health nurses produced the most digital health research in England, followed by nurses working in community care, with several disciplines underrepresented or missing. Web/online health services or information was the most researched technology, followed by mobile health and telehealth. Nurses based in the south-east and north-west of England produced the most digital health research, with other regions less well represented. CONCLUSION Nurse leaders should support nurses to conduct more digital health research by providing dedicated time, funding, and professional development opportunities, particularly in under researched clinical areas, technologies, and geographic regions to further evidence-based practice and patient care. More digital nursing data is needed to support nurse led research in areas like artificial intelligence and data science. The findings supported the national Philips Ives Review by identifying areas of digital nursing research that need more investment in England.
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Affiliation(s)
- Siobhan O'Connor
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, United Kingdom.
| | - Louise Cave
- NHS England Transformation Directorate, NHS England, United Kingdom.
| | - Natasha Philips
- School of Health & Society, University of Salford, United Kingdom.
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Pannunzio V, Morales Ornelas HC, Gurung P, van Kooten R, Snelders D, van Os H, Wouters M, Tollenaar R, Atsma D, Kleinsmann M. Patient and Staff Experience of Remote Patient Monitoring-What to Measure and How: Systematic Review. J Med Internet Res 2024; 26:e48463. [PMID: 38648090 DOI: 10.2196/48463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/25/2023] [Accepted: 02/20/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Patient and staff experience is a vital factor to consider in the evaluation of remote patient monitoring (RPM) interventions. However, no comprehensive overview of available RPM patient and staff experience-measuring methods and tools exists. OBJECTIVE This review aimed at obtaining a comprehensive set of experience constructs and corresponding measuring instruments used in contemporary RPM research and at proposing an initial set of guidelines for improving methodological standardization in this domain. METHODS Full-text papers reporting on instances of patient or staff experience measuring in RPM interventions, written in English, and published after January 1, 2011, were considered for eligibility. By "RPM interventions," we referred to interventions including sensor-based patient monitoring used for clinical decision-making; papers reporting on other kinds of interventions were therefore excluded. Papers describing primary care interventions, involving participants under 18 years of age, or focusing on attitudes or technologies rather than specific interventions were also excluded. We searched 2 electronic databases, Medline (PubMed) and EMBASE, on February 12, 2021.We explored and structured the obtained corpus of data through correspondence analysis, a multivariate statistical technique. RESULTS In total, 158 papers were included, covering RPM interventions in a variety of domains. From these studies, we reported 546 experience-measuring instances in RPM, covering the use of 160 unique experience-measuring instruments to measure 120 unique experience constructs. We found that the research landscape has seen a sizeable growth in the past decade, that it is affected by a relative lack of focus on the experience of staff, and that the overall corpus of collected experience measures can be organized in 4 main categories (service system related, care related, usage and adherence related, and health outcome related). In the light of the collected findings, we provided a set of 6 actionable recommendations to RPM patient and staff experience evaluators, in terms of both what to measure and how to measure it. Overall, we suggested that RPM researchers and practitioners include experience measuring as part of integrated, interdisciplinary data strategies for continuous RPM evaluation. CONCLUSIONS At present, there is a lack of consensus and standardization in the methods used to measure patient and staff experience in RPM, leading to a critical knowledge gap in our understanding of the impact of RPM interventions. This review offers targeted support for RPM experience evaluators by providing a structured, comprehensive overview of contemporary patient and staff experience measures and a set of practical guidelines for improving research quality and standardization in this domain.
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Affiliation(s)
- Valeria Pannunzio
- Department of Design, Organisation and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Hosana Cristina Morales Ornelas
- Department of Sustainable Design Engineering, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Pema Gurung
- Walaeus Library, Leiden University Medical Center, Leiden, Netherlands
| | - Robert van Kooten
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Dirk Snelders
- Department of Design, Organisation and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Hendrikus van Os
- National eHealth Living Lab, Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Michel Wouters
- Department of Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, Netherlands
| | - Rob Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, Netherlands
| | - Douwe Atsma
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Maaike Kleinsmann
- Department of Design, Organisation and Strategy, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
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Mbwayo AW, Mathai M, Mutavi T, Waruinge S, Triplett N, Concepcion T, Collins PY, Dorsey S. Training community health volunteers to use mobile platform during the COVID-19 pandemic: The Kenya experience. Glob Ment Health (Camb) 2024; 11:e38. [PMID: 38618483 PMCID: PMC11016365 DOI: 10.1017/gmh.2024.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/16/2024] Open
Abstract
This study describes an alternative to face-to-face training method for community health volunteers (CHVs) as used by a collaborative group from the University of Nairobi, University of Washington and the Nairobi Metropolitan Mental Health Team during the COVID-19 lockdown in Kenya. This qualitative study describes the experiences of 17 CHVs enrolled in a training study, required to utilize different digital platforms (Google Meet or Jitsi) as a training forum for the first time. Verbatim extracts of the participants' daily experiences are extracted from a series of write-ups in the group WhatsApp just before the training. Daily failures and success experiences in joining a Google meet or Jitsi are recorded. Then, 17 participants, 10 women and 7 men, aged between 21 and 51 years (mean = 33), owning a smartphone, were enrolled in the study. None had used Jitsi or Google meet before. Different challenges were reported in login to either and a final decision to use Jitsi, which became the training platform. Training CHVs to deliver a psychosocial intervention using smartphones is possible. However, the trainer must establish appropriate and affordable methods when resources are constrained.
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Affiliation(s)
- Anne W. Mbwayo
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Muthoni Mathai
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Teresia Mutavi
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
| | - Stella Waruinge
- Department of Public Mental Health, University of Cape Town, Cape Town, South Africa
| | - Noah Triplett
- Department of Psychology, Department of Global Health, University of Washington, Seattle, USA
| | - Tessa Concepcion
- Department of Psychology, Department of Global Health, University of Washington, Seattle, USA
| | - Pamela Y. Collins
- Department of Mental Health, Johns Hopkins University, Baltimore, USA
| | - Shannon Dorsey
- Department of Psychology, Department of Global Health, University of Washington, Seattle, USA
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Jabin MSR. Operational disruption in healthcare associated with software functionality issue due to software security patching: a case report. Front Digit Health 2024; 6. [DOI: 10.3389/fdgth.2024.1367431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Despite many benefits, the extensive deployment of Health Information Technology (HIT) systems by healthcare organizations has encountered many challenges, particularly in the field of telemetry concerning patient monitoring and its operational workflow. These challenges can add more layers of complexity when an unplanned software security patching is performed, affecting patient monitoring and causing disruption in daily clinical operations. This study is a reflection on what happened associated with software security patching and why it happened through the lens of an incident report to develop potential preventive and corrective strategies using qualitative analyses—inductive and deductive approaches. There is a need for such analyses to identify the underlying mechanism behind such issues since very limited research has been conducted on the study of software patching. The incident was classified as a “software functionality” issue, and the consequence was an “incident with a noticeable consequence but no patient harm”, and the contributing factor was a software update, i.e., software security patching. This report describes how insufficient planning of software patching, lack of training for healthcare professionals, contingency planning on unplanned system disruption, and HIT system configuration can compromise healthcare quality and cause risks to patient safety. We propose 15 preventive and corrective strategies grouped under four key areas based on the system approach and social-technical aspects of the patching process. The key areas are (i) preparing, developing, and deploying patches; (ii) training the frontline operators; (iii) ensuring contingency planning; and (iv) establishing configuration and communication between systems. These strategies are expected to minimize the risk of HIT-related incidents, enhance software security patch management in healthcare organizations, and improve patient safety. However, further discussion should be continued about general HIT problems connected to software security patching.
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Deiner MS, Deiner NA, Hristidis V, McLeod SD, Doan T, Lietman TM, Porco TC. Use of Large Language Models to Assess the Likelihood of Epidemics From the Content of Tweets: Infodemiology Study. J Med Internet Res 2024; 26:e49139. [PMID: 38427404 PMCID: PMC10943433 DOI: 10.2196/49139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/20/2023] [Accepted: 01/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Previous work suggests that Google searches could be useful in identifying conjunctivitis epidemics. Content-based assessment of social media content may provide additional value in serving as early indicators of conjunctivitis and other systemic infectious diseases. OBJECTIVE We investigated whether large language models, specifically GPT-3.5 and GPT-4 (OpenAI), can provide probabilistic assessments of whether social media posts about conjunctivitis could indicate a regional outbreak. METHODS A total of 12,194 conjunctivitis-related tweets were obtained using a targeted Boolean search in multiple languages from India, Guam (United States), Martinique (France), the Philippines, American Samoa (United States), Fiji, Costa Rica, Haiti, and the Bahamas, covering the time frame from January 1, 2012, to March 13, 2023. By providing these tweets via prompts to GPT-3.5 and GPT-4, we obtained probabilistic assessments that were validated by 2 human raters. We then calculated Pearson correlations of these time series with tweet volume and the occurrence of known outbreaks in these 9 locations, with time series bootstrap used to compute CIs. RESULTS Probabilistic assessments derived from GPT-3.5 showed correlations of 0.60 (95% CI 0.47-0.70) and 0.53 (95% CI 0.40-0.65) with the 2 human raters, with higher results for GPT-4. The weekly averages of GPT-3.5 probabilities showed substantial correlations with weekly tweet volume for 44% (4/9) of the countries, with correlations ranging from 0.10 (95% CI 0.0-0.29) to 0.53 (95% CI 0.39-0.89), with larger correlations for GPT-4. More modest correlations were found for correlation with known epidemics, with substantial correlation only in American Samoa (0.40, 95% CI 0.16-0.81). CONCLUSIONS These findings suggest that GPT prompting can efficiently assess the content of social media posts and indicate possible disease outbreaks to a degree of accuracy comparable to that of humans. Furthermore, we found that automated content analysis of tweets is related to tweet volume for conjunctivitis-related posts in some locations and to the occurrence of actual epidemics. Future work may improve the sensitivity and specificity of these methods for disease outbreak detection.
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Affiliation(s)
- Michael S Deiner
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
| | - Natalie A Deiner
- College of Letters and Science, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Vagelis Hristidis
- Department of Computer Science and Engineering, University of California, Riverside, Riverside, CA, United States
| | - Stephen D McLeod
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- American Academy of Ophthalmology, San Francisco, CA, United States
| | - Thuy Doan
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Thomas M Lietman
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Travis C Porco
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
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Acharya A, Black RC, Smithies A, Darzi A. Evaluating the Impact of the National Health Service Digital Academy on Participants' Perceptions of Their Identity as Leaders of Digital Health Change: Mixed Methods Study. JMIR MEDICAL EDUCATION 2024; 10:e46740. [PMID: 38381477 PMCID: PMC10918534 DOI: 10.2196/46740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 10/14/2023] [Accepted: 01/31/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND The key to the digital leveling-up strategy of the National Health Service is the development of a digitally proficient leadership. The National Health Service Digital Academy (NHSDA) Digital Health Leadership program was designed to support emerging digital leaders to acquire the necessary skills to facilitate transformation. This study examined the influence of the program on professional identity formation as a means of creating a more proficient digital health leadership. OBJECTIVE This study aims to examine the impact of the NHSDA program on participants' perceptions of themselves as digital health leaders. METHODS We recruited 41 participants from 2 cohorts of the 2-year NHSDA program in this mixed methods study, all of whom had completed it >6 months before the study. The participants were initially invited to complete a web-based scoping questionnaire. This involved both quantitative and qualitative responses to prompts. Frequencies of responses were aggregated, while free-text comments from the questionnaire were analyzed inductively. The content of the 30 highest-scoring dissertations was also reviewed by 2 independent authors. A total of 14 semistructured interviews were then conducted with a subset of the cohort. These focused on individuals' perceptions of digital leadership and the influence of the course on the attainment of skills. In total, 3 in-depth focus groups were then conducted with participants to examine shared perceptions of professional identity as digital health leaders. The transcripts from the interviews and focus groups were aligned with a previously published examination of leadership as a framework. RESULTS Of the 41 participants, 42% (17/41) were in clinical roles, 34% (14/41) were in program delivery or management roles, 20% (8/41) were in data science roles, and 5% (2/41) were in "other" roles. Interviews and focus groups highlighted that the course influenced 8 domains of professional identity: commitment to the profession, critical thinking, goal orientation, mentoring, perception of the profession, socialization, reflection, and self-efficacy. The dissertation of the practice model, in which candidates undertake digital projects within their organizations supported by faculty, largely impacted metacognitive skill acquisition and goal orientation. However, the program also affected participants' values and direction within the wider digital health community. According to the questionnaire, after graduation, 59% (24/41) of the participants changed roles in search of more prominence within digital leadership, with 46% (11/24) reporting that the course was a strong determinant of this change. CONCLUSIONS A digital leadership course aimed at providing attendees with the necessary attributes to guide transformation can have a significant impact on professional identity formation. This can create a sense of belonging to a wider health leadership structure and facilitate the attainment of organizational and national digital targets. This effect is diminished by a lack of locoregional support for professional development.
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Affiliation(s)
- Amish Acharya
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Ruth Claire Black
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Alisdair Smithies
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
| | - Ara Darzi
- Institute of Global Health Innovation, Imperial College London, London, United Kingdom
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Liang F, Yang X, Peng W, Zhen S, Cao W, Li Q, Xiao Z, Gong M, Wang Y, Gu D. Applications of digital health approaches for cardiometabolic diseases prevention and management in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100817. [PMID: 38456090 PMCID: PMC10920052 DOI: 10.1016/j.lanwpc.2023.100817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/04/2023] [Accepted: 05/23/2023] [Indexed: 03/09/2024]
Abstract
Cardiometabolic diseases (CMDs) are the major types of non-communicable diseases, contributing to huge disease burdens in the Western Pacific region (WPR). The use of digital health (dHealth) technologies, such as wearable gadgets, mobile apps, and artificial intelligence (AI), facilitates interventions for CMDs prevention and treatment. Currently, most studies on dHealth and CMDs in WPR were conducted in a few high- and middle-income countries like Australia, China, Japan, the Republic of Korea, and New Zealand. Evidence indicated that dHealth services promoted early prevention by behavior interventions, and AI-based innovation brought automated diagnosis and clinical decision-support. dHealth brought facilitators for the doctor-patient interplay in the effectiveness, experience, and communication skills during healthcare services, with rapidly development during the pandemic of coronavirus disease 2019. In the future, the improvement of dHealth services in WPR needs to gain more policy support, enhance technology innovation and privacy protection, and perform cost-effectiveness research.
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Affiliation(s)
- Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Xueli Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, 22 Qixiangtai Rd, Tianjin 300070, People's Republic of China
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, 22 Qixiangtai Rd, Tianjin 300070, People's Republic of China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, 251 Ningda Road, Xining City 810016, People's Republic of China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, Xining 810008, People's Republic of China
| | - Shihan Zhen
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Wenzhe Cao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Qian Li
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Zhiyi Xiao
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
| | - Mengchun Gong
- Institute of Health Management, Southern Medical University, No. 1023-1063, Shatai South Road, Guangzhou 510515, People's Republic of China
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, International Obesity and Metabolic Disease Research Center, Xi'an Jiaotong University, Xi'an 710061, People's Republic of China
| | - Dongfeng Gu
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
- School of Medicine, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen 518055, People's Republic of China
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Gebler R, Lehmann M, Löwe M, Gruhl M, Wolfien M, Goldammer M, Bathelt F, Karschau J, Hasselberg A, Bierbaum V, Lange T, Polotzek K, Held HC, Albrecht M, Schmitt J, Sedlmayr M. Supporting regional pandemic management by enabling self-service reporting-A case report. PLoS One 2024; 19:e0297039. [PMID: 38295046 PMCID: PMC10829976 DOI: 10.1371/journal.pone.0297039] [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: 07/31/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic revealed a need for better collaboration among research, care, and management in Germany as well as globally. Initially, there was a high demand for broad data collection across Germany, but as the pandemic evolved, localized data became increasingly necessary. Customized dashboards and tools were rapidly developed to provide timely and accurate information. In Saxony, the DISPENSE project was created to predict short-term hospital bed capacity demands, and while it was successful, continuous adjustments and the initial monolithic system architecture of the application made it difficult to customize and scale. METHODS To analyze the current state of the DISPENSE tool, we conducted an in-depth analysis of the data processing steps and identified data flows underlying users' metrics and dashboards. We also conducted a workshop to understand the different views and constraints of specific user groups, and brought together and clustered the information according to content-related service areas to determine functionality-related service groups. Based on this analysis, we developed a concept for the system architecture, modularized the main services by assigning specialized applications and integrated them into the existing system, allowing for self-service reporting and evaluation of the expert groups' needs. RESULTS We analyzed the applications' dataflow and identified specific user groups. The functionalities of the monolithic application were divided into specific service groups for data processing, data storage, predictions, content visualization, and user management. After composition and implementation, we evaluated the new system architecture against the initial requirements by enabling self-service reporting to the users. DISCUSSION By modularizing the monolithic application and creating a more flexible system, the challenges of rapidly changing requirements, growing need for information, and high administrative efforts were addressed. CONCLUSION We demonstrated an improved adaptation towards the needs of various user groups, increased efficiency, and reduced burden on administrators, while also enabling self-service functionalities and specialization of single applications on individual service groups.
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Affiliation(s)
- Richard Gebler
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Martin Lehmann
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Maik Löwe
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Mirko Gruhl
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Markus Wolfien
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Miriam Goldammer
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Franziska Bathelt
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
- Thiem-Research GmbH at Carl-Thiem-Clinic, Cottbus, Germany
| | - Jens Karschau
- Center for Evidence-Based Healthcare, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Andreas Hasselberg
- Center for Evidence-Based Healthcare, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Veronika Bierbaum
- Center for Evidence-Based Healthcare, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Toni Lange
- Center for Evidence-Based Healthcare, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Katja Polotzek
- Center for Evidence-Based Healthcare, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Hanns-Christoph Held
- Clinic and Polyclinic for Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | | | - Jochen Schmitt
- Center for Evidence-Based Healthcare, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, University Hospital Carl Gustav Carus Dresden, Dresden, Germany
| | - Martin Sedlmayr
- Institute for Medical Informatics and Biometry, University Hospital Dresden and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Su JJ, Bayuo J, Lin RS, Batalik L, Chen X, Abu-Odah H, Chan EA. Providing compassionate care via eHealth. Nurs Ethics 2024:9697330231196226. [PMID: 38243793 DOI: 10.1177/09697330231196226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
BACKGROUND eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. PURPOSE to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the COVID-19 pandemic. METHODS A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. ETHICAL CONSIDERATIONS Permission to conduct the study was obtained from the Institutional Review Board. RESULTS Participants stated that "eHealth enabled compassionate care during the pandemic" by ensuring patient care availability and accessibility. They shared experiences of "communicating compassionate care via eHealth" with suggestions of addressing patients' needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended "setting realistic mutual expectations" considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered "low eHealth literacy hinders compassion." Additionally, they recommended the need for "institutional/system-level support to foster compassionate care." CONCLUSION Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients.
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Affiliation(s)
- Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Rose Sy Lin
- School of Nursing, University of Rochester, NY, USA
| | - Ladislav Batalik
- Department of Rehabilitation, University Hospital Brno, Czech Republic; Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Xi Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Engle Angela Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Garcia CN, Duran MC, Ramirez M. Refining Cultural Adaptations of a Behavioral Intervention for Latino Caregivers of People Living With Dementia: Qualitative Interview Study in Washington State. JMIR Aging 2024; 7:e53671. [PMID: 38206663 PMCID: PMC10811572 DOI: 10.2196/53671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND In the United States, Latino caregivers of individuals with dementia face unique challenges and an elevated risk of adverse health outcomes. Despite the increasing prevalence of Alzheimer disease and related dementias among Latino adults, few evidence-based interventions are tailored to their cultural context. To address this gap, we examined the cultural adaptations required for the STAR caregivers (STAR-C) virtual intervention, an evidence-based intervention that educates family caregivers to manage behavioral and psychological symptoms of dementia. While STAR-C has shown effectiveness, neither the original in-person nor the virtual intervention considered the distinct experiences of Latino caregivers, who often bring culturally significant values into caregiving interactions. OBJECTIVE This study's objective was to test and refine the preliminary cultural adaptations of the STAR-C web-based training modules for Latino caregivers of people living with dementia. METHODS Through qualitative interviews with 15 Latino caregivers in Washington State, we identified key adaptations to enhance the cultural relevance of the web-based training modules. RESULTS The interviews highlighted 4 main themes for adaptation: the delivery of the STAR-C web-based training modules, comprehensive dementia education, simplified problem-solving strategies, and prioritizing caregiver well-being. CONCLUSIONS This study's findings informed the development of culturally adapted STAR-C web-based training modules that aim to provide tailored support to Latino caregivers. While further research is needed to assess the efficacy of these adaptations, our work contributes to bridging the gap in dementia caregiving for Latino families, potentially reducing health disparities and enhancing health care services for this population.
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Affiliation(s)
- Celeste N Garcia
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Miriana C Duran
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
| | - Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States
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16
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Shih HJ, Xue H, Min H, Wojtusiak J, Chang J. Informing Patient-Provider Engagement for Shared Decision Making Through Mobile Health Applications. Patient Prefer Adherence 2023; 17:3489-3501. [PMID: 38146503 PMCID: PMC10749551 DOI: 10.2147/ppa.s438710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023] Open
Abstract
Objective The study utilized a cross-sectional dataset to identify demographic and health factors associated with patient utilization of mHealth applications for engaging with healthcare providers. The focus was on adults with chronic health conditions as the primary app user group. The goal was to reveal specific barriers and facilitators to app adoption among smartphone users, with the aim of highlighting opportunities for upgrades that promote patient empowerment as a prerequisite for shared decision-making (SDM). Methods Data from the Health Information National Trends Survey (HINTS 5, Cycle 4, 2020) with 3865 respondents (≥18 years old) stratified analyses and weighted logistic regression were used. Results The study found that individuals having a wellness app on a smartphone increased the likelihood (OR 2.68, CI: 2.02-3.56, p-value < 0.0001) of discussing health conditions with providers. Furthermore, individuals with multiple chronic health conditions were more likely (OR 1.93, CI 1.26-2.95, p-value < 0.01) to use apps to use mobile health applications to engage with healthcare providers. Other significant variables affecting app usage such as race, marital status, and educational level. Conclusion Due to difficulties obtaining in-person healthcare, the COVID-19 epidemic forced a swift deployment of mHealth technologies. Even in the absence of a crisis, mobile health applications continue to be crucial for improving patient-provider engagement and developing novel approaches to healthcare delivery. During the pandemic, people with numerous chronic diseases used apps to stay in touch with doctors and maintain their reliance on these platforms. Nonetheless, different smartphone users continue to use mHealth application in different ways. The findings revealing barriers in mHealth app adoption among certain patient subgroups suggest opportunities for developers, in collaboration with users and providers, to enhance inclusion and acceptability when upgrading mHealth application platforms.
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Affiliation(s)
- Huan-Ju Shih
- Department of Health and Human Services, George Mason University, Fairfax City, VA, USA
| | - Hong Xue
- Department of Health and Human Services, George Mason University, Fairfax City, VA, USA
| | - Hua Min
- Department of Health and Human Services, George Mason University, Fairfax City, VA, USA
| | - Janusz Wojtusiak
- Department of Health and Human Services, George Mason University, Fairfax City, VA, USA
| | - Jongwha Chang
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, College Station, TX, USA
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Santos FSD, Braga LDCA, Santos RVPDS, Santana MKTSD, Pereira GS, Muniz VDO, Almeida ÉS, Sousa ARD. "Fala-M@no-COVID-19": technological development of a health navigation program for men during the pandemic. Rev Bras Enferm 2023; 76:e20220534. [PMID: 38055470 DOI: 10.1590/0034-7167-2022-0534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 07/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE to develop a care-educational technology similar to a health navigation program for men during the COVID-19 pandemic. METHODS a methodological and qualitative study of a care-educational technology of health navigation program, structured by Program Development Cycle, with 16 patient navigators and 10 professional navigators. It used reflective thematic content analysis and an adaptation model for data processing. RESULTS the "Fala-M@ano-COVID-19"; navigation program was developed by: I) Observation of reality, problem mapping, needs assessment: content selection, creation of domains and questions; II) Theoretical-conceptual and methodological definition, creation of product under the elaboration of care plans, based on theory, process and taxonomies by a flowchart of operationalization of actions; and III) Self-assessment: qualitative research with professional navigators. FINAL CONSIDERATIONS the technology developed, with theoretical and methodological support, allowed to derive a viable navigation program compatible with reality based on the audience's needs.
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Antonacci G, Benevento E, Bonavitacola S, Cannavacciuolo L, Foglia E, Fusi G, Garagiola E, Ponsiglione C, Stefanini A. Healthcare professional and manager perceptions on drivers, benefits, and challenges of telemedicine: results from a cross-sectional survey in the Italian NHS. BMC Health Serv Res 2023; 23:1115. [PMID: 37853448 PMCID: PMC10585875 DOI: 10.1186/s12913-023-10100-x] [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: 11/29/2022] [Accepted: 10/01/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The Covid-19 pandemic provided new challenges and opportunities for patients and healthcare providers while accelerating the trend of digital healthcare transformation. This study explores the perspectives of healthcare professionals and managers on (i) drivers to the implementation of telemedicine services and (ii) perceived benefits and challenges related to the use of telemedicine across the Italian National Health Service. METHODS An online cross-sectional survey was distributed to professionals working within 308 healthcare organisations in different Italian regions. Quantitative and qualitative data were collected through a self-administered questionnaire (June-September 2021). Responses were analysed using summary statistics and thematic analysis. RESULTS Key factors driving the adoption of telemedicine have been grouped into (i) organisational drivers (reduce the virus spread-80%; enhance care quality and efficiency-61%), (ii) technological drivers (ease of use-82%; efficacy and reliability-64%; compliance with data governance regulations-64%) and (iii) regulatory drivers (regulations' semplification-84%). Nearly all respondents perceive telemedicine as useful in improving patient care (96%). The main benefits reported by respondents are shorter waiting lists, reduced Emergency Department attendance, decreased patient and clinician travel, and more frequent patient-doctor interactions. However, only 7% of respondents believe that telemedicine services are more effective than traditional care and 66% of the healthcare professionals believe that telemedicine can't completely substitute in-person visits due to challenges with physical examination and patient-doctor relationships. Other reported challenges include poor quality and interoperability of telemedicine platforms and scarce integration of telemedicine with traditional care services. Moreover, healthcare professionals believe that some groups of patients experience difficulties in accessing and using the technologies due to socio-cultural factors, technological and linguistic challenges and the absence of caregivers. CONCLUSIONS Respondents believe that telemedicine can be useful to complement and augment traditional care. However, many challenges still need to be overcome to fully consider telemedicine a standard of care. Strategies that could help address these challenges include additional regulations on data governance and reimbursements, evidence-based guidelines for the use of telemedicine, greater integration of tools and processes, patient-centred training for clinicians, patient-facing material to assist patients in navigating virtual sessions, different language options, and greater involvement of caregivers in the care process.
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Affiliation(s)
- Grazia Antonacci
- Department of Primary Care and Public Health, Imperial College London, National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) Northwest London, London, UK.
- Business School, Centre for Health Economics and Policy Innovation (CHEPI), Imperial College London, London, UK.
| | - Elisabetta Benevento
- Department of Energy, Systems, Territory and Construction Engineering, University of Pisa, Pisa, Italy
| | | | | | - Emanuela Foglia
- Healthcare Datascience LAB, LIUC- Carlo Cattaneo University, Castellanza, VA, Italy
| | - Giulia Fusi
- LIUC- Cattaneo University, Castellanza, VA, Italy
| | - Elisabetta Garagiola
- Healthcare Datascience LAB, LIUC- Carlo Cattaneo University, Castellanza, VA, Italy
| | - Cristina Ponsiglione
- Department of Industrial Engineering, University of Naples Federico II, Naples, Italy
| | - Alessandro Stefanini
- Department of Energy, Systems, Territory and Construction Engineering, University of Pisa, Pisa, Italy
- School of Economics and Business, Kaunas University of Technology, Kaunas, Lithuania
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Qiu L, Cheng J, Gao H, Xiong W, Ren H. Federated Semi-Supervised Learning for Medical Image Segmentation via Pseudo-Label Denoising. IEEE J Biomed Health Inform 2023; 27:4672-4683. [PMID: 37155394 DOI: 10.1109/jbhi.2023.3274498] [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: 05/10/2023]
Abstract
Distributed big data and digital healthcare technologies have great potential to promote medical services, but challenges arise when it comes to learning predictive model from diverse and complex e-health datasets. Federated Learning (FL), as a collaborative machine learning technique, aims to address the challenges by learning a joint predictive model across multi-site clients, especially for distributed medical institutions or hospitals. However, most existing FL methods assume that clients possess fully labeled data for training, which is often not the case in e-health datasets due to high labeling costs or expertise requirement. Therefore, this work proposes a novel and feasible approach to learn a Federated Semi-Supervised Learning (FSSL) model from distributed medical image domains, where a federated pseudo-labeling strategy for unlabeled clients is developed based on the embedded knowledge learned from labeled clients. This greatly mitigates the annotation deficiency at unlabeled clients and leads to a cost-effective and efficient medical image analysis tool. We demonstrated the effectiveness of our method by achieving significant improvements compared to the state-of-the-art in both fundus image and prostate MRI segmentation tasks, resulting in the highest Dice scores of 89.23% and 91.95% respectively even with only a few labeled clients participating in model training. This reveals the superiority of our method for practical deployment, ultimately facilitating the wider use of FL in healthcare and leading to better patient outcomes.
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Mumtaz H, Riaz MH, Wajid H, Saqib M, Zeeshan MH, Khan SE, Chauhan YR, Sohail H, Vohra LI. Current challenges and potential solutions to the use of digital health technologies in evidence generation: a narrative review. Front Digit Health 2023; 5:1203945. [PMID: 37840685 PMCID: PMC10568450 DOI: 10.3389/fdgth.2023.1203945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Digital health is a field that aims to improve patient care through the use of technology, such as telemedicine, mobile health, electronic health records, and artificial intelligence. The aim of this review is to examine the challenges and potential solutions for the implementation and evaluation of digital health technologies. Digital tools are used across the world in different settings. In Australia, the Digital Health Translation and Implementation Program (DHTI) emphasizes the importance of involving stakeholders and addressing infrastructure and training issues for healthcare workers. The WHO's Global Task Force on Digital Health for TB aims to address tuberculosis through digital health innovations. Digital tools are also used in mental health care, but their effectiveness must be evaluated during development. Oncology supportive care uses digital tools for cancer patient intervention and surveillance, but evaluating their effectiveness can be challenging. In the COVID and post-COVID era, digital health solutions must be evaluated based on their technological maturity and size of deployment, as well as the quality of data they provide. To safely and effectively use digital healthcare technology, it is essential to prioritize evaluation using complex systems and evidence-based medical frameworks. To address the challenges of digital health implementation, it is important to prioritize ethical research addressing issues of user consent and addressing socioeconomic disparities in access and effectiveness. It is also important to consider the impact of digital health on health outcomes and the cost-effectiveness of service delivery.
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Affiliation(s)
- Hassan Mumtaz
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Muhammad Hamza Riaz
- Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Pakistan
| | - Hanan Wajid
- Department of Internal Medicine, Shalamar Medical & Dental College, Lahore, Pakistan
| | - Muhammad Saqib
- Department of Internal Medicine, Khyber Medical College, Peshawar, Pakistan
| | | | | | | | - Hassan Sohail
- Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan
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Karampatakis GD, Wood HE, Griffiths CJ, Lea NC, Ashcroft RE, Day B, Walker N, Coulson NS, De Simoni A. Ethical and Information Governance Considerations for Promoting Digital Social Interventions in Primary Care. J Med Internet Res 2023; 25:e44886. [PMID: 37756051 PMCID: PMC10568391 DOI: 10.2196/44886] [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: 12/07/2022] [Revised: 04/28/2023] [Accepted: 07/31/2023] [Indexed: 09/28/2023] Open
Abstract
Promoting online peer support beyond the informal sector to statutory health services requires ethical considerations and evidence-based knowledge about its impact on patients, health care professionals, and the wider health care system. Evidence on the effectiveness of digital interventions in primary care is sparse, and definitive guidance is lacking on the ethical concerns arising from the use of social media as a means for health-related interventions and research. Existing literature examining ethical issues with digital interventions in health care mainly focuses on apps, electronic health records, wearables, and telephone or video consultations, without necessarily covering digital social interventions, and does not always account for primary care settings specifically. Here we address the ethical and information governance aspects of undertaking research on the promotion of online peer support to patients by primary care clinicians, related to medical and public health ethics.
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Affiliation(s)
- Georgios Dimitrios Karampatakis
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Helen E Wood
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Chris J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Nathan C Lea
- Department of Medical Informatics & Statistics, The European Institute for Innovation through Health Data, Ghent University Hospital, Ghent, Belgium
| | | | - Bill Day
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil S Coulson
- Medical School, Nottingham City Hospital, Nottingham, United Kingdom
| | - Anna De Simoni
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
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22
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Li Z, Wu X, Xu L, Liu M, Huang C. Hot Topic Recognition of Health Rumors Based on Anti-Rumor Articles on the WeChat Official Account Platform: Topic Modeling. J Med Internet Res 2023; 25:e45019. [PMID: 37733396 PMCID: PMC10557010 DOI: 10.2196/45019] [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: 12/13/2022] [Revised: 07/22/2023] [Accepted: 08/15/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Social networks have become one of the main channels for obtaining health information. However, they have also become a source of health-related misinformation, which seriously threatens the public's physical and mental health. Governance of health-related misinformation can be implemented through topic identification of rumors on social networks. However, little attention has been paid to studying the types and routes of dissemination of health rumors on the internet, especially rumors regarding health-related information in Chinese social media. OBJECTIVE This study aims to explore the types of health-related misinformation favored by WeChat public platform users and their prevalence trends and to analyze the modeling results of the text by using the Latent Dirichlet Allocation model. METHODS We used a web crawler tool to capture health rumor-dispelling articles on WeChat rumor-dispelling public accounts. We collected information from health-debunking articles posted between January 1, 2016, and August 31, 2022. Following word segmentation of the collected text, a document topic generation model called Latent Dirichlet Allocation was used to identify and generalize the most common topics. The proportion distribution of the themes was calculated, and the negative impact of various health rumors in different periods was analyzed. Additionally, the prevalence of health rumors was analyzed by the number of health rumors generated at each time point. RESULTS We collected 9366 rumor-refuting articles from January 1, 2016, to August 31, 2022, from WeChat official accounts. Through topic modeling, we divided the health rumors into 8 topics, that is, rumors on prevention and treatment of infectious diseases (1284/9366, 13.71%), disease therapy and its effects (1037/9366, 11.07%), food safety (1243/9366, 13.27%), cancer and its causes (946/9366, 10.10%), regimen and disease (1540/9366, 16.44%), transmission (914/9366, 9.76%), healthy diet (1068/9366, 11.40%), and nutrition and health (1334/9366, 14.24%). Furthermore, we summarized the 8 topics under 4 themes, that is, public health, disease, diet and health, and spread of rumors. CONCLUSIONS Our study shows that topic modeling can provide analysis and insights into health rumor governance. The rumor development trends showed that most rumors were on public health, disease, and diet and health problems. Governments still need to implement relevant and comprehensive rumor management strategies based on the rumors prevalent in their countries and formulate appropriate policies. Apart from regulating the content disseminated on social media platforms, the national quality of health education should also be improved. Governance of social networks should be clearly implemented, as these rapidly developed platforms come with privacy issues. Both disseminators and receivers of information should ensure a realistic attitude and disseminate health information correctly. In addition, we recommend that sentiment analysis-related studies be conducted to verify the impact of health rumor-related topics.
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Affiliation(s)
- Ziyu Li
- Chongqing Medical University, College of Medical Informatics, Chongqing, China
| | - Xiaoqian Wu
- Chongqing Medical University, College of Medical Informatics, Chongqing, China
- Department of Quality Management, Daping Hospital, Army Medical University (The Third Military Medical University), Chongqing, China
| | - Lin Xu
- Chongqing Medical University, College of Medical Informatics, Chongqing, China
- Department of Quality Management, Xinqiao Hospital, Army Medical University (The Second Military Medical University), Chongqing, China
| | - Ming Liu
- Chongqing Medical University, College of Medical Informatics, Chongqing, China
| | - Cheng Huang
- Chongqing Medical University, College of Medical Informatics, Chongqing, China
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23
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Ramirez M, Duran MC, Penfold RB, Pabiniak CJ, Hansen KE, Ornelas IJ. STAR-Caregivers Virtual Training and Follow-up: a cultural adaptation for Latino caregivers of people with dementia. Transl Behav Med 2023; 13:625-634. [PMID: 37130336 PMCID: PMC10496441 DOI: 10.1093/tbm/ibad028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
STAR-Caregivers Virtual Training and Follow-up (STAR-VTF) is an evidence-based intervention that teaches family caregivers how to manage behavioral and psychological symptoms of dementia. The study objective was to identify what adaptations to STAR-VTF are needed to improve cultural relevance for Latino caregivers. A qualitative research study was conducted that interviewed Spanish- and English-speaking caregivers of people with dementia who self-identify as Hispanic/Latino (N = 30) and healthcare and social service providers of older Latino clients and/or Latino family caregivers (N = 14). Thematic analysis methods were applied to code and analyze interview transcripts. The codebook was theory-driven, relying mainly on codes that directly represented components of the Cultural Treatment Adaptation Framework. Based on the content of the excerpts, the codes were sorted into themes that represented opportunities to culturally adapt STAR-VTF. Three themes were identified: (i) there was a need to increase awareness about dementia and decrease stigma; (ii) semantics mattered as certain words and phrases could be stigmatizing, offensive, or culturally inappropriate; and (iii) there was a need to incorporate into program materials the traditional family structure and nature of caregiving in Latino families. Based on findings, adaptations were performed on STAR-VTF that included expanding content to improve understanding of dementia, revising language that was viewed as problematic, and adding cultural examples to reflect the range of family involvement in caring for people living with dementia and multigenerational living. Findings from this qualitative research study advance understanding of the Latino caregiver experience and how to modify programs to better serve their needs.
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Affiliation(s)
- Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Miriana C Duran
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Robert B Penfold
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Chester J Pabiniak
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Kelly E Hansen
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - India J Ornelas
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
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24
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Alghamdi A, Ramsay AIG, Abrams R, Bailey JV. The impact of COVID-19 on patient engagement with primary healthcare: lessons from the saudi primary care setting. BMC PRIMARY CARE 2023; 24:177. [PMID: 37674122 PMCID: PMC10483780 DOI: 10.1186/s12875-023-02131-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND There have been significant achievements in controlling COVID-19 in Saudi Arabia (SA), but as in most healthcare settings worldwide, health services have been seriously disrupted. Also, with pandemic control measures such as lockdowns and curfews, and innovations such as digital health services, the delivery of primary healthcare (PHC) services has dramatically changed. However, little is known about patients' experiences of PHCs during the pandemic, their views on the pandemic-related interventions in SA, and patient views on impact on their medical care. METHODS Qualitative semi-structured online interviews were conducted for twenty-four Saudi patients across SA aged 18 and above who were diverse in terms of age, gender, education and health status. Data were analysed using thematic analysis yielding four major themes as an impact of COVID-19 on patient engagement with PHCs. RESULTS The COVID-19 pandemic has had profound mixed impacts on patient engagement with PHC in SA. Fear of infection or of breaking lockdown rules has negatively impacted the utilisation of PHCs but positively changed patients' attitudes towards seeking medical help for self-limiting conditions. The pandemic has also negatively impacted routine preventive care at PHCs, especially for patients with long-term health conditions. The mandatory use of some digital health services in SA that existed pre-pandemic has provided patients with a perception of better care during the pandemic. Yet, a lack of awareness of optional digital health services, such as virtual clinics, hindered optimal use. Despite pandemic-related disruption of patient engagement with PHCs, the reduced waiting time in PHC centres and healthcare providers' communication and empathy during the pandemic contributed to patients' perceptions of better care compared to pre-pandemic. However, patients living outside the main cities in SA perceived care quality as less good during the pandemic compared to PHCs in the main cities in SA. CONCLUSION The lessons learned from patients' experiences and views of PHCs during the pandemic were beneficial in promoting patient engagement with PHCs. The digital health services mandated in response to the pandemic have accelerated digital health innovation in SA and allowed patients to recognise the benefits of digital health. This has huge potential for increasing continuous patient engagement with PHCs. Yet, patients' experiences of digital health services during the pandemic are essential for informing appropriate implementation and utilisation of e-health services. Patients' positive experiences of PHCs during the pandemic, such as the reduction in waiting times and the perception of improved healthcare providers' professionalism, communication and empathy, can be built on to sustain engagement with PHC services. These findings might have significance for clinicians and policymakers to support patient engagement with PHCs, particularly in healthcare systems like SA that struggle with the overuse of emergency departments (EDs) for PHC-treatable conditions.
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Affiliation(s)
- Alaa Alghamdi
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK.
- Department of Family and Community Medicine, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Angus I G Ramsay
- Department of Applied Health Research, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Ruth Abrams
- Faculty of Health and Medical Sciences, School of Health Sciences, University of Surrey, Surrey, UK
| | - Julia V Bailey
- Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK
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25
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Choi S, Powers T. Engaging and informing patients: Health information technology use in community health centers. Int J Med Inform 2023; 177:105158. [PMID: 37494783 DOI: 10.1016/j.ijmedinf.2023.105158] [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: 02/27/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE This paper aims to address the relationship between the community health center (CHC) patient mix and the level of patient engagement health information technology (HIT) comprehensiveness. PARTICIPANTS The study was conducted on sample CHCs (n = 3,592 CHC-years) active between 2016 and 2018. METHODS Patient engagement HIT comprehensiveness was measured based on a framework of patient engagement through HIT that includes a two-part dichotomy of patient engagement and patient informing. Univariate analysis was used to describe CHC characteristics and multivariable ordered logistic regression analysis was used to test hypothesized relationships. RESULTS The study identified four levels of patient engagement HIT comprehensiveness: 1) to neither engage nor inform, 2) to primarily inform, 3) to primarily engage, and 4) to engage and inform. It was found that CHCs serving disproportionate shares of patients with disadvantageous socioeconomic characteristics are less likely to incorporate more comprehensive patient engagement HIT. CONCLUSION The results highlight the different levels of patient engagement HIT use among CHCs and a negative association between CHC's higher proportion of patients with a disadvantageous sociodemographic background and patient engagement HIT comprehensiveness.
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Affiliation(s)
- Seongwon Choi
- Department of Management, California State University Los Angeles, College of Business and Economics, 5154 University Dr, Los Angeles, CA 90032, USA.
| | - Thomas Powers
- Department of Marketing, Industrial Distribution and Economics, University of Alabama at Birmingham, Collat School of Business, 710 13th St S, Birmingham, AL 35294, USA
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26
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Melo LCDN, Silva BMD, Nitschke RG, Viegas SMDF. Virtual social networks and health technologies in the daily life of clients and households: care and health promotion. CIENCIA & SAUDE COLETIVA 2023; 28:2193-2202. [PMID: 37531528 DOI: 10.1590/1413-81232023288.05252023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 03/28/2023] [Indexed: 08/04/2023] Open
Abstract
This study aimed to understand the use of technosociality in the daily lives of the Family Health Strategy clients during the COVID-19 pandemic for care and health promotion. This holistic, qualitative, multiple case study based on the Comprehensive Everyday Life Sociology was conducted with 61 clients from three Brazilian municipalities, two in Minas Gerais and one in Santa Catarina. The sources of evidence were the open-ended individual interview and field notes. We adopted thematic content analysis to analyze data. The use of virtual social networks and health technologies for care, monitoring, prevention of risks and conditions, health promotion, and access to information is found in clients' daily lives. We highlight the importance of support and solidarity networks. The infodemic and misinformation about COVID-19 denote uncertainty about the veracity of information and concern about mental health. We should pay close attention to using technologies and social networks for health promotion, enabling strategies to enhance their use and minimize the indicated harms.
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Affiliation(s)
- Leila Cristine do Nascimento Melo
- Universidade Federal de São João del-Rei. R. Sebastião Gonçalves Coelho 400, Campus Centro-Oeste, Bairro Chanadour. 35501-296 Divinópolis MG Brasil.
| | - Bruna Moreira da Silva
- Universidade Federal de São João del-Rei. R. Sebastião Gonçalves Coelho 400, Campus Centro-Oeste, Bairro Chanadour. 35501-296 Divinópolis MG Brasil.
| | | | - Selma Maria da Fonseca Viegas
- Universidade Federal de São João del-Rei. R. Sebastião Gonçalves Coelho 400, Campus Centro-Oeste, Bairro Chanadour. 35501-296 Divinópolis MG Brasil.
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27
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Wang F, Liu L, Xue Y, Dan S, An XJ. [Multisystemic inflammatory syndrome in children after severe acute respiratory syndrome coronavirus 2 infection: a clinical analysis of four cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:685-688. [PMID: 37529949 PMCID: PMC10414176 DOI: 10.7499/j.issn.1008-8830.2302126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/10/2023] [Indexed: 08/03/2023]
Abstract
OBJECTIVES To investigate the clinical features and treatment strategies of multisystemic inflammatory syndrome in children (MIS-C) after severe acute respiratory syndrome coronavirus 2 infection. METHODS A retrospective analysis was performed on the medical data of four children with MIS-C who were admitted to the Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical Universityfrom January to February 2023. RESULTS All four children had multiple organ involvements and elevated inflammatory markers, with a poor response to standard therapy for Kawasaki disease after admission. Two children were treated with intravenous immunoglobulin therapy pulse therapy twice, and all four children were treated with glucocorticoids. The children had a good prognosis after the treatment. CONCLUSIONS MIS-C often appears within 4-6 weeks or a longer time after severe acute respiratory syndrome coronavirus 2 infection, and anti-inflammatory therapy in addition to the standard treatment regimen for Kawasaki disease can help to achieve a favorable treatment outcome.
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Affiliation(s)
- Fei Wang
- Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Lu Liu
- Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Ying Xue
- Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Shi Dan
- Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
| | - Xin-Jiang An
- Department of Cardiology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, Jiangsu 221006, China
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28
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Ballart X, Ferraioli F, Iruela A. [Administrative burden, motivation and well-being among primary care physicians: comparison of management models]. GACETA SANITARIA 2023; 37:102306. [PMID: 37263124 DOI: 10.1016/j.gaceta.2023.102306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 03/19/2023] [Accepted: 03/21/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To analyze the relationship between administrative burden and intrinsic motivation and between administrative burden and professional well-being among family and community medicine physicians. To analyze the extent to which attention to three basic needs (autonomy, sense of competence and relationship capacity) that one of the main motivation theories identifies as a generator of intrinsic motivation compensates for the negative effect of the administrative burden. To compare management models. METHOD Data from a survey (542 valid questionnaires) carried out through the Catalan Society of Family and Community Medicine are used. Data analysis is based on multiple regression and ANOVA techniques. RESULTS The perception of administrative burden and "red tape" are clearly demotivating and reduce job satisfaction. On the contrary, individual autonomy, networking opportunities between professionals and performance feedback are motivating and feed the perception of professional well-being. The EBA (Association Based Entity) model presents results above the ICS (Catalan Health Institute) and OSI (Integrated Health Organizations) models both in controlling the negative effect of administrative burden and in the management of basic psychological needs. CONCLUSIONS The motivation and professional well-being of primary care physicians would benefit from reforms that limit the administrative burden of some procedures and red tape. At the primary health center level, greater attention to individual autonomy, improving relatedness between professionals and the sense of competence based on better information on individual performance can offset the negative effects of the administrative burden.
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Affiliation(s)
- Xavier Ballart
- Departamento de Ciencia Política, Facultad de Ciencias Políticas y Sociología, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España.
| | - Francisco Ferraioli
- Departamento de Ciencia Política, Facultad de Ciencias Políticas y Sociología, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, España
| | - Antoni Iruela
- CAP Vallcarca, Barcelona, España; Departamento y Facultad de Medicina, Universitat de Vic, Barcelona, España
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29
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Porcu G, Chen YX, Bonaugurio AS, Villa S, Riva L, Messina V, Bagarella G, Maistrello M, Leoni O, Cereda D, Matone F, Gori A, Corrao G. Web-based surveillance of respiratory infection outbreaks: retrospective analysis of Italian COVID-19 epidemic waves using Google Trends. Front Public Health 2023; 11:1141688. [PMID: 37275497 PMCID: PMC10233021 DOI: 10.3389/fpubh.2023.1141688] [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: 01/11/2023] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Large-scale diagnostic testing has been proven insufficient to promptly monitor the spread of the Coronavirus disease 2019. Electronic resources may provide better insight into the early detection of epidemics. We aimed to retrospectively explore whether the Google search volume has been useful in detecting Severe Acute Respiratory Syndrome Coronavirus outbreaks early compared to the swab-based surveillance system. Methods The Google Trends website was used by applying the research to three Italian regions (Lombardy, Marche, and Sicily), covering 16 million Italian citizens. An autoregressive-moving-average model was fitted, and residual charts were plotted to detect outliers in weekly searches of five keywords. Signals that occurred during periods labelled as free from epidemics were used to measure Positive Predictive Values and False Negative Rates in anticipating the epidemic wave occurrence. Results Signals from "fever," "cough," and "sore throat" showed better performance than those from "loss of smell" and "loss of taste." More than 80% of true epidemic waves were detected early by the occurrence of at least an outlier signal in Lombardy, although this implies a 20% false alarm signals. Performance was poorer for Sicily and Marche. Conclusion Monitoring the volume of Google searches can be a valuable tool for early detection of respiratory infectious disease outbreaks, particularly in areas with high access to home internet. The inclusion of web-based syndromic keywords is promising as it could facilitate the containment of COVID-19 and perhaps other unknown infectious diseases in the future.
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Affiliation(s)
- Gloria Porcu
- Biostatistics, Epidemiology and Public Health Unit, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
| | - Yu Xi Chen
- Biostatistics, Epidemiology and Public Health Unit, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Andrea Stella Bonaugurio
- Biostatistics, Epidemiology and Public Health Unit, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Simone Villa
- Centre for Multidisciplinary Research in Health Science, University of Milan, Milan, Italy
| | - Leonardo Riva
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, Milan, Italy
- PoliS Lombardia, Milan, Italy
| | - Vincenzina Messina
- Department of Informatics, Systems and Communication, University of Milano-Bicocca, Milan, Italy
- PoliS Lombardia, Milan, Italy
| | - Giorgio Bagarella
- Directorate General for Health, Lombardy Region, Milan, Italy
- Agency for Health Protection of the Metropolitan Area of Milan, Lombardy Region, Milan, Italy
| | - Mauro Maistrello
- Directorate General for Health, Lombardy Region, Milan, Italy
- Local Health Unit of Melegnano and Martesana, Milan, Italy
| | - Olivia Leoni
- Directorate General for Health, Lombardy Region, Milan, Italy
| | - Danilo Cereda
- Directorate General for Health, Lombardy Region, Milan, Italy
| | | | - Andrea Gori
- ASST Fatebenefratelli-Sacco, Luigi Sacco Hospital – University of Milan, Milan, Italy
- Department of Pathophysiology and Transplantation, School of Medicine and Surgery, University of Milan, Milan, Italy
| | - Giovanni Corrao
- Biostatistics, Epidemiology and Public Health Unit, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
- National Centre for Healthcare Research and Pharmacoepidemiology, University of Milano-Bicocca, Milan, Italy
- Directorate General for Health, Lombardy Region, Milan, Italy
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30
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Alscher A, Schnellbächer B, Wissing C. Adoption of Digital Vaccination Services: It Is the Click Flow, Not the Value—An Empirical Analysis of the Vaccination Management of the COVID-19 Pandemic in Germany. Vaccines (Basel) 2023; 11:vaccines11040750. [PMID: 37112662 PMCID: PMC10145467 DOI: 10.3390/vaccines11040750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/19/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023] Open
Abstract
This research paper examines the adoption of digital services for the vaccination during the COVID-19 pandemic in Germany. Based on a survey in Germany’s federal state with the highest vaccination rate, which used digital vaccination services, its platform configuration and adoption barriers are analyzed to understand existing and future levers for optimizing vaccination success. Though technological adoption and resistance models have been originally developed for consumer-goods markets, this study gives empirical evidence especially for the applicability of an adjusted model explaining platform adoption for vaccination services and for digital health services in general. In this model, the configuration areas of personalization, communication, and data management have a remarkable effect to lower adoption barriers, but only functional and psychological factors affect the adoption intention. Above all, the usability barrier stands out with the strongest effect, while the often-cited value barrier is not significant at all. Personalization is found to be the most important factor for managing the usability barrier and thus for addressing the needs, preferences, situation, and, ultimately, the adoption of the citizens as users. Implications are given for policy makers and managers in such a pandemic crisis to focus on the click flow and server-to-human interaction rather than emphasizing value messages or touching traditional factors.
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31
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Tolppa T, Pari V, Pell C, Aryal D, Hashmi M, Shamal Ghalib M, Jawad I, Tripathy S, Tirupakuzhi Vijayaraghavan BK, Beane A, Dondorp AM, Haniffa R. Determinants of Implementation of a Critical Care Registry in Asia: Lessons From a Qualitative Study. J Med Internet Res 2023; 25:e41028. [PMID: 36877557 PMCID: PMC10028509 DOI: 10.2196/41028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The Collaboration for Research, Implementation, and Training in Critical Care in Asia (CCA) is implementing a critical care registry to capture real-time data to facilitate service evaluation, quality improvement, and clinical studies. OBJECTIVE The purpose of this study is to examine stakeholder perspectives on the determinants of implementation of the registry by examining the processes of diffusion, dissemination, and sustainability. METHODS This study is a qualitative phenomenological inquiry using semistructured interviews with stakeholders involved in registry design, implementation, and use in 4 South Asian countries. The conceptual model of diffusion, dissemination, and sustainability of innovations in health service delivery guided interviews and analysis. Interviews were coded using the Rapid Identification of Themes from Audio recordings procedure and were analyzed based on the constant comparison approach. RESULTS A total of 32 stakeholders were interviewed. Analysis of stakeholder accounts identified 3 key themes: innovation-system fit; influence of champions; and access to resources and expertise. Determinants of implementation included data sharing, research experience, system resilience, communication and networks, and relative advantage and adaptability. CONCLUSIONS The implementation of the registry has been possible due to efforts to increase the innovation-system fit, influence of motivated champions, and the support offered by access to resources and expertise. The reliance on individuals and the priorities of other health care actors pose a risk to sustainability.
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Affiliation(s)
- Timo Tolppa
- Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
| | - Vrindha Pari
- Chennai Critical Care Consultants Group, Chennai, India
| | - Christopher Pell
- Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
- Department of Global Health, Amsterdam UMC location University of Amsterdam, Amsterdam, Netherlands
| | - Diptesh Aryal
- Hospital for Advanced Medicine and Surgery, Kathmandu, Nepal
| | | | | | - Issrah Jawad
- Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
| | - Swagata Tripathy
- Department of Anaesthesia and Intensive Care Medicine, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Bharath Kumar Tirupakuzhi Vijayaraghavan
- Chennai Critical Care Consultants Group, Chennai, India
- Critical Care Medicine Department, Apollo Hospital, Chennai, India
- Indian Registry of IntenSive Care, Chennai, India
| | - Abi Beane
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Arjen M Dondorp
- Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Rashan Haniffa
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
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Frennert S, Erlingsdóttir G, Muhic M, Rydenfält C, Milos Nymberg V, Ekman B. 'It increases my ability to influence my ways of working': A qualitative study on digitally mediated patient management in primary healthcare. Scand J Caring Sci 2023; 37:88-105. [PMID: 35833314 DOI: 10.1111/scs.13099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/19/2022] [Accepted: 06/19/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Digitally mediated primary healthcare is increasingly influencing working conditions, raising questions about how digitally mediated patient management is experienced. AIM The aim of this study was to generate insights, through the lens of postphenomenology, into how digitally mediated primary healthcare affects the work and working environment, by gathering perspectives from primary healthcare professionals who regularly manage patient errands through a digital platform. METHODS Two rounds of interviews were conducted with a diversified sample of primary healthcare professionals at a primary healthcare centre. The first round of interviews was conducted during the initial phase of the deployment of a digital platform for patient management, with the second round conducted a year later (n = 24). The interview transcripts were analysed using reflexive thematic analysis. RESULTS Four themes relating to digitally mediated care work were identified: 'positive feelings towards digitally mediated primary healthcare', 'seeing a positive work atmosphere as a prerequisite for change', 'experiencing increased control over the pace of workflow' and 'reconfiguration of previous problems'. CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE Building on postphenomenology, our study adds to the understanding of how material and symbolic aspects mutually affect the mediating role of a digital platform for patient management. Thus, the results indicate that the experience of using digitally mediated care processes is conditioned by the discourse towards digitalisation at the workplace and the management's approach to and inclusion of employees in the digital transition of primary healthcare, as well as the usefulness and usability of the digital platform. The findings can inform both practice and policy.
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Motulsky A, Gautier L, Moreault MP, Badr J, Liang MQ, Davy A, Duhoux A, Lussier MT. Evaluating the implementation of a referral system for virtual pharmacy counselling in a province-wide nurse phone line. Healthc Manage Forum 2023; 36:107-112. [PMID: 36710567 PMCID: PMC9975893 DOI: 10.1177/08404704221147454] [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] [Indexed: 01/31/2023]
Abstract
Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various "virtual" services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist - AYP) to a universal phone consultation service led by the universal public health system in Quebec (811 Info-Santé), through a direct bridge. Semi-structured interviews were conducted with clinician users of the service, and stakeholders involved in this pilot project funded by the Ministry of Economy (n = 22); documents were also analyzed, and content of the question was asked through the AYP service. Adoption of the service was low, and it suggests a poor alignment between the need and the service as implemented. Further research should investigate the mechanisms for an appropriate integration of digital services for primary care universal consultation services.
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Affiliation(s)
- Aude Motulsky
- Université de Montréal, Montreal, Québec, Canada.,Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada.,Aude Motulsky, Université de Montréal, Montreal, Québec, Canada. E-mail:
| | - Lara Gautier
- Université de Montréal, Montreal, Québec, Canada
| | - Marie-Pierre Moreault
- Université de Montréal, Montreal, Québec, Canada.,Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Janine Badr
- Université de Montréal, Montreal, Québec, Canada.,Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Man Qing Liang
- Université de Montréal, Montreal, Québec, Canada.,Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Amirav Davy
- University of Victoria, Victoria, British Columbia, Canada
| | | | - Marie-Thérèse Lussier
- Université de Montréal, Montreal, Québec, Canada.,Centre hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
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Liu SH, Wu YR, Chen W, Su CH, Chin CL. Using Ballistocardiogram and Impedance Plethysmogram for Minimal Contact Measurement of Blood Pressure Based on a Body Weight-Fat Scale. SENSORS (BASEL, SWITZERLAND) 2023; 23:2318. [PMID: 36850917 PMCID: PMC9966183 DOI: 10.3390/s23042318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Electronic health (eHealth) is a strategy to improve the physical and mental condition of a human, collecting daily physiological data and information from digital apparatuses. Body weight and blood pressure (BP) are the most popular and important physiological data. The goal of this study is to develop a minimal contact BP measurement method based on a commercial body weight-fat scale, capturing biometrics when users stand on it. The pulse transit time (PTT) is extracted from the ballistocardiogram (BCG) and impedance plethysmogram (IPG), measured by four strain gauges and four footpads of a commercial body weight-fat scale. Cuffless BP measurement using the electrocardiogram (ECG) and photoplethysmogram (PPG) serves as the reference method. The BP measured by a commercial BP monitor is considered the ground truth. Twenty subjects participated in this study. By the proposed model, the root-mean-square errors and correlation coefficients (r2s) of estimated systolic blood pressure and diastolic blood pressure are 7.3 ± 2.1 mmHg and 4.5 ± 1.8 mmHg, and 0.570 ± 0.205 and 0.284 ± 0.166, respectively. This accuracy level achieves the C grade of the corresponding IEEE standard. Thus, the proposed method has the potential benefit for eHealth monitoring in daily application.
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Affiliation(s)
- Shing-Hong Liu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan
| | - Yan-Rong Wu
- Department of Computer Science and Information Engineering, Chaoyang University of Technology, Taichung City 41349, Taiwan
| | - Wenxi Chen
- Biomedical Information Engineering Laboratory, The University of Aizu, Aizu-Wakamatsu City 965-8580, Japan
| | - Chun-Hung Su
- Institute of Medicine, School of Medicine, Chung-Shan Medical University, Taichung City 40201, Taiwan
- Department of Internal Medicine, Chung-Shan Medical University Hospital, Taichung City 40201, Taiwan
| | - Chiun-Li Chin
- Department of Medical Informatics, Chung-Shan Medical University, Taichung City 40201, Taiwan
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Mujtaba M, Kotwani S, Qayyum D, Saghir T, Bhatti KI, Khalid MR, Khanzada MF, Aman S, Shaikh KA, Buraro S, Karim M. Impact of COVID-19 on cardiovascular clinics: Are we ready for telemedicine? SAGE Open Med 2023; 11:20503121231153755. [PMID: 36778198 PMCID: PMC9912032 DOI: 10.1177/20503121231153755] [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: 10/14/2022] [Accepted: 01/12/2023] [Indexed: 02/11/2023] Open
Abstract
Objective The need for telemedicine was felt more than ever during the COVID-19 pandemic, which impacted health care worldwide. Therefore, this study aimed to determine the difficulties faced by patients in visiting the cardiac outpatient department during COVID-19, along with assessing the awareness and acceptability of telemedicine. Methods In this cross-sectional study, selected patients presenting to outpatient department of a tertiary care cardiac hospital were interviewed regarding the difficulties faced by patients in visiting the outpatient department during COVID-19 and their awareness and acceptability of telemedicine using a self-designed structured questionnaire. Results Of the 403 patients, 58.3% were male, the mean age was 53.04 ± 11.73 years, and most (77.7%) were urban residents. Ischemic heart disease was present in 69.5%, followed by hypertension (38.7%) and heart failure (29.3%). A total of 26.6% required emergency room visits. Limited appointments (55.6%) was the most common problem faced by patients during COVID-19, followed by financial issues (17.1%), fear of acquiring infection (13.4%), and limited mobility due to lockdown (22.6%). Only 12.2% were aware of telemedicine, 4.5% had previously used it, and 41.2% were willing to opt for telemedicine in the future. No internet access (39.2%) was the key barrier to the usage of telemedicine, followed by a lack of free medicine (39%) and a lack of a smart device (31.5%). Conclusion Limited appointments due to COVID-19 restrictions has made it difficult for patients to visit the clinics, which has led to increased emergency room visits. Telemedicine awareness was found to be limited; however, many patients were willing to adopt it provided their limitations could be overcome.
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Affiliation(s)
- Mustajab Mujtaba
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan,Mustajab Mujtaba, National Institute of
Cardiovascular Diseases, A203, Mehran Square, Clifton block 8, Karachi 75530,
Pakistan.
| | - Sapna Kotwani
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
| | - Danish Qayyum
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
| | - Tahir Saghir
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
| | | | | | | | - Saba Aman
- Dr. Ruth K.M. Pfau Civil Hospital
Karachi, Karachi, Pakistan
| | | | | | - Musa Karim
- National Institute of Cardiovascular
Diseases, Karachi, Pakistan
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36
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Bali AO, Halbusi HA, Ahmad AR, Lee KY. Public engagement in government officials' posts on social media during coronavirus lockdown. PLoS One 2023; 18:e0280889. [PMID: 36689430 PMCID: PMC9870155 DOI: 10.1371/journal.pone.0280889] [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] [Received: 03/14/2022] [Accepted: 01/10/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Social media has been a common platform to disseminate health information by government officials during the COVID-19 pandemic. However, little is known about the determinants of public engagement in officials' posts on social media, especially during lockdown. OBJECTIVES This study aims to investigate how the public engages in officials' posts about COVID-19 on social media and to identify factors influencing the levels of engagement. METHODS A total of 511 adults aged 18 or over completed an online questionnaire during lockdown in Iraq. Levels of engagement in officials' posts on social media, trust in officials and compliance of government instructions were assessed. RESULTS Fear of COVID-19 and trust in officials were positively associated with compliance of government instructions. Trust in officials was also associated with active engagement in officials' posts on social media, including commenting, posting and sharing of the posts. CONCLUSIONS Trust in government has been established during the COVID-19 pandemic. Public engagement in officials' posts is crucial to reinforce health policies and disseminate health information.
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Affiliation(s)
- Ahmed Omar Bali
- Diplomacy and Public Relations Department, University of Human Development, Sulaymaniah, Iraq
| | | | - Araz Ramazan Ahmad
- Department of Administration, College of Humanities, University of Raparin, Ranya, Iraq
- Department of International Relations & Diplomacy, Faculty of Administrative Sciences and Economics, Tishk International University, Erbil, Iraq
| | - Ka Yiu Lee
- Department of People and Society, Swedish University of Agricultural Sciences, Alnarp, Sweden
- Department of Health Sciences, Swedish Winter Sports Research Centre, Mid Sweden University, Östersund, Sweden
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Pozza A, Giangrasso B, Baldo D, Fort A, Millozzi G, Iocca F, Angelo NL, Pugi D, Gualtieri G, Lorenzi L, Gioia F, Bocci Benucci S, Fioravanti G, Coluccia A, Ferretti F, Casale S. Mobile opportunity against stress: Open study protocol on the effectiveness of a mobile platform for stress self-management in the post-pandemic era. Front Psychol 2023; 13:917574. [PMID: 36755986 PMCID: PMC9901297 DOI: 10.3389/fpsyg.2022.917574] [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: 04/11/2022] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
Mobile health platforms have shown promise in the management of various mental health conditions (including stress, anxiety, and depression) and cognitive behavioral strategies emerged as a popular and effective option offered by the platforms. This paper presents the protocol of a study aimed to test the effectiveness of a mobile platform that uses cognitive-behavioral strategies for stress self-management in the Tuscany region (Italy). The mobile app is adapted to the specific needs of each vulnerable population for which it is designed: young and older people, healthcare professionals, entrepreneurs. The app will be evaluated on the following outcomes: (i) perceived susceptibility and severity of the pandemic situation, perceived benefits, and costs of preventive health behaviors, (ii) knowledge about Covid-19 preventive behaviors and negative consequences of social distancing, (iii) stress and psychopathological symptoms (i.e., anxiety, depression, and post-traumatic stress symptoms) and cognitive distortions. If successful, we expect that the platform could give various groups clinical benefits by providing symptom self-monitoring and early intervention, consolidating the number of mental health programs available, and decreasing barriers to treatment-seeking. This population-level approach has the potential to improve mental health outcomes in pandemic periods for many people.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Barbara Giangrasso
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - David Baldo
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Ada Fort
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | | | - Francesco Iocca
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Nicole Loren Angelo
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Daniele Pugi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | | | - Lore Lorenzi
- Santa Maria Alle Scotte University Hospital of Siena, Siena, Italy
| | - Francesca Gioia
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Sara Bocci Benucci
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Giulia Fioravanti
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
| | - Anna Coluccia
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Fabio Ferretti
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Silvia Casale
- Department of Health Sciences, Psychology Unit, University of Florence, Florence, Italy
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Precision public-health intervention for care coordination: a real-world study. Br J Gen Pract 2023; 73:e220-e230. [PMID: 36823048 PMCID: PMC9923768 DOI: 10.3399/bjgp.2022.0067] [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: 02/11/2022] [Accepted: 08/11/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Health emergencies disproportionally affect vulnerable populations. Digital tools can help primary care providers find, and reach, the right patients. AIM To evaluate whether digital interventions delivered directly to GPs' clinical software were more effective at promoting primary care appointments during the COVID-19 pandemic than interventions delivered by post. DESIGN AND SETTING Real-world, non-randomised, interventional study involving GP practices in all Australian states. METHOD Intervention material was developed to promote care coordination for vulnerable older veterans during the COVID-19 pandemic, and sent to GPs either digitally to the clinical practice software system or in the post. The intervention material included patient-specific information sent to GPs to support care coordination, and education material sent via post to veterans identified in the administrative claims database. To evaluate the impact of intervention delivery modalities on outcomes, the time to first appointment with the primary GP was measured; a Cox proportional hazards model was used, adjusting for differences and accounting for pre-intervention appointment numbers. RESULTS The intervention took place in April 2020, during the first weeks of COVID-19 social distancing restrictions in Australia. GPs received digital messaging for 51 052 veterans and postal messaging for 26 859 veterans. The digital group was associated with earlier appointments (adjusted hazard ratio 1.38 [1.34 to 1.41]). CONCLUSION Data-driven digital solutions can promote care coordination at scale during national emergencies, opening up new perspectives for precision public-health initiatives.
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Chalutz Ben-Gal H. Artificial intelligence (AI) acceptance in primary care during the coronavirus pandemic: What is the role of patients' gender, age and health awareness? A two-phase pilot study. Front Public Health 2023; 10:931225. [PMID: 36699881 PMCID: PMC9868720 DOI: 10.3389/fpubh.2022.931225] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/15/2022] [Indexed: 01/11/2023] Open
Abstract
Background Artificial intelligence (AI) is steadily entering and transforming the health care and Primary Care (PC) domains. AI-based applications assist physicians in disease detection, medical advice, triage, clinical decision-making, diagnostics and digital public health. Recent literature has explored physicians' perspectives on the potential impact of digital public health on key tasks in PC. However, limited attention has been given to patients' perspectives of AI acceptance in PC, specifically during the coronavirus pandemic. Addressing this research gap, we administered a pilot study to investigate criteria for patients' readiness to use AI-based PC applications by analyzing key factors affecting the adoption of digital public health technology. Methods The pilot study utilized a two-phase mixed methods approach. First, we conducted a qualitative study with 18 semi-structured interviews. Second, based on the Technology Readiness and Acceptance Model (TRAM), we conducted an online survey (n = 447). Results The results indicate that respondents who scored high on innovativeness had a higher level of readiness to use AI-based technology in PC during the coronavirus pandemic. Surprisingly, patients' health awareness and sociodemographic factors, such as age, gender and education, were not significant predictors of AI-based technology acceptance in PC. Conclusions This paper makes two major contributions. First, we highlight key social and behavioral determinants of acceptance of AI-enabled health care and PC applications. Second, we propose that to increase the usability of digital public health tools and accelerate patients' AI adoption, in complex digital public health care ecosystems, we call for implementing adaptive, population-specific promotions of AI technologies and applications.
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Babili A, Nsanzimana S, Rwagasore E, Lester RT. SMS-based digital health intervention in Rwanda's home-based care program for remote management of COVID-19 cases and contacts: A qualitative study of sustainability and scalability. Front Digit Health 2023; 4:1071790. [PMID: 36714610 PMCID: PMC9879010 DOI: 10.3389/fdgth.2022.1071790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 11/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background COVID-19 pandemic resulted in unprecedented global health challenges. Rwanda identified its first COVID-19 case on March 14, 2020 and subsequently introduced Home-Base Care (HBC) Program in August 2020 following community transmission of the virus and to alleviate logistical and financial strain on the healthcare system. Cases and contacts eligible for HBC were remotely supported by WelTel, an SMS-based mHealth intervention that was successfully implemented before for HIV epidemic in Rwanda. Enrolled cases and contacts were supported and monitored daily via their cell and/or mobile phones until they complete isolation/quarantine period. This study explored the rationale, perspectives, and experiences of key informants (KIs) during the implementation WelTel's mHealth tool for HBC in Rwanda. Methods Semi-structured one-on-one virtual interviews were conducted with KIs in this qualitative study. The KIs were classified into 2 major categories: (A) Senior staff including policymakers, directors, and senior managers; (B) Technical teams including case managers, and other staff supporting the implementation of WelTel (e.g., IT staff). Interviews were audio-recorded, transcribed, and analyzed in NVivo. Thematic analysis was conducted using a hybrid approach. A topic guide was developed using the Modified Consolidated Framework for Implementation Research and feedback from local stakeholders. Results 7 KIs were interviewed. Five themes emerged following thematic analysis including: SMS-Based mHealth for Home-Isolation; Facilitators for Intervention Adoption; Barriers for Intervention Adoption; Infection prevention and control for Home-Isolation; and SMS-Based mHealth for Future Pandemics and Epidemics. Based on interviews, strong political commitment and advanced digital infrastructure were major facilitators for adopting WelTel for HBC. A major barrier to adopting WelTel was identified as technical-based issues. This was followed by local communication culture. All participates agreed on the significance of using WelTel to improve access and adherence to infection prevention and control measures, understand transmission dynamics, and inform public health decision-making regarding HBC. Conclusions Rwanda successfully adopted WelTel for supporting and monitoring COVID-19 cases and contacts in home-isolation and the implementation was instrumental to the country's effort to manage the pandemic. Experiences and perspectives of cases and contacts enrolled into WelTel must be explored to understand the appropriateness and effectiveness of the intervention.
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Affiliation(s)
- Abdulaa Babili
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom,Correspondence: Abdulaa Babili
| | - Sabin Nsanzimana
- Central Administration, Rwanda Biomedical Center, Kigali, Rwanda
| | - Edson Rwagasore
- Department of Public Health Surveillance and Emergency Preparedness and Response, Rwanda Biomedical Center, Kigali, Rwanda
| | - Richard T. Lester
- Faculty of Medicine, Division of Infectious Diseases, University of British Columbia, Vancouver, BC, Canada
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Yang CL, Simpson LA, Eng JJ. A Pilot Study for Remote Evaluation of Upper Extremity Motor Function After Stroke: The Arm Capacity and Movement Test (ArmCAM). Am J Occup Ther 2023; 77:23991. [PMID: 36706274 DOI: 10.5014/ajot.2023.050020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
IMPORTANCE A simple measure that can be administered remotely by means of videoconferencing is needed for telerehabilitation. OBJECTIVE To develop a valid and reliable measure, the Arm Capacity and Movement Test (ArmCAM), that can be administered remotely by means of videoconferencing to evaluate upper extremity motor function poststroke. DESIGN Cross-sectional. SETTING Participants' homes. PARTICIPANTS A sample of people with stroke (N = 31). OUTCOMES AND MEASURES Test-retest and interrater reliabilities were assessed through intraclass correlation coefficients (ICCs), Cohen's κ, standard error of measurement (SEM), and minimal detectable change (MDC). Interrater reliability validity was examined with Pearson and Spearman rank correlation coefficients. RESULTS The ArmCAM (range = 0-30) consists of 10 items and takes 15 min to administer with no special equipment except for a computer and internet access. The ICCs for test-retest reliability and interrater reliability were .997 and .993, respectively. The SEM and MDC95 were 0.74 and 2.05 points, respectively. Individual items' test-retest reliability and interrater levels of agreement ranged from .811 to .957 and from .475 to .842, respectively, as measured with Cohen's κ. Correlations between the ArmCAM and the Rating of Everyday Arm-use in the Community and Home scale; the Stroke Impact Scale, hand function domain; the Fugl-Meyer Assessment for upper extremity; and the Action Research Arm Test were good to excellent. CONCLUSIONS AND RELEVANCE The ArmCAM has good reliability and validity. It is an easy-to-use assessment designed to be administered remotely by means of videoconferencing. What This Article Adds: The ArmCAM is a psychometrically sound instrument that can be easily administered remotely by means of videoconferencing to evaluate upper extremity motor function after stroke.
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Affiliation(s)
- Chieh-Ling Yang
- Chieh-ling Yang, OT, PhD, is Assistant Professor, Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan, and Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Lisa A Simpson
- Lisa A. Simpson, OT, PhD, is Research Associate, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Janice J Eng
- Janice J. Eng, PhD, BSc (PT/OT), is Professor, Centre for Aging SMART at Vancouver Coastal Health, Vancouver, British Columbia, Canada, and Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada;
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Exploring experiences and needs of perinatal women in digital healthcare: A meta-ethnography of qualitative evidence. Int J Med Inform 2023; 169:104929. [PMID: 36435014 DOI: 10.1016/j.ijmedinf.2022.104929] [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: 04/08/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The aim of this review is to identify, appraise, and synthesize the available qualitative evidence on the experiences and needs of perinatal women by using digital technologies in healthcare. METHODS This review was consolidated following the eMERGe meta-ethnography reporting guidance. We conducted a comprehensive search in eight databases from inception to 12 October 2021. Published and unpublished qualitative and mixed-method studies published in English were included. The methodological quality was assessed using the critical appraisal skill program checklist. A meta-ethnographic synthesis was used according to Noblit and Hare's seven-step iterative process. RESULTS A total of 3,843 articles were retrieved, and 27 qualitative studies pertaining to 3,775 perinatal women from 13 countries across different ethnicities were included. Four overarching themes emerged for the aspect of experiences: (1) normalization of experience, (2) attainment of valuable knowledge, (3) empowerment and self-confidence boosting, and (4) beneficial features of digital platforms. For the aspect of needs, the derived themes included the following: (1) necessity of credible resources, (2) importance of personalization, (3) concern about cybersecurity, and (4) urging additional support. Our line-of-argument for interpreting the perinatal women's experiences can offer a much greater engagement in digital healthcare, while the findings on the perinatal women's needs can add value for improving the design of digital healthcare in the future. CONCLUSION This review offers a deeper understanding of the perinatal women's experiences and needs when using digital technologies in healthcare. Our findings provide meaningful recommendations for clinical practice and future research.
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Donelle L, Comer L, Hiebert B, Hall J, Shelley JJ, Smith MJ, Kothari A, Burkell J, Stranges S, Cooke T, Shelley JM, Gilliland J, Ngole M, Facca D. Use of digital technologies for public health surveillance during the COVID-19 pandemic: A scoping review. Digit Health 2023; 9:20552076231173220. [PMID: 37214658 PMCID: PMC10196539 DOI: 10.1177/20552076231173220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/14/2023] [Indexed: 05/24/2023] Open
Abstract
Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.
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Affiliation(s)
- Lorie Donelle
- College of Nursing, University of South
Carolina, USA
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Leigha Comer
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Brad Hiebert
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Jodi Hall
- Arthur Labatt Family School of Nursing, Western University, Canada
| | | | | | - Anita Kothari
- School of Health Studies, Western University, Canada
| | - Jacquelyn Burkell
- Faculty of Information and Media
Studies, Western University, Canada
| | - Saverio Stranges
- Schulich School of Medicine &
Dentistry, Western University, Canada
| | - Tommy Cooke
- Surveillance Studies Centre, Queen's University, Canada
| | - James M. Shelley
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Jason Gilliland
- Department of Geography and
Environment, Western University, Canada
| | - Marionette Ngole
- Arthur Labatt Family School of Nursing, Western University, Canada
| | - Danica Facca
- Faculty of Information and Media
Studies, Western University, Canada
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Russo-Spena T, Mele C, Cavacece Y, Ebraico S, Dantas C, Roseiro P, van Staalduinen W. Enabling Value Co-Creation in Healthcare through Blockchain Technology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:67. [PMID: 36612386 PMCID: PMC9819921 DOI: 10.3390/ijerph20010067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/25/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic highlighted the need to manage complex relations within the healthcare ecosystem. The role of new technologies in achieving this goal is a topic of current interest. Among them, blockchain technology is experiencing widespread application in the healthcare context. The present work investigates how this technology fosters value co-creation paths in the new digital healthcare ecosystems. To this end, a multiple case study has been conducted examining the development and application of blockchain by 32 healthcare tech companies. The results show blockchain technology adoption's current and potential impacts on value co-creation regarding data and resource sharing, patient participation, and collaboration between professionals. Three main areas of activity emerge from the case studies where blockchain implementation brings significant benefits for value co-creation: improving service interaction, impacting actors' engagement, and fostering ecosystem transparency.
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Affiliation(s)
- Tiziana Russo-Spena
- Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia Monte S. Angelo, 80126 Naplese, Italy
| | - Cristina Mele
- Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia Monte S. Angelo, 80126 Naplese, Italy
| | - Ylenia Cavacece
- Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia Monte S. Angelo, 80126 Naplese, Italy
| | - Sara Ebraico
- Department of Economics, Management, Institutions, University of Naples Federico II, Via Cintia Monte S. Angelo, 80126 Naplese, Italy
| | | | - Pedro Roseiro
- TICE.PT—The Portuguese National ICT Cluster, Campus Universitário de Santiago (IT), 3810-193 Aveiro, Portugal
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Kwasnicka D, Keller J, Perski O, Potthoff S, Ten Hoor GA, Ainsworth B, Crutzen R, Dohle S, van Dongen A, Heino M, Henrich JF, Knox L, König LM, Maltinsky W, McCallum C, Nalukwago J, Neter E, Nurmi J, Spitschan M, Van Beurden SB, Van der Laan LN, Wunsch K, Levink JJJ, Sanderman R. White Paper: Open Digital Health - accelerating transparent and scalable health promotion and treatment. Health Psychol Rev 2022; 16:475-491. [PMID: 35240931 DOI: 10.1080/17437199.2022.2046482] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020-2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19-20th August 2021).
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Affiliation(s)
- Dominika Kwasnicka
- NHMRC CRE in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wrocław, Poland
| | - Jan Keller
- Department of Education and Psychology; Freie Universität Berlin, Berlin, Germany
| | - Olga Perski
- Department of Behavioural Science and Health, University College London, London, UK
| | - Sebastian Potthoff
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Gill A Ten Hoor
- Department of Work & Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University/CAPHRI, Maastricht, the Netherlands
| | - Simone Dohle
- Department of Psychology, University of Cologne, Cologne, Germany and Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Anne van Dongen
- Department of Psychology, Health, and Technology, University of Twente, Enschede, the Netherlands
| | - Matti Heino
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Julia F Henrich
- Faculty of Social and Behavioural Sciences, Leiden University, Institute of Psychology, Unit of Health-, Medical- and Neuropsychology, Leiden, The Netherlands
| | - Liam Knox
- Sheffield Institute for Translational Neuroscience, The University of Sheffield, Sheffield, UK
| | - Laura M König
- Faculty of Life Sciences, University of Bayreuth, Bayreuth, Germany
| | - Wendy Maltinsky
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, UK
| | - Claire McCallum
- Centre for Digital Health and Care, Faculty of Engineering, University of Bristol, Bristol, UK
| | - Judith Nalukwago
- Center for Communication Programs, USAID-Social and Behavior Change Activity, Johns Hopkins University Bloomberg School of Public Health, Kampala, Uganda
| | - Efrat Neter
- Department of Behavioral Sciences, Ruppin Academic Center, Emeq Hefer, Israel
| | - Johanna Nurmi
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.,University of Cambridge, Behavioural Science Group, Primary Care Unit, Institute of Public Health, Forvie Site, Cambridge, UK
| | - Manuel Spitschan
- TUM Department of Sport and Health Sciences (TUM SG), Technical University of Munich, Munich, Germany and Translational Sensory and Circadian Neuroscience, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | | | - L Nynke Van der Laan
- Department of Communication and Cognition, Tilburg University, Tilburg, The Netherlands
| | - Kathrin Wunsch
- Karlsruhe Institute of Technology, Institute of Sports and Sports Science, Karlsruhe, Germany
| | - Jasper J J Levink
- Levink Life Sciences BV & Stichting Feniks Ontwikkelingsbegeleiding, Utrecht, The Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health, and Technology, University of Twente, Enschede, the Netherlands.,Department of Health Psychology, University Medical Center Groningen University of Groningen, Groningen, The Netherlands
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Aisyah DN, Manikam L, Kiasatina T, Naman M, Adisasmito W, Kozlakidis Z. The Use of a Health Compliance Monitoring System During the COVID-19 Pandemic in Indonesia: Evaluation Study. JMIR Public Health Surveill 2022; 8:e40089. [PMID: 36219836 PMCID: PMC9683531 DOI: 10.2196/40089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/31/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND COVID-19 cases are soaring in Asia. Indonesia, Southeast Asia's most populous country, is now ranked second in the number of cases and deaths in Asia, after India. The compliance toward mask wearing, social distancing, and hand washing needs to be monitored to assess public behavioral changes that can reduce transmission. OBJECTIVE This study aimed to evaluate this compliance in Indonesia between October 2020 and May 2021 and demonstrate the use of the Bersatu Lawan COVID-19 (BLC) mobile app in monitoring this compliance. METHODS Data were collected in real time by the BLC app from reports submitted by personnel of military services, police officers, and behavioral change ambassadors. Subsequently, the data were analyzed automatically by the system managed by the Indonesia National Task Force for the Acceleration of COVID-19 Mitigation. RESULTS Between October 1, 2020, and May 2, 2021, the BLC app generated more than 165 million reports, with 469 million people monitored and 124,315,568 locations under observation in 514 districts/cities in 34 provinces in Indonesia. This paper grouped them into 4 colored zones, based on the degree of compliance, and analyzed variations among regions and locations. CONCLUSIONS Compliance rates vary among the 34 provinces and among the districts and cities of those provinces. However, compliance to mask wearing seems slightly higher than social distancing. This finding suggests that policy makers need to promote higher compliance in other measures, including social distancing and hand washing, whose efficacies have been proven to break the chain of transmission when combined with masks wearing.
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Affiliation(s)
- Dewi Nur Aisyah
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
- Indonesia One Health University Network, Depok, Indonesia
| | - Logan Manikam
- Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
- Aceso Global Health Consultants Pte Limited, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | | | - Maryan Naman
- Aceso Global Health Consultants Pte Limited, Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Wiku Adisasmito
- Indonesia One Health University Network, Depok, Indonesia
- Faculty of Public Health, Universitas Indonesia, Depok, Indonesia
| | - Zisis Kozlakidis
- International Agency for Research on Cancer, World Health Organization, Lyon, France
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Bouabida K, Lebouché B, Pomey MP. Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic. Healthcare (Basel) 2022; 10:2293. [PMID: 36421617 PMCID: PMC9690761 DOI: 10.3390/healthcare10112293] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 07/25/2023] Open
Abstract
The use of telehealth and digital health platforms has increased during the COVID-19 pandemic due to the implementation of physical distancing measures and restrictions. To address the pandemic threat, telehealth was promptly and extensively developed, implemented, and used to maintain continuity of care offered through multi-purpose technology platforms considered as virtual healthcare facilities. The aim of this paper is to define telehealth and discuss some aspects of its utilization, role, and impact, but also opportunities and future implications particularly during the COVID-19 pandemic. In order to support our reflection and consolidate our viewpoints, numerous bibliographical sources and relevant literature were identified through an electronic keyword search of four databases (PubMed, Web of Science, Google Scholar, and ResearchGate). In this paper, we consider that telehealth to be a very interesting approach which can be effective and affordable for health systems aiming to facilitate access to care, maintain quality and safety of care, and engage patients and health professionals and users of health services. However, we also believe that telehealth faces many challenges, such as the issue of lack of human contact in care, confidentiality, and data security, also accessibility and training in the use of platforms for telehealth. Despite the many challenges it faces, we believe telehealth has enormous potential for strengthening and improving healthcare services. In this paper, we also call for and encourage further studies to build a solid and broad understanding of telehealth challenges with its short-term and long-term clinical, organizational, socio-economic, and ethical impacts.
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Affiliation(s)
- Khayreddine Bouabida
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada
- École de Santé Publique, Département de Gestion, D’évaluation et de Politique de Santé, Université de Montréal, Montreal, QC H3N 1X9, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, Faculty of Medicine & Health Sciences, McGill University, Montréal, QC H3A 0G4, Canada
- Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3J1, Canada
- Chronic Viral Illness Service, Department of Medicine, Division of Infectious Diseases, McGill University Health Centre, Montréal, QC H4A 3J1, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montréal, QC H4A 3J1, Canada
| | - Marie-Pascale Pomey
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montreal, QC H2X 0A9, Canada
- École de Santé Publique, Département de Gestion, D’évaluation et de Politique de Santé, Université de Montréal, Montreal, QC H3N 1X9, Canada
- Hospital Center of the University of Montreal (CHUM), Montreal, QC H2X 0C1, Canada
- Centre of Excellence on Partnership with Patients and the Public, Montreal, QC H2X 0A9, Canada
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Walsh L, Hyett N, Juniper N, Li C, Hill S. The Experiences of Stakeholders Using Social Media as a Tool for Health Service Design and Quality Improvement: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214851. [PMID: 36429570 PMCID: PMC9690250 DOI: 10.3390/ijerph192214851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. This scoping review explores the benefits, risks, barriers and enablers for using social media as a tool for stakeholder engagement in health service design and QI. METHODS The searches were conducted on 16 August 2022. Inclusion criteria were: studies of any health service stakeholders, in any health setting, where social media was used as a tool for service design or QI. Data was analysed using deductive content analysis. A committee of stakeholders provided input on research questions, data analysis and key findings. RESULTS 61 studies were included. Benefits included improved organisational communication and relationship building. Risks/limitations included low quality of engagement and harms to users. Limited access and familiarity with social media were frequently reported barriers. Making discussions safe and facilitating access were common enablers. CONCLUSION The benefits, risks, barriers and enablers identified highlight the complexity of social media as an engagement tool for health service design and QI. Understanding these experiences may help implementers design more effective social media-based engagement activities.
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Affiliation(s)
- Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia
- Correspondence: ; Tel.: +61-3-9479-1578
| | - Nerida Hyett
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia
| | | | - Chi Li
- Albury Wodonga Health, Wodonga, VIC 3690, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia
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Garavand A, Jalali S, Hajipour Talebi A, Sabahi A. Advantages and disadvantages of teleworking in healthcare institutions during COVID-19: A systematic review. INFORMATICS IN MEDICINE UNLOCKED 2022; 34:101119. [PMID: 36373130 PMCID: PMC9637285 DOI: 10.1016/j.imu.2022.101119] [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: 09/02/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction The prevalence of COVID-19 as pandemic disease and efforts to control it have caused extensive changes in work methods and the global growth of teleworking, especially in health. This study aimed to investigate the advantages and disadvantages of teleworking in healthcare institutions during the Covid-19 era. Methods This systematic review was conducted up to January 1, 2022, by searching the relevant keywords in PubMed, Scopus, Web of Science, and ProQuest databases. Study selection has been conducted based on inclusion and exclusion criteria. Data extraction was done using the data extraction form based on the study objectives. Results From all 276 articles retrieved, 14 studies were included in the study. The results show that England had the highest number of articles (6 articles). The advantages of teleworking have ten categories, and the disadvantages have nine categories. The most important benefits of teleworking include facilitating service delivery, increasing satisfaction, supporting healthcare providers, and reducing costs. The most important disadvantages of using teleworking have been the lack of facilities and support, the lack of technology acceptance, and reduced interactions between healthcare providers. Conclusion Although teleworking was a suitable solution for some problems in healthcare institutions during COVID-19, it is also associated with obstacles. It is recommended that managers make policies and guidelines to use appropriate technologies, provide facilities, and have continuous support and increased interactions between healthcare providers and patients.
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Sirimsi MM, De Loof H, Van den Broeck K, De Vliegher K, Pype P, Remmen R, Van Bogaert P. Scoping review to identify strategies and interventions improving interprofessional collaboration and integration in primary care. BMJ Open 2022; 12:e062111. [PMID: 36302577 PMCID: PMC9621161 DOI: 10.1136/bmjopen-2022-062111] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To identify strategies and interventions used to improve interprofessional collaboration and integration (IPCI) in primary care. DESIGN Scoping review DATA SOURCES: Specific Medical Subject Headings terms were used, and a search strategy was developed for PubMed and afterwards adapted to Medline, Eric and Web of Science. STUDY SELECTION In the first stage of the selection, two researchers screened the article abstracts to select eligible papers. When decisions conflicted, three other researchers joined the decision-making process. The same strategy was used with full-text screening. Articles were included if they: (1) were in English, (2) described an intervention to improve IPCI in primary care involving at least two different healthcare disciplines, (3) originated from a high-income country, (4) were peer-reviewed and (5) were published between 2001 and 2020. DATA EXTRACTION AND SYNTHESIS From each paper, eligible data were extracted, and the selected papers were analysed inductively. Studying the main focus of the papers, researchers searched for common patterns in answering the research question and exposing research gaps. The identified themes were discussed and adjusted until a consensus was reached among all authors. RESULTS The literature search yielded a total of 1816 papers. After removing duplicates, screening titles and abstracts, and performing full-text readings, 34 papers were incorporated in this scoping review. The identified strategies and interventions were inductively categorised under five main themes: (1) Acceptance and team readiness towards collaboration, (2) acting as a team and not as an individual; (3) communication strategies and shared decision making, (4) coordination in primary care and (5) integration of caregivers and their skills and competences. CONCLUSIONS We identified a mix of strategies and interventions that can function as 'building blocks', for the development of a generic intervention to improve collaboration in different types of primary care settings and organisations.
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Affiliation(s)
- Muhammed Mustafa Sirimsi
- Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Centre of Research and Innovations in Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hans De Loof
- Laboratory of Physiopharmacology, Faculty of pharmaceutic sciences, University of Antwerp, Antwerp, Belgium
| | - Kris Van den Broeck
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Peter Pype
- Center for family medicine, Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Ghent, Belgium
| | - Roy Remmen
- Family Medicine and Population Health (FAMPOP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Peter Van Bogaert
- Centre for research and innovation in care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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