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Karstoft K, Thorsen IK, Nielsen JS, Solomon TPJ, Masuki S, Nose H, Ried-Larsen M. Health benefits of interval walking training. Appl Physiol Nutr Metab 2024; 49:1002-1007. [PMID: 38507778 DOI: 10.1139/apnm-2023-0595] [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] [Indexed: 03/22/2024]
Abstract
Interval walking training (IWT) is a free-living training intervention involving alternating fast and slow walking cycles. IWT is efficacious in improving physical fitness and muscle strength, and reducing factors associated with lifestyle-related diseases. In individuals with type 2 diabetes, IWT improves glycemic control directly through enhanced glucose effectiveness, challenging conventional views on mechanisms behind training-induced improvements in glycemic control. Whereas adherence to IWT in short-term studies is high, ensuring long-term adherence remains a challenge, particularly in populations with chronic diseases and/or overweight/obesity. Long-term studies in real-world settings are imperative to ascertain the widespread effectiveness of IWT and elucidate its impact on hard endpoints.
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Affiliation(s)
- Kristian Karstoft
- Department of Clinical Pharmacology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ida Kær Thorsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jens Steen Nielsen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Shizue Masuki
- Department of Sports Medical Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Hiroshi Nose
- Department of e-Health Sciences, Shinshu University Graduate School of Medicine, Matsumoto, Nagano, Japan
| | - Mathias Ried-Larsen
- Centre for Physical Activity Research, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- The University of Southern Denmark, Institute of Sports and Clinical Biomechanics, Odense, Denmark
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Zangger G, Mortensen SR, Tang LH, Thygesen LC, Skou ST. Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: Data from a cross-sectional survey of 19,231 individuals. Digit Health 2024; 10:20552076241233158. [PMID: 38410789 PMCID: PMC10896057 DOI: 10.1177/20552076241233158] [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] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives This study explored associations between digital health literacy and physical activity levels and assessed potential interactions of long-term health conditions. Methods A cross-sectional survey was sent to 34,000 inhabitants in Region Zealand, Denmark. The survey included items on physical activity levels and three electronic Health Literacy Questionnaire (eHLQ) scales (1, 4, and 5). Associations were assessed by logistic regression and adjusted for confounders. Results A total of 19,231 participated in the survey. Positive associations were found between higher digital health literacy and being active >30 min./week at moderate-to-vigorous intensity (eHLQ 1: OR 1.24, p < 0.001; eHLQ 4: OR 1.13, p = 0.012; eHLQ 5: OR 1.25, p < 0.001), compliance with the World Health Organization minimum recommendations for physical activity (eHLQ 1: OR 1.33 p < 0.001; eHLQ 4: OR 1.08 p = 0.025; eHLQ 5: OR 1.32, p < 0.001), and self-reported physical active (eHLQ 1: OR 1.50 p < 0.001; eHLQ 4: OR 1.24 p < 0.001; eHLQ 5: OR 1.54 p < 0.001), even when fully adjusted for covariates. No significant interaction was found for long-term health conditions. However, individuals with more long-term health conditions exhibited the lowest digital health literacy scores (9% to 19% scored <2.0). Conclusion A higher digital health literacy is positively associated with higher physical activity levels. This highlights the importance of screening and promoting digital health literacy in managing digital health and digital physical activity interventions. Future research should explore strategies and targeted interventions to enhance digital health literacy and improve health outcomes.
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Affiliation(s)
- Graziella Zangger
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Herman Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren T. Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Ramjee S, Mohamedthani H, Patel AU, Goiriz R, Harwood CA, Osborne RH, Cheng C, Hasan ZU. The Effect of Remote Digital Services on Health Care Inequalities Among People Under Long-Term Dermatology Follow-Up: Cross-Sectional Questionnaire Study. JMIR DERMATOLOGY 2023; 6:e48981. [PMID: 38064259 PMCID: PMC10746975 DOI: 10.2196/48981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 10/13/2023] [Accepted: 11/07/2023] [Indexed: 12/25/2023] Open
Abstract
BACKGROUND Given the expansion of remote digital dermatology services from the National Health Service, particularly during the COVID-19 pandemic, there is a need for methods that identify patients at risk of digital exclusion to guide equitable representation in service co-design processes and tailor remote services to the needs of their patient population. OBJECTIVE This quality improvement project aims to inform the redesign of remote services to optimally support the ongoing needs of patients with chronic skin diseases, ensuring that the services are tailored to patients' digital health literacy requirements. METHODS We profiled the digital health literacy of 123 people with chronic skin conditions who require long-term surveillance in 2 specialist clinics (London, United Kingdom) using the Multidimensional Readiness and Enablement Index for Health Technology (READHY) questionnaire alongside the Optimizing Health Literacy and Access (Ophelia) process for hierarchical cluster analysis. RESULTS The cluster analysis of READHY dimensions in responding participants (n=116) revealed 7 groups with distinct digital and health literacy characteristics. High READHY scores in groups 1 (n=22, 19%) and 2 (n=20, 17.2%) represent those who are confident with managing their health and using technology, whereas the lower-scoring groups, 6 (n=4, 3.4%) and 7 (n=12, 10.3%), depended on traditional services. Groups 3 (n=27, 23.3%), 4 (n=23, 19.8%), and 5 (n=8, 6.9%) had varying digital skills, access, and engagement, highlighting a population that may benefit from a co-designed dermatology service. CONCLUSIONS By identifying patient groups with distinguishable patterns of digital access and health literacy, our method demonstrates that 63.8% (n=74) of people attending specialist clinics in our center require support in order to optimize remote follow-up or need an alternative approach. Future efforts should streamline the READHY question profile to improve its practicality and use focus groups to elicit strategies for engaging patients with digital services.
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Affiliation(s)
- Serena Ramjee
- Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom
| | - Hanen Mohamedthani
- Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom
| | - Aditya Umeshkumar Patel
- Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom
| | - Rebeca Goiriz
- Dermatology Department, Barts Health NHS Trust, London, United Kingdom
| | - Catherine A Harwood
- Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, United Kingdom
- Dermatology Department, Barts Health NHS Trust, London, United Kingdom
| | - Richard H Osborne
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christina Cheng
- Centre for Global Health and Equity, School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Zeeshaan-Ul Hasan
- Dermatology Department, Barts Health NHS Trust, London, United Kingdom
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Sollie M, Hansen M, Thomsen JB. Health Technology Readiness amongst Patients with Suspected Breast Cancer Using the READHY-tool - a Cross-sectional Study. J Med Syst 2023; 47:118. [PMID: 37971517 PMCID: PMC10654165 DOI: 10.1007/s10916-023-02016-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
Information technologies are increasingly used when informing patients about their disease, treatment and prognosis. These digital platforms have many advantages compared to traditional education interventions. However, there are concerns that some patients may have difficulty with this mode of information delivery. Newly diagnosed breast cancer patients are dependent on understanding their treatment options to make informed treatment decisions. Yet, there is a lack of published material on breast cancer patients and their relationship with technology. We aimed to assess health technology readiness profiles amongst women with a suspected breast cancer diagnosis. Secondly, we wanted to investigate the potential differences between these profiles according to sociodemographic factors and the patients´ current use of technology. This cross-sectional study used the Readiness and Enablement Index for Health Technology (READHY) questionnaire. We included all patients (n = 92) referred to our department with suspected breast cancer. Cluster analysis revealed three distinct profiles: medium (n = 54), high (n = 18), and low (n = 20) health technology readiness. The third profile showed difficulties in health literacy, eHealth literacy, and health insights, along with higher emotional stress. Our study found that most patients had medium to high health technology readiness, but we also identified a group with lower health technology readiness. Based on our results, healthcare personnel dealing with women with suspected breast cancer should be aware of patients struggling with health technology. Age and technology familiarity may indicate vulnerable patients. Future studies should explore optimal methods for information delivery to these distinct profiles and evaluate the long-term impacts.
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Affiliation(s)
- Martin Sollie
- Research Unit for Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark.
- OPEN, Open Patient Data Explorative Network, Odense University Hospital, Region of Southern, Odense, Denmark.
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark.
| | - Marianne Hansen
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark
| | - Jørn Bo Thomsen
- Research Unit for Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark
- Department of Plastic Surgery, Odense University Hospital, J.B. Winsløws Vej 4, Indgang 20 Penthouse 2. sal, Odense C, DK, 5000, Denmark
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Krag T, Jørgensen EH, Phanareth K, Kayser L. Experiences With In-Person and Virtual Health Care Services for People With Chronic Obstructive Pulmonary Disease: Qualitative Study. JMIR Rehabil Assist Technol 2023; 10:e43237. [PMID: 37578832 PMCID: PMC10463085 DOI: 10.2196/43237] [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: 10/05/2022] [Revised: 04/20/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND The World Health Organization and the European Commission predict increased use of health technologies in the future care for patients in Europe. Studies have shown that services based on telehealth, which includes components of education, as well as rehabilitation initiatives can support the self-management of individuals living with COPD. This raises an interest in how virtual and in-person interactions and roles can best be organized in a way that suits people living with COPD in relation to their treatment and rehabilitation. OBJECTIVE This study aims to investigate how individuals living with COPD experience different combinations of virtual and in-person care, to help us better understand what aspects are valued and how to best combine elements of these services in future care. METHODS Two rounds of semistructured interviews were conducted with 13 and 4 informants, respectively. The individuals were all recruited in relation to a research project led by the telehealth initiative Epital Health. The first round of interviews included 11 informants, as 2 dropped out. Of these, 7 received the telemedicine service provided by Epital Health, 3 participated in a 12-week COPD program provided by their respective municipality, and 1 did not receive any supplementary service besides the usual care. In the second round, which included 4 informants, all had at one point received the telemedicine service and participated in a municipality-based rehabilitation program. A content analysis of the interviews was performed based on deductive coding with 4 categories, namely, (1) Self-management, (2) Health-related support, (3) Digital context, and (4) Well-being. RESULTS Medical and emotional support from health care professionals is a key aspect of care for individuals with COPD. Acute treatment with at-home medicine, monitoring one's own condition through technology, and having easy access and close contact with health care professionals familiar to them can promote self-management and well-being, as well as provide a feeling of security. Having regular meetings with a network of peers and health care professionals provides education, support, and tools to cope with the condition and improve own health. Furthermore, group-based activity motivates and increases the activity level of the individuals. Continued offers of services are desired as many experience a decrease in achieved benefits after the service ends. More emphasis is placed on the importance of the therapeutic and medical elements of care compared with factors such as technology. The identified barriers related to optimal utilization of the virtual service were related to differentiation in levels of contact depending on disease severity and skills related to the practical use of equipment. CONCLUSIONS A combination of virtual and in-person services providing lasting medical and social support is suggested for the future. This should build upon the preferences and needs of individuals living with COPD and support relationships to caregivers and peers.
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Affiliation(s)
- Thea Krag
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
| | | | | | - Lars Kayser
- Department of Public Health, University of Copenhagen, Copenhagen K, Denmark
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Rasmussen B, Wynter K, Hamblin PS, Rodda C, Steele C, Holton S, Zoffmann V, Currey J. Feasibility and acceptability of an online guided self-determination program to improve diabetes self-management in young adults. Digit Health 2023; 9:20552076231167008. [PMID: 37021125 PMCID: PMC10068990 DOI: 10.1177/20552076231167008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 03/15/2023] [Indexed: 04/03/2023] Open
Abstract
Objective Evaluate the feasibility and acceptability of an online guided self-determination (GSD) program to improve diabetes self-management skills among young adults with type 1 diabetes (YAD). Methods An online program comprising seven structured interactive conversations was designed. A pre- and post- interventional study used a sequential, two-phase multiple method design. Phase one comprised a training program for diabetes educators (DEs). In Phase two YAD participated in program and completed pre- and post-surveys assessing motivation to self-manage, perceived competence in diabetes and communication with DEs. Both YAD and DEs provided a program evaluation. Results The online GSD program was acceptable, feasible and effective in improving autonomous motivation in self-management and communication with DEs. Easy access and program flexibility were highly appreciated by both participant groups and perceived to assist YAD to stay motivated. Conclusion The program had a significant impact on the diabetes self-management of YAD and was a feasible and acceptable way to engage and communicate with DEs. The GSD platform contributes to age appropriate and person-centred diabetes self-management. It can potentially reach geographically distanced populations, or with social circumstances or other barriers impeding in-person service provision.
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Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Centre for Quality and Patient
Safety Research in the Institute for Health Transformation,
Deakin
University, Geelong, Australia
- The Centre for Quality and Patient Safety Research in the Institute
of Health Transformation – Western Health Partnership,
Western
Health, St Albans, Australia
- Faculty of Health and Medical Sciences,
University of
Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark and Steno
Diabetes Center, Odense, Denmark
- Bodil Rasmussen, School of Nursing and
Midwifery, Centre for Quality and Patient Safety Research in the Institute for
Health Transformation, Deakin University, Geelong, Australia; The Centre for
Quality and Patient Safety Research in the Institute of Health Transformation -
Western Health Partnership, Western Health, St Albans, Australia; Faculty of
Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes
Center, Odense, Denmark.
| | - Karen Wynter
- School of Nursing and Midwifery, Centre for Quality and Patient
Safety Research in the Institute for Health Transformation,
Deakin
University, Geelong, Australia
- The Centre for Quality and Patient Safety Research in the Institute
of Health Transformation – Western Health Partnership,
Western
Health, St Albans, Australia
| | - Peter S Hamblin
- Endocrinology & Diabetes Department,
Western
Health, St Albans, Australia
- Institute for Health Transformation, Faculty of Health,
Deakin
University, Burwood, Australia
- Western Health, University of Melbourne, St Albans, Australia
| | - Christine Rodda
- Western Health, University of Melbourne, St Albans, Australia
- Western Health, Sunshine Hospital, St Albans, Australia
| | - Cheryl Steele
- Western Health, Sunshine Hospital, St Albans, Australia
| | - Sara Holton
- School of Nursing and Midwifery, Centre for Quality and Patient
Safety Research in the Institute for Health Transformation,
Deakin
University, Geelong, Australia
- The Centre for Quality and Patient Safety Research in the Institute
of Health Transformation – Western Health Partnership,
Western
Health, St Albans, Australia
| | - Vibeke Zoffmann
- School of Nursing and Midwifery, Centre for Quality and Patient
Safety Research in the Institute for Health Transformation,
Deakin
University, Geelong, Australia
- Department of Public Health, University of
Copenhagen, Copenhagen K, Denmark
- The Interdisciplinary Research Unit of Women's, Children's and
Families’ Health, Juliane Marie Centre: Copenhagen University Hospital,
Rigshospitalet, Copenhagen, Denmark
| | - Judy Currey
- School of Nursing and Midwifery, Centre for Quality and Patient
Safety Research in the Institute for Health Transformation,
Deakin
University, Geelong, Australia
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Kulzer B, Heinemann L, Roos T. Patients' Experience of New Technologies and Digitalization in Diabetes Care in Germany. J Diabetes Sci Technol 2022; 16:1521-1531. [PMID: 34553987 PMCID: PMC9631513 DOI: 10.1177/19322968211041377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Little is little known about how people with diabetes experience advancing digitization and new technologies in diabetes. RESEARCH QUESTION What are the attitudes of people with diabetes (or, in the case of children with diabetes, their parents) toward digitization and advancing technology in diabetology? What significant advantages and disadvantages do they see, and how do they assess current developments of digitization in diabetology (eg, hybrid closed-loop systems, do-It-Yourself (DIY) closed-loop systems, data protection, and data donation)? MATERIAL AND METHOD 3,427 people with diabetes (47.7% female, 65.6% type 1 diabetes (T1D), 25.5% type 2 diabetes (T2D), 8.1% parents of children with diabetes; 0.8% other type of diabetes, age 49.2 ± 19.3 years) were interviewed with an online survey. RESULTS Overall, survey participants had a very positive attitude toward digitization (82.6%) and considered the potential for optimizing diabetology through digitization to be very high (78.8%). The highest rated advantages of digitization were "greater personal responsibility and self-determination in therapy" (80.0%), "better quality of treatment" (80.0%), and "better communication with the doctor/diabetes team" (77.3%), while the highest rated disadvantages were the "error-proneness of digital applications" (35.9%), the "risk of misuse of patient data" (32.3%) and the "fear that digitization will replace the doctor in many cases" (31.1%). The possibility of evaluating and analyzing glucose data by means of software, and AID systems, and the possibility of improving the interoperability of the various applications are currently rated as the most significant topics. CONCLUSIONS The vast majority of people with diabetes are very positive about new technologies in diabetology and expect that it will improve and simplify their diabetes therapy and reduce the burdens associated with diabetes. In particular, people with type 1 diabetes have high expectations for AID systems, viewing them as a kind of "technical cure" for their diabetes.
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Affiliation(s)
- Bernhard Kulzer
- Diabetes-Zentrum Mergentheim,
Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Universität
Bamberg, Germany
| | - Lutz Heinemann
- Science Consulting in Diabetes GmbH,
Kaarst, Germany
- Lutz Heinemann, PhD, Science Consulting in
Diabetes GmbH, Geranienweg 7a, Kaarst 41564, Germany.
| | - Timm Roos
- Diabetes-Zentrum Mergentheim,
Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Universität
Bamberg, Germany
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Kristjánsdóttir Ó, Welander Tärneberg A, Stenström P, Castor C, Kristensson Hallström I. eHealth literacy and socioeconomic and demographic characteristics of parents of children needing paediatric surgery in Sweden. Nurs Open 2022; 10:509-524. [PMID: 36053815 PMCID: PMC9834140 DOI: 10.1002/nop2.1316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/23/2022] [Accepted: 07/15/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim of the study was to describe different eHealth literacy domains among parents of children needing paediatric surgery in Sweden, and the correlation between these eHealth literacy domains and parents' socioeconomic factors and demographic characteristics. DESIGN Descriptive correlational design. METHOD Thirty-five Swedish-speaking parents participated as a historical control group within an ongoing Swedish clinical trial developing eHealth solutions for families after hospital care; of these, 30 completed the eHealth Literacy Questionnaire and the socioeconomic and demographic questionnaire. RESULTS Of the seven eHealth literacy domains assessed, parents' strengths lay in those pertaining to their own digital competence, control and safety, while their weakness concerned their motivation to engage with digital services, and their ability to access eHealth platforms that work. Overall, parents presented adequate eHealth literacy. Of the five socioeconomic and demographic variables assessed (i.e. monthly wages, education levels, age, gender and residency), monthly wages correlated the strongest, and positively, with the seven eHealth literacy domains.
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Affiliation(s)
| | | | - Pernilla Stenström
- Department of Pediatric Surgery and NeonatologySkåne University Hospital, Lund UniversityLundSweden
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Pitchalard K, Wimolphan P, Singkhorn O, Purkey E, Moonpanane K. Feasibility and Acceptability of the HOME Model to Promote Self-Management Among Ethnic Minority Elderly with Type 2 Diabetes Mellitus in Rural Thailand: A Pilot Study. Health Equity 2022; 6:629-637. [PMID: 36081879 PMCID: PMC9448522 DOI: 10.1089/heq.2021.0161] [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] [Accepted: 07/30/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction: Ethnic minority elderly (EME) people are recognized as a vulnerable group who have higher prevalence of type 2 diabetes mellitus (T2DM) than the majority of the population. The aim of this study was to explore the feasibility, acceptability, and effect of the HOME model (Home intervention; Online monitoring; Multidisciplinary approach; and Equity and education) specifically for enhancing self-management activities, glycemic control, and satisfaction of EME with T2DM in rural areas in Thailand. Methods: In this quasi-experimental study, a single group used a pre-test and post-test, which were conducted as a pilot study to examine the effect of the HOME model. Results: Overall, 23 dyads of EME with T2DM and their family caregivers completed the 12-week intervention. They reported that the HOME model was helpful and motivating, and they reported satisfaction with the service provided. EME with T2DM showed significant reduction of blood glucose level, and significant improvement in self-management activities, happiness, and satisfaction compared with baseline. Family caregivers had also significant improvements in happiness and reported satisfaction with the HOME model. Conclusion: The primary evidence suggested that the HOME model was acceptable and feasible for EME with T2DM and their families in rural Thailand.
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Affiliation(s)
| | | | | | - Eva Purkey
- School of Medicine, Queen's University, Kingston, Ontario, Canada
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10
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Xie L, Zhang S, Xin M, Zhu M, Lu W, Mo PKH. Electronic health literacy and health-related outcomes among older adults: A systematic review. Prev Med 2022; 157:106997. [PMID: 35189203 DOI: 10.1016/j.ypmed.2022.106997] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/17/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
This review aims to identify, appraise, and synthesize research evidence of the association between electronic health (eHealth) literacy and health outcomes in older adults. English-written articles that presented the relationships between eHealth literacy and health-related outcomes in older adults were identified by searching five scientific databases (Web of Science, PubMed, Cochrane Library, APA PsycInfo, and EMBASE) hand-searching reference lists. Searches yielded 2993 studies after duplicates were removed, of which 24 publications were included in the final review. eHealth literacy was relatively low in older adults, and the eHealth Literacy Scale, developed by Norman and Skinner in 2006, was the most frequently used instrument in the included studies (21/24, 87.5%). The health-related outcomes associated with eHealth literacy were grouped into four categories: physical, behavioral, psychosocial, and cognitive. For behavioral (e.g., health-promoting behaviors, self-care, and medication adherence) and cognitive (e.g., health knowledge and health decision making) outcomes, the evidence was mostly consistent that eHealth literacy was positively associated with better outcomes. For physical (e.g., health-related quality of life) and psychosocial outcomes (e.g., anxiety and self-efficacy), the associations were less consistent, with some studies showing significant associations while others showed no associations. Most included studies were assessed as moderate quality. Overall, higher eHealth literacy is associated with more positive health behaviors and better health knowledge and attitude in older adults, however, the associations with some physical and psychosocial outcomes are less consistent. Clarifying the pathways of the relationships between eHealth literacy and some health-related outcomes is needed for further exploring their underlying mechanisms.
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Affiliation(s)
- Luyao Xie
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Shuxian Zhang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Meiqi Xin
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China
| | - Weiyi Lu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Phoenix Kit-Han Mo
- The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China.
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Thorsen IK, Kayser L, Teglgaard Lyk-Jensen H, Rossen S, Ried-Larsen M, Midtgaard J. " I Tried Forcing Myself to do It, but Then It Becomes a Boring Chore": Understanding (dis)engagement in Physical Activity Among Individuals With Type 2 Diabetes Using a Practice Theory Approach. QUALITATIVE HEALTH RESEARCH 2022; 32:520-530. [PMID: 34964675 DOI: 10.1177/10497323211064598] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Lack of physical activity (PA) is common among individuals with type 2 diabetes (T2D). We apply a practice theory approach to investigate PA engagement in the context of T2D. Data were collected through semi-structured individual interviews (n = 23) and focus groups (n = 3x6) and analyzed by deductive-inductive reflexive thematic analysis using a practice theory framework. Forty-one purposefully selected individuals with T2D (29 men) between the ages of 54 and 77 years were included. The analysis resulted in three main themes informed by five subthemes, reflecting the key elements of practice theory (i.e., meanings, materialities, and competencies). One overarching theme identified PA engagement as an unsustainable and insurmountable project in constant and unequal competition with the practice of physical inactivity. To increase PA among individuals with T2D, future PA interventions and strategies should aim to establish a stronger link between PA and everyday life practices.
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Affiliation(s)
- Ida K Thorsen
- The Centre for Physical Activity Research, Rigshospitalet, 4321University of Copenhagen, Copenhagen, Denmark
| | - Lars Kayser
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
| | | | - Sine Rossen
- Copenhagen Centre for Cancer and Health, Municipality of Copenhagen, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- The Centre for Physical Activity Research, Rigshospitalet, 4321University of Copenhagen, Copenhagen, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, 4321University of Copenhagen, Copenhagen, Denmark
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Bults M, van Leersum CM, Olthuis TJJ, Bekhuis REM, den Ouden MEM. Barriers and Drivers Regarding the Use of Mobile Health Apps Among Patients With Type 2 Diabetes Mellitus in the Netherlands: Explanatory Sequential Design Study. JMIR Diabetes 2022; 7:e31451. [PMID: 35084357 PMCID: PMC8832276 DOI: 10.2196/31451] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/01/2021] [Accepted: 11/24/2021] [Indexed: 02/06/2023] Open
Abstract
Background Self-monitoring of blood glucose levels, food intake, and physical activity supports self-management of patients with type 2 diabetes mellitus (T2DM). There has been an increase in the development and availability of mobile health apps for T2DM. Objective The aim of this study is to explore the actual use of mobile health apps for diabetes among patients with T2DM and the main barriers and drivers among app users and nonusers. Methods An explanatory sequential design was applied, starting with a web-based questionnaire followed by semistructured in-depth interviews. Data were collected between July and December 2020. Questionnaire data from 103 respondents were analyzed using IBM SPSS Statistics (version 25.0). Descriptive statistics were performed for the actual use of apps and items of the Unified Theory of Acceptance and Use of Technology (UTAUT). The UTAUT includes 4 key constructs: performance expectancy (the belief that an app will help improve health performance), effort expectancy (level of ease associated with using an app), social influence (social support), and facilitating conditions (infrastructural support). Differences between users and nonusers were analyzed using chi-square tests for individual items. Independent 2-tailed t tests were performed to test for differences in mean scores per the UTAUT construct. In total, 16 respondents participated in the interviews (10 users and 6 nonusers of apps for T2DM). We performed content analysis using a deductive approach on all transcripts, guided by the UTAUT. Results Regarding actual use, 55.3% (57/103) were nonusers and 44.7% (46/103) were users of apps for T2DM. The main driver for the use of apps was the belief that using apps for managing diabetes would result in better personal health and well-being. The time and energy required to keep track of the data and understand the app were mentioned as barriers. Mean scores were significantly higher among users compared with nonusers of apps for T2DM for the constructs performance expectancy (4.06, SD 0.64 vs 3.29, SD 0.89; P<.001), effort expectancy (4.04, SD 0.62 vs 3.50, SD 0.82; P<.001), social influence (3.59, SD 0.55 vs 3.29, SD 0.54; P=.007), and facilitating conditions (4.22, SD 0.48 vs 3.65, SD 0.70; P<.001). On the basis of 16 in-depth interviews, it was recognized that health care professionals play an important role in supporting patients with T2DM in using apps. However, respondents noticed that their health care professionals were often not supportive of the use of apps for managing diabetes, did not show interest, or did not talk about apps. Reimbursement by insurance companies was mentioned as a missing facilitator. Conclusions Empowering health care professionals’ engagement is of utmost importance in supporting patients with T2DM in the use of apps. Insurance companies can play a role in facilitating the use of diabetes apps by ensuring reimbursement.
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Affiliation(s)
- Marloes Bults
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Catharina Margaretha van Leersum
- Science, Technology, and Policy Studies, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
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Informationstechnologie in der Diabetesbehandlung – Erleben der Patienten. DER DIABETOLOGE 2021. [DOI: 10.1007/s11428-021-00753-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kayser L, Karnoe A, Duminski E, Jakobsen S, Terp R, Dansholm S, Roeder M, From G. Health professionals’ eHealth literacy and system experience prior to and three months after implementation of an electronic health record system: A longitudinal study. (Preprint). JMIR Hum Factors 2021; 9:e29780. [PMID: 35486414 PMCID: PMC9107047 DOI: 10.2196/29780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 11/22/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background The implementation of an integrated electronic health record (EHR) system can potentially provide health care providers with support standardization of patient care, pathways, and workflows, as well as provide medical staff with decision support, easier access, and the same interface across features and subsystems. These potentials require an implementation process in which the expectations of the medical staff and the provider of the new system are aligned with respect to the medical staff’s knowledge and skills, as well as the interface and performance of the system. Awareness of the medical staff’s level of eHealth literacy may be a way of understanding and aligning these expectations and following the progression of the implementation process. Objective The objective of this study was to investigate how a newly developed and modified instrument measuring the medical staff’s eHealth literacy (staff eHealth Literacy Questionnaire [eHLQ]) can be used to inform the system provider and the health care organization in the implementation process and evaluate whether the medical staff’s perceptions of the ease of use change and how this may be related to their level of eHealth literacy. Methods A modified version of the eHLQ was distributed to the staff of a medical department in Denmark before and 3 months after the implementation of a new EHR system. The survey also included questions related to users’ perceived ease of use and their self-reported information technology skills. Results The mean age of the 194 participants before implementation was 43.1 (SD 12.4) years, and for the 198 participants after implementation, it was 42.3 (SD 12.5) years. After the implementation, the only difference compared with the preimplementation data was a small decrease in staff eHLQ5 (motivated to engage with digital services; unpaired 2-tailed t test; P=.009; effect size 0.267), and the values of the scales relating to the medical staff’s knowledge and skills (eHLQ1-3) were approximately ≥3 both before and after implementation. The range of scores was narrower after implementation, indicating that some of those with the lowest ability benefited from the training and new experiences with the EHR. There was an association between perceived ease of use and the 3 tested staff eHLQ scales, both before and after implementation. Conclusions The staff eHLQ may be a good candidate for monitoring the medical staff’s digital competence in and response to the implementation of new digital solutions. This may enable those responsible for the implementation to tailor efforts to the specific needs of segments of users and inform them if the process is not going according to plan with respect to the staff’s information technology–related knowledge and skills, trust in data security, motivation, and experience of a coherent system that suits their needs and supports the workflows and data availability.
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Affiliation(s)
- Lars Kayser
- Section of Health Service Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Astrid Karnoe
- Section of Health Service Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Emily Duminski
- Section of Health Service Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Svend Jakobsen
- Department of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
| | - Rikke Terp
- Department of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
| | - Susanne Dansholm
- Department of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
| | - Michael Roeder
- Department of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
| | - Gustav From
- Department of Internal Medicine, Herlev-Gentofte Hospital, Hellerup, Denmark
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