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Maaß L, Angoumis K, Freye M, Pan CC. Mapping Digital Public Health Interventions Among Existing Digital Technologies and Internet-Based Interventions to Maintain and Improve Population Health in Practice: Scoping Review. J Med Internet Res 2024; 26:e53927. [PMID: 39018096 PMCID: PMC11292160 DOI: 10.2196/53927] [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: 10/24/2023] [Revised: 01/31/2024] [Accepted: 05/15/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND The rapid progression and integration of digital technologies into public health have reshaped the global landscape of health care delivery and disease prevention. In pursuit of better population health and health care accessibility, many countries have integrated digital interventions into their health care systems, such as web-based consultations, electronic health records, and telemedicine. Despite the increasing prevalence and relevance of digital technologies in public health and their varying definitions, there has been a shortage of studies examining whether these technologies align with the established definition and core characteristics of digital public health (DiPH) interventions. Hence, the imperative need for a scoping review emerges to explore the breadth of literature dedicated to this subject. OBJECTIVE This scoping review aims to outline DiPH interventions from different implementation stages for health promotion, primary to tertiary prevention, including health care and disease surveillance and monitoring. In addition, we aim to map the reported intervention characteristics, including their technical features and nontechnical elements. METHODS Original studies or reports of DiPH intervention focused on population health were eligible for this review. PubMed, Web of Science, CENTRAL, IEEE Xplore, and the ACM Full-Text Collection were searched for relevant literature (last updated on October 5, 2022). Intervention characteristics of each identified DiPH intervention, such as target groups, level of prevention or health care, digital health functions, intervention types, and public health functions, were extracted and used to map DiPH interventions. MAXQDA 2022.7 (VERBI GmbH) was used for qualitative data analysis of such interventions' technical functions and nontechnical characteristics. RESULTS In total, we identified and screened 15,701 records, of which 1562 (9.94%) full texts were considered relevant and were assessed for eligibility. Finally, we included 185 (11.84%) publications, which reported 179 different DiPH interventions. Our analysis revealed a diverse landscape of interventions, with telemedical services, health apps, and electronic health records as dominant types. These interventions targeted a wide range of populations and settings, demonstrating their adaptability. The analysis highlighted the multifaceted nature of digital interventions, necessitating precise definitions and standardized terminologies for effective collaboration and evaluation. CONCLUSIONS Although this scoping review was able to map characteristics and technical functions among 13 intervention types in DiPH, emerging technologies such as artificial intelligence might have been underrepresented in our study. This review underscores the diversity of DiPH interventions among and within intervention groups. Moreover, it highlights the importance of precise terminology for effective planning and evaluation. This review promotes cross-disciplinary collaboration by emphasizing the need for clear definitions, distinct technological functions, and well-defined use cases. It lays the foundation for international benchmarks and comparability within DiPH systems. Further research is needed to map intervention characteristics in this still-evolving field continuously. TRIAL REGISTRATION PROSPERO CRD42021265562; https://tinyurl.com/43jksb3k. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/33404.
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Affiliation(s)
- Laura Maaß
- University of Bremen, SOCIUM Research Center on Inequality and Social Policy, Bremen, Germany
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
- Digital Health Section, European Public Health Association - EUPHA, Utrecht, Netherlands
| | - Konstantinos Angoumis
- University of Bielefeld, Bielefeld, Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Merle Freye
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
- University of Bremen, Institute for Information, Health and Medical Law - IGMR, Bremen, Germany
| | - Chen-Chia Pan
- Leibniz ScienceCampus Digital Public Health Bremen, Bremen, Germany
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- University of Bremen, Institute for Public Health and Nursing Research - IPP, Bremen, Germany
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Mash RJ, Schouw D. Evaluating the implementation of group empowerment and training (GREAT) for diabetes in South Africa: convergent mixed methods. BMJ Open 2024; 14:e085171. [PMID: 38803263 PMCID: PMC11328609 DOI: 10.1136/bmjopen-2024-085171] [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: 05/29/2024] Open
Abstract
OBJECTIVE Type 2 diabetes is a leading contributor to the burden of disease in South Africa. Primary care is struggling to support self-management and lifestyle change. Group empowerment and training (GREAT) for diabetes is a feasible and cost-effective intervention in our setting. This study aimed to evaluate the implementation of GREAT for diabetes. DESIGN A convergent mixed-methods study evaluated a range of implementation outcomes: acceptability, appropriateness, adoption, feasibility, fidelity, reach and cost. SETTING Ten primary care facilities from a district in all nine provinces of South Africa. PARTICIPANTS Descriptive exploratory individual semistructured interviews were conducted with 34 key stakeholders from national policy-makers to primary care providers. Three focus group interviews were held with 35 patients. RESULTS The National Department of Health saw GREAT as an acceptable and appropriate intervention, but only five of the nine provinces adopted GREAT. District-level and facility-level managers also saw GREAT as an acceptable and appropriate intervention. Factors related to feasibility included physical space, sufficient staff numbers, availability of resource materials, the health information system, adaptation to the model of care (selection of facilities, patients, adjustment of patient flow and appointment systems, leadership from local managers and the whole clinical team) and inclusion in systems for quality improvement. No major changes were made to the design of GREAT and fidelity to the session content ranged from 66% to 94%. Incremental costs were US$494 per facility. Due to disruption from the COVID-19 pandemic, only 14 facilities implemented and reached 588 patients at the time of evaluation. CONCLUSION Key lessons were learnt on how to implement GREAT for diabetes in a middle-income country setting. The findings informed the design of a programme theory using a health system framework. The programme theory will guide further scale-up in each province and scale-out to provinces that have not yet implemented. QUESTION This study focused on evaluating how to implement GREAT for type 2 diabetes in primary care and to take it to scale in South Africa. FINDING The findings led to a programme theory on how to successfully implement GREAT for diabetes in the South African context. MEANING The study demonstrates relevant contextual factors that need to be considered in the implementation of group diabetes education programme in a middle-income country.
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Affiliation(s)
- Robert James Mash
- Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
| | - Darcelle Schouw
- Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
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Khuzaiyah S, Adnani QES, Muthoharoh A, Chabibah N, Widyastuti W, Susiatmi SA, Zuhana N, Ersila W, Barach P, Lee KY. Indonesian COVID-19 lesson: A mixed-methods study on adolescent health status and health services during pandemic. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12457. [PMID: 38433114 DOI: 10.1111/jcap.12457] [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: 01/11/2024] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
TOPIC The COVID-19 pandemic affected adolescents' physical and psychological health. There must be specific services to cater to the needs of adolescents during COVID-19 in Indonesia. Lessons learned from previous pandemics will be beneficial for nurses and other health professionals to prepare services for future pandemics. PURPOSE This mixed-method study aimed to examine 459 Indonesian adolescents' health, literacy, preventive measures, and preferred health services during the COVID-19 pandemic. This study also examines sociodemographics, respondent characteristics, health information sources, and media choices. RESULTS A total of 47.5% of adolescents knew about COVID-19, 26.8% experienced physical health changes, and 61.7% considered wearing masks. Adolescent health information came from teachers (26.6%) and the Internet (32.9%). Psychological changes showed 67.8% irritation. Indonesians preferred online counseling (53.8%) and WhatsApp (45.8%) for pandemic health services. COVID-19 literacy did not affect physical or mental health (p > 0.05). CONCLUSIONS Most adolescents reported mental and physical health changes during COVID-19. Our data suggest that adolescents' strong COVID-19 knowledge did not prevent anxiety and other psychological difficulties. The longitudinal studies could be utilized if pandemic demands social and physical distance. The government, as well as nurses, might utilize WhatsApp-based remote online treatment for health services.
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Affiliation(s)
- Siti Khuzaiyah
- Midwifery Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
- Nursing and Midwifery Program, PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, Brunei
| | | | - Ainun Muthoharoh
- Pharmacy Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
| | - Nur Chabibah
- Midwifery Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
| | - Windha Widyastuti
- Nursing Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
| | - Sandi Ari Susiatmi
- Midwifery Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
| | - Nina Zuhana
- Midwifery Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
| | - Wahyu Ersila
- Midwifery Program, Faculty of Health Sciences, Universitas Muhammadiyah Pekajangan Pekalongan, Pekalongan, Central Java, Indonesia
| | - Paul Barach
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Interdisciplinary Research Institute for Health Law and Science, Sigmund Freud University, Vienna, Austria
| | - Ka Yiu Lee
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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Lim GP, Appalasamy JR, Ahmad B, Quek KF, Ramadas A. Social Media-Delivered Lifestyle Interventions Among Individuals Living with Diabetes and Prediabetes: A Scoping Review. Curr Nutr Rep 2023; 12:721-732. [PMID: 37976017 DOI: 10.1007/s13668-023-00507-7] [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] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE OF REVIEW There is a lack of synthesized evidence on social media-delivered lifestyle interventions for managing and preventing diabetes. This scoping review aims to evaluate recently reported lifestyle interventions delivered on social media for individuals with diabetes and prediabetes. RECENT FINDINGS Twelve studies were included in this review. A team of multidisciplinary healthcare professionals coordinated most interventions, half of which lasted for 6 months, and used a combination of videos, texts, images or audio to deliver the educational materials. The glycosylated hemoglobin (HbA1c) level improved in most of the studies, followed by diabetes self-care and fasting plasma glucose. The dietary intakes were only assessed in two interventions among the individuals with prediabetes and showed promising improvements. This scoping review provides a holistic overview of the recent designs of lifestyle interventions for diabetes management and prevention on social media. This is essential for various healthcare professionals and stakeholders to formulate and implement population-based, cost-effective interventions in combating diabetes using social media.
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Affiliation(s)
- Geok Pei Lim
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | | | - Badariah Ahmad
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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Krüger L, Krotsetis S, Nydahl P. [ChatGPT: curse or blessing in nursing care?]. Med Klin Intensivmed Notfmed 2023; 118:534-539. [PMID: 37401955 DOI: 10.1007/s00063-023-01038-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/28/2023] [Accepted: 06/03/2023] [Indexed: 07/05/2023]
Abstract
Artificial intelligence (AI) has been used in healthcare for some years for risk detection, diagnostics, documentation, education and training and other purposes. A new open AI application is ChatGPT, which is accessible to everyone. The application of ChatGPT as AI in education, training or studies is currently being discussed from many perspectives. It is questionable whether ChatGPT can and should also support nursing professions in health care. The aim of this review article is to show and critically discuss possible areas of application of ChatGPT in theory and practice with a focus on nursing practice, pedagogy, nursing research and nursing development.
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Affiliation(s)
- Lars Krüger
- Herz- und Diabeteszentrum NRW, Universitätsklinikum der Ruhr-Universität Bochum, Bad Oeynhausen, Deutschland
| | - Susanne Krotsetis
- Pflegeentwicklung und Pflegewissenschaft angegliedert der Pflegedirektion, des Universitätsklinikums Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland
| | - Peter Nydahl
- Pflegeforschung und -entwicklung, Pflegedirektion, Universitätsklinikum Schleswig-Holstein, Haus V40, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland.
- Universitätsinstitut für Pflegewissenschaft und -praxis, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich.
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Webster EM, Ahsan MD, Perez L, Levi SR, Thomas C, Christos P, Hickner A, Hamilton JG, Babagbemi K, Cantillo E, Holcomb K, Chapman-Davis E, Sharaf RN, Frey MK. Chatbot Artificial Intelligence for Genetic Cancer Risk Assessment and Counseling: A Systematic Review and Meta-Analysis. JCO Clin Cancer Inform 2023; 7:e2300123. [PMID: 37934933 PMCID: PMC10730073 DOI: 10.1200/cci.23.00123] [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: 07/05/2023] [Revised: 08/25/2023] [Accepted: 09/11/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE Most individuals with a hereditary cancer syndrome are unaware of their genetic status to underutilization of hereditary cancer risk assessment. Chatbots, or programs that use artificial intelligence to simulate conversation, have emerged as a promising tool in health care and, more recently, as a potential tool for genetic cancer risk assessment and counseling. Here, we evaluated the existing literature on the use of chatbots in genetic cancer risk assessment and counseling. METHODS A systematic review was conducted using key electronic databases to identify studies which use chatbots for genetic cancer risk assessment and counseling. Eligible studies were further subjected to meta-analysis. RESULTS Seven studies met inclusion criteria, evaluating five distinct chatbots. Three studies evaluated a chatbot that could perform genetic cancer risk assessment, one study evaluated a chatbot that offered patient counseling, and three studies included both functions. The pooled estimated completion rate for the genetic cancer risk assessment was 36.7% (95% CI, 14.8 to 65.9). Two studies included comprehensive patient characteristics, and none involved a comparison group. Chatbots varied as to the involvement of a health care provider in the process of risk assessment and counseling. CONCLUSION Chatbots have been used to streamline genetic cancer risk assessment and counseling and hold promise for reducing barriers to genetic services. Data regarding user and nonuser characteristics are lacking, as are data regarding comparative effectiveness to usual care. Future research may consider the impact of chatbots on equitable access to genetic services.
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Haregu T, Delobelle P, Issaka A, Shrestha A, Panniyammakal J, Thankappan KR, Parasuraman G, Schouw D, Ramalingam A, Cao Y, Levitt N, Oldenburg B. Digital Health Solutions for Community-Based Control of Diabetes During COVID-19 Pandemic: A Scoping Review of Implementation Outcomes. J Diabetes Sci Technol 2023:19322968231167853. [PMID: 37056165 PMCID: PMC10102819 DOI: 10.1177/19322968231167853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND The COVID-19 pandemic has added to the pre-existing challenges of diabetes management in many countries. It has accelerated the wider use of digital health solutions which have tremendous potential to improve health outcomes for people with diabetes. However, little is known about the attributes and the implementation of these solutions. OBJECTIVE To identify and describe digital health solutions for community-based diabetes management and to highlight their key implementation outcomes. METHODS We searched Ovid Medline, CINAHL, Embase, PsycINFO, and Web of Science for relevant articles. A purposive search was also used to identify grey literature. Articles that described digital health solutions that aimed to improve community-based diabetes management were included in this review. We applied a thematic synthesis of evidence to describe the characteristics of digital health solutions, and to summarize their key implementation outcomes. RESULTS We included 15 articles that reported digital health solutions that primarily focused on community-based diabetes management. Nine of the 15 innovations involved were mobile applications and/or web-based platforms, and five were based on social media platforms. The majority of the digital health solutions were used for diabetes education and support. High engagement, utilization, and satisfaction rates with digital health solutions were observed. The use of digital health solutions was also associated with improvement in self-management, taking medication, and reduction in glycated hemoglobin (HbA1c) levels. CONCLUSION COVID-19 triggered digital health solutions have tremendous potential to improve health outcomes for people with diabetes. Further studies are needed to evaluate the sustainability and scale-up of these solutions.
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Affiliation(s)
- Tilahun Haregu
- Baker Heart and Diabetes Institute,
Melbourne, Victoria, Australia
| | - Peter Delobelle
- Chronic Disease Initiative Africa,
University of Cape Town, Cape Town, South Africa
| | - Ayuba Issaka
- Baker Heart and Diabetes Institute,
Melbourne, Victoria, Australia
| | - Abha Shrestha
- Baker Heart and Diabetes Institute,
Melbourne, Victoria, Australia
- Division of Family Medicine and Primary
Care, Stellenbosch University, Stellenbosch, South Africa
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute of
Medical Science and Technology, Trivandrum, India
| | | | | | - Darcelle Schouw
- Division of Family Medicine and Primary
Care, Stellenbosch University, Stellenbosch, South Africa
| | - Archana Ramalingam
- Sree Chitra Tirunal Institute of
Medical Science and Technology, Trivandrum, India
| | - Yingting Cao
- Baker Heart and Diabetes Institute,
Melbourne, Victoria, Australia
| | - Naomi Levitt
- Chronic Disease Initiative Africa,
University of Cape Town, Cape Town, South Africa
| | - Brian Oldenburg
- Baker Heart and Diabetes Institute,
Melbourne, Victoria, Australia
- School of Psychology and Public Health,
La Trobe University, Melbourne, Victoria, Australia
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Mathose TT, Mash R. Factors influencing insulin initiation in primary care facilities in Cape Town, South Africa. S Afr Fam Pract (2004) 2023; 65:e1-e7. [PMID: 36861914 PMCID: PMC9982463 DOI: 10.4102/safp.v65i1.5656] [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: 10/28/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Type 2 diabetes (T2DM) is a leading cause of mortality in South Africa and resistance to the use of insulin is common. This study aimed to explore factors that influence the initiation of insulin in patients with T2DM in primary care facilities in Cape Town, South Africa. METHODS An exploratory descriptive qualitative study was conducted. Seventeen semi-structured interviews were held with patients eligible for insulin, on insulin and primary care providers. Participants were selected by maximum variation purposive sampling. Data were analysed using the framework method in Atlas-ti. RESULTS Factors related to the health system, service delivery, clinical care and patients. Systemic issues related to the required inputs of workforce, educational materials, and supplies. Service delivery issues related to workload, poor continuity and parallel coordination of care. Clinical issues related to adequate counselling. Patient factors included a lack of trust, concerns about injections, impact on lifestyle and disposal of needles. CONCLUSION Although resource constraints are likely to remain, district and facility managers can improve supplies, educational materials, continuity and coordination. Counselling must be improved and may require innovative alternative approaches to support clinicians who face high number of patients. Alternative approaches using group education, telehealth and digital solutions should be considered.Contribution: This study identified key factors influencing insulin initiation in patients with T2DM in primary care. These can be addressed by those responsible for clinical governance, service delivery and in further research.
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Affiliation(s)
- Tasunungurwa T Mathose
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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Mash RJ, Cairncross J. Comprehensive patient education and counselling for non-communicable diseases in primary care, Western Cape. S Afr Fam Pract (2004) 2023; 65:e1-e11. [PMID: 36861909 PMCID: PMC9982477 DOI: 10.4102/safp.v65i1.5634] [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: 09/19/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Treatment of non-communicable diseases (NCD) requires patient education and counselling (PEC). Initiatives have focused on Group Empowerment and Training (GREAT) for diabetes and Brief behaviour change counselling (BBCC). However, the implementation of comprehensive PEC in primary care remains a challenge. The aim of this study was to explore how such PEC could be implemented. METHODS This was a descriptive, exploratory, qualitative study at the end of the first year of a participatory action research project to implement comprehensive PEC for NCDs at two primary care facilities in the Western Cape. Focus group interviews were held with healthcare workers and reports from co-operative inquiry group meetings were used as qualitative data. RESULTS Staff were trained in GREAT for diabetes and BBCC. There were problems with training appropriate staff and sufficient numbers and a need for ongoing support. Implementation was limited by poor internal sharing of information, staff turnover and leave, rotation of staff, lack of space and fears of disrupting the efficiency of service delivery. Facilities had to embed the initiatives into appointment systems and fast track patients who attended GREAT. For those patients that were exposed to PEC, there were reported benefits. CONCLUSION Group empowerment was feasible to introduce, while BBCC was more challenging as it required extra time in the consultation.Contribution: Implementation of PEC requires alternative approaches that do not extend consultations (such as GREAT and maybe digital solutions) as well as commitment to facility organisation for PEC from managers.
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Affiliation(s)
- Robert J Mash
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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Clements M, Kaufman N, Mel E. Using Digital Health Technology to Prevent and Treat Diabetes. Diabetes Technol Ther 2023; 25:S90-S108. [PMID: 36802181 DOI: 10.1089/dia.2023.2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- Mark Clements
- Children's Mercy Hospital, Kansas City, MO, USA
- University of Missouri-Kansas City, Kansas City, MO, USA
| | - Neal Kaufman
- Fielding School of Public Health, Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Canary Health Inc., Los Angeles, CA, USA
| | - Eran Mel
- Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
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Mash RJ, Cairncross J. Piloting of virtual group education for diabetes in Cape Town: An exploratory qualitative study. S Afr Fam Pract (2004) 2023; 65:e1-e7. [PMID: 36744488 PMCID: PMC9983288 DOI: 10.4102/safp.v65i1.5635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Diabetes is a major public health problem. During the coronavirus disease 2019 (COVID-19) pandemic, patient education and counselling (PEC) for diabetes were curtailed. This project explored the possibility of offering group empowerment and training (GREAT) for diabetes via computer or tablets and Zoom video conferencing. The aim was to explore whether this was feasible in the low-income community context of primary health care in Cape Town, South Africa. METHODS Three dieticians facilitated four sessions of GREAT for diabetes with a group of five patients with type-2 diabetes. Once the programme was completed, focus group interviews were held with the facilitators and the patients to explore their experience. Interviews were recorded and analysed using a simplified framework method. RESULTS Usual primary care was not offering PEC and service delivery was brief and mechanistic. The content, resources and group processes were successfully translated into the virtual environment. The guiding style of communication was more difficult. Patients reported changes in their self-management and appreciated being able to save time and money while participating from home. Patients required considerable support and training to use the technology. All participants were concerned about safety and crime with the hardware. CONCLUSION It was feasible to conduct GREAT for diabetes via tablets and Zoom video conferencing in this low-income community. To implement at scale, a number of concerns need to be addressed. The feasibility of conducting the sessions via smartphone technology should be evaluated.Contribution: Demonstrates how digital technology could be used to develop new ways of empowering people with type 2 diabetes.
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Affiliation(s)
- Robert J Mash
- Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.
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