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Denecke K, Gabarron E, Petersen C. Current Trends and New Approaches in Participatory Health Informatics. Methods Inf Med 2023; 62:151-153. [PMID: 38158213 DOI: 10.1055/s-0043-1777732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Sciences, Bern, Switzerland
| | - Elia Gabarron
- Department of Education, ICT and Learning, Østfold University College, Halden, Norway
- Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
| | - Carolyn Petersen
- Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, United States
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2
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Qu Z, Oedingen C, Bartling T, Krauth C, Schrem H. Systematic review on the involvement and engagement of patients as advisers for the organisation of organ transplantation services. BMJ Open 2023; 13:e072091. [PMID: 37164468 PMCID: PMC10173988 DOI: 10.1136/bmjopen-2023-072091] [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: 05/12/2023] Open
Abstract
OBJECTIVES This systematic review aims to derive practical lessons from publications on patient involvement and engagement in the organisation of organ transplantation services. DESIGN This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Inclusion criteria for the analysis of publications in English cited in the databases PubMed and Web of Science until 6 December 2022 required that patients participated as advisers in the organisation of organ transplantation services. Quality assessment was performed using the Guidance for Reporting Involvement of Patients and the Public (GRIPP) 2 small form and the Critical Appraisal Skills Programme (CASP) tool for the assessment of the risks of bias. RESULTS Deployed search strings identified 2263 records resulting in a total of 11 articles. The aims and strategies, deployed methods, observed effects, observed barriers and proposed improvements for the future varied vastly. All reported that well-developed programmes involving and engaging patients at an organisational level provide additional benefits for patients and foster patient-centred care. Lessons learnt include: (1) to empower patients, the information provided to them should be individualised to prioritise their needs; (2) financial as well as organisational resources are important to successfully implement patient involvement and engagement; (3) systematic feedback from patients in organisational structures to health providers is required to improve clinical workflows and (4) the consideration of ethical issues and the relationship between investigators and participating patients should be clarified and reported. CONCLUSIONS Actionable management recommendations could be derived. The quantitative impact on clinical outcome and economic clinical process improvements remains to be investigated. Study quality can be improved using the GRIPP 2 guidance and the CASP tool. PROSPERO REGISTRATION NUMBER CRD42022186467.
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Affiliation(s)
- Zhi Qu
- Transplant Center, Hannover Medical School, Hannover, Germany
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Carina Oedingen
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Tim Bartling
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Christian Krauth
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- Center for Health Economics Research Hannover (CHERH), Hannover Medical School, Hannover, Germany
| | - Harald Schrem
- General, Visceral and Transplant Surgery, Medical University Graz, Graz, Austria
- Transplant Center Graz, Medical University Graz, Graz, Austria
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3
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Kjörk EK, Sunnerhagen KS, Lundgren-Nilsson Å, Andersson AK, Carlsson G. Development of a Digital Tool for People With a Long-Term Condition Using Stroke as a Case Example: Participatory Design Approach. JMIR Hum Factors 2022; 9:e35478. [PMID: 35657650 PMCID: PMC9206198 DOI: 10.2196/35478] [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: 12/18/2021] [Revised: 03/29/2022] [Accepted: 05/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background In patient care, demand is growing for digital health tools to enable remote services and enhance patient involvement. People with chronic conditions often have multiple health problems, and long-term follow-up is recommended to meet their needs and enable access to appropriate support. A digital tool for previsit preparation could enhance time efficiency and guide the conversation during the visit toward the patient’s priorities. Objective This study aims to develop a digital previsit tool and explore potential end user’s perceptions, using a participatory approach with stroke as a case example. Methods The digital tool was developed and prototyped according to service design principles, informed by qualitative participant data and feedback from an expert panel. All features were processed in workshops with a team that included a patient partner. The resulting tool presented questions about health problems and health information. Study participants were people with stroke recruited from an outpatient clinic and patient organizations in Sweden. Development and data collection were conducted in parallel. For conceptualization, the initial prototype was based on the Post-Stroke Checklist and research. Needs and relevance were explored in focus groups, and we used a web survey and individual interviews to explore perceived utility, ease of use, and acceptance. Data were thematically analyzed following the Framework Method. Results The development process included 22 participants (9 women) with a median age of 59 (range 42-83) years and a median of 51 (range 4-228) months since stroke. Participants were satisfied or very satisfied with using the tool and recommended its use in clinical practice. Three main themes were constructed based on focus group data (n=12) and interviews (n=10). First, valuable accessible information illuminated the need for information to confirm experiences, facilitate responses, and invite engagement in their care. Amendments to the information in turn reconfigured their expectations. Second, utility and complexity in answering confirmed that the questions were relevant and comprehensible. Some participants perceived the answer options as limiting and suggested additional space for free text. Third, capturing needs and value of the tool highlighted the tool’s potential to identify health problems and the importance of encouraging further dialog. The resulting digital tool, Strokehälsa [Strokehealth] version 1.0, is now incorporated into a national health platform. Conclusions The participatory approach to tool development yielded a previsit digital tool that the study group perceived as useful. The holistic development process used here, which integrated health information, validated questions, and digital functionality, offers an example that could be applicable in the context of other long-term conditions. Beyond its potential to identify care needs, the tool offers information that confirms experiences and supports answering the questions in the tool. The tool is freely shared for adaptation in different contexts. Trial Registration researchweb 236341; https://www.researchweb.org/is/vgr/project/236341
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Affiliation(s)
- Emma K Kjörk
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Åsa Lundgren-Nilsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | | | - Gunnel Carlsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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4
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Yeung AWK, Kulnik ST, Parvanov ED, Fassl A, Eibensteiner F, Völkl-Kernstock S, Kletecka-Pulker M, Crutzen R, Gutenberg J, Höppchen I, Niebauer J, Smeddinck JD, Willschke H, Atanasov AG. Research on Digital Technology Use in Cardiology: Bibliometric Analysis. J Med Internet Res 2022; 24:e36086. [PMID: 35544307 PMCID: PMC9133979 DOI: 10.2196/36086] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/11/2022] Open
Abstract
Background Digital technology uses in cardiology have become a popular research focus in recent years. However, there has been no published bibliometric report that analyzed the corresponding academic literature in order to derive key publishing trends and characteristics of this scientific area. Objective We used a bibliometric approach to identify and analyze the academic literature on digital technology uses in cardiology, and to unveil popular research topics, key authors, institutions, countries, and journals. We further captured the cardiovascular conditions and diagnostic tools most commonly investigated within this field. Methods The Web of Science electronic database was queried to identify relevant papers on digital technology uses in cardiology. Publication and citation data were acquired directly from the database. Complete bibliographic data were exported to VOSviewer, a dedicated bibliometric software package, and related to the semantic content of titles, abstracts, and keywords. A term map was constructed for findings visualization. Results The analysis was based on data from 12,529 papers. Of the top 5 most productive institutions, 4 were based in the United States. The United States was the most productive country (4224/12,529, 33.7%), followed by United Kingdom (1136/12,529, 9.1%), Germany (1067/12,529, 8.5%), China (682/12,529, 5.4%), and Italy (622/12,529, 5.0%). Cardiovascular diseases that had been frequently investigated included hypertension (152/12,529, 1.2%), atrial fibrillation (122/12,529, 1.0%), atherosclerosis (116/12,529, 0.9%), heart failure (106/12,529, 0.8%), and arterial stiffness (80/12,529, 0.6%). Recurring modalities were electrocardiography (170/12,529, 1.4%), angiography (127/12,529, 1.0%), echocardiography (127/12,529, 1.0%), digital subtraction angiography (111/12,529, 0.9%), and photoplethysmography (80/12,529, 0.6%). For a literature subset on smartphone apps and wearable devices, the Journal of Medical Internet Research (20/632, 3.2%) and other JMIR portfolio journals (51/632, 8.0%) were the major publishing venues. Conclusions Digital technology uses in cardiology target physicians, patients, and the general public. Their functions range from assisting diagnosis, recording cardiovascular parameters, and patient education, to teaching laypersons about cardiopulmonary resuscitation. This field already has had a great impact in health care, and we anticipate continued growth.
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Affiliation(s)
- Andy Wai Kan Yeung
- Division of Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.,Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Emil D Parvanov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | - Anna Fassl
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Fabian Eibensteiner
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Rik Crutzen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Johanna Gutenberg
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Isabel Höppchen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Center for Human Computer Interaction, Paris Lodron University Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria.,REHA Zentrum Salzburg, Salzburg, Austria
| | - Jan David Smeddinck
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
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5
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Hartasanchez SA, Heen AF, Kunneman M, García-Bautista A, Hargraves IG, Prokop LJ, May CR, Montori VM. Remote shared decision making through telemedicine: A systematic review of the literature. PATIENT EDUCATION AND COUNSELING 2022; 105:356-365. [PMID: 34147314 DOI: 10.1016/j.pec.2021.06.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To assess the extent to which shared decision making (SDM) can take place in telemedicine (remote SDM). METHODS We searched Medline, Cochrane, and Scopus from 2010 until August 7th, 2020 for articles on remote SDM in the care of any patient using any technology. We also conducted a search for telemedicine articles citing key reports on SDM outcome measures. Two reviewers independently screened titles and abstracts, reviewed full text eligible studies, and synthesized their content using thematic analysis. RESULTS Of the 12 eligible articles, most were European with patients with chronic disease or mental and behavioral health. 8 articles used synchronous remote SDM and 1 used asynchronous remote SDM. Themes related to interactional workability of both telemedicine technologies and SDM emerged, namely access to broadband, digital literacy, and satisfaction with the convenience of remote visits. CONCLUSIONS Telemedicine technologies may foster virtual interactions that support remote SDM, which, in turn, may promote productive patient-clinician interactions and patient-centered care. PRACTICE IMPLICATIONS Digitally-mediated consultations surged amidst the COVID-19 pandemic. The extent to which SDM frameworks developed for in-person use need any adaptation for remote SDM remains unclear. Investment in innovation, design, implementation, and effectiveness research to advance remote SDM are needed.
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Affiliation(s)
- Sandra A Hartasanchez
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Anja Fog Heen
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marleen Kunneman
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Andrea García-Bautista
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Ian G Hargraves
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Victor M Montori
- Knowledge and Evaluation Research Unit, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
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6
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Seljelid B, Varsi C, Solberg Nes L, Øystese KA, Børøsund E. Feasibility of a Digital Patient–Provider Communication Intervention to Support Shared Decision Making in Chronic Health Care, InvolveMe: A Pilot Study (Preprint). JMIR Form Res 2021; 6:e34738. [PMID: 35389356 PMCID: PMC9030980 DOI: 10.2196/34738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 01/21/2022] [Accepted: 03/14/2022] [Indexed: 01/19/2023] Open
Abstract
Background Enhanced communication with health care providers (HCPs) can improve symptom management and health-related quality of life (HRQoL) for patients with chronic health conditions. Access to appropriate communication venues is needed to improve communication, however. As such, digital communication interventions mediated by patient portals carry the potential to support patient-provider communication and interaction and through this, also facilitate shared decision-making (SDM). The InvolveMe intervention was designed to provide patients with the opportunity to communicate symptoms and informational needs prior to consultation via digital assessment, including prioritizing what is most important to discuss with their HCPs, as well as to interact with HCPs through secure messages between outpatient visits. Objective The aim of this study was to assess the feasibility of the InvolveMe intervention by investigating acceptability, demand (ie, system use), and limited efficacy. Methods The study was designed as a single-arm, pre-post feasibility study combining quantitative and qualitative methods for data collection. Patients from an endocrine outpatient clinic were invited to use the InvolveMe intervention for 3 months, and HCPs administering InvolveMe were invited to participate in a focus group. Guided by descriptions of how to design feasibility studies by Bowen et al, feasibility was tested by exploring (1) acceptability, using data collected during recruitment from patient participants and nonparticipants (ie, declined to participate or did not meet study requirements), HCP experiences with recruitment, and the System Usability Scale (SUS); (2) demand via exploration of system use through extraction of system log data and HCP experiences with system use; and (3) limited efficacy testing, via exploration of potential effects from the Short-Form Health Survey (RAND 36), Hospital Anxiety and Depression Scale, and Health Literacy Questionnaire. Results Patient participants (N=23) were a median 54 (range 26-78) years old and primarily male (14/23, 61%). Nonparticipants (N=16) were a median 73 (range 55-80) years old and primarily male (12/16, 75%). The average SUS score was 72.2, indicating good system usability. Assessments were completed by 8 participants from home prior to outpatient visits. The assessments entailed various bodily symptoms and needs for information. Participants sent 17 secure messages related to patient administrative matters, symptoms, and challenges. Focus group participants (N=4) were all female and registered nurses. Data were analyzed in 2 predefined themes: Acceptability and Demand. Acceptability included the subthemes intervention attractiveness and intervention suitability. Demand included the subthemes elements of SDM and intervention challenges and opportunities. All patient participants completed outcome measures at baseline, and 19 (19/23, 83%) completed outcome measures at 3 months. These preliminary efficacy findings were mixed and inconclusive. Conclusions The study design provided findings from both patient and HCP perspectives and supported feasibility of the InvolveMe intervention. The investigation of acceptability and demand supported the potential for remote SDM mediated by patient portals using assessments and secure messages. Trial Registration ClinicalTrials.gov NCT NCT04218721; https://www.clinicaltrials.gov/ct2/show/NCT04218721
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Affiliation(s)
- Berit Seljelid
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cooperation, Patient Education and Equivalent Health Services, Oslo University Hospital, Oslo, Norway
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Psychiatry & Psychology, College of Medicine & Science, Mayo Clinic, Rochester, MN, United States
| | - Kristin Astrid Øystese
- Section of Specialized Endocrinology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Department of Medical Biochemistry, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
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7
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Storm M, Venegas M, Gocinski A, Myers A, Brooks J, Fortuna KL. Stakeholders' Perspectives on Partnering to Inform the Software Development Lifecycle of Smartphone Applications for People with Serious Mental Illness: Enhancing the Software Development Lifecycle Through Stakeholder Engagement. PROCEEDINGS. IEEE GLOBAL HUMANITARIAN TECHNOLOGY CONFERENCE 2021; 2021:195-199. [PMID: 35005226 PMCID: PMC8742631 DOI: 10.1109/ghtc53159.2021.9612444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
Serious mental illness (SMI) is a leading disability worldwide. Partnering with people with SMI to co-produce smartphone apps to support mental health outcomes throughout the software development lifecycle may support patient engagement with smartphone health app interventions. Partnering with this community is often challenging and requires a highly specialized community engagement training and skillset. The purpose of this study was to identify stakeholders' perspectives on partnering to inform the software development lifecycle of a smartphone health app intervention for people with SMI. We conducted thirty-five semi-structured qualitative interviews with 20 mental health patients and 15 peer support specialists. We identified six themes: (1) co-produce health app intervention content; (2) selection of app technology features; (3) integration of human factors in digital health apps; (4) consideration of personalized patient preferences in digital health apps; (5) identify unrecognized concerns early in the software development lifecycle; and (6) inclusion of real-world social, cognitive, and environmental contexts. Integration of these considerations may elucidate the partnering process to facilitate engagement among vulnerable populations that commonly disengage from mental health smartphone apps use such as people with SMI.
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Affiliation(s)
- Marianne Storm
- University of Stavanger & Molde University College, Norway
| | | | | | | | | | - Karen L Fortuna
- Geisel School of Medicine, Dartmouth College, Hanover NH, USA
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8
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Storm M, Fjellså HMH, Skjærpe JN, Myers AL, Bartels SJ, Fortuna KL. Usability Testing of a Mobile Health Application for Self-Management of Serious Mental Illness in a Norwegian Community Mental Health Setting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168667. [PMID: 34444416 PMCID: PMC8392347 DOI: 10.3390/ijerph18168667] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/08/2021] [Accepted: 08/13/2021] [Indexed: 12/03/2022]
Abstract
Background: For digital tools to have high usability and fit service users’ health needs and socio-environmental context, it is important to explore usability with end-users and identify facilitators and barriers to uptake. Objective: To conduct user testing of the smartphone health application, PeerTECH, in a Norwegian community mental health setting. Methods: Semistructured interviews and usability testing of the PeerTECH app using the Think-Aloud approach and task analysis among 11 people (three individuals with a serious mental illness, two peer support workers, and six mental health professionals). Results: Study participants perceived PeerTECH as a relevant tool to support self-management of their mental and physical health conditions, and they provided valuable feedback on existing features as well as suggestions for adaptions to the Norwegian context. The task analysis revealed that PeerTECH is easy to manage for service users and peer support workers. Conclusions: Adapting the PeerTECH smartphone app to the Norwegian context may be a viable and useful tool to support individuals with serious mental illness.
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Affiliation(s)
- Marianne Storm
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway; (H.M.H.F.); (J.N.S.)
- Correspondence:
| | - Hilde Marie Hunsbedt Fjellså
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway; (H.M.H.F.); (J.N.S.)
| | - Jorunn N. Skjærpe
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, 4021 Stavanger, Norway; (H.M.H.F.); (J.N.S.)
| | - Amanda L. Myers
- School of Public Health, Rivier University, Nashua, NH 03060, USA;
| | - Stephen J. Bartels
- Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA 02114, USA;
| | - Karen L. Fortuna
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03766, USA;
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9
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Seljelid B, Varsi C, Solberg Nes L, Øystese KA, Børøsund E. A Digital Patient-Provider Communication Intervention (InvolveMe): Qualitative Study on the Implementation Preparation Based on Identified Facilitators and Barriers. J Med Internet Res 2021; 23:e22399. [PMID: 33830063 PMCID: PMC8294341 DOI: 10.2196/22399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/09/2020] [Accepted: 03/18/2021] [Indexed: 01/15/2023] Open
Abstract
Background Chronic health conditions are affecting an increasing number of individuals, who experience various symptoms that decrease their quality of life. Digital communication interventions that enable patients to report their symptoms have been shown to positively impact chronic disease management by improving access to care, patient-provider communication, clinical outcomes, and health-related quality of life. These interventions have the potential to prepare patients and health care providers (HCPs) before visits and improve patient-provider communication. Despite the recent rapid development and increasing number of digital communication interventions that have shown positive research results, barriers to realizing the benefits offered through these types of interventions still exist. Objective The aim of this study is to prepare for the implementation of a digital patient-provider communication intervention in the daily workflow at 2 outpatient clinics by identifying potential determinants of implementation using the Consolidated Framework for Implementation Research (CFIR) to tailor the use of digital communication intervention to the intended context and identify key aspects for an implementation plan. Methods A combination of focus groups, workshops, and project steering committee meetings was conducted with HCPs (n=14) and patients (n=2) from 2 outpatient clinics at a university hospital. The CFIR was used to guide data collection and analysis. Transcripts, written minutes, and notes were analyzed and coded into 5 CFIR domains using thematic analysis. Results Data were examined and analyzed into 18 CFIR constructs relevant to the study purpose. On the basis of the identified determinants, important intervention tailoring includes adjustments to the digital features and adjustments to fit the clinical workflow and a decision to conduct a future pilot study. Furthermore, it was decided to provide the intervention to patients as early as possible in their disease trajectory, with tailored information about its use. Key aspects for the implementation plan encompassed maintaining the identified engagement and positive attitude, involving key stakeholders in the implementation process, and providing the needed support and training. Conclusions This study offers insight into the involvement of stakeholders in the tailoring and implementation planning of a digital communication intervention in clinical practice. Stakeholder involvement in the identification of implementation facilitators and barriers can contribute to the tailoring of digital communication interventions and how they are used and can also inform systematic and targeted implementation planning.
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Affiliation(s)
- Berit Seljelid
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cooperation, Patient Education and Equivalent Health Services, CEO's Staff, Oslo University Hospital, Oslo, Norway
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatry & Psychology, College of Medicine & Science, Mayo Clinic, Rochester, MN, United States
| | - Kristin Astrid Øystese
- Section of Specialized Endocrinology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.,Department of Medical Biochemistry, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
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10
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Balanescu AR, Bojinca VC, Schweitzer AM, Joca B, Mardale DA, Badea D, Bojinca M. Translation and cultural adaptation of a romanian version of the communication assessment tool (CAT_Ro). BMC Health Serv Res 2021; 21:184. [PMID: 33639947 PMCID: PMC7913309 DOI: 10.1186/s12913-021-06186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The communication between health providers and patients influences the quality of medical care. The Communication Skills Assessment (CAT) is a reliable, validated tool, which was developed to assess interpersonal communication skills between physicians and patients. The purpose of this study was to obtain a Romanian version of the CAT (CAT_Ro), using a controlled and systematic process to translate and cross-culturally adapt the original questionnaire, since there are no validated instruments to assess healthcare professionals' communication capability in Romania. METHODS The study was conducted in two Departments of Internal Medicine and Rheumatology from Bucharest, Romania, using a rigorous scientific methodology for the translation process, according to literature recommendations, implicating conceptual evaluation, semantics, and cultural adaptation, which involved several steps. The updated version was pre-tested in a pilot study, which included 89 outpatients. RESULTS The results showed a narrow range of variability in item interpretation, without differences in patients' responses according to variables such as age, gender, education, disease type, number of previous visits with the same doctor. CONCLUSION CAT-Ro is the result of a comprehensive process study. It represents the first translation and cultural adaptation in Romanian of an instrument able to assess the health providers' communication skills, which was validated in a pilot study and is to be used in more extensive studies with patients from several specialties.
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Affiliation(s)
- Andra Rodica Balanescu
- University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu street, sector 2, 020021, Bucharest, Romania
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, 37-39 Ion Mihalache Bl. Sector 1, 011172, Bucharest, Romania
| | - Violeta Claudia Bojinca
- University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu street, sector 2, 020021, Bucharest, Romania.
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, 37-39 Ion Mihalache Bl. Sector 1, 011172, Bucharest, Romania.
| | | | | | - Denise Ani Mardale
- Department of Internal Medicine and Rheumatology, "Sf. Maria" Hospital, 37-39 Ion Mihalache Bl. Sector 1, 011172, Bucharest, Romania
| | - Denisa Badea
- Department of Internal Medicine and Rheumatology, "Dr. Ion Cantacuzino" Clinical Hospital, 5-7 Ion Movila Street, Bucharest, 030167, Romania
| | - Mihai Bojinca
- University of Medicine and Pharmacy "Carol Davila", 37 Dionisie Lupu street, sector 2, 020021, Bucharest, Romania
- Department of Internal Medicine and Rheumatology, "Dr. Ion Cantacuzino" Clinical Hospital, 5-7 Ion Movila Street, Bucharest, 030167, Romania
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