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van den Berg JJ, Silverman T, Fernandez MI, Henny KD, Gaul ZJ, Sutton MY, Operario D. Using eHealth to Reach Black and Hispanic Men Who Have Sex With Men Regarding Treatment as Prevention and Preexposure Prophylaxis: Protocol for a Small Randomized Controlled Trial. JMIR Res Protoc 2018; 7:e11047. [PMID: 30012549 PMCID: PMC6066633 DOI: 10.2196/11047] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/27/2018] [Accepted: 06/28/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Black and Hispanic men who have sex with men in the United States continue to be disproportionately affected by HIV and AIDS. Uptake of and knowledge about biobehavioral HIV prevention approaches, such as treatment as prevention and preexposure prophylaxis, are especially low in these populations. eHealth campaigns and social media messaging about treatment as prevention and preexposure prophylaxis may help to fill this gap in knowledge and lead to increased uptake of such strategies; however, no evidence exists of the effects of these targeted forms of communication on treatment as prevention and preexposure prophylaxis uptake in these populations. OBJECTIVE We describe the protocol for a 3-part study aiming to develop and evaluate an eHealth intervention with information about treatment as prevention and preexposure prophylaxis for HIV-positive and HIV-negative black and Hispanic men who have sex with men. METHODS Phases 1 and 2 will involve focus groups and cognitive interviews with members of the target populations, which we will use to create a culturally tailored, interactive website and applicable social media messaging for these men. Phase 3 will be a small randomized controlled trial of the eHealth intervention, in which participants will receive guided social media messages plus the newly developed website (active arm) or the website alone (control arm), with assessments at baseline and 6 months. RESULTS Participant recruitment began in August 2017 and will end in August 2020. CONCLUSIONS Public health interventions are greatly needed to increase knowledge about and uptake of biobehavioral HIV prevention strategies such as treatment as prevention and preexposure prophylaxis among black and Hispanic men who have sex with men. eHealth communication campaigns offer a strategy for engaging these populations in health communication about biobehavioral HIV prevention. TRIAL REGISTRATION ClinicalTrials.gov NCT03404531; https://www.clinicaltrials.gov/ct2/show/NCT03404531 (Archived by WebCite at http://www.webcitation.org/70myofp0R). REGISTERED REPORT IDENTIFIER RR1-10.2196/11047.
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Affiliation(s)
- Jacob J van den Berg
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - Taylor Silverman
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
| | - M Isabel Fernandez
- College of Osteopathic Medicine, Division of Health Professions, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Kirk D Henny
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Zaneta J Gaul
- Centers for Disease Control and Prevention, Atlanta, GA, United States.,ICF, Atlanta, GA, United States
| | - Madeline Y Sutton
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Don Operario
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University, Providence, RI, United States
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102
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DeRosa AP, Stribling JC. A Case Report of Health Seminars Supporting Patient Education, Engagement, and Health Literacy. JOURNAL OF CONSUMER HEALTH ON THE INTERNET 2018. [DOI: 10.1080/15398285.2018.1513269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Antonio P. DeRosa
- Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr Biomedical Information Center, New York, New York, USA
| | - Judy C. Stribling
- Weill Cornell Medicine, Samuel J. Wood Library & C.V. Starr Biomedical Information Center, New York, New York, USA
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103
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Nes AAG, van Dulmen S, Brembo EA, Eide H. An mHealth Intervention for Persons with Diabetes Type 2 Based on Acceptance and Commitment Therapy Principles: Examining Treatment Fidelity. JMIR Mhealth Uhealth 2018; 6:e151. [PMID: 29970357 PMCID: PMC6053615 DOI: 10.2196/mhealth.9942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/15/2018] [Accepted: 05/29/2018] [Indexed: 11/24/2022] Open
Abstract
Background Web-based interventions are becoming an alternative of treatment aimed to support behavioral changes and several advantages over traditional treatments are reported. New ways of delivering an intervention may result in new challenges regarding monitoring of treatment fidelity (TF) which is essential to ensure internal and external validity. Despite the importance of the theme, only a few studies in this field are reported. Objective To examine TF of a mobile phone delivered intervention based on Acceptance and Commitment Therapy (ACT) with electronic diaries and written situational feedback for persons with diabetes mellitus type 2, the recommendations from the Behavior Change Consortium (BCC) established by The National Institutes of Health (NHI) were applied. To analyze fidelity, they recommend 5 areas to be investigated (1) design of the study, (2) provider training, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment. In the current study, these areas were examined based on the analysis of therapists’ adherence to the treatment protocol and participants’ and therapists’ experience with the intervention. Methods To investigate the therapists’ adherence to the treatment protocol, a total of 251 written feedback text messages were divided into text segments. Qualitative thematic analyses were then performed to examine how ACT and other therapeutic processes were used in the feedback by the therapists. For the therapists’ and participants’ experience analysis, participants answered a self-reported questionnaire and participated in 2 interviews. The therapists continuously reported their experiences to the researcher responsible for the project. Results The results show high adherence to the TF strategies 20/21 (95%) applicable items of the fidelity checklist recommended by NHI BCC were identified in the present study. Measured provider skill acquisition post-training was the only item absent in the fidelity checklist. The results also show high therapists’ adherence to the treatment protocol. All ACT processes (values, committed action, acceptance, contact with the present moment, self as context and cognitive defusion) were found in the coded text segments of the feedback in addition to communication and motivation strategies. For 336/730 (46%) of total possible text segments coded independently by 2 researchers, the interrater reliability measured by Cohen’s kappa was .85. The evaluation of participants’ and therapists’ experience with the intervention was generally positive. Conclusions Based on the analyses of therapists’ adherence to the treatment protocol grounded by ACT-principles and participants’ and therapists’ experience with the intervention, the 5 areas of TF recommended by NHI BCC were analyzed indicating a high level of TF. These results ensure an appropriate level of internal and external validity of the study and reliable intervention results and facilitate a precise replication of this intervention concept. Web-based psychological interventions to support people with chronic conditions are becoming increasingly more common. This study supports the results from a previous study which indicated that ACT could be reliably delivered in a written web-based format. Trial Registration ClinicalTrials.gov NCT01297049; https://clinicaltrials.gov/ct2/show/NCT01297049 (Archived by WebCite at http://www.webcitation.org/70WC4Cm4T)
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Affiliation(s)
| | - Sandra van Dulmen
- Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands.,Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Espen Andreas Brembo
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Hilde Eide
- Science Centre Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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104
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Coetzee B, Kohrman H, Tomlinson M, Mbewu N, LeRoux I, Adam M. Community health workers' experiences of using video teaching tools during home visits-A pilot study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:167-175. [PMID: 28872210 PMCID: PMC7534510 DOI: 10.1111/hsc.12488] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 06/07/2023]
Abstract
Innovations in health, such as the use of tablet computers, show promise in broadening the scope of work of community health workers (CHWs), and play an important role in keeping CHWs and their clients up to date with advancements in health. While the use of mobile phones and tablets is innovative, the applicability of these technologies in different contexts remains poorly understood. Furthermore, little is known about the acceptability and feasibility of the use of video teaching tools on such devices across diverse contexts. In this study, we aimed to explore the acceptability and feasibility of using tablets with teaching videos (about HIV, alcohol, nutrition and breastfeeding) to support the health promotion efforts of 24 CHWs who work with pregnant mothers and mothers of young children in an urban township in South Africa. Between November 2015 and May 2016, we conducted focus groups and identified four key themes (with several sub-themes) that demonstrated factors related to the acceptability and feasibility of these devices and their content. Focus group transcripts were analysed thematically using qualitative data analysis software. The findings indicated that while the devices contained several supportive features (such as lightening the workload, and stimulating interest in their work), they also contained several restrictive features (safety and confidentiality). CHWs considered the video content an important tool to engage not only their clients but also family members and the community at large. Issues surrounding safety, privacy and confidentiality of using these devices require careful consideration prior to implementation in large-scale studies. Furthermore, stigma associated with household visits by CHWs and the nature of their work also need to be addressed by researchers and programme implementers. Overall, CHWs deemed the devices and the video content an acceptable and feasible means with which to provide health promotion and education among their clients.
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Affiliation(s)
- Bronwyne Coetzee
- Department of Psychology, Stellenbosch University, Matieland, South Africa
| | - Hannah Kohrman
- University of California, San Francisco, San Francisco, CA, USA
| | - Mark Tomlinson
- Department of Psychology, Stellenbosch University, Matieland, South Africa
| | - Nokwanele Mbewu
- Philani Maternal, Child Health and Nutrition Project, Elonwabeni, Cape Town, South Africa
| | - Ingrid LeRoux
- Philani Maternal, Child Health and Nutrition Project, Elonwabeni, Cape Town, South Africa
| | - Maya Adam
- Department of Pediatrics, Stanford University School of Medicine, Menlo Park, CA, USA
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105
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Prosser C, Meyer W, Ellis J, Lee R. Evolutionary ARMS Race: Antimalarial Resistance Molecular Surveillance. Trends Parasitol 2018; 34:322-334. [PMID: 29396203 DOI: 10.1016/j.pt.2018.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/02/2018] [Accepted: 01/03/2018] [Indexed: 01/13/2023]
Abstract
Molecular surveillance of antimalarial drug resistance markers has become an important part of resistance detection and containment. In the current climate of multidrug resistance, including resistance to the global front-line drug artemisinin, there is a consensus to upscale molecular surveillance. The most salient limitation to current surveillance efforts is that skill and infrastructure requirements preclude many regions. This includes sub-Saharan Africa, where Plasmodium falciparum is responsible for most of the global malaria disease burden. New molecular and data technologies have emerged with an emphasis on accessibility. These may allow surveillance to be conducted in broad settings where it is most needed, including at the primary healthcare level in endemic countries, and extending to the village health worker.
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Affiliation(s)
- Christiane Prosser
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School-Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Institute for Medical Research, Westmead, NSW, Australia.
| | - Wieland Meyer
- Molecular Mycology Research Laboratory, Centre for Infectious Diseases and Microbiology, Westmead Clinical School-Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia; Westmead Institute for Medical Research, Westmead, NSW, Australia
| | - John Ellis
- School of Life Sciences, University of Technology Sydney, NSW, Australia
| | - Rogan Lee
- Centre for Infectious Diseases and Microbiology Laboratory Services, Institute of Clinical Pathology & Medical Research, Westmead Hospital, Westmead, NSW, Australia
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106
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Tsoh JY, Sentell T, Gildengorin G, Le GM, Chan E, Fung LC, Pasick RJ, Stewart S, Wong C, Woo K, Burke A, Wang J, McPhee SJ, Nguyen TT. Healthcare Communication Barriers and Self-Rated Health in Older Chinese American Immigrants. J Community Health 2018; 41:741-52. [PMID: 26746205 DOI: 10.1007/s10900-015-0148-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Older Chinese immigrants are a growing population in the United States who experience multiple healthcare communication barriers such as limited English proficiency and low health literacy. Each of these obstacles has been associated with poor health outcomes but less is known about their effects in combination. This study examined the association between healthcare communication barriers and self-rated health among older Chinese immigrants. Cross-sectional survey data were obtained from 705 Chinese American immigrants ages 50-75 living in San Francisco, California. Communication barriers examined included spoken English proficiency, medical interpreter needs, and health literacy in written health information. The study sample (81 % females, mean age = 62) included 67 % who spoke English poorly or not at all, 34 % who reported needing a medical interpreter, and 37 % who reported "often" or "always" needing assistance to read health information. Two-thirds reported poor self-rated health; many reported having access to racial-concordant (74 %) and language-concordant (86 %) healthcare services. Both poor spoken English proficiency and low health literacy were associated with poor self-rated health, independent of other significant correlates (unemployment, chronic health conditions, and having a primary doctor who was ethnic Chinese). Results revealed that spoken English proficiency and print health literacy are independent communication barriers that are directly associated with health status among elderly Chinese American immigrants. Access to racial- or language-concordant health care services did not appear to resolve these barriers. These findings underscore the importance of addressing both spoken and written healthcare communication needs among older Chinese American immigrants.
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Affiliation(s)
- Janice Y Tsoh
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave (TRC-0984), San Francisco, CA, 94143, USA. .,Asian American Research Center for Health (ARCH), San Francisco, CA, USA.
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Ginny Gildengorin
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Gem M Le
- Asian American Research Center for Health (ARCH), San Francisco, CA, USA.,Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Elaine Chan
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave (TRC-0984), San Francisco, CA, 94143, USA
| | - Lei-Chun Fung
- Health Education Department, Chinatown Public Health Center, San Francisco, CA, USA
| | - Rena J Pasick
- Asian American Research Center for Health (ARCH), San Francisco, CA, USA.,University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA
| | - Susan Stewart
- Division of Biostatistics, University of California, Davis, CA, USA
| | - Ching Wong
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Kent Woo
- NICOS Chinese Health Coalition, San Francisco, CA, USA
| | - Adam Burke
- Asian American Research Center for Health (ARCH), San Francisco, CA, USA.,Health Education/Holistic Health Studies, San Francisco State University, San Francisco, CA, USA
| | - Jun Wang
- Asian American Research Center for Health (ARCH), San Francisco, CA, USA.,Academy of Chinese Culture and Health Sciences, Oakland, CA, USA
| | - Stephen J McPhee
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Tung T Nguyen
- Asian American Research Center for Health (ARCH), San Francisco, CA, USA.,Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
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107
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Ringwald J, Marwedel L, Junne F, Ziser K, Schäffeler N, Gerstner L, Wallwiener M, Brucker SY, Hautzinger M, Zipfel S, Teufel M. Demands and Needs for Psycho-Oncological eHealth Interventions in Women With Cancer: Cross-Sectional Study. JMIR Cancer 2017; 3:e19. [PMID: 29175813 PMCID: PMC5722981 DOI: 10.2196/cancer.7973] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/28/2017] [Accepted: 09/22/2017] [Indexed: 01/22/2023] Open
Abstract
Background Over the last decade, a growing body of studies regarding the application of eHealth and various digital interventions has been published and are widely used in the psycho-oncological care. However, the effectiveness of eHealth applications in psycho-oncological care is still questioned due to missing considerations regarding evidence-based studies on the demands and needs in cancer-affected patients. Objective This cross-sectional study aimed to explore the cancer-affected women’s needs and wishes for psycho-oncological content topics in eHealth applications and whether women with cancer differ in their content topics and eHealth preferences regarding their experienced psychological burden. Methods Patients were recruited via an electronic online survey through social media, special patient Internet platforms, and patient networks (both inpatients and outpatients, University Hospital Tuebingen, Germany). Participant demographics, preferences for eHealth and psycho-oncological content topics, and their experienced psychological burden of distress, quality of life, and need for psychosocial support were evaluated. Results Of the 1172 patients who responded, 716 were included in the study. The highest preference for psycho-oncological content topics reached anxiety, ability to cope, quality of life, depressive feelings, and adjustment toward a new life situation. eHealth applications such as Web-based applications, websites, blogs, info email, and consultation hotline were considered to be suitable to convey these content topics. Psychological burden did not influence the preference rates according to psycho-oncological content and eHealth applications. Conclusions Psycho-oncological eHealth applications may be very beneficial for women with cancer, especially when they address psycho-oncological content topics like anxiety, ability to cope, depressive feelings, self-esteem, or adjustment to a new life situation. The findings of this study indicate that psycho-oncological eHealth applications are a promising medium to improve the psychosocial care and enhance individual disease management and engagement among women with cancer.
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Affiliation(s)
- Johanna Ringwald
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.,Comprehensive Cancer Center Tuebingen-Stuttgart, University Hospital Tuebingen, Tuebingen, Germany
| | - Lennart Marwedel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Katrin Ziser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Norbert Schäffeler
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Lena Gerstner
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Markus Wallwiener
- Department of Obstetrics and Gynecology, University Hospital Heidelberg, Heidelberg, Germany
| | - Sara Yvonne Brucker
- Department of Obstetrics and Gynecology, University Hospital Tuebingen, Tuebingen, Germany
| | - Martin Hautzinger
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.,Comprehensive Cancer Center Tuebingen-Stuttgart, University Hospital Tuebingen, Tuebingen, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, LVR-Clinic Essen, University of Duisburg-Essen, Essen, Germany
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108
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Spence AD, Khasawneh M, Allen PB, Addley J. Communication of alcohol and smoking lifestyle advice to the gastroenterological patient. Best Pract Res Clin Gastroenterol 2017; 31:597-604. [PMID: 29195680 DOI: 10.1016/j.bpg.2017.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/08/2017] [Accepted: 09/16/2017] [Indexed: 02/07/2023]
Abstract
Effective communication between healthcare staff and patients is central to development of the patient-professional relationship. Many barriers influence this communication, often resulting in patients' lack of understanding and retention of information, particularly affecting advice regarding lifestyle habits, such as alcohol consumption and smoking. Alcohol and smoking misuse are potentially modifiable risk factors known to adversely affect a variety of gastroenterological conditions and improvements in communication with patients regarding this is an important management component. This review discusses the clinical impact of these factors and how healthcare professionals can improve communication. We discuss how enhancing verbal communication skills through medical training leads to greater outcomes in patient satisfaction and adherence to treatment and advice. In addition, with the rapid digitalisation of society, platforms such as social media and smartphone applications may be considered as adjuncts to traditional forms of communication.
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Affiliation(s)
- Andrew D Spence
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
| | - Mais Khasawneh
- South Eastern Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - Patrick B Allen
- South Eastern Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - Jennifer Addley
- South Eastern Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
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109
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Semakula D, Nsangi A, Oxman AD, Oxman M, Austvoll-Dahlgren A, Rosenbaum S, Morelli A, Glenton C, Lewin S, Kaseje M, Chalmers I, Fretheim A, Kristoffersen DT, Sewankambo NK. Effects of the Informed Health Choices podcast on the ability of parents of primary school children in Uganda to assess claims about treatment effects: a randomised controlled trial. Lancet 2017; 390:389-398. [PMID: 28539196 DOI: 10.1016/s0140-6736(17)31225-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 03/17/2017] [Accepted: 04/03/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND As part of the Informed Health Choices project, we developed a podcast called The Health Choices Programme to help improve the ability of people to assess claims about the benefits and harms of treatments. We aimed to evaluate the effects of the podcast on the ability of parents of primary school children in Uganda to assess claims about the effects of treatments. METHODS We did this randomised controlled trial in central Uganda. We recruited parents of children aged 10-12 years who were in their fifth year of school at 35 schools that were participating in a linked trial of the Informed Health Choices primary school resources. The parents were randomly allocated (1:1), via a web-based random number generator with block sizes of four and six, to listen to either the Informed Health Choices podcast (intervention group) or typical public service announcements about health issues (control group). Randomisation was stratified by parents' highest level of formal education attained (primary school, secondary school, or tertiary education) and the allocation of their children's school in the trial of the primary school resources (intervention vs control). The primary outcome, measured after listening to the entire podcast, was the mean score and the proportion of parents with passing scores on a test with two multiple choice questions for each of nine key concepts essential to assessing claims about treatments (18 questions in total). We did intention-to-treat analyses. This trial is registered with the Pan African Clinical Trial Registry, number PACTR201606001676150. FINDINGS We recruited parents between July 21, 2016, and Oct 7, 2016. We randomly assigned 675 parents to the podcast group (n=334) or the public service announcement group (n=341); 561 (83%) participants completed follow-up. The mean score for parents in the podcast group was 67·8% (SD 19·6) compared with 52·4% (17·6) in the control group (adjusted mean difference 15·5%, 95% CI 12·5-18·6; p<0·0001). In the podcast group, 203 (71%) of 288 parents had a predetermined passing score (≥11 of 18 correct answers) compared with 103 (38%) of 273 parents in the control group (adjusted difference 34%, 95% CI 26-41; p<0·0001). No adverse events were reported. INTERPRETATION Listening to the Informed Health Choices podcast led to a large improvement in the ability of parents to assess claims about the effects of treatments. Future studies should assess the long-term effects of use of the podcast, the effects on actual health choices and outcomes, and how transferable our findings are to other countries. FUNDING Research Council of Norway.
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Affiliation(s)
- Daniel Semakula
- College of Health Sciences, Makerere University, Kampala, Uganda; University of Oslo, Oslo, Norway
| | - Allen Nsangi
- College of Health Sciences, Makerere University, Kampala, Uganda; University of Oslo, Oslo, Norway
| | - Andrew D Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway.
| | - Matt Oxman
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Morelli
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway; Infodesignlab, Oslo, Norway
| | - Claire Glenton
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
| | - Simon Lewin
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway; Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | | | | | - Atle Fretheim
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway; University of Oslo, Oslo, Norway
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110
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Talaminos A, Naranjo D, Barbarov G, Roa LM, Reina‐Tosina J. Design and implementation of a standardised framework for the management of a wireless body network in an Mobile Health environment. Healthc Technol Lett 2017. [DOI: 10.1049/htl.2016.0101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Alejandro Talaminos
- Biomedical Engineering Group, Faculty of Engineering University of Seville Seville 41092 Spain
| | - David Naranjo
- Biomedical Engineering Group, Faculty of Engineering University of Seville Seville 41092 Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER‐BBN) Madrid 28035 Spain
| | - Gerardo Barbarov
- Biomedical Engineering Group, Faculty of Engineering University of Seville Seville 41092 Spain
| | - Laura M. Roa
- Biomedical Engineering Group, Faculty of Engineering University of Seville Seville 41092 Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER‐BBN) Madrid 28035 Spain
| | - Javier Reina‐Tosina
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER‐BBN) Madrid 28035 Spain
- Department of Signal Theory and Communications, Faculty of Engineering University of Seville Seville 41092 Spain
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111
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Paige SR, Stellefson M, Chaney BH, Chaney JD, Alber JM, Chappell C, Barry AE. Examining the Relationship between Online Social Capital and eHealth Literacy: Implications for Instagram Use for Chronic Disease Prevention among College Students. AMERICAN JOURNAL OF HEALTH EDUCATION 2017; 48:264-277. [PMID: 29152031 DOI: 10.1080/19325037.2017.1316693] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background College students actively seek online health information and use Instagram, an image- and video-based social networking website, to build social networks grounded in trust and behavioral norms (social capital), which have the potential to prevent chronic disease. Purpose This study aimed to: (1) examine how intensity of Instagram use moderates the relationship between eHealth Literacy and online social capital in college students, and (2) discuss how Instagram can be used as a social awareness platform for chronic disease prevention among college students. Methods Hierarchical regression analyses were conducted to analyze web-based survey data from a random sample of college students (N=327). Results Online bridging social capital was associated with greater eHealth Literacy (P<.05) and intensity of Instagram use (P<.001), when controlling for socio-demographic variables. The relationship between eHealth Literacy and online bridging social capital was strongest among respondents' with average (P<.01) and high (P<.01) intensity Instagram use, as compared to low Instagram intensity. Discussion High intensity of Instagram may strengthen college students' low eHealth Literacy, especially when interacting with heterogeneous connections with weaker ties. Translation to Health Education Practice Health education specialists should continue to explore how college students' intensity of Instagram use can be strengthened to build bridging online social capital, and ultimately prevent chronic disease.
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Affiliation(s)
- Samantha R Paige
- Department of Health Education & Behavior, University of Florida; PO Box 118210, Gainesville, FL 32611
| | - Michael Stellefson
- Department of Health Education & Behavior, University of Florida; PO Box 118210, Gainesville, FL 32611
| | - Beth H Chaney
- Department of Health Education & Promotion, East Carolina University; 3105 Carol G. Belk Building, Greenville, NC 27858
| | - J Don Chaney
- Department of Health Education & Promotion, East Carolina University; 2202 Carol G. Belk Building, Greenville, NC 27858
| | - Julia M Alber
- Department of Health Education & Behavior, University of Florida; PO Box 118210, Gainesville, FL 32611
| | - Chelsea Chappell
- Department of Health Education & Behavior, University of Florida; PO Box 118210, Gainesville, FL 32611
| | - Adam E Barry
- Department of Health & Kinesiology, Texas A&M University; 314C Blocker Hall, College Station, TX 77843
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Hsu GIH, Crawford SY, Paolella G, Cuellar S, Wirth SM, Venepalli NK, Wang E, Hughes D, Boyd AD. Design of Customized Mobile Application for Patient Adherence to Oral Anticancer Medications Utilizing User-Centered Design. THE JOURNAL OF BIOCOMMUNICATION 2017; 41:e3. [PMID: 36405405 PMCID: PMC9139883 DOI: 10.5210/jbc.v41i1.7499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adherence and compliance to oral anticancer medications (OAMs) can be challenging for patients due to their complex regimens. The goal of this research project was to design an effective and engaging user interface (UI), based on user-centered design (UCD) and incorporate animations, to reinforce and improve patient's understanding of the key aspects of taking OAMs. This current paper encompasses the development process and describes the initial phase of the project, which focused on the design and development of the tablet-based educational application (app). A UCD approach was implemented by consulting with oncology clinicians and patients at an early stage of development. Animations were developed and incorporated to convey complex medical concepts and information. An iterative design process will help ensure that the tool is customized for patient engagement.
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Affiliation(s)
| | | | | | | | | | | | - Edward Wang
- Department of Biomedical and Health Information Sciences
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113
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Jacobs RJ, Ownby RL, Acevedo A, Waldrop-Valverde D. A qualitative study examining health literacy and chronic illness self-management in Hispanic and non-Hispanic older adults. J Multidiscip Healthc 2017; 10:167-177. [PMID: 28461754 PMCID: PMC5404800 DOI: 10.2147/jmdh.s135370] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Chronic illness and low levels of health literacy affect health outcomes for many individuals, particularly older adults and racial/ethnic minorities. This study sought to understand the knowledge, strengths, and areas of need regarding self-management of chronic illness in order to lay the groundwork for content development of an intervention to increase health literacy and maximize patient engagement in chronic disease self-care. PATIENTS AND METHODS In-depth, qualitative interviews were conducted in Spanish and English with 25 older adults with various chronic illnesses. Topics included knowledge and understanding of chronic conditions, medications, and disease self-management skills. Qualitative data were coded by searching text and conducting cross-case analysis. An inductive analysis was then employed to allow for the patterns and themes to emerge. RESULTS Emerged themes included 1) social support, 2) coping strategies, 3) spirituality, 4) chronic disease health literacy, 5) anger, and 6) depression. While participants had a general overall knowledge of chronic illness, they had deficits in knowledge regarding their own illnesses and medications. CONCLUSION Chronic illness self-management is a complex and dynamic behavioral process. This study identified themes that leverage patient motivation to engage in self-care in a personalized manner. This information will guide the development of an intervention to promote health literacy and optimal disease self-management.
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Affiliation(s)
- Robin J Jacobs
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | | | - Amarilis Acevedo
- College of Psychology, Nova Southeastern University, Fort Lauderdale, FL
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114
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Quinn S, Bond R, Nugent C. Quantifying health literacy and eHealth literacy using existing instruments and browser-based software for tracking online health information seeking behavior. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2016.12.032] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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115
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Muller I, Rowsell A, Stuart B, Hayter V, Little P, Ganahl K, Müller G, Doyle G, Chang P, Lyles CR, Nutbeam D, Yardley L. Effects on Engagement and Health Literacy Outcomes of Web-Based Materials Promoting Physical Activity in People With Diabetes: An International Randomized Trial. J Med Internet Res 2017; 19:e21. [PMID: 28115299 PMCID: PMC5294369 DOI: 10.2196/jmir.6601] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/11/2016] [Accepted: 11/23/2016] [Indexed: 11/25/2022] Open
Abstract
Background Developing accessible Web-based materials to support diabetes self-management in people with lower levels of health literacy is a continuing challenge. Objective The objective of this international study was to develop a Web-based intervention promoting physical activity among people with type 2 diabetes to determine whether audiovisual presentation and interactivity (quizzes, planners, tailoring) could help to overcome the digital divide by making digital interventions accessible and effective for people with all levels of health literacy. This study also aimed to determine whether these materials can improve health literacy outcomes for people with lower levels of health literacy and also be effective for people with higher levels of health literacy. Methods To assess the impact of interactivity and audiovisual features on usage, engagement, and health literacy outcomes, we designed two versions of a Web-based intervention (one interactive and one plain-text version of the same content) to promote physical activity in people with type 2 diabetes. We randomly assigned participants from the United Kingdom, Austria, Germany, Ireland, and Taiwan to either an interactive or plain-text version of the intervention in English, German, or Mandarin. Intervention usage was objectively recorded by the intervention software. Self-report measures were taken at baseline and follow-up (immediately after participants viewed the intervention) and included measures of health literacy, engagement (website satisfaction and willingness to recommend the intervention to others), and health literacy outcomes (diabetes knowledge, enablement, attitude, perceived behavioral control, and intention to undertake physical activity). Results In total, 1041 people took part in this study. Of the 1005 who completed health literacy information, 268 (26.67%) had intermediate or low levels of health literacy. The interactive intervention overall did not produce better outcomes than did the plain-text version. Participants in the plain-text intervention group looked at significantly more sections of the intervention (mean difference –0.47, 95% CI –0.64 to –0.30, P<.001), but this did not lead to better outcomes. Health literacy outcomes, including attitudes and intentions to engage in physical activity, significantly improved following the intervention for participants in both intervention groups. These improvements were similar across higher and lower health literacy levels and in all countries. Participants in the interactive intervention group had acquired more diabetes knowledge (mean difference 0.80, 95% CI 0.65-0.94, P<.001). Participants from both groups reported high levels of website satisfaction and would recommend the website to others. Conclusions Following established practice for simple, clear design and presentation and using a person-based approach to intervention development, with in-depth iterative feedback from users, may be more important than interactivity and audiovisual presentations when developing accessible digital health interventions to improve health literacy outcomes. ClinicalTrial International Standard Randomized Controlled Trial Number (ISRCTN): 43587048; http://www.isrctn.com/ISRCTN43587048. (Archived by WebCite at http://www.webcitation.org/6nGhaP9bv)
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Affiliation(s)
- Ingrid Muller
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Alison Rowsell
- Department of Psychology, University of Southampton, Southampton, United Kingdom.,University of Southampton, Department of Health Sciences, Southampton, United Kingdom
| | - Beth Stuart
- Primary Care and Population Sciences, University of Southampton, Southampton, United Kingdom
| | - Victoria Hayter
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Paul Little
- Primary Care and Population Sciences, University of Southampton, Southampton, United Kingdom
| | - Kristin Ganahl
- Gesundheit Österreich GmbH (Austrian Public Health Institute), Vienna, Austria
| | - Gabriele Müller
- Centre for Evidence-based Healthcare, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany
| | - Gerardine Doyle
- UCD College of Business, University College Dublin, Dublin, Ireland
| | - Peter Chang
- Taipei Medical University and National Taipei Hospital, Taipei, Taiwan
| | - Courtney R Lyles
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | - Don Nutbeam
- School of Public Health, University of Sydney, Sydney, Australia
| | - Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, United Kingdom
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116
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Using WeChat official accounts to improve malaria health literacy among Chinese expatriates in Niger: an intervention study. Malar J 2016; 15:567. [PMID: 27881122 PMCID: PMC5121985 DOI: 10.1186/s12936-016-1621-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 11/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaria is the main health risk for Chinese expatriates working in Niger. Health education is a recommended intervention for prevention of malaria among non-immune travellers and expatriate workers. It is urgent to develop an effective and feasible way for these populations to obtain information about the prevention and treatment of malaria. METHODS An individually randomized, unblinded, controlled trial was used to evaluate the effectiveness of using WeChat official accounts for health education to improve malaria health literacy among Chinese expatriates in Niger. A total 1441 participants completed a baseline malaria health literacy questionnaire and were randomly assigned to an intervention or comparison group in a ratio of 1:1. From July to October 2014, 50 malaria prevention and treatment messages were sent to the intervention group; 50 health news messages were concurrently sent to the control group. Both groups completed the malaria health literacy questionnaire again 4 months after the start of the education intervention. A questionnaire addressing satisfaction with the health education programme was completed by the intervention group. Malaria morbidity data for 2013 and 2014 were also collected. RESULTS At baseline, participant health literacy rates were 58.29, 62, 54, and 34% for skills, knowledge, practice, and attitude, respectively. After the intervention, rates for all four aspects of malaria literacy were above 70%. There was greater change in knowledge, attitude, practice, skills, and overall health literacy among the intervention group compared with the controls, with a statistically significant difference (p < 0.01). This was especially true for acquisition of malaria-related knowledge, practice and attitude; comprehensive intervention practices; and, correct use of rapid diagnostic tests (p < 0.001). The reported malaria morbidity during the study period decreased from 23.72 to 15.40%. Participants reported high levels of satisfaction with the WeChat health education programme with over 80% stating that they would continue to follow the programme. CONCLUSIONS The present health education intervention, via a WeChat official account, for the prevention and treatment of malaria among non-immune travellers and expatriate workers proved to be an effective, sustainable, feasible, and well accepted strategy for improving malaria health literacy among Chinese expatriates in Niger.
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Yardley L, Spring BJ, Riper H, Morrison LG, Crane DH, Curtis K, Merchant GC, Naughton F, Blandford A. Understanding and Promoting Effective Engagement With Digital Behavior Change Interventions. Am J Prev Med 2016; 51:833-842. [PMID: 27745683 DOI: 10.1016/j.amepre.2016.06.015] [Citation(s) in RCA: 542] [Impact Index Per Article: 67.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/25/2016] [Accepted: 06/18/2016] [Indexed: 01/08/2023]
Abstract
This paper is one in a series developed through a process of expert consensus to provide an overview of questions of current importance in research into engagement with digital behavior change interventions, identifying guidance based on research to date and priority topics for future research. The first part of this paper critically reflects on current approaches to conceptualizing and measuring engagement. Next, issues relevant to promoting effective engagement are discussed, including how best to tailor to individual needs and combine digital and human support. A key conclusion with regard to conceptualizing engagement is that it is important to understand the relationship between engagement with the digital intervention and the desired behavior change. This paper argues that it may be more valuable to establish and promote "effective engagement," rather than simply more engagement, with "effective engagement" defined empirically as sufficient engagement with the intervention to achieve intended outcomes. Appraisal of the value and limitations of methods of assessing different aspects of engagement highlights the need to identify valid and efficient combinations of measures to develop and test multidimensional models of engagement. The final section of the paper reflects on how interventions can be designed to fit the user and their specific needs and context. Despite many unresolved questions posed by novel and rapidly changing technologies, there is widespread consensus that successful intervention design demands a user-centered and iterative approach to development, using mixed methods and in-depth qualitative research to progressively refine the intervention to meet user requirements.
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Affiliation(s)
- Lucy Yardley
- Department of Psychology, University of Southampton, Southampton, United Kingdom.
| | - Bonnie J Spring
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Heleen Riper
- Department of Clinical Psychology, VU University Amsterdam, Amsterdam, Netherlands
| | - Leanne G Morrison
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - David H Crane
- Research Department of Clinical, Education and Health Psychology, University College London, London, United Kingdom
| | - Kristina Curtis
- Centre for Technology Enabled Health Research, Coventry University, Coventry, United Kingdom
| | - Gina C Merchant
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Felix Naughton
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Ann Blandford
- Institute of Digital Health, University College London, London, United Kingdom
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118
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Rowsell A, Muller I, Murray E, Little P, Byrne CD, Ganahl K, Müller G, Gibney S, Lyles CR, Lucas A, Nutbeam D, Yardley L. Views of People With High and Low Levels of Health Literacy About a Digital Intervention to Promote Physical Activity for Diabetes: A Qualitative Study in Five Countries. J Med Internet Res 2015; 17:e230. [PMID: 26459743 PMCID: PMC4642371 DOI: 10.2196/jmir.4999] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 09/07/2015] [Accepted: 09/22/2015] [Indexed: 11/23/2022] Open
Abstract
Background Low health literacy is associated with poor health-related knowledge, illness self-management, health service use, health, and survival, and thus addressing issues related to low health literacy has been highlighted as a pressing international priority. Objective To explore views of a digital health promotion intervention designed to be accessible to people with lower levels of health literacy, in particular examining reactions to the interactive and audiovisual elements of the intervention. Methods Qualitative think-aloud interviews were carried out with 65 adults with type 2 diabetes in the UK, Ireland, USA, Germany, and Austria, with purposive sampling to ensure representation of people with lower levels of health literacy. Inductive thematic analysis was used to identify common themes. We then systematically compared views in subgroups based on country, health literacy level, age, gender, and time since diagnosis. Results Most participants from the chosen countries expressed positive views of most elements and features of the intervention. Some interactive and audiovisual elements required modification to increase their usability and perceived credibility and relevance. There were some differences in views based on age and gender, but very few differences relating to health literacy level or time since diagnosis. Conclusions In general, participants found the intervention content and format accessible, appropriate, engaging, and motivating. Digital interventions can and should be designed to be accessible and engaging for people with a wide range of health literacy levels.
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Affiliation(s)
- Alison Rowsell
- Department of Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, United Kingdom
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Boyd AD, Moores K, Shah V, Sadhu E, Shroff A, Groo V, Dickens C, Field J, Baumann M, Welland B, Gutowski G, Flores JD, Zhao Z, Bahroos N, Hynes DM, Wilkie DJ. My Interventional Drug-Eluting Stent Educational App (MyIDEA): Patient-Centered Design Methodology. JMIR Mhealth Uhealth 2015; 3:e74. [PMID: 26139587 PMCID: PMC4526975 DOI: 10.2196/mhealth.4021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 05/11/2015] [Accepted: 05/30/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient adherence to medication regimens is critical in most chronic disease treatment plans. This study uses a patient-centered tablet app, "My Interventional Drug-Eluting Stent Educational App (MyIDEA)." This is an educational program designed to improve patient medication adherence. OBJECTIVE Our goal is to describe the design, methodology, limitations, and results of the MyIDEA tablet app. We created a mobile technology-based patient education app to improve dual antiplatelet therapy adherence in patients who underwent a percutaneous coronary intervention and received a drug-eluting stent. METHODS Patient advisers were involved in the development process of MyIDEA from the initial wireframe to the final launch of the product. The program was restructured and redesigned based on the patient advisers' suggestions as well as those from multidisciplinary team members. To accommodate those with low health literacy, we modified the language and employed attractive color schemes to improve ease of use. We assumed that the target patient population may have little to no experience with electronic tablets, and therefore, we designed the interface to be as intuitive as possible. RESULTS The MyIDEA app has been successfully deployed to a low-health-literate elderly patient population in the hospital setting. A total of 6 patients have interacted with MyIDEA for an average of 17.6 minutes/session. CONCLUSIONS Including patient advisers in the early phases of a mobile patient education development process is critical. A number of changes in text order, language, and color schemes occurred to improve ease of use. The MyIDEA program has been successfully deployed to a low-health-literate elderly patient population. Leveraging patient advisers throughout the development process helps to ensure implementation success.
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Affiliation(s)
- Andrew Dallas Boyd
- Department of Biomedical and Health Information Sciences, University of Illinois at Chicago, Chicago, IL, United States.
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Jones TM, Dean CM, Hush JM, Dear BF, Titov N. A systematic review of the efficacy of self-management programs for increasing physical activity in community-dwelling adults with acquired brain injury (ABI). Syst Rev 2015; 4:51. [PMID: 25927591 PMCID: PMC4422226 DOI: 10.1186/s13643-015-0039-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 03/31/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Individuals living with acquired brain injury, typically caused by stroke or trauma, are far less likely to achieve recommended levels of physical activity for optimal health and well-being. With a growing number of people living with chronic disease and disability globally, self-management programs are seen as integral to the management of these conditions and the prevention of secondary health conditions. However, to date, there has been no systematic review of the literature examining the efficacy of self-management programs specifically on physical activity in individuals with acquired brain injury, whether delivered face-to-face or remotely. Therefore, the purpose of this review is to evaluate the efficacy of self-management programs in increasing physical activity levels in adults living in the community following acquired brain injury. The efficacy of remote versus face-to-face delivery was also examined. METHODS A systematic review of the literature was conducted. Electronic databases were searched. Two independent reviewers screened all studies for eligibility, assessed risk of bias, and extracted relevant data. RESULTS Five studies met the inclusion criteria for this review. Studies were widely heterogeneous with respect to program content and delivery characteristics and outcomes, although all programs utilized behavioral change principles. Four of the five studies examined interventions in which physical activity was a component of a multifaceted intervention, where the depth to which physical activity specific content was covered, and the extent to which skills were taught and practiced, could not be clearly established. Three studies showed favorable physical activity outcomes following self-management interventions for stroke; however, risk of bias was high, and overall efficacy remains unclear. Although not used in isolation from face-to-face delivery, remote delivery via telephone was the predominant form of delivery in two studies with support for its inclusion in self-management programs for individuals following stroke. CONCLUSIONS The efficacy of self-management programs in increasing physical activity levels in community-dwelling adults following acquired brain injury (ABI) is still unknown. Research into the efficacy of self-management programs specifically aimed at improving physical activity in adults living in the community following acquired brain injury is needed. The efficacy of remote delivery methods also warrants further investigation. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42013006748.
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Affiliation(s)
- Taryn M Jones
- Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia. .,Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia.
| | - Catherine M Dean
- Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia. .,Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia.
| | - Julia M Hush
- Department of Health Professions, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, NSW, 2109, Australia. .,Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia.
| | - Blake F Dear
- Department of Psychology, Centre for Emotional Health, Building C3A, Level 7, Macquarie University, Sydney, 2109, Australia. .,Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia.
| | - Nickolai Titov
- Department of Psychology, Centre for Emotional Health, Building C3A, Level 7, Macquarie University, Sydney, 2109, Australia. .,Centre for Physical Health, Macquarie University, Ground Floor, 75 Talavera Rd, Sydney, 2109, Australia.
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Chung SY, Nahm ES. Testing reliability and validity of the eHealth Literacy Scale (eHEALS) for older adults recruited online. Comput Inform Nurs 2015; 33:150-6. [PMID: 25783223 PMCID: PMC4442634 DOI: 10.1097/cin.0000000000000146] [Citation(s) in RCA: 108] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Currently, vast amounts of health information and health management tools are available to the public online. To maximize the benefits of these e-health technologies, it is important to assess the e-health literacy of individuals. The eHealth Literacy Scale has been used widely in the past several years, but mainly in younger populations. The purpose of this study was to test the psychometric aspects of the eHealth Literacy Scale for older adults using a secondary data analysis (N=866; mean age, 62.8±8.5 years). Reliability of the eHealth Literacy Scale was examined by calculating α coefficients and conducting test-retest procedures. Its validity was assessed using exploratory factor analysis and the hypothesis testing procedure. Findings demonstrated that eHealth Literacy Scale was internally consistent (α=.94) and stable (t244=-1.48, P=.140). The exploratory factor analysis yielded a single factor structure explaining 67.3% of the variance. The hypothesis testing also supported the validity of eHealth Literacy Scale. In recent years, there have been great efforts to use e-health interventions to engage patients in healthcare and to help them manage their own health. Our study suggests that the eHealth Literacy Scale, a short screening tool for e-health literacy, can be successfully used for older adults.
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Affiliation(s)
- Seon-Yoon Chung
- University of Maryland School of Nursing, 655 W. Lombard St, Baltimore, MD 21201, Tel: (C) 347-863-0976
| | - Eun-Shim Nahm
- University of Maryland School of Nursing, 655 W. Lombard St, Baltimore, MD 21201, Tel: (C) 347-863-0976
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122
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Toçi E, Burazeri G, Myftiu S, Sørensen K, Brand H. Health literacy in a population-based sample of adult men and women in a South Eastern European country. J Public Health (Oxf) 2015; 38:6-13. [DOI: 10.1093/pubmed/fdv006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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123
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Kobayashi LC, Wardle J, von Wagner C. Internet use, social engagement and health literacy decline during ageing in a longitudinal cohort of older English adults. J Epidemiol Community Health 2014; 69:278-83. [PMID: 25428933 PMCID: PMC4345520 DOI: 10.1136/jech-2014-204733] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Health literacy skills tend to decline during ageing, which is often attributed to age-related cognitive decline. Whether health literacy skills may be influenced by technological and social factors during ageing is unknown. Methods We investigated whether internet use and social engagement protect against health literacy decline during ageing, independent of cognitive decline. We used prospective data from 4368 men and women aged ≥52 years in the English Longitudinal Study of Ageing from 2004 to 2011. Health literacy was measured at baseline (2004–2005) and at follow-up (2010–2011) using a reading comprehension test of a fictitious medicine label. The influences of consistent internet use and engagement in each of the civic, leisure and cultural activities on health literacy decline over the follow-up were estimated. Results After adjusting for cognitive decline and other covariates, consistent internet use (1379/4368; 32%) was protectively associated with health literacy decline (OR=0.77; 95% CI 0.60 to 0.99), as was consistent engagement in cultural activities (1715/4368; 39%; OR=0.73; 95% CI 0.56 to 0.93). As the number of activities engaged in increased, the likelihood of health literacy decline steadily decreased (ptrend<0.0001), with OR=0.51 (95% CI 0.33 to 0.79) for engaging in all four of the internet use and civic, leisure and cultural activities versus none. Conclusions Internet use and social engagement, particularly in cultural activities (eg, attending the cinema, art galleries, museums and the theatre), may help older adults to maintain health literacy during ageing. Support for older adults to maintain socially engaged lives and to access the internet should help promote the maintenance of functional literacy skills during ageing.
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Affiliation(s)
- Lindsay C Kobayashi
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Christian von Wagner
- Department of Epidemiology and Public Health, University College London, London, UK
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