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Ankolekar A, Vanneste BGL, Bloemen-van Gurp E, van Roermund JG, van Limbergen EJ, van de Beek K, Marcelissen T, Zambon V, Oelke M, Dekker A, Roumen C, Lambin P, Berlanga A, Fijten R. Development and validation of a patient decision aid for prostate Cancer therapy: from paternalistic towards participative shared decision making. BMC Med Inform Decis Mak 2019; 19:130. [PMID: 31296199 PMCID: PMC6624887 DOI: 10.1186/s12911-019-0862-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 07/02/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Patient decision aids (PDAs) can support the treatment decision making process and empower patients to take a proactive role in their treatment pathway while using a shared decision-making (SDM) approach making participatory medicine possible. The aim of this study was to develop a PDA for prostate cancer that is accurate and user-friendly. METHODS We followed a user-centered design process consisting of five rounds of semi-structured interviews and usability surveys with topics such as informational/decisional needs of users and requirements for PDAs. Our user-base consisted of 8 urologists, 4 radiation oncologists, 2 oncology nurses, 8 general practitioners, 19 former prostate cancer patients, 4 usability experts and 11 healthy volunteers. RESULTS Informational needs for patients centered on three key factors: treatment experience, post-treatment quality of life, and the impact of side effects. Patients and clinicians valued a PDA that presents balanced information on these factors through simple understandable language and visual aids. Usability questionnaires revealed that patients were more satisfied overall with the PDA than clinicians; however, both groups had concerns that the PDA might lengthen consultation times (42 and 41%, respectively). The PDA is accessible on http://beslissamen.nl/ . CONCLUSIONS User-centered design provided valuable insights into PDA requirements but challenges in integrating diverse perspectives as clinicians focus on clinical outcomes while patients also consider quality of life. Nevertheless, it is crucial to involve a broad base of clinical users in order to better understand the decision-making process and to develop a PDA that is accurate, usable, and acceptable.
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Affiliation(s)
- Anshu Ankolekar
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Ben G. L. Vanneste
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Esther Bloemen-van Gurp
- Fontys University of Applied Sciences, Eindhoven, The Netherlands
- Zuyd University of Applied Sciences, Heerlen, The Netherlands
| | - Joep G. van Roermund
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Evert J. van Limbergen
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Kees van de Beek
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Tom Marcelissen
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Matthias Oelke
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
- St. Antonius-Hospital Gronau, Gronau, Germany
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Cheryl Roumen
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Philippe Lambin
- The D-Lab, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht University, Maastricht, The Netherlands
| | - Adriana Berlanga
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Dr. Tanslaan 12, 6229 ET Maastricht, The Netherlands
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Validation of the short assessment of health literacy (SAHL-D) and short-form development: Rasch analysis. BMC Med Res Methodol 2019; 19:122. [PMID: 31200647 PMCID: PMC6567391 DOI: 10.1186/s12874-019-0762-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/29/2019] [Indexed: 01/01/2023] Open
Abstract
Background Accurate measurement of health literacy is essential to improve accessibility and effectiveness of health care and prevention. One measure frequently applied in international research is the Short Assessment of Health Literacy (SAHL). While the Dutch SAHL (SAHL-D) has proven to be valid and reliable, its administration is time consuming and burdensome for participants. Our aim was to further validate, strengthen and shorten the SAHL-D using Rasch analysis. Methods Available cross-sectional SAHL-D data was used from adult samples (N = 1231) to assess unidimensionality, local independence, item fit, person fit, item hierarchy, scale targeting, precision (person reliability and person separation), and presence of differential item functioning (DIF) depending on age, gender, education and study sample. Results Thirteen items for a short form were selected based on item fit and DIF, and scale properties were compared between the two forms. The long form had several items with DIF for age, gender, educational level and study sample. Both forms showed lower measurement precision at higher health literacy levels. Conclusions The findings support the validity and reliability of the SAHL-D for the long form and the short form, which can be used for a rapid assessment of health literacy in research and clinical practice. Electronic supplementary material The online version of this article (10.1186/s12874-019-0762-4) contains supplementary material, which is available to authorized users.
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Govender R, Taylor SA, Smith CH, Gardner B. Helping Patients With Head and Neck Cancer Understand Dysphagia: Exploring the Use of Video-Animation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2019; 28:697-705. [PMID: 31136243 PMCID: PMC6802865 DOI: 10.1044/2018_ajslp-18-0184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/05/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
Purpose Patients newly diagnosed with head and neck cancer should be informed of the ramifications of cancer treatment on swallowing function during their pretreatment consultation. The purpose of this study was to explore (a) the usefulness and (b) the acceptability of video-animation in helping patients to understand the basics of the swallowing mechanism and dysphagia. Method Thirteen patients treated for head and neck cancer participated in this study. Think-aloud, a type of qualitative methodology, was used to encourage patients to verbalize their thoughts while watching two short video-animations showing the process of normal/abnormal swallowing. Transcripts were analyzed using thematic analysis. Results Four main themes were identified as follows: (a) patient interest and engagement, (b) acceptability of visual imagery and narration, (c) information provision and learning, and (d) personal relevance and intended action. Patients appeared interested and engaged in the video-animations, asking several spontaneous questions about how to maintain or improve swallowing function. Learning was evident from patients' recognition and verbalizations of grossly disordered swallowing patterns. Most patients reported the images to be visually acceptable and could often relate what they were seeing to their own swallowing experience. Many patients also verbalized recognition of the need to keep muscles active through exercises. Conclusions These results suggest that the video-animations of swallowing were acceptable, interesting, informative, and relevant for most patients. It was therefore useful not only as an education tool, but also showed potential to influence patients' intentions to undertake preventative interventions that may preserve better swallowing function after cancer treatment.
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Affiliation(s)
- Roganie Govender
- Head and Neck Cancer Centre, University College London Hospital NHS Foundation Trust, United Kingdom
- Research Department of Behavioural Science and Health, University College London, United Kingdom
| | - Stuart A. Taylor
- Centre for Medical Imaging, University College London, United Kingdom
| | - Christina H. Smith
- UCL Division of Psychology and Language Sciences, University College London, United Kingdom
| | - Benjamin Gardner
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
- Research Department of Epidemiology and Public Health, University College London, United Kingdom
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Wong C, Wu HC, Cleary EG, Patton AP, Xie A, Grinstein G, Koch-Weser S, Brugge D. Visualizing Air Pollution: Communication of Environmental Health Information in a Chinese Immigrant Community. JOURNAL OF HEALTH COMMUNICATION 2019; 24:339-358. [PMID: 31030632 PMCID: PMC8258432 DOI: 10.1080/10810730.2019.1597949] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study developed and evaluated a visual approach to promoting environmental health literacy about highway pollution. The Interactive Map of Chinatown Traffic Pollution was the centerpiece of a communication approach designed to make complex scientific information about traffic-related air pollution comprehensible to Chinese immigrants with limited English proficiency. The map enabled visualization of the spatial distribution of ultrafine particles (less than 100 nanometers in diameter), a toxic and invisible form of air pollution, in Boston Chinatown. A university-community partnership enabled design of intergenerational training sessions aimed toward empowering community members to take health-promoting actions that reduce exposure to ultrafine particulate pollution. A mixed methods approach was taken to evaluation. Nine high school youth learned to use the map and then tutored adults recruited from English as a Second Language (ESL) classes and from a community workshop. Seventy-three of these adults completed a pre-post survey measuring change in three domains: pollution knowledge, attitudes toward environmental issues, and self-efficacy in using maps. Adult participants demonstrated statistically significant improvements in all three domains (Wilcoxon signed-rank test, all p < 0.01). Seventeen adults and nine youth participated in interviews. Interview participants reported adjusting daily routines to reduce exposure to pollution.
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Affiliation(s)
- Carolyn Wong
- a Institute for Asian American Studies , University of Massachusetts Boston , Boston , USA
| | - Hsin-Ching Wu
- a Institute for Asian American Studies , University of Massachusetts Boston , Boston , USA
- b Department of Public Policy and Public Affairs , University of Massachusetts Boston , Boston , USA
| | - Ekaterina G Cleary
- c Center for Integration of Science and Industry , Bentley University , Waltham , USA
| | | | - Alan Xie
- a Institute for Asian American Studies , University of Massachusetts Boston , Boston , USA
| | - Georges Grinstein
- e Center for Data Science , University of Massachusetts Amherst , Amherst Center , USA
| | - Susan Koch-Weser
- f Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston , MA , USA
| | - Doug Brugge
- f Department of Public Health and Community Medicine , Tufts University School of Medicine , Boston , MA , USA
- g Department of Civil and Environmental Engineering , Tufts University , Medford , USA
- h Tisch College of Civic Life , Tufts University , Medford , USA
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105
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Readability of Dutch online patient-directed health information on breast reconstruction. EUROPEAN JOURNAL OF PLASTIC SURGERY 2019. [DOI: 10.1007/s00238-019-1498-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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106
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den Bakker CM, Schaafsma FG, van der Meij E, Meijerink WJ, van den Heuvel B, Baan AH, Davids PH, Scholten PC, van der Meij S, van Baal WM, van Dalsen AD, Lips DJ, van der Steeg JW, Leclercq WK, Geomini PM, Consten EC, Schraffordt Koops SE, de Castro SM, van Kesteren PJ, Cense HA, Stockmann HB, Ten Cate AD, Bonjer HJ, Huirne JA, Anema JR. Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development. J Med Internet Res 2019; 21:e9938. [PMID: 30724740 PMCID: PMC6381532 DOI: 10.2196/jmir.9938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/16/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention (“ikherstel” intervention or “I recover” intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures. Objective This study aimed to further develop the “ikherstel” eHealth intervention using Intervention Mapping (IM) to fit a broader patient population. Methods The IM protocol was used to guide further development of the “ikherstel” intervention. First, patients’ needs were identified using (1) the information of a process evaluation of the earlier performed “ikherstel” study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed. Results The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as “achieving earlier recovery including return to normal activities and work.” The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands. Conclusions The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed. Trial Registration Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686
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Affiliation(s)
- Chantal M den Bakker
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Frederieke G Schaafsma
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands
| | - Eva van der Meij
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Baukje van den Heuvel
- Department of Operation Rooms, Radboud University Medical Center, Nijmegen, Netherlands
| | - Astrid H Baan
- Department of Surgery, Amstelland Ziekenhuis, Amstelveen, Netherlands
| | - Paul Hp Davids
- Department of Surgery, Diakonessenhuis, Utrecht, Netherlands
| | - Petrus C Scholten
- Department of Obstetrics and Gynaecology, Diakonessenhuis, Utrecht, Netherlands
| | | | - W Marchien van Baal
- Department of Obstetrics and Gynaecology, Flevoziekenhuis, Almere, Netherlands
| | | | - Daniel J Lips
- Department of Surgery, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
| | - Jan Willem van der Steeg
- Department of Obstetrics and Gynaecology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
| | | | - Peggy Maj Geomini
- Department of Obstetrics and Gynaecology, Máxima Medisch Centrum, Veldhoven, Netherlands
| | - Esther Cj Consten
- Department of Surgery, Meander Medisch Centrum, Amersfoort, Netherlands
| | | | - Steve Mm de Castro
- Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Paul Jm van Kesteren
- Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Huib A Cense
- Department of Surgery, Rode Kruis Ziekenhuis, Beverwijk, Netherlands
| | | | - A Dorien Ten Cate
- Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Haarlem, Netherlands
| | - Hendrik J Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Judith Af Huirne
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | - Johannes R Anema
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands
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Søgaard Neilsen A, Wilson RL. Combining e-mental health intervention development with human computer interaction (HCI) design to enhance technology-facilitated recovery for people with depression and/or anxiety conditions: An integrative literature review. Int J Ment Health Nurs 2019; 28:22-39. [PMID: 30133096 DOI: 10.1111/inm.12527] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2018] [Indexed: 01/20/2023]
Abstract
Computer scientists contend that understanding human computer interaction (HCI) is an important factor in developing successful computer user experiences. Mental health professionals across a range of disciplines are increasingly developing and implementing Internet-based treatments for people with a variety of mental health conditions. Many therapeutic and economic benefits are associated with technology-enabled treatments for a range of mental health disorders. Despite this, the role of HCI and associated design elements remains poorly understood in regard to the impact on patient safety, effectiveness, and to adherence of treatment for computer users who engage with e-mental health interventions. An integrative literature review was conducted to investigate how adequately HCI and user-centred design is incorporated in the development of e-mental health interventions for depression and anxiety, and subsequently reported in literature to inform evidence-based practice. The PRISMA model was used to locate, select, and include 30 relevant articles. The main finding of this review is that Internet-based e-mental health interventions are routinely implemented without sufficiently describing the relevant HCI design features applied. This is a limitation that in turn jeopardizes the assessment validity of e-mental interventions generally, leaving those who administer the interventions with incomplete evidence to support the safe, reliable, dependable, credible, and trustworthy implementation of the interventions. The recommendation arising from this review is that human computer interaction should be carefully considered when mental health nurses and other practitioners adopt e-mental health interventions for therapeutic purposes to assure the quality and safety of e-mental health interventions on offer to patients.
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Affiliation(s)
| | - Rhonda L Wilson
- E Mental Health, Clinical Institute of Research, University of Southern Denmark, Odense, Denmark
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108
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Visscher BB, Steunenberg B, Heijmans M, Hofstede JM, Devillé W, van der Heide I, Rademakers J. Evidence on the effectiveness of health literacy interventions in the EU: a systematic review. BMC Public Health 2018; 18:1414. [PMID: 30594180 PMCID: PMC6310940 DOI: 10.1186/s12889-018-6331-7] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/17/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In the last decade, the attention for health literacy has increased in the European Union. This is due to three main reasons. First, reviews have shown that inadequate health literacy is associated with worse health outcomes, higher health care use and expenditure. Second, in all European countries the population is aging and the number of chronically ill people is rising. Improving health literacy in this group can offer greater opportunities to take an active part in society, be independent and improve quality of life. Third, since most research on health literacy has been conducted outside Europe and relatively little is known about the development of health literacy interventions and its effects on outcome measures in European countries. The aim of this systematic review was to assess the evidence on the effectiveness of health literacy interventions in the European Union published between 1995 and 2018. METHODS Searches have been performed in Medline, PubMed, EMBASE, CINAHL, Cochrane library, PsychINFO, ERIC, Web of Science and SCOPUS for publications on health literacy intervention studies in European Union countries. Studies were included if the research was conducted in one or more Member States of the European Union, the publication described an intervention study, the intervention was aimed at health literacy, the publication described an outcome measure related to health literacy and the publication was written in English, French or German. RESULTS A total of 23 studies were included. Three types of interventions were identified; aimed at improving health literacy, tailored to different health literacy levels and aimed at improving health outcomes in general that differentiated in effects for people with different health literacy levels. Most interventions identified in the review focus on the functional level of health literacy or numeracy. The strength of evidence from the European health literacy intervention studies was low and there was a huge heterogeneity in study design, measurement tools and outcomes measured. CONCLUSIONS Promising interventions were tailored to the needs of patients, addressing functional, interactive and critical skills and use not difficult animated spoken text. Future research should focus on the development and assessment of such interventions and use stronger designs.
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Affiliation(s)
- Boudewijn B. Visscher
- University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands
| | - Bas Steunenberg
- University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS Utrecht, The Netherlands
| | - Monique Heijmans
- Nivel (Netherlands institute for health services research), Otterstraat 118, 3513 CR Utrecht, The Netherlands
| | - Jolien M. Hofstede
- Nivel (Netherlands institute for health services research), Otterstraat 118, 3513 CR Utrecht, The Netherlands
| | - Walter Devillé
- Nivel (Netherlands institute for health services research), Otterstraat 118, 3513 CR Utrecht, The Netherlands
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Iris van der Heide
- Nivel (Netherlands institute for health services research), Otterstraat 118, 3513 CR Utrecht, The Netherlands
| | - Jany Rademakers
- Nivel (Netherlands institute for health services research), Otterstraat 118, 3513 CR Utrecht, The Netherlands
- Department of Family Medicine, Maastricht University, CAPHRI, (Care and Public Health Research Institute), Maastricht, The Netherlands
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Tri S, Albers L, Koshman S, Bucci C, Kertland H, Semchuk B. Dual antiplatelet therapy: A new whiteboard video for patient education. Can Pharm J (Ott) 2018; 151:368-371. [PMID: 30559910 DOI: 10.1177/1715163518802866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Samantha Tri
- Department of Pharmacy Services (Tri, Albers, Semchuk), Regina General Hospital and Pasqua Hospital, Regina, Saskatchewan.,Division of Cardiology (Koshman), Department of Medicine, University of Alberta, Edmonton, Alberta.,Department of Pharmacy (Bucci), Sunnybrook Health Sciences Centre, Toronto.,Department of Pharmacy (Kertland), St. Michael's Hospital, Toronto, Ontario
| | - Lori Albers
- Department of Pharmacy Services (Tri, Albers, Semchuk), Regina General Hospital and Pasqua Hospital, Regina, Saskatchewan.,Division of Cardiology (Koshman), Department of Medicine, University of Alberta, Edmonton, Alberta.,Department of Pharmacy (Bucci), Sunnybrook Health Sciences Centre, Toronto.,Department of Pharmacy (Kertland), St. Michael's Hospital, Toronto, Ontario
| | - Sheri Koshman
- Department of Pharmacy Services (Tri, Albers, Semchuk), Regina General Hospital and Pasqua Hospital, Regina, Saskatchewan.,Division of Cardiology (Koshman), Department of Medicine, University of Alberta, Edmonton, Alberta.,Department of Pharmacy (Bucci), Sunnybrook Health Sciences Centre, Toronto.,Department of Pharmacy (Kertland), St. Michael's Hospital, Toronto, Ontario
| | - Claudia Bucci
- Department of Pharmacy Services (Tri, Albers, Semchuk), Regina General Hospital and Pasqua Hospital, Regina, Saskatchewan.,Division of Cardiology (Koshman), Department of Medicine, University of Alberta, Edmonton, Alberta.,Department of Pharmacy (Bucci), Sunnybrook Health Sciences Centre, Toronto.,Department of Pharmacy (Kertland), St. Michael's Hospital, Toronto, Ontario
| | - Heather Kertland
- Department of Pharmacy Services (Tri, Albers, Semchuk), Regina General Hospital and Pasqua Hospital, Regina, Saskatchewan.,Division of Cardiology (Koshman), Department of Medicine, University of Alberta, Edmonton, Alberta.,Department of Pharmacy (Bucci), Sunnybrook Health Sciences Centre, Toronto.,Department of Pharmacy (Kertland), St. Michael's Hospital, Toronto, Ontario
| | - Bill Semchuk
- Department of Pharmacy Services (Tri, Albers, Semchuk), Regina General Hospital and Pasqua Hospital, Regina, Saskatchewan.,Division of Cardiology (Koshman), Department of Medicine, University of Alberta, Edmonton, Alberta.,Department of Pharmacy (Bucci), Sunnybrook Health Sciences Centre, Toronto.,Department of Pharmacy (Kertland), St. Michael's Hospital, Toronto, Ontario
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Bach T, Behrendt M, Tanidir Y, Cornford P, Sun Y, Van Poppel H. Harnessing New Media Tools in Patient Information. Eur Urol 2018; 74:685-687. [PMID: 30270127 DOI: 10.1016/j.eururo.2018.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 11/25/2022]
Abstract
New media in patient information: without a visual component, your message might not be heard.
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Affiliation(s)
- Thorsten Bach
- Urology Department, Asklepios Hospital Harburg, Hamburg, Germany.
| | - Mark Behrendt
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Philip Cornford
- Urology Department, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Yinghao Sun
- Urology Department, Shanghai Second Military Medical University Hospital, Shanghai, People's Republic of China
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Levin-Zamir D, Bertschi I. Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081643. [PMID: 30081465 PMCID: PMC6121358 DOI: 10.3390/ijerph15081643] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 07/28/2018] [Accepted: 07/30/2018] [Indexed: 12/24/2022]
Abstract
Health literacy describes skills and competencies that enable people to gain access to, understand and apply health information to positively influence their own health and the health of those in their social environments. In an increasingly media saturated and digitized world, these skill sets are necessary for accessing and navigating sources of health information and tools, such as television, the Internet, and mobile apps. The concepts of Media Health Literacy (MHL) and eHealth Literacy (eHL) describe the specific competencies such tasks require. This article introduces the two concepts, and then reviews findings on the associations of MHL and eHL with several contextual variables in the social environment such as socio-demographics, social support, and system complexity, as a structural variable. As eHL and MHL are crucial for empowering people to actively engage in their own health, there is a growing body of literature reporting on the potential and the effectiveness of intervention initiatives to positively influence these competencies. From an ethical standpoint, equity is emphasized, stressing the importance of accessible media environments for all—including those at risk of exclusion from (digital) media sources. Alignment of micro and macro contextual spheres will ultimately facilitate both non-digital and digital media to effectively support and promote public health.
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Affiliation(s)
- Diane Levin-Zamir
- Department of Health Education and Promotion, Clalit Health Services, Tel Aviv 62098, Israel.
- School of Public Health, University of Haifa, Haifa 31905, Israel.
| | - Isabella Bertschi
- Department of Psychology, University of Zurich, Zürich 8050, Switzerland.
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112
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Inadequate Health Literacy in Patients with Arterial Vascular Disease. Eur J Vasc Endovasc Surg 2018; 56:239-245. [DOI: 10.1016/j.ejvs.2018.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 04/22/2018] [Indexed: 11/20/2022]
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113
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Wangmar J, Jervaeus A, Fritzell K, Wångdahl J, Hultcrantz R, Wengström Y. Health literacy levels and views about being invited to a colorectal cancer screening program. Acta Oncol 2018; 57:743-749. [PMID: 29308944 DOI: 10.1080/0284186x.2017.1420911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Sweden has not yet implemented a national screening program for colorectal cancer, but a nationwide study is ongoing; the Screening of Swedish Colons (SCREESCO). Previous research shows that the use of health care services, together with several health-related outcomes, is associated with an individual's level of health literacy. However, the relation between health literacy and participation in colorectal cancer screening has produced varying results reported within the few studies addressing this issue and therefore, further research is warranted. MATERIAL AND METHODS The aim was to explore health literacy and views about being invited to screening, among participants and non-participants in a national colorectal cancer screening program. They were randomly sampled to fecal immunochemical test or colonoscopy and a mixed methods approach was applied, using questionnaires, focus group discussions and interviews. RESULTS The majority of individuals, whether they were participants or non-participants in the SCREESCO program, had an acceptable level of health literacy and no significant differences in health literacy levels between the groups were found. Participants expressed that it was important and appreciated to be able to choose information sources on an individual basis. Among non-participants, the importance of receiving invitations with a clear message that quickly draws one's attention was highlighted. However, both groups expressed a positive outlook towards the invitation. The mixed methods approach revealed that findings from interviews and focus group discussions corresponded to items in the health literacy scales. CONCLUSION A majority of individuals displayed acceptable levels of health literacy, regardless of whether they chose to participate or not. Similarities between the groups were seen in the qualitative findings regarding views of the invitation. Currently, the SCREESCO invitation letter is distributed by regular mail, but in the future a more dynamic approach could be valuable to increase clarity in the message about importance of screening.
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Affiliation(s)
- Johanna Wangmar
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Anna Jervaeus
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Kaisa Fritzell
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Josefin Wångdahl
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Rolf Hultcrantz
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Wengström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
- Theme Cancer, Karolinska University Hospital, Stockholm, Sweden
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114
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Geboers B, Uiters E, Reijneveld SA, Jansen CJM, Almansa J, Nooyens ACJ, Verschuren WMM, de Winter AF, Picavet HSJ. Health literacy among older adults is associated with their 10-years' cognitive functioning and decline - the Doetinchem Cohort Study. BMC Geriatr 2018; 18:77. [PMID: 29558890 PMCID: PMC5859753 DOI: 10.1186/s12877-018-0766-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/12/2018] [Indexed: 11/11/2022] Open
Abstract
Background Many older adults have low levels of health literacy which affects their ability to participate optimally in healthcare. It is unclear how cognitive decline contributes to health literacy. To study this, longitudinal data are needed. The aim of this study was therefore to assess the associations of cognitive functioning and 10-years’ cognitive decline with health literacy in older adults. Methods Data from 988 participants (mean age = 65.3) of the Doetinchem Cohort Study were analyzed. Health literacy was measured by the Brief Health Literacy Screening. Memory, mental flexibility, information processing speed, and global cognitive functioning were assessed at the same time as health literacy and also 10 years earlier. Logistic regression analyses were performed, adjusted for age, gender, and educational level. Results Higher scores on tests in all cognitive domains were associated with a lower likelihood of having low health literacy after adjustment for confounders (all ORs < 0.70, p-values<.001). Similar associations were found for past cognitive functioning (all ORs < 0.75, p-values<.05). Before adjustment, stronger cognitive decline was associated with a greater likelihood of having low health literacy (all ORs > 1.37, p-values<.05). These associations lost significance after adjustment for educational level, except for the association of memory decline (OR = 1.40, p = .023, 95% CI: 1.05 to 1.88). Conclusion Older adults with poorer cognitive functioning and stronger cognitive decline are at risk for having low health literacy, which can affect their abilities to promote health and self-manage disease. Low health literacy and declining cognitive functioning might be a barrier for person-centered care, even in relatively young older adults.
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Affiliation(s)
- Bas Geboers
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Ellen Uiters
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Carel J M Jansen
- Department of Communication and Information Studies, Faculty of Arts, University of Groningen, Groningen, the Netherlands
| | - Josué Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Astrid C J Nooyens
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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115
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Basir L, Rasteh B, Montazeri A, Araban M. Four-level evaluation of health promotion intervention for preventing early childhood caries: a randomized controlled trial. BMC Public Health 2017; 17:767. [PMID: 28969655 PMCID: PMC5625785 DOI: 10.1186/s12889-017-4783-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/21/2017] [Indexed: 11/12/2022] Open
Abstract
Background Early childhood caries (ECC) is the most common dental disease among children, which can affect children’s primary teeth during their teething. This study evaluates an intervention for preventing early childhood caries in a pediatric population in Ahvaz, Iran. Method The population of this study (IRCT2017070210804N10) consists of 104 women with 12 to 36 months of age without dental caries referred to a health care center in Ahvaz, Iran. The children were randomly assigned to either an experimental or control group in equal numbers. First, the demographic information of participants was collected through a questionnaire containing components of perceived threat, health literacy, and oral health behaviors using a valid and reliable questionnaire. The ECC status of the children was established by a dentist. Control group received “standard well baby care”. The experimental group received standard well baby care in addition to educational interventions, including lecture and group discussion. After 6 months, the participant completed the questionnaire for the second time, and the children’s teeth were reexamined. Data were analyzed using SPSS version 15 at a significance level of p < 0.05. Results The mean ages of women and children were 31 ± 6.68 years and 18 ± 7.21 months, respectively. Before the intervention, no significant difference was documented between the groups for the study variables, p > 0.05. However, after the intervention, a significant difference was observed between the perceived threats (41.15 ± 4.46 in the experimental group and 38.26 ± 4.21 in the control group, p = 0.001), health literacy (20.98 ± 2.15 in the experimental group and 19.76 ± 2.70 in the control group, p = 0.01), oral health behaviors (7.75 ± 2.30 in the experimental group and 6.15 ± 2.65 in the control group, p = 0.01), and the incidence of ECC (13% in the experimental group and 35% in the control group,p = 0.001). Conclusion This intervention had positive effects on the perceived threat, health literacy, and health behaviors; and the intervention could reduce the incidence of ECC. The finding of this study provided a suggestion for evidence-based decision-making processes regarding ECCs prevention programs. Trial registration IRCT2017070210804N10 (retrospectively registered)
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Affiliation(s)
- Leila Basir
- Department of Pediatric Dentistry, School of dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bita Rasteh
- School of dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marzieh Araban
- Social Determinants of Health Research center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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116
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Hoek AE, Hamer MVD, Deelstra CK, Beeck EFV, Dippel DWJ, Haagsma JA, Rood PPM. Attitude of patients, healthcare professionals, and noninjured lay persons towards online video instructions on mild traumatic brain injury: a cross-sectional study. Int J Emerg Med 2017; 10:25. [PMID: 28752502 PMCID: PMC5532175 DOI: 10.1186/s12245-017-0151-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 07/17/2017] [Indexed: 11/10/2022] Open
Abstract
Background The objective of this study was to determine the attitude of patients, healthcare professionals, and noninjured lay persons towards adding a video with discharge instructions to patient care for patients with mild traumatic brain injury (MTBI). A survey was conducted at the emergency department (ED). Participants consisted of MTBI patients (n = 50), healthcare professionals (n = 50), and noninjured lay persons (n = 50). The participants viewed a video with discharge instructions on MTBI and filled out a questionnaire that measured their attitude towards the use of a video as part of discharge instructions. Findings Nearly all healthcare professionals (94%) and 70% of the noninjured lay persons considered the video to be a valuable addition to oral discharge instructions. For 84% of patients, verbal information from the doctor is of importance. And, 50% of patients would like to receive additional video discharge instructions. Conclusions The majority of noninjured lay persons and healthcare professionals and half of the MTBI patients consider a video with discharge instructions to be a valuable addition to patient care. Video discharge instructions are a relative low-cost measure that could enhance patient care at the ED, provided that this does not compromise the personal contact between patient and healthcare professional.
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Affiliation(s)
- Amber E Hoek
- Department of Emergency Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Maaike van den Hamer
- Department of Emergency Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Carianne K Deelstra
- Department of Emergency Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Ed F van Beeck
- Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Diederik W J Dippel
- Department of Neurology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Emergency Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Public Health, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Pleunie P M Rood
- Department of Emergency Medicine, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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117
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Cleary EG, Patton AP, Wu HC, Xie A, Stubblefield J, Mass W, Grinstein G, Koch-Weser S, Brugge D, Wong C. Making Air Pollution Visible: A Tool for Promoting Environmental Health Literacy. JMIR Public Health Surveill 2017; 3:e16. [PMID: 28404541 PMCID: PMC5406619 DOI: 10.2196/publichealth.7492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Digital maps are instrumental in conveying information about environmental hazards geographically. For laypersons, computer-based maps can serve as tools to promote environmental health literacy about invisible traffic-related air pollution and ultrafine particles. Concentrations of these pollutants are higher near major roadways and increasingly linked to adverse health effects. Interactive computer maps provide visualizations that can allow users to build mental models of the spatial distribution of ultrafine particles in a community and learn about the risk of exposure in a geographic context. OBJECTIVE The objective of this work was to develop a new software tool appropriate for educating members of the Boston Chinatown community (Boston, MA, USA) about the nature and potential health risks of traffic-related air pollution. The tool, the Interactive Map of Chinatown Traffic Pollution ("Air Pollution Map" hereafter), is a prototype that can be adapted for the purpose of educating community members across a range of socioeconomic contexts. METHODS We built the educational visualization tool on the open source Weave software platform. We designed the tool as the centerpiece of a multimodal and intergenerational educational intervention about the health risk of traffic-related air pollution. We used a previously published fine resolution (20 m) hourly land-use regression model of ultrafine particles as the algorithm for predicting pollution levels and applied it to one neighborhood, Boston Chinatown. In designing the map, we consulted community experts to help customize the user interface to communication styles prevalent in the target community. RESULTS The product is a map that displays ultrafine particulate concentrations averaged across census blocks using a color gradation from white to dark red. The interactive features allow users to explore and learn how changing meteorological conditions and traffic volume influence ultrafine particle concentrations. Users can also select from multiple map layers, such as a street map or satellite view. The map legends and labels are available in both Chinese and English, and are thus accessible to immigrants and residents with proficiency in either language. The map can be either Web or desktop based. CONCLUSIONS The Air Pollution Map incorporates relevant language and landmarks to make complex scientific information about ultrafine particles accessible to members of the Boston Chinatown community. In future work, we will test the map in an educational intervention that features intergenerational colearning and the use of supplementary multimedia presentations.
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Affiliation(s)
| | - Allison P Patton
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, United States
| | - Hsin-Ching Wu
- Department of Public Policy and Public Affairs, University of Massachusetts Boston, Boston, MA, United States.,Institute for Asian American Studies, University of Massachusetts Boston, Boston, MA, United States
| | - Alan Xie
- Institute for Asian American Studies, University of Massachusetts Boston, Boston, MA, United States
| | - Joseph Stubblefield
- Computer Science Department, University of Massachusetts Lowell, Lowell, MA, United States
| | - William Mass
- Computer Science Department, University of Massachusetts Lowell, Lowell, MA, United States
| | - Georges Grinstein
- Computer Science Department, University of Massachusetts Lowell, Lowell, MA, United States.,Center for Data Science, University of Massachusetts Amherst, Amherst, MA, United States
| | - Susan Koch-Weser
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States
| | - Doug Brugge
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States.,Department of Civil and Environmental Engineering, Tufts University, Medford, MA, United States.,Tisch College of Civic Life, Tufts University, Medford, MA, United States
| | - Carolyn Wong
- Institute for Asian American Studies, University of Massachusetts Boston, Boston, MA, United States
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118
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Witteman HO, Presseau J, Nicholas Angl E, Jokhio I, Schwalm JD, Grimshaw JM, Bosiak B, Natarajan MK, Ivers NM. Negotiating Tensions Between Theory and Design in the Development of Mailings for People Recovering From Acute Coronary Syndrome. JMIR Hum Factors 2017; 4:e6. [PMID: 28249831 PMCID: PMC5352859 DOI: 10.2196/humanfactors.6502] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 11/13/2022] Open
Abstract
Background Taking all recommended secondary prevention cardiac medications and fully participating in a formal cardiac rehabilitation program significantly reduces mortality and morbidity in the year following a heart attack. However, many people who have had a heart attack stop taking some or all of their recommended medications prematurely and many do not complete a formal cardiac rehabilitation program. Objective The objective of our study was to develop a user-centered, theory-based, scalable intervention of printed educational materials to encourage and support people who have had a heart attack to use recommended secondary prevention cardiac treatments. Methods Prior to the design process, we conducted theory-based interviews and surveys with patients who had had a heart attack to identify key determinants of secondary prevention behaviors. Our interdisciplinary research team then partnered with a patient advisor and design firm to undertake an iterative, theory-informed, user-centered design process to operationalize techniques to address these determinants. User-centered design requires considering users’ needs, goals, strengths, limitations, context, and intuitive processes; designing prototypes adapted to users accordingly; observing how potential users respond to the prototype; and using those data to refine the design. To accomplish these tasks, we conducted user research to develop personas (archetypes of potential users), developed a preliminary prototype using behavior change theory to map behavior change techniques to identified determinants of medication adherence, and conducted 2 design cycles, testing materials via think-aloud and semistructured interviews with a total of 11 users (10 patients who had experienced a heart attack and 1 caregiver). We recruited participants at a single cardiac clinic using purposive sampling informed by our personas. We recorded sessions with users and extracted key themes from transcripts. We held interdisciplinary team discussions to interpret findings in the context of relevant theory-based evidence and iteratively adapted the intervention accordingly. Results Through our iterative development and testing, we identified 3 key tensions: (1) evidence from theory-based studies versus users’ feelings, (2) informative versus persuasive communication, and (3) logistical constraints for the intervention versus users’ desires or preferences. We addressed these by (1) identifying root causes for users’ feelings and addressing those to better incorporate theory- and evidence-based features, (2) accepting that our intervention was ethically justified in being persuasive, and (3) making changes to the intervention where possible, such as attempting to match imagery in the materials to patients’ self-images. Conclusions Theory-informed interventions must be operationalized in ways that fit with user needs. Tensions between users’ desires or preferences and health care system goals and constraints must be identified and addressed to the greatest extent possible. A cluster randomized controlled trial of the final intervention is currently underway.
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Affiliation(s)
- Holly O Witteman
- Department of Family and Emergency Medicine, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Office of Education and Professional Development, Faculty of Medicine, Laval University, Quebec City, QC, Canada.,Pavillon Ferdinand-Vandry 2881, Quebec City, QC, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Emily Nicholas Angl
- Patients Canada, Toronto, ON, Canada.,Pivot Design Group Inc, Toronto, ON, Canada
| | | | - J D Schwalm
- Department of Medicine, Division of Cardiology, Hamilton Health Sciences, Hamilton, ON, Canada.,Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Jeremy M Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada.,Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Beth Bosiak
- Women's College Research Institute, Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada
| | - Madhu K Natarajan
- Department of Medicine, Division of Cardiology, Hamilton Health Sciences, Hamilton, ON, Canada.,Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Noah M Ivers
- Women's College Research Institute, Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, ON, Canada.,Family Practice Health Centre, Women's College Hospital, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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119
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Fransen MP, Dekker E, Timmermans DRM, Uiters E, Essink-Bot ML. Accessibility of standardized information of a national colorectal cancer screening program for low health literate screening invitees: A mixed method study. PATIENT EDUCATION AND COUNSELING 2017; 100:327-336. [PMID: 27613567 DOI: 10.1016/j.pec.2016.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 07/19/2016] [Accepted: 09/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To explore the accessibility of standardized printed information materials of the national Dutch colorectal cancer screening program among low health literate screening invitees and to assess the effect of the information on their knowledge about colorectal cancer and the screening program. METHODS Linguistic tools were used to analyze the text and design characteristics. The accessibility, comprehensibility and relevance of the information materials were explored in interviews and in observations (n=25). The effect of the information on knowledge was assessed in an online survey (n=127). RESULTS The materials employed a simple text and design. However, respondents expressed problems with the amount of information, and the difference between screening and diagnostic follow-up. Knowledge significantly increased in 10 out of 16 items after reading the information but remained low for colorectal cancer risk, sensitivity of testing, and the voluntariness of colorectal cancer screening. CONCLUSION Despite intelligible linguistic and design characteristics, screening invitees with low health literacy had problems in accessing, comprehending and applying standard information materials on colorectal cancer screening, and lacked essential knowledge for informed decision-making about participation. PRACTICE IMPLICATIONS To enable equal access to informed decision-making, information strategies need to be adjusted to the skills of low health literate screening invitees.
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Affiliation(s)
- Mirjam P Fransen
- Department of Public Health, Academic Medical Center-University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Academic Medical Center-University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Daniëlle R M Timmermans
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, PO Box 7057, 1007 MB Amsterdam, The Netherlands; National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Ellen Uiters
- National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Marie-Louise Essink-Bot
- Department of Public Health, Academic Medical Center-University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
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120
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Robins S, Barr HJ, Idelson R, Lambert S, Zelkowitz P. Online Health Information Regarding Male Infertility: An Evaluation of Readability, Suitability, and Quality. Interact J Med Res 2016; 5:e25. [PMID: 27769954 PMCID: PMC5097174 DOI: 10.2196/ijmr.6440] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/23/2016] [Accepted: 09/24/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Many men lack knowledge about male infertility, and this may have consequences for their reproductive and general health. Men may prefer to seek health information online, but these sources of information vary in quality. OBJECTIVE The objective of this study is to determine if online sources of information regarding male infertility are readable, suitable, and of appropriate quality for Internet users in the general population. METHODS This study used a cross-sectional design to evaluate online sources resulting from search engine queries. The following categories of websites were considered: (1) Canadian fertility clinics, (2) North American organizations related to fertility, and (3) the first 20 results of Google searches using the terms "male infertility" and "male fertility preservation" set to the search locations worldwide, English Canada, and French Canada. Websites that met inclusion criteria (N=85) were assessed using readability indices, the Suitability Assessment of Materials (SAM), and the DISCERN tool. The associations between website affiliation (government, university/medical, non-profit organization, commercial/corporate, private practice) and Google placement to readability, suitability, and quality were also examined. RESULTS None of the sampled websites met recommended levels of readability. Across all websites, the mean SAM score for suitability was 45.37% (SD 11.21), or "adequate", while the DISCERN mean score for quality was 43.19 (SD 10.46) or "fair". Websites that placed higher in Google obtained a higher overall score for quality with an r (58) value of -.328 and a P value of .012, but this position was not related to readability or suitability. In addition, 20% of fertility clinic websites did not include fertility information for men. CONCLUSIONS There is a lack of high quality online sources of information on male fertility. Many websites target their information to women, or fail to meet established readability criteria for the general population. Since men may prefer to seek health information online, it is important that health care professionals develop high quality sources of information on male fertility for the general population.
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Affiliation(s)
- Stephanie Robins
- Jewish General Hospital, Department of Psychiatry, Montreal, QC, Canada
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121
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Meppelink CS, Smit EG, Diviani N, Van Weert JCM. Health Literacy and Online Health Information Processing: Unraveling the Underlying Mechanisms. JOURNAL OF HEALTH COMMUNICATION 2016; 21:109-120. [PMID: 27668318 DOI: 10.1080/10810730.2016.1193920] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The usefulness of the Internet as a health information source largely depends on the receiver's health literacy. This study investigates the mechanisms through which health literacy affects information recall and website attitudes. Using 2 independent surveys addressing different Dutch health websites (N = 423 and N = 395), we tested the mediating role of cognitive load, imagination ease, and website involvement. The results showed that the influence of health literacy on information recall and website attitudes was mediated by cognitive load and imagination ease but only marginally by website involvement. Thus, to improve recall and attitudes among people with lower health literacy, online health communication should consist of information that is not cognitively demanding and that is easy to imagine.
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Affiliation(s)
- Corine S Meppelink
- a Amsterdam School of Communication Research , University of Amsterdam , Amsterdam , The Netherlands
| | - Edith G Smit
- a Amsterdam School of Communication Research , University of Amsterdam , Amsterdam , The Netherlands
| | - Nicola Diviani
- a Amsterdam School of Communication Research , University of Amsterdam , Amsterdam , The Netherlands
| | - Julia C M Van Weert
- a Amsterdam School of Communication Research , University of Amsterdam , Amsterdam , The Netherlands
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Experiences and preferences of care among Swedish immigrants following a prenatal diagnosis of congenital heart defect in the fetus: a qualitative interview study. BMC Pregnancy Childbirth 2016; 16:130. [PMID: 27256335 PMCID: PMC4890283 DOI: 10.1186/s12884-016-0912-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 05/17/2016] [Indexed: 11/22/2022] Open
Abstract
Background Immigrants experience significant challenges when in contact with healthcare and report less satisfaction with maternity care compared to native Swedes. Research that gives voice to pregnant immigrant women and their partners following a prenatal diagnosis of a fetal anomaly is scarce. Thus, the aim of this study was to explore experiences and preferences of care following a prenatal diagnosis of congenital heart defect among Swedish immigrants. Methods Pregnant immigrants and their partners were consecutively recruited following a prenatal diagnosis of a congenital heart defect in the fetus. Nine respondents were interviewed in five interviews, four with the aid of a professional interpreter. The material was analyzed using manifest qualitative content analysis. Results The analysis resulted in five categories: 1) “Trustworthy information”, 2) “Language barriers”, 3) “Psychosocial situation”, 4) “Peer support”, and 5) “Religious positions”. Conclusion The potential need for interpreter services, visual information, psychosocial support, coordination with welfare officers, and respect for religious positions about termination of pregnancy are all important aspects for health professionals to consider when consulting immigrants faced with a prenatal diagnosis of fetal anomaly in the fetus. Peer support within this context needs to be further explored in future studies.
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123
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Xesfingi S, Vozikis A. eHealth Literacy: In the Quest of the Contributing Factors. Interact J Med Res 2016; 5:e16. [PMID: 27226146 PMCID: PMC4899620 DOI: 10.2196/ijmr.4749] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 12/02/2015] [Accepted: 03/29/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Understanding the factors that influence eHealth in a country is particularly important for health policy decision makers and the health care market, as it provides critical information to develop targeted and tailored interventions for relevant patient-consumer segments, and further suggests appropriate strategies for training the health illiterate part of the population. OBJECTIVE The objective of the study is to assess the eHealth literacy level of Greek citizens, using the eHealth Literacy Scale (eHEALS), and further explore the factors that shape it and are associated with it. METHODS This empirical study relies on a unique sample of 1064 citizens in Greece in the year 2013. The participants were requested to answer various questions about their ability to solve health-related issues using the Internet, and to provide information about their demographic characteristics and life-style habits. Ordered logit models were used to describe a certain citizen's likelihood of being eHealth literate. RESULTS The demographic factors show that the probability of an individual being eHealth literate decreases by 23% (P=.001) when the individual ages and increases by 53% (P<.001) when he or she acquires higher level of education. Among the life-style variables, physical exercise appears to be strongly and positively associated with the level of eHealth literacy (P=.001). Additionally, other types of technology literacies, such as computer literacy and information literacy, further enhance the eHealth performance of citizens and have the greatest impact among all factors. CONCLUSIONS The factors influencing eHealth literacy are complex and interdependent. However, the Internet is a disruptive factor in the relationship between health provider and health consumer. Further research is needed to examine how several factors associate with eHealth literacy, since, the latter is not only related to health care outcomes but also can be a tool for disseminating social inequalities.
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Affiliation(s)
- Sofia Xesfingi
- University of Piraeus, Department of Economics, University of Piraeus, Piraeus, Greece.
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van Weert JCM, van Munster BC, Sanders R, Spijker R, Hooft L, Jansen J. Decision aids to help older people make health decisions: a systematic review and meta-analysis. BMC Med Inform Decis Mak 2016; 16:45. [PMID: 27098100 PMCID: PMC4839148 DOI: 10.1186/s12911-016-0281-8] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 04/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Decision aids have been overall successful in improving the quality of health decision making. However, it is unclear whether the impact of the results of using decision aids also apply to older people (aged 65+). We sought to systematically review randomized controlled trials (RCTs) and clinical controlled trials (CCTs) evaluating the efficacy of decision aids as compared to usual care or alternative intervention(s) for older adults facing treatment, screening or care decisions. METHODS A systematic search of (1) a Cochrane review of decision aids and (2) MEDLINE, Embase, PsycINFO, Cochrane library central registry of studies and Cinahl. We included published RCTs/CCTs of interventions designed to improve shared decision making (SDM) by older adults (aged 65+) and RCTs/CCTs that analysed the effect of the intervention in a subgroup with a mean age of 65+. Based on the International Patient Decision aid Standards (IPDAS), the primary outcomes were attributes of the decision and the decision process. Other behavioral, health, and health system effects were considered as secondary outcomes. If data could be pooled, a meta-analysis was conducted. Data for which meta-analysis was not possible were synthesized qualitatively. RESULTS The search strategy yielded 11,034 references. After abstract and full text screening, 22 papers were included. Decision aids performed better than control resp. usual care interventions by increasing knowledge and accurate risk perception in older people (decision attributes). With regard to decision process attributes, decision aids resulted in lower decisional conflict and more patient participation. CONCLUSIONS This review shows promising results on the effectiveness of decision aids for older adults. Decision aids improve older adults' knowledge, increase their risk perception, decrease decisional conflict and seem to enhance participation in SDM. It must however be noted that the body of literature on the effectiveness of decision aids for older adults is still in its infancy. Only one decision aid was specifically developed for older adults, and the mean age in most studies was between 65 and 70, indicating that the oldest-old were not included. Future research should expand on the design, application and evaluation of decision aids for older, more vulnerable adults.
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Affiliation(s)
- Julia C M van Weert
- Amsterdam School of Communication Research/ASCoR, Department of Communication Science, University of Amsterdam, P.O. Box 15791, 1001 NG, Amsterdam, The Netherlands.
| | - Barbara C van Munster
- University Medical Center Groningen (UMCG), Department of Medicine, Groningen, The Netherlands.,Gelre Hospitals, Department of Geriatrics, Apeldoorn, The Netherlands
| | - Remco Sanders
- Amsterdam School of Communication Research/ASCoR, Department of Communication Science, University of Amsterdam, P.O. Box 15791, 1001 NG, Amsterdam, The Netherlands
| | - René Spijker
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Medical Library, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jesse Jansen
- Sydney School of Public Health, Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, Sydney, Australia
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Sak G, Diviani N, Allam A, Schulz PJ. Comparing the quality of pro- and anti-vaccination online information: a content analysis of vaccination-related webpages. BMC Public Health 2016; 16:38. [PMID: 26769342 PMCID: PMC4714533 DOI: 10.1186/s12889-016-2722-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 01/11/2016] [Indexed: 11/30/2022] Open
Abstract
Background The exponential increase in health-related online platforms has made the Internet one of the main sources of health information globally. The quality of health contents disseminated on the Internet has been a central focus for many researchers. To date, however, few comparative content analyses of pro- and anti-vaccination websites have been conducted, and none of them compared the quality of information. The main objective of this study was therefore to bring new evidence on this aspect by comparing the quality of pro- and anti-vaccination online sources. Methods Based on past literature and health information quality evaluation initiatives, a 40-categories assessment tool (Online Vaccination Information Quality Codebook) was developed and used to code a sample of 1093 webpages retrieved via Google and two filtered versions of the same search engine. The categories investigated were grouped into four main quality dimensions: web-related design quality criteria (10 categories), health-specific design quality criteria (3 categories), health related content attributes (12 categories) and vaccination-specific content attributes (15 categories). Data analysis comprised frequency counts, cross tabulations, Pearson’s chi-square, and other inferential indicators. Results The final sample included 514 webpages in favor of vaccination, 471 against, and 108 neutral. Generally, webpages holding a favorable view toward vaccination presented more quality indicators compared to both neutral and anti-vaccination pages. However, some notable exceptions to this rule were observed. In particular, no differences were found between pro- and anti-vaccination webpages as regards vaccination-specific content attributes. Conclusions Our analyses showed that the overall quality of pro-vaccination webpages is superior to anti-vaccination online sources. The developed coding scheme was proven to be a helpful and reliable tool to judge the quality of vaccination-related webpages. Based on the results, we advance recommendations for online health information providers as well as directions for future research in this field. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2722-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gabriele Sak
- Institute of Communication and Health (ICH), Università della Svizzera italiana (USI), Via G. Buffi 13, 6900, Lugano, Switzerland.
| | - Nicola Diviani
- Institute of Communication and Health (ICH), Università della Svizzera italiana (USI), Via G. Buffi 13, 6900, Lugano, Switzerland.,Amsterdam School of Communication Research / ASCoR, University of Amsterdam, Amsterdam, The Netherlands
| | - Ahmed Allam
- Department of Pathology, Yale University School of Medicine, New Haven, USA
| | - Peter J Schulz
- Institute of Communication and Health (ICH), Università della Svizzera italiana (USI), Via G. Buffi 13, 6900, Lugano, Switzerland
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Bickmore TW, Utami D, Matsuyama R, Paasche-Orlow MK. Improving Access to Online Health Information With Conversational Agents: A Randomized Controlled Experiment. J Med Internet Res 2016; 18:e1. [PMID: 26728964 PMCID: PMC4717285 DOI: 10.2196/jmir.5239] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 11/23/2015] [Accepted: 11/26/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Conventional Web-based search engines may be unusable by individuals with low health literacy for finding health-related information, thus precluding their use by this population. OBJECTIVE We describe a conversational search engine interface designed to allow individuals with low health and computer literacy identify and learn about clinical trials on the Internet. METHODS A randomized trial involving 89 participants compared the conversational search engine interface (n=43) to the existing conventional keyword- and facet-based search engine interface (n=46) for the National Cancer Institute Clinical Trials database. Each participant performed 2 tasks: finding a clinical trial for themselves and finding a trial that met prespecified criteria. RESULTS Results indicated that all participants were more satisfied with the conversational interface based on 7-point self-reported satisfaction ratings (task 1: mean 4.9, SD 1.8 vs mean 3.2, SD 1.8, P<.001; task 2: mean 4.8, SD 1.9 vs mean 3.2, SD 1.7, P<.001) compared to the conventional Web form-based interface. All participants also rated the trials they found as better meeting their search criteria, based on 7-point self-reported scales (task 1: mean 3.7, SD 1.6 vs mean 2.7, SD 1.8, P=.01; task 2: mean 4.8, SD 1.7 vs mean 3.4, SD 1.9, P<.01). Participants with low health literacy failed to find any trials that satisfied the prespecified criteria for task 2 using the conventional search engine interface, whereas 36% (5/14) were successful at this task using the conversational interface (P=.05). CONCLUSIONS Conversational agents can be used to improve accessibility to Web-based searches in general and clinical trials in particular, and can help decrease recruitment bias against disadvantaged populations.
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Affiliation(s)
- Timothy W Bickmore
- Northeastern University, College of Computer and Information Science, Boston, MA, United States.
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Logsdon MC, Davis D, Eckert D, Smith F, Stikes R, Rushton J, Myers J, Capps J, Sparks K. Feasibility of Two Educational Methods for Teaching New Mothers: A Pilot Study. Interact J Med Res 2015; 4:e20. [PMID: 26449647 PMCID: PMC4704909 DOI: 10.2196/ijmr.4583] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/11/2015] [Accepted: 08/15/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Printed health educational materials are commonly issued to prepare patients for hospital discharge. Teaching methods that engage multiple senses have been shown to positively affect learning outcomes, suggesting that paper materials may not be the most effective approach when educating new mothers. In addition, many written patient educational materials do not meet national health literacy guidelines. Videos that stimulate visual and auditory senses provide an alternative, potentially more effective, strategy for delivering health information. The acceptability of these methods, as perceived by nurses executing patient education initiatives, is important for determining the most appropriate strategy. OBJECTIVE The purpose of this study was to determine the feasibility of 2 educational methods for teaching new mothers how to care for themselves and their infants after hospital discharge. Feasibility was measured by adequate enrollment, acceptability of the intervention to patients and nurses, and initial efficacy. METHODS New mothers (n=98) on a Mother-Baby Unit received health information focused on self-care and infant care delivered as either simple printed materials or YouTube videos on an iPad. Mothers completed a pretest, post-test, and an acceptability survey. Following completion of the initiative, nurses who participated in delivering the health education using one of these 2 methods were asked to complete a survey to determine their satisfaction with and confidence in using the materials. RESULTS Mothers, on average, were 26 years old; 72% had a high school education; and 41% were African American. The improvement in knowledge scores was significantly higher for the iPad group (8.6% vs 4.4%, P=.02) compared to the pamphlet group. Group (B=4.81, P=.36) and time (B=6.12, P<.001) significantly affected scores, while no significant interaction effect was observed (B=5.69, P=.09). There were no significant differences in responses between the groups (all P values >.05). The nurses had a mean age of 44.3 years (SD 13.9) and had, on average, 16.6 years of experience (SD 13.8). The nurses felt confident and satisfied administering both educational modalities. CONCLUSIONS The pamphlet and iPad were identified as feasible and acceptable modalities for educating new mothers about self-care and infant care, though the iPad was more effective in improving knowledge. Understanding the acceptability of different teaching methods to patient educators is important for successful delivery of informational materials at discharge.
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Affiliation(s)
- M Cynthia Logsdon
- University of Louisville, School of Nursing, Louisville, KY, United States.
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Bull S, Ezeanochie N. From Foucault to Freire Through Facebook: Toward an Integrated Theory of mHealth. HEALTH EDUCATION & BEHAVIOR 2015; 43:399-411. [PMID: 26384499 DOI: 10.1177/1090198115605310] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To document the integration of social science theory in literature on mHealth (mobile health) and consider opportunities for integration of classic theory, health communication theory, and social networking to generate a relevant theory for mHealth program design. METHOD A secondary review of research syntheses and meta-analyses published between 2005 and 2014 related to mHealth, using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) methodology for assessment of the quality of each review. High-quality articles from those reviews using a randomized controlled design and integrating social science theory in program design, implementation, or evaluation were reviewed. Results There were 1,749 articles among the 170 reviews with a high AMSTAR score (≥30). Only 13 were published from 2005 to 2014, used a randomized controlled design and made explicit mention of theory in any aspect of their mHealth program. All 13 included theoretical perspectives focused on psychological and/or psychosocial theories and constructs. Conclusions There is a very limited use of social science theory in mHealth despite demonstrated benefits in doing so. We propose an integrated theory of mHealth that incorporates classic theory, health communication theory, and social networking to guide development and evaluation of mHealth programs.
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Affiliation(s)
- Sheana Bull
- University of Colorado Denver, Aurora, CO, USA
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Bol N, van Weert JCM, de Haes HCJM, Loos EF, Smets EMA. The effect of modality and narration style on recall of online health information: results from a Web-based experiment. J Med Internet Res 2015; 17:e104. [PMID: 25910416 PMCID: PMC4425819 DOI: 10.2196/jmir.4164] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/03/2015] [Indexed: 11/13/2022] Open
Abstract
Background Older adults are increasingly using the Internet for health information; however, they are often not able to correctly recall Web-based information (eHealth information). Recall of information is crucial for optimal health outcomes, such as adequate disease management and adherence to medical regimes. Combining effective message strategies may help to improve recall of eHealth information among older adults. Presenting information in an audiovisual format using conversational narration style is expected to optimize recall of information compared to other combinations of modality and narration style. Objective The aim of this paper is to investigate the effect of modality and narration style on recall of health information, and whether there are differences between younger and older adults. Methods We conducted a Web-based experiment using a 2 (modality: written vs audiovisual information) by 2 (narration style: formal vs conversational style) between-subjects design (N=440). Age was assessed in the questionnaire and included as a factor: younger (<65 years) versus older (≥65 years) age. Participants were randomly assigned to one of four experimental webpages where information about lung cancer treatment was presented. A Web-based questionnaire assessed recall of eHealth information. Results Audiovisual modality (vs written modality) was found to increase recall of information in both younger and older adults (P=.04). Although conversational narration style (vs formal narration style) did not increase recall of information (P=.17), a synergistic effect between modality and narration style was revealed: combining audiovisual information with conversational style outperformed combining written information with formal style (P=.01), as well as written information with conversational style (P=.045). This finding suggests that conversational style especially increases recall of information when presented audiovisually. This combination of modality and narration style improved recall of information among both younger and older adults. Conclusions We conclude that combining audiovisual information with conversational style is the best way to present eHealth information to younger and older adults. Even though older adults did not proportionally recall more when audiovisual information was combined with conversational style than younger adults, this study reveals interesting implications for improving eHealth information that is effective for both younger and older adults.
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Affiliation(s)
- Nadine Bol
- Amsterdam School of Communication Research / ASCoR, Department of Communication Science, University of Amsterdam, Amsterdam, Netherlands.
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