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Sezgin E, Kocaballi AB, Dolce M, Skeens M, Militello L, Huang Y, Stevens J, Kemper AR. Chatbot for Social Need Screening and Resource Sharing With Vulnerable Families: Iterative Design and Evaluation Study. JMIR Hum Factors 2024; 11:e57114. [PMID: 39028995 PMCID: PMC11297373 DOI: 10.2196/57114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 05/03/2024] [Accepted: 05/24/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Health outcomes are significantly influenced by unmet social needs. Although screening for social needs has become common in health care settings, there is often poor linkage to resources after needs are identified. The structural barriers (eg, staffing, time, and space) to helping address social needs could be overcome by a technology-based solution. OBJECTIVE This study aims to present the design and evaluation of a chatbot, DAPHNE (Dialog-Based Assistant Platform for Healthcare and Needs Ecosystem), which screens for social needs and links patients and families to resources. METHODS This research used a three-stage study approach: (1) an end-user survey to understand unmet needs and perception toward chatbots, (2) iterative design with interdisciplinary stakeholder groups, and (3) a feasibility and usability assessment. In study 1, a web-based survey was conducted with low-income US resident households (n=201). Following that, in study 2, web-based sessions were held with an interdisciplinary group of stakeholders (n=10) using thematic and content analysis to inform the chatbot's design and development. Finally, in study 3, the assessment on feasibility and usability was completed via a mix of a web-based survey and focus group interviews following scenario-based usability testing with community health workers (family advocates; n=4) and social workers (n=9). We reported descriptive statistics and chi-square test results for the household survey. Content analysis and thematic analysis were used to analyze qualitative data. Usability score was descriptively reported. RESULTS Among the survey participants, employed and younger individuals reported a higher likelihood of using a chatbot to address social needs, in contrast to the oldest age group. Regarding designing the chatbot, the stakeholders emphasized the importance of provider-technology collaboration, inclusive conversational design, and user education. The participants found that the chatbot's capabilities met expectations and that the chatbot was easy to use (System Usability Scale score=72/100). However, there were common concerns about the accuracy of suggested resources, electronic health record integration, and trust with a chatbot. CONCLUSIONS Chatbots can provide personalized feedback for families to identify and meet social needs. Our study highlights the importance of user-centered iterative design and development of chatbots for social needs. Future research should examine the efficacy, cost-effectiveness, and scalability of chatbot interventions to address social needs.
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Affiliation(s)
- Emre Sezgin
- Nationwide Children's Hospital, Columbus, OH, United States
| | - A Baki Kocaballi
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Millie Dolce
- Nationwide Children's Hospital, Columbus, OH, United States
| | - Micah Skeens
- Nationwide Children's Hospital, Columbus, OH, United States
| | | | - Yungui Huang
- Nationwide Children's Hospital, Columbus, OH, United States
| | - Jack Stevens
- Nationwide Children's Hospital, Columbus, OH, United States
| | - Alex R Kemper
- Nationwide Children's Hospital, Columbus, OH, United States
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Efrati Y, Rosenberg H, Ophir Y. Effective parental strategies against problematic smartphone use among adolescents: A 6-month prospective study. Addict Behav 2024; 154:108024. [PMID: 38555777 DOI: 10.1016/j.addbeh.2024.108024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/02/2024]
Abstract
Problematic Smartphone Use (PSU) among adolescents is growing problem worldwide and multiple studies investigated its associated parental risk and protective factors. The available studies, however, typically do not address the multidimensional nature of PSU. They also rely heavily on cross-sectional designs with a small number of potentially contributing variables. This 6-month prospective study examines the relationships between a large range of parental factors with the three known dimensions of PSU: social environment pressure, emotional gain, and addiction-like behaviors. Specifically the study examines whether, and to what extent, the various dimensions of current and future PSU are related to parental support giving, general quality of communication, specific communication about smartphone use, and the four common mediation strategies. The sample comprised 1187 triads of mothers, fathers, and adolescents. The data-analysis pipeline consisted of three consecutive phases: (1) analyses of parental factors at baseline, (2) analyses of parental factors change over 6-months, and (3) interaction analyses between parental factors and the time-period of the study. The pipeline elicited three factors that moderated the change in PSU over time: Communication about smartphones with mothers, parental support giving, and parental co-use. The implications of these findings are discussed in the context of the existing literature and the familial, microsystem theoretical framework. Altogether, this prospective study scrutinized key parental factors and strategies that could be utilized by parents for coping with one of the most difficult parenting challenges of the digital era. Further research may build upon these findings to develop designated interventions to reduce PSU.
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Affiliation(s)
- Yaniv Efrati
- Bar-Ilan University, Faculty of Education, Ramat Gan, Israel.
| | | | - Yaakov Ophir
- Department of Education, Ariel University, Israel; The Centre for Human-Inspired Artificial Intelligence, University of Cambridge, United Kingdom
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Flower KB, Gutierrez-Wu JC, McBride JP, Sylvester F, Díaz-González de Ferris ME. Spanish-Speaking Parents' Experiences Accessing Care: Evolving Challenges and Promising Approaches. Acad Pediatr 2024; 24:391-393. [PMID: 38253176 DOI: 10.1016/j.acap.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/22/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Kori B Flower
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC.
| | - Jennifer C Gutierrez-Wu
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research (JC Gutierrez-Wu), University of North Carolina, Chapel Hill, NC
| | - Jennifer Pilotos McBride
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC
| | - Francisco Sylvester
- Division of Pediatric Gastroenterology (F Sylvester), Department of Pediatrics, University of North Carolina at Chapel Hill
| | - Maria E Díaz-González de Ferris
- Division of General Pediatrics and Adolescent Medicine (KB Flower, JC Gutierrez-Wu, JP McBride, and ME Díaz-González de Ferris), Department of Pediatrics, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC
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Dijkman EM, ter Brake WWM, Drossaert CHC, Doggen CJM. Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review. Healthcare (Basel) 2023; 12:11. [PMID: 38200917 PMCID: PMC10778720 DOI: 10.3390/healthcare12010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Assessment of (digital) health literacy in the hospital can raise staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools should ideally address multiple domains of health literacy, fit to the complex hospital context and have a short administration time, to enable routine assessment. This review aims to create an overview of tools for measuring (digital) health literacy in hospitals. A search in Scopus, PubMed, WoS and CINAHL, following PRISMA guidelines, generated 7252 hits; 251 studies were included in which 44 assessment tools were used. Most tools (57%) were self-reported and 27% reported an administration time of <5 min. Almost all tools addressed the domain 'understanding' (98%), followed by 'access' (52%), 'apply' (50%), 'appraise' (32%), 'numeracy' (18%), and 'digital' (18%). Only four tools were frequently used: the Newest Vital Sign (NVS), the Short Test of Functional Health Literacy for Adults ((S)TOFHLA), the Brief Health Literacy Screener (BHLS), and the Health Literacy Questionnaire (HLQ). While the NVS and BHLS have a low administration time, they cover only two domains. HLQ covers the most domains: access, understanding, appraise, and apply. None of these four most frequently used tools measured digital skills. This review can guide health professionals in choosing an instrument that is feasible in their daily practice, and measures the required domains.
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Affiliation(s)
- Eline M. Dijkman
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Department of Surgery, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Wouter W. M. ter Brake
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
| | | | - Carine J. M. Doggen
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
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Benoit JR, Hartling L, Scott SD. Bridging evidence-to-care gaps with mHealth: Designing a symptom checker for parents accessing knowledge translation resources on acute children's illnesses in a smartphone application. PEC INNOVATION 2023; 2:100152. [PMID: 37214490 PMCID: PMC10194162 DOI: 10.1016/j.pecinn.2023.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/06/2023] [Accepted: 03/28/2023] [Indexed: 05/24/2023]
Abstract
Background Smartphone applications offer a novel platform for delivering health information to parents. This study created and evaluated an app-based symptom checker that recommends educational tools to parents based on their child's symptoms. Methods Symptoms extracted from 23 knowledge translation (KT) tools for 10 children's illnesses comprised a set of plain-language symptoms. The symptom checker works by producing confusion matrices evaluating a child's reported symptoms against possible illnesses, comparing precision scores to examine how well each illness matched reported symptoms, and ordering possible illnesses by performance score. Performance was evaluated by extracting symptoms from 8 clinical vignettes, and examining correct first-try matches. Results We created a final list of 54 plain-language symptoms. Visualizations of the symptom set creation process and logic mapping are presented, as well as images of the working symptom checker. The symptom checker matched 100% (8/8) of tested clinical vignettes to the appropriate illness resource. Discussion Symptom checkers are a potentially useful tool to integrate into apps that parents use for their children's health. The design of these systems has the potential to change parents' relationship with technology, affecting both their adoption and acceptance of symptom checkers. Our design choices contribute to addressing current barriers to the adoption of symptom checkers, reducing functional, critical, and interactive literacy requirements for parents.
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Affiliation(s)
- James R.A. Benoit
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Lisa Hartling
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
| | - Shannon D. Scott
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta T6G 1C9, Canada
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Siminoff LA, Wilson-Genderson M, West SM, Hasz RD, Suplee L, Clarke J, Barker KL, Mulvania PA. Messaging White and Black Next of Kin in Advance to Promote Authorization for Tissue Donation. Prog Transplant 2023:15269248231212922. [PMID: 37946530 DOI: 10.1177/15269248231212922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Introduction: Organ Procurement Organizations seek authorization for tissue donation from next-of-kin of deceased patients. Best practices for achieving contact and authorization are unknown, notably, authorization rates are lower for Black compared to White patients. Research Questions: Can next-of-kin (NOK) contact and authorization rates be improved if they are texted prior to telephone contact? Is a text message containing an infographic more effective, and does an infographic culturally tailored to Black families improve contact and authorization rates in the Black population? Design: This three-armed randomized trial compared (1) telephonic contact initiation (control condition); (2) generic text messaging prior to telephonic contact; and (3) text messaging one of two versions of an infographic prior to telephonic contact: (a) a generic infographic or (b) a culturally tailored infographic (sent to Black NOK only) at one Northeastern Organ Procurement Organization. Results: Tissue Donation Professionals (N = 47) and 2399 White and 745 Black NOK were included, of which 35.6% were registered donors. Authorization rates were much higher for White than Black (40.1% v 16.3%, P < 0.0001). The generic infographic resulted in significantly lower rates of contact for White NOK compared to the control condition 83.5% v 89.5%, P = 0.002), but study arm assignments were not otherwise associated with differences in contact or authorization rates. Conclusion: Although the analysis did not find a benefit for text messaging, it is possible that training for staff making requests and refining the content of the messaging could be more effective.
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Affiliation(s)
- Laura A Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Maureen Wilson-Genderson
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | | | | | | | - John Clarke
- Gift of Life Donor Program, Philadelphia, PA, USA
| | - K Laura Barker
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
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Abstract
PURPOSE OF REVIEW Health literacy influences how children and families participate in their medical care, use health services, and overall health outcomes. Health literacy is underexplored in pediatric dermatology. In this scoping review, we provide examples of how limited health literacy can be a barrier to patient care in pediatric dermatology and how to mitigate its effects. RECENT FINDINGS Limited health literacy is associated with worse health outcomes, decreased medication adherence, and decreased use of the healthcare system versus those with adequate health literacy. Materials created to help patients understand their medical conditions and treatment options often are written at a reading level far above that of the average patient and caregiver. Given the reading level of patient-facing materials, those with limited health literacy are more susceptible to medication administration errors, with omissions or incorrect dosing being most frequent to occur. There is limited research about how skills related to health literacy, including numeracy and electronic health literacy, can be addressed in pediatric dermatology. SUMMARY Health literacy impacts patient care, treatment, and adherence in pediatric dermatology. This article gives examples of how to address common challenges in the pediatric dermatology clinic and presents areas for further research and improvement.
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Affiliation(s)
| | | | - Carrie C Coughlin
- Division of Dermatology, Departments of Medicine and Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Kang NG, You MA. The Effects of a Smartphone-Based Education Program Designed to Help Mothers Safely Administer Medication to Their Children. Comput Inform Nurs 2023; 41:77-85. [PMID: 35314588 PMCID: PMC9907687 DOI: 10.1097/cin.0000000000000859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aimed to determine the effect of a smartphone-based medication education program to help mothers safely administer medication to their children at home. A quasi-experimental, non-equivalent control group, pretest-posttest design was utilized. There were 33 participants in the experimental group and 30 in the control group. The experimental group participated in the KidsMedi program for 6 weeks. The experimental group, receiving the KidsMedi program, had a statistically significant higher perception of antipyretic analgesics and higher eHealth literacy than the control group. The medication education program developed in this study is a mobile Web-based program. It is an effective program for mothers to improve their knowledge about administering drugs to children at home. This program is not affected by time and place, allowing repetitive self-directed learning. Nurses can utilize this program in daycare centers, schools, hospitals, communities, and public institutions to educate parents about safe medication for children.
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Kukafka R, Law E, Mathews J, Lim SH, Shi L, Chua JS, Du R, Chan YH, Tan TC, Chee C, Chong YS. Evaluating the Effectiveness of the Supportive Parenting App on Parental Outcomes: Randomized Controlled Trial. J Med Internet Res 2023; 25:e41859. [PMID: 36645699 PMCID: PMC9887516 DOI: 10.2196/41859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/21/2022] [Accepted: 11/30/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Adjusting to new or additional parenting responsibilities increases stress and affects parental well-being. Existing research has highlighted both parents' desire to receive more support. It has also been found that receiving sufficient social support enhances parenting outcomes. With the increasing popularity of mobile health apps, a Supportive Parenting App (SPA) intervention was developed to fulfill the support needs of parents during the perinatal period. OBJECTIVE This study aimed to examine the effectiveness of the SPA on parental outcomes during the perinatal period. METHODS A 2-group pretest and repeated posttest randomized controlled trial was conducted wherein 200 couples (N=400 mothers and fathers) were recruited from 2 public health care institutions in Singapore. Parents were randomly assigned to intervention (100/200, 50%) or control (100/200, 50%) groups. The SPA intervention consisted of a mobile app-based psychoeducation and peer support program to support parents from pregnancy to 6 months post partum. The outcome measures included postnatal depression, anxiety, parental bonding, parental self-efficacy, perceived social support, and parenting satisfaction. Data were collected at baseline (at >24 weeks of gestation-age of viability in Singapore) and at the first, second, fourth, sixth, ninth, and 12th month post partum. Linear mixed models were used to compare parental outcomes between the groups, and a linear mixed model for repeated measures was used to examine within-group changes. RESULTS Parents in the intervention group mostly showed better outcomes compared with those in the control group. Parents in the intervention group had higher perceived social support than those in the control group at the first (effect size=1.59, 95% CI 0.38-2.80; Cohen standardized effect size=1.31; P=.01), second (effect size=1.98, 95% CI 1.09-2.88; Cohen standardized effect size=2.21; P=.003), and fourth (effect size=2.57, 95% CI 1.62-3.51; Cohen standardized effect size=2.72; P=.048) months post partum. However, parents in the intervention group showed significantly poorer parental bonding (effect size=1.67, 95% CI 0.24-3.11; Cohen standardized effect size=1.16; P=.02). The other parental outcomes did not differ significantly between groups. The scores of mothers and fathers also differed significantly for all outcomes except parental self-efficacy. CONCLUSIONS Parents in the intervention group generally fared better, especially regarding perceived social support. However, the lack of statistical significance in most outcomes showed the limited effectiveness of the SPA intervention, which may be because of the COVID-19 pandemic. Parental differences in outcome scores suggest that mothers and fathers have different support needs; therefore, interventions should be tailored accordingly. Further improvements and evaluations are needed to examine the effectiveness of the SPA intervention in enhancing parental outcomes. Despite statistically insignificant results, limitations should be considered to further improve mobile health app-based interventions such as SPA, as they could serve as reliable and convenient sources of support for parents. TRIAL REGISTRATION Clinicaltrails.gov NCT4706442; https://clinicaltrials.gov/ct2/show/NCT04706442.
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Affiliation(s)
| | - Evelyn Law
- National University Hospital, Singapore, Singapore
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- Division of Nursing, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jancy Mathews
- National University Polyclinics, Corporate Office, Singapore, Singapore
| | | | - Luming Shi
- Singapore Clinical Research Institute, Singapore, Singapore
| | - Jing Shi Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ruochen Du
- Biostatistics Unit, Yong Loo Lin School of Medicine, Singapore, Singapore
| | | | - Thiam Chye Tan
- Mount Elizabeth Novena Specialist Centre, Singapore, Singapore
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Theiss LM, Wood L, Shao C, Marques I, Kim DH, Hollis R, Gunnells D, Hardiman K, Cannon J, Morris M, Kennedy G, Chu DI. Disparities in Perioperative Use of Patient Engagement Technologies - Not All Use is Equal. Ann Surg 2023; 277:e218-e225. [PMID: 36827493 PMCID: PMC9971636 DOI: 10.1097/sla.0000000000004970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the association of patient-level characteristics on the use of a patient engagement technology during the perioperative period. SUMMARY OF BACKGROUND DATA As implementation of patient engagement technologies continues to grow, it remains unclear who uses, and not uses, these technologies. Existing literature suggests significant disparities in usage of other technologies by patient age, race, sex, and geographic location, however, have yet to characterize patient usage of patient engagement technologies. METHODS This is a retrospective cohort study of patients undergoing elective surgery by a colorectal surgeon between January 2018 and March 2020 who enrolled in a patient engagement technology at a single institution. Patients enrolled received educational content, healthcare reminders, patient reported outcome (PRO) surveys, and health checks preoperatively, in-hospital, and for 30-days postdischarge. The primary outcome was patient activation of the patient engagement technology. Secondary outcomes were completion of at least 1 PRO survey, 1 in-hospital health check, and 1 postdischarge health check. RESULTS Of 549 patients who enrolled in the patient engagement technology, 473 (86.2%) activated. On multivariable stepwise regression, female patients [odds ratio (OR) 2.4, confidence interval (CI) 1.4-4.0, P = 0.001] and privately insured patients (OR 2.0, CI 1.1-3.8, P = 0.03) were more likely to activate. Black patients were less likely to activate (OR 0.5, CI 0.3-0.9, P = 0.02). Once activated, privately insured patients were more likely to complete PRO surveys (OR 2.3, CI 1.2-4.3, P = 0.01), in-hospital health checks (OR 2.4, CI 1.4-4.1, P = 0.002), and postdischarge health checks (OR 1.9, CI 1.1 -3.3, P < 0.001) than uninsured patients. Black patients were less likely to complete PRO surveys (OR 0.4, CI 0.3-0.7, P = 0.001) and in-hospital health checks (OR 0.6, CI 0.4-0.9, P = 0.03) than White patients. CONCLUSIONS Use of a patient engagement technology in the perioperative period differs significantly by sex, race/ethnicity, and insurance status. These technologies may not be used equally by all patients, which should be considered during implementation of interventions to improve surgical outcomes.
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Affiliation(s)
- Lauren M Theiss
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Lauren Wood
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Connie Shao
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Isabel Marques
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Dae Hyun Kim
- College of Business, Idaho State University, Pocatello, ID
| | - Robert Hollis
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Drew Gunnells
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Karin Hardiman
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Jamie Cannon
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Melanie Morris
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Gregory Kennedy
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
| | - Daniel I Chu
- Division of Gastrointestinal Surgery, University of Alabama at Birmingham, Birmingham AL
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Luz RMD, Marinho DCDB, Lima APE, Coriolano-Marinus MWL. Intervenções educativas em desenvolvimento infantil e os pressupostos do letramento em saúde: revisão integrativa. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0116pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Objetivos: analisar na literatura evidências científicas que abordem intervenções educativas conduzidas por profissionais de saúde sobre desenvolvimento infantil na primeira infância em contexto comunitário e identificar quais pressupostos do letramento em saúde estão presentes durante a implementação das intervenções. Método: revisão integrativa nas bases de dados PubMed, CINAHL e Web of Science. De 300 estudos encontrados, 11 foram selecionados para a amostra. Resultados: os profissionais de saúde são capacitados para implementar intervenções com pais/mães/cuidadores, para promoção do desenvolvimento infantil em contextos comunitários. Os pais são orientados a desenvolver um ambiente estimulante e propício para o desenvolvimento dos filhos. As principais dimensões do letramento em saúde encontradas foram acessar e aplicar. Conclusão: ratifica-se a importância da capacitação dos profissionais de saúde, com competências e habilidades comunicativas para orientar pais/mães/cuidadores a estimularem o desenvolvimento dos filhos em seu ambiente familiar com atividades lúdicas e interativas.
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Luz RMD, Marinho DCDB, Lima APE, Coriolano-Marinus MWL. Educational interventions in child development and health literacy assumptions: an integrative review. Rev Bras Enferm 2022; 76:e20220116. [PMID: 36542053 PMCID: PMC9749774 DOI: 10.1590/0034-7167-2022-0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 08/02/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES to analyze scientific evidence in the literature that addresses educational interventions conducted by health professionals on early childhood development in a community context and to identify which health literacy assumptions are present during the implementation of interventions. METHOD an integrative review in PubMed, CINAHL and Web of Science databases. Of 300 studies found, we selected 11 for the sample. RESULTS health professionals are trained to implement interventions with parents/caregivers to promote child development in community settings. Parents are encouraged to develop an environment that is encouraging and conducive to the development of their children. The main dimensions of health literacy found were access and apply. CONCLUSION it confirms the importance of training health professionals, with skills and communicative skills to guide parents/caregivers to encourage the development of their children in their family environment with playful and interactive activities.
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Kristjánsdóttir Ó, Welander Tärneberg A, Stenström P, Castor C, Kristensson Hallström I. eHealth literacy and socioeconomic and demographic characteristics of parents of children needing paediatric surgery in Sweden. Nurs Open 2022; 10:509-524. [PMID: 36053815 PMCID: PMC9834140 DOI: 10.1002/nop2.1316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/23/2022] [Accepted: 07/15/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The aim of the study was to describe different eHealth literacy domains among parents of children needing paediatric surgery in Sweden, and the correlation between these eHealth literacy domains and parents' socioeconomic factors and demographic characteristics. DESIGN Descriptive correlational design. METHOD Thirty-five Swedish-speaking parents participated as a historical control group within an ongoing Swedish clinical trial developing eHealth solutions for families after hospital care; of these, 30 completed the eHealth Literacy Questionnaire and the socioeconomic and demographic questionnaire. RESULTS Of the seven eHealth literacy domains assessed, parents' strengths lay in those pertaining to their own digital competence, control and safety, while their weakness concerned their motivation to engage with digital services, and their ability to access eHealth platforms that work. Overall, parents presented adequate eHealth literacy. Of the five socioeconomic and demographic variables assessed (i.e. monthly wages, education levels, age, gender and residency), monthly wages correlated the strongest, and positively, with the seven eHealth literacy domains.
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Affiliation(s)
| | | | - Pernilla Stenström
- Department of Pediatric Surgery and NeonatologySkåne University Hospital, Lund UniversityLundSweden
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14
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Nageswaran S, Gower WA, King NM, Golden SL. Tracheostomy decision-making for children with medical complexity: What supports and resources do caregivers need? Palliat Support Care 2022:1-7. [PMID: 36000170 PMCID: PMC9950280 DOI: 10.1017/s1478951522001122] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Caregivers of children with medical complexity (CMC) face decisions about life-sustaining interventions, such as tracheostomy. Our objective is to describe the support needs of caregivers of CMC and the resources they use surrounding tracheostomy decision-making (TDM) for their children. METHODS This qualitative study, conducted between 2013 and 2015, consisted of semi-structured interviews with 56 caregivers of 41 CMC who had tracheostomies, and 5 focus groups of 33 clinicians at a tertiary care children's hospital. Participants were asked about their perspectives on the TDM process. Qualitative data were transcribed, coded, and organized into themes. RESULTS Caregivers used five domains of resources surrounding TDM: (1) social network including extended family members, friends, and clergy; (2) healthcare providers including physicians and nurses; (3) other parents of children with tracheostomy; (4) tangible materials such as print materials, videos, tracheostomy tubes, mannequins, and simulation labs; and (5) internet including websites, social media, and online health communities. Caregivers used these resources for (1) decision-making, (2) becoming knowledgeable and skillful about child's diagnosis, tracheostomy, and home care, and (3) emotional and spiritual well-being. Caregivers agreed that they received enough support, but there were gaps. Clinicians were knowledgeable about these resources, discussed social network and internet less often than the other domains, and identified gaps in supporting caregivers. SIGNIFICANCE OF RESULTS Caregivers' need for support and use of resources surrounding tracheostomy placement for CMC extended beyond decision-making, and included becoming knowledgeable and getting emotional/spiritual support. Healthcare providers exploring these resources with caregivers could improve the quality of TDM communication.
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Affiliation(s)
- Savithri Nageswaran
- Department of Pediatrics, Wake Forest School of Medicine
- Department of Social Science and Health Policy, Wake Forest University
| | - William A. Gower
- Department of Pediatrics, Wake Forest School of Medicine
- Department of Pediatrics, University of North Carolina School of Medicine (current affiliation)
| | - Nancy M.P. King
- Department of Social Science and Health Policy, Wake Forest University
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15
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Lawrence J, Measey MA, Hoq M, Hiscock H, Rhodes A. Virtual health care for children: Parental willingness to adopt virtual health-care technologies. J Paediatr Child Health 2022; 58:1323-1329. [PMID: 35429361 DOI: 10.1111/jpc.15974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
AIM To understand parental awareness and appetite for virtual health modalities, including asynchronous communication and remote monitoring. To understand which socio-demographic characteristics are associated with greater awareness and appetite for virtual health. METHODS Nationally representative survey of Australian parents, recruited via an online panel in February 2021 as part of the Royal Children's Hospital National Child Health Poll. Participants were randomly selected from the consumer panel. RESULTS 1981 (59.4% response rate) parents completed the survey. 39.9% were aware of virtual health care, defined by digital technology and medical devices to support remote monitoring. Higher levels of awareness were associated with being male, having previous teleconsultation experience, higher education attainment and employment. Most parents reported an appetite for asynchronous communication using an app or website to either provide information prior to a consult (65.9%), provide a photo of a rash or similar (61.7%) or receive medical advice (58.1%). Appetite for wearable devices was similar at 59.9%. CONCLUSIONS Whilst awareness of virtual healthcare was low, appetite exists amongst Australian parents to use technology to support their child's health care. Health-care models, which incorporate asynchronous communication or symptom monitoring through apps, are likely to be acceptable and offer an accessible and sustainable alternative to traditional face-to-face health care.
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Affiliation(s)
- Joanna Lawrence
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Mary-Anne Measey
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,RCH National Child Health Poll, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Monsurul Hoq
- RCH National Child Health Poll, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Harriet Hiscock
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Health Services Research Unit, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Anthea Rhodes
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,RCH National Child Health Poll, The Royal Children's Hospital, Melbourne, Victoria, Australia
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16
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Batool SH, Safdar M, Eman S. Relationship between parents' health literacy and child health: systematic review. LIBRARY HI TECH 2022. [DOI: 10.1108/lht-11-2021-0398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeParents' health literacy is an important element to ensure the sound health of children. One of the major purposes of this study was to systematically collect and review the literature that identified the relationship between two variables: parents' health literacy and their child's health.Design/methodology/approachTo meet the purpose, the authors searched four well-reputed research databases such as Web of Science, Scopus, Google Scholar and LISTA (Library, Information Science and Technology Abstracts) comprehensively to collect the relevant research on the topic. Except for books, various types of content from different years were used for this review. The investigators used Preferred Items for Systematic Reviews and Meta-analysis guidelines to select eligible studies for this review. The authors also assessed the quality of the reviewed research in the light of well-reputed quality guidelines shared by Boynton and Greenhalgh (2004).FindingsThe majority of the reviewed studies found a statistically significant relationship between parents' health literacy and the health of their children. Findings also identified that the majority of the reviewed literature scored from 9 to 12 on the quality assessment criteria. Results also highlighted that the majority of the reviewed research on parents' health literacy and child health has been conducted in the USA and utilized quantitative methods to conduct research on the topic under this study.Research limitations/implicationsThis systematic review has multiple theoretical and practical implications for parents, policymakers and researchers.Originality/valueThis is the first systematically collected and reviewed paper on the relationship between parents' health literacy and child health.
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17
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Randell KA, Ragavan MI, Query LA, Sundaram M, Bair-Merritt M, Miller E, Denise Dowd M. Intimate Partner Violence and the Pediatric Electronic Health Record: A Qualitative Study. Acad Pediatr 2022; 22:824-832. [PMID: 34455099 PMCID: PMC8882201 DOI: 10.1016/j.acap.2021.08.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore expert perspectives on risks associated with the pediatric electronic health record (EHR) for intimate partner violence (IPV) survivors and their children and to identify strategies that may mitigate these risks. METHODS We conducted semistructured interviews with multidisciplinary pediatric IPV experts (nursing, physicians, social workers, hospital security, IPV advocates) recruited via snowball sampling. We coded interview transcripts using thematic analysis, then consolidated codes into themes. RESULTS Twenty-eight participants completed interviews. Participants identified the primary source of risk as an abuser's potential access to a child's EHR by legal and illegal means. They noted that abuser's access to multiple pediatric EHR components (eg, online health portals, clinical notes, contact information) may result in escalated violence, stalking, and manipulation of IPV survivors. Suggested risk mitigation strategies included limited and coded documentation, limiting EHR access, and discussing documentation with the IPV survivor. Challenges to using these strategies included healthcare providers' usual practice of detailed documentation and that information documented may confer both risk and benefit concurrently. Reported potential benefits of the pediatric EHR for IPV survivors included ensuring continuity of care, decreasing need to repeatedly talk about trauma histories, and communication of safety plans. CONCLUSIONS Our findings suggest the pediatric EHR may confer both risks and benefits for IPV survivors and their children. Further work is needed to develop best practices to address IPV risks related to the pediatric EHR, to ensure consistent use of these practices, and to include these practices as standard functionalities of the pediatric EHR.
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Affiliation(s)
- Kimberly A Randell
- Division of Emergency Medicine (KA Randell, LA Query, and MD Dowd), Children's Mercy Kansas City, Kansas City, Mo; University of Missouri-Kansas City School of Medicine (KA Randell, LA Query, and MD Dowd), Kansas City, Mo.
| | - Maya I Ragavan
- Division of General Academic Pediatrics (MI Ragavan), University of Pittsburgh/Children's Hospital of Pittsburgh, Pittsburgh, Pa
| | - Lindsey A Query
- Division of Emergency Medicine (KA Randell, LA Query, and MD Dowd), Children's Mercy Kansas City, Kansas City, Mo; University of Missouri-Kansas City School of Medicine (KA Randell, LA Query, and MD Dowd), Kansas City, Mo
| | - Mangai Sundaram
- University of California Berkley (M Sundaram), Berkeley, Calif
| | - Megan Bair-Merritt
- Division of General Academic Pediatrics (M B-Merritt), Boston University School of Medicine/Boston Medical Center, Boston, Mass
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine (E Miller), University of Pittsburgh/Children's Hospital of Pittsburgh, Pittsburgh, Pa
| | - Mary Denise Dowd
- Division of Emergency Medicine (KA Randell, LA Query, and MD Dowd), Children's Mercy Kansas City, Kansas City, Mo; University of Missouri-Kansas City School of Medicine (KA Randell, LA Query, and MD Dowd), Kansas City, Mo
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18
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Urstad KH, Andersen MH, Larsen MH, Borge CR, Helseth S, Wahl AK. Definitions and measurement of health literacy in health and medicine research: a systematic review. BMJ Open 2022; 12:e056294. [PMID: 35165112 PMCID: PMC8845180 DOI: 10.1136/bmjopen-2021-056294] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The way health literacy is understood (conceptualised) should be closely linked to how it is measured (operationalised). This study aimed to gain insights into how health literacy is defined and measured in current health literacy research and to examine the relationship between health literacy definitions and instruments. DESIGN Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES The MEDLINE, PsycINFO, ERIC and CINAHL databases were searched for articles published during two randomly selected months (March and October) in 2019. ELIGIBILITY CRITERIA We included articles with a quantitative design that measured health literacy, were peer-reviewed and original, were published in the English language and included a study population older than 16 years. DATA EXTRACTION AND SYNTHESIS Six researchers screened the articles for eligibility and extracted the data independently. All health literacy definitions and instruments were considered in relation to category 1 (describing basic reading and writing skills, disease-specific knowledge and practical skills) and category 2 (social health literacy competence and the ability to interpret and critically assess health information). The categories were inspired by Nutbeam's descriptions of the different health literacy levels. RESULTS 120 articles were included in the review: 60 within public health and 60 within clinical health. The majority of the articles (n=77) used instruments from category 1. In total, 79 of the studies provided a health literacy definition; of these, 71 were in category 2 and 8 were in category 1. In almost half of the studies (n=38), health literacy was defined in a broad perspective (category 2) but measured with a more narrow focus (category 1). CONCLUSION Due to the high degree of inconsistency between health literacy definitions and instruments in current health literacy research, there is a risk of missing important information about health literacy considered be important to the initial understanding of the concept recognised in the studies. PROSPERO REGISTRATION NUMBER CRD42020179699.
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Affiliation(s)
- Kristin Hjorthaug Urstad
- Department of Quality and Health Technology, University of Stavanger, Stavanger, Norway
- Faculty of Health Sciences, VID Specialized University, Oslo, Akershus, Norway
| | - Marit Helen Andersen
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Marie Hamilton Larsen
- Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diaconal University College, Oslo, Akershus, Norway
| | - Christine Råheim Borge
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Sølvi Helseth
- Faculty of Health Scienes, Oslo Metropolitan University, Oslo, Norway
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Astrid Klopstad Wahl
- Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
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19
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Mörelius E, Robinson S, Arabiat D, Whitehead L. Digital Interventions to Improve Health Literacy Among Parents of Children Aged 0 to 12 Years With a Health Condition: Systematic Review. J Med Internet Res 2021; 23:e31665. [PMID: 34941559 PMCID: PMC8734927 DOI: 10.2196/31665] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/06/2021] [Accepted: 10/29/2021] [Indexed: 01/11/2023] Open
Abstract
Background Parental health literacy is associated with child health outcomes. Parents are increasingly turning to the internet to obtain health information. In response, health care providers are using digital interventions to communicate information to assist parents in managing their child’s health conditions. Despite the emergence of interventions to improve parental health literacy, to date, no systematic evaluation of the effectiveness of the interventions has been undertaken. Objective The aim of this review is to examine the effect of digital health interventions on health literacy among parents of children aged 0-12 years with a health condition. This includes evaluating parents’ engagement (use and satisfaction) with digital health interventions, the effect of these interventions on parental health knowledge and health behavior, and the subsequent impact on child health outcomes. Methods This systematic review was registered a priori on PROSPERO (International Prospective Register of Systematic Reviews) and developed according to the Joanna Briggs Institute methodology for systematic reviews. The databases CINAHL, MEDLINE, and PsycINFO were searched for relevant literature published between January 2010 and April 2021. Studies were included if they were written in English. A total of 2 authors independently assessed the search results and performed a critical appraisal of the studies. Results Following the review of 1351 abstracts, 31 (2.29%) studies were selected for full-text review. Of the 31 studies, 6 (19%) studies met the inclusion criteria. Of the 6 studies, 1 (17%) was excluded following the critical appraisal, and the 5 (83%) remaining studies were quantitative in design and included digital health interventions using web-based portals to improve parents’ health knowledge and health behavior. Owing to heterogeneity in the reported outcomes, meta-analysis was not possible, and the findings were presented in narrative form. Of the 5 studies, satisfaction was measured in 3 (60%) studies, and all the studies reported high satisfaction with the digital intervention. All the studies reported improvement in parental health literacy at postintervention as either increase in disease-specific knowledge or changes in health behavior. Of the 5 studies, only 1 (20%) study included child health outcomes, and this study reported significant improvements related to increased parental health knowledge. Conclusions In response to a pandemic such as COVID-19, there is an increased need for evidence-based digital health interventions for families of children living with health conditions. This review has shown the potential of digital health interventions to improve health knowledge and behavior among parents of young children with a health condition. However, few digital health interventions have been developed and evaluated for this population. Future studies with robust research designs are needed and should include the potential benefits of increased parent health literacy for the child. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020192386; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=192386
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Affiliation(s)
- Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,The Centre for Evidence Informed Nursing, Midwifery and Healthcare Practice, Joondalup, WA, Australia
| | - Suzanne Robinson
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.,The Centre for Evidence Informed Nursing, Midwifery and Healthcare Practice, Joondalup, WA, Australia
| | - Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.,Maternal and Child Nursing Department, Faculty of Nursing, The University of Jordan, Amman, Jordan.,Australian Research Council Centre of Excellence for the Digital Child, Joondalup, WA, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia.,The Centre for Evidence Informed Nursing, Midwifery and Healthcare Practice, Joondalup, WA, Australia
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20
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Sørensen K, Levin-Zamir D, Duong TV, Okan O, Brasil VV, Nutbeam D. Building health literacy system capacity: a framework for health literate systems. Health Promot Int 2021; 36:i13-i23. [PMID: 34897445 PMCID: PMC8672927 DOI: 10.1093/heapro/daab153] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The human and social implications of poor health literacy are substantial and wide-ranging. Health literacy represents the personal competencies and organizational structures, resources and commitment that enable people to access, understand, appraise and use information and services in ways that promote and maintain good health. A large-scale societal improvement of health literacy will require political buy-in and a systematic approach to the development of health literacy capacity at all levels. This article builds the case for enhancing health literacy system capacity and presents a framework with eight action areas to accommodate the structural transformation needed at micro, meso and macro levels, including a health literate workforce, health literate organization, health literacy data governance, people-centred services and environments based on user engagement, health literacy leadership, health literacy investments and financial resources, health literacy-informed technology and innovation, and partnerships and inter-sectoral collaboration. Investment in the health literacy system capacity ensures an imperative and systemic effort and transformation which can be multiplied and sustained over time and is resilient towards external trends and events, rather than relying on organizational and individual behavioural change alone. Nevertheless, challenges still remain, e.g. to specify the economic benefits more in detail, develop and integrate data governance systems and go beyond healthcare to engage in health literacy system capacity within a wider societal context.
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Affiliation(s)
| | - Diane Levin-Zamir
- Department of Health Education and Promotion,
Clalit, Tel Aviv and School of Public Health, University of Haifa,
Haifa, Israel
| | - Tuyen V Duong
- School of Nutrition and Health Sciences, Taipei
Medical University, Taipei, Taiwan
| | - Orkan Okan
- Interdisciplinary Centre for Health Literacy
Research, Bielefeld University, Germany
| | | | - Don Nutbeam
- Sydney School of Public Health, University of
Sydney, Sydney, Australia
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21
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Information and Communication Technology Access and Use Among Low-Income Latino Immigrant Parents. Matern Child Health J 2021; 25:1807-1813. [PMID: 34687401 DOI: 10.1007/s10995-021-03265-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Development of mHealth interventions to address health disparities for Latino children in immigrant families requires understanding access to and use of information and communication technology. METHODS We examined access to information and communication technology and use of common applications/programs by low-income immigrant Latino parents of infants to inform development of mHealth interventions for this population. Latino immigrant parents reported technology use and access of common applications/software via survey. RESULTS Of the 157 participants, we found nearly all parents owned a smartphone and that 60% accessed the internet only via their smartphone. Around one-quarter of participants had access to unlimited data. Frequent use of text messaging was common, but frequent email use was less common. Less than 10% of participants frequently used health-oriented applications. DISCUSSION Our findings suggest that mHealth interventions that use data, email, or an application interface may not have the intended reach or effectiveness among low-income immigrant Latino parents. Consideration of these findings is important in guiding the development of future mHealth programs for the low-income Latino population. This study was registered at clinicaltrials.gov (NCT02647814).
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22
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Hutton JS, Huang G, Wiley C, DeWitt T, Ittenbach RF. Randomized Trial of a Mobile App Introduced During Well-Visits to Enhance Guidance for Reading With Young Children. Acad Pediatr 2021; 21:977-987. [PMID: 34020099 DOI: 10.1016/j.acap.2021.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/28/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To estimate feasibility, usability and efficacy of a mobile parenting app (Rx for Success; RxS) to enhance reading guidance provided to parents of young children during well-visits. METHODS This trial was conducted at a clinic serving primarily families of Hispanic ethnicity and low-socioeconomic status (SES) where Reach Out and Read (ROR) is standard practice. It involved 252 parent-child dyads in 2 age groups (~6-months old, ~18-months old) randomized during well-visits to receive RxS or a children's book modeling alternatives to screen time (Control) by research coordinators. RxS involves videos, activities and "push" messages. Follow-up assessments were conducted approximately 6 months later, including impression and use, shared reading behaviors, child language and screen time. RESULTS A total of 217 dyads completed both visits (110 RxS, 107 Control). Time to introduce RxS was under 3 minutes and 32% of parents experienced largely minor performance issues. Parent impression of RxS was favorable for both age groups at baseline and follow-up, though use was infrequent, attributable to a desire for more relevant and updated content. Significant findings favoring RxS included shared reading as a favorite activity, more frequent shared reading reported at 12 months and higher language scores at 24 months. Screen time was equivalent between cohorts, exceeding American Academy of Pediatrics guidelines. CONCLUSIONS A mobile app introduced to parents of young children from low-SES backgrounds was feasible during well-visits, rated as helpful, and effective to enhance shared reading at younger and language at older ages. While a potentially impactful enhancement to ROR, features needing improvement were identified.
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Affiliation(s)
- John S Hutton
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio.
| | - Guixia Huang
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
| | - Catherine Wiley
- Community Health Center at Connecticut Children's Hospital (C Wiley), Hartford, Conn
| | - Thomas DeWitt
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio; Reading and Literacy Discovery Center, Cincinnati Children's Hospital Medical Center (JS Hutton and T DeWitt), Cincinnati, Ohio
| | - Richard F Ittenbach
- Division of Biostatistics and Epidemiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center (G Huang and RF Ittenbach), Cincinnati, Ohio
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23
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Bondoc M, Hancu M, DiMarzio M, Sheldon BL, Shao MM, Khazen O, Pilitsis JG. Age as an Independent Predictor of Adult Spinal Cord Stimulation Pain Outcomes. Stereotact Funct Neurosurg 2021; 100:1-7. [PMID: 34280929 DOI: 10.1159/000517426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/21/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Spinal cord stimulation (SCS) is an efficacious chronic pain treatment most commonly used in middle-aged patients. Results from previous studies that investigated SCS' effects in older patient populations have been equivocal. We examine whether SCS outcomes correlate with age. METHODS We retrospectively examined prospectively collected outcomes from 189 patients who underwent SCS at Albany Medical Center between 2012 and 2020. The patients completed the Numerical Rating Scale (NRS), McGill Pain Questionnaire (MPQ), Oswestry Disability Index (ODI), Beck Depression Inventory (BDI), and Pain Catastrophizing Scale (PCS) preoperatively and 1 year postoperatively. The mean percent change in each outcome was determined and compared via a regression analysis to determine relationships between patient age and each respective outcome metrics. Demographics were compared between patients aged under 65 versus those aged 65 and older via χ2 tests. RESULTS All subjects demonstrated the expected improvement on NRS, BDI, PCS, and MPQ from baseline to 1-year follow-up, with several demonstrating statistically significant changes: NRS-worst pain (18.66%, p < 0.001), NRS-least pain (26.9%, p < 0.001), NRS-average pain (26.9%, p < 0.01), NRS-current pain (26.4%, p < 0.001), ODI (19.6%, p < 0.001), PCS (29.8%, p < 0.001), and MPQ (29.4%, p < 0.001). There was no significant difference between patients aged under 65 versus those aged 65 and older based on lead type (p = 0.454). Six patients (3.1%) had lead migration, one of whom was 65 or older. Regression analysis revealed improvements in MPQ-sensory and MPQ-affective scores as age increased (p < 0.001, R2 = 0.09; p = 0.046, R2 = 0.05, respectively). Age did not correlate with NRS, ODI, BDI, or PCS. Diagnosis, spinal level of SCS, and lead type were not found to influence any respective outcome measure based on covariate analysis. CONCLUSION This study represents the largest study where age was correlated to specific pain, depression, and disability outcomes following SCS. We provide evidence that SCS outcomes are equivalent, or better, in older patients following SCS. Based on these findings, SCS is a viable option for treatment of chronic pain in elderly patient populations.
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Affiliation(s)
- Melanie Bondoc
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Maria Hancu
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Marisa DiMarzio
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Breanna L Sheldon
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Miriam M Shao
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Olga Khazen
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA
| | - Julie G Pilitsis
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, New York, USA.,Department of Neurosurgery, Albany Medical Center, Albany, New York, USA
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Flower KB, Wurzelmann S, Tucker C, Rojas C, Díaz-González de Ferris ME, Sylvester F. Spanish-Speaking Parents' Experiences Accessing Academic Medical Center Care: Barriers, Facilitators and Technology Use. Acad Pediatr 2021; 21:793-801. [PMID: 33096286 PMCID: PMC7573670 DOI: 10.1016/j.acap.2020.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/11/2020] [Accepted: 10/17/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVE Children of Spanish-speaking caregivers face multiple barriers to care in academic medical centers. This study identified barriers and facilitators of health care and described use of health information technology in order to guide interventions and optimize services. METHODS In-depth, audiotaped interviews were conducted with monolingual Spanish-speaking caregivers (N = 28) of children receiving care in academic medical center clinics using a structured interview guide. Interviews were transcribed in Spanish, and key themes were identified using thematic analysis. Illustrative quotes for each theme were translated into English. RESULTS Language-specific barriers included arrival/registration occurring in English, lack of bilingual personnel, heavy reliance on interpreters, long wait times, and challenging phone communication. Non-language-specific barriers included medical center size and complexity, distance to services, lack of convenient and coordinated appointments, missing work/school, and financial barriers including insurance coverage or lack of citizenship. Caregivers identified interpreters, bilingual physicians and staff, and written materials in Spanish as facilitators of care. Most caregivers had internet access and expressed interest in health information technology, including patient portals, to communicate about their children's health. CONCLUSIONS Caregivers of Spanish-speaking children encounter many language-specific barriers, which are compounded by non-language-specific barriers arising from complex health systems and social needs. Caregivers with limited resources described working hard to meet children's complex health care needs despite these barriers. Most caregivers had internet access and interest in patient portals. Academic medical centers may need multifaceted interventions that improve the availability of bilingual staff and interpreters and also address caregivers' social and informational needs.
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Affiliation(s)
- Kori B Flower
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics (KB Flower, ME Díaz-González de Ferris), University of North Carolina at Chapel Hill.
| | - Samuel Wurzelmann
- School of Medicine, University of North Carolina at Chapel Hill (S Wurzelmann)
| | - Christine Tucker
- Department of Maternal and Child Health (C Tucker), Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Claudia Rojas
- Center for Latino Health and Division of General Internal Medicine, Department of Internal Medicine (C Rojas), University of North Carolina at Chapel Hill
| | - Maria E Díaz-González de Ferris
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics (KB Flower, ME Díaz-González de Ferris), University of North Carolina at Chapel Hill
| | - Francisco Sylvester
- Division of Pediatric Gastroenterology, Department of Pediatrics (F Sylvester), University of North Carolina at Chapel Hill
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Ettinger AK, Landsittel D, Abebe KZ, Bey J, Chavis V, Navratil JD, Savage Friedman F, Dermody TS, Miller E. THRIVE Conceptual Framework and Study Protocol: A Community-Partnered Longitudinal Multi-Cohort Study to Promote Child and Youth Thriving, Health Equity, and Community Strength. Front Pediatr 2021; 9:797526. [PMID: 35186824 PMCID: PMC8856106 DOI: 10.3389/fped.2021.797526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Given the profound inequities in maternal and child health along racial, ethnic, and socioeconomic lines, strength-based, community-partnered research is required to foster thriving children, families, and communities, where thriving is defined as optimal development across physical, mental, cognitive, and social domains. The Pittsburgh Study (TPS) is a community-partnered, multi-cohort study designed to understand and promote child and youth thriving, build health equity, and strengthen communities by integrating community partners in study design, implementation, and dissemination. TPS launched the Tracking Health, Relationships, Identity, EnVironment, and Equity (THRIVE) Study to evaluate children's developmental stages and contexts from birth through completion of high school and to inform a child health data hub accessible to advocates, community members, educators, health professionals, and policymakers. METHODS AND ANALYSIS TPS is rooted in community-partnered participatory research (CPPR), health equity, antiracism, and developmental science. Using our community-informed conceptual framework of child thriving, the THRIVE Study will assess cross-cutting measures of place, environment, health service use, and other social determinants of health to provide longitudinal associations with developmentally appropriate child and youth thriving outcomes across participants in six cohorts spanning from pregnancy through adolescence (child ages 0-18 years). Data from electronic health records, school records, and health and human services use are integrated to assess biological and social influences of thriving. We will examine changes over time using paired t-tests and adjusted linear regression models for continuous thriving scores and McNemar tests and adjusted logistic regression models for categorical outcomes (thriving/not thriving). Data analyses will include mixed models with a random intercept (in combination with the previously-specified types of regression models) to account for within-subject correlation. DISCUSSION By enhancing assessment of child and youth well-being, TPS will fill critical gaps in our understanding of the development of child and youth thriving over time and test strategies to support thriving in diverse communities and populations. Through CPPR and co-design, the study aims to improve child health inequities across multiple socioecological levels and developmental domains.
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Affiliation(s)
- Anna K Ettinger
- Department of Psychology, Center for Children and Families, University of Pittsburgh, Pittsburgh, PA, United States
| | - Doug Landsittel
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Kaleab Z Abebe
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jamil Bey
- UrbanKind Institute, Pittsburgh, PA, United States
| | - Val Chavis
- Department of Psychology, Center for Children and Families, University of Pittsburgh, Pittsburgh, PA, United States
| | - Judith D Navratil
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | | | - Terence S Dermody
- Departments of Pediatrics and Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Liaqat F, Mahmood K, Ali FH. Demographic and socio-economic differences in financial information literacy among university students. INFORMATION DEVELOPMENT 2020. [DOI: 10.1177/0266666920939601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Financial information literacy helps to manage earnings, especially among those students who study non-commerce subjects. Thus, this study attempts to explore the differences in such literacy through their demographic and socioeconomic characteristics. A well-structured instrument was used to gather data from 382 non-commerce students in universities in Pakistan using a multi stage sampling technique. Analyses were conducted through percentage of correct response technique and group comparisons. The findings indicate an average level of financial knowledge among university students. The demographic differences reveal that most of the students are male, graduate, with age above 26, enrolled in a private university, residing in dormitories, and score higher in academic subjects are more financially literate. While the socioeconomic differences indicate that those students who follow family advice, study minor finance courses, maintain a bank account, and have higher parental income are more knowledgeable about finance. The study recommends arranging awareness sessions to impart financial knowledge to students.
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Ben-Sasson A, Ben-Sasson E, Jacobs K, Malinovitch R. The relationship between users’ technology approaches and experiences in a child development mobile application. HEALTH AND TECHNOLOGY 2020. [DOI: 10.1007/s12553-020-00457-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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