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Wilson S, Tolley C, Mc Ardle R, Lawson L, Beswick E, Hassan N, Slight R, Slight S. Recommendations to advance digital health equity: a systematic review of qualitative studies. NPJ Digit Med 2024; 7:173. [PMID: 38951666 PMCID: PMC11217442 DOI: 10.1038/s41746-024-01177-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024] Open
Abstract
The World Health Organisation advocates Digital Health Technologies (DHTs) for advancing population health, yet concerns about inequitable outcomes persist. Differences in access and use of DHTs across different demographic groups can contribute to inequities. Academics and policy makers have acknowledged this issue and called for inclusive digital health strategies. This systematic review synthesizes literature on these strategies and assesses facilitators and barriers to their implementation. We searched four large databases for qualitative studies using terms relevant to digital technology, health inequities, and socio-demographic factors associated with digital exclusion summarised by the CLEARS framework (Culture, Limiting conditions, Education, Age, Residence, Socioeconomic status). Following the PRISMA guidelines, 10,401 articles were screened independently by two reviewers, with ten articles meeting our inclusion criteria. Strategies were grouped into either outreach programmes or co-design approaches. Narrative synthesis of these strategies highlighted three key themes: firstly, using user-friendly designs, which included software and website interfaces that were easy to navigate and compatible with existing devices, culturally appropriate content, and engaging features. Secondly, providing supportive infrastructure to users, which included devices, free connectivity, and non-digital options to help access healthcare. Thirdly, providing educational support from family, friends, or professionals to help individuals develop their digital literacy skills to support the use of DHTs. Recommendations for advancing digital health equity include adopting a collaborative working approach to meet users' needs, and using effective advertising to raise awareness of the available support. Further research is needed to assess the feasibility and impact of these recommendations in practice.
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Affiliation(s)
- Sarah Wilson
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
| | - Clare Tolley
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
| | - Ríona Mc Ardle
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Lauren Lawson
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Nehal Hassan
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK
| | - Robert Slight
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Sarah Slight
- School of Pharmacy, Newcastle University, Newcastle Upon Tyne, UK.
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
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Logie CH, Okumu M, Berry I, Kortenaar JL, Hakiza R, Musoke DK, Katisi B, Nakitende A, Kyambadde P, Lester R, Perez-Brumer AG, Admassu Z, Mbuagbaw L. Kukaa Salama (Staying Safe): a pre-post trial of an interactive informational mobile health intervention for increasing COVID-19 prevention practices with urban refugee youth in Uganda. Int Health 2024; 16:107-116. [PMID: 37458073 PMCID: PMC10759295 DOI: 10.1093/inthealth/ihad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/08/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Tailored coronavirus disease 2019 (COVID-19) prevention strategies are needed for urban refugee youth in resource-constrained contexts. We developed an 8-wk interactive informational mobile health intervention focused on COVID-19 prevention practices informed by the Risk, Attitude, Norms, Ability, Self-regulation-or RANAS-approach. METHODS We conducted a pre-post trial with a community-recruited sample of refugee youth aged 16-24 y in Kampala, Uganda. Data were collected before (T1) and immediately following (T2) the intervention, and at the 16-wk follow up (T3), to examine changes in primary (COVID-19 prevention self-efficacy) and secondary outcomes (COVID-19 risk awareness, attitudes, norms and self-regulation practices; depression; sexual and reproductive health [SRH] access; food/water security; COVID-19 vaccine acceptability). RESULTS Participants (n=346; mean age: 21.2 [SD 2.6] y; cisgender women: 50.3%; cisgender men: 48.0%; transgender persons: 1.7%) were largely retained (T2: n=316, 91.3%; T3: n=302, 87.3%). In adjusted analyses, COVID-19 prevention self-efficacy, risk awareness, attitudes and vaccine acceptance increased significantly from T1 to T2, but were not sustained at T3. Between T1 and T3, COVID-19 norms and self-regulation significantly increased, while community violence, water insecurity and community SRH access decreased. CONCLUSIONS Digital approaches for behaviour change hold promise with urban refugee youth but may need booster messaging and complementary programming for sustained effects.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario M5S 1V4, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario M5S 1B2, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, BC V6Z 2K5, Canada
| | - Moses Okumu
- School of Social Work, University of Illinois Urbana-Champaign, Urbana, Illinois 61820, United States
- School of Social Sciences, Uganda Christian University, Mukono, Uganda
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
| | - Jean-Luc Kortenaar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
| | - Robert Hakiza
- Young African Refugees for Integral Development (YARID), Kampala, Uganda
| | | | - Brenda Katisi
- Young African Refugees for Integral Development (YARID), Kampala, Uganda
| | | | - Peter Kyambadde
- National AIDS and STI Control Programme, Ministry of Health, Kampala, Uganda
- Most at Risk Population Initiative, Mulago Hospital, Kampala, Uganda
| | - Richard Lester
- Department of Medicine, University of British Columbia, Vancouver, British Columbia V6T 1Z3, Canada
| | - Amaya G Perez-Brumer
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario M5T 3M7, Canada
| | - Zerihun Admassu
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario M5S 1V4, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario L8S 4L8, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON L8N 3Z5, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4K1, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON L8G 5E4, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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3
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Hussein R, Griffin AC, Pichon A, Oldenburg J. A guiding framework for creating a comprehensive strategy for mHealth data sharing, privacy, and governance in low- and middle-income countries (LMICs). J Am Med Inform Assoc 2023; 30:787-794. [PMID: 36259962 PMCID: PMC10018261 DOI: 10.1093/jamia/ocac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/26/2022] [Accepted: 10/05/2022] [Indexed: 11/12/2022] Open
Abstract
With the numerous advances and broad applications of mobile health (mHealth), establishing concrete data sharing, privacy, and governance strategies at national (or regional) levels is essential to protect individual privacy and data usage. This article applies the recent Health Data Governance Principles to provide a guiding framework for low- and middle-income countries (LMICs) to create a comprehensive mHealth data governance strategy. We provide three objectives: (1) establish data rights and ownership to promote equitable benefits from health data, (2) protect people through building trust and addressing patients' concerns, and (3) promote health value by enhancing health systems and services. We also recommend actions for realizing each objective to guide LMICs based on their unique mHealth data ecosystems. These objectives require adopting a regulatory framework for data rights and protection, building trust for data sharing, and enhancing interoperability to use new datasets in advancing healthcare services and innovation.
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Affiliation(s)
- Rada Hussein
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Ashley C Griffin
- Department of Health Policy, VA Palo Alto Health Care System, Stanford University School of Medicine, Stanford, California, USA
| | - Adrienne Pichon
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Jan Oldenburg
- Participatory Health Consulting, LLC, Richmond, Virginia, USA
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4
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Kiptinness C, Naik P, Thuo N, Malen RC, Dettinger JC, Pintye J, Rafferty M, Jomo E, Nyamasyo N, Wood T, Isabelli P, Morris S, Hattery D, Stergachis A, Were D, Sharma M, Ngure K, Mugambi ML, Ortblad KF. Online HIV prophylaxis delivery: Protocol for the ePrEP Kenya pilot study. Front Public Health 2023; 11:1054559. [PMID: 36908449 PMCID: PMC9998902 DOI: 10.3389/fpubh.2023.1054559] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/31/2023] [Indexed: 03/14/2023] Open
Abstract
Background Online pharmacies in Kenya provide sexual and reproductive health products (e.g., HIV self-testing, contraception) and could be leveraged to increase the reach of HIV pre-exposure and post-exposure prophylaxis (PrEP/PEP) to populations who do not frequently attend health facilities. To date, evidence is limited for operationalizing online PrEP/PEP delivery and the type of populations reached with this differential service delivery model. Methods The ePrEP Kenya Pilot will deliver daily oral PrEP and PEP via MYDAWA, a private online pharmacy retailer, to clients in Nairobi for 18 months. Potential clients will obtain information about PrEP/PEP on MYDAWA's sexual wellness page and self-screen for HIV risk. Individuals ≥18 years, identified as at HIV risk, and willing to pay for a blood-based HIV self-test and PrEP/PEP delivery will be eligible for enrollment. To continue with online PrEP/PEP initiation, eligible clients will purchase a blood-based HIV self-test for 250 KES (~USD 2) [delivered to their setting of choice for 99 KES (~USD 1)], upload an image of their self-test result, and attend a telemedicine visit with a MYDAWA provider. During the telemedicine visit, providers will screen clients for PrEP/PEP eligibility, including clinical concerns (e.g., kidney disease), discuss self-test results, and complete counseling on PrEP/PEP use and safety. Providers will refer clients who self-test HIV positive or report any existing medical conditions to the appropriate services at healthcare facilities that meet their preferences. Eligible clients will be prescribed PrEP (30-day PrEP supply at initiation; 90-day PrEP supply at follow-up visits) or PEP (28-day supply) for free and have it delivered for 99 KES (~USD 1). We will measure PrEP and PEP initiation among eligible clients, PEP-to-PrEP transition, PrEP continuation, and implementation outcomes (e.g., feasibility, acceptability, and costs). Discussion Establishing pathways to increase PrEP and PEP access is crucial to help curb new HIV infections in settings with high HIV prevalence. The findings from this study will provide evidence on the implementation of online pharmacy PrEP and PEP service delivery that can help inform guidelines in Kenya and similar settings.
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Affiliation(s)
- Catherine Kiptinness
- Partners in Health Research and Development, Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Paulami Naik
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Nicholas Thuo
- Partners in Health Research and Development, Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rachel C. Malen
- Public Health Science Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Julia C. Dettinger
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Jillian Pintye
- Department of Biobehavioral Nursing and Health Informatics, Seattle, WA, United States
| | | | | | | | | | | | | | | | - Andy Stergachis
- Department of Global Health, University of Washington, Seattle, WA, United States
- Department of Pharmacy, University of Washington, Seattle, WA, United States
| | | | - Monisha Sharma
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Kenneth Ngure
- School of Public Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | | | - Katrina F. Ortblad
- Public Health Science Division, Fred Hutchinson Cancer Center, Seattle, WA, United States
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5
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Takasaki Y, Abizaid C, Coomes OT. COVID-19 contagion across remote communities in tropical forests. Sci Rep 2022; 12:20727. [PMID: 36456613 PMCID: PMC9713114 DOI: 10.1038/s41598-022-25238-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Understanding COVID-19 contagion among poor populations is hampered by a paucity of data, and especially so in remote rural communities with limited access to transportation, communication, and health services. We report on the first study on COVID-19 contagion across rural communities without road access. We conducted telephone surveys with over 400 riverine communities in the Peruvian Amazon in the early phase of the pandemic. During the first wave (April-June, 2020), COVID-19 spread from cities to most communities through public and private river transportation according to their remoteness. The initial spread was delayed by transportation restrictions but at the same time was driven in unintended ways by government social assistance. During the second wave (August, 2020), although people's self-protective behaviors (promoted through communication access) helped to suppress the contagion, people responded to transportation restrictions and social assistance in distinct ways, leading to greater contagion among Indigenous communities than mestizo communities. As such, the spatial contagion during the early phase of the pandemic in tropical forests was shaped by river transportation and social behaviors. These novel findings have important implications for research and policies on pandemics in rural areas.
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Affiliation(s)
- Yoshito Takasaki
- Graduate School of Economics, University of Tokyo, Tokyo, Japan.
| | - Christian Abizaid
- Department of Geography and Planning and School of the Environment, University of Toronto, Toronto, ON, Canada
| | - Oliver T Coomes
- Department of Geography, McGill University, Montreal, QC, Canada
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Foo CD, Verma M, Tan SM, Haldane V, Reyes KA, Garcia F, Canila C, Orano J, Ballesteros AJ, Marthias T, Mahendradhata Y, Tuangratananon T, Rajatanavin N, Poungkantha W, Mai Oanh T, The Due O, Asgari-Jirhandeh N, Tangcharoensathien V, Legido-Quigley H. COVID-19 public health and social measures: a comprehensive picture of six Asian countries. BMJ Glob Health 2022; 7:e009863. [PMID: 36343969 PMCID: PMC9644075 DOI: 10.1136/bmjgh-2022-009863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/15/2022] [Indexed: 11/09/2022] Open
Abstract
The COVID-19 pandemic will not be the last of its kind. As the world charts a way towards an equitable and resilient recovery, Public Health and Social Measures (PHSMs) that were implemented since the beginning of the pandemic need to be made a permanent feature of health systems that can be activated and readily deployed to tackle sudden surges in infections going forward. Although PHSMs aim to blunt the spread of the virus, and in turn protect lives and preserve health system capacity, there are also unintended consequences attributed to them. Importantly, the interactions between PHSMs and their accompanying key indicators that influence the strength and duration of PHSMs are elements that require in-depth exploration. This research employs case studies from six Asian countries, namely Indonesia, Singapore, South Korea, Thailand, the Philippines and Vietnam, to paint a comprehensive picture of PHSMs that protect the lives and livelihoods of populations. Nine typologies of PHSMs that emerged are as follows: (1) physical distancing, (2) border controls, (3) personal protective equipment requirements, (4) transmission monitoring, (5) surge health infrastructure capacity, (6) surge medical supplies, (7) surge human resources, (8) vaccine availability and roll-out and (9) social and economic support measures. The key indicators that influence the strength and duration of PHSMs are as follows: (1) size of community transmission, (2) number of severe cases and mortality, (3) health system capacity, (4) vaccine coverage, (5) fiscal space and (6) technology. Interactions between PHSMs can be synergistic or inhibiting, depending on various contextual factors. Fundamentally, PHSMs do not operate in silos, and a suite of PHSMs that are complementary is required to ensure that lives and livelihoods are safeguarded with an equity lens. For that to be achieved, strong governance structures and community engagement are also required at all levels of the health system.
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Affiliation(s)
- Chuan De Foo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Monica Verma
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - See Mieng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Victoria Haldane
- University of Toronto Dalla Lana School of Public Health, Toronto, Ontario, Canada
| | - Katherine Ann Reyes
- School of Public Health, Pamantasan ng Lungsod ng Maynila, Manila, Philippines
- Alliance for Improving Health Outcomes, Quezon, Philippines
| | - Fernando Garcia
- College of Public Health, University of the Philippines, Manila, Philippines
| | - Carmelita Canila
- College of Public Health, University of the Philippines, Manila, Philippines
| | | | | | - Tiara Marthias
- Department of Public Health, Gadjah Mada University Faculty of Medicine Public Health and Nursing, Yogyakarta, Indonesia
- The University of Melbourne Nossal Institute for Global Health, Melbourne, Victoria, Australia
| | - Yodi Mahendradhata
- Department of Public Health, Gadjah Mada University Faculty of Medicine Public Health and Nursing, Yogyakarta, Indonesia
| | | | | | - Warapon Poungkantha
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Tran Mai Oanh
- Health Strategy and Policy Institute, Ministry of Health, Hanoi, Viet Nam
| | - Ong The Due
- Health Strategy and Policy Institute, Ministry of Health, Hanoi, Viet Nam
| | - Nima Asgari-Jirhandeh
- Asia-Pacific Observatory on Health Systems and Policies, World Health Organization, New Delhi, India
| | | | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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7
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Lepere P, Babington-Ashaye A, Martínez-Pérez GZ, Ekouevi DK, Labrique AB, Calmy A. How mHealth Can Contribute to Improving the Continuum of Care: A Scoping Review Approach to the Case of Human Immunodeficiency Virus in Sub-Saharan Africa. Public Health Rev 2022; 43:1604557. [PMID: 36211227 PMCID: PMC9537374 DOI: 10.3389/phrs.2022.1604557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives: To determine mHealth’s contribution to improving the continuum of care in sub-Saharan Africa towards achieving treatment targets for human immunodeficiency virus (HIV) endorsed by the 2016 Political Declaration on ending acquired immunodeficiency syndrome (AIDS). Methods: PubMed, Medline, Embase, Web of Science Core Collection and Cochrane databases; three observatories and four repositories were searched to identify and select relevant articles, projects and guidelines published from 1 January 2017, to 30 April 2021. Records focusing on the use of mHealth related to HIV treatment cascade or healthcare provider/patient relationship were considered. Results: From 574 identified records, 381 (206 scientific manuscripts and 175 mHealth projects) were considered. After screening, 36 articles (nine randomized control trials, five cohort studies, 19 qualitative studies, and three economic studies) and 23 projects were included. Conclusion: The cross-cutting benefits of mHealth that enhance patient empowerment have been identified. Important challenges such as gaps between research and implementation, lack of transdisciplinary collaboration, and lack of economic evidence were identified to support future mHealth research and accelerate the achievement of treatment targets for HIV.
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Affiliation(s)
- Philippe Lepere
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- *Correspondence: Philippe Lepere,
| | - Awa Babington-Ashaye
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Didier Koumavi Ekouevi
- Département de Santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo
- INSERM U1219 Bordeaux Population Health Centre Recherche (BPH), Bordeaux, France
| | - Alain Bernard Labrique
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
- Department of International Health, Johns Hopkins Bloomberg School of Public Health & Johns Hopkins University Global Digital Health Initiative, Baltimore, MD, United States
| | - Alexandra Calmy
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Service des Maladies Infectieuses, Hôpitaux Universitaires de Genève (HUG), Geneva, Switzerland
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Wang Y, Faradiba D, Del Rio Vilas VJ, Asaria M, Chen YT, Babigumira JB, Dabak SV, Wee HL. The Relative Importance of Vulnerability and Efficiency in COVID-19 Contact Tracing Programmes: A Discrete Choice Experiment. Int J Public Health 2022; 67:1604958. [PMID: 35936996 PMCID: PMC9346065 DOI: 10.3389/ijph.2022.1604958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/24/2022] [Indexed: 12/03/2022] Open
Abstract
Objectives: This study aims to assess the trade-offs between vulnerability and efficiency attributes of contact tracing programmes based on preferences of COVID-19 contact tracing practitioners, researchers and other relevant stakeholders at the global level. Methods: We conducted an online discrete choice experiment (DCE). Respondents were recruited globally to explore preferences according to country income level and the prevailing epidemiology of COVID-19 in the local setting. The DCE attributes represented efficiency (timeliness, completeness, number of contacts), vulnerability (vulnerable population), cooperation and privacy. A mixed-logit model and latent class analysis were used. Results: The number of respondents was 181. Timeliness was the most important attribute regardless of country income level and COVID-19 epidemiological condition. Vulnerability of contacts was the second most important attribute for low-to-lower-middle-income countries and third for upper-middle-to-high income countries. When normalised against conditional relative importance of timeliness, conditional relative importance of vulnerability ranged from 0.38 to 0.42. Conclusion: Vulnerability and efficiency criteria were both considered to be important attributes of contact tracing programmes. However, the relative values placed on these criteria varied significantly between epidemiological and economic context.
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Affiliation(s)
- Yi Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Dian Faradiba
- Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand
- *Correspondence: Dian Faradiba,
| | - Victor J. Del Rio Vilas
- World Health Organization - Regional Office for South-East Asia, New Delhi, India
- Global Outbreak Alert and Response Network (GOARN), Geneva, Switzerland
| | - Miqdad Asaria
- London School of Economics and Political Science, London, United Kingdom
| | - Yu Ting Chen
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Joseph Brian Babigumira
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | | | - Hwee-Lin Wee
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
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9
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Bardus M, Al Daccache M, Maalouf N, Al Sarih R, Elhajj IH. Data Management and Privacy Policy of COVID-19 Contact-Tracing Apps: Systematic Review and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e35195. [PMID: 35709334 PMCID: PMC9278406 DOI: 10.2196/35195] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/04/2022] [Accepted: 02/17/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND COVID-19 digital contact-tracing apps were created to assist public health authorities in curbing the pandemic. These apps require users' permission to access specific functions on their mobile phones, such as geolocation, Bluetooth or Wi-Fi connections, or personal data, to work correctly. As these functions have privacy repercussions, it is essential to establish how contact-tracing apps respect users' privacy. OBJECTIVE This study aimed to systematically map existing contact-tracing apps and evaluate the permissions required and their privacy policies. Specifically, we evaluated the type of permissions, the privacy policies' readability, and the information included in them. METHODS We used custom Google searches and existing lists of contact-tracing apps to identify potentially eligible apps between May 2020 and November 2021. We included contact-tracing or exposure notification apps with a Google Play webpage from which we extracted app characteristics (eg, sponsor, number of installs, and ratings). We used Exodus Privacy to systematically extract the number of permissions and classify them as dangerous or normal. We computed a Permission Accumulated Risk Score representing the threat level to the user's privacy. We assessed the privacy policies' readability and evaluated their content using a 13-item checklist, which generated a Privacy Transparency Index. We explored the relationships between app characteristics, Permission Accumulated Risk Score, and Privacy Transparency Index using correlations, chi-square tests, or ANOVAs. RESULTS We identified 180 contact-tracing apps across 152 countries, states, or territories. We included 85.6% (154/180) of apps with a working Google Play page, most of which (132/154, 85.7%) had a privacy policy document. Most apps were developed by governments (116/154, 75.3%) and totaled 264.5 million installs. The average rating on Google Play was 3.5 (SD 0.7). Across the 154 apps, we identified 94 unique permissions, 18% (17/94) of which were dangerous, and 30 trackers. The average Permission Accumulated Risk Score was 22.7 (SD 17.7; range 4-74, median 16) and the average Privacy Transparency Index was 55.8 (SD 21.7; range 5-95, median 55). Overall, the privacy documents were difficult to read (median grade level 12, range 7-23); 67% (88/132) of these mentioned that the apps collected personal identifiers. The Permission Accumulated Risk Score was negatively associated with the average App Store ratings (r=-0.20; P=.03; 120/154, 77.9%) and Privacy Transparency Index (r=-0.25; P<.001; 132/154, 85.7%), suggesting that the higher the risk to one's data, the lower the apps' ratings and transparency index. CONCLUSIONS Many contact-tracing apps were developed covering most of the planet but with a relatively low number of installs. Privacy-preserving apps scored high in transparency and App Store ratings, suggesting that some users appreciate these apps. Nevertheless, privacy policy documents were difficult to read for an average audience. Therefore, we recommend following privacy-preserving and transparency principles to improve contact-tracing uptake while making privacy documents more readable for a wider public.
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Affiliation(s)
- Marco Bardus
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Melodie Al Daccache
- Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Noel Maalouf
- Department of Electrical and Computer Engineering, School of Engineering, Lebanese American University, Byblos, Lebanon
- Department of Electrical and Computer Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Rayan Al Sarih
- Department of Electrical and Computer Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Imad H Elhajj
- Department of Electrical and Computer Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
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Olateju Z, Olufunlayo T, MacArthur C, Leung C, Taylor B. Community health workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria-A qualitative study. PLoS One 2022; 17:e0265092. [PMID: 35259204 PMCID: PMC8903241 DOI: 10.1371/journal.pone.0265092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Community Health Workers are globally recognised as crucial members of healthcare systems in low and middle-income countries, but their role and experience during COVID-19 is not well-understood. This study aimed to explore factors that influence CHWs' ability and willingness to work in the COVID-19 pandemic in Lagos. DESIGN A generic qualitative study exploring Community Health Workers experiences and perceptions of working during the COVID-19 pandemic in Lagos, Nigeria. METHODS 15 semi-structured, in-depth, video interviews were conducted with Community Health Workers purposively sampled across seven of Lagos' Local Government Areas with the highest COVID-19 burden. Interviews explored Community Health Workers' attitudes towards COVID-19, its management, and their experiences working in Lagos. Data was analysed thematically using the framework method. RESULTS Three main themes were identified. 1. Influences on ability to undertake COVID-19 Role: Trust and COVID-19 knowledge were found to aid Community Health Workers in their work. However, challenges included exhaustion due to an increased workload, public misconceptions about COVID-19, stigmatisation of COVID-19 patients, delayed access to care and lack of transportation. 2. Influences on willingness to work in COVID-19 Role: Community Health Workers' perceptions of COVID-19, attitudes towards responsibility for COVID-19 risk at work, commitment and faith appeared to increase willingness to work. 3. Suggested Improvements: Financial incentives, provision of adequate personal protective equipment, transportation, and increasing staff numbers were seen as potential strategies to address many of the challenges faced. CONCLUSION Despite Community Health Workers being committed to their role, they have faced many challenges during the COVID-19 pandemic in Nigeria. Changes to their working environment may make their role during disease outbreaks more fulfilling and sustainable. International input is required to enhance Nigeria's policies and infrastructure to better support Community Health Workers during both current and future outbreaks.
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Affiliation(s)
- Zahra Olateju
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Tolulope Olufunlayo
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Yaba, Lagos State, Nigeria
| | - Christine MacArthur
- Department of Maternal Health, Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
| | - Charlotte Leung
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, England, United Kingdom
| | - Beck Taylor
- Department of Public Health, Institute of Applied Health Research, University of Birmingham, Birmingham, England, United Kingdom
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11
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Díaz-Agea JL, Orcajada-Muñoz I, Leal-Costa C, Adánez-Martínez MG, De Souza Oliveira AC, Rojo-Rojo A. How Did the Pandemic Affect Communication in Clinical Settings? A Qualitative Study with Critical and Emergency Care Nurses. Healthcare (Basel) 2022; 10:373. [PMID: 35206987 PMCID: PMC8872094 DOI: 10.3390/healthcare10020373] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 01/10/2023] Open
Abstract
The objective of the present study was to determine the subjective impact of the pandemic due to COVID-19 on communication, as perceived by nurses working at emergency services and Intensive Care Units at various hospitals in the Region of Murcia (Spain). A qualitative study was conducted based on the content analysis of 12 semi-structured individual interviews. The participant recruitment process was performed through a snowball sampling technique. Four main dimensions, eleven categories, and two sub-categories were obtained: (1) communication (communicative expressions, both verbal and non-verbal-, and limitations); (2) emotional aspects (positive, negative); (3) overload (first wave, second wave, and third wave); and (4) relationships (health professionals-patients, healthcare professionals, patients-family, and family-health professionals). The main findings of the study show that communication was slightly affected during the pandemic, especially the non-verbal kind, with verbal communication maintained and, in some occasions, strengthened. The lack of training in communication skills and its influence on the management of difficult periods was another important finding. Communication in general deteriorated during the pandemic, especially during the initial waves. Non-verbal communication was more affected due to the use of Personal Protective Equipment and the initial fear of infection, with this finding strongly observed in departments such as emergencies or critical care. The nurses who were interviewed underlined negative emotional aspects associated with a deficit in communication. The positive aspects described were associated with the creation of mutual support spaces and the group cohesion of the work teams during the pandemic. As an implication for current and future clinical practice, we recommend a coordinated institutional response to mitigate the potential emotional effects on workers by designing appropriate communication and emotional expression protocols.
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Affiliation(s)
- José Luis Díaz-Agea
- Faculty of Nursing, Universidad Católica de Murcia, 30107 Guadalupe, Spain; (J.L.D.-A.); (I.O.-M.); (A.C.D.S.O.); (A.R.-R.)
| | - Irene Orcajada-Muñoz
- Faculty of Nursing, Universidad Católica de Murcia, 30107 Guadalupe, Spain; (J.L.D.-A.); (I.O.-M.); (A.C.D.S.O.); (A.R.-R.)
| | - César Leal-Costa
- Faculty of Nursing, Universidad de Murcia, 30120 El Palmar, Spain
| | | | | | - Andrés Rojo-Rojo
- Faculty of Nursing, Universidad Católica de Murcia, 30107 Guadalupe, Spain; (J.L.D.-A.); (I.O.-M.); (A.C.D.S.O.); (A.R.-R.)
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12
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Caffarelli C, Santamaria F, Procaccianti M, Piro E, delle Cave V, Borrelli M, Santoro A, Grassi F, Bernasconi S, Corsello G. Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology. Ital J Pediatr 2021; 47:232. [PMID: 34876198 PMCID: PMC8650733 DOI: 10.1186/s13052-021-01184-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
In this article, we describe the advances in the field of pediatrics that have been published in the Italian Journal of Pediatrics in 2020. We report progresses in understanding allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, orthopedics, respiratory tract illnesses, rheumatology in childhood.
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Affiliation(s)
- Carlo Caffarelli
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci, 14 Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Michela Procaccianti
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci, 14 Parma, Italy
| | - Ettore Piro
- Department of Sciences for Health Promotion and Mother and Child Care ‘’G. D’Alessandro”, University of Palermo, Palermo, Italy
| | - Valeria delle Cave
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Melissa Borrelli
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Angelica Santoro
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci, 14 Parma, Italy
| | - Federica Grassi
- Clinica Pediatrica, Department of Medicine and Surgery, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci, 14 Parma, Italy
| | | | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care ‘’G. D’Alessandro”, University of Palermo, Palermo, Italy
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Abstract
The fight against the COVID-19 pandemic still involves many struggles and challenges. The greatest challenge that most governments are currently facing is the lack of a precise, accurate, and automated mechanism for detecting and tracking new COVID-19 cases. In response to this challenge, this study proposes the first blockchain-based system, called the COVID-19 contact tracing system (CCTS), to verify, track, and detect new cases of COVID-19. The proposed system consists of four integrated components: an infection verifier subsystem, a mass surveillance subsystem, a P2P mobile application, and a blockchain platform for managing all transactions between the three subsystem models. To investigate the performance of the proposed system, CCTS has been simulated and tested against a created dataset consisting of 300 confirmed cases and 2539 contacts. Based on the metrics of the confusion matrix (i.e., recall, precision, accuracy, and F1 Score), the detection evaluation results proved that the proposed blockchain-based system achieved an average of accuracy of 75.79% and a false discovery rate (FDR) of 0.004 in recognizing persons in contact with COVID-19 patients within two different areas of infection covered by GPS. Moreover, the simulation results also demonstrated the success of the proposed system in performing self-estimation of infection probabilities and sending and receiving infection alerts in P2P communications in crowds of people by users. The infection probability results have been calculated using the binomial distribution function technique. This result can be considered unique compared with other similar systems in the literature. The new system could support governments, health authorities, and citizens in making critical decisions regarding infection detection, prediction, tracking, and avoiding the COVID-19 outbreak. Moreover, the functionality of the proposed CCTS can be adapted to work against any other similar pandemics in the future.
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14
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Quach HL, Nguyen KC, Hoang NA, Pham TQ, Tran DN, Le MTQ, Do HT, Vien CC, Phan LT, Ngu ND, Tran TA, Phung DC, Tran QD, Dang TQ, Dang DA, Vogt F. Association of public health interventions and COVID-19 incidence in Vietnam, January to December 2020. Int J Infect Dis 2021; 110 Suppl 1:S28-S43. [PMID: 34332082 PMCID: PMC8318669 DOI: 10.1016/j.ijid.2021.07.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Vietnam implemented various public health interventions such as contact tracing and testing, mandatory quarantine, and lockdowns in response to coronavirus disease 2019 (COVID-19). However, the effects of these measures on the epidemic remain unclear. METHODS This article describes the public health interventions in relation to COVID-19 incidence. Maximum likelihood estimations were used to assess containment delays (time between symptom onset and start of isolation) and multivariable regression was employed to identify associated factors between interventions and COVID-19 incidence. The effective reproductive numbers (Rt) were calculated based on transmission pairs. RESULTS Interventions were introduced periodically in response to the epidemic. Overall, 817 (55.4%) among 1474 COVID-19 cases were imported. Based on a serial interval of 8.72 ± 5.65 days, it was estimated that Rt decreased to below 1 (lowest at 0.02, 95% CI 0-0.12) during periods of strict border control and contact tracing, and increased ahead of new clusters. The main method to detect cases shifted over time from passive notification to active case-finding at immigration or in lockdown areas, with containment delays showing significant differences between modes of case detection. CONCLUSIONS A combination of early, strict, and consistently implemented interventions is crucial to control COVID-19. Low-middle income countries with limited capacity can contain COVID-19 successfully using non-pharmaceutical interventions.
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Affiliation(s)
- Ha-Linh Quach
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Khanh Cong Nguyen
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - Ngoc-Anh Hoang
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
| | - Thai Quang Pham
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam; School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Duong Nhu Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Hung Thai Do
- Nha Trang Pasteur Institute, Nha Trang City, Khanh Hoa, Vietnam
| | - Chien Chinh Vien
- Tay Nguyen Institute of Hygiene and Epidemiology, Dak Lak, Vietnam
| | - Lan Trong Phan
- Ho Chi Minh Pasteur Institute, Ho Chi Minh City, Vietnam
| | - Nghia Duy Ngu
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tu Anh Tran
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Dinh Cong Phung
- National Agency for Science and Technology Information, Ministry of Science and Technology, Hanoi, Vietnam
| | - Quang Dai Tran
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Tan Quang Dang
- General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Duc-Anh Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Florian Vogt
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Kirby Institute, University of New South Wales, Sydney, NSW, Australia
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15
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“Through their eyes, I can work” – rural physicians' perceptions about mobile phone use among community health workers – a qualitative analysis. HEALTH EDUCATION 2021. [DOI: 10.1108/he-12-2020-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Physicians who are primary care providers in rural communities form an essential stakeholder group in rural mobile health (mHealth) delivery. This study was exploratory in nature and was conducted in Udupi district of Karnataka, India. The purpose of this study is to examine the perceptions of rural medical officers (MOs) (rural physicians) regarding the benefits and challenges of mobile phone use by community health workers (CHWs).
Design/methodology/approach
In-depth interviews were conducted among 15 MOs belonging to different primary health centers of the district. Only MOs with a minimum five years of experience were recruited in the study using purposive and snowball sampling. This was followed by thematic analysis of the data collected.
Findings
The perceptions of MOs regarding the CHWs' use of mobile phones were largely positive. However, they reported the existence of some challenges that limits the potential of its full use. The findings were categorized under four themes namely, benefits of mobile phone use to CHWs, benefits of mobile phone-equipped CHWs, current mobile phone use by CHWs and barriers to CHWs' mobile phone use. The significant barriers reported in the CHWs' mobile phone use were poor mobile network coverage, technical illiteracy, lack of consistent technical training and call and data expense of the CHWs. The participants recommend an increased number of mobile towers, frequent training in mobile phone use and basic English language for the CHWs as possible solutions to the barriers.
Originality/value
Studies examining the perceptions of doctors who are a primary stakeholder group in mHealth as well as in the public health system scenario are limited. To the authors’ knowledge, this is one of the first studies to examine the perception of rural doctors regarding CHWs' mobile phone use for work in India.
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16
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Lyon V, LeRouge C, Fruhling A, Thompson M. Home testing for COVID-19 and other virus outbreaks: The complex system of translating to communities. Health Syst (Basingstoke) 2021; 10:298-317. [PMID: 34745591 PMCID: PMC8567871 DOI: 10.1080/20476965.2021.1952905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/25/2021] [Indexed: 10/20/2022] Open
Abstract
Home testing is an emerging innovation that can enable nations and health care systems to safely and efficiently test large numbers of patients to manage COVID-19 and other viral outbreaks. In this position paper, we explore the process of moving home testing across the translational continuum from labs to households, and ultimately into practice and communities for optimal public health impact. We focus on the four translational science drivers to accelerate the implementation of systems-wide home testing programmes 1) collaboration and team science, 2) technology, 3) multilevel interventions, and 4) knowledge integration. We use the Socio Ecological Model (SEM) as a framework to illustrate our vision for the ideal future state of a comprehensive system of stakeholders utilising tech-enabled home testing for COVID-19 and other virus outbreaks, and we suggest SEM as a tool to address key translational readiness and response questions.
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Affiliation(s)
- Victoria Lyon
- Department of Family Medicine, Primary Care Innovation Lab, University of Washington, Seattle, Washington, USA
| | - Cynthia LeRouge
- Department of Family Medicine, Primary Care Innovation Lab, University of Washington, Seattle, Washington, USA
- Department of Information Systems & Business Analytics, Florida International University, Miami, FL, USA
| | - Ann Fruhling
- School of Interdisciplinary Informatics, University of Nebraska, Omaha, NE, USA
| | - Matthew Thompson
- Department of Family Medicine, Primary Care Innovation Lab, University of Washington, Seattle, Washington, USA
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17
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Salmon PM, Stevens N, McLean S, Hulme A, Read GJM. Human Factors and Ergonomics and the management of existential threats: A work domain analysis of a COVID-19 return from lockdown restrictions system. HUMAN FACTORS AND ERGONOMICS IN MANUFACTURING 2021; 31:412-424. [PMID: 34230798 PMCID: PMC8250482 DOI: 10.1002/hfm.20897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/03/2021] [Accepted: 03/22/2021] [Indexed: 06/13/2023]
Abstract
Following strict "lockdown" restrictions designed to control the spread of the COVID-19 virus, many jurisdictions are now engaged in a process of easing restrictions in an attempt to stimulate economic and social activity while continuing to suppress virus transmission. This is challenging and complex, and in several regions, new outbreaks have emerged. We argue that systems Human Factors and Ergonomics methods can assist in understanding and optimizing the return from lockdown. To demonstrate, we used work domain analysis to develop an abstraction hierarchy model of a generic "return from lockdown restrictions" system. The model was assessed to identify (a) issues preventing a successful return from lockdown; and (b) leverage points that could be exploited to optimize future processes. The findings show that the aim of continuing to suppress virus transmission conflicts with the aims of returning to pre-virus economic and social activity levels. As a result, many functions act against each other, ensuring that the system cannot optimally achieve all three of its primary aims. Potential leverage points include modifying the goals and rules of the system and enhancing communications and feedback. Specifically, it is argued that moderating economic aims and modifying how social and community activities are undertaken will result in longer term suppression of the virus.
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Affiliation(s)
- Paul M. Salmon
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Nicholas Stevens
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Scott McLean
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Adam Hulme
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
| | - Gemma J. M. Read
- Centre for Human Factors and Sociotechnical SystemsUniversity of the Sunshine CoastSunshine CoastQueenslandAustralia
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18
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The Novel Coronavirus (COVID-19) Pandemic and the Response in Low-to-Middle Income Countries. CURRENT BREAST CANCER REPORTS 2021; 13:63-68. [PMID: 33880139 PMCID: PMC8051280 DOI: 10.1007/s12609-021-00409-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
Purpose of Review The COVID-19 pandemic has posed an unprecedented challenge to healthcare, particularly in resource-constrained low and middle-income countries (LMICs). We aim to summarize the challenges faced by LMICs in providing breast cancer care during the pandemic and their response during this crisis. Recent Findings Conversion of oncology centers into COVID-19 isolation centers and lack of LMIC applicable guidelines for breast cancer treatment worsened the challenge for providers. Few LMICs changed their management framework, taking steps like triaging patients, prioritizing care, therapeutic spacing, and a shift to telehealth. Summary Modified protocols where available have served LMICs well for resource allocation; however, effectiveness of these cannot be determined due to lack of outcomes reporting. This pandemic has underscored the importance of flexibility, prompt intervention, good communication, and reassessment to address unexpected healthcare challenges and has been a learning lesson to help tailor guidelines early in the future.
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19
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Alvarez E, Obando D, Crespo S, Garcia E, Kreplak N, Marsico F. Estimating COVID-19 cases and outbreaks on-stream through phone calls. ROYAL SOCIETY OPEN SCIENCE 2021; 8:202312. [PMID: 33959370 PMCID: PMC8074976 DOI: 10.1098/rsos.202312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
One of the main problems in controlling COVID-19 epidemic spread is the delay in confirming cases. Having information on changes in the epidemic evolution or outbreaks rise before laboratory-confirmation is crucial in decision making for Public Health policies. We present an algorithm to estimate on-stream the number of COVID-19 cases using the data from telephone calls to a COVID-line. By modelling the calls as background (proportional to population) plus signal (proportional to infected), we fit the calls in Province of Buenos Aires (Argentina) with coefficient of determination R 2 > 0.85. This result allows us to estimate the number of cases given the number of calls from a specific district, days before the laboratory results are available. We validate the algorithm with real data. We show how to use the algorithm to track on-stream the epidemic, and present the Early Outbreak Alarm to detect outbreaks in advance of laboratory results. One key point in the developed algorithm is a detailed track of the uncertainties in the estimations, since the alarm uses the significance of the observables as a main indicator to detect an anomaly. We present the details of the explicit example in Villa Azul (Quilmes) where this tool resulted crucial to control an outbreak on time. The presented tools have been designed in urgency with the available data at the time of the development, and therefore have their limitations which we describe and discuss. We consider possible improvements on the tools, many of which are currently under development.
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Affiliation(s)
- Ezequiel Alvarez
- International Center for Advanced Studies (ICAS), ICIFI-CONICET ECyT-UNSAM, Campus Miguelete, 25 de Mayo y Francia, CP1650, San Martìn, Buenos Aires, Argentina
| | - Daniela Obando
- Ministerio de Salud de la Provincia de Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Sebastian Crespo
- Ministerio de Salud de la Provincia de Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Enio Garcia
- Ministerio de Salud de la Provincia de Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Nicolas Kreplak
- Ministerio de Salud de la Provincia de Buenos Aires, La Plata, Buenos Aires, Argentina
| | - Franco Marsico
- Ministerio de Salud de la Provincia de Buenos Aires, La Plata, Buenos Aires, Argentina
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20
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Samad N, Sodunke TE, Banna HA, Sapkota A, Fatema AN, Iskandar K, Jahan D, Hardcastle TC, Nusrat T, Chowdhury TS, Haque M. Convalescent Plasma Therapy for Management of COVID-19: Perspectives and Deployment in the Current Global Pandemic. Risk Manag Healthc Policy 2020; 13:2707-2728. [PMID: 33262668 PMCID: PMC7695687 DOI: 10.2147/rmhp.s281388] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/29/2020] [Indexed: 12/15/2022] Open
Abstract
The world is striving against the severe crisis of the COVID-19 pandemic. Healthcare professionals are struggling to treat their patients based on nonspecific therapies. Amidst this uncertainty, convalescent plasma therapy (CPT) has appeared to be an interim adjuvant therapy for severely ill patients of COVID-19 until long-term clinical trial treatment options are available. Considering the transfusion-related hazards, especially lung injuries and microbial transmission, where sensitivity is not ensured, rigorous trials should be conducted to determine this therapy's efficacy. Moreover, the ratio of recovered cases to plasma donors is not satisfying, which questioning this therapy's availability and accessibility. Although some countries are making the treatment free, the attributable cost mandates a justification for its suitability and sustainability. Our article aimed to review the published facts and findings of CPT's effectiveness in lowering the mortality rate of COVID-19. This pandemic showed that healthcare systems worldwide need core reform. A unified global collaboration must align and coordinate to face the current pandemic and enhance world readiness for future outbreaks based on health equity and equality.
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Affiliation(s)
- Nandeeta Samad
- Department of Public Health, North South University, Dhaka1229, Bangladesh
| | | | - Hasan Al Banna
- Institute of Social Welfare and Research, University of Dhaka, Dhaka1000, Bangladesh
| | - Ashmita Sapkota
- Department of Microbiology, Mahidol University, Ratchathewi, Bangkok10400, Thailand
| | | | - Katia Iskandar
- School of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Dilshad Jahan
- Department of Hematology, Asgar Ali Hospital, Dhaka1204, Bangladesh
| | - Timothy Craig Hardcastle
- Department of Surgery, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Umbilo, Berea4001, South Africa
| | - Tanzina Nusrat
- Department of Microbiology, Chittagong Medical College, Chattogram4203, Bangladesh
| | | | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur57000, Malaysia
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