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Huh J, Koola J, Contreras A, Castillo AK, Ruiz M, Tedone KG, Yakuta M, Schiaffino MK. Consumer Health Informatics Adoption among Underserved Populations: Thinking beyond the Digital Divide. Yearb Med Inform 2018; 27:146-155. [PMID: 30157518 PMCID: PMC6115231 DOI: 10.1055/s-0038-1641217] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives:
Underserved populations can benefit from consumer health informatics (CHI) that promotes self-management at a lower cost. However, prior literature suggested that the digital divide and low motivation constituted barriers to CHI adoption. Despite increased Internet use, underserved populations continue to show slow CHI uptake. The aim of the paper is to revisit barriers and facilitators that may impact CHI adoption among underserved populations.
Methods:
We surveyed the past five years of literature. We searched PubMed for articles published between 2012 and 2017 that describe empirical evaluations involving CHI use by underserved populations. We abstracted and summarized data about facilitators and barriers impacting CHI adoption.
Results:
From 645 search results, after abstract and full-text screening, 13 publications met the inclusion criteria of identifying barriers to and facilitators of underserved populations' CHI adoption. Contrary to earlier literature, the studies suggested that the motivation to improve health literacy and adopt technology was high among studied populations. Beyond the digital divide, barriers included: low health and computer literacy, challenges in accepting the presented information, poor usability, and unclear content. Factors associated with increased use were: user needs for information, user-access mediated by a proxy person, and early user engagement in system design.
Conclusions:
While the digital divide remains a barrier, newer studies show that high motivation for CHI use exists. However, simply gaining access to technology is not sufficient to improve adoption unless CHI technology is tailored to address user needs. Future interventions should consider building larger empirical evidence on identifying CHI barriers and facilitators.
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Affiliation(s)
- Jina Huh
- Michigan State University, MI, USA
| | - Jejo Koola
- University of California San Diego, CA, USA
| | - Alejandro Contreras
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Alanah Kp Castillo
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Melissa Ruiz
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Keely G Tedone
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Melissa Yakuta
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
| | - Melody K Schiaffino
- Institute for Behavioral and Community Health, San Diego State University, CA, USA
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Risica PM, Gavarkovs A, Parker DR, Jennings E, Phipps M. A tailored video intervention to reduce smoking and environmental tobacco exposure during and after pregnancy: Rationale, design and methods of Baby's Breath. Contemp Clin Trials 2016; 52:1-9. [PMID: 27818283 DOI: 10.1016/j.cct.2016.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/28/2016] [Accepted: 10/29/2016] [Indexed: 11/29/2022]
Abstract
Low-cost interventions to decrease environmental tobacco smoke (ETS) exposure of pregnant women and their newborns are needed to lower health risks of exposed fetuses and infants. Baby's Breath is a tailored video intervention developed and tested in a randomized controlled trial. The study aimed to test the efficacy of tailored video versus usual care approaches to reduce the ETS exposure of fetuses of low-income women during and after pregnancy; and to assess this intervention separately among non-smoking and smoking women. Participating women, recruited early in pregnancy, who spoke English, were at least 18years old, smoke exposed (current smokers, quit smoking on their own, or were exposed to smoke of others), pregnant with only one baby, and had access to a telephone and video player, were randomized to experimental or control conditions. Intervention participants received newsletters containing content aimed at smoking cessation and avoidance (5 during and 3 after pregnancy), in addition to videos (3 during and 2 after pregnancy) individually tailored on behavioral theory-based survey questions. Comparison participants received newsletters and videos on healthy pregnancy topics. Outcomes included salivary cotinine of both mother and baby (32weeks gestation and 6months postpartum) as well as self-reported ETS exposure and avoidance behaviors. This study may demonstrate the efficacy of a low-cost intervention to decrease ETS exposure, and will fill an important gap in describing the utility of this innovative intervention technology, as well as demonstration of potential benefits to this type of intervention.
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Affiliation(s)
- Patricia Markham Risica
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, United States; Department of Behavioral and Social Sciences, Brown School of Public Health, Brown University, Providence, RI, United States; Institute for Community Health Promotion, Brown School of Public Health, Brown University, Providence, RI, United States.
| | - Adam Gavarkovs
- Department of Behavioral and Social Sciences, Brown School of Public Health, Brown University, Providence, RI, United States.
| | - Donna R Parker
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, United States; Memorial Hospital of RI, Center of Primary Care and Prevention, Pawtucket, RI, United States; Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States.
| | - Ernestine Jennings
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States.
| | - Maureen Phipps
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, United States; Department of Obstetrics & Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, United States; Women & Infants Hospital of Rhode Island, Providence, RI, United States.
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Baskwill A, Sumpton B. The Use of an Informational Video to Improve Patient Satisfaction, Preparedness, Mood, and Empowerment. Int J Ther Massage Bodywork 2015; 8:12-8. [PMID: 26668674 PMCID: PMC4669207 DOI: 10.3822/ijtmb.v8i4.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Massage therapy is commonly used in Canada for the treatment of a wide range of health concerns. Massage therapy is changing to meet the health care needs of Canadians. Rapid changes to the profession may create a gap between patient expectations of massage therapy treatment based on historic views of the profession and their experience in today’s practice. This gap could lead to patient confusion, dissatisfaction, or other negative outcomes. Purpose This study sought to understand whether patient satisfaction, preparedness, mood, and patient empowerment are improved when new patients who attend a student massage therapy clinic watch an informational video, compared to those who receive the standard paper information sheet. Participants The study used a convenience sample of new patients who presented for their first massage therapy appointment to the Humber College Student Massage Therapy Clinic. Participants were randomized either to the intervention group (video and paper information) or the comparison group (paper information only). The outcomes of interest in this study were patient preparedness, satisfaction, mood, and empowerment. Data were collected using two questionnaires, one before treatment and one after. Results A total of 108 patients participated in the study (55 comparison group; 53 intervention group). Demographic and clinical characteristics were comparable between the two groups. A statistically significant difference was seen between the two groups when comparing their responses to the pre-appointment statement: “I know what will happen in my initial massage therapy appointment” (p < .001). There was no statistically significant difference seen when comparing the responses of the related post-appointment statement (p = .63). Conclusion This study found that an informational video improved perceived knowledge as patients entered the massage therapy treatment, but did not have a significant effect on satisfaction, mood, or patient empowerment. Other student clinics should consider the addition of an informational video to their procedures to increase patient knowledge of what to expect.
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Affiliation(s)
- Amanda Baskwill
- Massage Therapy Program, Humber Institute of Technology and Advanced Learning, Toronto, ON, Canada
| | - Bryn Sumpton
- Massage Therapy Program, Humber Institute of Technology and Advanced Learning, Toronto, ON, Canada
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Gans KM, Risica PM, Dulin-Keita A, Mello J, Dawood M, Strolla LO, Harel O. Innovative video tailoring for dietary change: final results of the Good for you! cluster randomized trial. Int J Behav Nutr Phys Act 2015; 12:130. [PMID: 26445486 PMCID: PMC4596558 DOI: 10.1186/s12966-015-0282-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 09/11/2015] [Indexed: 11/12/2022] Open
Abstract
Background Effective, low-cost approaches are needed to enhance dietary behavior change. While both video and tailoring technology have been effective interventions to improve diet, these approaches have never been combined to study the effectiveness of tailored videos. The purpose of this paper is to discuss the results of Good For You!, a randomized trial that tested the efficacy of innovative, individually tailored videos in helping worksite employees decrease dietary fat and increase fruit and vegetable (F&V) intake. Methods Worksites were matched on approximate size, type of company and workforce composition and randomized to one of three experimental conditions: Non-Tailored written information (NT) (n = 14), Tailored Written information (TW) (n = 14), or Tailored Written + Tailored Video (TW + TV) (n = 15). Evaluation was conducted at baseline, 4 and 7 months. We used the NCI Fat Screener and an adapted Food Habits Questionnaire (FHQ) to estimate fat intake and fat-related behaviors, the NCI F&V Screener and F&V Habits Questionnaire (FVHQ) to measure F&V intake and behaviors. Generalized linear models were examined for all outcome measurements. Results 2525 worksite employees were recruited. At 4 months, dietary fat intake decreased significantly more for TW (−2.95 %) and TW + TV (−3.14 %) compared with NT (−2.42 %). FHQ scores decreased significantly more for TW + TV than the other two groups. Fruit intake increased the most for TW + TV compared to NT and TW. Both TW (1.30 cups) and TW + TV (1.59 cups) increased F&V intake significantly more than NT (0.78 cups). TW + TV showed the largest increase in F&V behaviors on the FVFQ. At 8 months, dietary fat change continued to be significantly better for TW + TV (−3.48 %) than NT (3.01 %). F&V intake increased significantly more for the TW + TV group (1.38 cups) compared to the NT group (1.04 cups) and FVHQ changes were significantly greater in TW + TV and TW than for NT. Conclusions The tailored intervention participants were more likely to decrease fat and increase F&V intake. The TW + TV group was generally the stronger of the two tailored interventions, especially at the longer term follow-up, demonstrating the promise of tailored video as an intervention to change eating habits. Future studies should explore newer channels and technologies in addition to DVDs for delivering tailored video interventions such as the internet and smart phones. Trial Registration ClinicalTrials.gov identifier: NCT00301678
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Affiliation(s)
- Kim M Gans
- Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, 02912, USA. .,Department of Human Development and Family Studies and the Center for Health Interventions and Prevention, University of Connecticut, 348 Mansfield Road, Unit 1058, Room 330, Storrs, Connecticut, 06269, USA.
| | - Patricia Markham Risica
- Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, 02912, USA
| | - Akilah Dulin-Keita
- Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, 02912, USA
| | - Jennifer Mello
- Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, 02912, USA
| | - Mahin Dawood
- Department of Human Development and Family Studies and the Center for Health Interventions and Prevention, University of Connecticut, 348 Mansfield Road, Unit 1058, Room 330, Storrs, Connecticut, 06269, USA
| | - Leslie O Strolla
- Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, 02912, USA
| | - Ofer Harel
- Department of Statistics, University of Connecticut, 215 Glenbrook Road Unit 4120, Storrs, CT, 06269, USA
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Kowalski C, Lee SYD, Ansmann L, Wesselmann S, Pfaff H. Meeting patients' health information needs in breast cancer center hospitals - a multilevel analysis. BMC Health Serv Res 2014; 14:601. [PMID: 25422099 PMCID: PMC4247601 DOI: 10.1186/s12913-014-0601-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 11/12/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer patients are confronted with a serious diagnosis that requires them to make important decisions throughout the journey of the disease. For these decisions to be made it is critical that the patients be well informed. Previous studies have been consistent in their findings that breast cancer patients have a high need for information on a wide range of topics. This paper investigates (1) how many patients feel they have unmet information needs after initial surgery, (2) whether the proportion of patients with unmet information needs varies between hospitals where they were treated and (3) whether differences between the hospitals account for some of these variation. METHODS Data from 5,024 newly-diagnosed breast cancer patients treated in 111 breast center hospitals in Germany were analyzed and combined with data on hospital characteristics. Multilevel linear regression models were calculated taking into account hospital characteristics and adjusting for patient case mix. RESULTS Younger patients, those receiving mastectomy, having statutory health insurance, not living with a partner and having a foreign native language report higher unmet information needs. The data demonstrate small between-hospital variation in unmet information needs. In hospitals that provide patient-specific information material and that offer health fairs as well as those that are non-teaching or have lower patient-volume, patients are less likely to report unmet information needs. CONCLUSION We found differences in proportions of patients with unmet information needs between hospitals and that hospitals' structure and process-related attributes of the hospitals were associated with these differences to some extent. Hospitals may contribute to reducing the patients' information needs by means that are not necessarily resource-intensive.
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Cangelosi PR, Sorrell JM. Use of technology to enhance mental health for older adults. J Psychosoc Nurs Ment Health Serv 2014; 52:17-20. [PMID: 25062353 DOI: 10.3928/02793695-20140721-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Recent research suggests that older adults may gain significant mental health benefits from health resources made available through emerging modern technologies, especially because this population is becoming more Internet savvy. Technology-enhanced interventions for older adults have been shown to be helpful not only for general wellness activities (i.e., exercise), but also to specifically enhance mental health. This article focuses on two types of interventions for mental health: (a) cognitive-behavioral therapy for depression and anxiety and (b) assistive technology for individuals with dementia. Nurses should reevaluate their assumptions that older adults fear technology and explore whether different types of modern technology might be effective in enhancing mental health for these clients.
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