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Watkins VJ, Shee AW, Field M, Alston L, Hills D, Albrecht SL, Ockerby C, Hutchinson AM. Rural healthcare workforce preparation, response, and work during the COVID-19 pandemic in Australia: Lessons learned from in-depth interviews with rural health service leaders. Health Policy 2024; 145:105085. [PMID: 38820760 DOI: 10.1016/j.healthpol.2024.105085] [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: 05/10/2024] [Accepted: 05/19/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Low population density, geographic spread, limited infrastructure and higher costs are unique challenges in the delivery of healthcare in rural areas. During the COVID-19 pandemic, emergency powers adopted globally to slow the spread of transmission of the virus included population-wide lockdowns and restrictions upon movement, testing, contact tracing and vaccination programs. The aim of this research was to document the experiences of rural health service leaders as they prepared for the emergency pandemic response, and to derive from this the lessons learned for workforce preparedness to inform recommendations for future policy and emergency planning. METHODOLOGY AND METHODS Interviews were conducted with leaders from two rural public health services in Australia, one small (500 staff) and one large (3000 staff). Data were inductively coded and analysed thematically. PARTICIPANTS Thirty-three participants included health service leaders in executive, clinical, and administrative roles. FINDINGS Six major themes were identified: Working towards a common goal, Delivery of care, Education and training, Organizational governance and leadership, Personal and psychological impacts, and Working with the Local Community. Findings informed the development of a applied framework. CONCLUSION The study findings emphasise the critical importance of leadership, teamwork and community engagement in preparing the emergency pandemic response in rural areas. Informed by this research, recommendations were made to guide future rural pandemic emergency responses or health crises around the world.
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Affiliation(s)
- Vanessa J Watkins
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety in the Institute for Health Transformation, Geelong, Victoria Australia.
| | - Anna Wong Shee
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Michael Field
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia; Western Alliance Academic Health Science Centre, Geelong, Victoria, Australia
| | - Laura Alston
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Danny Hills
- Federation University Australia, Health Innovation and Transformation Centre, Ballarat, Victoria, Australia
| | - Simon L Albrecht
- Deakin University, School of Psychology, Burwood, Victoria, Australia
| | | | - Alison M Hutchinson
- Deakin University, School of Nursing and Midwifery, Centre for Quality and Patient Safety in the Institute for Health Transformation, Geelong, Victoria Australia; Barwon Health, Geelong, Victoria, Australia
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Leeson-Smith M, Geddes L, Johnson H, Pit S, Ramsden R. Prevalence of technology and connectivity issues in general practices in rural New South Wales and their impact on staff capability to perform their job. Aust J Rural Health 2024. [PMID: 38706198 DOI: 10.1111/ajr.13129] [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: 10/15/2023] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 05/07/2024] Open
Abstract
OBJECTIVE To identify the technology and connectivity issues in rural and remote general practices, and the factors independently associated with these issues that negatively impact staff's capability to perform their job. METHODS An annual cross-sectional survey of rural and remote general practice managers. Dependent variables included demographic data, practice size, geographic location, connection type and frequency of connectivity issues. Descriptive statistics are presented, and bivariate logistic regression was undertaken to determine factors independently associated with connectivity issues that negatively impact staff's capability to perform their job. PARTICIPANTS One hundred sixty-eight general practice managers from rural and remote New South Wales. RESULTS The majority of respondents (87%, n = 146) indicated that technology and connectivity issues had impacted staff's capability to perform their job. Internet problems were the most frequently reported issue (36%, n = 61). In bivariate analysis, practices that had a total clinical staff headcount between 5 and 7 (OR 0.27; 95% CI 0.10-0.67; p = 0.005) or between 8 and 11 (OR 0.39; 95% CI 0.16-0.95; p = 0.038) were significantly less likely to report technology and connectivity issues that negatively impact staff's capability to perform their job, compared with practices with a total clinical headcount of less than five. CONCLUSIONS Technology and connectivity issues persist in rural and remote general practices. This is the first study to demonstrate that technology and connectivity issues impact on rural staff's capability to perform their job. Furthermore, smaller practices face more technology and connectivity issues that negatively impact staff's capability to do their job than larger practices. Further research is required to find solutions to address these challenges.
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Affiliation(s)
- Margot Leeson-Smith
- Rural Clinical School, School Of Medicine, Sydney Program, University of Notre Dame Sydney, Chippendale, New South Wales, Australia
| | - Louise Geddes
- Rural Clinical School, School Of Medicine, Sydney Program, University of Notre Dame Sydney, Chippendale, New South Wales, Australia
| | - Heath Johnson
- Rural Doctors Network, St Leonards, New South Wales, Australia
| | - Sabrina Pit
- University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
- School of Medicine, University of Western Sydney, Campbelltown, New South Wales, Australia
- Work Wiser International, Lennox Head, New South Wales, Australia
| | - Robyn Ramsden
- Rural Doctors Network, St Leonards, New South Wales, Australia
- Deakin University, Melbourne, Victoria, Australia
- Charles Sturt University, Bathurst, New South Wales, Australia
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He F, Mnatzaganian G, Rutherford D, Njovu M, Blackberry I. Weekend / holiday effect on stroke mortality in regional Australia: A ten-year retrospective study. J Stroke Cerebrovasc Dis 2024; 33:107739. [PMID: 38703876 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107739] [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: 11/22/2023] [Revised: 04/24/2024] [Accepted: 04/27/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND There is a deficiency in the evidence from rural and regional centres in Australia on the weekend effect following presentation with acute stroke. OBJECTIVE To estimate the association between admission over a weekend/holiday and all-cause mortality 3-day, 7-day, 14-day, 1-month, 3-month, 6-month, and 12-month following acute stroke. METHODS The records of stroke patients admitted to a main regional hospital in Australia from 2010 to 2020 were linked with the National Death Index. Time to death following ischaemic, haemorrhagic, and total stroke at different time points was modelled using Weibull, Exponential, or Gompertz regression based on best model fit determined by Akaike's information criterion. RESULTS Of 1669 patients, 1273 (76.3%) were admitted on a weekday, and 396 (23.7%) on a weekend/ or holiday. After adjusting for age, sex, and Charlson Comorbidity Index, stroke type and country of birth, admissions over a weekend/holiday following total stroke were significantly associated with an increased risk of dying within three days from admission [hazard ratio (HR): 1.59, 95% confidence interval: 1.01-2.50]. In haemorrhagic stroke, increased risk of death was significantly higher at three days (HR: 2.19, 95% confidence interval: 1.17-4.08), 14 days (HR: 1.73, 95% confidence interval: 1.02-2.93), and 1 month (HR: 1.82, 95% confidence interval: 1.09-3.03) following admission on the weekend/ or holiday compared to those admitted during the weekdays. CONCLUSIONS This study reports a short-term adverse weekend/holiday effect following admission for haemorrhagic stroke or total stroke. No significant weekend/holiday effect was found in ischaemic stroke.
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Affiliation(s)
- Fan He
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia.
| | - George Mnatzaganian
- Rural Department of Community Health, La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Victoria, Australia
| | - David Rutherford
- Division of Medicine, Albury Wodonga Health, Albury, New South Wales, Australia
| | - Michael Njovu
- Rehabilitation Medicine Department, Albury Wodonga Health, Wodonga, Victoria, Australia; School of Clinical Medicine, University of New South Wales, Albury Campus, Albury, Australia
| | - Irene Blackberry
- John Richards Centre for Rural Ageing Research, La Trobe Rural Health School, La Trobe University, Victoria, Australia; Care Economy Research Institute, La Trobe University, Albury-Wodonga, Victoria, Australia
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Wilkens J, Thulesius H, Ekman B. From office to digital primary care services: analysing income-related inequalities in utilization. Int J Equity Health 2024; 23:86. [PMID: 38689241 PMCID: PMC11061960 DOI: 10.1186/s12939-024-02184-6] [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: 01/29/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
The use of digital technologies to deliver primary health care has increased over the past decade. While some technologies have been shown to be medically effective and efficient, the effects of digital primary care on the policy goal of equality in the use of such types of care have not been studied using large register data. The aim of this study was to analyse how digital contacts differ from officebased visits by income as an indicator of socioeconomic status. Specifically, we estimated differences in primary care utilization across income, factors of contribution to these inequalities, and applied a needs-based standardisation of utilization to estimate differences in equity.We used a purposively built consultation level dataset with 726 000 Swedish adult patients diagnosed with an infection, including clinical and sociodemographic variables. Applying concentration indexes (CI) and graphical illustrations we measured how the two types of services are distributed relative to income. We estimated how much of the inequalities were attributed to different sociodemographic factors by decomposing the concentration indexes. Standardised utilization for sex, age and comorbidity allowed for the estimation of horizontal inequity indexes for both types of services.Utilization by the two types of care showed large income inequalities. Office-based visits were propoor (CI -0.116), meaning lowincome patients utilized relatively more of these services, while digital contacts were prorich (CI 0.205). However, within the patient group who had at least one digital contact, the utilization was also propoor (CI -0,101), although these patients had higher incomes on average. The standardised utilization showed a smaller prorich digital utilization (CI 0.143), although large differences remained. Decomposing the concentration indexes showed that education level and being born in Sweden were strong attributes of prorich digital service utilization.The prorich utilization effects of digital primary care may risk undermining the policy goals of access and utilization to services regardless of socioeconomic status. As digital health technologies continue to expand, policy makers need to be aware of the risk.
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Affiliation(s)
- Jens Wilkens
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 20205.
| | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 20205
| | - Björn Ekman
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 20205
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Ji H, Dong J, Pan W, Yu Y. Associations between digital literacy, health literacy, and digital health behaviors among rural residents: evidence from Zhejiang, China. Int J Equity Health 2024; 23:68. [PMID: 38594723 PMCID: PMC11003150 DOI: 10.1186/s12939-024-02150-2] [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: 01/16/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
OBJECTIVE Within the digital society, the limited proficiency in digital health behaviors among rural residents has emerged as a significant factor intensifying health disparities between urban and rural areas. Addressing this issue, enhancing the digital literacy and health literacy of rural residents stands out as a crucial strategy. This study aims to investigate the relationship between digital literacy, health literacy, and the digital health behaviors of rural residents. METHODS Initially, we developed measurement instruments aimed at assessing the levels of digital literacy and health literacy among rural residents. Subsequently, leveraging micro survey data, we conducted assessments on the digital literacy and health literacy of 968 residents in five administrative villages in Zhejiang Province, China. Building upon this foundation, we employed Probit and Poisson models to empirically scrutinize the influence of digital literacy, health literacy, and their interaction on the manifestation of digital health behaviors within the rural population. This analysis was conducted from a dual perspective, evaluating the participation of digital health behaviors among rural residents and the diversity to which they participate in such behaviors. RESULTS Digital literacy exhibited a notably positive influence on both the participation and diversity of digital health behaviors among rural residents. While health literacy did not emerge as a predictor for the occurrence of digital health behavior, it exerted a substantial positive impact on the diversity of digital health behaviors in the rural population. There were significant interaction effects between digital literacy and health literacy concerning the participation and diversity of digital health behaviors among rural residents. These findings remained robust even after implementing the instrumental variable method to address endogeneity issues. Furthermore, the outcomes of robust analysis and heterogeneity analysis further fortify the steadfastness of the aforementioned conclusions. CONCLUSION The findings suggest that policymakers should implement targeted measures aimed at enhancing digital literacy and health literacy among rural residents. This approach is crucial for improving rural residents' access to digital health services, thereby mitigating urban-rural health inequality.
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Affiliation(s)
- Hao Ji
- Zhejiang A&F University, College of Economics and Management, Hangzhou, People's Republic of China
- Hangzhou Medical College, Center for Medical Intelligence and Health Policy Research, Hangzhou, People's Republic of China
| | - Junqiang Dong
- Zhejiang A&F University, Mental Health Education Center, Hangzhou, People's Republic of China
| | - Weiguang Pan
- Research Academy for Rural Revitalization of Zhejiang Province, Zhejiang A & F University, Hangzhou, People's Republic of China.
| | - Yingying Yu
- Hangzhou Medical College, Center for Medical Intelligence and Health Policy Research, Hangzhou, People's Republic of China.
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Thompson S, Shukralla H, Fyfe K, Newman E, Fitzgerald K. Barriers and enablers of dementia training in healthcare workers in rural and remote Australia: A scoping review to inform future approaches to training. Aust J Rural Health 2024; 32:236-248. [PMID: 38409904 DOI: 10.1111/ajr.13090] [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: 07/23/2023] [Revised: 01/03/2024] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
INTRODUCTION Dementia is now responsible for the greatest burden of disease of any chronic illness in older Australians. Rural and remote communities bear the impacts of this disproportionately. Additional training and education for healthcare staff to support people living with dementia is needed. OBJECTIVE The objective of this scoping review was to map and synthesise the evidence related to barriers and enablers of accessing dementia training for Australian healthcare workers located in rural and remote areas. DESIGN This scoping review systematically searched multiple databases in January 2023 for peer-reviewed literature on the topic. Reviewers used Covidence to screen titles and abstracts of located sources, and to screen full-text articles. FINDINGS From 187 articles screened, seven peer-reviewed journal articles were included in the final data analysis; all were from Australia or Canada. The most common barrier described was low staffing, precluding release of staff for dementia training. Enablers to participation in dementia training were availability of online training programs, as well as training providers collaborating with end users to ensure the training met their learning needs. DISCUSSION This review provides evidence of barriers and enablers specific to rural and remote healthcare workers accessing dementia training. It also explores other approaches to training that have been trialled successfully in different settings. CONCLUSION Addressing the identified barriers and enablers may assist in developing training approaches appropriate for existing staff, and in meeting training needs for the future workforce.
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Affiliation(s)
- Sandra Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - Heidi Shukralla
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
| | - Katrina Fyfe
- Dementia Training Australia, University of Western Australia, Perth, Western Australia, Australia
| | - Ellie Newman
- Dementia Training Australia, University of Western Australia, Perth, Western Australia, Australia
| | - Kathryn Fitzgerald
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, Western Australia, Australia
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Li X, Mohanty I, Chai P, Niyonsenga T. Healthcare utilization and its association with socioeconomic status in China: Evidence from the 2011-2018 China Health and Retirement Longitudinal Study. PLoS One 2024; 19:e0297025. [PMID: 38483924 PMCID: PMC10939203 DOI: 10.1371/journal.pone.0297025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 12/26/2023] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Healthcare utilization often favors the higher-socioeconomic status (SES) and having chronic diseases may exacerbate this inequality. This study aims to examine the trends in health service use over time, the effect of SES on healthcare utilization, and the role of chronic diseases in this association. METHODS Data used in this study were from the China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013, 2015, and 2018, which is the first nationally representative survey of the middle-aged and older. The sample included people aged 45 years and older who responded to all the waves. A total of 10,922 adults were included in this study. Healthcare utilization was categorized into outpatient and inpatient service use and SES was measured by per-capita household expenditure. A multilevel zero-inflated negative binomial regression model was performed to analyze outpatient and inpatient service use, separately. RESULTS The rates of outpatient service use in 2011, 2013, 2015, and 2018 were 19.11%, 21.45%, 20.12%, and 16.32%, respectively, while the rates of inpatient service use were 8.40%, 13.04%, 14.17%, and 18.79%, respectively. Compared to individuals in the lowest quintile of per-capita household expenditure, those in higher quintiles had higher odds of outpatient service use (Q2: odds ratio = 1.233, p < 0.0001; Q3: 1.416, p < 0.0001; Q4: 1.408, p < 0.0001; or Q5: 1.439, p < 0.0001) and higher rates of inpatient service use (Q2: incidence rate ratio = 1.273, p < 0.0001; Q3: 1.773, p < 0.0001; Q4: 2.071, p < 0.0001; or Q5: 1.992, p < 0.0001). Additionally, having morbidity generally increased healthcare utilization, but did not play a significant role in moderating the relationship between SES and healthcare utilization. CONCLUSIONS Healthcare utilization rates were overall low in China, but relatively high for people in higher quintiles of per-capita household expenditure or those with morbidity, compared to their counterparts. Policy actions are required to provide more health education to the public, to further optimize health insurance schemes targeting outpatient services, especially for the low-SES, and to establish new health delivery models for NCD management in the primary health care setting.
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Affiliation(s)
- Xi Li
- Health Research Institute (HRI), Faculty of Health, University of Canberra, Canberra, Australia
| | - Itismita Mohanty
- Health Research Institute (HRI), Faculty of Health, University of Canberra, Canberra, Australia
| | - Peipei Chai
- Department of Health Economics and National Health Accounts Research, China National Health Development Research Center, Beijing, China
| | - Theo Niyonsenga
- Health Research Institute (HRI), Faculty of Health, University of Canberra, Canberra, Australia
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Ochnik D, Cholewa-Wiktor M, Jakubiak M, Pataj M. eHealth tools use and mental health: a cross-sectional network analysis in a representative sample. Sci Rep 2024; 14:5173. [PMID: 38431653 PMCID: PMC10908800 DOI: 10.1038/s41598-024-55910-z] [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: 08/17/2023] [Accepted: 02/28/2024] [Indexed: 03/05/2024] Open
Abstract
eHealth tools usage is vital for health care systems and increased significantly after the COVID-19 pandemic, which aggravated mental health issues. This cross-sectional study explored whether sociodemographic characteristics and mental health indices (stress and symptoms of anxiety and depression) were linked to the behavioral intention to use eHealth tools and eHealth tools usage in a representative sample from Poland using a network approach. Measurements were conducted in March 2023 among 1000 participants with a mean age of 42.98 (18-87) years, with 51.50% women. The measures included the behavioral intention to use eHealth tools (BI) based on the UTUAT2; eHealth tool use frequency (use behavior) including ePrescription, eSick leave, eReferral, electronic medical documentation (EMD), Internet Patient Account (IKP), telephone consultation, video consultation, mobile health applications, and private and public health care use; and the PSS-4, GAD-2, and PHQ-2. Furthermore, sociodemographic factors (sex, age, children, relationship status, education, and employment) were included in the research model. Network analysis revealed that mental health indices were weakly related to eHealth tools use. Higher stress was positively linked with mobile health application use but negatively linked to video consultation use. Use of various eHealth tools was intercorrelated. Sociodemographic factors were differentially related to the use of the eight specific eHealth tools. Although mental health indices did not have strong associations in the eHealth tools use network, attention should be given to anxiety levels as the factor with the high expected influence.
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Affiliation(s)
- Dominika Ochnik
- Faculty of Medicine, Department of Social Sciences, Academy of Silesia, 40-555, Katowice, Poland.
| | - Marta Cholewa-Wiktor
- Faculty of Management, Department of Marketing, Lublin University of Technology, 20-618, Lublin, Poland
| | - Monika Jakubiak
- Faculty of Economics, Institute of Management and Quality Sciences, Maria Curie-Sklodowska University in Lublin, 20-031, Lublin, Poland
| | - Magdalena Pataj
- Faculty of Political Science and Journalism, Institute of Social Communication and Media, Maria Curie-Skłodowska University, 20-612, Lublin, Poland
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Heponiemi T, Kaihlanen AM, Virtanen L, Kainiemi E, Saukkonen P, Koponen P, Koskinen S, Elovainio M. The Mediating Role of Digital Competence in the Associations Between the Factors Affecting Healthcare Utilization and Access to Care. Int J Public Health 2024; 68:1606184. [PMID: 38250321 PMCID: PMC10796446 DOI: 10.3389/ijph.2023.1606184] [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: 05/09/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives: To examine with a population-based longitudinal survey design whether poor health, longstanding activity limitation, impaired cognitive functioning, mental distress, or loneliness predict poor access to healthcare and whether digital competence mediates these associations. Methods: The data were from the longitudinal FinHealth -survey gathered in Finland in 2017 and 2020 including 3,771 respondents (57.1% women). Linear regression analyses were used to examine the associations of factors affecting healthcare utilization with access to care adjusted for age, sex, and education. Counterfactual causal mediation framework was used to examine the mediating role of digital competence in the relationships among these factors and access to healthcare. Results: Factors affecting healthcare utilization were associated with poor access to care and these associations were partly mediated by low digital competence. Low digital competence mediated 12%, 9% and 8%, of the associations of impaired cognitive functioning, longstanding activity limitation, and loneliness with poor access to care, respectively. Conclusion: According to our results, one way to improve the access to healthcare among vulnerable groups could be to improve their digital competence.
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Affiliation(s)
| | | | - Lotta Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Emma Kainiemi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Seppo Koskinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marko Elovainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Ferreira VR, Metting E, Schauble J, Seddighi H, Beumeler L, Gallo V. eHealth tools to assess the neurological function for research, in absence of the neurologist - a systematic review, part I (software). J Neurol 2024; 271:211-230. [PMID: 37847293 PMCID: PMC10770248 DOI: 10.1007/s00415-023-12012-6] [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: 06/28/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Neurological disorders remain a worldwide concern due to their increasing prevalence and mortality, combined with the lack of available treatment, in most cases. Exploring protective and risk factors associated with the development of neurological disorders will allow for improving prevention strategies. However, ascertaining neurological outcomes in population-based studies can be both complex and costly. The application of eHealth tools in research may contribute to lowering the costs and increase accessibility. The aim of this systematic review is to map existing eHealth tools assessing neurological signs and/or symptoms for epidemiological research. METHODS Four search engines (PubMed, Web of Science, Scopus & EBSCOHost) were used to retrieve articles on the development, validation, or implementation of eHealth tools to assess neurological signs and/or symptoms. The clinical and technical properties of the software tools were summarised. Due to high numbers, only software tools are presented here. FINDINGS A total of 42 tools were retrieved. These captured signs and/or symptoms belonging to four neurological domains: cognitive function, motor function, cranial nerves, and gait and coordination. An additional fifth category of composite tools was added. Most of the tools were available in English and were developed for smartphone device, with the remaining tools being available as web-based platforms. Less than half of the captured tools were fully validated, and only approximately half were still active at the time of data collection. INTERPRETATION The identified tools often presented limitations either due to language barriers or lack of proper validation. Maintenance and durability of most tools were low. The present mapping exercise offers a detailed guide for epidemiologists to identify the most appropriate eHealth tool for their research. FUNDING The current study was funded by a PhD position at the University of Groningen. No additional funding was acquired.
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Affiliation(s)
- Vasco Ribeiro Ferreira
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands.
| | - Esther Metting
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
- University Medical College Groningen, Groningen, The Netherlands
| | - Joshua Schauble
- Department of Knowledge Infrastructure, University of Groningen, Campus Fryslân, Leeuwarden, The Netherlands
| | - Hamed Seddighi
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
- Department of Psychology, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Lise Beumeler
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
- Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, The Netherlands
| | - Valentina Gallo
- Department of Sustainable Health, University of Groningen, Campus Fryslân, Wirdumerdijk 34, 8911 CE, Leeuwarden, The Netherlands
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Stanimirovic D. Failures and fallacies of eHealth initiatives: Are we finally able to overcome the underlying theoretical and practical orthodoxies? Digit Health 2024; 10:20552076241254019. [PMID: 38766362 PMCID: PMC11100379 DOI: 10.1177/20552076241254019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/29/2024] [Indexed: 05/22/2024] Open
Abstract
The growing and ubiquitous digitalization trends embodied in eHealth initiatives have led to the widespread adoption of digital solutions in the healthcare sector. These initiatives have been heralded as a potent transformative force aiming to improve healthcare delivery, enhance patient outcomes and increase the efficiency of healthcare systems. However, despite the significant potential and possibilities offered by eHealth initiatives, the article highlights the importance of critically examining their implications and cautions against the misconception that technology alone can solve complex public health concerns and healthcare challenges. It emphasizes the need to critically consider the sociocultural context, education and training, organizational and institutional aspects, regulatory frameworks, user involvement and other important factors when implementing eHealth initiatives. Disregarding these crucial elements can render eHealth initiatives inefficient or even counterproductive. In view of that, the article identifies failures and fallacies that can hinder the success of eHealth initiatives and highlights areas where they often fall short of meeting rising and unjustified expectations. To address these challenges, the article recommends a more realistic and evidence-based approach to planning and implementing eHealth initiatives. It calls for consistent research agendas, appropriate evaluation methodologies and strategic orientations within eHealth initiatives. By adopting this approach, eHealth initiatives can contribute to the achievement of societal goals and the realization of the key health priorities and development imperatives of healthcare systems on a global scale.
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Fletcher R, Regan C, Leigh L, Dizon J, Deering A. Online mental health screening for rural fathers over the perinatal period. Aust J Rural Health 2023; 31:796-804. [PMID: 37232517 DOI: 10.1111/ajr.12997] [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: 02/23/2023] [Revised: 04/30/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To determine the feasibility of identifying distressed fathers in rural areas of NSW via a 'light touch' support program (SMS4dads). DESIGN A retrospective observational study using self-reported distress and routinely captured help-seeking behaviour over a 14-month period (September 2020-December 2021) comparing rural and urban fathers. SETTING Rural and urban Local Health Districts in NSW. PARTICIPANTS A total of 3261 expectant and new fathers enrolled in a text-based information and support service (SMS4dads). MAIN OUTCOME MEASURES Registrations, K10 score, program engagement, attrition, escalation and referral to online mental health services. RESULTS Rural (13.3%) and urban (13.2%) enrolments were equivalent. Rural fathers had higher rates of distress than urban fathers (rural 19%; urban 16%) and were more likely to be smokers, consume alcohol at risky levels and report lower education levels. Rural fathers were more likely to exit the program early (HR = 1.32; 95% CI 1.08-1.62; p = 0.008); however, once adjusted for demographic factors aside from rurality, this increased likelihood was nonsignificant (HR = 1.10; 95% CI 0.88-1.38; p = 0.401). Although engagement with psychological support during the program was equivalent, a greater proportion of rural participants were escalated to online mental health support (7.7%) than urban participants (6.1%); however, this was nonsignificant (p = 0.222). CONCLUSION Digital platforms offering text-based parenting information in a 'light touch' format may be an effective way to screen rural fathers for mental distress and connect them to online support.
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Affiliation(s)
- Richard Fletcher
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Casey Regan
- School of Health Sciences, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Jason Dizon
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - April Deering
- New South Wales Ministry of Health, St Leonards, New South Wales, Australia
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Jendly M, Santschi V, Tancredi S, Konzelmann I, Raboud L, Chiolero A. eHealth profile of patients with diabetes. Front Public Health 2023; 11:1240879. [PMID: 37655284 PMCID: PMC10466783 DOI: 10.3389/fpubh.2023.1240879] [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: 06/15/2023] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
Background Digital health technology can be useful to improve the health of patients with diabetes and to support patient-centered care and self-management. In this cross-sectional study, we described the eHealth profile of patients with diabetes, based on their use of digital health technology, and its association with sociodemographic characteristics. Methods We used data from the "Qualité Diabète Valais" cohort study, conducted in one region of Switzerland (Canton Valais) since 2019. Participants with type 1 or type 2 diabetes completed questionnaires on sociodemographic characteristics and on the use of digital health technology. We defined eHealth profiles based on three features, i.e., ownership or use of (1) internet-connected devices (smartphone, tablet, or computer), (2) mHealth applications, and (3) connected health tools (activity sensor, smart weight scale, or connected blood glucose meter). We assessed the association between sociodemographic characteristics and participants' eHealth profiles using stratified analyses and logistic regression models. Results Some 398 participants (38% women) with a mean age of 65 years (min: 25, max: 92) were included. The vast majority (94%) were Swiss citizens or bi-national and 68% were economically inactive; 14% had a primary level education, 51% a secondary level, and 32% a tertiary level. Some 75% of participants had type 2 diabetes. Some 90% of the participants owned internet-connected devices, 43% used mHealth applications, and 44% owned a connected health tool. Older age and a lower educational level were associated with lower odds of all features of the eHealth profile. To a lesser extent, having type 2 diabetes or not being a Swiss citizen were also associated with a lower use of digital health technology. There was no association with sex. Conclusion While most participants owned internet-connected devices, only about half of them used mHealth applications or owned connected health tools. Older participants and those with a lower educational level were less likely to use digital health technology. eHealth implementation strategies need to consider these sociodemographic patterns among patients with diabetes.
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Affiliation(s)
- Mathieu Jendly
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Valérie Santschi
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | | | - Leila Raboud
- Observatoire Valaisan de la Santé (OVS), Sion, Switzerland
| | - Arnaud Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
- Observatoire Valaisan de la Santé (OVS), Sion, Switzerland
- School of Population and Global Health, McGill University, Montreal, QC, Canada
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Campanozzi LL, Gibelli F, Bailo P, Nittari G, Sirignano A, Ricci G. The role of digital literacy in achieving health equity in the third millennium society: A literature review. Front Public Health 2023; 11:1109323. [PMID: 36891330 PMCID: PMC9986277 DOI: 10.3389/fpubh.2023.1109323] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Healthcare in the third millennium is largely delivered through systems involving the use of the technological devices and services, foremost among them telemedicine. For the adequate delivery of digital medicine services, however, it is necessary for users to be digitally literate, that is, able to consciously make use of technology. In order to understand how relevant digital literacy is in determining the effectiveness of e-Health services, we performed a traditional literature review on 3 major databases by combining the terms "Digital Literacy" and "Computer Literacy" with the terms "Telemedicine" and "Telehealth". Starting from an initial library of 1,077 papers, we selected 38 articles. At the outcome of the search, we found that digital literacy is a pivotal element in conditioning the effectiveness of telemedicine and digital medicine services in general, however, with some limitations.
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Affiliation(s)
| | - Filippo Gibelli
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Paolo Bailo
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Giulio Nittari
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Ascanio Sirignano
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Giovanna Ricci
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
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15
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Inequity in Access and Delivery of Virtual Care Interventions: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159411. [PMID: 35954768 PMCID: PMC9367842 DOI: 10.3390/ijerph19159411] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/27/2023]
Abstract
The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched MEDLINE, EMBASE, and CINAHL using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barriers identified in the review included having digitally literate caregivers present during virtual care appointments, conducting virtual care appointments in culturally sensitive manner, and having a focus on enhancing patients’ digital literacy. We identified evidence-based practices for virtual care interventions to ensure equity in access and delivery for their virtual care patients.
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Oliveira ECT, Louvison MCP, Teixeira DSDC, de Menezes TN, Rosa TEDC, Duarte YADO. Difficulties in accessing health services among the elderly in the city of São Paulo-Brazil. PLoS One 2022; 17:e0268519. [PMID: 35588124 PMCID: PMC9119537 DOI: 10.1371/journal.pone.0268519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
To identify difficulties in accessing health services by the elderly in the city of São Paulo/Brazil and the contributory factors that reflect inequalities. This is a cross-sectional study that used data from the Health, Well-being and Aging Study (SABE). The population is composed of elderly ≥ 60 years old, of both sexes, living in the urban area of São Paulo. For this analysis, we used data from the 2015 cohort of the SABE study, containing a sample of 1,221 individuals. The proportions of access difficulty and, through logistic regression, the associated factors were verified, based on Andersen’s Behavioral Model, which considers factors of predisposition, enabling and need as individual determinants of access to health care. It was observed that 37.0% of the elderly reported difficulty accessing health services when they needed it. This difficulty was greatest among females (42.3%), aged 60 to 69 years (40.9%), black race/color (58.8%), illiterate (44.5%), single/separated/divorced (44.3%), with income slower than one salary minimum (46.8%), without health insurance (51.9%), with poor/very poor self-assessment of health (54.7%), with multimorbidity (40.1%), frail (47.2%) and among those who used polypharmacy (40.8%). After multivariate analysis, in the final model, there was a positive association between difficulty of access and predisposing factors (female gender, age group 60 to 69 years, black race/color, illiterate), enabling factors (possession of health insurance) and need factors (regular and poor/very poor self-assessment of health and pre-fragility and frailty condition). The presence of difficulty in access associated with predisposing, enabling and need factors reflect the existence of inequalities caused by barriers that point to weaknesses in the organization of services. The identification of these barriers that hinder access highlights important points that can have an impact on the equity and resolution of care.
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Affiliation(s)
| | - Marília Cristina Prado Louvison
- Department of Policy, Management and Health, Faculty of Public Health, University of São Paulo (USP), São Paulo, São Paulo, Brazil
| | | | | | | | - Yeda Aparecida de Oliveira Duarte
- Coordinator of the Health, Well-Being and Aging Study (SABE), School of Nursing, Faculty of Public Health, University of São Paulo (USP), São Paulo, São Paulo, Brazil
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17
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Borda M, Grishchenko N, Kowalczyk-Rólczyńska P. Patient Readiness for Remote Healthcare Services in the Context of the COVID-19 Pandemic: Evidence From European Countries. Front Public Health 2022; 10:846641. [PMID: 35372199 PMCID: PMC8964525 DOI: 10.3389/fpubh.2022.846641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/16/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the fact that remote services were successfully implemented in most European social and health systems before 2020, the COVID-19 pandemic has led to an unprecedented development of health and social care services provided in this form. This paper compares the readiness of patients to use the digital solutions in healthcare systems implemented in EU countries, in response to the current pandemic situation. In the study, technological, health insurance, and demographic variables were selected on the basis of substantive criteria. Next, the linear ordering method was applied to make a ranking of the analyzed countries according to the level of patients' readiness to use digital healthcare services. The main findings show that the Netherlands and Ireland are characterized by the highest level of patients' readiness for using remote healthcare services. On the other hand, Romania and Bulgaria are among the countries with the lowest readiness. The study also made it possible to group European countries according to the level of patients' preparedness.
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Affiliation(s)
- Marta Borda
- Department of Insurance, Wroclaw University of Economics and Business, Wroclaw, Poland
| | - Natalia Grishchenko
- Institute of Social Policy, National Research University Higher School of Economics, Moscow, Russia
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18
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Lu ZA, Shi L, Que JY, Zheng YB, Wang QW, Liu WJ, Huang YT, Liu XX, Yuan K, Yan W, Shi J, Bao YP, Lu L. Accessibility to Digital Mental Health Services among the General Public throughout COVID-19: Trajectories, Influencing Factors and Association with Long-Term Mental Health Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063593. [PMID: 35329280 PMCID: PMC8955845 DOI: 10.3390/ijerph19063593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 12/30/2022]
Abstract
Digital mental health services (DMHSs) have great potential for mitigating the mental health burden related to COVID-19, but public accessibility (ease of acquiring services when needed) to DMHSs during the pandemic is largely unknown. Accessibility to DMHSs was tracked longitudinally among a nationwide sample of 18,804 adults in China from before to one year after COVID-19 outbreak. Unconditional and conditional latent growth curve models and latent growth mixture models were fitted to explore the overall growth trend, influencing factors, and latent trajectory classes of accessibility to DMHSs throughout COVID-19. Generalized estimating equation models and generalized linear mixed models were employed to explore the association between accessibility to DMHSs and long-term mental health symptoms. We found that people generally reported increased difficulty in accessing DMHSs from before to one year after COVID-19 outbreak. Males, youngsters, individuals with low socioeconomic status, and individuals greatly affected by COVID-19 reported greater difficulty in accessing DMHSs. Four DMHS accessibility trajectory classes were identified: “lowest–great increase” (6.3%), “moderate low–slight increase” (44.4%), “moderate high–slight decrease” (18.1%) and “highest–great decrease” (31.2%). Trajectory classes reporting greater difficulty in accessing DMHSs were at higher risk for long-term mental symptoms. In conclusion, an overall increase in difficulty in accessing DMHSs is observed throughout COVID-19, and heterogeneity exists in DMHS accessibility trajectories. Our results suggest that easy access to DMHSs should be consistently facilitated. Moreover, access gaps should be reduced across demographic groups, and target populations for service allocation should alter as the pandemic evolves.
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Affiliation(s)
- Zheng-An Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Jian-Yu Que
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Yong-Bo Zheng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing 100871, China
| | - Qian-Wen Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Wei-Jian Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Yue-Tong Huang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Xiao-Xing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
- Correspondence: (Y.-P.B.); (L.L.)
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China; (Z.-A.L.); (L.S.); (J.-Y.Q.); (Y.-B.Z.); (Q.-W.W.); (W.-J.L.); (Y.-T.H.); (X.-X.L.); (K.Y.); (W.Y.)
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing 100871, China
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China;
- Correspondence: (Y.-P.B.); (L.L.)
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Broomfield G, Brown SD, Yap MB. Socioeconomic factors and parents' preferences for internet- and mobile-based parenting interventions to prevent youth mental health problems: A discrete choice experiment. Internet Interv 2022; 28:100522. [PMID: 35309756 PMCID: PMC8924632 DOI: 10.1016/j.invent.2022.100522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/12/2022] [Accepted: 03/05/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The positive impact of parenting programs for youth mental health is undermined by difficulties engaging parents. Low engagement disproportionately impacts parents of lower-socioeconomic positions (SEPs). Internet- and mobile-based interventions hold potential for overcoming barriers to enrolment, but additional research is needed to understand how programs can appropriately meet the needs of parents across SEPs. Consumer preference methods such as discrete choice experiments may be valuable in this endeavour. METHOD A discrete choice experiment was used to determine the relative influence of modifiable program features on parents' intent to enrol. 329 Australian parents of children aged 0-18 repeatedly selected their preferred program from randomized sets of hypothetical programs in an online survey. Each hypothetical program was unique, varying across four program features: module duration, program platform, user control, and program cost. Cumulative link models were used to predict choices, with education, household income, and community advantage used as indicators of SEP. RESULTS Overall, parents preferred cheaper programs and briefer modules. Parents' preferences differed based on their socioeconomic challenges. Lower-income parents preferred briefer modules, cheaper programs and application-based programs compared to higher-income parents. Parents with less education preferred briefer modules and a predefined module order. Parents living in areas of less advantage preferred website-based programs, user choice of module order, and more expensive programs. CONCLUSIONS This study offers program developers evidence-based strategies for tailoring internet- and mobile-based parenting interventions to increase lower-SEP parent enrolment. Findings also highlight the importance of considering parents' socioeconomic challenges to ensure programs do not perpetuate existing mental health inequalities, as "one-size-fits-all" approaches are likely insufficient for reaching lower-SEP parents.
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Affiliation(s)
- Grace Broomfield
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Scott D. Brown
- School of Psychological Sciences, The University of Newcastle, Callaghan, Australia
| | - Marie B.H. Yap
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia,Corresponding author at: Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, 18 Innovation Walk, Clayton, Melbourne 3800, Australia.
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20
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Ngusie HS, Kassie SY, Chereka AA, Enyew EB. Healthcare providers' readiness for electronic health record adoption: a cross-sectional study during pre-implementation phase. BMC Health Serv Res 2022; 22:282. [PMID: 35232436 PMCID: PMC8889777 DOI: 10.1186/s12913-022-07688-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/25/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The adoption of an electronic health record (EHR) in the healthcare system has the potential to make healthcare service delivery effective and efficient by providing accurate, up-to-date, and complete information. Despite its great importance, the adoptions of EHR in low-income country settings, like Ethiopia, were lagging and increasingly failed. Assessing the readiness of stakeholders before the actual adoption of EHR is considered the prominent solution to tackle the problem. However, little is known about healthcare providers' EHR readiness in this study setting. Accordingly, this research was conducted aiming at examining healthcare providers' readiness for EHR adoption and associated factors in southwestern Ethiopia. METHODS An institutional-based cross-sectional study was conducted from September 1 to October 30, 2021. A total of 423 healthcare providers working in public hospitals were selected using a simple random sampling technique. Multivariable logistic regression was fitted to identify determinant factors of overall healthcare providers' readiness after the other covariates were controlled. RESULT In this study, the overall good readiness level of EHR adoption was 52.8% (n = 204) [95% CI of 47.9% to 56.6%]. Age, computer literacy, computer access at health facilities, attitude towards EHRs, awareness about EHRs, perceived benefit, and perceived technology self-efficacy were significantly associated with the overall health care providers' readiness for the adoption of EHR using a cut point of P-value less than 0.05. CONCLUSION Around half of the respondents had a good level of overall healthcare providers' readiness for the adoption of EHR which was considered inadequate. This finding implied that a huge effort is required to improve readiness before the actual implementation of EHRs. The finding implied that younger-aged groups were more ready for such technology which in turn implied; the older one needs more concern. Enhancing computer literacy, confidence building to raise self-efficacy of such technology, addressing the issue of computer availability at health facilities, building a positive attitude, awareness campaign of EHR, and recognizing the usefulness of such systems were the necessary measures to improve EHR readiness in this setting. Additionally, further studies are recommended to encompass all types of EHR readiness such as organizational readiness, technology readiness, societal readiness, and so on. Additionally, exploring the healthcare provider opinion with qualitative study and extending the proposed study to other implementation settings are recommended to be addressed by future works.
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Affiliation(s)
- Habtamu Setegn Ngusie
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Sisay Yitayih Kassie
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Alex Ayenew Chereka
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Ermias Bekele Enyew
- Department of Health Informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
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21
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Tian H, Chen J. A bibliometric analysis on global eHealth. Digit Health 2022; 8:20552076221091352. [PMID: 35433016 PMCID: PMC9006363 DOI: 10.1177/20552076221091352] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/15/2022] [Indexed: 02/02/2023] Open
Abstract
Background The current coronavirus disease 2019 pandemic highlights the potential of eHealth. Drawing the knowledge map of eHealth research through data mining and visual analysis technology was helpful to systematically present the research status and future trends of global academic circles. Methods Based on the web of Science Core Collection (SCIE/SSCI) database, using bibliometric theory and visual analysis technology, this work analyzed the global eHealth research publications from 2000 to 2021, and introduced the interdisciplinary characteristics, hot topics and future trends in this field. Results A total of 10188 authors, 891 journals, 3586 institutions, 98 countries using 12 languages had conducted eHealth research in the world. The United States, the Netherlands, Australia and the United Kingdom were the main forces and international cooperation. However, the international co-operation between Eastern and Western countries was still relatively few. The frontier of global eHealth research mainly focused on #0eHealth innovation, #1physical activity, #2generalised anxiety disorder, #3lightweight authentication protocol, #4 eHealth information, #5technology readiness, #6 ehealth literacy scale, #7family carer, #8citance analysis, #9 guiding patient. Clusters #3 lightweight authentication protocol and #9 guiding patient were the latest clusters, indicating the research trend and direction of eHealth in the future. Conclusions Cooperation network framework at the regional, national and global levels and the cooperation of multidisciplinary teams with complementary backgrounds and expertise were needed to realize the in-depth popularization and application of eHealth knowledge. Interdisciplinary international cooperation should be the trend of eHealth research in the future.
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Affiliation(s)
- Hua Tian
- College of Life Science, Xinyang Normal University, Xinyang, China
| | - Jie Chen
- School of Marxism, Xinyang Normal University, Xinyang, China
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22
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Oshni Alvandi A, Bain C, Burstein F. Understanding digital health ecosystem from Australian citizens' perspective: A scoping review. PLoS One 2021; 16:e0260058. [PMID: 34780547 PMCID: PMC8592460 DOI: 10.1371/journal.pone.0260058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/30/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Digital health (DH) and the benefits of related services are fairly well understood. However, it still is critical to map the digital health care landscape including the key elements that define it as an ecosystem. Particularly, knowing the perspectives of citizens on this digital transformation is an important angle to capture. In this review we aim to analyze the relevant studies to identify how DH is understood and experienced by Australian citizens and what they may require from DH platforms. MATERIALS AND METHODS A scoping literature review was conducted across several electronic databases (ACM Digital Library, OVID, PubMed, Scopus, IEEE, Science Direct, SAGE), as well as grey literature. Additionally, citation mining was conducted to identify further relevant studies. Identified studies were subjected to eligibility criteria and the final set of articles was independently reviewed, analyzed, discussed and interpreted by three reviewers. RESULTS Of 3811 articles, 98 articles met the inclusion criteria with research-based articles-as opposed to review articles or white papers- comprising the largest proportion (72%) of the selected literature. The qualitative analysis of the literature revealed five key elements that capture the essence of the digital health ecosystem interventions from the viewpoint of the Australian citizens. The identified elements were "consumer/user", "health care", "technology", "use and usability", "data and information". These elements were further found to be associated with 127 subcategories. CONCLUSIONS This study is the first of its kind to analyze and synthesize the relevant literature on DH ecosystems from the citizens' perspective. Through the lens of two research questions, this study defines the key components that were found crucial to understanding citizens' experiences with DH. This understanding lays a strong foundation for designing and fostering DH ecosystem. The results provide a solid ground for empirical testing.
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Affiliation(s)
| | - Chris Bain
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
| | - Frada Burstein
- Faculty of Information Technology, Monash University, Clayton, Victoria, Australia
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23
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Ayres L, Pelkowitz L, Simon P, Thompson SC. Necessity as the Catalyst of Change: Exploring Client and Provider Perspectives of Accelerated Implementation of Telehealth by a Regional Australian Community Service Organisation during COVID-19 Restrictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111433. [PMID: 34769949 PMCID: PMC8583583 DOI: 10.3390/ijerph182111433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 12/17/2022]
Abstract
Community services have played a significant role in supporting the psychosocial health and well-being of vulnerable populations during the SARS-CoV-2 (COVID-19) pandemic. To meet increased community needs, organisations were required to rapidly modify service provision, often using remote delivery systems. This in-depth study, undertaken early in the pandemic, explored staff and clients’ experiences of adapting to using telehealth to provide and access services in one regional social services agency. Semi-structured interviews from 15 staff and 11 clients from a regional not-for-profit agency in Western Australia were recorded and transcribed. Inductive coding, and thematic analysis identified eight subthemes, with experiences and perceptions of telehealth varying substantially among staff and client groups. Distinct benefits and challenges were associated with telehealth. Participants highlighted tensions and complexities and commented on the place of telehealth in the community service sector. Clients expressed the importance of relationships and communication. This study provides in-depth insights into the contextualised experiences of staff and clients during a time at which change was both enabled and necessary. The findings highlight the need for tailored service delivery; choice; client collaboration; ongoing staff training relating to telehealth; and guidelines specific to telehealth in the community service sector.
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Affiliation(s)
- Leah Ayres
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6530, Australia; (L.P.); (S.C.T.)
- Correspondence:
| | - Lindi Pelkowitz
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6530, Australia; (L.P.); (S.C.T.)
| | - Perlin Simon
- Centacare Family Services, Geraldton, WA 6530, Australia;
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Geraldton, WA 6530, Australia; (L.P.); (S.C.T.)
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24
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Foley K, Freeman T, Ward P, Lawler A, Osborne R, Fisher M. Exploring access to, use of and benefits from population-oriented digital health services in Australia. Health Promot Int 2021; 36:1105-1115. [PMID: 33367568 DOI: 10.1093/heapro/daaa145] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The provision of population-oriented, on-demand digital health services in many countries exemplifies the perceived utility of digital health services in supporting population health. Yet, limited knowledge exists regarding the equity of these services. Using mixed-method research, we recruited users of a health website and general practice patients to surveys (n = 441) and telephone interviews (n = 40). We contribute specific evidence investigating barriers to access, use and benefit from digital health services within an equity framework that incorporates social determinant factors, eHealth Literacy and trust. Our research highlights the foundational role of trust in predicting use, showcases which groups are unlikely to benefit from population-oriented digital health services, and proposes strategies to enhance the equity of these services. The theoretical framework we developed serves as a roadmap for future health promotion research and action by outlining the complex and interrelated pathways that can promote and threaten digital health equity.
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Affiliation(s)
- Kristen Foley
- Public Health and Southgate Institute for Health, Society and Equity, Flinders University, Sturt Road, 5042 Adelaide, Australia
| | - Toby Freeman
- Public Health and Southgate Institute for Health, Society and Equity, Flinders University, Sturt Road, 5042 Adelaide, Australia
| | - Paul Ward
- Public Health and Southgate Institute for Health, Society and Equity, Flinders University, Sturt Road, 5042 Adelaide, Australia
| | - Anthony Lawler
- School of Medicine, University of Tasmania, Churchill Avenue, 7005 Hobart, Australia
| | - Richard Osborne
- Center for Global Health and Equity, Swinburne University of Technology, John Street, 3122 Hawthorn, Australia
| | - Matt Fisher
- Public Health and Southgate Institute for Health, Society and Equity, Flinders University, Sturt Road, 5042 Adelaide, Australia
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25
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Treanor CJ, Kouvonen A, Lallukka T, Donnelly M. Acceptability of Computerized Cognitive Behavioral Therapy for Adults: Umbrella Review. JMIR Ment Health 2021; 8:e23091. [PMID: 34255714 PMCID: PMC8292944 DOI: 10.2196/23091] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/26/2021] [Accepted: 04/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mental ill-health presents a major public health problem. A potential part solution that is receiving increasing attention is computer-delivered psychological therapy, particularly during the COVID-19 pandemic as health care systems moved to remote service delivery. However, computerized cognitive behavioral therapy (cCBT) requires active engagement by service users, and low adherence may minimize treatment effectiveness. Therefore, it is important to investigate the acceptability of cCBT to understand implementation issues and maximize potential benefits. OBJECTIVE This study aimed to produce a critical appraisal of published reviews about the acceptability of cCBT for adults. METHODS An umbrella review informed by the Joanna Briggs Institute (JBI) methodology identified systematic reviews about the acceptability of cCBT for common adult mental disorders. Acceptability was operationalized in terms of uptake of, dropping out from, or completion of cCBT treatment; factors that facilitated or impeded adherence; and reports about user, carer, and health care professional experience and satisfaction with cCBT. Databases were searched using search terms informed by relevant published research. Review selection and quality appraisal were guided by the JBI methodology and the AMSTAR tool and undertaken independently by 2 reviewers. RESULTS The systematic searches of databases identified 234 titles, and 9 reviews (covering 151 unique studies) met the criteria. Most studies were comprised of service users with depression, anxiety, or specifically, panic disorder or phobia. Operationalization of acceptability varied across reviews, thereby making it difficult to synthesize results. There was a similar number of guided and unguided cCBT programs; 34% of guided and 36% of unguided users dropped out; and guidance included email, telephone, face-to-face, and discussion forum support. Guided cCBT was completed in full by 8%-74% of the participants, while 94% completed one module and 67%-84% completed some modules. Unguided cCBT was completed in full by 16%-66% of participants, while 95% completed one module and 54%-93% completed some modules. Guided cCBT appeared to be associated with adherence (sustained via telephone). A preference for face-to-face CBT compared to cCBT (particularly for users who reported feeling isolated), internet or computerized delivery problems, negative perceptions about cCBT, low motivation, too busy or not having enough time, and personal circumstances were stated as reasons for dropping out. Yet, some users favored the anonymous nature of cCBT, and the capacity to undertake cCBT in one's own time was deemed beneficial but also led to avoidance of cCBT. There was inconclusive evidence for an association between sociodemographic variables, mental health status, and cCBT adherence or dropping out. Users tended to be satisfied with cCBT, reported improvements in mental health, and recommended cCBT. Overall, the results indicated that service users' preferences were important considerations regarding the use of cCBT. CONCLUSIONS The review indicated that "one size did not fit all" regarding the acceptability of cCBT and that individual tailoring of cCBT is required in order to increase population reach, uptake, and adherence and therefore, deliver treatment benefits and improve mental health.
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Affiliation(s)
- Charlene J Treanor
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Anne Kouvonen
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.,Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Michael Donnelly
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
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26
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Zhang C, Peng XQ, Jiang YZ, Liu R, Qi ZX, Zhou M, Zhao SQ, Ge JJ, You H, Li ZG. Online medical services utilization evaluated through the lens of socioecological theory and the information-motivation-behavioral skills model: evidence from China. Ann N Y Acad Sci 2021; 1500:82-92. [PMID: 33983658 DOI: 10.1111/nyas.14609] [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: 12/26/2020] [Revised: 04/13/2021] [Accepted: 04/21/2021] [Indexed: 12/01/2022]
Abstract
Online medical services (OMS) have become increasingly advantageous, but there are still several barriers to utilization among patients. This study aims to explore the factors influencing OMS utilization (OMSU) for patients in micro-, meso-, and macrosystems based on socioecological theory (SET) and from the perspective of the information-motivation-behavioral skills (IMB) model. We selected 1065 participants through multistage stratified cluster random sampling in Jiangsu, China. In microsystems, information and behavioral skills were positively associated with intention (β = 0.84; β = 3.21) and actual utilization (OR = 1.69; OR = 1.69). Education level (β = 0.83) and personal motivation (β = 1.68) were positively related to intention. Chronic diseases (OR = 2.03) had a positive relationship with actual use. In mesosystems, recommendations from people around the patients (β = 1.14; OR = 1.99), provision of OMS in the nearest primary medical facility (β = 0.98; OR = 3.60), and provision of instructional information by medical institutions (β = 1.01; OR = 1.65) were related to OMSU. The average monthly household income (β = 0.54) was related to intention. Patients who had information about the OMSU experiences of people around them (OR = 1.73) correlated with actual utilization. In macrosystems, the social medical insurance type (OR = 0.66) was associated with OMSU. This study supports the applicability of the SET and IMB model to interpret patients' OMSU.
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Affiliation(s)
- Chi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Xue-Qing Peng
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yong-Zhi Jiang
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Rui Liu
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Zi-Xin Qi
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China
| | - Meng Zhou
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Shi-Qi Zhao
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jin-Jin Ge
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Hua You
- School of Nursing, Nanjing Medical University, Nanjing, China.,School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhi-Guang Li
- School of Health Policy & Management, Nanjing Medical University, Nanjing, China.,The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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27
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Jayawardana D, Gannon B. Use of telehealth mental health services during the COVID-19 pandemic. AUST HEALTH REV 2021; 45:442-446. [PMID: 33583488 DOI: 10.1071/ah20325] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 12/29/2020] [Indexed: 01/22/2023]
Abstract
During the COVID-19 pandemic, specific mental health telehealth services in Australia have been an important source of help for the increasingly stressed population. This study examined trends in the uptake of telehealth items for mental health during the first 6 months of the COVID-19 pandemic using administrative Medicare data. During the peak of the pandemic there was a 50% reduction in the in-person consultations for mental health but also a substantial increase in uptake largely of the newly introduced temporary Medicare Benefits Schedule telehealth services. Further, the use of telehealth varied across age, gender and state/territory. These findings have important implications for the allocation of resources for telehealth, both now, and into the post-COVID-19 era.
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Affiliation(s)
- Danusha Jayawardana
- Centre for the Business and Economics of Health, Level 5, Sir Llew Edwards Building, University of Queensland, St Lucia, Qld 4072, Australia; and Corresponding author.
| | - Brenda Gannon
- Centre for the Business and Economics of Health, Level 5, Sir Llew Edwards Building, University of Queensland, St Lucia, Qld 4072, Australia; and School of Economics, Level 6, Colin Clark Building, University of Queensland, St Lucia, Qld 4072, Australia.
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28
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Ali MA, Alam K, Taylor B, Ashraf M. Examining the determinants of eHealth usage among elderly people with disability: The moderating role of behavioural aspects. Int J Med Inform 2021; 149:104411. [PMID: 33618191 DOI: 10.1016/j.ijmedinf.2021.104411] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/28/2020] [Accepted: 02/03/2021] [Indexed: 01/23/2023]
Abstract
BACKGROUND Existing studies have demonstrated that behavioural barriers impede eHealth usage among senior citizens. However, thus far, no analysis of how such barriers affect elderly people with disabilities (PwD) has been conducted. Thus, the study investigates the predictors of eHealth usage among elderly PwD. METHODS Using data from a 2018 nationwide disability survey comprising 14,798 respondents in Australia, multivariate logistic regression models are used to predict the relationship between eHealth usage and the various characteristics of respondents, including access to information and communication technologies (ICTs), socioeconomic status, and level of education. RESULTS Although most participants (approximately 88%) have access to ICTs, few (only around 9%) have used eHealth services. The results show a number of factors are associated with an increased likelihood of using eHealth services, including higher educational attainment (odds ratio [OR] = 3.12, 95% confidence interval [CI]: 2.38, 4.24), employment (OR = 1.43, 95% CI: 1.06, 1.94), higher household income (OR = 1.39, 95% CI: 1.00, 1.96), and ICT access (OR = 15.92, 95% CI: 10.51, 27.01). The probability of eHealth use is lower for the oldest-old (OR = 0.35, 95% CI: 0.22, 0.45). In addition, the estimates from interaction effects suggest the effect of ICT penetration on use of eHealth falls by a negligible amount because of resistive attitudinal barriers (OR = 0.01, 95% CI: 0.01, 0.06). CONCLUSION Given the challenges of ageing populations and pandemics, such as COVID-19, eHealth services are a vital part of an effective, inclusive, and robust health care system. This study demonstrates the presence of a significant digital divide among elderly PwD and suggests that public and private efforts should be made to increase the availability of ICT infrastructure. Training could also increase inclusion in this regard.
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Affiliation(s)
- Mohammad Afshar Ali
- School of Business, Faculty of Business, Education, Law & Arts, University of Southern Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Toowoomba, Australia; Department of Economics, Jagannath University, Dhaka, Bangladesh.
| | - Khorshed Alam
- School of Business, Faculty of Business, Education, Law & Arts, University of Southern Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
| | - Brad Taylor
- School of Business, Faculty of Business, Education, Law & Arts, University of Southern Queensland, Springfield, Australia.
| | - Mahfuz Ashraf
- WHO Collaborative Centre on eHealth, UNSW, Australia; Crown Institution of Higher Education, North Sydney, NSW, Australia.
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Bhatia R. Telehealth and COVID-19: Using technology to accelerate the curve on access and quality healthcare for citizens in India. TECHNOLOGY IN SOCIETY 2021; 64:101465. [PMID: 33814651 PMCID: PMC8008321 DOI: 10.1016/j.techsoc.2020.101465] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 10/01/2020] [Accepted: 11/25/2020] [Indexed: 05/06/2023]
Abstract
The current COVID-19 pandemic has reinstated the importance of telehealth as a business model for accelerating the accessibility of healthcare and improving the quality of healthcare for citizens of a country. Telehealth service has a tremendous potential in a developing country like India where the healthcare facilities in India are heavily concentrated in urban cities while their majority (67%) of the population resides in rural areas. At the same time, a high teledensity of almost 90% supports telehealth overall reach. However, the growth of telehealth in India till now has been sluggish but the corona virus (COVID-19) crisis has redefined the telehealth ecosystem by reducing the risk of infection through person-to-person contact. In this study, we explore the perception of healthcare users towards telehealth services and analyze the key enablers for the telehealth services in the current scenario. We collected data from 1170 participants through personal interview. The results of the study shows a considerable segment of the population is having high healthcare need, have aspirations for accessing better healthcare for themselves and their family members and use ICT to a significant extent. At the same time, they have positive attitude towards telehealth and socio-demographic factors like age, geographical location, educational qualification, family size affects the attitude towards telehealth services. The results of the study shows there is a significant market for telehealth services in India to be explored by the technology firms, hospitals and other healthcare stakeholders and going forward it has an enormous capability to transform the complete healthcare ecosystem, especially in developing countries like India post the COVID-19 crisis.
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Affiliation(s)
- Ridhi Bhatia
- Faculty of Management Studies, Manav Rachna International Institute of Research and Studies, India
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30
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Eslami Andargoli A. e-Health in Australia: A synthesis of thirty years of e-Health initiatives. TELEMATICS AND INFORMATICS 2021. [DOI: 10.1016/j.tele.2020.101478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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31
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Does digital inclusion affect quality of life? Evidence from Australian household panel data. TELEMATICS AND INFORMATICS 2020. [DOI: 10.1016/j.tele.2020.101405] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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