Setting up a health education website: practical advice for health professionals

The Knowledge, Attitude, Practices, and Satisfaction of Non-Invasive Prenatal Testing among Chinese Pregnant Women under Different Payment Schemes: A Comparative Study

Non-invasive prenatal testing (NIPT) for aneuploidy screening has been widely applied across China, and costs can affect Chinese pregnant women’s choices. This study aims to assess the knowledge, attitude, practices (KAP) and satisfaction regarding NIPT among pregnant women in China, and to further explore the relationship between payment schemes and women’s acceptability of and satisfaction with NIPT. A questionnaire survey was performed in Shenzhen and Zhengzhou, China, which separately applied “insurance coverage” and “out-of-pocket” payment scheme for NIPT. The major differences between the two cities were compared using chi-square test, Wilcoxon rank sum test, and propensity score matched analysis. Logistic regression models were applied to explore predictors for women’s acceptability and satisfaction. Compared with Zhengzhou participants, a higher proportion of Shenzhen women had heard of NIPT (87.30% vs. 64.03%), were willing to receive NIPT (91.80% vs. 80.43%) and had taken NIPT (83.12% vs. 54.54%), while their satisfaction level was lower. Having NIPT-related knowledge was associated with higher acceptability, and receiving genetic counseling helped to improve satisfaction. Besides, women with higher annual household incomes were more likely to take and be satisfied with NIPT. In conclusion, more attention should be paid to health education, subsidies for NIPT, and genetic counseling.

The Technological Growth in eHealth Services

The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services.

Trialling a patient-led cancer care website in an acute cancer care setting

Health ICT is rapidly gaining popularity among policy makers and health consumers. Specific platforms for use in cancer care are missing.

Aim:

The aim of this pilot study was to: 1) test the feasibility, functionality and usability of a patient-led cancer care web platform: CanCare, in a sample of people undergoing cancer treatment and 2) ascertain if CanCare could enhance communication between patients, family, friends and health professionals.

Methods:

Cancer patients receiving chemotherapy were invited to participate. Data were collected via semi-structured interviews, online surveys and a website usage program.

Results:

Nine patients with four different types of cancer completed the study. All saw the potential of the website but many found it too complex to use, particularly when unwell post treatment. Many were frustrated by the lack of integration with existing hospital systems and the need to enter relevant data manually. The cancer-specific information tab rated highly and was used extensively. The website used alone did not promote interactions between family and/or health professionals.

Conclusion:

A patient-led cancer care website has the potential to help patients manage their cancer care but needs to be intuitive to use, integrated into hospital systems and requires significant family/carer and health professional engagement.

Development of a health-related website for parents of children receiving hematopoietic stem cell transplant: HSCT-CHESS

INTRODUCTION

Parents of pediatric hematopoietic stem cell transplant (HSCT) play a pivotal role in the care of their child during and after transplant. In addition to the child's comforter, parents also serve as care coordinators and conduits of communication between various health care providers, family and community members. The stress on the parent and family is enormous during this process, which for many is compounded by geographic dislocation to accompany their child during the rigorous treatment and recovery process. For many parents, their own recovery spans months to years.

METHODS

Parental activation, a process of becoming informed to participate in decisions, collaborate with health care providers, and manage care provided the conceptual framework to develop an eHealth approach for this population. HSCT-CHESS was developed, based on previous success with an existing eHealth system of integrated services, the Comprehensive Health Enhancement Support System (CHESS). CHESS(TM) is designed to help individuals and families cope with a health crisis or medical concern. The iterative user-centered development process for HSCT-CHESS included parents of HSCT recipients, representatives from an HSCT Advocacy Group, and members of the clinical, research, development and design teams. This rigorous process, including online focus groups and surveys, utilization of a parental user group, and an editorial and development process are described.

CONCLUSION

As the population of cancer survivors and caregivers increase and as the oncology workforce becomes more stretched; developing eHealth applications may be an approach to address many of caregivers unmet needs. The purpose in describing this process is to help others when considering such an endeavor. HSCT-CHESS is now being tested in a randomized controlled trial versus standard care to evaluate its impact on the quality of life of both the parent and child HSCT recipient.

Internet use among adolescent and young adults (AYA) with cancer

BACKGROUND

The Internet serves as an important resource for adult cancer patients, but little is known about Internet use among adolescent and young adults (AYA) with cancer. The aims of this study were to describe (1) cancer-specific websites which AYA with cancer visit and (2) Internet features desired by AYA on cancer-specific websites and how many current AYA cancer websites contain these features.

PROCEDURE

Individual phone interviews were conducted with a convenience sample of 16 AYA with cancer from across North America in June 2005. Content analysis of these interviews were coded and validated for desired website features. Current AYA cancer websites were identified on the Internet and the features on these sites were compared to the features desired by our sample.

RESULTS

Favorite websites visited by AYA with cancer (cancer-related and unrelated) were identified along with current Internet use. Twenty-one distinct cancer website features desired by AYA with cancer were described. Twenty-seven unique AYA cancer websites were found on the Internet during May-June 2006. Each site contained 7.7 (SD = 2.7) of the 21 features identified by participants as desirable, but the highest ranked features did not occur in the majority of these websites.

CONCLUSIONS

AYA with cancer indicate that they prefer to visit cancer websites that contain cancer-related information, provide the ability to chat with AYA with cancer, and offer some type of game. Although many websites exist for AYA with cancer, few individual sites contain the web features identified as most desired by AYA with cancer.

Developing a web-based information resource for palliative care: an action-research inspired approach

Background

General Practitioners and community nurses rely on easily accessible, evidence-based online information to guide practice. To date, the methods that underpin the scoping of user-identified online information needs in palliative care have remained under-explored. This paper describes the benefits and challenges of a collaborative approach involving users and experts that informed the first stage of the development of a palliative care website [1].

Method

The action research-inspired methodology included a panel assessment of an existing palliative care website based in Victoria, Australia; a pre-development survey (n = 197) scoping potential audiences and palliative care information needs; working parties conducting a needs analysis about necessary information content for a redeveloped website targeting health professionals and caregivers/patients; an iterative evaluation process involving users and experts; as well as a final evaluation survey (n = 166).

Results

Involving users in the identification of content and links for a palliative care website is time-consuming and requires initial resources, strong networking skills and commitment. However, user participation provided crucial information that led to the widened the scope of the website audience and guided the development and testing of the website. The needs analysis underpinning the project suggests that palliative care peak bodies need to address three distinct audiences (clinicians, allied health professionals as well as patients and their caregivers).

Conclusion

Web developers should pay close attention to the content, language, and accessibility needs of these groups. Given the substantial cost associated with the maintenance of authoritative health information sites, the paper proposes a more collaborative development in which users can be engaged in the definition of content to ensure relevance and responsiveness, and to eliminate unnecessary detail. Access to volunteer networks forms an integral part of such an approach.

Breast and prostate cancer online discussion boards: a thematic analysis of gender differences and similarities

Online discussion boards are being used increasingly by cancer survivors, highlighting the need for understanding this potentially supportive communication process. Two online discussion boards, a prostate group and a breast cancer group, were studied using mixed methodology of both Grounded Theory and a quasi-numerative approach. Both men's and women's dialogues fell under two themes, information support and emotional support. Information support accounted for 60 per cent of communications in women and 64 per cent in men and emotional support 40 per cent in women and 36 per cent in men. However, there were gender differences in the language styles of these communications. Further research is recommended to understand adequately the emotional content within women's and men's dialogues in the context of breast and prostate cancer discussion boards.

Support provision and emotional work in an Internet support group for cancer patients

OBJECTIVE

The study examined the content and frequency of messages to an Internet support group, using a conceptual framework based on support-giving and emotional work. The main questions addressed concerned what correspondents seem to be gaining from their involvement and whether the high-frequency correspondents differ motivationally from the lower-frequency correspondents.

METHODS

Messages to an Internet support group for women with breast cancer were collected over 12 months. The number of contributions written by individual correspondents could be determined. Messages were reliably coded for their main themes in terms of seeking or providing support.

RESULTS

The majority of correspondents (94%) wrote fewer than 10 messages. Two high-frequency correspondents emerged whose messages significantly less often referred to seeking and more often to providing support than did the messages of the less-frequent correspondents. These volunteer emotion workers both reported gaining personal satisfaction from their role.

CONCLUSION

The high-frequency correspondents act as informal volunteer emotion workers for the other users, and valuably supplement the role of the group's initiators. Further research is needed on how to amplify the psychological rewards for volunteer emotion workers in online support groups for adults with cancer.

PRACTICE IMPLICATIONS

Volunteer assistants in electronic groups may be crucial to the sustainability of online support initiatives.

Patients' characteristics and rate of Internet use to obtain cancer information

The aim of this study was to present baseline data on the access to Internet by French breast cancer patients attending genetic clinics and to examine factors affecting Internet health-related use. Twenty-four percent of participants used Internet to obtain information about the disease. This rate was higher among patients with health occupations [adjusted odds ratio (adjOR) 2.6; 95% confidence interval (CI) 1.3-5.1], the most highly educated (adjOR 2.1; 95% CI 1.1-4.0) and those under 41 years of age (adjOR 7.3; 95% CI 2.1-26.2). Almost one of every three women was dissatisfied of this source of information.

Web Based Health Education, E-learning, for Weight Management

Obesity is a major health problem across the United States and becoming a progressive world wide problem. An overweight person could access the weight management program and develop a personalized weight reduction plan. The customer enters specific data to personalize the program and in the future an artificial intelligence program can evaluate customer behavior and adjust accordingly. This is an on-line program with class room support, offered as back up when desired by the patient.

Los cuidados de soporte en Oncología radioterápica

Over the past two decades radiation oncology has evolved into a high-technology, multi-disciplinary field of medicine which requires not only the command of highly complex modes of treatment but also the grouping together of skilled teams of medical professionals who are able to provide individualized assistance to the cancer patient. Supportive care in Radiation Oncology integrates key aspects of diagnosis and treatment with the objective of alleviating physical and psycho-social co-morbidities inherent in the disease, as well as the treatment of the cancer. This article addresses the impact of treatment on the individual and the issues facing health-provision professionals who provide clinical and supportive care. Future directions for clinical development are discussed.