An examination of online health information seeking by deaf people

Assessing Patient Feedback on the Feasibility of the YourRx Telepharmacy Mobile Application

Background: Telepharmacy is a method utilized in pharmacy practice that delivers pharmaceutical care services via telecommunication technology. In the Philippines, the current process for patients to avail of telepharmacy services utilizes a variety of existing applications or websites instead of a single application. Objectives: This study aimed to assess patient feedback on the feasibility of the newly developed telepharmacy mobile application, YourRx. Specifically, it evaluated the application's functionality, usability, security, and performance. Methods: The study had 3 phases: (1) the design and development phase, (2) the implementation phase, wherein the pharmacists and patients were oriented beforehand with the use of YourRx mobile application, and (3) the evaluation phase, where the mobile application was evaluated for its functionality, usability, security, and performance by the patients through the use of a survey questionnaire and an interview. Results: YourRx application was developed and evaluated successfully. It is available for Android users and has primary features, including video calls, sharing, and setting an appointment. A total of 46 patients used the YourRx. Most of the patients were very satisfied with the navigation, service acquisition, and overall design of the YourRx. They expressed convenience in acquiring telepharmacy services because the application was easy to understand, use, and navigate. Conclusion: YourRx is a pioneering telepharmacy mobile application in the Philippines. The results of this study substantiate that YourRx is a user-friendly platform that provides patients convenient access to telepharmacy services with less time and effort thus improving patient health outcomes.

Examining the differences of perceptions and experience with online health information accessibility between deaf and hearing individuals: A qualitative study

OBJECTIVE

Describe and compare the experiences and preferences of Deaf and hearing individuals with different levels of health literacy in accessing, interpreting, and acting upon online health information.

METHODS

We conducted semi-structured interviews with 17 Deaf and 10 hearing participants with high and low health literacy from three healthcare sites. We conducted thematic analysis of the transcripts to explore information navigation experiences, information sources and dissemination preferences.

RESULTS

We found thematic differences between Deaf and hearing participants with high and low health literacy in terms of information needs, information search experiences, information search perceptions, and preferred information dissemination approaches. Relative to hearing counterparts, Deaf participants were more likely to encounter challenges in accessing and understanding online information. Deaf participants with low health literacy were more likely to rely on visual graphics to support their understanding of the information than those with high health literacy. Deaf participants advocated for tailored approaches to disseminate health information to Deaf communities.

CONCLUSION

Our findings suggest that differences in online health information navigation experiences and accessibility may inform disparities in health literacy outcomes between Deaf and hearing individuals.

PRACTICE IMPLICATIONS

Online health information should be presented in a manner accessible to Deaf community members.

Using Gaze Tracking as a Research Tool in the Deaf Health Literacy and Access to Health Information Project: Protocol for a Multisite Mixed Methods Study and Preliminary Results

BACKGROUND

Previous studies have identified the internet as a major source of health information. Reliable and accessible sources of web-based health information are critical for cultivating patient-centered care. However, the accessibility and use of web-based health information remains largely unknown for deaf individuals. We used gaze-tracking technology to understand the navigation and use of web-based health information by deaf adults who communicate with sign language and by hearing adults.

OBJECTIVE

This paper discusses our protocol for implementing gaze-tracking technology in a study that included both deaf and hearing participants. We report the preliminary results and lessons learned from the implementation of the protocol.

METHODS

We conducted gaze-tracking sessions with 450 deaf signers and 450 hearing participants as a part of a larger, multisite mixed methods research study. Then, we conducted qualitative elicitation interviews with a subsample of 21 deaf and 13 hearing participants, who engaged in a search task and reviewed their gaze recordings. To our knowledge, no study has implemented a similar research protocol to better understand the experiences of deaf adults. As such, we also examined research staff notes and observations from team meetings regarding the conduct of gaze-tracking data to delineate lessons learned and best practices for research protocols in this area.

RESULTS

Findings from the implementation of this study protocol highlight the use of gaze technology with deaf participants. We developed additional protocol steps to minimize gaze disruption from either lipreading or communicating in sign language. For example, research assistants were often unable to maintain eye contact with participants while signing because of the need to simultaneously point at the computer monitor to provide instructions related to gaze study components, such as the calibration process. In addition to developing ways to effectively provide instructions in American Sign Language, a practice exercise was included in the gaze tracker session to familiarize participants with the computer and technology. The use of the playback feature permitted a deeper dialogue between researchers and participants, which we found vital for understanding the experiences of deaf participants.

CONCLUSIONS

On the basis of our experience using the study protocol through a large research project, incorporating gaze-tracking technology offers beneficial avenues for better understanding how individuals interact with health information. Gaze tracking can determine the type and placement of visual content that attracts attention from the viewers of diverse backgrounds, including deaf individuals. The lessons learned through this study will help future researchers in determining ideal study designs, such as suitable protocols and participant characteristics (eg, deaf signers), while including gaze trackers in their projects. This approach explored how different ways of presenting health information can affect or enable visual learners to engage and use health information effectively.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/26708.

Development of an Online Telepharmacy Service in the Philippines and Analysis of Its Usage During the COVID-19 Pandemic

Background: To augment traditional sources of health information at a time of reduced accessibility, a free online telepharmacy service was developed during the COVID-19 pandemic. Objectives: This study details the process of developing and operating an online telepharmacy service, analyzes its usage, and assesses users' health information-seeking patterns. Methods: The service utilized various platforms for receiving and processing queries, communication, and promotion. Submissions received from March 20 to May 31, 2020 were processed for analysis. Parameters analyzed were time patterns of query submission, response time, service feedback, user and patient demographics, and subjects of inquiry. Results: A total of 271 queries were analyzed. Query frequency decreased over time, consistent with relaxation of quarantine restrictions and increasing availability of information. Peak hours of query influx were outside typical business hours. The majority of users were from the general public (93.8%) and preferred to receive responses through text (61.2%). The majority of users from the general public belonged to the 15- to 25-year-old age group (41.1%) and sought information for oneself. Most submissions mentioned COVID-related topics. From the general public, there was greatest interest in drug indications and vitamins, supplements, and herbal products, and from healthcare professionals, in drug procurement. Users who provided feedback (n = 12) all expressed satisfaction with the service and the information they received. Conclusion: Transition to the "new normal" entails adopting alternative platforms to augment traditional sources of health information. An online telepharmacy service may be utilized to provide and clarify medication information as part of primary care.

Modelling the information seeking and searching behaviour of users with impairments: are existing models applicable?

Purpose

A substantial number of models have been developed over the years, with the purpose of describing the information seeking and searching of people in various user groups and contexts. Several models have been frequently applied in user studies, but are rarely included in research on participants with impairments. Models are purposeful when developing theories. Consequently, it might be valuable to apply models when studying this user group, as well. The purpose of this study was to explore whether existing models are applicable in describing the online information seeking and searching of users with impairments, with an overall aim to increase the use of models in studies involving impairments.

Design/methodology/approach

Six models were selected according to the following criteria: the model should address information seeking or searching, include the interaction between users and systems whilst incorporating assistive technology. Two user groups were selected from each of the categories: cognitive, sensory and motor impairments, namely dyslexia, autism, blindness, deafness, paralysation and Parkinson's. The models were then analysed based on known barriers reported for these cohorts.

Findings

All the selected models had potential to be applied in user studies involving impairments. While three of the models had the highest potential to be used in the current form, the other three models were applicable either through minor revisions or by combining models.

Originality/value

This study contributes with a new perspective on the use of models in information seeking and searching research on users with impairments.

Health information seeking and people with disability: A systematic search and scoping review

BACKGROUND

Health information and access to it are important aspects of maintaining health. There are 61 million people with disability in the U.S., many of whom experience health disparities. However, it may not be clear to health professionals how people with disability seek health information.

OBJECTIVE

Assess the breadth, examine the characteristics, and evaluate the risk of bias in the existing literature related to health information seeking and people with disability.

METHODS

The authors conducted a systematic search across five databases (Pubmed, Scopus, PsycINFO, HealthSTAR, and CINAHL) to identify empirical journal articles related to health information seeking among people with disability. Analysis of data items and a quality assessment were completed.

RESULTS

Forty-two articles met the criteria for inclusion and were assessed. The articles primarily used survey methodology (50%), and primarily focused on ten disability types, including MS (19%), CP (17%) and general disability (17%). The articles primarily investigated the internet (88%), and healthcare providers (71%) as sources of health information. Trustworthiness (31%), accuracy (29%), and accessibility (29%) were also commonly assessed. The overall quality was high, with room for improvement in minimizing bias.

CONCLUSIONS

The literature addressing health information seeking among people with disability is heterogeneous, but generally of high quality. Future research may benefit from an inclusive definition of disability and a more consistent definition of health information. Focused research on best practices and interactions among sources of health information would be valuable additions.

Genetic testing and eHealth usage among Deaf women

In the past decade, accessible information in American Sign Language (ASL) about cancer and genetic testing is expanding on eHealth platforms, including social network sites, commercial sites, and mobile apps. Primary data on genetic testing awareness and genetic testing for BRCA 1/2 among Deaf women were gathered using HINTS-ASL survey between November 2016 and April 2018, and secondary data for hearing women were drawn from NCI's HINTS 5 Cycle 1 survey in 2017. Deaf women who had heard of DNA testing (63%) were more likely to be young adults, college graduates, and/or have a family history of cancer. Compared to hearing women, Deaf women who had heard of genetic testing were more likely to use social networking sites to read or share information about medical topics and watch health-related videos. Making eHealth platforms accessible in ASL and easy-to-understand text can help reduce knowledge gap in genetic testing, since some Deaf women may not be using genetic testing to help identify whether they are at increased risk for breast and ovarian cancer early on, before they are diagnosed with cancer.

Accessibility assessment of assistive technology for the hearing impaired

Objective:

to assess the automatic accessibility of assistive technology in online courses for the hearing impaired.

Method:

evaluation study guided by the Assessment and Maintenance step proposed in the Model of Development of Digital Educational Material. The software Assessor and Simulator for the Accessibility of Sites (ASES) was used to analyze the online course "Education on Sexual and Reproductive Health: the use of condoms" according to the accessibility standards of national and international websites.

Results:

an error report generated by the program identified, in each didactic module, one error and two warnings related to two international principles and six warnings involved with six national recommendations. The warnings relevant to hearing-impaired people were corrected, and the course was considered accessible by automatic assessment.

Conclusion:

we concluded that the pages of the course were considered, by the software used, appropriate to the standards of web accessibility.

Promoting Help Seeking to Veterans

BACKGROUND

Few studies have considered different messaging strategies that may augment campaign efficacy to generate help-seeking behaviors among populations at increased risk for suicide, mainly US military veterans.

AIMS

Findings are presented from the pilot evaluation of the It's Your Call campaign implemented by the Department of Veterans Affairs (VA). Three messaging strategies (with varying intensity and mix of messages) were compared to explore which best promote use of the Veterans Crisis Line (VCL) among veteran populations.

METHOD

Daily VCL call data were obtained for 10 US cities during 2011-2012 where the campaign was active, and modeled using Poisson regression to identify changes in utilization patterns associated with the implementation of different messaging strategies.

RESULTS

Significant increases in call rates were only evident during the campaign in communities where mixed messages were disseminated. Further, use of mixed messages yielded greater increases in call rates when compared with the other tested strategies. This was an observational study where identification of causal relationships between variables was limited.

CONCLUSION

Findings are encouraging as messaging was associated with help seeking, and they provide insights into strategies that may rapidly promote crisis line use. Results also underscore the need for further research on suicide prevention campaigns and dissemination practices.

Disparities in Health Information Access: Results of a County-Wide Survey and Implications for Health Communication

Health knowledge and behavior can be shaped by the extent to which individuals have access to reliable and understandable health information. Based on data from a population-based telephone survey of 1,503 respondents of ages 18 years and older living in Douglas County, Nebraska, in 2013, this study assesses disparities in health information access and their related covariates. The two most frequently reported sources of health information are the Internet and health professionals, followed by print media, peers, and broadcast media. Relative to non-Hispanic Whites, Blacks are more likely to report health professionals as their primary source of health information (odds ratio [OR] = 2.61, p < .001) and less likely to report peers (OR = 0.39, p < .05). A comparison between Whites and Hispanics suggests that Hispanics are less likely to get their health information through the Internet (OR = 0.51, p < .05) and more likely to get it from broadcast media (OR = 4.27, p < .01). Relative to their counterparts, participants with no health insurance had significantly higher odds of reporting no source of health information (OR = 3.46, p < .05). Having no source of health information was also associated with an annual income below $25,000 (OR = 2.78, p < .05 compared to middle income range) and being born outside of the United States (OR = 5.00, p < .05). Access to health information is lowest among society's most vulnerable population groups. Knowledge of the specific outlets through which people are likely to obtain health information can help health program planners utilize the communication channels that are most relevant to the people they intend to reach.

Exploring women's responses to online media coverage of weight loss surgery

The purpose of this study was to understand the reactions of women to online news articles about weight loss surgery and related reader comments. Focus groups were conducted; open-ended questions were asked to elicit responses to existing online news media content related to weight loss surgery. The participants described the online articles as predominantly supportive of weight loss surgery and in response they expressed a desire to see more critical content, including different and competing perspectives. Participants felt the online comments represented extreme perspectives and were predominately negative. These were therefore not viewed as helpful or informative. Nevertheless, readers viewed comments as a form of entertainment. Because of the aggressive and anonymous nature of reader comments in response to online news stories, the participants did not feel comfortable leaving comments themselves on the news sites. Findings highlight the importance of gathering readers' perspectives in response to interactive media content and, in particular, health information.

Health information needs, sources, and barriers of primary care patients to achieve patient-centered care: A literature review

To synthesize findings from previous studies assessing information needs of primary care patients on the Internet and other information sources in a primary care setting. A systematic review of studies was conducted with a comprehensive search in multiple databases including OVID MEDLINE, CINAHL, and Scopus. The most common information needs among patients were information about an illness or medical condition and treatment methods, while the most common information sources were the Internet and patients' physicians. Overall, patients tend to prefer the Internet for the ease of access to information, while they trust their physicians more for their clinical expertise and experience. Barriers to information access via the Internet include the following: socio-demographic variables such as age, ethnicity, income, education, and occupation; information search skills; and reliability of health information.

CONCLUSION

Further research is warranted to assess how to create accurate and reliable health information sources for both Internet and non-Internet users.

Quality comparison of websites related to developmental disabilities

The Internet is commonly used to seek health-related information, but little is known about the quality of websites on developmental disabilities. Therefore, we sought to evaluate the characteristics and quality of websites located by searching ten common terms related to developmental disabilities and explore relations between website characteristics and website quality in order to make recommendations on ways to ensure locating good online information. We located 208 unique websites in our November 2012 US searches of Google and Bing. Two independent coders evaluated 10 characteristics of the websites and two different coders assessed the quality of the websites. From the 208 websites, 104 (50%) provided relevant information about the disability being searched. Of these 104 websites, those found to be of highest quality were least likely to be a sponsored result, contain advertisements, be from a for-profit company, and did contain references to peer-reviewed publications or had a top-level domain of .gov or .org. Individuals with developmental disabilities and their family members who choose to obtain disability-related information online should remain vigilant to ensure that they locate high-quality and accurate information and should not replace information obtained from health-care professionals and educational specialists with information found online.