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Mangal S, Berger L, Bruzzese JM, de la Cruz A, Lor M, Naqvi IA, Solis de Ovando E, Spiegel-Gotsch N, Stonbraker S, Arcia A. Seeing things the same way: perspectives and lessons learned from research-design collaborations. J Am Med Inform Assoc 2024; 31:542-547. [PMID: 37437899 PMCID: PMC10797272 DOI: 10.1093/jamia/ocad124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/15/2023] [Accepted: 07/10/2023] [Indexed: 07/14/2023] Open
Abstract
Information visualizations are increasingly being developed by informatics researchers to communicate health information to lay audiences. For high-quality results, it is advisable to collaborate with creative professionals such as graphic designers, illustrators, or user interface/user experience designers. However, such collaborations are often a novel experience for both parties, each of which may be unfamiliar with the needs and processes of the other. We have coalesced our experiences from both the research and design perspectives to offer practical guidance in hopes of promoting the success of future collaborations. We offer suggestions for determining design needs, communicating with design professionals, and carrying out the design process. We assert that successful collaborations are predicated on careful and intentional planning at the outset of a project, a thorough understanding of each party's scope expertise, clear communication, and ample time for the design process to unfold.
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Affiliation(s)
- Sabrina Mangal
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA
| | | | | | | | - Maichou Lor
- University of Wisconsin-Madison School of Nursing, Madison, Wisconsin, USA
| | - Imama A Naqvi
- Department of Neurology, Division of Stroke and Cerebrovascular Diseases, Columbia University Irving Medical Center, New York, New York, USA
| | - Eugenio Solis de Ovando
- Seidenberg School of Computer Science and Information Systems, Pace University, New York, New York, USA
| | | | | | - Adriana Arcia
- Hahn School of Nursing and Health Science, University of San Diego, San Diego, California, USA
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Brin M, Trujillo P, Huang MC, Cioe P, Chen H, Xu W, Schnall R. Development and evaluation of visualizations of smoking data for integration into the Sense2Quit app for tobacco cessation. J Am Med Inform Assoc 2024; 31:354-362. [PMID: 37632226 PMCID: PMC10797277 DOI: 10.1093/jamia/ocad162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/29/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
IMPORTANCE Due to insufficient smoking cessation apps for persons living with HIV, our study focused on designing and testing the Sense2Quit app, a patient-facing mHealth tool which integrated visualizations of patient information, specifically smoking use. OBJECTIVES The purpose of this paper is to detail rigorous human-centered design methods to develop and refine visualizations of smoking data and the contents and user interface of the Sense2Quit app. The Sense2Quit app was created to support tobacco cessation and relapse prevention for people living with HIV. MATERIALS AND METHODS Twenty people living with HIV who are current or former smokers and 5 informaticians trained in human-computer interaction participated in 5 rounds of usability testing. Participants tested the Sense2Quit app with use cases and provided feedback and then completed a survey. RESULTS Visualization of smoking behaviors was refined through each round of usability testing. Further, additional features such as daily tips, games, and a homescreen were added to improve the usability of the app. A total of 66 changes were made to the Sense2Quit app based on end-user and expert recommendations. DISCUSSION While many themes overlapped between usability testing with end-users and heuristic evaluations, there were also discrepancies. End-users and experts approached the app evaluation from different perspectives which ultimately allowed us to fill knowledge gaps and make improvements to the app. CONCLUSION Findings from our study illustrate the best practices for usability testing for development and refinement of an mHealth-delivered consumer informatics tool for improving tobacco cessation yet further research is needed to fully evaluate how tools informed by target user needs improve health outcomes.
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Affiliation(s)
- Maeve Brin
- School of Nursing, Columbia University, New York, NY, United States
| | - Paul Trujillo
- School of Nursing, Columbia University, New York, NY, United States
| | - Ming-Chun Huang
- School of Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Patricia Cioe
- School of Public Health, Brown University, Providence, RI, United States
| | - Huan Chen
- School of Engineering, Case Western Reserve University, Cleveland, OH, United States
| | - Wenyao Xu
- Department of Computer Science & Engineering, University at Buffalo, the State University of New York, Buffalo, NY, United States
| | - Rebecca Schnall
- School of Nursing, Columbia University, New York, NY, United States
- Columbia University School of Public Health, New York, NY, United States
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Chau D, Parra J, Santos MG, Bastías MJ, Kim R, Handley MA. Community engagement in the development of health-related data visualizations: a scoping review. J Am Med Inform Assoc 2024; 31:479-487. [PMID: 37279890 PMCID: PMC10797278 DOI: 10.1093/jamia/ocad090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/07/2023] [Accepted: 05/10/2023] [Indexed: 06/08/2023] Open
Abstract
OBJECTIVE This scoping review aims to address a gap in the literature on community engagement in developing data visualizations intended to improve population health. The review objectives are to: (1) synthesize literature on the types of community engagement activities conducted by researchers working with community partners and (2) characterize instances of "creative data literacy" within data visualizations developed in community-researcher partnerships. METHODS Using the 2018 PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, the review focuses on peer-reviewed journal articles from 2010 to 2022 in PubMed, Web of Science, and Google Scholar. A community engagement tool was applied to the studies by independent reviewers to classify levels of community engagement, social determinants, and vulnerable populations. RESULTS Twenty-seven articles were included in the scoping review. Twelve articles worked with vulnerable populations. Four articles attempted to alleviate barriers to representation in their respective studies, with addressing language barriers being the most prevalent approach. Thirteen articles considered social determinants of health. Sixteen studies engaged in iterative approaches with intended users when developing the visualization or tool. DISCUSSION Only a few significant examples of creative data literacy are incorporated in the studies. We recommend a specific focus on engaging intended users at every step of the development process, addressing language and cultural differences, and empowering intended users as data storytellers. CONCLUSIONS There is room for deeper and more meaningful community involvement in the development of health-related data visualizations geared towards them.
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Affiliation(s)
- Darren Chau
- University of California Berkeley, Berkeley, California, USA
| | - José Parra
- Partnerships for Research in Implementation Science for Equity (PRISE) Center at University of California San Francisco, San Francisco, California, USA
| | - Maricel G Santos
- Department of English Language & Literature, San Francisco State University, San Francisco, California, USA
| | - María José Bastías
- Graduate College of Education, San Francisco State University, San Francisco, California, USA
| | - Rebecca Kim
- Department of English Language & Literature, San Francisco State University, San Francisco, California, USA
| | - Margaret A Handley
- Partnerships for Research in Implementation Science for Equity (PRISE) Center at University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Pila S, Stern BZ, Rothrock NE, Franklin PD. Evaluating a web-based personalized decision report for total knee or hip replacement: Lessons learned from patients. J Eval Clin Pract 2023; 29:844-853. [PMID: 37316454 PMCID: PMC11210323 DOI: 10.1111/jep.13887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/16/2023]
Abstract
RATIONALE Patient-reported outcomes (PROs) are increasingly used in the context of clinical care, but evaluation of patients' perspectives of PRO-based applications in routine care remains limited. AIMS AND OBJECTIVES This paper investigates patients' acceptability of a personalized web-based decision report for total knee or hip replacement and identifies opportunities to refine the report. METHOD This qualitative evaluation was embedded in a pragmatic cluster randomized trial of the report. We interviewed 25 patients with knee and hip osteoarthritis about their experiences using the personalized decision report in the context of a surgical consultation. The web-based report contained current descriptive PRO scores of pain, function and general physical health; tailored predicted postoperative PRO scores (i.e., personalized likely outcomes based on actual knee or hip replacement outcomes of similar patients in a national registry); and information about alternative nonoperative treatments. Two trained researchers analysed the interview data qualitatively using a combination of inductive and deductive coding. RESULTS We identified three major categories for evaluation: content of report, presentation of data in report and engagement with report. Patients generally liked the report overall but specifically valued different pages of the report based on where they were in the surgical decision-making process. Patients identified areas of confusion in data presentation related to graph orientation, terminology and interpretation of T-scores. Patients also highlighted support needs to meaningfully engage with the information in the report. CONCLUSION Our findings highlight areas of opportunity to further refine this personalized web-based decision report and similar patient-facing PRO applications for routine clinical care. Specific examples include additional tailoring of reports via filterable web-based dashboards and scalable educational supports to facilitate more independent patient understanding and use.
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Affiliation(s)
- Sarah Pila
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brocha Z Stern
- Center for Education in Health Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nan E Rothrock
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Patricia D Franklin
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Turner K, Stover AM, Tometich DB, Geiss C, Mason A, Nguyen OT, Hume E, McCormick R, Powell S, Hallanger-Johnson J, Patel KB, Kirtane KS, Jammigumpula N, Moore C, Perkins R, Rollison DE, Jim HS, Oswald LB, Crowder S, Gonzalez BD, Robinson E, Tabriz AA, Islam JY, Gilbert SM. Oncology Providers' and Professionals' Experiences With Suicide Risk Screening Among Patients With Head and Neck Cancer: A Qualitative Study. JCO Oncol Pract 2023; 19:e892-e903. [PMID: 36395441 PMCID: PMC10337750 DOI: 10.1200/op.22.00433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE There has been limited study of the implementation of suicide risk screening for patients with head and neck cancer (HNC) as a part of routine care. To address this gap, this study assessed oncology providers' and professionals' perspectives about barriers and facilitators of implementing a suicide risk screening among patients with HNC. MATERIALS AND METHODS All patients with HNC with an in-person visit completed a suicide risk screening on an electronic tablet. Patients reporting passive death wish were then screened for active suicidal ideation and referred for appropriate intervention. Interviews were conducted with 25 oncology providers and professionals who played a key role in implementation including nurses, medical assistants, patient access representatives, advanced practice providers, physicians, social workers, and informatics staff. The interview guide was based on the Consolidated Framework for Implementation Research. Interviews were transcribed and analyzed for themes. RESULTS Participants identified multilevel implementation barriers, such as intervention level (eg, patient difficulty with using a tablet), process level (eg, limited nursing engagement), organizational level (eg, limited clinic Wi-Fi connectivity), and individual level (eg, low clinician self-efficacy for interpreting and acting upon patient-reported outcome scores). Participants noted facilitators, such as effective care coordination across nursing and social work staff and the opportunity for patients to be screened multiple times. Participants recommended strengthening patient and clinician education and providing patients with other modalities for data entry (eg, desktop computer in the waiting room). CONCLUSION Participants identified important intervention modifications that may be needed to optimize suicide risk screening in cancer care settings.
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Affiliation(s)
- Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Angela M. Stover
- Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC
| | | | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL
| | - Arianna Mason
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL
| | - Oliver T. Nguyen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Emma Hume
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Rachael McCormick
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Sean Powell
- Department of Social Work, Moffitt Cancer Center, Tampa, FL
| | | | - Krupal B. Patel
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL
| | - Kedar S. Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL
| | - Neelima Jammigumpula
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
| | - Colin Moore
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | - Randa Perkins
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
- Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL
| | - Dana E. Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Sylvia Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Edmondo Robinson
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
- Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL
| | - Amir Alishahi Tabriz
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Jessica Y. Islam
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Scott M. Gilbert
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
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6
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Turchioe MR, Mangal S, Goyal P, Axsom K, Myers A, Liu LG, Lee J, Campion TR, Creber RM. A RE-AIM Evaluation of a Visualization-Based Electronic Patient-Reported Outcome System. Appl Clin Inform 2023; 14:227-237. [PMID: 36603838 PMCID: PMC10033223 DOI: 10.1055/a-2008-4036] [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: 08/08/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Health care systems are primarily collecting patient-reported outcomes (PROs) for research and clinical care using proprietary, institution- and disease-specific tools for remote assessment. The purpose of this study was to conduct a Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) evaluation of a scalable electronic PRO (ePRO) reporting and visualization system in a single-arm study. METHODS The "mi.symptoms" ePRO system was designed using gerontechnological design principles to ensure high usability among older adults. The system enables longitudinal reporting of disease-agnostic ePROs and includes patient-facing PRO visualizations. We conducted an evaluation of the implementation of the system guided by the RE-AIM framework. Quantitative data were analyzed using basic descriptive statistics, and qualitative data were analyzed using directed content analysis. RESULTS Reach-the total reach of the study was 70 participants (median age: 69, 31% female, 17% Black or African American, 27% reported not having enough financial resources). Effectiveness-half (51%) of participants completed the 2-week follow-up survey and 36% completed all follow-up surveys. Adoption-the desire for increased self-knowledge, the value of tracking symptoms, and altruism motivated participants to adopt the tool. Implementation-the predisposing factor was access to, and comfort with, computers. Three enabling factors were incorporation into routines, multimodal nudges, and ease of use. Maintenance-reinforcing factors were perceived usefulness of viewing symptom reports with the tool and understanding the value of sustained symptom tracking in general. CONCLUSION Challenges in ePRO reporting, particularly sustained patient engagement, remain. Nonetheless, freely available, scalable, disease-agnostic systems may pave the road toward inclusion of a more diverse range of health systems and patients in ePRO collection and use.
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Affiliation(s)
| | - Sabrina Mangal
- University of Washington School of Nursing, Seattle, Washington, United States
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Parag Goyal
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, United States
| | - Kelly Axsom
- Division of Cardiology, Center for Advanced Cardiac Care, Columbia University Medical Center, New York, New York, United States
| | - Annie Myers
- Columbia University School of Nursing, New York, New York, United States
| | - Lisa G. Liu
- Department of Pediatrics, University of California San Francisco, San Francisco, California, United States
| | - Jessie Lee
- Department of Pediatrics, University of California San Francisco, San Francisco, California, United States
| | - Thomas R. Campion
- University of Washington School of Nursing, Seattle, Washington, United States
- Clinical and Translational Science Center, Weill Cornell Medicine, New York, New York, United States
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7
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Mavragani A, Johnston FH, Campbell SL, Williamson GJ, Lucani C, Bowman DMJS, Cooling N, Jones PJ. Evaluating User Preferences, Comprehension, and Trust in Apps for Environmental Health Hazards: Qualitative Case Study. JMIR Form Res 2022; 6:e38471. [PMID: 36548030 PMCID: PMC9816954 DOI: 10.2196/38471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Climate change is projected to increase environmental health hazard risks through fire-related air pollution and increased airborne pollen levels. To protect vulnerable populations, it is imperative that evidence-based and accessible interventions are available. The environmental health app, AirRater, was developed in 2015 in Australia to provide information on multiple atmospheric health hazards in near real time. The app allows users to view local environmental conditions, and input and track their personal symptoms to enable behaviors that protect health in response to environmental hazards. OBJECTIVE This study aimed to develop insights into users' perceptions of engagement, comprehension, and trust in AirRater to inform the future development of environmental health apps. Specifically, this study explored which AirRater features users engaged with, what additional features or functionality needs users felt they required, users' self-perception of understanding app information, and their level of trust in the information provided. METHODS A total of 42 adult AirRater users were recruited from 3 locations in Australia to participate in semistructured interviews to capture location- or context-specific experiences. Participants were notified of the recruitment opportunity through multiple avenues including newsletter articles and social media. Informed consent was obtained before participation, and the participants were remunerated for their time and perspectives. A preinterview questionnaire collected data including age range, any preexisting conditions, and location (postcode). All participant data were deidentified. Interviews were recorded, transcribed, and analyzed using thematic analysis in NVivo 12 (QSR International). RESULTS Participants discussed app features and functionality, as well as their understanding of, and trust in, the information provided by the app. Most (26/42, 62%) participants used and valued visual environmental hazard features, especially maps, location settings, and hazard alerts. Most (33/42, 78%) found information in the app easy to understand and support their needs, irrespective of their self-reported literacy levels. Many (21/42, 50%) users reported that they did not question the accuracy of the data presented in the app. Suggested enhancements include the provision of meteorological information (eg, wind speed or direction, air pressure, UV rating, and humidity), functionality enhancements (eg, forecasting, additional alerts, and the inclusion of health advice), and clarification of existing information (eg, symptom triggers), including the capacity to download personal summary data for a specified period. CONCLUSIONS Participants' perspectives can inform the future development of environmental health apps. Specifically, participants' insights support the identification of key elements for the optimal development of environmental health app design, including streamlining, capacity for users to customize, use of real time data, visual cues, credibility, and accuracy of data. The results also suggest that, in the future, iterative collaboration between developers, environmental agencies, and users will likely promote better functional design, user trust in the data, and ultimately better population health outcomes.
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Affiliation(s)
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Public Health Services, Tasmanian Department of Health, Hobart, Australia
| | - Sharon L Campbell
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.,Public Health Services, Tasmanian Department of Health, Hobart, Australia
| | | | - Chris Lucani
- School of Natural Sciences, University of Tasmania, Hobart, Australia
| | | | - Nick Cooling
- School of Medicine, University of Tasmania, Hobart, Australia
| | - Penelope J Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
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O'Hara DV, Yi TW, Lee VW, Jardine M, Dawson J. Digital health technologies to support medication adherence in chronic kidney disease. Nephrology (Carlton) 2022; 27:917-924. [PMID: 36176176 PMCID: PMC9828762 DOI: 10.1111/nep.14113] [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: 05/08/2022] [Revised: 07/24/2022] [Accepted: 09/17/2022] [Indexed: 01/12/2023]
Abstract
Non-adherence to medications is a critical challenge in the management of people with chronic kidney disease (CKD). This review explores the complexities of adherence in this population, the unique barriers and enablers of good adherence behaviours, and the role of emerging digital health technologies in bridging the gap between evidence-based treatment plans and the real-world standard of care. We present the current evidence supporting the use of digital health interventions among CKD populations, identifying the key research questions that remain unanswered, and providing practical strategies for clinicians to support medication adherence in a digital age.
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Affiliation(s)
- Daniel V. O'Hara
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Renal MedicineRoyal North Shore HospitalSydneyNew South WalesAustralia
| | - Tae Won Yi
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia,Department of Medicine, Clinician Investigator ProgramUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | - Vincent W. Lee
- Department of Renal MedicineWestmead HospitalSydneyNew South WalesAustralia,Westmead Applied Research Centre, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Meg Jardine
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Renal MedicineConcord Repatriation General HospitalSydneyNew South WalesAustralia
| | - Jessica Dawson
- NHMRC Clinical Trials CentreThe University of SydneySydneyNew South WalesAustralia,Department of Nutrition and DieteticsSt George HospitalSydneyNew South WalesAustralia
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Marzouk S, He S, Lee J. Emoji Education: How Students Can Help Increase Health Awareness by Making Emojis. JMIR MEDICAL EDUCATION 2022; 8:e39059. [PMID: 36367758 PMCID: PMC9700240 DOI: 10.2196/39059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 09/08/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Emojis can improve health communication, especially when incorporating emojis into traditionally word-only texts. Beyond improving communication, emojis also offer greater access to health care, especially for vulnerable and marginalized populations with limited health literacy. A recent study found that 94% of patients with limited health literacy preferred health reports with emojis. Moreover, health officials are considering adding emojis to cardiopulmonary resuscitation guidelines and public health guidelines for handwashing. As the world evolves with new technology and new methods of communication, we must also evolve the language and method we use to communicate health information to patients. In this viewpoint, we aim to discuss the methods health care professionals can use to develop novel communication methods using emojis and the benefits of their incorporation into health care communication.
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Affiliation(s)
- Sammer Marzouk
- Department of Chemistry and Chemical Biology, Harvard College, Cambridge, MA, United States
| | - Shuhan He
- Massachusetts General Hospital, Boston, MA, United States
| | - Jarone Lee
- Massachusetts General Hospital, Boston, MA, United States
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10
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Bakken S. Meeting the information and communication needs of health disparate populations. J Am Med Inform Assoc 2022; 29:1827-1828. [PMID: 36217862 PMCID: PMC9552280 DOI: 10.1093/jamia/ocac164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023] Open
Affiliation(s)
- Suzanne Bakken
- Department of Biomedical Informatics, School of Nursing, Data Science Institute, Columbia University, New York, New York, USA
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11
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Snyder LE, Phan DF, Williams KC, Piqueiras E, Connor SE, George S, Kwan L, Villatoro Chavez J, Tandel MD, Frencher SK, Litwin MS, Gore JL, Hartzler AL. Comprehension, utility, and preferences of prostate cancer survivors for visual timelines of patient-reported outcomes co-designed for limited graph literacy: meters and emojis over comics. J Am Med Inform Assoc 2022; 29:1838-1846. [PMID: 36040190 PMCID: PMC9552288 DOI: 10.1093/jamia/ocac148] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/10/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Visual timelines of patient-reported outcomes (PRO) can help prostate cancer survivors manage longitudinal data, compare with population averages, and consider future trajectories. PRO visualizations are most effective when designed with deliberate consideration of users. Yet, graph literacy is often overlooked as a design constraint, particularly when users with limited graph literacy are not engaged in their development. We conducted user testing to assess comprehension, utility, and preference of longitudinal PRO visualizations designed for prostate cancer survivors with limited literacy. MATERIALS AND METHODS Building upon our prior work co-designing longitudinal PRO visualizations with survivors, we engaged 18 prostate cancer survivors in a user study to assess 4 prototypes: Meter, Words, Comic, and Emoji. During remote sessions, we collected data on prototype comprehension (gist and verbatim), utility, and preference. RESULTS Participants were aged 61-77 (M = 69), of whom half were African American. The majority of participants had less than a college degree (95%), had inadequate health literacy (78%), and low graph literacy (89%). Among the 4 prototypes, Meter had the best gist comprehension and was preferred. Emoji was also preferred, had the highest verbatim comprehension, and highest rated utility, including helpfulness, confidence, and satisfaction. Meter and Words both rated mid-range for utility, and Words scored lower than Emoji and Meter for comprehension. Comic had the poorest comprehension, lowest utility, and was least preferred. DISCUSSION Findings identify design considerations for PRO visualizations, contributing to the knowledge base for visualization best practices. We describe our process to meaningfully engage patients from diverse and hard-to-reach groups for remote user testing, an important endeavor for health equity in biomedical informatics. CONCLUSION Graph literacy is an important design consideration for PRO visualizations. Biomedical informatics researchers should be intentional in understanding user needs by involving diverse and representative individuals during development.
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Affiliation(s)
- Lauren E Snyder
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Daniel F Phan
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
- Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA
| | - Kristen C Williams
- Department of Urology, University of California, Los Angeles, California, USA
| | - Eduardo Piqueiras
- Department of Urology, University of California, Los Angeles, California, USA
| | - Sarah E Connor
- Department of Urology, University of California, Los Angeles, California, USA
| | - Sheba George
- Department of Community Health Sciences, The Fielding School of Public Health, University of California, Los Angeles, California, USA
- Department of Preventive & Social Medicine and the Center for Biomedical Informatics, Charles R. Drew University of Medicine & Science, Los Angeles, California, USA
| | - Lorna Kwan
- Department of Urology, University of California, Los Angeles, California, USA
| | | | - Megha D Tandel
- Department of Urology, University of California, Los Angeles, California, USA
| | - Stanley K Frencher
- Department of Urology, University of California, Los Angeles, California, USA
| | - Mark S Litwin
- Department of Urology, University of California, Los Angeles, California, USA
- Department of Community Health Sciences, The Fielding School of Public Health, University of California, Los Angeles, California, USA
- School of Nursing, University of California, Los Angeles, California, USA
- Department of Health Policy & Management, The Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - John L Gore
- Department of Urology, University of Washington, Seattle, Washington, USA
| | - Andrea L Hartzler
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
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12
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Kim MT, Heitkemper EM, Hébert ET, Hecht J, Crawford A, Nnaka T, Hutson TS, Rhee H, Radhakrishnan K. Redesigning culturally tailored intervention in the precision health era: Self-management science context. Nurs Outlook 2022; 70:710-724. [PMID: 35933178 PMCID: PMC9722518 DOI: 10.1016/j.outlook.2022.05.015] [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: 01/17/2022] [Revised: 05/18/2022] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nurse scientists have significantly contributed to health equity and ensuring cultural tailoring of interventions to meet unique needs of individuals. Methodologies for cultural tailoring of self-mangament interventions among marginalized populations have limitedly accommodated intersectionality and group heterogeneity when addressing health needs. PURPOSE Identify methodological limitations in cultural tailoring of interventions among priority populations and issue recommendations on cultural elements that researchers can target to ensure valid cultural tailoring approaches. METHODS Synthesis of literature on health equity, self-management, and implementation and dissemination research. FINDINGS Among priority populations, intersectionality and group heterogeneity has made group-based cultural tailoring approaches less effective in eliciting desirable health outcomes. Precision health methodology could be useful for cultural tailoring of interventions due to the methodology's focus on individual-level tailoring approaches. DISCUSSION We offer ways to advance health equity research using precision health approaches in cultural tailoring through targeting unique elements of culture and relevant psychosocial phenotypes.
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Affiliation(s)
- Miyong T Kim
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX.
| | - Elizabeth M Heitkemper
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
| | - Emily T Hébert
- The Center for Health Equity Research, Health Science Center at Houston, School of Publics Health Austin, The University of Texas, Austin, TX
| | - Jacklyn Hecht
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
| | - Alison Crawford
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
| | - Tonychris Nnaka
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
| | - Tara S Hutson
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
| | - Hyekyun Rhee
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
| | - Kavita Radhakrishnan
- The Center for Health Equity Research, School of Nursing, The University of Texas, Austin, TX
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13
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Myers ER. Core feature sets: not just for outcomes, not just for research. Am J Obstet Gynecol 2022; 226:605-606. [PMID: 35500999 DOI: 10.1016/j.ajog.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/01/2022] [Indexed: 11/26/2022]
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14
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Hyland CJ, Guo R, Dhawan R, Kaur MN, Bain PA, Edelen MO, Pusic AL. Implementing patient-reported outcomes in routine clinical care for diverse and underrepresented patients in the United States. J Patient Rep Outcomes 2022; 6:20. [PMID: 35254556 PMCID: PMC8901833 DOI: 10.1186/s41687-022-00428-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient-reported outcomes (PROs) are used increasingly in routine clinical care and inform policies, reimbursements, and quality improvement. Less is known regarding PRO implementation in routine clinical care for diverse and underrepresented patient populations. OBJECTIVE This review aims to identify studies of PRO implementation in diverse and underrepresented patient populations, elucidate representation of clinical specialties, assess implementation outcomes, and synthesize patient needs, concerns, and preferences. METHODS MEDLINE, Embase, Web of Science, CINAHL, and PsycINFO were searched September 2021 for studies aiming to study PRO implementation in diverse and underrepresented patient populations within the United States. Studies were screened and data extracted by three independent reviewers. Implementation outcomes were assessed according to Proctor et al. taxonomy. A descriptive analysis of data was conducted. RESULTS The search yielded 8,687 records, and 28 studies met inclusion criteria. The majority were observational cohort studies (n = 21, 75%) and conducted in primary care (n = 10, 36%). Most studies included majority female (n = 19, 68%) and non-White populations (n = 15, 54%), while fewer reported socioeconomic (n = 11, 39%) or insurance status (n = 9, 32.1%). Most studies assessed implementation outcomes of feasibility (n = 27, 96%) and acceptability (n = 19, 68%); costs (n = 3, 11%), penetration (n = 1, 4%), and sustainability (n = 1, 4%) were infrequently assessed. CONCLUSION PRO implementation in routine clinical care for diverse and underrepresented patient populations is generally feasible and acceptable. Research is lacking in key clinical specialties. Further work is needed to understand how health disparities drive PRO implementation outcomes.
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Affiliation(s)
- Colby J Hyland
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
| | - Ruby Guo
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Ravi Dhawan
- Harvard School of Public Health, Brigham and Women's Hospital, Boston, MA, USA
| | - Manraj N Kaur
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Paul A Bain
- Harvard Medical School, Countway Library, Boston, MA, USA
| | - Maria O Edelen
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrea L Pusic
- Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
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15
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Hernandez-Sanchez S, Moreno-Perez V, Garcia-Campos J, Marco-Lledó J, Navarrete-Muñoz EM, Lozano-Quijada C. Twelve tips to make successful medical infographics. MEDICAL TEACHER 2021; 43:1353-1359. [PMID: 33342338 DOI: 10.1080/0142159x.2020.1855323] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
In the health sciences, professionals must keep up to date to conduct their evidence-based practise. Hence, there is a growing need to share medical knowledge efficiently among healthcare professionals, patients, and undergraduate health science students. Infographics (text and image) are a hybrid element that serves to represent information in an attractive and meaningful visual format. Actually, with the use of the Internet and social networks, infographics have become a popular format for sharing medical information around the world.On the basis of a published literature review, we provide 12 tips in this article to make a successfully health-related infographic with the aim of assisting clinicians, educators, and researchers in their task of communicating and transforming complex information into a visual, attractive, didactic and shareable format.By following these basic recommendations, it is possible to improve the dissemination of scientific and health-related knowledge to different audiences who can benefit from infographics.
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Affiliation(s)
- Sergio Hernandez-Sanchez
- Traslational Research Centre of Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Victor Moreno-Perez
- Traslational Research Centre of Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Jonatan Garcia-Campos
- Department of Behavioral Sciences and Health, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Javier Marco-Lledó
- Department of Behavioral Sciences and Health, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Eva Maria Navarrete-Muñoz
- Traslational Research Centre of Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Carlos Lozano-Quijada
- Traslational Research Centre of Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
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16
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Affiliation(s)
- Debbie Lai
- Division of Psychology and Language Sciences, University College of London, London, UK
| | - Jennifer 8 Lee
- Emojination and Unicode Consortium, Mountain View, California
| | - Shuhan He
- Department of Emergency Medicine, Massachusetts General Hospital, Boston
- Lab of Computer Science, Department of Internal Medicine, Center for Innovation in Digital Healthcare, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
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17
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Senathirajah Y, Hribar M. Human Factors and Organizational Issues Section Synopsis IMIA Yearbook 2021. Yearb Med Inform 2021; 30:100-104. [PMID: 34479383 PMCID: PMC8416209 DOI: 10.1055/s-0041-1726524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE To select the best papers that made original and high impact contributions in the area of human factors and organizational issues in biomedical informatics in 2020. METHODS A rigorous extraction process based on queries from Web of Science® and PubMed/Medline was conducted to identify the scientific contributions published in 2020 that address human factors and organizational issues in biomedical informatics. The screening of papers on titles and abstracts independently by the two section editors led to a total of 1,562 papers. These papers were discussed for a selection of 12 finalist papers, which were then reviewed by the two section editors, two chief editors, and by three external reviewers from internationally renowned research teams. RESULTS The query process resulted in 12 papers that reveal interesting and rigorous methods and important studies in human factors that move the field forward, particularly in clinical informatics and emerging technologies such as brain-computer interfaces. This year three papers were clearly outstanding and help advance in the field. They provide examples of applying existing frameworks together in novel and highly illuminating ways, showing the value of theory development in human factors. Emerging themes included several which discussed physician burnout, mobile health, and health equity. Those concerning the Corona Virus Disease 2019 (Covid-19) were included as part of that section. CONCLUSION The selected papers make important contributions to human factors and organizational issues, expanding and deepening our knowledge of how to apply theory and applications of new technologies in health.
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Affiliation(s)
- Yalini Senathirajah
- U. Pittsburgh School of Medicine, Dept. of Biomedical Informatics, Pittsburgh, PA, USA
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18
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Abstract
OBJECTIVE Human factors and ergonomics (HF/E) frameworks and methods are becoming embedded in the health informatics community. There is now broad recognition that health informatics tools must account for the diverse needs, characteristics, and abilities of end users, as well as their context of use. The objective of this review is to synthesize the current nature and scope of HF/E integration into the health informatics community. METHODS Because the focus of this synthesis is on understanding the current integration of the HF/E and health informatics research communities, we manually reviewed all manuscripts published in primary HF/E and health informatics journals during 2020. RESULTS HF/E-focused health informatics studies included in this synthesis focused heavily on EHR customizations, specifically clinical decision support customizations and customized data displays, and on mobile health innovations. While HF/E methods aimed to jointly improve end user safety, performance, and satisfaction, most HF/E-focused health informatics studies measured only end user satisfaction. CONCLUSION HF/E-focused health informatics researchers need to identify and communicate methodological standards specific to health informatics, to better synthesize findings across resource intensive HF/E-focused health informatics studies. Important gaps in the HF/E design and evaluation process should be addressed in future work, including support for technology development platforms and training programs so that health informatics designers are as diverse as end users.
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19
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Efficacy, Use, and Usability of the VIP-HANA App for Symptom Self-management in PLWH with HANA Conditions. AIDS Behav 2021; 25:1699-1710. [PMID: 33386508 DOI: 10.1007/s10461-020-03096-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2020] [Indexed: 01/27/2023]
Abstract
The purpose of this study was to evaluate the efficacy of the VIP-HANA application (app) for improving symptom burden in a randomized control trial of 100 people living with HIV (PLWH) who have non-AIDS conditions associated with HIV. The intervention group received the VIP-HANA app which allowed them to report their symptoms every week and receive self-management strategies tailored to their symptoms. The control arm received an app to report their symptoms every week but did not receive any strategies. The results of our study suggest that symptom burden improved in the participants of both study arms. Although these findings do not support the efficacy of VIP-HANA in improving symptom burden in PLWH who have HIV-associated non-AIDS (HANA) conditions, this could be a function of the study design. Findings suggest that PLWH are interested in monitoring their symptoms, which could have implications for the wider use of digital health for patient surveillance.
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20
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Chiang S, Moss R, Black AP, Jackson M, Moss C, Bidwell J, Meisel C, Loddenkemper T. Evaluation and recommendations for effective data visualization for seizure forecasting algorithms. JAMIA Open 2021; 4:ooab009. [PMID: 33709064 PMCID: PMC7935496 DOI: 10.1093/jamiaopen/ooab009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 12/15/2022] Open
Abstract
Objective Seizure forecasting algorithms have become increasingly accurate and may reduce the morbidity and mortality caused by seizure unpredictability. Translating these benefits into meaningful health outcomes for people with epilepsy requires effective data visualization of algorithm outputs. To date, no studies have investigated patient and physician perspectives on effective translation of algorithm outputs into data visualizations through health information technology. Materials and Methods We developed front-end data visualizations as part of a Seizure Forecast Visualization Toolkit. We surveyed 627 people living with epilepsy and caregivers, and 28 epilepsy healthcare providers. Respondents scored each visualization in terms of international standardized software quality criteria for functionality, appropriateness, and usability. Results People with epilepsy and caregivers ranked hourly radar charts highest for protecting against errors in interpreting forecasts, reducing anxiety from seizure unpredictability, and understanding seizure patterns. Accuracy in interpreting visuals, such as a risk gauge, was dependent on seizure frequency. Visuals showing hourly/daily forecasts were more useful for patients who experienced seizure cycling than those who did not. Hourly line graphs and monthly heat maps were rated highest among clinicians for ease of understanding, anticipated integration into clinical practice, and the likelihood of clinical usage. Epilepsy providers indicated that daily heat maps, daily line graphs, and hourly line graphs were most useful for interpreting seizure diary patterns, assessing therapy impact, and counseling on seizure safety. Discussion The choice of data visualization impacts the effective translation of seizure forecast algorithms into meaningful health outcomes. Conclusion This effort underlines the importance of incorporating standardized, quantitative methods for assessing the effectiveness of data visualization to translate seizure forecast algorithms into clinical practice.
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Affiliation(s)
- Sharon Chiang
- Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA
| | - Robert Moss
- Seizure Tracker, LLC, Springfield, Virginia, USA
| | - Angela P Black
- Department of Pediatrics, Corridor Primary Care, San Marcos, Texas, USA
| | - Michele Jackson
- Divison of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Chuck Moss
- Seizure Tracker, LLC, Springfield, Virginia, USA
| | - Jonathan Bidwell
- Divison of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christian Meisel
- Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Tobias Loddenkemper
- Divison of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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21
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Stonbraker S, Flynn G, George M, Cunto-Amesty S, Alcántara C, Abraído-Lanza AF, Halpern M, Rowell-Cunsolo T, Bakken S, Schnall R. Feasibility and acceptability of using information visualizations to improve HIV-related communication in a limited-resource setting: a short report. AIDS Care 2021; 34:535-541. [PMID: 33565321 PMCID: PMC8353010 DOI: 10.1080/09540121.2021.1883517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Infographics (visualizations that present information) can assist clinicians to offer health information to patients with low health literacy in an accessible format. In response, we developed an infographic intervention to enhance clinical, HIV-related communication. This study reports on its feasibility and acceptability at a clinical setting in the Dominican Republic. We conducted in-depth interviews with physicians who administered the intervention and patients who received it. We conducted audio-recorded interviews in Spanish using semi-structured interview guides. Recordings were professionally transcribed verbatim then analyzed using descriptive content analysis. Physician transcripts were deductively coded according to constructs of Bowen et al.'s feasibility framework and patient transcripts were inductively coded. Three physicians and 26 patients participated. Feasibility constructs endorsed by physicians indicated that infographics were easy to use, improved teaching, and could easily be incorporated into their workflow. Coding of patient transcripts identified four categories that indicated the intervention was acceptable and useful, offered feedback regarding effective clinical communication, and recommended improvements to infographics. Taken together, these data indicate our intervention was a feasible and acceptable way to provide clinical, HIV-related information and provide important recommendations for future visualization design as well as effective clinical communication with similar patient populations.
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Affiliation(s)
- Samantha Stonbraker
- College of Nursing, University of Colorado, Denver, CO, USA.,Clínica de Familia La Romana, La Romana, Dominican Republic
| | - Gabriella Flynn
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Maureen George
- School of Nursing, Columbia University, New York, NY, USA
| | | | | | | | - Mina Halpern
- Clínica de Familia La Romana, La Romana, Dominican Republic
| | | | - Suzanne Bakken
- School of Nursing, Columbia University, New York, NY, USA
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22
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Vaughn J, Shah N, Jonassaint J, Harris N, Docherty S, Shaw R. User-Centered App Design for Acutely Ill Children and Adolescents. J Pediatr Oncol Nurs 2020; 37:359-367. [PMID: 32646317 DOI: 10.1177/1043454220938341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background and Objectives: The high level of acceptance and consistent use of smartphones by children and adolescents present new opportunities to monitor and collect health data. For acutely ill children and adolescents, collecting symptom data via smartphone applications (apps) provides patient-reported data that can be collected daily and offers the potential to provide a more comprehensive picture of the symptom experience. The purpose of this study was to employ user-centered design principles and medical professional input in order to obtain feedback and insight into redesigning our Technology Recordings for better Understanding Blood and Marrow Transplant (TRU-PBMT) app. This redesigned app will be used for children and adolescents with cancer or undergoing blood and marrow transplantation. Method: We interviewed six pediatric blood and marrow transplant patients (ages 10-17 years) who had pilot tested the app, and we surveyed 30 pediatric oncology clinicians. Results: Interview feedback from previous app users and survey feedback from clinicians guided the app redesign. We incorporated suggestions to make the app more engaging, meaningful, personal, and motivating in order to increase symptom reporting. We added emojis to the symptom tracker, a mood scale, and personalized symptom graphs. Conclusion: Leveraging mobile health technologies may be a useful and acceptable approach to obtain symptom data; however, design and software development needs to be evidenced-based and informed by user needs. Our approach using patient and clinician feedback was valuable in the redesign of the TRU-PBMT app and will contribute to symptom research for acutely ill children and adolescents.
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Affiliation(s)
| | | | - Jude Jonassaint
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | | | - Ryan Shaw
- Duke University School of Nursing, Durham, NC, USA
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23
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Bakken S. Consumer- and patient-oriented informatics innovation: continuing the legacy of Warner V. Slack. J Am Med Inform Assoc 2020; 27:183-184. [PMID: 31972023 PMCID: PMC7647256 DOI: 10.1093/jamia/ocz224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Affiliation(s)
- Suzanne Bakken
- School of Nursing, Department of Biomedical Informatics, Data Science Institute, Columbia University, New York, NY, USA
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