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Cramer EM, Babalola B, Agosto Maldonado LE, Chung JE. Health-related needs of survivors of hypertensive disorders of pregnancy: implications for health communication interventions. JOURNAL OF COMMUNICATION IN HEALTHCARE 2024; 17:101-110. [PMID: 38165210 DOI: 10.1080/17538068.2023.2298522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are key contributors to maternal morbidity, mortality, and future risk of cardiovascular disease. This exploratory study aimed to unearth the health-related needs of women with a reported history of HDP by inquiring about preferences for care. METHOD Deductive, qualitative analysis was conducted of HDP survivors' retrospective 'wishes' about the care received. RESULTS In analyzing 244 open-ended, online survey responses, we identified a taxonomy of health-related needs arising across the trajectory of HDP: clinical information, needs requiring clinical knowledge, such as information about the etiology or prognosis of HDP; medical, needs associated with HDP intervention and management; logistical, needs regarding practical information, such as how to contact a provider or obtain the correct medical device; emotional, needs involving a desire for support or validation; and communication, needs for improved explanations and recognition of HDP. CONCLUSIONS A taxonomy of diverse health-related needs may assist clinicians in approaching HDP patients more holistically. Additionally, opportunities exist for health communication research to inform standard approaches to HDP-related communication flowing from provider to patient.
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Affiliation(s)
- Emily M Cramer
- Department of Strategic, Legal and Management Communication, Howard University, Washington, DC, USA
| | - Bukky Babalola
- Department of Communication Studies, Howard University, Washington, DC, USA
| | | | - Jae Eun Chung
- Department of Strategic, Legal and Management Communication, Howard University, Washington, DC, USA
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2
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Skeens R, Cavanaugh KL, Cronin R, Chen Q, Liu Y, Huth H, Jackson GP. Parent Activation in the Neonatal Intensive Care Unit. Am J Perinatol 2023; 40:1413-1420. [PMID: 34638138 DOI: 10.1055/s-0041-1736294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Patient activation is the knowledge, skills, and confidence to manage one's health; parent activation is a comparable concept related to a parent's ability to manage a child's health. Activation in adults is a modifiable risk factor and associated with clinical outcomes and health care utilization. We examined activation in parents of hospitalized newborns observing temporal trends and associations with sociodemographic characteristics, neonate characteristics, and outcomes. STUDY DESIGN Participants included adult parents of neonates admitted to a level-IV neonatal intensive care unit in an academic medical center. Activation was measured with the 10-item Parent version of the Patient Activation Measure (P-PAM) at admission, discharge, and 30 days after discharge. Associations with sociodemographic variables, health literacy, clinical variables, and health care utilization were evaluated. RESULTS A total of 96 adults of 64 neonates were enrolled. The overall mean P-PAM score on admission was 81.8 (standard deviation [SD] = 18), 88.8 (SD = 13) at discharge, and 86.8 (SD = 16) at 30-day follow-up. Using linear mixed regression model, P-PAM score was significantly associated with timing of measurement. Higher P-PAM scores were associated with higher health literacy (p = 0.002) and higher in mothers compared to fathers (p = 0.040). There were no significant associations of admission P-PAM scores with sociodemographic characteristics. Parents of neonates who had a surgical diagnosis had a statistically significant (p = 0.003) lower score than those who did not. There were no associations between discharge P-PAM scores and neonates' lengths of stay or other indicators of illness severity. CONCLUSION Parental activation in the NICU setting was higher than reported in the adult and limited pediatric literature; scores increased from admission to discharge and 30-day postdischarge. Activation was higher in mothers and parents with higher health literacy. Additional larger scale studies are needed to determine whether parental activation is associated with long-term health care outcomes as seen in adults. KEY POINTS · Little is known about activation in parents of neonates.. · Activation plays a role in health outcomes in adults.. · Larger studies are needed to explore parent activation..
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Affiliation(s)
- Ryan Skeens
- Division of Neonatology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Kerri L Cavanaugh
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Center for Effective Health Communication, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert Cronin
- Department of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - QinGxia Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Yuhan Liu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hannah Huth
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Gretchen P Jackson
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
- IBM Watson Health, Cambridge, Massachusetts
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Lu Y, Barrett LA, Lin RZ, Amith M, Tao C, He Z. Understanding Information Needs and Barriers to Accessing Health Information Across All Stages of Pregnancy: Systematic Review. JMIR Pediatr Parent 2022; 5:e32235. [PMID: 35188477 PMCID: PMC8902674 DOI: 10.2196/32235] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/15/2021] [Accepted: 12/08/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Understanding consumers' health information needs across all stages of the pregnancy trajectory is crucial to the development of mechanisms that allow them to retrieve high-quality, customized, and layperson-friendly health information. OBJECTIVE The objective of this study was to identify research gaps in pregnancy-related consumer information needs and available information from different sources. METHODS We conducted a systematic review of CINAHL, Cochrane, PubMed, and Web of Science for relevant articles that were published from 2009 to 2019. The quality of the included articles was assessed using the Critical Appraisal Skills Program. A descriptive data analysis was performed on these articles. Based on the review result, we developed the Pregnancy Information Needs Ontology (PINO) and made it publicly available in GitHub and BioPortal. RESULTS A total of 33 articles from 9 countries met the inclusion criteria for this review, of which the majority were published no earlier than 2016. Most studies were either descriptive (9/33, 27%), interviews (7/33, 21%), or surveys/questionnaires (7/33, 21%); 20 articles mentioned consumers' pregnancy-related information needs. Half (9/18, 50%) of the human-subject studies were conducted in the United States. More than a third (13/33, 39%) of all studies focused on during-pregnancy stage; only one study (1/33, 3%) was about all stages of pregnancy. The most frequent consumer information needs were related to labor delivery (9/20, 45%), medication in pregnancy (6/20, 30%), newborn care (5/20, 25%), and lab tests (6/20, 30%). The most frequently available source of information was the internet (15/24, 63%). PINO consists of 267 classes, 555 axioms, and 271 subclass relationships. CONCLUSIONS Only a few articles assessed the barriers to access to pregnancy-related information and the quality of each source of information; further work is needed. Future work is also needed to address the gaps between the information needed and the information available.
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Affiliation(s)
- Yu Lu
- School of Information, Florida State University, Tallahassee, FL, United States
| | - Laura A Barrett
- School of Information, Florida State University, Tallahassee, FL, United States
| | - Rebecca Z Lin
- Washington University School of Medicine at St. Louis, St. Louis, MO, United States
| | - Muhammad Amith
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Cui Tao
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Zhe He
- School of Information, Florida State University, Tallahassee, FL, United States
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Caroline B, Sandi C, Shazima T, Viveca L. Parents' Perceptions About Future Digital Parental Support-A Phenomenographic Interview Study. Front Digit Health 2021; 3:729697. [PMID: 34778868 PMCID: PMC8578718 DOI: 10.3389/fdgth.2021.729697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/01/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Parents use digital sources (such as the internet or online forums and applications) during pregnancy and after childbirth to receive informative support. Research shows that there is further need for innovation development in digital parental support despite informative support available in digital form. Purpose: To explore parents' perceptions of future digital parental support concerning pregnancy and the first 18 months of parenthood. Method: A phenomenographic interview study with an inductive approach including 15 semi-structured interviews was conducted. Results: The analysis process resulted in three descriptive categories: Opportunities for virtual and in-person meetings, Individualized digital parental support, and Professional knowledge and trustworthiness concerning future digital parental support. Conclusion: The results broaden the knowledge about how future digital parental support can be designed to facilitate the functional, interactive, and critical digital health literacy of new and would-be parents. To succeed, healthcare organizations should allow healthcare professionals to assume an active role in developing digital parental support, both as health educators (i.e., providing parents with knowledge) and facilitators (i.e., facilitating parents' use of digital parental support). However, parents perceived that future digital parental support should complement standard care instead of replacing in-person meetings with healthcare professionals.
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Affiliation(s)
- Bäckström Caroline
- School of Health Sciences, University of Skövde, Skövde, Sweden.,Research Group Family Centered Health (FamCeH), University of Skövde, Skövde, Sweden
| | - Chamoun Sandi
- Region Jönköping County, Högland Hospital of Eksjö, Maternity Ward, Eksjö, Sweden
| | | | - Larsson Viveca
- School of Health Sciences, University of Skövde, Skövde, Sweden.,Research Group Family Centered Health (FamCeH), University of Skövde, Skövde, Sweden
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5
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Lu Y, Zhang Z, Min K, Luo X, He Z. Pregnancy-Related Information Seeking in Online Health Communities: A Qualitative Study. DIVERSITY, DIVERGENCE, DIALOGUE : 16TH INTERNATIONAL CONFERENCE, ICONFERENCE 2021, BEIJING, CHINA, MARCH 17-31, 2021 : PROCEEDINGS. ICONFERENCE (CONFERENCE) (16TH : 2021 : ONLINE) 2021; 12646:18-36. [PMID: 35274109 PMCID: PMC8907008 DOI: 10.1007/978-3-030-71305-8_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Pregnancy often imposes risks on women's health. Consumers are increasingly turning to online resources (e.g., online health communities) to look for pregnancy-related information for better care management. To inform design opportunities for online support interventions, it is critical to thoroughly understand consumers' information needs throughout the entire course of pregnancy including three main stages: pre-pregnancy, during-pregnancy, and postpartum. In this study, we present a content analysis of pregnancy-related question posts on Yahoo! Answers to examine how they formulated their inquiries, and the types of replies that information seekers received. This analysis revealed 14 main types of information needs, most of which were "stage-based". We also found that peers from online health communities provided a variety of support, including affirmation of pregnancy, opinions or suggestions, health information, personal experience, and reference to health providers' service. Insights derived from the findings are drawn to discuss design opportunities for tailoring informatics interventions to support consumers' information needs at different pregnancy stages.
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Affiliation(s)
- Yu Lu
- Florida State University, Tallahassee FL 32306, USA
- Pace University, New York NY 10038, USA
| | | | | | - Xiao Luo
- Indiana University - Purdue University Indianapolis, Indianapolis IN 46202, USA
| | - Zhe He
- Florida State University, Tallahassee FL 32306, USA
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Sulieman L, Robinson JR, Jackson GP. Automating the Classification of Complexity of Medical Decision-Making in Patient-Provider Messaging in a Patient Portal. J Surg Res 2020; 255:224-232. [PMID: 32570124 PMCID: PMC7303623 DOI: 10.1016/j.jss.2020.05.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/09/2020] [Accepted: 05/05/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Patient portals are consumer health applications that allow patients to view their health information. Portals facilitate the interactions between patients and their caregivers by offering secure messaging. Patients communicate different needs through portal messages. Medical needs contain requests for delivery of care (e.g. reporting new symptoms). Automating the classification of medical decision complexity in portal messages has not been investigated. MATERIALS AND METHODS We trained two multiclass classifiers, multinomial Naïve Bayes and random forest on 500 message threads, to quantify and label the complexity of decision-making into four classes: no decision, straightforward, low, and moderate. We compared the performance of the models to using only the number of medical terms without training a machine learning model. RESULTS Our analysis demonstrated that machine learning models have better performance than the model that did not use machine learning. Moreover, machine learning models could quantify the complexity of decision-making that the messages contained with 0.59, 0.45, and 0.58 for macro, micro, and weighted precision and 0.63,0.41, and 0.63 for macro, micro, and weighted recall. CONCLUSIONS This study is one of the first to attempt to classify patient portal messages by whether they involve medical decision-making and the complexity of that decision-making. Machine learning classifiers trained on message content resulted in better message thread classification than classifiers that employed medical terms in the messages alone.
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Affiliation(s)
- Lina Sulieman
- Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Jamie R Robinson
- Vanderbilt University Medical Center, Nashville, Tennessee; IBM Watson Health, IBM, Cambridge, Massachusetts
| | - Gretchen P Jackson
- Vanderbilt University Medical Center, Nashville, Tennessee; IBM Watson Health, IBM, Cambridge, Massachusetts
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Huth HB, Skeens R, Anders S, Herzberg S, Simpson C, Novak L, Jackson GP. Health Management in the Home: A Qualitative Study of Pregnant Women and Their Caregivers. J Patient Exp 2020; 7:1227-1233. [PMID: 33457569 PMCID: PMC7786694 DOI: 10.1177/2374373520948442] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
With growth in consumer health technologies, patients and caregivers have become increasingly involved in their health and medical care. Such health-related engagement often occurs at home. Pregnancy is a common condition and, for many women, their first exposure to health management practices. This study examined how pregnant women and caregivers managed health in their homes. Participants completed sociodemographic surveys and semi-structured interviews about living situation, information needs, and technology use. Using an iterative, inductive coding approach, we identified themes about health management, including the physical home, help at home, community, the virtual home, and biggest concerns. Most expectant mothers encountered everyday problems with mobility and household management. Pregnant women desired more assistance from caregivers, who often did not know how to help. Caregivers who provided help took on new roles. Many expectant families did not trust advice found online. Over half of expectant families had biggest concerns that involved the home.
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Affiliation(s)
- Hannah B Huth
- Indiana University, Bloomington, IN, USA.,Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Ryan Skeens
- Vanderbilt University School of Medicine Neonatology Fellowship, Vanderbilt University, Nashville, TN, USA
| | - Shilo Anders
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Simone Herzberg
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Christopher Simpson
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Laurie Novak
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA
| | - Gretchen P Jackson
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA.,Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
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8
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Zhu C, Zeng R, Zhang W, Evans R, He R. Pregnancy-Related Information Seeking and Sharing in the Social Media Era Among Expectant Mothers: Qualitative Study. J Med Internet Res 2019; 21:e13694. [PMID: 31799939 PMCID: PMC6920903 DOI: 10.2196/13694] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 09/26/2019] [Accepted: 10/22/2019] [Indexed: 01/12/2023] Open
Abstract
Background Social media has become the most popular communication tool used by Chinese citizens, including expectant mothers. An increasing number of women have adopted various forms of social media channels, such as interactive websites, instant messaging, and mobile apps, to solve problems and obtain answers to queries during pregnancy. Although the use of the internet by pregnant women has been studied extensively worldwide, limited research exists that explores the changing social media usage habits in China, where the 1 child policy ended in 2015. Objective This study aimed to (1) present the status quo of pregnancy-related information seeking and sharing via social media among Chinese expectant mothers, (2) reveal the impact of social media usage, and (3) shed light on pregnancy-related health services delivered via social media channels. Methods A qualitative approach was employed to examine social media usage and its consequences on pregnant women. A total of 20 women who had conceived and were at various stages of pregnancy were interviewed from July 20 to August 10, 2017. Thematic analysis was conducted on the collected data to identify patterns in usage. Results Overall, 80% (16/20) of participants were aged in their 20s (mean 28.5 years [SD 4.3]). All had used social media for pregnancy-related purposes. For the seeking behavior, 18 codes were merged into 4 themes, namely, gravida, fetus, delivery, and the postpartum period; whereas for sharing behaviors, 10 codes were merged into 4 themes, namely, gravida, fetus, delivery, and caretaker. Lurking, small group sharing, bad news avoidance, and cross-checking were identified as the preferred patterns for using social media. Overall, 95% (19/20) of participants reported a positive mental impact from using social media during their pregnancy. Conclusions It is indisputable that social media has played an increasingly important role in supporting expectant mothers in China. The specific seeking and sharing patterns identified in this study indicate that the general quality of pregnancy-related information on social media, as well as Chinese culture toward pregnancy, is improving. The new themes that merge in pregnancy-related social media use represent a shift toward safe pregnancy and the promotion of a more enjoyable pregnancy. Future prenatal care should provide further information on services related to being comfortable during pregnancy and reducing the inequality of social media–based services caused by the digital divide.
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Affiliation(s)
- Chengyan Zhu
- College of Public Administration, Huazhong University of Science and Technology, Wuhan, China
| | - Runxi Zeng
- Center for Communication and Social Development, School of Journalism and Communication, Chongqing University, Chongqing, China
| | - Wei Zhang
- Smart Health Institute, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Richard Evans
- College of Engineering, Design and Physical Sciences, Brunel University London, London, United Kingdom
| | - Rongrong He
- School of Public Administration, Sichuan University, Chengdu, China
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