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Carandang RR, Ancheta YM, Beleno G, Gonzales AM, Longaza NI. "I'm not very skilled in using gadgets:" A qualitative exploration of the facilitators and barriers to using telepharmacy services among Filipino senior citizens. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 15:100477. [PMID: 39131879 PMCID: PMC11315059 DOI: 10.1016/j.rcsop.2024.100477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 08/13/2024] Open
Abstract
Background Telepharmacy provides remote care by pharmacists to distant patients via telecommunications. It is a new service used in the Philippines during the COVID-19 pandemic. However, its utilization among vulnerable populations, notably senior citizens, remains relatively unexplored. Objective This study explored the facilitators and barriers to telepharmacy use among senior citizens in Pasig City, Philippines. Pasig City, a highly urbanized area in Metro Manila, is known for its quality and accessible healthcare services and has a high population of senior citizens. Methods Six focus groups were conducted: three with telepharmacy users and three with non-users, each with 3-5 participants. Focus groups were concluded upon reaching data saturation, where no new insights emerged. Verbatim transcripts were analyzed using deductive and inductive content analysis, guided by the Health Belief Model. Coding and data management were facilitated by MAXQDA software. Results Filipino senior citizens recognize the convenience and reliability of telepharmacy services for healthcare advice. Their use is influenced by social factors (friends, family, social media) and personal relevance, especially for those with chronic conditions. Positive experiences increase their likelihood of continued use and recommendations to peers. However, barriers such as poor service knowledge, low self-efficacy, and limited access (lack of smartphones, unreliable internet) hinder broader adoption. Conclusions Telepharmacy enhances the health and well-being of Filipino senior citizens by offering convenient and effective pharmaceutical care. However, barriers exist that need to be addressed through a multifaceted approach, including education and training for seniors, improved internet infrastructure, and the design of user-friendly platforms.
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Affiliation(s)
- Rogie Royce Carandang
- College of Pharmacy, Adamson University, Ermita, Manila 1000, Philippines
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Department of Community and Global Health, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan
| | | | - Geneveve Beleno
- College of Pharmacy, Adamson University, Ermita, Manila 1000, Philippines
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Nakamoto CH, Cutler DM, Beaulieu ND, Uscher-Pines L, Mehrotra A. The Impact Of Telemedicine On Medicare Utilization, Spending, And Quality, 2019-22. Health Aff (Millwood) 2024; 43:691-700. [PMID: 38630943 DOI: 10.1377/hlthaff.2023.01142] [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] [Indexed: 04/19/2024]
Abstract
Telemedicine use remains substantially higher than it was before the COVID-19 pandemic, although it has fallen from pandemic highs. To inform the ongoing debate about whether to continue payment for telemedicine visits, we estimated the association of greater telemedicine use across health systems with utilization, spending, and quality. In 2020, Medicare patients receiving care at health systems in the highest quartile of telemedicine use had 2.5 telemedicine visits per person (26.8 percent of visits) compared with 0.7 telemedicine visits per person (9.5 percent of visits) in the lowest quartile of telemedicine use. In 2021-22, relative to those in the lowest quartile, Medicare patients of health systems in the highest quartile had an increase of 0.21 total outpatient visits (telemedicine and in-person) per patient per year (2.2 percent relative increase), a decrease of 14.4 annual non-COVID-19 emergency department visits per 1,000 patients per year (2.7 percent relative decrease), a $248 increase in per patient per year spending (1.6 percent relative increase), and increased adherence for metformin and statins. There were no clear differential changes in hospitalizations or receipt of preventive care.
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Affiliation(s)
| | - David M Cutler
- David M. Cutler, Harvard University and National Bureau of Economic Research, Cambridge, Massachusetts
| | | | | | - Ateev Mehrotra
- Ateev Mehrotra , Harvard University and Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Riboli-Sasco E, El-Osta A, El Asmar ML, Karki M, Kerr G, Sathaymoorthy G, Majeed A. Investigating barriers & facilitators for the successful implementation of the BP@home initiative in London: Primary care perspectives. PLoS One 2024; 19:e0298898. [PMID: 38422101 PMCID: PMC10903909 DOI: 10.1371/journal.pone.0298898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic led to the implementation of a national policy of shielding to safeguard clinically vulnerable patients. To ensure consistent care for high-risk patients with hypertension, NHS England introduced the BP@home initiative to enable patients to self-monitor their blood pressure by providing them with blood pressure monitors. This study aimed to identify barriers and facilitators to the implementation of the initiative based on the experience and perspectives of programme managers and healthcare professionals (HCPs) involved in its implementation in London. METHODS AND FINDINGS We conducted five semi-structured focus groups and one individual interview with a total of 20 healthcare professionals involved at different levels and stages in the BP@home initiative across four of the five London Integrated Care Systems (ICSs). All focus groups and interviews were audio-recorded, transcribed and analysed thematically following the Framework Method. Respondents reported being challenged by the lack of adequate IT, human and financial resources to support the substantial additional workload associated with the programme. These issues resulted in and reinforced the differential engagement capacities of PCNs, practices and patients, thus raising equity concerns among respondents. However respondents also identified several facilitators, including the integration of the eligibility criteria into the electronic health record (EHR), especially when combined with the adoption of practice-specific, pragmatic and opportunistic approaches to the onboarding of patients. Respondents also recommended the provision of blood pressure monitors (BPMs) on prescription, additional funding and training based on needs assessment, the incorporation of BP@home into daily practice and simplification of IT tools, and finally the adoption of a person-centred care approach. Contextualised using the second iteration of the Consolidated Framework for Implementation Research (CFIR), these findings support key evidence-based recommendations to help streamline the implementation of the BP@home initiative in London's primary care setting. CONCLUSIONS Programs such as BP@Home are likely to become more common in primary care. To successfully support HCPs' aim to care for their hypertensive patients, their implementation must be accompanied by additional financial, human and training resources, as well as supported task-shifting for capacity building. Future studies should explore the perspectives of HCPs based in other parts of the UK as well as patients' experiences with remote monitoring of blood pressure.
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Affiliation(s)
- Eva Riboli-Sasco
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College London, London, United Kindgom
| | - Austen El-Osta
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College London, London, United Kindgom
| | - Marie Line El Asmar
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College London, London, United Kindgom
| | - Manisha Karki
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College London, London, United Kindgom
| | | | | | - Azeem Majeed
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College London, London, United Kindgom
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Liu M, Zhou J, Lan Y, Zhang H, Wu M, Zhang X, Leng L, Mi X, Li J. A Neglected Narrative in the COVID-19 Pandemic: Epidemiological and Clinical Impacts of the COVID-19 Outbreak on Syphilis. Clin Cosmet Investig Dermatol 2023; 16:2485-2496. [PMID: 37719933 PMCID: PMC10505047 DOI: 10.2147/ccid.s417522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/11/2023] [Indexed: 09/19/2023]
Abstract
The COVID-19 pandemic has profoundly changed our lives. While healthcare resources were redistributed and mobilized to focus on dealing with the COVID-19 crisis, there have been unmet medical needs of patients with other diseases such as syphilis, weaving an integral but neglected component of the pandemic story. In different countries, the epidemiology of newly reported syphilis underwent diverse changes during the COVID-19 pandemic. Asymptomatic cases experienced the largest decline in number. From the perspective of transmission, on one hand, the implementation of lockdown measures led to a higher degree of abstinence and sex distancing in many countries, thereby reducing the transmission of syphilis. On the other hand, vertical transmission was reported to have increased significantly during COVID-19. Meanwhile, the volume of STI clinic capacity declined, and STI staff were redeployed to facilitate the contact tracing of COVID-19. As a result, many STI centers converted traditional in-person clinical services to telemedicine and self-testing. However, syphilis testing and clinical treatment cannot fully adapt to this conversion. In syphilis diagnosis, COVID-19 infection and vaccination were reported to cause false positivity in syphilis serological tests. Diverse cutaneous manifestations of COVID-19 could resemble the skin lesions in syphilis patients, requiring differential diagnosis from clinicians. As for the post-pandemic years, consequent to service interruptions and diagnosis delays, a surge in the number of confirmed cases of syphilis is expected. The COVID-19 pandemic has also been a meaningful lesson for the control and prevention of infectious diseases. The experience in combating COVID-19 has underscored the importance of maintaining a robust and well-supported medical system for the provision of sexual health services and better healthcare equality even during eras of crisis, not least for syphilis patients.
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Affiliation(s)
- Mingjuan Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- 4+4 M.D. Program, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Jia Zhou
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Yining Lan
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Mengyin Wu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Xinyi Zhang
- Departments of Internal Medicine and Cellular & Molecular Physiology, Yale School of Medicine, New Haven, CT, USA
| | - Ling Leng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Xia Mi
- Department of Dermatology, Strategic Support Force Medical Center, Beijing, People’s Republic of China
| | - Jun Li
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
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Bruno B, Mercer MB, Hizlan S, Peskin J, Ford PJ, Farrell RM, Rose SL. Virtual prenatal visits associated with high measures of patient experience and satisfaction among average-risk patients: a prospective cohort study. BMC Pregnancy Childbirth 2023; 23:234. [PMID: 37024808 PMCID: PMC10077310 DOI: 10.1186/s12884-023-05421-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 02/02/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Virtual visits have the potential to decrease barriers to prenatal care stemming from transportation, work, and childcare concerns. However, data regarding patient experience and satisfaction with virtual visits remain limited in obstetrics. To address this gap, we explore average-risk pregnant women's experiences with virtual visits and compare satisfaction with virtual vs. in-person visits as a secondary aim. METHODS In this IRB-approved, prospective cohort study, we surveyed pregnant women after their first virtual visit between October 7, 2019 and March 20, 2020. Using heterogeneous purposive sampling, we identified a subset of respondents with diverse experiences and opinions for interviews. For comparison, Consumer Assessment of Healthcare Providers and Systems (CAHPS) satisfaction data were collected after in-person visits during the study timeframe from a control cohort with the same prenatal providers. Logistic regression controlling for age, previous pregnancies, and prior live births compared satisfaction data between virtual and in-person visits. Other quantitative survey data were analyzed through descriptive statistics. Free text survey responses and interview data were analyzed using content analysis. RESULTS Ninety five percent (n = 165/174) of surveys and 90% (n = 18/20) of interviews were completed. Most participants were Caucasian, married, and of middle to high income. 69% (114/165) agreed that their virtual appointment was as good as in-person; only 13% (21/165) disagreed. Almost all (148/165, 90%) would make another virtual appointment. Qualitative data highlighted ease of access, comparable provider-patient communication, confidence in care quality, and positive remote monitoring experiences. Recognizing these advantages but also inherent limitations, interviews emphasized interspersing telemedicine with in-person prenatal encounters. CAHPS responses after in-person visits were available for 60 patients. Logistic regression revealed no significant difference in three measures of satisfaction (p = 0.16, 0.09, 0.13) between virtual and in-person visits. CONCLUSIONS In an average-risk population, virtual prenatal visits provide a patient-centered alternative to traditional in-person encounters with high measures of patient experience and no significant difference in satisfaction. Obstetric providers should explore telemedicine to improve access - and, during the ongoing pandemic, to minimize exposures - using patients' experiences for guidance. More research is needed regarding virtual visits' medical quality, integration into prenatal schedules, and provision of equitable care for diverse populations.
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Affiliation(s)
- Bethany Bruno
- Department of Obstetrics & Gynecology, Medical University of South Carolina, Charleston, SC, 29425, USA.
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA.
| | - Mary Beth Mercer
- Office of Patient Experience, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Sabahat Hizlan
- Office of Patient Experience, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Julian Peskin
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA
- OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Paul J Ford
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA
- Center for Bioethics, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Ruth M Farrell
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA
- OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
- Center for Bioethics, Cleveland Clinic, Cleveland, OH, 44195, USA
- Genomic Medicine Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Susannah L Rose
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, 44195, USA
- Office of Patient Experience, Cleveland Clinic, Cleveland, OH, 44195, USA
- Center for Bioethics, Cleveland Clinic, Cleveland, OH, 44195, USA
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Effiong A. Postacute Sequelae of COVID-19 and Adverse Psychiatric Outcomes: Protocol for an Etiology and Risk Systematic Review. JMIRX MED 2023; 4:e43880. [PMID: 37725530 PMCID: PMC10414129 DOI: 10.2196/43880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/24/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND The postacute sequelae of COVID-19 (PASC) is a syndrome characterized by persistent COVID-19 symptoms or the onset of new symptoms following recovery from the initial or acute phase of the illness. Such symptoms often occur 4 or more weeks after being diagnosed with COVID-19. Although a lot of work has gone into understanding the long-term mental health effects of PASC, many questions related to the etiology and risk of this condition remain. OBJECTIVE This protocol is for a systematic review assessing the association between PASC and adverse psychiatric outcomes and whether people with PASC are at greater risk of developing an adverse psychiatric outcome than those without PASC. METHODS Various medical literature databases (eg, PubMed and EMBASE) will be searched for eligible articles, using predefined search criteria. Gray literature will also be explored. Epidemiological observational studies and secondary analyses of randomized controlled trials that report a quantitative relationship between PASC and at least one adverse psychiatric outcome will be included. The Population, Exposure of interest, Comparator, and Outcome framework will be used as a standardized framework for the inclusion criteria. The Joanna Briggs Institute critical appraisal tools will be used to assess methodological quality and critically appraise the risk of bias in included studies. A random-effects meta-analysis will be conducted if possible. A formal narrative synthesis will be performed if a meta-analysis is impossible due to substantial heterogeneity across studies. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the cumulative certainty of the evidence for all outcomes. Ethical approval is not required. The study results will be published in a peer-reviewed journal. RESULTS This study documents and addresses etiology, risk factors, and long-term symptoms of COVID-19 among people with PASC. It focuses on a key priority area for new evidence syntheses on the clinical management of COVID-19 and pandemic-related conditions. It will include evidence on nonhospitalized and hospitalized patients with a history of PASC. CONCLUSIONS Substantial heterogeneity across studies may limit the ability to perform a meta-analysis. Findings will inform disease prevention, decision-making, health care policy, and clinical research (Reviewed by the Plan P #PeerRef Community). TRIAL REGISTRATION PROSPERO CRD42022308737; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308737.
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Affiliation(s)
- Andem Effiong
- Faculty of Medicine, Memorial University, St John's, NL, Canada
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Broffman L, Harrison S, Zhao M, Goldman A, Patnaik I, Zhou M. The Relationship Between Broadband Speeds, Device Type, Demographic Characteristics, and Care-Seeking Via Telehealth. Telemed J E Health 2023; 29:425-431. [PMID: 35867048 DOI: 10.1089/tmj.2022.0058] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: This study sought to examine the complex relationship between individual and environmental characteristics, broadband access, device type (computer or smartphone), and telehealth utilization as it relates to the digital divide. Methods: We analyzed a combination of electronic health record and publicly available zip code-level data for 2,770 men seeking treatment on a large, nationally available, direct-to-consumer telehealth platform. Using logistic regression, we determined the likelihood of accessing the platform through a smartphone (vs. a computer) based on key features of the environment, including broadband access and income, and demographic characteristics, including age and race. Results: We found that living in areas with higher rates of broadband adoption significantly decreased the likelihood of accessing virtual care using a smartphone (odds ratio [OR] = 0.17, p < 0.001). Compared with the 18-29 age category, the odds of accessing virtual care using a smartphone decreased for men between the age categories of 40-59 (OR = 0.63, p < 0.01) and over 60 (OR = 0.29, p < 0.001) years. Belonging to historically marginalized communities of color (Black, Hispanic, and Native American) almost doubled the odds of using a smartphone to access the platform (OR = 1.8, p < 0.001). Broadband availability and median area income were not significantly associated with mobile use. Conclusions: Telehealth platform design and policy solutions intended to expand access to virtual care should be flexible enough to accommodate the sometimes competing needs of patients who are at the greatest risk of being left behind.
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Affiliation(s)
| | | | - Michael Zhao
- Roman Health Ventures, Inc., New York, New York, USA
| | - Alex Goldman
- Roman Health Ventures, Inc., New York, New York, USA
| | - Ira Patnaik
- Roman Health Ventures, Inc., New York, New York, USA
| | - Megan Zhou
- Roman Health Ventures, Inc., New York, New York, USA
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Linkage role of ICT and Big Data in COVID-19: a case of Korea’s digital and social communication practices. JOURNAL OF INFORMATION COMMUNICATION & ETHICS IN SOCIETY 2023. [DOI: 10.1108/jices-02-2022-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Purpose
This paper aims to discuss characteristics of Korea’s system responses with a research framework of the structure, conduct and performance theory and explain the role of information, communication technologies (ICT) and Big Data from a technology-mediated control (TMC) perspective.
Design/methodology/approach
This study examines the contextual nature of Korea’s diagnostic, preventive and treatment efforts. Particular attention is paid to issues related to the effective use of Big Data analytics and its applications, reporting mechanisms and public safety measures. The research model defines key factors in assessing the effectiveness of Korea’s responses.
Findings
Findings of this research suggest: effective strategic planning and operational execution use well-tested and designed crisis-responsive manuals; linkage role of ICT/Big Data is prominent in trace, test and treat and participation (3T + P); and aggressive epidemic investigations require synergistic efforts of national and local government units, broad societal support and participation and contribution of global firms offering their domestic and global supply chain network capabilities.
Research limitations/implications
The Korean Government's effective response experiences suggest the synergy of political, social, cultural and technological factors. Future studies may explore how personal privacy and public safety are both achieved in different social–cultural–political contexts (Ahn et al., 2020; Delgado et al., 2020; Sharma and Bashir, 2020). Other emerging organizational issues and international comparative studies are worth further investigation in future studies.
Practical implications
This case study suggests how to apply ICT capabilities for organizing a national response to the coronavirus pandemic (COVID-19) pandemic. Public and private partnership in the framework of sociotechnological synergy (i.e. integration of ICT and social orchestration) is essential for the 3T process. In support of public policy initiatives, global firms share their IT infrastructure and supply chain integration experiences to accommodate global-level crises like the COVID-19 pandemic.
Social implications
This study extends the TMC framework to a national level. In the adapted TMC framework, the control source, control target and linkage mechanism are specified. Using TMC, this shows the dynamic roles of ICT/Big Data in Korea’s COVID-19 response experiences.
Originality/value
The impacts of the COVID-19 are rapid and enormous. Despite the controversial early policy decisions and the rapid rise of confirmed patients, the world has recognized Korea’s effective responses to the COVID-19 pandemic.
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Barwise A, Huschka T, Woo C, Egginton J, Huang L, Allen JS, Johnson M, Hamm K, Wolfersteig W, Phelan S, Allyse M. Perceptions and Use of Telehealth among diverse communities: A Multisite Community Engaged Mixed Methods Study. J Med Internet Res 2023; 25:e44242. [PMID: 36867682 PMCID: PMC10057900 DOI: 10.2196/44242] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Telehealth has been increasingly adopted by healthcare systems since the start of the COVID-19 pandemic. Although telehealth may provide convenience for patients and clinicians, there are several barriers to accessing it and using it effectively to provide high quality patient care. OBJECTIVE This study, was part of a larger multisite community engaged study conducted to understand the impact of COVID-19 on diverse communities. The work described here explored the perceptions of and experience with telehealth use among diverse and underserved community members during COVID-19. METHODS We used mixed methods across three regions in the US (Midwest, Arizona, and Florida) from January 2021-November 2021. We promoted our study through social media and community partnerships, disseminating flyers in English and Spanish. We developed a moderator guide and conducted focus groups in English and Spanish mostly using a videoconferencing platform. Participants were placed in focus groups with others who shared similar demographic attributes and geographic location. Focus groups were audio-recorded and transcribed. We analyzed our qualitative data using the framework analytic approach. We developed our broader survey using validated scales and with input from community and scientific leaders and distributed it through social media in English and Spanish. We included a previously published questionnaire which had been used to assess perceptions about telehealth among patients with HIV. We analyzed our quantitative data using SAS software and standard statistical approaches. We examined the effect of region, age, ethnicity/race and education on use and perceptions of telehealth. RESULTS We included data from 47 focus groups. Due to our mode of dissemination, we cannot calculate a response rate for the survey. However, we received 3447 English language and 146 Spanish language responses. Over 90% of participants had internet access and 94% had used telehealth. About half of all participants agreed or strongly agreed that telehealth would be beneficial in the future because it better fit their schedules and they would not need to travel. However, about half also agreed or strongly agreed they would not be able to express themselves well and could not be examined when using telehealth. Indigenous participants were especially concerned about these issues when compared to other racial groups. CONCLUSIONS This work describes findings from a mixed methods community engaged research study about telehealth including perceived benefits and concerns. Although participants enjoyed the benefits of telehealth (not having to travel and easier scheduling) they also had concerns (not being able to express themselves well and not having a physical exam) about telehealth.. These sentiments were especially notable among the Indigenous population. Our work highlights the importance of fully understanding the impact of these novel health delivery modalities on the patient experience and actual or perceived quality of care received. CLINICALTRIAL
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Affiliation(s)
- Amelia Barwise
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | - Todd Huschka
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | | | - Jason Egginton
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | - Lily Huang
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, US
| | | | | | - Kathryn Hamm
- Office of Evaluation and Partner Contracts, Southwest Interdisciplinary Research Center,, Arizona State University, Phoenix, US
| | - Wendy Wolfersteig
- Office of Evaluation and Partner Contracts, Southwest Interdisciplinary Research Center,, Arizona State University, Phoenix, US
| | - Sean Phelan
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | - Megan Allyse
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, US
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The Impact of Digital Competence on Telehealth Utilization. HEALTH POLICY AND TECHNOLOGY 2023. [DOI: 10.1016/j.hlpt.2023.100724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Nikolova SP, Pancheva-Dimitrova RZ, Yoncheva N, Vasileva V, Cherkezova B. Essential elements of a care delivery model for children with neurological impairments during the COVID-19 pandemic: Notes from Bulgaria. Front Public Health 2022; 10:932847. [PMID: 36033756 PMCID: PMC9413062 DOI: 10.3389/fpubh.2022.932847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/25/2022] [Indexed: 01/25/2023] Open
Affiliation(s)
- Silviya Pavlova Nikolova
- Department of Social Medicine and Health Care Organisation, Medical University of Varna, Varna, Bulgaria,*Correspondence: Silviya Pavlova Nikolova
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Ftouni R, AlJardali B, Hamdanieh M, Ftouni L, Salem N. Challenges of Telemedicine during the COVID-19 pandemic: a systematic review. BMC Med Inform Decis Mak 2022; 22:207. [PMID: 35922817 PMCID: PMC9351100 DOI: 10.1186/s12911-022-01952-0] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/22/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has prompted the decrease of in-person visits to reduce the risk of virus transmission. Telemedicine is an efficient communication tool employed between healthcare providers and patients that prevents the risk of exposure to infected persons. However, telemedicine use is not infallible; its users reported multiple issues that complicated the expansion of this technology. So, this systematic review aimed to explore the barriers and challenges of telemedicine use during the pandemic and to propose solutions for improving future use. METHODS A systematic review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) statement. PubMed, Scopus, Web of Science, Academic Search Complete, CINAHL, Embase, and Science Direct were used to look for articles addressing barriers and challenges, in addition to articles proposing solutions. Studies were screened by title and abstract, followed by a full-text review. Risk of bias assessment was done using Critical Appraisal Skills Program for qualitative studies, Newcastle-Ottawa Scale for cross-sectional studies, and A MeaSurement Tool to Assess Systematic Reviews for systematic reviews. After the extraction of data, a narrative synthesis and analysis of the outcomes were performed. RESULTS Among 1194 papers identified, only 27 studies were included. Barriers and challenges were assembled under 7 categories: technical aspects, privacy, data confidentiality and reimbursement, physical examination and diagnostics, special populations, training of healthcare providers and patients, doctor-patient relationship, and acceptability. Poor internet connection and lack of universal access to technology were among the technical barriers. Concerns about patient privacy and reimbursement hindered the use of telemedicine too. Physical examination and certain procedures were impossible to perform via telemedicine. Training both healthcare providers and patients was deficient. The doctor-patient relationship was troubled by telemedicine, and both healthcare providers and patients were reluctant to use telemedicine. CONCLUSION Widespread use of telemedicine is still hampered by various barriers and challenges. Healthcare providers should work with various stakeholders to implement the proposed solutions. More research and policy changes are essential to optimize telemedicine utilization.
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Affiliation(s)
- Racha Ftouni
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Baraa AlJardali
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
- Division of Urology, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Hamdanieh
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Louna Ftouni
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
- Division of Neurosurgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon
| | - Nariman Salem
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
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Factors influencing the delivery of telerehabilitation for stroke: A systematic review. PLoS One 2022; 17:e0265828. [PMID: 35544471 PMCID: PMC9094559 DOI: 10.1371/journal.pone.0265828] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/08/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Despite the available evidence regarding effectiveness of stroke telerehabilitation, there has been little focus on factors influencing its delivery or translation from the research setting into practice. There are complex challenges to embedding telerehabilitation into stroke services and generating transferable knowledge about scaling up and routinising this service model. This review aimed to explore factors influencing the delivery of stroke telerehabilitation interventions, including platforms, technical requirements, training, support, access, cost, usability and acceptability. Methods MEDLINE, EMBASE, CINAHL, Web of Science and Cochrane Library and Central Registry of Clinical Trials were searched to identify full-text articles of randomised controlled trials (RCTs) and protocols for RCTs published since a Cochrane review on stroke telerehabilitation services. A narrative synthesis was conducted, providing a comprehensive description of the factors influencing stroke telerehabilitation intervention delivery. Results Thirty-one studies and ten protocols of ongoing studies were included. Interventions were categorised as synchronous telerehabilitation (n = 9), asynchronous telerehabilitation (n = 11) and tele-support (n = 11). Telephone and videoconference were the most frequently used modes of delivery. Usability and acceptability with telerehabilitation were high across all platforms, although access issues and technical challenges may be potential barriers to the use of telerehabilitation in service delivery. Costs of intervention delivery and training requirements were poorly reported. Conclusions This review synthesises the evidence relating to factors that may influence stroke telerehabilitation intervention delivery at a crucial timepoint given the rapid deployment of telerehabilitation in response to the COVID-19 pandemic. It recommends strategies, such as ensuring adequate training and technical infrastructure, shared learning and consistent reporting of cost and usability and acceptability outcomes, to overcome challenges in embedding and routinising this service model and priorities for research in this area.
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Kim EG, Park SK, Nho JH. The Effect of COVID-19-Related Lifestyle Changes on Depression. Psychiatry Investig 2022; 19:371-379. [PMID: 35620822 PMCID: PMC9136519 DOI: 10.30773/pi.2021.0381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/08/2022] [Accepted: 03/06/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to identify the effect of coronavirus disease (COVID-19)-related lifestyle changes on depression. METHODS This secondary data analysis study included 229,269 adults from a community health survey conducted in the South Korea in 2020. Data were collected using a structured questionnaire about participants' lifestyle changes related to COVID-19 and the Patient Health Questionnaire-9. The data were analyzed using a complex sample independent t-test, analysis of variance, Pearson's correlation coefficient, and multiple regression analysis. RESULTS The mean age of the participants was 48.76; 49.6% were male, and 50.4% were female. The multiple regression showed that depression increased due to COVID-19-related lifestyle changes (physical activity, sleep duration, consumption of convenience foods, alcohol consumption, smoking, and use of public transportation). The explanatory power was 27.3%, and the model was suitable (Wald F=63.75, p<0.001). CONCLUSION This study identified the effect of COVID-19-related lifestyle changes on depression, and the results have implications for future depression-relieving interventions.
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Affiliation(s)
- Eun Gyeong Kim
- Department of Nursing, Kunsan National University, Gunsan, Republic of Korea
| | - Sook Kyoung Park
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Republic of Korea
| | - Ju-Hee Nho
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Republic of Korea
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Joseph RC, Ali M. A conceptual analysis of the ethicality of Web-based messaging on the COVID-19 pandemic. JOURNAL OF INFORMATION COMMUNICATION & ETHICS IN SOCIETY 2022. [DOI: 10.1108/jices-02-2021-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to examine the primary sources and methods of Web-based messaging during the early stages of the coronavirus pandemic. The authors use ethical lens to develop a conceptual framework to inform and reduce conflicts of Web-based messaging associated with COVID-19.
Design/methodology/approach
This paper provides a comprehensive review of three different ethical schools and identifies the cohesive theme of common good across them. Common good leading to a greater good serves as the overarching ethical construct for Web-based messages that focus on society and not the singular individual, business or political ideology.
Findings
The findings suggest that the ethical construct of common good focuses on prioritizing the society over the individual and draws upon utilitarian principles focused on consequences, Kantian principles focused on intentions and Aristotelian principles focused on the definition of good. Web-based messaging on COVID-19 originates from diverse public and private sources and ethically can be governed by adherence to achieving the greatest good for society. Pervasive conflicts with COVID-19 messaging can be mitigated by pursuing a more ethical agenda with messages.
Originality/value
This manuscript provides a conceptual framework, based on ethical principles, to serve as a blueprint for Web-based messaging during a pandemic. This work offers an ethical perspective for communication during a pandemic and it is original in conceptualizing the components of Web-based messaging and decomposing them into the different levels where conflicts can occur. This article can serve as a template for Web-based communication pertaining to future pandemics and other events that benefit from prioritizing the impact on society over the impact on the individual.
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Rosas YG, Sigal M, Park A, Barnett ML. Predicting a Rapid Transition to Telehealth-Delivered Parent-Child Interaction Therapy Amid COVID-19: A Mixed Methods Study. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2022; 2:293-304. [PMID: 36105665 PMCID: PMC9462633 DOI: 10.1007/s43477-022-00057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/29/2022] [Indexed: 12/31/2022]
Abstract
The sudden onset of COVID-19 forced mental health therapists to rapidly transition to telehealth services. While some therapists and organizations were able to achieve an expeditious transition, others struggled. Using the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework, which outlines key phases that guide the implementation process, the current mixed methods study examined what factors predicted the transition to internet-based Parent-Child Interaction Therapy (iPCIT), a telehealth-delivered evidence-based practice (EBP). We investigated two areas related to the transition: (1) if PCIT therapists transitioned to provide iPCIT and (2) if they made this transition quickly. In Fall 2019, 324 therapists completed a survey about implementing PCIT. After stay-at-home orders, 223 of those therapists completed a follow-up survey about their transition to telehealth, organizational characteristics, their caseloads, and telehealth training. The majority of therapists (82%) transitioned to provide iPCIT, with 48% making the transition in less than a week. Open-ended responses indicated that therapists who did not transition-faced challenges related to limited client resources, a lack of training, and organizational delays. Qualitative findings informed predictors for two logistic regression models that are statistical models that predict the probability of an event occurring, with criterion variables (1) whether therapists transitioned to provide iPCIT and (2) whether they transitioned in less than a week. Results showed that caseload in Fall 2019 and receipt of iPCIT training were associated with iPCIT transition. Organizational setting, resiliency, and baseline caseload predicted rapid transition to iPCIT. Implications regarding supporting the implementation of telehealth delivery of EBPs are discussed.
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Affiliation(s)
- Yessica Green Rosas
- grid.133342.40000 0004 1936 9676Department of Counseling, Clinical, and School Psychology, Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA 93106-9490 USA
| | - Marika Sigal
- grid.27860.3b0000 0004 1936 9684Department of Human Ecology, University of California, Davis, Davis, CA USA
| | - Alayna Park
- grid.170202.60000 0004 1936 8008Department of Psychology, University of Oregon, Eugene, OR USA
| | - Miya L. Barnett
- grid.133342.40000 0004 1936 9676Department of Counseling, Clinical, and School Psychology, Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, CA 93106-9490 USA
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Hussain S, Ameen K. Are They Facilitating the Information Poor? An Appraisal of Information Services of Public Libraries in Punjab. PUBLIC LIBRARY QUARTERLY 2021. [DOI: 10.1080/01616846.2021.2018866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sumaira Hussain
- Institute of Information Management, University of the Punjab, Lahore
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18
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Barnett ML, Sigal M, Green Rosas Y, Corcoran F, Rastogi M, Jent JF. Therapist Experiences and Attitudes About Implementing Internet-Delivered Parent-Child Interaction Therapy During COVID-19. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:630-641. [PMID: 33994769 PMCID: PMC8112899 DOI: 10.1016/j.cbpra.2021.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 03/19/2021] [Indexed: 12/01/2022]
Abstract
It has been widely recognized that access to mental health treatment is imperative to address current and long-term stressors for children and parents during COVID-19. Internet-delivered Parent-Child Interaction Therapy (iPCIT, previously referred to as I-PCIT) is a strong model for remote service delivery during social distancing restrictions due to its empirical base. However, this treatment modality was not widely implemented before COVID-19, likely due to barriers to providing telehealth services. This mixed methods study conducted a follow-up survey to gather therapist experiences (N = 223) in delivering iPCIT during COVID-19, including qualitative data on the benefits and challenges to delivering iPCIT. The vast majority of therapists (82%) indicated that they transitioned to deliver PCIT via telehealth in response to COVID-19. PCIT caseloads decreased slightly from the first survey to the COVID-19 follow-up survey, but the racial and ethnic composition of caseloads were not significantly different between the two surveys. Of the 183 therapists who transitioned to deliver PCIT via telehealth, 82% expressed interest in continuing to provide iPCIT following the COVID-19 pandemic. Reported benefits of iPCIT included decreased barriers to access and the ability to practice skills within the naturalistic home environment. Challenges to iPCIT were primarily issues with technology as well as other logistical barriers, which could limit engagement for some families. Findings from this study may be beneficial in improving future implementation of iPCIT during and post-COVID-19.
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Taha-Mehlitz S, Hendie A, Taha A. The Development of Electronic Health and Artificial Intelligence in Surgery after the SARS-CoV-2 Pandemic-A Scoping Review. J Clin Med 2021; 10:jcm10204789. [PMID: 34682912 PMCID: PMC8537136 DOI: 10.3390/jcm10204789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND SARS-CoV-2 has significantly transformed the healthcare environment, and it has triggered the development of electronic health and artificial intelligence mechanisms, for instance. In this overview, we concentrated on enhancing the two concepts in surgery after the pandemic, and we examined the factors on a global scale. OBJECTIVE The primary goal of this scoping review is to elaborate on how surgeons have used eHealth and AI before; during; and after the current global pandemic. More specifically, this review focuses on the empowerment of the concepts of electronic health and artificial intelligence after the pandemic; which mainly depend on the efforts of countries to advance the notions of surgery. DESIGN The use of an online search engine was the most applied method. The publication years of all the studies included in the study ranged from 2013 to 2021. Out of the reviewed studies; forty-four qualified for inclusion in the review. DISCUSSION We evaluated the prevalence of the concepts in different continents such as the United States; Europe; Asia; the Middle East; and Africa. Our research reveals that the success of eHealth and artificial intelligence adoption primarily depends on the efforts of countries to advance the notions in surgery. CONCLUSIONS The study's primary limitation is insufficient information on eHealth and artificial intelligence concepts; particularly in developing nations. Future research should focus on establishing methods of handling eHealth and AI challenges around confidentiality and data security.
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Affiliation(s)
- Stephanie Taha-Mehlitz
- Clarunis, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, 4002 Basel, Switzerland;
| | - Ahmad Hendie
- Department of Computer Engineering, McGill University, Montreal, QC H3A 0C6, Canada;
| | - Anas Taha
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, 4321 Allschwil, Switzerland
- Correspondence: ; Tel.: +41-61-207-54-02
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Yao R, Zhang W, Evans R, Cao G, Rui T, Shen L. Inequities in Healthcare Services Caused by the Adoption of Digital Health Technologies: A Scoping Review (Preprint). J Med Internet Res 2021; 24:e34144. [PMID: 35311682 PMCID: PMC8981004 DOI: 10.2196/34144] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/15/2022] [Accepted: 02/24/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Rui Yao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Wenli Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Richard Evans
- Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada
| | - Guang Cao
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Tianqi Rui
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lining Shen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Hubei Provincial Research Center for Health Technology Assessment, Wuhan, China
- Institute of Smart Health, Huazhong University of Science & Technology, Wuhan, China
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21
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Gega L, Aboujaoude E. How Digital Technology Mediated the Effects of the COVID-19 Pandemic on Mental Health: The Good, the Bad, and the Indifferent. Front Digit Health 2021; 3:733151. [PMID: 34713202 PMCID: PMC8521901 DOI: 10.3389/fdgth.2021.733151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Lina Gega
- Department of Health Sciences & Hull York Medical School, University of York, York, United Kingdom
| | - Elias Aboujaoude
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States
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Hannemann N, Götz NA, Schmidt L, Hübner U, Babitsch B. Patient connectivity with healthcare professionals and health insurer using digital health technologies during the COVID-19 pandemic: a German cross-sectional study. BMC Med Inform Decis Mak 2021; 21:250. [PMID: 34433452 PMCID: PMC8386151 DOI: 10.1186/s12911-021-01605-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/05/2021] [Indexed: 11/11/2022] Open
Abstract
Background Digital health technologies enable patients to make a personal contribution to the improvement of their health by enabling them to manage their health. In order to exploit the potential of digital health technologies, Internet-based networking between patients and health care providers is required. However, this networking and access to digital health technologies are less prevalent in sociodemographically deprived cohorts. The paper explores how the use of digital health technologies, which connect patients with health care providers and health insurers has changed during the COVID-19 pandemic. Methods The data from a German-based cross-sectional online study conducted between April 29 and May 8, 2020, were used for this purpose. A total of 1.570 participants were included in the study. Accordingly, the influence of sociodemographic determinants, subjective perceptions, and personal competencies will affect the use of online booking of medical appointments and medications, video consultations with providers, and the data transmission to health insurers via an app. Results The highest level of education (OR 1.806) and the presence of a chronic illness (OR 1.706) particularly increased the likelihood of using online booking. With regard to data transmission via an app to a health insurance company, the strongest increase in the probability of use was shown by belonging to the highest subjective social status (OR 1.757) and generation Y (OR 2.303). Furthermore, the results show that the higher the subjectively perceived restriction of the subjects' life situation was due to the COVID-19 pandemic, the higher the relative probability of using online booking (OR 1.103) as well as data transmission via an app to a health insurance company (OR 1.113). In addition, higher digital literacy contributes to the use of online booking (OR 1.033) and data transmission via an app to the health insurer (OR 1.034). Conclusions Socially determined differences can be identified for the likelihood of using digital technologies in health care, which persist even under restrictive conditions during the COVID-19 pandemic. Thus, the results indicate a digital divide with regard to the technologies investigated in this study.
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Affiliation(s)
- Niels Hannemann
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany.
| | - Nina-Alexandra Götz
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany
| | - Lisa Schmidt
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany
| | - Ursula Hübner
- Health Informatics Research Group, Hochschule Osnabrück, Albrechtstr. 30, 49076, Osnabrück, Germany
| | - Birgit Babitsch
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany
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Online and telephone access to general practice: a cross-sectional patient survey. BJGP Open 2021; 5:BJGPO.2020.0179. [PMID: 33910917 PMCID: PMC8450875 DOI: 10.3399/bjgpo.2020.0179] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background Improving access to primary health care in the UK has focused on the use of telephone and online access, but little is known about how awareness of and use varies between different patient groups. Aim To determine how patients are interacting with telephone and online channels for accessing general practice services and information, and to analyse how this varies according to patient characteristics and health status. Design & setting A cross-sectional self-administered survey of adult patients in general practices across the West Midlands, UK. Method Descriptive statistics were used to show participants’ awareness of and interaction with online information sources and remote access. Multivariable logistic regression was used to model the relationships between demographic and health characteristics, and awareness and use of online services and alternatives to face-to-face consultations (for example, telephone). Results A total of 2789 patients (19.0% response rate) from 43 general practices participated. The study found 60.8% (n = 1651/2715) of participants were aware of online services and 30.3% (n = 811/2674) reported having used one. Daily internet usage and frequently visiting the GP showed the strongest associations with knowledge and use of online services. Conclusion The study shows that there is the potential for inequitable awareness and use of telephone and online services in general practice populations. Given that their use has greatly increased owing to the COVID-19 pandemic, future service design will need to ensure equity is taken into account.
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Treharne GJ, Johnstone G, Fletcher BD, Lamar RSM, White D, Stebbings S, Harrison A. Fears about COVID-19 and perceived risk among people with rheumatoid arthritis or ankylosing spondylitis following the initial lockdown in Aotearoa New Zealand. Musculoskeletal Care 2021; 20:290-298. [PMID: 34388290 PMCID: PMC8441895 DOI: 10.1002/msc.1585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/01/2021] [Indexed: 12/23/2022]
Abstract
Background The COVID‐19 pandemic has disrupted all aspects of life and may raise particular fears for people with rheumatic disease. There is a need for research on fears and perceived risk of SARS‐CoV‐2 so as to understand the impact on wellbeing and inform service provision. Objectives The aim of this study was to examine the correlates of COVID‐19 fears and perceived risk of SARS‐CoV‐2 among people with rheumatoid arthritis or ankylosing spondylitis. Design A cross‐sectional survey design was applied in Aotearoa New Zealand in the period after initial nationwide lockdowns. Method An online survey was completed from July to September 2020 by 126 individuals with rheumatoid arthritis (n = 96) or ankylosing spondylitis (n = 30) who had previously been recruited to the Patient Opinion Real‐Time Anonymous Liaison (PORTAL) study in 2015 or 2018. The survey included demographics and health information as well as measures of COVID‐19 fears and experiences, functional disability and fatigue‐related disability. Results Fears about COVID‐19 were higher among younger participants, those who had been tested for SARS‐CoV‐2, and those who experienced more flares over the initial lockdown. Perceived risk of SARS‐CoV‐2 infection was also higher among individual who had been tested for SARS‐CoV‐2 and those taking biologic medications. Conclusion Fears about COVID‐19 and perceived risk of infection are related to age, health and medications among individuals with rheumatoid arthritis or ankylosing spondylitis. These findings inform how health professionals can help address the concerns of particular groups of people with rheumatic disease by providing relevant information about the ongoing effects of the pandemic.
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Affiliation(s)
- Gareth J Treharne
- Department of Psychology, University of Otago, Dunedin, Aotearoa New Zealand
| | - Grace Johnstone
- Department of Psychology, University of Otago, Dunedin, Aotearoa New Zealand
| | - Benjamin D Fletcher
- Department of Psychology, University of Otago, Dunedin, Aotearoa New Zealand
| | - Roisin S M Lamar
- Department of Psychology, University of Otago, Dunedin, Aotearoa New Zealand
| | - Douglas White
- Department of Rheumatology, Waikato Clinical School, University of Auckland, Hamilton, Aotearoa New Zealand
| | - Simon Stebbings
- Department of Medicine, University of Otago, Dunedin, Aotearoa New Zealand
| | - Andrew Harrison
- Department of Medicine, University of Otago, Wellington, Aotearoa New Zealand
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Mental health and quality of life for people with rheumatoid arthritis or ankylosing spondylitis in Aotearoa New Zealand following the COVID-19 national lockdown. Rheumatol Int 2021; 41:1763-1772. [PMID: 34297180 PMCID: PMC8298198 DOI: 10.1007/s00296-021-04952-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/14/2021] [Indexed: 01/25/2023]
Abstract
The aim of this study was to investigate the effects of lockdown on the mental health (anxiety and depression) and quality of life (QOL) of people with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in the context of the COVID-19 pandemic and public health measures instituted at a national level by the New Zealand Government. The present cohort was 104 individuals with RA (73.1%) and AS (26.9%) who had previously completed surveys for the Patient Opinion Real-Time Anonymous Liaison (PORTAL) project in 2018. Participants completed an online survey between July and September 2020 assessing their experiences over the first national COVID-19 lockdown in New Zealand (March–May, 2020). Fear of SARS-CoV-2 infection, baseline anxiety, and being younger in age were all predictors of participants’ current anxiety levels. Current QOL scores were significantly lower than prior to lockdown and were predicted by baseline QOL and current depression. No variables predicted current depression other than baseline levels. The COVID-19 pandemic appears to have had an impact on QOL and anxiety levels, but not depression for people with RA and AS in New Zealand. These novel findings imply that appropriate screening of mental health issues should be included in planning within the ongoing COVID-19 pandemic and for future pandemics to optimise the wellbeing of people with RA and AS.
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Solo-Josephson P, Murren-Boezem J, Zettler-Greeley CM. Patient and Visit Characteristics of Families Accessing Pediatric Urgent Care Telemedicine During the COVID-19 Pandemic. Telemed J E Health 2021; 28:558-565. [PMID: 34265215 DOI: 10.1089/tmj.2021.0135] [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: 11/12/2022] Open
Abstract
Background: Telemedicine expansion during the coronavirus pandemic improved health care access for some. However, studies show disparate uptake among marginalized communities, where minority patients experience higher infection rates. We examined changes in pediatric telemedicine utilization as related to social determinants of health and characteristics of families accessing care. Materials and Methods: This IRB-approved study is a retrospective, cross-sectional comparison of completed visits for parent-initiated, urgent care telemedicine services received by a pediatric health care system between January to May 2019 and January to May 2020. Patient and visit characteristics were evaluated by region (Florida or Delaware Valley) and year for age, race, gender, ethnicity, zip code, language, median household income, insurance type, and patient draw. Results: Outcomes varied by region. Pediatric patient visits jumped by 172% in 2020 from the year prior. In Florida, the proportion of Hispanic patients utilizing telemedicine increased, as did patients utilizing government-supported health insurance during the pandemic (ps < 0.05). Practically meaningful, although nonsignificant increases in patient language diversity were found across years in both regions (ps > 0.05). Rural patient utilization remained low (2-5%; ps > 0.05). Discussion: Changes in telemedicine use were observed among pediatric patients in vulnerable populations during the coronavirus disease 2019 (COVID-19) pandemic. Despite increased utilization among Hispanic and low-income families, access to virtual care remains a challenge among patients residing in rural locales. Conclusion: Researchers, health care providers, and policymakers should examine the implementation of varying mitigation strategies that support equal access and use of virtual health care among an increasingly diverse, post-COVID-19 pediatric patient population.
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Affiliation(s)
- Patricia Solo-Josephson
- Nemours Children's Hospital, Center for Health Delivery Innovation, Orlando, Florida, USA.,Section on Telehealth Care, American Academy of Pediatrics, Itasca, Illinois, USA.,University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Joanne Murren-Boezem
- Nemours Children's Hospital, Center for Health Delivery Innovation, Orlando, Florida, USA.,Section on Telehealth Care, American Academy of Pediatrics, Itasca, Illinois, USA.,University of Central Florida College of Medicine, Orlando, Florida, USA
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27
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Clouston SAP, Link BG. A retrospective on fundamental cause theory: State of the literature, and goals for the future. ANNUAL REVIEW OF SOCIOLOGY 2021; 47:131-156. [PMID: 34949900 PMCID: PMC8691558 DOI: 10.1146/annurev-soc-090320-094912] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Fundamental Cause Theory (FCT) was originally proposed to explain how socioeconomic inequalities in health emerged and persisted over time. The concept was that higher socioeconomic status helped some people to avoid risks and adopt protective strategies using flexible resources - knowledge, money, power, prestige and beneficial social connections. As a sociological theory, FCT addressed this issue by calling on social stratification, stigma, and racism as they affected medical treatments and health outcomes. The last comprehensive review was completed a decade ago. Since then, FCT has been tested, and new applications have extended central features. The current review consolidates key foci in the literature in order to guide future research in the field. Notable themes emerged around types of resources and their usage, approaches used to test the theory, and novel extensions. We conclude that after 25 years of use, there remain crucial questions to be addressed.
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Affiliation(s)
- Sean A. P. Clouston
- Program in Public Health and Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Bruce G. Link
- School of Public Policy and Department of Sociology, University of California at Riverside, Riverside, CA, USA
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28
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Szlamka Z, Kiss M, Bernáth S, Kámán P, Lubani A, Karner O, Demetrovics Z. Mental Health Support in the Time of Crisis: Are We Prepared? Experiences With the COVID-19 Counselling Programme in Hungary. Front Psychiatry 2021; 12:655211. [PMID: 34135783 PMCID: PMC8200459 DOI: 10.3389/fpsyt.2021.655211] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 04/29/2021] [Indexed: 01/07/2023] Open
Abstract
The Coronavirus disease 2019 (COVID-19) posed unexpected global economic and societal challenges. These include a heavy impact on mental health due to fast changing lockdown and quarantine measures, uncertainty about health and safety and the prospect of new waves of infections. To provide crisis mental health support during the pandemic, Eötvös Loránd University in Hungary launched a specialist online counselling programme, consisting of one to three sessions. The programme was available to all university members between 4th March and 25th May 2020. Overall, 47 clients received support. In this paper we discuss challenges reported by clients, key features of providing a brief mental health intervention online, reflect on counsellor experiences and give recommendations on how mental health services could be developed in the time of crisis. Most clients had challenges with developing a daily routine under quarantine; and many had hardship related to finances, housing, and distance learning. Common mental health consequences included fear from the virus and stress, anxiety, and fatigue due to the interruption to everyday life. In some cases, more complex conditions were triggered by the pandemic. Examples include addictive behaviours and symptoms of depression or psychosis. However, referring cases beyond the competency of counselling proved to be a challenge due to the closure of specialist services. Counsellors observed three key features to the online delivery of a brief crisis mental health intervention: [1] an explicit problem-oriented approach to counselling; [2] challenges of building rapport online; and [3] frames of online counselling. Counsellor experiences often overlapped with those of clients and included challenges of working from home and adjusting to online counselling methods. The possibility of online counselling allowed that mental health care could take place at all during the pandemic. Client experiences reflect findings from previous literature. Like other mental health initiatives launched to tackle COVID-19, the intervention's effectiveness was not measured given the unexpected context and short time frame for programme development. We recommend the use of impact measurement tools to develop mental health services in crises. Meanwhile, the pandemic brought to attention the need to better understand online delivery models. Counsellors should have access to training opportunities on online counselling and managing work-life balance in a remote setting. The COVID-19 counselling programme in Eötvös Loránd University, Hungary is an example of providing online mental health counselling in the time of crisis. Clearly, more studies are needed discussing delivery models and effectiveness of mental health interventions during the pandemic. Experience and knowledge sharing across practitioners should be encouraged to improve how the field reacts to unexpected, high risk events and crises.
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Affiliation(s)
- Zsófia Szlamka
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Márta Kiss
- Counselling Centre, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Sámuel Bernáth
- Counselling Centre, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Péter Kámán
- Counselling Centre, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Amina Lubani
- Counselling Centre, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Orsolya Karner
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Counselling Centre, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, Gibraltar
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29
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Yang X, Song B, Wu A, Mo PKH, Di J, Wang Q, Lau JTF, Wang L. Social, Cognitive, and eHealth Mechanisms of COVID-19-Related Lockdown and Mandatory Quarantine That Potentially Affect the Mental Health of Pregnant Women in China: Cross-Sectional Survey Study. J Med Internet Res 2021; 23:e24495. [PMID: 33302251 PMCID: PMC7836909 DOI: 10.2196/24495] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/01/2020] [Accepted: 11/30/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Although lockdown and mandatory quarantine measures have played crucial roles in the sharp decrease of the number of newly confirmed/suspected COVID-19 cases, concerns have been raised over the threat that these measures pose to mental health, especially the mental health of vulnerable groups, including pregnant women. Few empirical studies have assessed whether and how these control measures may affect mental health, and no study has investigated the prevalence and impacts of the use of eHealth resources among pregnant women during the COVID-19 outbreak. OBJECTIVE This study investigated (1) the effects of lockdown and mandatory quarantine on mental health problems (ie, anxiety and depressive symptoms), (2) the potential mediation effects of perceived social support and maladaptive cognition, and (3) the moderation effects of eHealth-related factors (ie, using social media to obtain health information and using prenatal care services during the COVID-19 pandemic) on pregnant women in China. METHODS An online cross-sectional survey was conducted among 19,515 pregnant women from all 34 Chinese provincial-level administrative regions from February 25 to March 10, 2020. RESULTS Of the 19,515 participants, 12,209 (62.6%) were subjected to lockdown in their areas of residence, 737 (3.8%) were subjected to mandatory quarantine, 8712 (44.6%) had probable mild to severe depression, 5696 (29.2%) had probable mild to severe anxiety, and 1442 (7.4%) had suicidal ideations. Only 640 (3.3%) participants reported that they used online prenatal care services during the outbreak. Significant sociodemographic/maternal factors of anxiety/depressive symptoms included age, education, occupation, the area of residence, gestational duration, the number of children born, complication during pregnancy, the means of using prenatal care services, and social media use for obtaining health information. Multiple indicators multiple causes modeling (χ214=495.21; P<.05; comparative fit index=.99; nonnormed fit index=.98; root mean square error of approximation=.04, 90% CI 0.038-0.045) showed that quarantine was directly and indirectly strongly associated with poor mental health through decreased perceived social support and increased maladaptive cognition (B=.04; β=.02, 95% CI 0.01-0.02; P=.001), while lockdown was indirectly associated with mental health through increased social support and maladaptive cognition among pregnant women (B=.03; β=.03, 95% CI 0.02-0.03; P=.001). Multigroup analyses revealed that the use of social media for obtaining health information and the means of using prenatal care services were significant moderators of the model paths. CONCLUSIONS Our findings provide epidemiological evidence for the importance of integrating mental health care and eHealth into the planning and implementation of control measure policies. The observed social and cognitive mechanisms and moderators in this study are modifiable, and they can inform the design of evidence-based mental health promotion among pregnant women.
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Affiliation(s)
- Xue Yang
- The Jockey Club School of Public Health and Primary, The Chinese University of Hong Kong, Hong Kong, China
| | - Bo Song
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Anise Wu
- Department of Psychology, University of Macau, Macao, Macao
| | - Phoenix K H Mo
- The Jockey Club School of Public Health and Primary, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Joseph T F Lau
- The Jockey Club School of Public Health and Primary, The Chinese University of Hong Kong, Hong Kong, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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30
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Hirschman KB, Bowles KH, Garcia-Gonzalez L, Shepard B, Walser TJ, Thomas GL, Stawnychy MA, Riegel B. Lessons learned from the implementation of a video health coaching technology intervention to improve self-care of family caregivers of adults with heart failure. Res Nurs Health 2020; 44:250-259. [PMID: 33341950 DOI: 10.1002/nur.22100] [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] [Received: 05/14/2020] [Revised: 11/13/2020] [Accepted: 12/06/2020] [Indexed: 12/18/2022]
Abstract
Individuals with heart failure (HF) typically live in the community and are cared for at home by family caregivers. These caregivers often lack supportive services and the time to access those services when available. Technology can play a role in conveniently bringing needed support to these caregivers. The purpose of this article is to describe the implementation of a virtual health coaching intervention with caregivers of HF patients ("Virtual Caregiver Coach for You"-ViCCY). A randomized controlled trial is currently in progress to test the efficacy of the intervention to improve self-care. In this trial, 250 caregivers will be randomly assigned to receive health information via a tablet computer (hereafter, tablet) plus 10 live health coaching sessions delivered virtually (intervention group; n = 125) or health information via a tablet only (control group; n = 125). Each tablet has specific health information websites preloaded. To inform others embarking on similar technology projects, here we highlight the technology challenges encountered with the first 15 caregivers who received the ViCCY intervention and the solutions used to overcome those challenges. Several adaptations to the implementation of ViCCY were needed to address hardware, software, and network connectivity challenges. Even with a well-designed research implementation plan, it is important to re-examine strategies at every step to solve implementation barriers and maximize fidelity to the intervention. Researcher and interventionist flexibility in adapting to new strategies is essential when implementing a technology-based virtual health coaching intervention.
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Affiliation(s)
- Karen B Hirschman
- NewCourtland Center for Transitions and Health, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kathryn H Bowles
- NewCourtland Center for Transitions and Health, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Home Care Policy & Research, Visiting Nurse Service of New York, New York, New York, USA
| | | | - Brooke Shepard
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tracie J Walser
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Gladys L Thomas
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael A Stawnychy
- NewCourtland Center for Transitions and Health, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Barbara Riegel
- NewCourtland Center for Transitions and Health, Philadelphia, Pennsylvania, USA.,School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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31
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Provenzi L, Grumi S, Borgatti R. Alone With the Kids: Tele-Medicine for Children With Special Healthcare Needs During COVID-19 Emergency. Front Psychol 2020; 11:2193. [PMID: 33013567 PMCID: PMC7509132 DOI: 10.3389/fpsyg.2020.02193] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/04/2020] [Indexed: 12/19/2022] Open
Affiliation(s)
- Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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