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Siebelink NM, Gaasterland A, Gielissen M, van der Weegen S, Boon B, van der Poel A. Barriers and facilitators influencing implementation of care technology for people with intellectual disabilities: A cross-sectional study among care professionals. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13262. [PMID: 38946655 DOI: 10.1111/jar.13262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 02/26/2024] [Accepted: 05/27/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Implementation issues often hinder reaching the potential of care technology to improve daily lives of people with intellectual disabilities. We investigated barriers to and facilitators of implementing different technology modalities (app/social robot/sensor/domotics) in long-term care. METHOD Care professionals (N = 83) from 12 Dutch disability care organisations completed a customised measurement instrument for determinants of innovations (MIDI) questionnaire. RESULTS Out of 27 determinants, 20 were identified as facilitators and 16 as barriers. We highlight common barriers: few colleagues who work with the technology; no (awareness of) formal ratification of technology use; no arrangements regarding turnover of staff using the technology; unsettling organisational changes; technological defects and limited IT preconditions. CONCLUSIONS The results, which could be combined and compared across study sites, provide insight into which implementation determinants were already well addressed, and where there is ground to gain when implementing care technology in disability care organisations.
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Affiliation(s)
- Nienke M Siebelink
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
| | | | - Marieke Gielissen
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
- Center for Long-term Care for People with Disabilities, Siza, Arnhem, The Netherlands
| | - Sanne van der Weegen
- National Centre of Expertise for Long-term Care, Vilans, Utrecht, The Netherlands
| | - Brigitte Boon
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
- Center for Long-term Care for People with Disabilities, Siza, Arnhem, The Netherlands
- Tranzo Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Agnes van der Poel
- Research & Advisory on Technology in Long-term Care, Academy Het Dorp, Arnhem, The Netherlands
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Hosszú D, Dima AL, Fernández FL, Schneider MP, van Dijk L, Tóth K, Duman M, Davis W, Andriciuc C, Egan R, Vrijens B, Kardas P, Bitterman N, Mucalo I, Ghiciuc CM, Ágh T. Engagement of medication users in the development and implementation of digital medication adherence technologies: a multi-stakeholder study. Expert Rev Pharmacoecon Outcomes Res 2024:1-8. [PMID: 38934097 DOI: 10.1080/14737167.2024.2373184] [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: 04/30/2024] [Accepted: 06/24/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND This study aims to create a comprehensive framework for the development and implementation of digital medication adherence technologies (DMATech), focusing on critical stages where engagement of medication users (MU) is considered meaningful, i.e. adds significant value, as agreed upon by participating stakeholders. METHODS Through a literature review and expert consensus, a framework was outlined covering key DMATech development and implementation phases and steps. An in-person workshop with MU representatives and adherence experts, using the Nominal Group Technique, further refined these stages for MU engagement. RESULTS The DMATech framework included three phases: 'Innovation,' 'Research and Development,' and 'Launch and Implementation,' each encompassing multiple steps. The workshop, attended by five MU representatives and nine adherence experts, identified critical stages for MU input including context analysis, ideation, proof of concept, prototype creation, DMATech's iteration, critical evaluation, healthcare implementation, real-world assessment, and improvement. Nevertheless, there was a divergence of consensus regarding the importance of MUs engagement in regulatory, financial, and marketing aspects. CONCLUSIONS This study provides a holistic framework for DMATech development and implementation and underscores the necessity of MU engagement at various stages. Modes of MU engagement cannot be generalized; a case-by-case evaluation of engagement strategies is essential.
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Affiliation(s)
- Dalma Hosszú
- Syreon Research Institute, Budapest, Hungary
- Institute of Psychology, University of Pécs, Pécs, Hungary
| | - Alexandra L Dima
- Health Technology Assessment in Primary Care and Mental Health (PRISMA), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública CIBERESP, Madrid, Spain
| | - Francisca Leiva Fernández
- Multiprofessional Teaching Unit of Community and Family Care; Andalusian Health Service; Health District Malaga-Guadalhorce; IBIMA-Platform Bionand; University of Málaga, Málaga, Spain
| | - Marie Paule Schneider
- Medication Adherence and Interprofessionality Research and Teaching Group, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Liset van Dijk
- Nivel, Netherlands Institution for Health Services Research, Utrecht, the Netherlands
- Department of PharmacoTherapy, Groningen Research Institute of Pharmacy, Epidemiology & Economics (PTEE), University of Groningen, Groningen, the Netherlands
| | - Krisztina Tóth
- Syreon Research Institute, Budapest, Hungary
- Bridge of Health Alliance against Breast Cancer Association, Budapest, Hungary
| | | | | | | | | | - Bernard Vrijens
- AARDEX Group, Liège, Belgium
- University of Liège, Liège, Belgium
| | - Przemyslaw Kardas
- Medication Adherence Research Centre, Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | | | - Iva Mucalo
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Cristina Mihaela Ghiciuc
- Pharmacology, Clinical Pharmacology and Algeziology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, Iași, Romania
| | - Tamás Ágh
- Syreon Research Institute, Budapest, Hungary
- Medication Adherence Research Group, Center for Health Technology Assessment and Pharmacoeconomic Research, University of Pécs, Pécs, Hungary
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Rzewuska Díaz M, Locock L, Keen A, Melvin M, Myhill A, Ramsay C. Implementation of a Web-Based Outpatient Asynchronous Consultation Service: Mixed Methods Study. J Med Internet Res 2024; 26:e48092. [PMID: 38833695 PMCID: PMC11185905 DOI: 10.2196/48092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/15/2023] [Accepted: 03/12/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Asynchronous outpatient patient-to-provider communication is expanding in UK health care, requiring evaluation. During the pandemic, Aberdeen Royal Infirmary in Scotland expanded its outpatient asynchronous consultation service from dermatology (deployed in May 2020) to gastroenterology and pain management clinics. OBJECTIVE We conducted a mixed methods study using staff, patient, and public perspectives and National Health Service (NHS) numerical data to obtain a rounded picture of innovation as it happened. METHODS Focus groups (3 web-based and 1 face-to-face; n=22) assessed public readiness for this service, and 14 interviews with staff focused on service design and delivery. The service's effects were examined using NHS Grampian service use data, a patient satisfaction survey (n=66), and 6 follow-up patient interviews. Survey responses were descriptively analyzed. Demographics, acceptability, nonattendance rates, and appointment outcomes of users were compared across levels of area deprivation in which they live and medical specialties. Interviews and focus groups underwent theory-informed thematic analysis. RESULTS Staff anticipated a simple technical system transfer from dermatology to other receptive medical specialties, but despite a favorable setting and organizational assistance, it was complicated. Key implementation difficulties included pandemic-induced technical integration delays, misalignment with existing administrative processes, and discontinuity in project management. The pain management clinic began asynchronous consultations (digital appointments) in December 2021, followed by the gastroenterology clinic in February 2022. Staff quickly learned how to explain and use this service. It was thought to function better for pain management as it fitted preexisting practices. From May to September 2022, the dermatology (adult and pediatric), gastroenterology, and pain management clinics offered 1709 appointments to a range of patients (n=1417). Digital appointments reduced travel by an estimated 44,712 miles (~71,956.81 km) compared to the face-to-face mode. The deprivation profile of people who chose to use this service closely mirrored that of NHS Grampian's population overall. There was no evidence that deprivation impacted whether digital appointment users subsequently received treatment. Only 18% (12/66) of survey respondents were unhappy or very unhappy with being offered a digital appointment. The benefits mentioned included better access, convenience, decreased travel and waiting time, information sharing, and clinical flexibility. Overall, patients, the public, and staff recognized its potential as an NHS service but highlighted informed choice and flexibility. Better communication-including the use of the term assessment instead of appointment-may increase patient acceptance. CONCLUSIONS Asynchronous pain management and gastroenterology consultations are viable and acceptable. Implementing this service is easiest when existing administrative processes face minimal disruption, although continuous support is needed. This study can inform practical strategies for supporting staff in adopting asynchronous consultations (eg, preparing for nonlinearity and addressing task issues). Patients need clear explanations and access to technical support, along with varied consultation options, to ensure digital inclusion.
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Affiliation(s)
| | - Louise Locock
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
| | - Andrew Keen
- NHS Grampian, Grampian, Aberdeen, United Kingdom
| | - Mike Melvin
- Public Research Partner, University of Aberdeen, Aberdeen, United Kingdom
| | - Anthony Myhill
- Public Research Partner, University of Aberdeen, Aberdeen, United Kingdom
| | - Craig Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom
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Sussex J, Smith J, Wu FM. Service innovations for people with multiple long-term conditions: reflections of a rapid evaluation team. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-76. [PMID: 38940736 DOI: 10.3310/ptru7108] [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: 06/29/2024]
Abstract
Background People living with multiple long-term conditions represent a significant concern for National Health Service policy and practice, and their care is a major theme in the 2019 National Health Service Long Term Plan. The Birmingham RAND and Cambridge Rapid Evaluation Centre team has undertaken a thematic synthesis of the 10 evaluations it has conducted from 2018 to 2023, exploring the needs, priorities and implications for people with multiple long-term conditions. Objectives The aims for this overarching study were to: (1) build a body of learning about service innovations in primary and community settings for people of all ages with multiple long-term conditions, focused on questions that matter most to people with multimorbidity; and (2) develop methodological insights about how rapid evaluation can be used to inform the scoping, testing and implementation of service innovations for people with multiple long-term conditions. Design The focus on multiple long-term conditions came from a Birmingham RAND and Cambridge Rapid Evaluation Centre prioritisation process undertaken in 2018 using James Lind Alliance methods. Cross-analysis of the findings from the 10 individual rapid evaluations was supplemented by (1) building aspects of multimorbidity into the design of later evaluations; (2) interviewing national and regional stakeholders (n=19) working in or alongside integrated care systems; (3) undertaking a rapid review of evidence on remote monitoring for people with multiple long-term conditions (19 papers included); and (4) testing overall insights with organisations representing patients and carers through a patient, public and professional engagement workshop with 10 participants plus members of the research team. Results While living with multiple long-term conditions is common and is the norm for people over the age of 50 using health and care services, it is not often a focus of health service provision or innovation, nor of research and evaluation activity. We discuss six themes emerging from the totality of the study: (1) our health system is mainly organised around single conditions and not multiple long-term conditions; (2) research calls and studies usually focus on single conditions and associated services; (3) building opportunities for engaged, informed individuals and carers and improved self-management; (4) the importance of measures that matter for patients and carers; (5) barriers to developing and implementing service innovations for people with multiple long-term conditions; and (6) what is needed to make patients with multiple long-term conditions a priority in healthcare planning and delivery. Limitations Care of people with multiple long-term conditions was not the principal focus of several of the rapid evaluations. While this was a finding in itself, it limited our learning about designing and implementing, as well as methodological approaches to evaluating, service innovations for people with multiple long-term conditions. Conclusions Through a thematic analysis of the portfolio of evaluations, we have deduced a set of suggested implications for how the needs of people with multiple long-term conditions can be better embedded in policy, research and practice. Future work Areas of uncertainty related to the care of people with multiple long-term conditions should be further explored, including developing and testing measures of patient experience of (un)co-ordinated care across settings, and interrogating the experience of health and care staff when working with people with multiple long-term conditions, to understand what works. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR134284) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 15. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Jon Sussex
- RAND Europe, Eastbrook House, Cambridge, UK
| | - Judith Smith
- University of Birmingham, Health Services Management Centre, Edgbaston, Birmingham, UK
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Jansen C, Bäuerle A, Jahre LM, Kocol D, Krakowczyk J, Geiger S, Dörrie N, Skoda EM, Teufel M. Needs and Demands for e-Health Interventions in Patients Attending a Psychosomatic Outpatient Clinic: A Baseline Assessment for a User-Centered Design Approach. Telemed J E Health 2024; 30:e1747-e1756. [PMID: 38436236 DOI: 10.1089/tmj.2023.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024] Open
Abstract
Objective: Increased utilization of e-health services can help to meet shortages of psychotherapeutic treatment. e-Health interventions can be effective if tailored according to the individual needs and demands of the target group. To gather comprehensive data for the development of a user-centered e-health intervention, a cross-sectional study was conducted among a heterogeneous cohort of 309 patients seeking treatment or consultation at psychosomatic university hospital in a densely populated region of Germany. Methods: Sociodemographic data, psychometric dimensions of mental burden, as well as needs and demands regarding an e-health intervention were assessed. A descriptive statistical analysis and a cluster analysis were performed to examine distribution of preferences and differences based on level of burden regarding needs and demands for e-health interventions. Results: Two hundred thirty-nine (N = 239) participants were included in the final data analysis. Among this primarily urban target group smartphone availability was favored by 77.8% of the participants. The cluster analysis revealed significant differences dependent on mental burden. 75.2% of participants with a high mental burden preferred longer interventions of 1-4 months compared with 49% in the low burden group, which also considered short interventions of up to 1 month (46%). Differences were also identified for content preferences and daily-life integration and were consistent irrespective of the initial reason for consultation. Conclusion: The findings of this study can provide a foundational framework for developing user-centered psychosomatic interventions. The potential relationship between individual burden and individual needs and demands highlights the crucial role of preliminary research to tailor interventions to effectively address diverse needs and preferences.
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Affiliation(s)
- Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Dilara Kocol
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Julia Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Sheila Geiger
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Pais-Cunha I, Fontoura Matias J, Almeida AL, Magalhães M, Fonseca JA, Azevedo I, Jácome C. Telemonitoring of pediatric asthma in outpatient settings: A systematic review. Pediatr Pulmonol 2024. [PMID: 38742250 DOI: 10.1002/ppul.27046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
Telemonitoring technologies are rapidly evolving, offering a promising solution for remote monitoring and timely management of asthma acute episodes. We aimed to describe current pediatric asthma telemonitoring technologies. A systematic review was conducted until September 2023 on Medline, Scopus, and Web of Science. We included studies of children (0-18 years) with asthma or recurrent wheezing whose respiratory condition was telemonitored outside the healthcare setting. A narrative synthesis was performed. We identified 40 telemonitoring technologies described in 40 studies. The more frequently used technologies for telemonitoring were mobile applications (n = 21) and web-based systems (n = 14). Telemonitoring duration varied between 2 weeks and 32 months. Data collection included asthma symptoms (n = 30), patient-reported outcome measures (PROMs) (n = 11), spirometry/peak flow readings (n = 20), medication adherence (n = 17), inhaler technique (n = 3), air quality (n = 2), and respiratory sounds (n = 2). Both parents and children were the technology target users in most studies (n = 23). Technology training was reported in 23 studies of which 3 provided ongoing support. Automatic feedback was found in 30 studies, mostly related with asthma control. HCP were involved in data management in 27 studies. Technologies were tested in samples from 4 to 327 children, with most studies including school-aged children and/or adolescents (n = 38) and eight including preschool children. This review provides an overview of existing technologies for the outpatient telemonitoring of pediatric asthma. Specific technologies for preschool children represent a gap in the literature that needs to be specifically addressed in future research.
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Affiliation(s)
- Inês Pais-Cunha
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
| | - José Fontoura Matias
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Ana Laura Almeida
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Manuel Magalhães
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
- Serviço De Pediatria, Centro Materno Infantil Do Norte, Centro Hospitalar Universitário Do Porto, Porto, Portugal
| | - João A Fonseca
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
- Allergy Unit, Instituto CUF Porto E Hospital CUF Porto, Porto, Portugal
| | - Inês Azevedo
- Serviço De Pediatria, Unidade De Gestão Autónoma Da Mulher E Da Criança, Centro Hospitalar Universitário São João, Porto, Portugal
- Departamento De Ginecologia-Obstetrícia e Pediatria, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Cristina Jácome
- CINTESIS@RISE, MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal
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Vasanthan L, Natarajan SK, Babu A, Kamath MS, Kamalakannan S. Digital health interventions for improving access to primary care in India: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002645. [PMID: 38743672 DOI: 10.1371/journal.pgph.0002645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/25/2024] [Indexed: 05/16/2024]
Abstract
Access to quality healthcare remains a challenge in low-and middle-income countries. Vulnerable populations with unmet needs face the greatest challenge in accessing primary care for appropriate and timely healthcare. The use of digital technologies can not only strengthen health systems but also improve access to health care, particularly for the vulnerable. This scoping review aims to assess the various digital health technologies and interventions available for improving access to primary care for the vulnerable in India. This scoping review employed the Joanna Brigg Institute's (JBI) guidelines and Arksey and O'Malley's methodological framework. The literature search was conducted in Medline/PubMed, Embase, Web of Science-Core Collection, Scopus, AgeLine, PsycINFO, CINAHL, ERIC, Cochrane CENTRAL, and Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register databases, using the keywords, such as 'Access', 'Healthcare', 'Assistive technology', 'Digital health' 'Vulnerable', 'India' and 'Healthcare technology'. A two-staged screening of titles and abstracts, followed by full-text was conducted independently by two reviewers, using the Rayyan software. Subsequently, the data was extracted from selected studies using a pre-designed and approved extraction form. The data was then synthesised and analysed narratively. The protocol for this review has been registered with open science forum (OSF) registries (https://osf.io/63pjw/). The search yielded about 3840 records, 3544 records were eligible for screening of titles and abstracts. We included seven studies after a two-round screening and identified seven different technological innovations developed to bridge gaps in access to primary care. The commonly used digital health interventions for improving access to primary care were virtual tele-health systems and mHealth applications in-built within an android smartphone or a tablet. Digital health interventions was either used as a standalone tele-health aid or a collaborative system for community workers, primary care physicians as well as the health service users. The purpose of these innovations was to increase awareness and knowledge to access support for specific aspects of healthcare. Virtual primary health care with the specialist in the hub supporting general physicians at the primary health centres in blocks and districts was another such model used for improving access to primary care. Digital health interventions was also used for mass community screening of disabilities, such as persons with hearing disability. To re-imagine a digitally empowered health systems in India, also inclusive of the vulnerable, it is important to inclusively conceptualise, systematically develop and rigorously evaluate any public health interventions including those that are enabled by digital health interventions to bridge the gaps in access to primary care in India. Such a strategy could address the paucity of evidence in public health interventions and provide sustainable strategies to strengthen health systems in India. Trial registration: Open Science Framework-Registration Link: https://osf.io/63pjw/.
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Affiliation(s)
- Lenny Vasanthan
- Department of Physical Medicine and Rehabilitation, Physiotherapy Unit, Christian Medical College, Vellore, Tamil Nadu, India
- Department of Physiotherapy, Honorary Clinical Senior Lecturer, Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
| | - Sindhu Kulandaipalayam Natarajan
- Division of Gastrointestinal Sciences, Wellcome Trust Research Laboratory, Christian Medical College, Vellore, Tamil Nadu, India
| | - Andrew Babu
- Department of Physical Medicine and Rehabilitation, Physiotherapy Unit, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mohan S Kamath
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sureshkumar Kamalakannan
- Department of Social Work, Education, and Community Well-being, Northumbria University, Newcastle Upon Tyne, United Kingdom
- Institute of Public Health Sciences, Public Health Foundation of India, Hyderabad, India
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Hui CY, Shenton AV, Martin C, Weatherill D, Moylan D, Hayes M, Rienda LG, Kinley E, Eck S, Pinnock H. Patient and public involvement workshop to shape artificial intelligence-supported connected asthma self-management research. PLOS DIGITAL HEALTH 2024; 3:e0000521. [PMID: 38814854 PMCID: PMC11139256 DOI: 10.1371/journal.pdig.0000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/28/2024] [Indexed: 06/01/2024]
Abstract
Digital interventions with artificial intelligence (AI) can potentially support people with asthma to reduce the risk of exacerbation. Engaging patients throughout the development process is essential to ensure usability of the intervention for the end-users. Using our Connected for Asthma (C4A) intervention as an exemplar, we explore how patient involvement can shape a digital intervention. Seven Patient and Public Involvement (PPI) colleagues from the Asthma UK Centre for Applied Research participated in four advisory workshops to discuss how they would prefer to use/interact with AI to support living with their asthma, the benefit and caveats to use the AI that incorporated asthma monitoring and indoor/outdoor environmental data. Discussion focussed on the three most wanted use cases identified in our previous studies. PPI colleagues wanted AI to support data collection, remind them about self-management tasks, teach them about asthma environmental triggers, identify risk, and empower them to confidently look after their asthma whilst emphasising that AI does not replace clinicians. The discussion informed the key components in the next C4A interventions, including the approach to interacting with AI, the technology features and the research topics. Attendees highlighted the importance of considering health inequities, the presentation of data, and concerns about data accuracy, data privacy, security and ownership. We have demonstrated how patient roles can shift from that of 'user' (the traditional 'tester' of a digital intervention), to a co-design partner who shapes the next iteration of the intervention. Technology innovators should seek practical and feasible strategies to involve PPI colleagues throughout the development cycle of a digital intervention; supporting researchers to explore the barriers, concerns, enablers and advantages of implementing digital healthcare.
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Affiliation(s)
- Chi Yan Hui
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - Ann Victoria Shenton
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - Claire Martin
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - David Weatherill
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - Dianna Moylan
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - Morag Hayes
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - Laura Gonzalez Rienda
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
| | - Emma Kinley
- School of Psychology, Faculty of Health, Liverpool John Moore’s University, United Kingdom
| | - Stefanie Eck
- Institute of General Practice and Health Services Research, TUM School of Medicine, Technical University of Munich (TUM), Germany
| | - Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, United Kingdom
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Baines R, Stevens S, Austin D, Anil K, Bradwell H, Cooper L, Maramba ID, Chatterjee A, Leigh S. Patient and Public Willingness to Share Personal Health Data for Third-Party or Secondary Uses: Systematic Review. J Med Internet Res 2024; 26:e50421. [PMID: 38441944 PMCID: PMC10951832 DOI: 10.2196/50421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND International advances in information communication, eHealth, and other digital health technologies have led to significant expansions in the collection and analysis of personal health data. However, following a series of high-profile data sharing scandals and the emergence of COVID-19, critical exploration of public willingness to share personal health data remains limited, particularly for third-party or secondary uses. OBJECTIVE This systematic review aims to explore factors that affect public willingness to share personal health data for third-party or secondary uses. METHODS A systematic search of 6 databases (MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and SocINDEX) was conducted with review findings analyzed using inductive-thematic analysis and synthesized using a narrative approach. RESULTS Of the 13,949 papers identified, 135 were included. Factors most commonly identified as a barrier to data sharing from a public perspective included data privacy, security, and management concerns. Other factors found to influence willingness to share personal health data included the type of data being collected (ie, perceived sensitivity); the type of user requesting their data to be shared, including their perceived motivation, profit prioritization, and ability to directly impact patient care; trust in the data user, as well as in associated processes, often established through individual choice and control over what data are shared with whom, when, and for how long, supported by appropriate models of dynamic consent; the presence of a feedback loop; and clearly articulated benefits or issue relevance including valued incentivization and compensation at both an individual and collective or societal level. CONCLUSIONS There is general, yet conditional public support for sharing personal health data for third-party or secondary use. Clarity, transparency, and individual control over who has access to what data, when, and for how long are widely regarded as essential prerequisites for public data sharing support. Individual levels of control and choice need to operate within the auspices of assured data privacy and security processes, underpinned by dynamic and responsive models of consent that prioritize individual or collective benefits over and above commercial gain. Failure to understand, design, and refine data sharing approaches in response to changeable patient preferences will only jeopardize the tangible benefits of data sharing practices being fully realized.
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Affiliation(s)
- Rebecca Baines
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Sebastian Stevens
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Prometheus Health Technologies Ltd, Newquay, United Kingdom
| | - Daniela Austin
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | | | - Hannah Bradwell
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Leonie Cooper
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | | | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Simon Leigh
- Prometheus Health Technologies Ltd, Newquay, United Kingdom
- Warwick Medical School, University of Warwick, Conventry, United Kingdom
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Popa V, Geissler J, Vermeulen R, Priest E, Capperella K, Susuzlu G, Terry SF, Brooke N. Delivering Digital Health Solutions that Patients Need: A Call to Action. Ther Innov Regul Sci 2024; 58:236-241. [PMID: 38082118 PMCID: PMC10850017 DOI: 10.1007/s43441-023-00592-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/27/2023] [Indexed: 02/09/2024]
Abstract
Digital health solutions have the potential to complement traditional healthcare approaches and deliver improved health outcomes, but there are system-wide challenges that need to be addressed. These include fragmentation of the digital health landscape, regulatory processes that lack the agility to accommodate the fast pace of digital health advances, and inadequate transparency around data sharing and data governance. All of these challenges have led to mistrust, limited understanding and sharing of best practices, a lack of digital education and awareness, and insufficient patient and public engagement and involvement. In this paper, we argue that for digital health solutions to fulfil their potential, there needs to be a significant increase in early, meaningful, and sustained engagement with the people they intend to benefit. The uptake as well as the impact of digital solutions created in partnership with patients for patients are greater and more relevant to the communities they address.
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11
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Siebelink NM, van Dam KN, Lukkien DRM, Boon B, Smits M, van der Poel A. Action Opportunities to Pursue Responsible Digital Care for People With Intellectual Disabilities: Qualitative Study. JMIR Ment Health 2024; 11:e48147. [PMID: 38416547 PMCID: PMC10938230 DOI: 10.2196/48147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/26/2023] [Accepted: 01/12/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Responsible digital care refers to any intentional systematic effort designed to increase the likelihood of a digital care technology developed through ethical decision-making, being socially responsible and aligned with the values and well-being of those impacted by it. OBJECTIVE We aimed to present examples of action opportunities for (1) designing "technology"; (2) shaping the "context" of use; and (3) adjusting the behavior of "users" to guide responsible digital care for people with intellectual disabilities. METHODS Three cases were considered: (1) design of a web application to support the preparation of meals for groups of people with intellectual disabilities, (2) implementation of an app to help people with intellectual disabilities regulate their stress independently, and (3) implementation of a social robot to stimulate interaction and physical activity among people with intellectual disabilities. Overall, 26 stakeholders participated in 3 multistakeholder workshops (case 1: 10/26, 38%; case 2: 10/26, 38%; case 3: 6/26, 23%) based on the "guidance ethics approach." We identified stakeholders' values based on bottom-up exploration of experienced and expected effects of using the technology, and we formulated action opportunities for these values in the specific context of use. Qualitative data were analyzed thematically. RESULTS Overall, 232 effects, 33 values, and 156 action opportunities were collected. General and case-specific themes were identified. Important stakeholder values included quality of care, autonomy, efficiency, health, enjoyment, reliability, and privacy. Both positive and negative effects could underlie stakeholders' values and influence the development of action opportunities. Action opportunities comprised the following: (1) technology: development of the technology (eg, user experience and customization), technology input (eg, recipes for meals, intervention options for reducing stress, and activities), and technology output (eg, storage and use of data); (2) context: guidelines, training and support, policy or agreements, and adjusting the physical environment in which the technology is used; and (3) users: integrating the technology into daily care practice, by diminishing (eg, "letting go" to increase the autonomy of people with intellectual disabilities), retaining (eg, face-to-face contact), and adding (eg, evaluation moments) certain behaviors of care professionals. CONCLUSIONS This is the first study to provide insight into responsible digital care for people with intellectual disabilities by means of bottom-up exploration of action opportunities to take account of stakeholders' values in designing technology, shaping the context of use, and adjusting the behavior of users. Although part of the findings may be generalized, case-specific insights and a complementary top-down approach (eg, predefined ethical frameworks) are essential. The findings represent a part of an ethical discourse that requires follow-up to meet the dynamism of stakeholders' values and further develop and implement action opportunities to achieve socially desirable, ethically acceptable, and sustainable digital care that improves the lives of people with intellectual disabilities.
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Affiliation(s)
| | - Kirstin N van Dam
- Academy Het Dorp, Arnhem, Netherlands
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Dirk R M Lukkien
- Vilans, Utrecht, Netherlands
- Copernicus Institute of Sustainable Development, Utrecht University, Utrecht, Netherlands
| | - Brigitte Boon
- Academy Het Dorp, Arnhem, Netherlands
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
- Siza, Arnhem, Netherlands
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Pappot H, Steen-Olsen EB, Holländer-Mieritz C. Experiences with Wearable Sensors in Oncology during Treatment: Lessons Learned from Feasibility Research Projects in Denmark. Diagnostics (Basel) 2024; 14:405. [PMID: 38396444 PMCID: PMC10887889 DOI: 10.3390/diagnostics14040405] [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: 11/29/2023] [Revised: 02/02/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The fraction of elderly people in the population is growing, the incidence of some cancers is increasing, and the number of available cancer treatments is evolving, causing a challenge to healthcare systems. New healthcare tools are needed, and wearable sensors could partly be potential solutions. The aim of this case report is to describe the Danish research experience with wearable sensors in oncology reporting from three oncological wearable research projects. CASE STUDIES Three planned case studies investigating the feasibility of different wearable sensor solutions during cancer treatment are presented, focusing on study design, population, device, aim, and planned outcomes. Further, two actual case studies performed are reported, focusing on patients included, data collected, results achieved, further activities planned, and strengths and limitations. RESULTS Only two of the three planned studies were performed. In general, patients found the technical issues of wearable sensors too challenging to deal with during cancer treatment. However, at the same time it was demonstrated that a large amount of data could be collected if the framework worked efficiently. CONCLUSION Wearable sensors have the potential to help solve challenges in clinical oncology, but for successful research projects and implementation, a setup with minimal effort on the part of patients is requested.
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Affiliation(s)
- Helle Pappot
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark (C.H.-M.)
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Emma Balch Steen-Olsen
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark (C.H.-M.)
| | - Cecilie Holländer-Mieritz
- Department of Oncology, Centre for Cancer and Organ Diseases, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark (C.H.-M.)
- Department of Oncology, Zealand University Hospital, 4700 Naestved, Denmark
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Šlapáková Losová V, Dvouletý O. The role of open innovation in addressing resource constraints in healthcare: a systematic literature review. J Health Organ Manag 2024; ahead-of-print. [PMID: 38270394 DOI: 10.1108/jhom-06-2023-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE The resource crisis in healthcare can be alleviated by engaging external stakeholders and resources in healthcare delivery. The authors use value and open innovation concepts to understand what motivates the stakeholders to join the healthcare innovation ecosystem and what value such an ecosystem brings to healthcare. DESIGN/METHODOLOGY/APPROACH A systematic literature review following the PRISMA framework method was applied to reach the research objective. Out of a total of 509 identified articles published till 2021, 25 were selected as relevant for this review. FINDINGS Six categories of actors were identified, including innovation intermediaries, which were so far neglected in the healthcare innovation literature. Furthermore, patients, healthcare providers, innovation suppliers, investors and influencers were described. The authors also distinguished internal and external stakeholders. The authors show why and how open innovation projects contribute to involving external stakeholders and resources in healthcare delivery by contributing to patient autonomy, relationship building, knowledge transfer, improving collaborative mindset and culture, advancing know-how and bringing additional finances. ORIGINALITY/VALUE This article is the first one to systematically describe the value of open innovation in healthcare. The authors challenge the positivist approach in value presented by value-based healthcare. The authors show how openness contributes to addressing the resource crisis by involving new stakeholders and resources in the care delivery process.
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Affiliation(s)
| | - Ondřej Dvouletý
- Department of Entrepreneurship, Prague University of Economics and Business, Prague, Czech Republic
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García-Rayado J, Callens C. Users' involvement in digital health collaborative projects. J Health Organ Manag 2024; ahead-of-print. [PMID: 38192045 DOI: 10.1108/jhom-04-2023-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
PURPOSE This research analyzes the roles of users in innovative digital health collaborative projects from the perspective of the user by considering three dimensions: their motivation, project activities and the support of the partnership for their effective involvement. DESIGN/METHODOLOGY/APPROACH The authors unraveled profiles of users by using a Q-methodological analysis of 24 statements and 44 service users. The statements for the three dimensions were designed according to previous models of stakeholder identification and customer participation in new product management. FINDINGS The authors obtained two profiles that advocate active participation of users, though with a different degree of involvement. One of them supports the role of users as "advisors" of users' preferences and needs, and the other indicates a higher involvement of users as "cocreators" of the innovation, with the same contribution and responsibility as the other partners. ORIGINALITY/VALUE Previous research has analyzed user involvement in digital health, as part of wider research on factors leading to the success and adoption of innovations. Moreover, previous research has analyzed user involvement in innovation projects, but without differentiating between projects carried out by an individual organization and those conducted by a partnership. This research contributes to filling this gap by revealing users' expectations about their involvement and how they think they will fit in with the dynamics of collaborative projects.
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Affiliation(s)
- Jaime García-Rayado
- Department of Accounting and Finance, Universidad de Zaragoza, Zaragoza, Spain
| | - Chesney Callens
- Department of Political Science, University of Antwerp, Antwerp, Belgium
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Leigh S, Baines R, Stevens S, Garba-Sani Z, Austin D, Chatterjee A. Walk a mile in my shoes: perspectives towards sharing of health and experience data among individuals living with sickle cell disorder. Mhealth 2024; 10:4. [PMID: 38323148 PMCID: PMC10839506 DOI: 10.21037/mhealth-23-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 11/29/2023] [Indexed: 02/08/2024] Open
Abstract
Background Advancements in digital health technologies (DHTs) mean people are increasingly recording and managing personal health data. As observed during the COVID-19 pandemic, sharing of such data may provide unrivalled opportunities in advancing our understanding of conditions otherwise poorly understood, including rare conditions. Methods A semi-structured focus group (n=25) explored perspectives and experiences of sharing health data among those with a group of rare haematological conditions, sickle cell disorder (SCD). The focus group explored (I) what 'feeling well' looks like; (II) how this could be monitored using DHTs; (III) which data healthcare professionals (HCPs) should pay greater attention to and; (IV) types of data willing to be shared, with whom, and under which conditions. Key themes were further assessed via an online survey (n=50). Results Patient-relevant measures of condition-management focused on "everything else that comes with" SCD, suggesting HCPs did not pay sufficient attention to day-to-day symptom variability. This was juxtaposed against the "fixed and one-off" electronic health record (EHR), collecting pre-specified data at pre-determined snapshots of time, not considered reflective of outcomes associated with "feeling well" day-to-day. Forty-four-point-seven percent of respondents had previously shared health data. Most were willing to share data concerning symptoms and health service utilisation, but were less willing to share genomic and EHR data. Sixty-one-point-seven percent believed HCPs did not pay enough attention to daily fluctuations in mental and physical health. Financial benefits (74.5%), trust in organisations seeking data (72.3%), and knowing how data will be used (61.7%) were key facilitators of data sharing. Seventy-one percent, 70% and 65.2% had not previously shared health data with the pharmaceutical industry, charitable organisations and digital health interventions respectively, but were open to doing so in the future. Conclusions Those living with the rare condition SCD were supportive of collecting and sharing data to foster research and improve understanding and outcomes. However, specific requirements were identified to respect privacy and informational needs regarding future use of data. DHTs can be a valuable tool in improving understanding of the day-to-day impact of health conditions, but understanding patient needs is critical in ensuring involvement in the process, as not all data types are considered of equal value, benefit, or risk.
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Affiliation(s)
- Simon Leigh
- Prometheus Health Technologies, Mor Workspace, Newquay, UK
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Rebecca Baines
- Centre for Health Technology, University of Plymouth, Plymouth, UK
| | - Sebastian Stevens
- Prometheus Health Technologies, Mor Workspace, Newquay, UK
- Centre for Health Technology, University of Plymouth, Plymouth, UK
| | | | - Daniella Austin
- School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Arunangsu Chatterjee
- Centre for Health Technology, University of Plymouth, Plymouth, UK
- School of Medicine, University of Leeds, Leeds, UK
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Brotherdale R, Berry K, Branitsky A, Bucci S. Co-producing digital mental health interventions: A systematic review. Digit Health 2024; 10:20552076241239172. [PMID: 38665886 PMCID: PMC11044797 DOI: 10.1177/20552076241239172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/28/2024] Open
Abstract
Objective Smartphone apps (apps) are widely recognised as promising tools for improving access to mental healthcare. However, a key challenge is the development of digital interventions that are acceptable to end users. Co-production with providers and stakeholders is increasingly positioned as the gold standard for improving uptake, engagement, and healthcare outcomes. Nevertheless, clear guidance around the process of co-production is lacking. The objectives of this review were to: (i) present an overview of the methods and approaches to co-production when designing, producing, and evaluating digital mental health interventions; and (ii) explore the barriers and facilitators affecting co-production in this context. Methods A pre-registered (CRD42023414007) systematic review was completed in accordance with The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Five databases were searched. A co-produced bespoke quality appraisal tool was developed with an expert by experience to assess the quality of the co-production methods and approaches. A narrative synthesis was conducted. Results Twenty-six studies across 24 digital mental health interventions met inclusion criteria. App interventions were rarely co-produced with end users throughout all stages of design, development, and evaluation. Co-producing digital mental health interventions added value by creating culturally sensitive and acceptable interventions. Reported challenges included resource issues exacerbated by the digital nature of the intervention, variability across stakeholder suggestions, and power imbalances between stakeholders and researchers. Conclusions Variation in approaches to co-producing digital mental health interventions is evident, with inconsistencies between stakeholder groups involved, stage of involvement, stakeholders' roles and methods employed.
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Affiliation(s)
- Rebecca Brotherdale
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Katherine Berry
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Alison Branitsky
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sandra Bucci
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Hosie A, Firdaus M, Clarkson J, Gupta E, Laidlaw L, Lamont T, Mooney M, Nevin G, Ramsay C, Rutherford S, Sardo AM, Soulsby I, Richards D, Stirling D, West M, Goulao B. Citizen science to improve patient and public involvement in GUideline Implementation in oral health and DEntistry (the GUIDE platform). Health Expect 2023; 27:e13921. [PMID: 38014917 PMCID: PMC10768863 DOI: 10.1111/hex.13921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Citizen science is a way to democratise science by involving groups of citizens in the research process. Clinical guidelines are used to improve practice, but their implementation can be limited. Involving patients and the public can enhance guideline implementation, but there is uncertainty about the best approaches to achieve this. Citizen science is a potential way to involve patients and the public in improving clinical guideline implementation. We aimed to explore the application of citizen science methods to involve patients and the public in the dissemination and implementation of clinical guidelines in oral health and dentistry. METHODS We developed GUIDE (GUideline Implementation in oral health and DEntistry), a citizen science online platform, using a participatory approach with researchers, oral health professionals, guideline developers and citizens. Recruitment was conducted exclusively online. The platform focused on prespecified challenges related to oral health assessment guidelines, and asked citizens to generate ideas, as well as vote and comment on other citizens' ideas to improve those challenges. Citizens also shared their views via surveys and two online synchronous group meetings. Data were collected on participant's demographics, platform engagement and experience of taking part. The most promising idea category was identified by an advisory group based on engagement, feasibility and relevance. We presented quantitative data using descriptive statistics and analysed qualitative data using inductive and deductive thematic analysis. RESULTS The platform was open for 6 months and we recruited 189 citizens, from which over 90 citizens actively engaged with the platform. Most citizens were over 34 years (64%), female (58%) and had a university degree (50%). They generated 128 ideas, 146 comments and 248 votes. The challenge that led to most engagement was related to prevention and oral health self-care. To take this challenge forward, citizens generated a further 36 ideas to improve a pre-existing National Health Service oral care prevention leaflet. Citizens discussed motivations to take part in the platform (understanding, values, self-care), reasons to stay engaged (communication and feedback, outputs and impact, and relevance of topics discussed) and suggestions to improve future platforms. CONCLUSION Citizen science is an effective approach to generate and prioritise ideas from a group of citizens to improve oral health and dental services. Prevention and oral health self-care were of particular interest to citizens. More research is needed to ensure recruitment of a diverse group of citizens and to improve retention in citizen science projects. PATIENT OR PUBLIC CONTRIBUTION This project was inherently conducted with the input of public partners (citizen scientists) in all key aspects of its conduct and interpretation. In addition, two public partners were part of the research team and contributed to the design of the project, as well as key decisions related to its conduct, analysis, interpretation and dissemination and are co-authors of this manuscript.
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Affiliation(s)
- Annabel Hosie
- Health Services Research UnitUniversity of AberdeenAberdeenUK
| | - Maria Firdaus
- Health Services Research UnitUniversity of AberdeenAberdeenUK
| | - Jan Clarkson
- Dental Health Services Research Unit, Dundee Dental SchoolThe University of DundeeDundeeUK
| | - Ekta Gupta
- Institute of DentistryUniversity of AberdeenAberdeenUK
| | | | - Thomas Lamont
- Dental Health Services Research Unit, Dundee Dental SchoolThe University of DundeeDundeeUK
| | - Margaret Mooney
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | - Gillian Nevin
- NHS Education for Scotland (Dental), DundeeScotlandUK
| | - Craig Ramsay
- Health Services Research UnitUniversity of AberdeenAberdeenUK
| | - Samantha Rutherford
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | | | | | - Derek Richards
- Dental Health Services Research Unit, Dundee Dental SchoolThe University of DundeeDundeeUK
| | - Douglas Stirling
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | - Michele West
- Scottish Dental Clinical Effectiveness Programme (SDCEP)NHS Education for ScotlandEdinburghUK
| | - Beatriz Goulao
- Health Services Research UnitUniversity of AberdeenAberdeenUK
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Frey AL, Baines R, Hunt S, Kent R, Andrews T, Leigh S. Association Between the Characteristics of mHealth Apps and User Input During Development and Testing: Secondary Analysis of App Assessment Data. JMIR Mhealth Uhealth 2023; 11:e46937. [PMID: 37991822 PMCID: PMC10701645 DOI: 10.2196/46937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/15/2023] [Accepted: 07/11/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND User involvement is increasingly acknowledged as a central part of health care innovation. However, meaningful user involvement during the development and testing of mobile health apps is often not fully realized. OBJECTIVE This study aims to examine in which areas user input is most prevalent and whether there is an association between user inclusion and compliance with best practices for mobile health apps. METHODS A secondary analysis was conducted on an assessment data set of 1595 health apps. The data set contained information on whether the apps had been developed or tested with user input and whether they followed best practices across several domains. Background information was also available regarding the apps' country of origin, targeted condition areas, subjective user ratings, download numbers, and risk (as per the National Institute for Health and Care Excellence Evidence Standards Framework [ESF]). Descriptive statistics, Mann-Whitney U tests, and Pearson chi-square analyses were applied to the data. RESULTS User involvement was reported by 8.71% (139/1595) of apps for only the development phase, by 33.67% (537/1595) of apps for only the testing phase, by 21.88% (349/1595) of apps for both phases, and by 35.74% (570/1595) of apps for neither phase. The highest percentage of health apps with reported user input during development was observed in Denmark (19/24, 79%); in the condition areas of diabetes (38/79, 48%), cardiology (15/32, 47%), pain management (20/43, 47%), and oncology (25/54, 46%); and for high app risk (ESF tier 3a; 105/263, 39.9%). The highest percentage of health apps with reported user input during testing was observed in Belgium (10/11, 91%), Sweden (29/34, 85%), and France (13/16, 81%); in the condition areas of neurodiversity (42/52, 81%), respiratory health (58/76, 76%), cardiology (23/32, 72%), and diabetes (56/79, 71%); and for high app risk (ESF tier 3a; 176/263, 66.9%). Notably, apps that reported seeking user input during testing demonstrated significantly more downloads than those that did not (P=.008), and user inclusion was associated with better compliance with best practices in clinical assurance, data privacy, risk management, and user experience. CONCLUSIONS The countries and condition areas in which the highest percentage of health apps with user involvement were observed tended to be those with higher digital maturity in health care and more funding availability, respectively. This suggests that there may be a trade-off between developers' willingness or ability to involve users and the need to meet challenges arising from infrastructure limitations and financial constraints. Moreover, the finding of a positive association between user inclusion and compliance with best practices indicates that, where no other guidance is available, users may benefit from prioritizing health apps developed with user input as the latter may be a proxy for broader app quality.
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Affiliation(s)
- Anna-Lena Frey
- Organisation for the Review of Care and Health Apps, Daresbury, United Kingdom
| | - Rebecca Baines
- Organisation for the Review of Care and Health Apps, Daresbury, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Sophie Hunt
- Organisation for the Review of Care and Health Apps, Daresbury, United Kingdom
| | - Rachael Kent
- Department of Digital Humanities, King's College London, London, United Kingdom
| | - Tim Andrews
- Organisation for the Review of Care and Health Apps, Daresbury, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Simon Leigh
- Organisation for the Review of Care and Health Apps, Daresbury, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
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Farias MA, Badino M, Marti M, Báscolo E, García Saisó S, D’Agostino M. [Digital transformation as a strategy to strengthen essential public health functions in the AmericasTransformação digital como estratégia de fortalecimento das funções essenciais de saúde pública nas Américas]. Rev Panam Salud Publica 2023; 47:e150. [PMID: 38024443 PMCID: PMC10648435 DOI: 10.26633/rpsp.2023.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/31/2023] [Indexed: 12/01/2023] Open
Abstract
This article systematizes the main actions taken to address the essential public health functions (EPHF) in the context of the digital transformation of health systems. A narrative review was conducted, in which the conceptual framework of the renewed EPHF was linked to the eight guiding principles of the digital transformation of the health sector.In the selected publications, the main actions in digital transformation included electronic health records, telemedicine, digital health legislation, digital literacy, patient portals, open-source technologies, and data governance. These actions make it possible to increase the quality and efficiency of health systems, promote accessibility, and improve health outcomes.
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Affiliation(s)
- María Alejandra Farias
- Escuela de Salud PúblicaUniversidad Nacional de CórdobaCórdobaArgentinaEscuela de Salud Pública, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Manuel Badino
- Escuela de Salud PúblicaUniversidad Nacional de CórdobaCórdobaArgentinaEscuela de Salud Pública, Universidad Nacional de Córdoba, Córdoba, Argentina.
| | - Myrna Marti
- Organización Panamericana de la SaludWashington D. C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington D. C., Estados Unidos de América.
| | - Ernesto Báscolo
- Organización Panamericana de la SaludWashington D. C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington D. C., Estados Unidos de América.
| | - Sebastián García Saisó
- Organización Panamericana de la SaludWashington D. C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington D. C., Estados Unidos de América.
| | - Marcelo D’Agostino
- Organización Panamericana de la SaludWashington D. C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington D. C., Estados Unidos de América.
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20
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Foley K, Lunnay B, Kevin C, Ward PR. Developing a Women's Thought Collective methodology for health research: The roles and responsibilities of researchers in the reflexive co-production of knowledge. Health Expect 2023; 26:1954-1964. [PMID: 37522791 PMCID: PMC10485336 DOI: 10.1111/hex.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Co-produced research holds enormous value within the health sciences. Yet, there can be a heavy focus on what research participants think, do and know; while the researcher's responsibility to explore and re/work their own knowledge or praxis tends to escape from view. This is reflected in the limited use of co-production to explore broad structural distributions of health and risk(s). We argue this missed opportunity has the potential to unfold as what Berlant calls a 'cruel optimism', where something desirable becomes an obstacle to flourishing and/or produces harm. We explore challenges to involving lay populations meaningfully in health research amidst a neoliberal cultural landscape that tends to responsibilise people with problems they cannot solve. METHODS AND FINDINGS Drawing together principles from hermeneutic and feminist philosophy, we develop a novel methodology for co-producing research about determinants of health and health risk (using a case study of alcohol consumption as an example) that centres on what researchers do, know and think during research: Women's Thought Collectives. DISCUSSION Keeping the constructed nature of social systems-because they shape ideas of value, expertise and knowledge-in view during co-produced research illuminates the potential for cruel optimisms within it. Such reflexive awareness carves out starting points for researchers to engage with how social hierarchies might (tacitly) operate during the co-production of knowledge. Our work has broad utility for diverse population groups and provides important considerations around the roles and responsibilities for reflexive co-production of knowledge at all levels of health systems. PATIENT OR PUBLIC CONTRIBUTION The development of these ideas was sparked by working with lay participants during the Women's Thought Collectives for Kristen Foley's doctoral research 2021-2023, but undertaken without their direct involvement-in accordance with the responsibilities of researchers in the reflexive co-production of knowledge. Forthcoming publications will address the outcomes and processes of this work.
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Affiliation(s)
- Kristen Foley
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideAustralia
| | - Belinda Lunnay
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideAustralia
| | - Catherine Kevin
- College of Humanities and Social ScienceFlinders UniversityAdelaideAustralia
| | - Paul R. Ward
- Research Centre for Public Health, Equity and Human FlourishingTorrens University AustraliaAdelaideAustralia
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21
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Jahre LM, Lortz J, Rassaf T, Rammos C, Mallien C, Skoda EM, Teufel M, Bäuerle A. Needs and demands for mHealth cardiac health promotion among individuals with cardiac diseases: a patient-centred design approach. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2023; 4:393-401. [PMID: 37794866 PMCID: PMC10545514 DOI: 10.1093/ehjdh/ztad038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/05/2023] [Indexed: 10/06/2023]
Abstract
Aims Cardiovascular diseases are one of the main contributors to disability and mortality worldwide. Meanwhile, risk factors can be modified by lifestyle changes. mHealth is an innovative and effective way to deliver cardiac health promotion. This study aims to examine the needs and demands regarding the design and contents of an mHealth intervention for cardiac health promotion among individuals with cardiac diseases. Different clusters were determined and analysed in terms of the intention to use an mHealth intervention. Methods and results A cross-sectional study was conducted via a web-based survey. Three hundred and four individuals with coronary artery diseases (CADs) and/or congestive heart failure (CHF) were included in the data analysis. Descriptive statistics were applied to evaluate needs and demands regarding an mHealth intervention. A k-medoids cluster analysis was performed. Individuals with CAD and CHF favoured an mHealth intervention that supports its users permanently and is easily integrated into everyday life. Handheld devices and content formats that involve active user participation and regular updates were preferred. Three clusters were observed and labelled high, moderate, and low burden, according to their psychometric properties. The high burden cluster indicated higher behavioural intention towards use of an mHealth intervention than the other clusters. Conclusion The results of the study are a valuable foundation for the development of an mHealth intervention for cardiac health promotion following a user-centred design approach. Individuals with cardiac diseases report positive attitudes in the form of high usage intention regarding mHealth. Highly burdened individuals report a high intention to use such interventions.
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Affiliation(s)
- Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Julia Lortz
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Tienush Rassaf
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Christos Rammos
- Department of Cardiology and Vascular Medicine, West-German Heart and Vascular Center Essen, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - Charlotta Mallien
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, Virchowstr. 174, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Virchowstr. 174, 45147 Essen, Germany
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22
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Nordin A, Kjellstrom S, Robert G, Masterson D, Areskoug Josefsson K. Measurement and outcomes of co-production in health and social care: a systematic review of empirical studies. BMJ Open 2023; 13:e073808. [PMID: 37739472 PMCID: PMC10533672 DOI: 10.1136/bmjopen-2023-073808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/30/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Co-production is promoted as an effective way of improving the quality of health and social care but the diversity of measures used in individual studies makes their outcomes difficult to interpret. OBJECTIVE The objective is to explore how empirical studies in health and social care have described the outcomes of co-production projects and how those outcomes were measured. DESIGN AND METHODS A scoping review forms the basis for this systematic review. Search terms for the concepts (co-produc* OR coproduc* OR co-design* OR codesign*) and contexts (health OR 'public service* OR "public sector") were used in: CINAHL with Full Text (EBSCOHost), Cochrane Central Register of Controlled trials (Wiley), MEDLINE (EBSCOHost), PsycINFO (ProQuest), PubMed (legacy) and Scopus (Elsevier). There was no date limit. Papers describing the process, original data and outcomes of co-production were included. Protocols, reviews and theoretical, conceptual and psychometric papers were excluded. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The Mixed Methods Appraisal Tool underpinned the quality of included papers. RESULTS 43 empirical studies were included. They were conducted in 12 countries, with the UK representing >50% of all papers. No paper was excluded due to the Mixed Methods Quality Appraisal screening and 60% of included papers were mixed methods studies. The extensive use of self-developed study-specific measures hampered comparisons and cumulative knowledge-building. Overall, the studies reported positive outcomes. Co-production was reported to be positively experienced and provided important learning. CONCLUSIONS The lack of common approaches to measuring co-production is more problematic than the plurality of measurements itself. Co-production should be measured from three perspectives: outputs of co-production processes, the experiences of participating in co-production processes and outcomes of co-production. Both self-developed study-specific measures and established measures should be used. The maturity of this research field would benefit from the development and use of reporting guidelines.
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Affiliation(s)
- Annika Nordin
- Department of Quality improvement and Leadership, Jönköping Academy of Improvement of Health and Welfare, Jönköping University School of Health and Welfare, Jonkoping, Sweden
| | - Sofia Kjellstrom
- Department of Quality improvement and Leadership, Jönköping Academy of Improvement of Health and Welfare, Jönköping University School of Health and Welfare, Jonkoping, Sweden
| | - Glenn Robert
- Department of Quality improvement and Leadership, Jönköping Academy of Improvement of Health and Welfare, Jönköping University School of Health and Welfare, Jonkoping, Sweden
- Division of Methodologies, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | - Daniel Masterson
- Department of Quality improvement and Leadership, Jönköping Academy of Improvement of Health and Welfare, Jönköping University School of Health and Welfare, Jonkoping, Sweden
| | - Kristina Areskoug Josefsson
- Department of Quality improvement and Leadership, Jönköping Academy of Improvement of Health and Welfare, Jönköping University School of Health and Welfare, Jonkoping, Sweden
- Department of Health Sciences, University West, Trollhattan, Sweden
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23
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McLean KA, Knight SR, Diehl TM, Varghese C, Ng N, Potter MA, Zafar SN, Bouamrane MM, Harrison EM. Readiness for implementation of novel digital health interventions for postoperative monitoring: a systematic review and clinical innovation network analysis. Lancet Digit Health 2023; 5:e295-e315. [PMID: 37100544 DOI: 10.1016/s2589-7500(23)00026-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 04/28/2023]
Abstract
An increasing number of digital health interventions (DHIs) for remote postoperative monitoring have been developed and evaluated. This systematic review identifies DHIs for postoperative monitoring and evaluates their readiness for implementation into routine health care. Studies were defined according to idea, development, exploration, assessment, and long-term follow-up (IDEAL) stages of innovation. A novel clinical innovation network analysis used coauthorship and citations to examine collaboration and progression within the field. 126 DHIs were identified, with 101 (80%) being early stage innovations (IDEAL stage 1 and 2a). None of the DHIs identified had large-scale routine implementation. There is little evidence of collaboration, and there are clear omissions in the evaluation of feasibility, accessibility, and the health-care impact. Use of DHIs for postoperative monitoring remains at an early stage of innovation, with promising but generally low-quality supporting evidence. Comprehensive evaluation within high-quality, large-scale trials and real-world data are required to definitively establish readiness for routine implementation.
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Affiliation(s)
- Kenneth A McLean
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Stephen R Knight
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Thomas M Diehl
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Chris Varghese
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Nathan Ng
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Mark A Potter
- Colorectal Unit, Western General Hospital, Edinburgh, UK
| | - Syed Nabeel Zafar
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Matt-Mouley Bouamrane
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Ewen M Harrison
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, UK.
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Gould DJ, Glanville-Hearst M, Bunzli S, Choong PFM, Dowsey MM. Research Buddy partnership in a MD-PhD program: lessons learned. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:4. [PMID: 36803954 PMCID: PMC9938357 DOI: 10.1186/s40900-023-00414-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND AIMS There is increasing recognition of the importance of patient involvement in research. In recent years, there has also been growing interest in patient partnerships with doctoral studies students. However, it can be difficult to know where to start and how to go about such involvement activities. The purpose of this perspective piece was to share experiential insight of the experience of a patient involvement program such that others can learn from this experience. BODY: This is a co-authored perspective piece centred on the experience of MGH, a patient who has had hip replacement surgery, and DG, a medical student completing a PhD, participating in a Research Buddy partnership over the course of over 3 years. The context in which this partnership took place was also described to facilitate comparison with readers' own circumstances and contexts. DG and MGH met regularly to discuss, and work together on, various aspects of DG's PhD research project. Reflexive thematic analysis was conducted on reflections from DG and MGH regarding their experience in the Research Buddy program to synthesise nine lessons which were then corroborated with reference to published literature on patient involvement in research. These lessons were: learn from experience; tailor the program; get involved early; embrace uniqueness; meet regularly; build rapport; ensure mutual benefit; broad involvement; regularly reflect and review. CONCLUSIONS In this perspective piece, a patient and a medical student completing a PhD reflected upon their experience co-designing a Research Buddy partnership within a patient involvement program. A series of nine lessons was identified and presented to inform readers seeking to develop or enhance their own patient involvement programs. Researcher-patient rapport is foundational to all other aspects of the patient's involvement.
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Affiliation(s)
- Daniel J Gould
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia.
| | - Marion Glanville-Hearst
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Samantha Bunzli
- School of Health Sciences and Social Work, Griffith University, Nathan Campus, Brisbane, QLD, Australia
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Peter F M Choong
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Michelle M Dowsey
- Department of Surgery, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
- Department of Orthopaedics, St. Vincent's Hospital, Melbourne, VIC, Australia
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25
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May S, Bruch D, Gehlhaar A, Linderkamp F, Stahlhut K, Heinze M, Allsop M, Muehlensiepen F. Digital technologies in routine palliative care delivery: an exploratory qualitative study with health care professionals in Germany. BMC Health Serv Res 2022; 22:1516. [PMID: 36514156 PMCID: PMC9745710 DOI: 10.1186/s12913-022-08802-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To explore health care professionals' (HCPs) perspectives, experiences and preferences towards digital technology use in routine palliative care delivery. METHODS HCPs (n = 19) purposively selected from a sample of settings that reflect routine palliative care delivery (i.e. specialized outpatient palliative care, inpatient palliative care, inpatient hospice care in both rural and urban areas of the German states of Brandenburg and Berlin) participated in an explorative, qualitative study using semi-structured interviews. Interview data were analyzed using structured qualitative content analysis. RESULTS Digital technologies are widely used in routine palliative care and are well accepted by HCPs. Central functions of digital technologies as experienced in palliative care are coordination of work processes, patient-centered care, and communication. Especially in outpatient care, they facilitate overcoming spatial and temporal distances. HCPs attribute various benefits to digital technologies that contribute to better coordinated, faster, more responsive, and overall more effective palliative care. Simultaneously, participants preferred technology as an enhancement not replacement of care delivery. HCPs fear that digital technologies, if overused, will contribute to dehumanization and thus significantly reduce the quality of palliative care. CONCLUSION Digital technology is already an essential part of routine palliative care delivery. While generally perceived as useful by HCPs, digital technologies are considered as having limitations and carrying risks. Hence, their use and consequences must be carefully considered, as they should discreetly complement but not replace human interaction in palliative care delivery.
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Affiliation(s)
- Susann May
- grid.473452.3Center for Health Services Research, Brandenburg Medical School, Seebad 82/83, Rüdersdorf bei Berlin, Germany
| | - Dunja Bruch
- Department of Cardiovascular Surgery, Heart Center Brandenburg, Brandenburg Medical School, Bernau bei Berlin, Germany ,grid.473452.3Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany
| | - Anne Gehlhaar
- grid.473452.3Center for Health Services Research, Brandenburg Medical School, Seebad 82/83, Rüdersdorf bei Berlin, Germany
| | - Felizitas Linderkamp
- grid.473452.3Center for Health Services Research, Brandenburg Medical School, Seebad 82/83, Rüdersdorf bei Berlin, Germany
| | - Kerstin Stahlhut
- grid.473452.3Department of Oncology and Palliative Medicine, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Brandenburg Germany
| | - Martin Heinze
- grid.473452.3Center for Health Services Research, Brandenburg Medical School, Seebad 82/83, Rüdersdorf bei Berlin, Germany ,grid.473452.3Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
| | - Matthew Allsop
- grid.9909.90000 0004 1936 8403Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, West Yorkshire UK
| | - Felix Muehlensiepen
- grid.473452.3Center for Health Services Research, Brandenburg Medical School, Seebad 82/83, Rüdersdorf bei Berlin, Germany ,grid.473452.3Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany ,grid.450307.50000 0001 0944 2786AGEIS, Université Grenoble Alpes, Grenoble, France
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