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Di Profio B, Lotto M, Ayala Aguirre PE, Villar CC, Romito GA, Cruvinel T, Pannuti CM. Digital surveillance: The interest in mouthwash-related information. Int J Dent Hyg 2024; 22:414-422. [PMID: 37721314 DOI: 10.1111/idh.12755] [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: 02/11/2022] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND The comprehension of the interests of Internet users regarding their health-related searches may reveal the community's demands about oral health. The study aimed to characterize the interests of Google users related to mouthwash in Australia, Brazil, Chile, Japan, Mexico, Russia, the United Kingdom, the United States, Saudi Arabia and South Africa applying the Google Trends. METHODS This longitudinal retrospective study analysed the mouthwash-related interest of Google users from January 2004 to December 2020. The monthly variation of relative search volume (RSV) and the main queries related were determined using Google Trends. Autoregressive integrated moving average (ARIMA) forecasting models were built to establish the predictive RSV values for mouthwash for additional 12 months. Auto-correlation plots and a general additive model (GAM) were used to diagnose trends and seasonality in RSV curves. In addition, the influence of social isolation related to the outbreak of COVID-19 were analysed. RESULTS The RSVs curves showed a considerable increase in searches related to mouthwash to AUS, BRA, JAP, MEX, GBR and USA (RSV > 25), while the growth was slight to CHI, KSA, RSA and RUS (RSV < 25) over the years, without influence of monthly seasonality. All countries showed a significant increase in mouthwash interest after the outbreak of COVID-19, except for KSA and RUS. The mouthwash-related searches were associated to specific brands or chemical compositions, treatments, whitening agents, homemade mouthwash and indications for the 'best mouthwash'. CONCLUSIONS In general, there was an increasing interest of Google users in mouthwash-related topics between 2004 and 2020. In addition, in most countries, there was an expansion in searches during the social isolation of the COVID-19 pandemics.
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Affiliation(s)
- Bruna Di Profio
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
| | - Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo FOB-USP, Bauru, Brazil
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Patricia E Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo FOB-USP, Bauru, Brazil
- Universidad de especialidades Espíritu Santo-UEES, Samborondón, Ecuador
| | - Cristina C Villar
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
| | - Giuseppe A Romito
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo FOB-USP, Bauru, Brazil
| | - Cláudio Mendes Pannuti
- Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo-FO-USP, São Paulo, Brazil
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Zhu J, Chen W. Use of aspirin in cardiovascular disease prevention-the role of online information search. Chronic Illn 2024:17423953241241761. [PMID: 38584373 DOI: 10.1177/17423953241241761] [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] [Indexed: 04/09/2024]
Abstract
OBJECTIVES This study intends to examine influences of online information search on the use of aspirin in cardiovascular diseases (CVDs) prevention among the applicable adult population in the United States. METHODS We used data of 2018 National Health Interview Survey (NHIS). Our study sample is limited to adults age 40 or older to be consistent with the American Heart Association/American College of Cardiology Foundation (AHA/ACCF) guidelines for aspirin use. Linear probability models were used to test the association between patient's aspirin use behaviors and the variables of interest in four separate models. RESULTS Our results show that the use of aspirin for CVD prevention was associated with online health information seeking in different ways. When patients received doctors' advice to use aspirin, online information seeking has a negative influence, depending on whether the individual has CVD risk factors. However, for patients without recommendations from providers, the effects of online information seeking on self-initiated aspirin use depend on the different types of preventions (primary vs. secondary) and CVD risk factors. CONCLUSION Overall, online health information might lead to both overuse and underuse of aspirin in CVD preventions. Findings in this study may lead to decision-making that is not consistent with advice from healthcare professionals and/or established clinical guidelines.
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Affiliation(s)
- Jingrong Zhu
- School of Economics and Management, Communication University of China, Beijing, China
| | - Wenjia Chen
- School of Economics and Management, Beijing Information Science and Technology University, Beijing, China
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Ishizuki S, Hirano M. Online health information searching and health literacy among middle-aged and older adults: A cross-sectional study. Nurs Health Sci 2024; 26:e13098. [PMID: 38369320 DOI: 10.1111/nhs.13098] [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: 12/27/2022] [Revised: 12/28/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
Given the rapid increase in health information available, health literacy is now more important than ever when searching for health information online. Furthermore, health literacy and online health information searching are reported to be associated with support from others. In this study, we examined the associations of health literacy and social support with online health information searching among individuals in their 50s and 60s. Between March and May 2022, an anonymous self-administered questionnaire was administered among 750 middle-aged and older adults (age 50-69) living in northern Japan. The questionnaire items included personal characteristics, frequency of online health information searching, health literacy domains, and social support. A total of 237 respondents answered all the items (response rate: 31.6%). Multiple logistic regression analysis revealed that communicative health literacy was significantly associated with searching for information about illnesses and health promotion, while critical health literacy was significantly associated with searching for information about medical institutions. Controlling for personal characteristics, health literacy, was associated with online health information searching, suggesting that improving health literacy is important in a digital and information society.
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Affiliation(s)
- Shiho Ishizuki
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Michiyo Hirano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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Chivela FL, Burch AE, Asagbra O. An Assessment of Patient Portal Messaging Use by Patients With Multiple Chronic Conditions Living in Rural Communities: Retrospective Analysis. J Med Internet Res 2023; 25:e44399. [PMID: 37526967 PMCID: PMC10427930 DOI: 10.2196/44399] [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: 12/13/2022] [Revised: 03/26/2023] [Accepted: 05/31/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Patient portals can facilitate the delivery of health care services and support self-management for patients with multiple chronic conditions. Despite their benefits, the evidence of patient portal use among patients with multimorbidity in rural communities is limited. OBJECTIVE This study aimed to explore the factors associated with portal messaging use by rural patients. METHODS We assessed patient portal use among patients with ≥1 chronic diagnoses who sent or received messages via the Epic MyChart (Epic Systems Corporation) portal between January 1, 2015, and November 9, 2021. Patient portal use was defined as sending or receiving a message through the portal during the study period. We fit a zero-inflated negative binomial model to predict portal use based on the patient's number of chronic conditions, sex, race, age, marital status, and insurance type. County-level characteristics, based on the patient's home address, were also included in the model to assess the influence of community factors on portal use. County-level factors included educational attainment, smartphone ownership, median income, and primary care provider density. RESULTS A total of 65,178 patients (n=38,587, 59.2% female and n=21,454, 32.92% Black) were included in the final data set, of which 38,380 (58.88%) sent at least 1 message via the portal during the 7-year study period. As the number of chronic diagnoses increased, so did portal messaging use; however, this relationship was driven primarily by younger patients. Patients with 2 chronic conditions were 1.57 times more likely to send messages via the portal than those with 1 chronic condition (P<.001). In comparison, patients with ≥7 chronic conditions were approximately 11 times more likely to send messages than patients with 1 chronic condition (P<.001). A robustness check confirmed the interaction effect of age and the number of diagnoses on portal messaging. In the model including only patients aged <65 years, there was a significant effect of increased portal messaging corresponding to the number of chronic conditions (P<.001). Conversely, this relationship was not significant for the model consisting of older patients. Other significant factors associated with increased portal use include being female; White; married; having private insurance; and living in an area with a higher average level of educational attainment, greater medical provider density, and a lower median income. CONCLUSIONS Patients' use of the portal to send messages to providers was incrementally related to their number of diagnoses. As the number of chronic diagnoses increased, so did portal messaging use. Patients of all ages, particularly those living in rural areas, could benefit from the convenience and cost-effectiveness of portal communication. Health care systems and providers are encouraged to increase the use of patient portals by implementing educational interventions to promote the advantages of portal communication, particularly among patients with multimorbidity.
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Affiliation(s)
- Fernando L Chivela
- Department of Health Services and Information Management, East Carolina University, Greenville, NC, United States
| | - Ashley E Burch
- Department of Health Services and Information Management, East Carolina University, Greenville, NC, United States
- Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Oghale Asagbra
- Department of Health Services and Information Management, East Carolina University, Greenville, NC, United States
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5
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Schmuter G, North VS, Kazim M, Tran AQ. Medical Accuracy of Patient Discussions in Oculoplastic Surgery on Social Media. Ophthalmic Plast Reconstr Surg 2023; 39:132-135. [PMID: 35943417 DOI: 10.1097/iop.0000000000002257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to characterize major topics of discussion in oculoplastic surgery on a social media forum and to evaluate the medical accuracy of the content discussed on these platforms. METHODS A cross-sectional analysis of oculoplastics key search terms was performed on 2 active forums (r/PlasticSurgery and r/CosmeticSurgery) on Reddit. The content analysis involved the top posts in Reddit's history from 2008 to 2022. Medical accuracy was determined by actively practicing, board-certified, and fellowship-trained oculoplastic surgeons. RESULTS The most common topics of patient discussions involved inquiring for advice regarding a procedure (44%) and sharing before-and-after photos (34%). The most common topics of patient discussions included providing support, encouragement, or sympathy for a patient (80%) and the cost of a procedure (62%). Misunderstanding of the medical pathophysiology of the patient's condition was seen in 68% of discussions on this social media platform. Medically inaccurate information was seen in 31% of all analyzed statements. When the type of physician performing a given procedure was disclosed, half reported an oculoplastic surgeon performed the surgery. CONCLUSIONS The social media platform, Reddit, is a popular source of advice and information for current and prospective oculoplastic surgery patients. Such social media forums should be used as a sort of psychosocial and psychological support rather than as a primary source of medical information.
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Affiliation(s)
- Gabriella Schmuter
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
- Department of Ophthalmology, Weill Cornell Medicine, New York, New York
| | - Victoria S North
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Michael Kazim
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
| | - Ann Q Tran
- Department of Ophthalmology, Edward Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
- Department of Ophthalmology, University of Illinois Eye and Ear Infirmary, Chicago, Illinois
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Bostancı SH, Yıldırım S, Yildirim DC. A study on next-generation digital tool for health data management: the e-Pulse portal. INTERNATIONAL JOURNAL OF HEALTH GOVERNANCE 2023. [DOI: 10.1108/ijhg-09-2022-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
PurposeThis study aims to investigate the working way of the e-Pulse portal in Türkiye as a sample of a next-generation digital tool for health data management. Accordingly, this study focuses on explaining the structure and key services of the e-Pulse portal in the context of health data management.Design/methodology/approachThis study is a technical paper that will explain how the e-Pulse portal works in Türkiye. Accordingly, the data are based on secondary sources and mostly the official website of the e-Pulse portal. As a sample case, this study investigates the e-Pulse portal from Türkiye. The data are categorized by tables, and some key factors are classified based on review results.FindingsAs a result of the review of the e-Pulse portal's sample account, it is seen that the e-Pulse portal provides comprehensive data for personal health data for both individuals and healthcare professionals. By permitting healthcare professionals, users or patients can share their personal health data on specific dates and numbers whenever they need and want. When sharing recorded personal health data, citizens or patients can get more efficient healthcare service on the time.Research limitations/implicationsBy giving descriptive evidence and review through the e-Pulse portal, countries with high-populated can see the key e-services and elements to manage health data through digital tools. On the other side, this study has some limitations. This study investigated the e-Pulse portal and its e-services for Türkiye and gave some findings mostly based on subjective deduction. Another digital portal can give different findings for the literature.Practical implicationsBased on the e-Pulse portal case, it is determined that by creating a digital portal with recorded personal up-to-date health data, healthcare services can be ensured more efficiently among high-populated countries in the long term. While population growth and pandemic possibilities such as COVID-19 increase throughout the world, serving more patients with these portals will increase efficiency and service quality, provided that patient information is well protected.Originality/valueThis study reveals key e-services and segments to provide personal health data management by a next-generation digital tool based on the e-Pulse portal. The main contribution of this study is expected to guide other countries when adapting next-generation technology or systems to manage health data in the future.
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Shaveet E, Urquhart C, Gallegos M, Dammann O, Corlin L. Web-Based Health Information–Seeking Methods and Time Since Provider Engagement: Cross-sectional Study. JMIR Form Res 2022; 6:e42126. [DOI: 10.2196/42126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 12/05/2022] Open
Abstract
Background
The use of web-based methods to seek health information is increasing in popularity. As web-based health information (WHI)–seeking affects health-related decision support and chronic symptom self-management, WHI-seeking from online sources may impact health care decisions and outcomes, including care-seeking decisions. Patients who are routinely connected to physicians are more likely to receive better and more consistent care. Little is known about whether WHI-seeking impacts the frequency at which patients engage with health care providers.
Objective
Our primary objective was to describe the associations between the use of web-based methods to seek information about one’s own health and the time since last engaging with a health care provider about one’s own health. Additionally, we aimed to assess participants’ trust in health care organizations to contextualize our findings.
Methods
We analyzed data from US adults participating in the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Survey (N=1034). Bivariate associations between demographic characteristics and health information–seeking methods were assessed with Pearson chi-squared tests. Bivariate associations of Medical Mistrust Index (MMI) scores with each health information–seeking method and time since provider engagement were assessed with F tests and adjusted Wald tests. We fit a multivariable logistic regression model to assess the association between WHI-seeking within the 12 months prior to survey (alone or in combination with provider-based methods versus provider only) and engagement with a provider more than 1 year prior to the time of survey, adjusting for age, race and ethnicity, sex, education, insurance coverage, and MMI.
Results
Age, race and ethnicity, educational attainment, health insurance source, MMI, and time since provider engagement were each significantly associated with the health information–seeking method in bivariate analyses. Compared to using only provider-based health information seeking methods, WHI-based methods alone or in combination with provider-based methods were associated with a 51% lower likelihood (odds ratio 0.49, 95% CI 0.27-0.87) of engaging with a provider within the previous year. Participants who used WHI-seeking methods alone and those who had not engaged with a health care provider within the previous year demonstrated a higher mean MMI score; however, MMI was not a significant predictor of time since engagement with a provider in the multivariable analysis.
Conclusions
Our findings from a nationally representative survey suggest that for those who use WHI-seeking methods (alone or in combination with provider-based information-seeking methods), there is a statistically significant lower likelihood of engaging with a provider in a year compared to those who only use provider-based methods. Future research should consider the intent of a person’s visit with a provider, trust in health care systems, methods of provider engagement, and specific web-based platforms for health information.
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8
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Teles S, Paúl C, Costa-Santos C, Ferreira A. Use of dementia and caregiving-related internet resources by informal caregivers: A cross-sectional study. Front Med (Lausanne) 2022; 9:978635. [PMID: 36186787 PMCID: PMC9518752 DOI: 10.3389/fmed.2022.978635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
Informal dementia caregivers are at greater risk of experiencing physical and mental health issues as compared to the general population. Internet-based resources may provide accessible opportunities to backing informal dementia caregivers by addressing their information and support needs. This cross-sectional study aims to characterize the use of dementia and caregiving-related internet resources by caregivers and identify variables associated with such use. Primary data were collected through a web-based survey (N = 158). Linear regression models were used to assess the associations of predisposing, enabling, and need variables with the frequency of using the internet for caregiving-related purposes. Most caregivers (93%) have ever used the internet to gather general information about dementia. The frequency of using internet resources was, however, moderate. The multivariable linear regression model suggests that being younger (β = −0.110, p = 0.009), not having a source of support to provide care (β = −2.554, p = 0.012), having used a face-to-face psychosocial intervention at some point (β = 2.731, p = 0.003), being employed (β = 2.558, p = 0.013), and appraising one's own physical health negatively (vs. appraising it as similar; β = 3.591, p < 0.001), are associated with a higher frequency of using caregiving-related internet resources. Our findings confirmed the association of age and perceived health status with caregiving-related internet use reported in other studies. The role of enabling variables as lifetime access to psychosocial interventions and having a usual source of support to provide care was a new addition. This study informs the design and deployment of information and support to dementia caregivers.
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Affiliation(s)
- Soraia Teles
- Department of Behavioural Sciences, School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- *Correspondence: Soraia Teles
| | - Constança Paúl
- Department of Behavioural Sciences, School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Cristina Costa-Santos
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Ana Ferreira
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
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Luciani M, De Maria M, Page SD, Barbaranelli C, Ausili D, Riegel B. Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory. BMC Public Health 2022; 22:598. [PMID: 35346104 PMCID: PMC8960109 DOI: 10.1186/s12889-022-12913-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Self-care is important at all stages of life and health status to promote well-being, prevent disease, and improve health outcomes. Currently, there is a need to better conceptualize self-care in the general adult population and provide an instrument to measure self-care in this group. Therefore, the aim of this study was to develop and evaluate the Self-Care Inventory (SCI), a theory-based instrument to measure self-care in the general adult population. Methods Based on the Middle Range Theory of Self-Care, the 20-item SCI was developed with three scales: Self-Care Maintenance (8 items), Self-Care Monitoring (6 items), and Self-Care Management (6 items). A cross sectional study with a US-based sample (n = 294) was conducted to test the SCI. Internal validity was assessed with Confirmatory Factor Analysis. Internal consistency reliability was assessed with Cronbach alpha for unidimensional scales or composite reliability and the global reliability index for multidimensional scales. Construct validity was investigated with Pearson correlation to test the relationship between general self-efficacy, positivity, stress, and self-care scores. Results The Self-Care Maintenance and Management scales were multidimensional and the Self-Care Monitoring scale was unidimensional. The global reliability index for multidimensional scales was 0.85 (self-care maintenance) and 0.88 (self-care management). Cronbach alpha coefficient of the self-care monitoring scale was 0.88. Test-retest reliability was 0.81 (self-care maintenance), 0.91 (self-care monitoring), and 0.76 (self-care management). The General Self-Efficacy Scale was positively related to all three self-care scale scores: self-care maintenance r = 0.46, p < 0. 001, self-care monitoring r = 0.31, p < 0. 001, and self-care management r = 0.32, p < 0. 001. The positivity score was positively related to self-care maintenance (r = 0.42, p < 0. 001), self-care monitoring (r = 0.29, p < 0. 001), and self-care management (r = 0.34, p < 0. 001) scores. The perceived stress was positively related to the self-care management (r = 0.20, p < 0. 001) score. Conclusions The SCI is a theoretically based instrument designed to measure self-care in the general adult population. Preliminary evidence of validity and reliability supports its use in the general adult population.
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Luo A, Qin L, Yuan Y, Yang Z, Liu F, Huang P, Xie W. The Effect of Online Health Information Seeking on Physician-Patient Relationships: Systematic Review. J Med Internet Res 2022; 24:e23354. [PMID: 35142620 PMCID: PMC8874798 DOI: 10.2196/23354] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/24/2021] [Accepted: 11/17/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The internet has now become part of human life and is constantly changing people's way of life. With the increasing popularity of online health information (OHI), it has been found that OHI can affect the physician-patient relationship by influencing patient behaviors. OBJECTIVE This study aims to systematically investigate the impact of OHI-seeking behavior on the physician-patient relationship. METHODS Literature retrieval was conducted on 4 databases (Web of Science, PubMed, China National Knowledge Infrastructure, SinoMed), and the time limit for literature publication was before August 1, 2021. RESULTS We selected 53 target papers (42 [79%] English papers and 11 [21%] Chinese papers) that met the inclusion criteria. Of these, 31 (58%) papers believe that patients' OHI behavior can enable them to participate in their own medical care, improve patient compliance, and improve the physician-patient relationship. In addition, 14 (26%) papers maintain a neutral attitude, some believing that OHI behavior has no significant effect on doctors and patients and others believing that due to changes in the factors affecting OHI behavior, they will have a negative or a positive impact. Furthermore, 8 (15%) papers believe that OHI search behavior has a negative impact on doctors and patients, while 6 (11%) papers show that OHI reduces Chinese patients' trust in doctors. CONCLUSIONS Our main findings showed that (1) OHI-seeking behavior has an impact on patients' psychology, behavior, and evaluation of doctors; (2) whether patients choose to discuss OHI with doctors has different effects on the physician-patient relationship; and (3) the negative impact of OHI on China's internet users is worthy of attention. Due to the low quality of OHI, poor health information literacy, short physician-patient communication time, and various types of negative news, patients' trust in doctors has declined, thus affecting the physician-patient relationship. Improvement of people's health information literacy and the quality of OHI are important factors that promote the positive impact of OHI on the physician-patient relationship.
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Affiliation(s)
- Aijing Luo
- The Second Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Medical Information Research, The Third Xiangya Hospital, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Lu Qin
- Key Laboratory of Medical Information Research, The Third Xiangya Hospital, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Yifeng Yuan
- The Second Xiangya Hospital, Central South University, Changsha, China.,Key Laboratory of Medical Information Research, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhengzijin Yang
- Key Laboratory of Medical Information Research, The Third Xiangya Hospital, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Fei Liu
- Key Laboratory of Medical Information Research, The Third Xiangya Hospital, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Panhao Huang
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wenzhao Xie
- Key Laboratory of Medical Information Research, The Third Xiangya Hospital, Central South University, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
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11
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Kindratt TB, Allicock M, Atem F, Dallo FJ, Balasubramanian BA. Email Patient-Provider Communication and Cancer Screenings Among US Adults: Cross-sectional Study. JMIR Cancer 2021; 7:e23790. [PMID: 34328421 PMCID: PMC8367146 DOI: 10.2196/23790] [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: 08/31/2020] [Revised: 04/12/2021] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
Background The growth of electronic medical records and use of patient portals have allowed for patients and health care providers to communicate via email and direct messaging between health care visits. Email patient-provider communication (PPC) may enhance traditional face-to-face PPC by allowing patients to ask questions, receive clear explanations, engage in shared decision-making, and confirm their understanding between in-person visits. Despite increasing trends in the use of email PPC since the early 2000s, few studies have evaluated associations between email PPC and the uptake of preventive services. Objective The objective of this study was to determine associations between the use of email PPC and the likelihood of undergoing breast, cervical, and colon cancer screenings among adults who have received health care in the past 12 months. Methods Secondary, cross-sectional data from the 2011-2015 National Health Interview Survey were combined and analyzed. For each cancer screening, inclusion criteria were based on the age of screening recommendations and prior history of cancer diagnosis (n=35,912 for breast, n=48,512 for cervical, and n=45,884 for colon). The independent variable was whether adults used email PPC in the past 12 months (yes or no). The dependent variables were whether (1) women (aged ≥40 years) received a mammogram in the past 12 months; (2) women (aged 21-65 years) received a Pap test in the past 12 months; and (3) individuals (aged ≥50 years) received a colon cancer screening in the past 12 months. Bivariate and multivariable logistic regression analyses were conducted. Results Adults who reported receiving all three cancer screenings in the past 12 months were more likely to be non-Hispanic White; be married or living with a partner; have a bachelor’s degree or higher education level; have health insurance coverage; and perceive their health as excellent, very good, or good (all P<.001). Men were more likely to receive colon cancer screenings than women (P<.001). Multivariable logistic regression models showed women who used email to communicate with their health care providers had greater odds of receiving breast (odds ratio [OR] 1.32, 95% CI 1.20-1.44) and cervical (OR 1.11, 95% CI 1.02-1.20) cancer screenings than women who did not use email PPC. Adults who used email to communicate with their health care providers had 1.55 times greater odds (95% CI 1.42-1.69) of receiving a colon cancer screening than those who did not use email PPC. Conclusions Our results demonstrate that email PPC is a marker of increased likelihood of adults completing age-appropriate cancer screenings, particularly breast, cervical, and colon cancer screenings. More research is needed to examine other factors related to the reasons for and quality of email PPC between patients and health care providers and determine avenues for health education and intervention to further explore this association.
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Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, United States
| | - Marlyn Allicock
- Department of Health Promotion and Behavioral Sciences, School of Public Health Dallas, UTHealth, The University of Texas Health Science Center at Houston, Dallas, TX, United States.,Center for Health Promotion and Prevention Research, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Folefac Atem
- Department of Biostatistics and Data Science, School of Public Health Dallas, UTHealth, The University of Texas Health Science Center at Houston, Dallas, TX, United States
| | - Florence J Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, United States
| | - Bijal A Balasubramanian
- Center for Health Promotion and Prevention Research, Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, United States.,Department of Epidemiology, Human Genetics, and Environmental Health Sciences, School of Public Health Dallas, UTHealth, The University of Texas Health Science Center at Houston, Dallas, TX, United States
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12
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Xie DX, Boss EF, Stewart CM. An Exploration of Otolaryngology in the Reddit Community. Laryngoscope 2021; 132:284-286. [PMID: 34319587 DOI: 10.1002/lary.29696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Deborah X Xie
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Emily F Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - C Matthew Stewart
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, U.S.A
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13
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Yang LS, Ma CT, Chan CH, Luk MS, Woo HK, Lee VWY, Leung AWK, Lee SLK, Yeung NCY, Li CK, Cheung YT. Awareness of diagnosis, treatment and risk of late effects in Chinese survivors of childhood cancer in Hong Kong. Health Expect 2021; 24:1473-1486. [PMID: 34101943 PMCID: PMC8369092 DOI: 10.1111/hex.13288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/22/2021] [Accepted: 05/12/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND For survivors of childhood cancer, awareness of personal health risks is a critical component of long-term health management. OBJECTIVE To evaluate the awareness of the diagnosis, treatment and risk of late effects among survivors of childhood cancer in Hong Kong. METHODS Between June 2019 and March 2020, this cross-sectional study recruited 155 adult survivors (mean age = 26.9, standard deviation [SD] = 6.4 years) and 45 parents of paediatric survivors (mean age = 11.1, SD = 3.6 years) from a long-term follow-up clinic. At >10 years post-treatment (mean = 13.4, SD = 7.6 years), they completed a structured questionnaire to report their cancer-specific knowledge. Multiple linear regression analysis was conducted to identify clinical, socioeconomic and behavioural factors associated with poor awareness. RESULTS The majority of participants accurately recalled their diagnoses (73.5%) and major treatment modalities (chemotherapy 92.4%, radiation 82.9% and surgery 88.2%). However, less than half (45%) of the participants recognized more than 25% of the total late effects for which they were at risk. The highest levels of awareness were reported for endocrine problems (49%), neurocognitive impairment (44%) and secondary cancers (43%), and the lowest for peripheral neuropathy (21%) and vision problems (23%). Compared with survivors of haematological malignancies, those of central nervous system (CNS) tumours (standardized estimate [B] = -9.33, 95% confidence interval [95% CI]: -13.41 to -5.26) and non-CNS solid tumours (B = -8.47, 95% CI: -12.39 to -4.94) had less knowledge about their diagnosis. Retaining medical records (P < .0001) and better medical information-seeking habits (P = .048) were associated with better awareness. CONCLUSIONS Survivors of childhood cancer in Hong Kong have deficient awareness of their personal health risks. They may benefit from the provision of a survivorship care plan and personalized education regarding treatment-related late effects. PATIENT CONTRIBUTION Patients contributed in designing the study tools. Results were presented at a non-governmental organization.
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Affiliation(s)
- Lok Sum Yang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chung Tin Ma
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chun Him Chan
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mei Shum Luk
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Hoi Kei Woo
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Vivian Wai-Yan Lee
- Centre for Learning Enhancement and Research, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Alex Wing Kwan Leung
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Samantha Lai-Ka Lee
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong
| | - Nelson Chun-Yiu Yeung
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Chi-Kong Li
- Department of Paediatrics & Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, Hong Kong.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong.,Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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14
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Turner K, Hong YR, Yadav S, Huo J, Mainous AG. Patient portal utilization: before and after stage 2 electronic health record meaningful use. J Am Med Inform Assoc 2021; 26:960-967. [PMID: 30947331 DOI: 10.1093/jamia/ocz030] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/14/2019] [Accepted: 02/22/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Patient portal functionalities, such as patient-physician e-communication, can benefit patients by improving clinical outcomes. Utilization has historically been low but may have increased in recent years due to the implementation of Stage 2 Meaningful Use for electronic health records. This study has 2 objectives: 1) to compare patient portal utilization rates before Stage 2 (2011-2013) and after Stage 2 (2014-2017), and 2) to examine whether disparities in patient portal utilization attenuate after Stage 2. MATERIALS AND METHODS We conducted an observational study using a pooled cross-sectional analysis of 2011-2017 National Health Interview Survey data (n = 254 183). RESULTS The mean percent use of patient portals significantly increased from the pre-Stage 2 to the post-Stage 2 period (6.9%, 95% CI, 6.2-7.5; P < .001). Non-Hispanic Black individuals (OR 0.81, 95% CI, 0.76-0.86; P < .0001) and Hispanic individuals (OR 0.79, 95% CI, 0.74-0.84; P < .0001) have lower odds of using patient portals compared to non-Hispanic White individuals. Although we found independent effects of race/ethnicity, we did not find a statistically significant interaction between race/ethnicity and time. We found a similar level of increase in patient portal utilization from the pre- to postperiod across racial and ethnic groups. DISCUSSION Health care policies such as Stage 2 Meaningful Use are likely contributing to increased patient portal utilization across all patients and helping to attenuate disparities in utilization between subgroups of patients. CONCLUSION Further research is needed to explore which patient portal functionalities are perceived as most beneficial to patients and whether patients have access to those functionalities.
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Affiliation(s)
- Kea Turner
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Young-Rock Hong
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Sandhya Yadav
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Jinhai Huo
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Arch G Mainous
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
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15
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Pleasants E, Guendelman S, Weidert K, Prata N. Quality of top webpages providing abortion pill information for Google searches in the USA: An evidence-based webpage quality assessment. PLoS One 2021; 16:e0240664. [PMID: 33476340 PMCID: PMC7819599 DOI: 10.1371/journal.pone.0240664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/01/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In the United States, the internet is widely used to seek health information. Despite an estimated 18 million Google searches on abortion per year and the demonstrated importance of the abortion pill as an option for pregnancy termination, the top webpage search results for abortion pill searches, as well as the content and quality of those webpages, are not well understood. METHODS We used Google's Custom Search Application Programming Interface (API) to identify the top 10 webpages presented for "abortion pill" searches on August 06, 2018. We developed a comprehensive, evidence-based Family Planning Webpage Quality Assessment Tool (FPWQAT), which was used to assess webpage quality for the five top webpages presenting text-based educational content. RESULTS Of the top webpages for "abortion pill" searches, a plannedparenthood.com page was the top result and scored highest on our assessment (81%), providing high-quality and useable information. The other four webpages, a Wikipedia.com page and three anti-abortion information webpages, scored much lower on our assessment (14%-43%). These four webpages had lower quality of information in less useable formats. The anti-abortion pages also presented a variety of disinformation about the abortion pill. CONCLUSIONS Both the lack of accurate clinical content on the majority of top webpages and the concerning disinformation they contained raise concerns about the quality of online abortion pill information, while underlining challenges posed by Google search results to informed choice for consumers. Healthcare providers and consumers must be informed of online abortion pill content that is not based in current clinical evidence, while advocates and policymakers should push for online information that is credible and useable. These changes are imperative given the importance of sound abortion pill information for reproductive decision-making at a time when in-person abortion services are further challenged in the US.
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Affiliation(s)
- Elizabeth Pleasants
- Wallace Center for Maternal, Child, and Adolescent Health Research, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- * E-mail:
| | - Sylvia Guendelman
- Wallace Center for Maternal, Child, and Adolescent Health Research, School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
| | - Karen Weidert
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Bixby Center for Population, Health and Sustainability, University of California, Berkeley, Berkeley, California, United States of America
| | - Ndola Prata
- School of Public Health, University of California, Berkeley, Berkeley, California, United States of America
- Bixby Center for Population, Health and Sustainability, University of California, Berkeley, Berkeley, California, United States of America
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16
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Al-Jefri M, Evans R, Lee J, Ghezzi P. Automatic Identification of Information Quality Metrics in Health News Stories. Front Public Health 2021; 8:515347. [PMID: 33392124 PMCID: PMC7775604 DOI: 10.3389/fpubh.2020.515347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 11/27/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: Many online and printed media publish health news of questionable trustworthiness and it may be difficult for laypersons to determine the information quality of such articles. The purpose of this work was to propose a methodology for the automatic assessment of the quality of health-related news stories using natural language processing and machine learning. Materials and Methods: We used a database from the website HealthNewsReview.org that aims to improve the public dialogue about health care. HealthNewsReview.org developed a set of criteria to critically analyze health care interventions' claims. In this work, we attempt to automate the evaluation process by identifying the indicators of those criteria using natural language processing-based machine learning on a corpus of more than 1,300 news stories. We explored features ranging from simple n-grams to more advanced linguistic features and optimized the feature selection for each task. Additionally, we experimented with the use of pre-trained natural language model BERT. Results: For some criteria, such as mention of costs, benefits, harms, and “disease-mongering,” the evaluation results were promising with an F1 measure reaching 81.94%, while for others the results were less satisfactory due to the dataset size, the need of external knowledge, or the subjectivity in the evaluation process. Conclusion: These used criteria are more challenging than those addressed by previous work, and our aim was to investigate how much more difficult the machine learning task was, and how and why it varied between criteria. For some criteria, the obtained results were promising; however, automated evaluation of the other criteria may not yet replace the manual evaluation process where human experts interpret text senses and make use of external knowledge in their assessment.
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Affiliation(s)
- Majed Al-Jefri
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Data Intelligence for Health Lab, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Roger Evans
- School of Computing, Engineering and Mathematics, University of Brighton, Brighton, United Kingdom
| | - Joon Lee
- Data Intelligence for Health Lab, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Pietro Ghezzi
- Brighton & Sussex Medical School, Falmer, Brighton, United Kingdom
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17
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Henderson LM, O'Meara ES, Haas JS, Lee CI, Kerlikowske K, Sprague BL, Alford-Teaster J, Onega T. The Role of Social Determinants of Health in Self-Reported Access to Health Care Among Women Undergoing Screening Mammography. J Womens Health (Larchmt) 2020; 29:1437-1446. [PMID: 32366199 PMCID: PMC7703148 DOI: 10.1089/jwh.2019.8267] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Background: Social determinants of health (SDOH) contribute to health care disparities, with social and economic barriers often leading to difficulties in obtaining necessary care. We evaluated barriers to receiving health care, focusing on caretaker responsibilities, health insurance and cost, and transportation. Materials and Methods: We included women ages ≥40 years receiving screening mammography across three Breast Cancer Surveillance Consortium registries from 2012 to 2017. Women self-reported social and financial barriers to receiving health care in the 12 months before their screening mammogram. We evaluated woman- and census-based community-level factors associated with reporting a barrier using multivariate logistic regression. We assessed interaction with urban versus nonurban residence using Wald tests. Results: Among 393,430 women, 3.6% reported a barrier with a higher proportion in urban versus nonurban settings (3.9% [n = 11,977] vs. 2.2% [n = 1,655], respectively; p < 0.001). Among women reporting a barrier, health care cost and/or no insurance was the most common (49.3%), and no transportation was the least common (7.8%). Compared with white women, odds of reporting barriers were higher among black (adjusted odds ratio [aOR] = 1.30, 95% confidence interval [CI]: 1.16-1.44), Hispanic (aOR = 1.66, 95% CI: 1.53-1.80), and other race (aOR = 1.84, 95% CI: 1.65-2.04) women. Barriers were less likely in women with higher median household income (aOR = 0.69, 95% CI: 0.61-0.79) or higher average health insurance costs (aOR = 0.85, 95% CI: 0.74-0.98), but were more likely in high diversity index areas (aOR = 1.28, 95% CI: 1.11-1.48). Conclusions: Social and financial barriers exist based on race/ethnicity and SDOH related to income, insurance costs, and place of residence among women undergoing screening mammography. Breast imaging facilities could utilize information on these barriers to improve biennial screening adherence or ensure that women with abnormal findings obtain appropriate follow-up care through targeted interventions.
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Affiliation(s)
- Louise M. Henderson
- Epidemiology Research, Department of Radiology, The University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ellen S. O'Meara
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Jennifer S. Haas
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christoph I. Lee
- Department of Radiology, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Health Services, University of Washington School of Public Health, Seattle, Washington, USA
- Hutchinson Institute for Cancer Outcomes Research, Seattle, Washington, USA
| | - Karla Kerlikowske
- Department of Medicine, University of California, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Brian L. Sprague
- Department of Surgery, University of Vermont, Burlington, Vermont, USA
- Department of Radiology, University of Vermont, Burlington, Vermont, USA
| | - Jennifer Alford-Teaster
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Tracy Onega
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
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18
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Lotto M, Strieder AP, Ayala Aguirre PE, Oliveira TM, Andrade Moreira Machado MA, Rios D, Cruvinel T. Parental-oriented educational mobile messages to aid in the control of early childhood caries in low socioeconomic children: A randomized controlled trial. J Dent 2020; 101:103456. [PMID: 32827598 PMCID: PMC7438225 DOI: 10.1016/j.jdent.2020.103456] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/16/2020] [Accepted: 08/18/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of educational messages as an aid in the control of early childhood caries (ECC) in low socioeconomic children. METHODS A single-blinded, randomized, and parallel-group study was conducted with 104 dyads of parents and children aged between 36-60 months, recruited in preschools from Bauru, Brazil. The participants were randomly allocated into control and intervention groups (1:1), stratified by parental eHealth literacy scores (eHEALS) and children's caries experience. Every 2 weeks, text messages were sent to parents of intervention group via WhatsApp. Visible plaque index (VPI) and the International Caries Detection and Assessment System (ICDAS) were assessed at baseline, 3- and 6-month follow-ups, while eHEALS and dietary habits were determined at baseline and 6-month follow-up. Statistical analysis was performed to intra and intergroup comparisons through Fischer's exact and McNemar tests, and Mann-Whitney U and Friedman tests, respectively (P < 0.05). RESULTS Despite similarities between groups, intervention increased parental eHEALS scores, influencing the reports about the children's consumption of sugar-free sweets and controlling the severity of ECC. CONCLUSION Therefore, mobile text messages were effective to control the severity of ECC in low socioeconomic preschoolers, improving parental eHealth literacy and changing children's dietary patterns. CLINICAL SIGNIFICANCE These findings demonstrate that parental-oriented WhatsApp messages can contribute to oral health education of socioeconomic vulnerable parents towards risk behavior changes to control ECC.
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Affiliation(s)
- Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Anna Paola Strieder
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Patricia Estefania Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Maria Aparecida Andrade Moreira Machado
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Vila Universitária, Bauru, SP, 17012-901, Brazil.
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19
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Turner K, Clary A, Hong YR, Alishahi Tabriz A, Shea CM. Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study. J Med Internet Res 2020; 22:e18870. [PMID: 32940620 PMCID: PMC7530687 DOI: 10.2196/18870] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/22/2020] [Accepted: 08/16/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; P=.01). Older age (OR 1.01, 95% CI 1.00-1.02; P<.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; P<.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; P=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; P<.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; P<.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; P<.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; P<.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients' needs and preferences.
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Affiliation(s)
- Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, United States
| | - Alecia Clary
- Center for Healthcare Transformation, Avalere Health, Washington, DC, United States
| | - Young-Rock Hong
- Department of Health Services Research, Management, and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Amir Alishahi Tabriz
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Christopher M Shea
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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20
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The Quantified Woman: Exploring Perceptions on Health App Use among Austrian Females of Reproductive Age. REPRODUCTIVE MEDICINE 2020. [DOI: 10.3390/reprodmed1020010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Smartphones have become the most important commodity for today’s digitalized society. Besides direct interpersonal communication, their most used features are third-party applications (apps). Apps for monitoring health parameters (health apps) are extremely popular, and their users are part of the Quantified Self movement. Little knowledge is available on how health apps are perceived by a female target audience, the Quantified Woman. We conducted a study among Austrian females of reproductive age (n = 150) to analyze prevalence, perceived benefits, and readiness for health app use. In the cross-sectional online German survey, nearly all participants used these apps (98.0%), predominantly for monitoring physical activity and female health (both 31.3%). For the latter, participants used a large variety of different apps for monitoring contraception and menstruation. Perceived benefits and readiness of health app use were only of medium range. Our study assessed aspects of health app use in an understudied segment of the general population. From a Public Health perspective, the Quantified Woman could be empowered by health data collection by enabling her to take active control over how her health graphs develop. We suggest assuring data security and privacy for sensitive female health data collected by health apps.
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21
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Mazmudar RS, Gupta N, Xiang L, Tripathi R, Bordeaux JS, Scott JF. Practices in higher-income communities are associated with shorter dermatologist wait times: A cross-sectional simulated telephone call study. J Am Acad Dermatol 2020; 83:911-912. [DOI: 10.1016/j.jaad.2019.12.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 11/25/2022]
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22
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Latulippe K, Hamel C, Giroux D. Integration of Conversion Factors for the Development of an Inclusive eHealth Tool With Caregivers of Functionally Dependent Older Persons: Social Justice Design. JMIR Hum Factors 2020; 7:e18120. [PMID: 32845242 PMCID: PMC7481878 DOI: 10.2196/18120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/31/2020] [Accepted: 05/14/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND eHealth can help reduce social health inequalities (SHIs); at the same time, it also has the potential to increase them. Several conversion factors can be integrated into the development of an eHealth tool to make it inclusive: (1) providing physical, technical, and financial access to eHealth; (2) enabling the integration of people at risk of SHIs into the research and development of digital projects targeting such populations (co-design or participatory research); (3) promoting consistency between the digital health literacy level of future users (FUs) and the eHealth tool; (4) developing an eHealth tool that is consistent with the technological skills of FUs; (5) ensuring that the eHealth tool is consistent with the help-seeking process of FUs; (6) respecting the learning capacities of FUs; and (7) being sensitive to FUs' cultural context. However, only little empirical evidence pointing out how these conversion factors can be integrated into an effective eHealth tool is available. OBJECTIVE On the basis of Amartya Sen's theoretical framework of social justice, the objective of this study was to explore how these 7 conversion factors can be integrated into an eHealth tool for caregivers of functionally dependent older persons. METHODS This study was based on a social justice design and participant observation as part of a large-scale research project funded by the Ministère de la Famille through the Quebec Ami des Aînés Program. Data were collected by recording the preparation sessions, the co-design and advisory committee sessions, as well as the debriefing sessions. The results were analyzed using Miles and Huberman's method. RESULTS A total of 78 co-designers participated in 11 co-design sessions, 24 preparation sessions, and 11 debriefing sessions. Of the 7 conversion factors, 5 could be explored in this experiment. The integration of conversion factors has been uneven. The participation of FUs in the development of the tool supports other conversion factors. Respecting the eHealth literacy level of FUs means that their learning abilities and technological skills are also respected because they are closely related to one another and are therefore practically difficult to be distinguished. CONCLUSIONS Conversion factors can be integrated into the development of eHealth tools that are intended to be inclusive and contribute to curbing SHIs by integrating FU participation into the tool design process.
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Affiliation(s)
- Karine Latulippe
- Laval University, Québec, QC, Canada.,Centre de recherche en santé durable VITAM, Quebec, QC, Canada
| | | | - Dominique Giroux
- Laval University, Québec, QC, Canada.,Centre de recherche en santé durable VITAM, Quebec, QC, Canada.,Centre d'Excellence du Vieillissement de Québec, Chu de Québec, Quebec, QC, Canada
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Mobile and Online Health Information: Exploring Digital Media Use among Austrian Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176053. [PMID: 32825293 PMCID: PMC7504633 DOI: 10.3390/ijerph17176053] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 01/07/2023]
Abstract
In today’s digitalized world, most parents are Internet-savvy and use online sources for child health information, mainly due to the 24/7 availability of advice. However, parents are often not specifically trained to identify reliable, evidence-based sources of information. In this cross-sectional online survey among a purposive, non-probabilistic sample of Austrian parents (n = 90, 81.1% females), we assessed aspects of health app use and family policy benefits-related and scenario-based Internet seeking behavior. We found that the surveyed parents showed a high health app use. The participants indicated that they prefer online information seeking to any other option in a scenario describing that their child would be sick at after-work hours, with social media channels being the least preferred source of online information. Mothers and younger parents were more likely to retrieve online information on family policy benefits. With the smartphone in everybody’s pocket, parents seemed to rely on mobile and online content when searching for child health information. Pediatricians are best suited to decide what treatment fits the child or their current medical condition, but nowadays they face increasing numbers of pre-informed parents seeking health information online. Provision of targeted parental education and guidance through the online information jungle could effectively empower parents and smooth personal and digital contacts in the delicate doctor–parent–child triangle.
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Zrubka Z, Brito Fernandes Ó, Baji P, Hajdu O, Kovacs L, Kringos D, Klazinga N, Gulácsi L, Brodszky V, Rencz F, Péntek M. Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study. J Med Internet Res 2020; 22:e19013. [PMID: 32667891 PMCID: PMC7448194 DOI: 10.2196/19013] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Digital health, which encompasses the use of information and communications technology in support of health, is a key driving force behind the cultural transformation of medicine toward people-centeredness. Thus, eHealth literacy, assisted by innovative digital health solutions, may support better experiences of care. OBJECTIVE The purpose of this study is to explore the relationship between eHealth literacy and patient-reported experience measures (PREMs) among users of outpatient care in Hungary. METHODS In early 2019, we conducted a cross-sectional survey on a large representative online sample recruited from the Hungarian general population. eHealth literacy was measured with the eHealth Literacy Scale (eHEALS). PREMs with outpatient care were measured with a set of questions recommended by the Organisation for Economic Co-operation and Development (OECD) for respondents who attended outpatient visit within 12 months preceding the survey. Bivariate relationships were explored via polychoric correlation, the Kruskal-Wallis test, and chi-square test. To capture nonlinear associations, after controlling covariates, we analyzed the relationship between eHEALS quartiles and PREMs using multivariate probit, ordinary least squares, ordered logit, and logistic regression models. RESULTS From 1000 survey respondents, 666 individuals (364 females, 54.7%) were included in the study with mean age of 48.9 (SD 17.6) years and mean eHEALS score of 29.3 (SD 4.9). Respondents with higher eHEALS scores were more likely to understand the health care professionals' (HCPs') explanations (χ29=24.2, P=.002) and to be involved in decision making about care and treatment (χ29=18.2, P=.03). In multivariate regression, respondents with lowest (first quartile) and moderately high (third quartile) eHEALS scores differed significantly, where the latter were more likely to have an overall positive experience (P=.02) and experience fewer problems (P=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs' explanations (P<.001) and being able to ask questions during their last consultation (P=.04). Patient-reported experiences of individuals with highest (fourth quartile) and lowest (first quartile) eHEALS levels did not differ significantly in any items of the PREM instrument, and neither did composite PREM scores generated from the PREM items (P>.05 in all models). CONCLUSIONS We demonstrated the association between eHealth literacy and PREMs. The potential patient-, physician-, and system-related factors explaining the negative experiences among people with highest levels of eHealth literacy warrant further investigation, which may contribute to the development of efficient eHealth literacy interventions. Further research is needed to establish causal relationship between eHealth literacy and patient-reported experiences.
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Affiliation(s)
- Zsombor Zrubka
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Óscar Brito Fernandes
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Ottó Hajdu
- Department of Comparative Economics, Eötvös Loránd University, Budapest, Hungary
| | - Levente Kovacs
- Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Dionne Kringos
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Niek Klazinga
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
- Premium Postdoctoral Research Program, Hungarian Academy of Sciences, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary
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Shaffer KM, Tigershtrom A, Badr H, Benvengo S, Hernandez M, Ritterband LM. Dyadic Psychosocial eHealth Interventions: Systematic Scoping Review. J Med Internet Res 2020; 22:e15509. [PMID: 32130143 PMCID: PMC7081137 DOI: 10.2196/15509] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/08/2019] [Accepted: 12/19/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Dyadic psychosocial interventions have been found beneficial both for people coping with mental or physical health conditions as well as their family members and friends who provide them with support. Delivering these interventions via electronic health (eHealth) may help increase their scalability. OBJECTIVE This scoping review aimed to provide the first comprehensive overview of dyadic eHealth interventions for individuals of all ages affected by mental or physical illness and their family members or friends who support them. The goal was to understand how dyadic eHealth interventions have been used and to highlight areas of research needed to advance dyadic eHealth intervention development and dissemination. METHODS A comprehensive electronic literature search of PubMed, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO was conducted for articles published in the English language through March 2019. Eligible records described a psychosocial eHealth intervention that intervened with both care recipients and their support person. RESULTS A total of 7113 records were reviewed of which 101 met eligibility criteria. There were 52 unique dyadic eHealth interventions identified, which were tested across 73 different trials. Of the unique interventions, 33 were conducted among dyads of children and their supporting parent, 1 was conducted with an adolescent-young adult care recipient population, and the remaining 18 were conducted among adult dyads. Interventions targeting pediatric dyads most commonly addressed a mental health condition (n=10); interventions targeting adult dyads most commonly addressed cancer (n=9). More than three-fourths of interventions (n=40) required some human support from research staff or clinicians. Most studies (n=64) specified one or more primary outcomes for care recipients, whereas less than one-fourth (n=22) specified primary outcomes for support persons. Where specified, primary outcomes were most commonly self-reported psychosocial or health factors for both care recipients (n=43) and support persons (n=18). Results of the dyadic eHealth intervention tended to be positive for care recipients, but evidence of effects for support persons was limited because of few studies specifying primary outcomes for supporters. Trials of dyadic eHealth interventions were most commonly randomized controlled trials (RCTs; n=44), and RCTs most commonly compared the dyadic eHealth intervention to usual care alone (n=22). CONCLUSIONS This first comprehensive review of dyadic eHealth interventions demonstrates that there is substantial, diverse, and growing literature supporting this interventional approach. However, several significant gaps were identified. Few studies were designed to evaluate the unique effects of dyadic interventions relative to individual interventions. There was also limited assessment and reporting of outcomes for support persons, and there were no interventions meeting our eligibility criteria specifically targeting the needs of older adult dyads. Findings highlight areas of research opportunities for developing dyadic eHealth interventions for novel populations and for increasing access to dyadic care.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Hoda Badr
- Baylor College of Medicine, Houston, TX, United States
| | | | - Marisol Hernandez
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- CUNY School of Medicine/City College of New York, New York, NY, United States
| | - Lee M Ritterband
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States
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KHademian F, Arshadi Montazer MR, Aslani A. Web-based health Information Seeking and eHealth Literacy among College students. A Self-report study. INVESTIGACION Y EDUCACION EN ENFERMERIA 2020; 38:e08. [PMID: 32124576 PMCID: PMC7871481 DOI: 10.17533/udea.iee.v38n1e08] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 02/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES This study aimed to assess web-based health information seeking and eHealth literacy among Iranian college students. METHODS The study was conducted in five colleges of the Shiraz University of Medical Sciences in Iran during 2018. The data were collected by a researcher-made questionnaire consisting of seven questions on a 4-point Likert-type scale, with scores ranging from 7 to 28. These questions were: 'I know how to use the Internet to answer my questions about health', 'I think there is enough information about health-related issues on the Internet', 'I know the vocabulary used in health issues on the Internet', 'I can tell high-quality health resources from low-quality health resources on the Internet', 'I know how to use the health information I find on the Internet to help me', 'I feel confident in using information from the Internet to make health decisions', and 'Searching for health-related information on the Internet will increase my knowledge in this field'. High eHealth literacy level is defined as above the total mean score and low eHealth literacy level is defined as lower than the total mean score. RESULTS In all, 386 college students participated in the study. The results showed that the mean score of eHealth literacy was 19.11 out of 28; 205 participants (54.4%) had low eHealth literacy. In addition, the students used the Internet to search for information regarding diseases symptoms (70%), physical illnesses (67.1%), existing treatments (65%), and diagnosis (63.1%). CONCLUSIONS The results showed that participants in this study usually searched for illnesses, symptoms, and treatments after they got sick and paid little attention to other aspects related to integral health.
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Affiliation(s)
| | | | - Azam Aslani
- Shiraz University of Medical Sciences, Iran,
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Pham T, Kuznetsova A, Gim H, Cordrey K, Milanaik R. The Internet's Effect on Parental Trust in Pediatrician Diagnosis of Autism and Likelihood of Seeking a Second Opinion. J Autism Dev Disord 2019; 49:4355-4362. [PMID: 31317368 DOI: 10.1007/s10803-019-04140-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study assessed how web-based information affects parental trust in physician's diagnosis of autism (PDA) and likelihood of seeking a second opinion. Participants of an online survey were randomly allocated to one of three hypothetical scenarios, all were given a vignette of a non-verbal 18-month-old child followed by (1) not viewing Internet results, (2) viewing results suggesting autism, or (3) viewing results suggesting language delay and rated their trust and likelihood of seeking a second opinion. When Internet results contradicted PDA, parents reported less trust in PDA and greater likelihood of seeking a second opinion. Due to the Internet's influence on parents' response to PDA, clinicians should discuss their differential diagnosis with parents, address Internet-related concerns, and recommend trustworthy sources.
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Affiliation(s)
- Tammy Pham
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, 1983 Marcus Ave, Suite 130, Lake Success, NY, 11042, USA
| | - Anna Kuznetsova
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, 1983 Marcus Ave, Suite 130, Lake Success, NY, 11042, USA
| | - Haelynn Gim
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, 1983 Marcus Ave, Suite 130, Lake Success, NY, 11042, USA
| | - Kyla Cordrey
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, 1983 Marcus Ave, Suite 130, Lake Success, NY, 11042, USA
| | - Ruth Milanaik
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, 1983 Marcus Ave, Suite 130, Lake Success, NY, 11042, USA.
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Li H, Xu J, Li L, Meng Q. Health-Related Internet Use in Hard-to-Reach Populations: Empirical Findings From a Survey in a Remote and Mountainous Province in China. J Med Internet Res 2019; 21:e12693. [PMID: 31152526 PMCID: PMC6658294 DOI: 10.2196/12693] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 04/29/2019] [Accepted: 05/07/2019] [Indexed: 11/13/2022] Open
Abstract
Background The expanding use of the internet contributes to more effective searches for health-related information and opens up opportunities for direct Web-based communication with health care professionals. However, little is known about how users’ characteristics on the demand side influence health-related internet use, especially in remote and rural areas within developing countries. The absence of accurate estimates of users’ characteristics and their impact on adaptations of health care services in developing countries constrains focused policy-centered discussions and the design of appropriate policies. Objective The aim of this study was to assess the prevalence of health-related internet use and to identify its determinants in a remote province in China. Methods We conducted a cross-sectional survey in June and July of 2018 in Ningxia, located in northwestern China. Rural households were selected by multistage random sampling, and households’ key members were interviewed face-to-face at the respondents’ home. Dependent variables were whether the households use Web health services or not. Independent variables were chosen based on the Andersen behavioral model. Sociodemographic characteristics were compared between households that used health-related Web services with nonusers. We applied logistic regression models to evaluate multivariate associations between respondents’ characteristics and their usage of Web-based health services and obtained odds ratios with 95% CI. Results A total of 1354 respondents from rural households were interviewed, of whom 707 (52.22%) were men. The mean age of the respondents was 44.54 years (SD 10.22). Almost half of the surveyed households (640/1354, 47.27%) reported using 1 or more Web-based health care services, whereas 37.8% (502/1354) reported using the internet to obtain health-related information, 15.51% (210/1354) used the internet to communicate with professionals about health issues, and 7.24% (98/1354) had engaged in Web-based consultations in the last year. After controlling for potential confounders, households engaged in health-related internet use were found to be wealthier, have higher health demands, and have less geographic access to high-quality health care compared with other households. Conclusions The internet has become a major health information resource in rural Ningxia. Social structures, family enabling factors, health needs, and characteristics relating to health care access were significant predictors of households’ health-related internet use in rural and remote areas in China. Those who belong to older age groups, have low income, and whose education levels do not extend beyond primary school education are significantly less likely to use Web-based health care services and to benefit from Web-based health care programs. A need for continued collaborative efforts involving multiple stakeholders, including communities, Web-based and other health care providers, family members, and the government is needed.
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Affiliation(s)
- HongMin Li
- National Health Commission Key Laboratory of Health Economics and Policy Research, School of Health Care Management, Shandong University, Ji'nan, China
| | - Jin Xu
- China Center for Health Development Studies, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Lingui Li
- Zhejiang Chinese Medical Univeristy, Hangzhou, China
| | - Qingyue Meng
- China Center for Health Development Studies, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
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Shaffer KM, Chow PI, Cohn WF, Ingersoll KS, Ritterband LM. Informal Caregivers' Use of Internet-Based Health Resources: An Analysis of the Health Information National Trends Survey. JMIR Aging 2018; 1:e11051. [PMID: 31518244 PMCID: PMC6715019 DOI: 10.2196/11051] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 01/05/2023] Open
Abstract
Background Informal caregivers express strong interest in technology innovations to help them in their caregiving role; however, divides across sociodemographic characteristics in internet and technology access may preclude the most vulnerable caregivers from accessing such resources. Objective This study aims to examine caregivers’ internet use, both generally and for seeking health-related information, and whether usage differs as a function of caregivers’ characteristics. Methods Data were analyzed from the Health Information National Trends Survey 5 Cycle 1. Participants were included in analyses if they self-identified as providing uncompensated care to a close individual. Caregivers reported internet use factors, age, education, rurality, general health, distress, and objective caregiving burden. We used chi-square tests of independence with jackknife variance estimation to compare whether internet use factors differed by caregivers’ characteristics. Results A total of 77.5% (303/391) caregivers surveyed reported ever using the internet. Of internet users, 88.1% (267/303) accessed from a home computer and 83.2% (252/303) from a mobile device. Most caregivers accessed health information for themselves (286/391, 73.1%) or others (264/391, 67.5%); fewer communicated with a doctor over the Web (148/391, 37.9%) or had a wellness app (171/391, 43.7%). Caregivers reporting younger age, more education, and good health were more likely to endorse any of these activities. Furthermore, two-thirds of caregivers (258/391, 66.0%) endorsed trust in health information from the internet. Conclusions Computers and mobile devices are practical platforms for disseminating caregiving-related information and supportive services to informal caregivers; these modalities may, however, have a more limited reach to caregivers who are older, have less education, and are in poorer health.
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Affiliation(s)
- Kelly M Shaffer
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States.,Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Philip I Chow
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Karen S Ingersoll
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Lee M Ritterband
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
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Sandefer RH, Westra BL, Khairat SS, Pieczkiewicz DS, Speedie SM. Assessment of Personal Health Care Management and Chronic Disease Prevalence: Comparative Analysis of Demographic, Socioeconomic, and Health-Related Variables. J Med Internet Res 2018; 20:e276. [PMID: 30341046 PMCID: PMC6231843 DOI: 10.2196/jmir.8784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 05/01/2018] [Accepted: 06/18/2018] [Indexed: 12/15/2022] Open
Abstract
Background The use of personal health care management (PHM) is increasing rapidly within the United States because of implementation of health technology across the health care continuum and increased regulatory requirements for health care providers and organizations promoting the use of PHM, particularly the use of text messaging (short message service), Web-based scheduling, and Web-based requests for prescription renewals. Limited research has been conducted comparing PHM use across groups based on chronic conditions. Objective This study aimed to describe the overall utilization of PHM and compare individual characteristics associated with PHM in groups with no reported chronic conditions, with 1 chronic condition, and with 2 or more such conditions. Methods Datasets drawn from the National Health Interview Survey were analyzed using multiple logistic regression to determine the level of PHM use in relation to demographic, socioeconomic, or health-related factors. Data from 47,814 individuals were analyzed using logistic regression. Results Approximately 12.19% (5737/47,814) of respondents reported using PHM, but higher rates of use were reported by individuals with higher levels of education and income. The overall rate of PHM remained stable between 2009 and 2014, despite increased focus on the promotion of patient engagement initiatives. Demographic factors predictive of PHM use included people who were younger, non-Hispanic, and who lived in the western region of the United States. There were also differences in PHM use based on socioeconomic factors. Respondents with college-level education were over 2.5 times more likely to use PHM than respondents without college-level education. Health-related factors were also predictive of PHM use. Individuals with health insurance and a usual place for health care were more likely to use PHM than individuals with no health insurance and no usual place for health care. Individuals reporting a single chronic condition or multiple chronic conditions reported slightly higher levels of PHM use than individuals reporting no chronic conditions. Individuals with no chronic conditions who did not experience barriers to accessing health care were more likely to use PHM than individuals with 1 or more chronic conditions. Conclusions The findings of this study illustrated the disparities in PHM use based on the number of chronic conditions and that multiple factors influence the use of PHM, including economics and education. These findings provide evidence of the challenge associated with engaging patients using electronic health information as the health care industry continues to evolve.
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Affiliation(s)
- Ryan H Sandefer
- Department of Health Informatics and Information Management, College of St. Scholastica, Duluth, MN, United States
| | - Bonnie L Westra
- Center for Nursing Informatics, School of Nursing & Institute for Health Informatics, University of Minnesota, Minneapolis, MN, United States
| | - Saif S Khairat
- Carolina Health Informatics Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - David S Pieczkiewicz
- Institute for Health Informatics, University of Minnesota Twin Cities, Minneapolis, MN, United States
| | - Stuart M Speedie
- Institute for Health Informatics, University of Minnesota Twin Cities, Minneapolis, MN, United States
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Cruvinel T, Ayala Aguirre PE, Lotto M, Marchini Oliveira T, Rios D, Pereira Cruvinel AF. Digital behavior surveillance: Monitoring dental caries and toothache interests of Google users from developing countries. Oral Dis 2018; 25:339-347. [PMID: 30270556 DOI: 10.1111/odi.12986] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 09/18/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine the differences between the levels of interest of South American Google users on information related to dental caries and toothache over time. MATERIALS AND METHODS The monthly variation of Relative Search Volume (RSV) for both queries was obtained in Google Trends between 2004 and 2017. The association between RSVs, Internet penetration, and disability-adjusted life-years (DALYs) for dental caries in permanent teeth were tested by distinct regression models. Forecasting ARIMA models were developed to analyze trends and predict the interests until December 2018. RESULTS In general, toothache-related searches presented an uptrend associated positively with Internet penetration and negatively with DALYs, whereas dental caries-related searches presented a downtrend associated negatively with Internet penetration and positively with DALYs. The seasonality affected only dental caries curves, with the highest rates observed in the first trimester and the lowest rates in June, July, and December. CONCLUSION The levels of interests of South American Google users in seeking dental caries and toothache information appear to have a direct connection with the burden of untreated dental caries lesions and Internet penetration. The no association between dental caries- and toothache-related interests reinforces the unfamiliarity of most people about the relationship of dental pain with the final stages of chronic oral diseases.
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Affiliation(s)
- Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Patricia E Ayala Aguirre
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Matheus Lotto
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Thaís Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Agnes F Pereira Cruvinel
- Discipline of Public Health, School of Medicine, Federal University of Fronteira Sul, Chapecó, Brazil
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Evaluating hospital websites in Kuwait to improve consumer engagement and access to health information: a cross-sectional analytical study. BMC Med Inform Decis Mak 2018; 18:82. [PMID: 30249244 PMCID: PMC6154923 DOI: 10.1186/s12911-018-0660-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/04/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Current advances in information and communication technology have made accessing and obtaining health-related information easier than ever before. Today, many hospital websites use a patient-centric approach to promote engagement and encourage learning for better health-related decision making. However, little is known about the current state of hospital websites in the State of Kuwait. This study aims to evaluate hospital websites in Kuwait and offer recommendations to improve patient engagement and access to health information. METHODS This study employs a cross-sectional analytical approach to evaluate hospital websites in Kuwait in 2017. The websites of hospitals that provide in-patient services were identified through a structured search. Only active websites that were available in either English or Arabic were considered. The evaluation of the websites involved a combination of automated and expert- based evaluation methods and was performed across four dimensions: Accessibility, Usability, Presence, and Content. RESULTS Nine hospitals met the inclusion criteria. Most of the websites fell short in all four dimensions. None of the websites passed the accessibility guidelines. The usability of websites varied between hospitals. Overall, the majority of hospitals in Kuwait have rudimentary online presence and their websites require careful reassessment with respect to design, content, and user experience. The websites focus primarily on promoting services provided by the hospital rather than engaging and communicating with patients or providing evidence-based information. CONCLUSIONS Healthcare organization and website developers should follow best-practices to improve their websites taking into consideration the quality, readability, objectivity, coverage and currency of the information as well as the design of their websites. Hospitals should leverage social media to gain outreach and better engagement with consumers. The websites should be offered in additional languages commonly spoken by people living in Kuwait. Efforts should be made to ensure that health information on hospital websites are evidence-based and checked by healthcare professionals.
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Agi J, Kasahara N, Lottenberg CL. Qualitative assessment of online information about age-related macular degeneration available in Portuguese. EINSTEIN-SAO PAULO 2018; 16:eAO4240. [PMID: 29898089 PMCID: PMC5995548 DOI: 10.1590/s1679-45082018ao4240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 01/18/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: To evaluate the quality of online information on age-related macular degeneration available in Portuguese. Methods: The search term “age-related macular degeneration” was used to browse the web using four different search engines. The first 40 websites appearing on match lists provided by each search engine were recorded and those listed in at least three tab pages selected. The Sandvik Severity Index was used as to assess website quality. Results: Quality of information available on selected websites was rated average (mean Sandvik Score 7.08±2.23). Conclusion: Most websites disseminating information about age-related macular degeneration were of average quality. The need to readjust web-based information to target lay public and promote increased understanding was emphasized.
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Affiliation(s)
- Jorge Agi
- Santa Casa de Misericórdia de São Paulo, Brazil
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Basch CH, MacLean SA, Romero RA, Ethan D. Health Information Seeking Behavior Among College Students. J Community Health 2018; 43:1094-1099. [DOI: 10.1007/s10900-018-0526-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Kreines FM, Farr A, Chervenak FA, Grünebaum A. Quality of web-based family-building information for LGBTQ individuals. EUR J CONTRACEP REPR 2018; 23:18-23. [DOI: 10.1080/13625187.2018.1432036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Alex Farr
- Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Frank A. Chervenak
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Amos Grünebaum
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, Cornell University, New York, NY, USA
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Haluza D, Naszay M, Stockinger A, Jungwirth D. Digital Natives Versus Digital Immigrants: Influence of Online Health Information Seeking on the Doctor-Patient Relationship. HEALTH COMMUNICATION 2017; 32:1342-1349. [PMID: 27710132 DOI: 10.1080/10410236.2016.1220044] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Ubiquitous Internet access currently revolutionizes the way people acquire information by creating a complex, worldwide information network. The impact of Internet use on the doctor-patient relationship is a moving target that varies across sociodemographic strata and nations. To increase scientific knowledge on the patient-Web-physician triangle in Austria, this study reports findings regarding prevailing online health information-seeking behavior and the respective impact on doctor-patient interactions among a nonprobability convenience sample of Internet users. To investigate digital age group-specific influences, we analyzed whether digital natives and digital immigrants differed in their perspectives. The questionnaire-based online survey collected sociodemographic data and online health information-seeking behavior from a sample of 562 respondents (59% females, mean age 37 ± 15 years, 54% digital natives). Most respondents (79%) referred to the Internet to seek health information, making it the most commonly used source for health information, even more prevalent then the doctor. We found similar predictors for using the Internet as a source for health-related information across digital age groups. Thus, the overall generational gap seems to be small among regular Internet users in Austria. However, study participants expressed a rather skeptical attitude toward electronic exchange of health data between health care professionals and patients, as well as toward reliability of online health information. To improve adoption of electronic doctor-patient communication and patient empowerment, public education and awareness programs are required to promote consumer-centered health care provision and patient empowerment.
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Affiliation(s)
- Daniela Haluza
- a Institute of Environmental Health, Center for Public Health , Medical University of Vienna
| | - Marlene Naszay
- a Institute of Environmental Health, Center for Public Health , Medical University of Vienna
| | - Andreas Stockinger
- a Institute of Environmental Health, Center for Public Health , Medical University of Vienna
| | - David Jungwirth
- a Institute of Environmental Health, Center for Public Health , Medical University of Vienna
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Stellefson M, Paige SR, Tennant B, Alber JM, Chaney BH, Chaney D, Grossman S. Reliability and Validity of the Telephone-Based eHealth Literacy Scale Among Older Adults: Cross-Sectional Survey. J Med Internet Res 2017; 19:e362. [PMID: 29074471 PMCID: PMC5680514 DOI: 10.2196/jmir.8481] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/24/2017] [Accepted: 09/10/2017] [Indexed: 11/13/2022] Open
Abstract
Background Only a handful of studies have examined reliability and validity evidence of scores produced by the 8-item eHealth literacy Scale (eHEALS) among older adults. Older adults are generally more comfortable responding to survey items when asked by a real person rather than by completing self-administered paper-and-pencil or online questionnaires. However, no studies have explored the psychometrics of this scale when administered to older adults over the telephone. Objective The objective of our study was to examine the reliability and internal structure of eHEALS data collected from older adults aged 50 years or older responding to items over the telephone. Methods Respondents (N=283) completed eHEALS as part of a cross-sectional landline telephone survey. Exploratory structural equation modeling (E-SEM) analyses examined model fit of eHEALS scores with 1-, 2-, and 3-factor structures. Subsequent analyses based on the partial credit model explored the internal structure of eHEALS data. Results Compared with 1- and 2-factor models, the 3-factor eHEALS structure showed the best global E-SEM model fit indices (root mean square error of approximation=.07; comparative fit index=1.0; Tucker-Lewis index=1.0). Nonetheless, the 3 factors were highly correlated (r range .36 to .65). Item analyses revealed that eHEALS items 2 through 5 were overfit to a minor degree (mean square infit/outfit values <1.0; t statistics less than –2.0), but the internal structure of Likert scale response options functioned as expected. Overfitting eHEALS items (2-5) displayed a similar degree of information for respondents at similar points on the latent continuum. Test information curves suggested that eHEALS may capture more information about older adults at the higher end of the latent continuum (ie, those with high eHealth literacy) than at the lower end of the continuum (ie, those with low eHealth literacy). Item reliability (value=.92) and item separation (value=11.31) estimates indicated that eHEALS responses were reliable and stable. Conclusions Results support administering eHEALS over the telephone when surveying older adults regarding their use of the Internet for health information. eHEALS scores best captured 3 factors (or subscales) to measure eHealth literacy in older adults; however, statistically significant correlations between these 3 factors suggest an overarching unidimensional structure with 3 underlying dimensions. As older adults continue to use the Internet more frequently to find and evaluate health information, it will be important to consider modifying the original eHEALS to adequately measure societal shifts in online health information seeking among aging populations.
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Affiliation(s)
- Michael Stellefson
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States
| | - Samantha R Paige
- Department of Health Education & Behavior, University of Florida, Gainesville, FL, United States
| | | | - Julia M Alber
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, CA, United States
| | - Beth H Chaney
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States
| | - Don Chaney
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, United States
| | - Suzanne Grossman
- Department of Community Health and Prevention, Drexel University, Philadelphia, PA, United States
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Zhang H, Zhang H, Wang X, Yang Z, Zhao Y. Analysis of Requirements for Developing an mHealth-Based Health Management Platform. JMIR Mhealth Uhealth 2017; 5:e117. [PMID: 28778840 PMCID: PMC5561389 DOI: 10.2196/mhealth.5890] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 01/25/2017] [Accepted: 03/25/2017] [Indexed: 12/23/2022] Open
Abstract
Background Studies have consistently shown that mobile and Web-based apps have positive impacts on people’s daily lifestyles, health management, and disease treatment. As the development of medical and health informatization in China has evolved, different kinds of mobile-based apps for individuals and hospitals have been developed by software vendors. However, doubts and challenges posed by the media have prevented these apps from having a stable and substantial user base. Analyses of user requirements have not typically been performed prior to the design of such mobile apps. The health information government authority in Liaoning Province, China, was planning to establish a mobile health (mHealth)-based health management platform, aiming to alleviate the difficulties citizens have in seeking hospital services. Objective The goal of this study was to determine the actual health and medical needs of citizens that may be addressed by medical information technologies. The results may contribute to the functional design and development of health management and appointed treatment-oriented mobile apps. Methods In this study, a semi-structured questionnaire on mHealth requirements was designed and tested, and 240 questionnaires were given to the outpatients of the First Hospital of the China Medical University in Shenyang, Liaoning Province, China; of these, 228 valid responses were collected, for a response rate of 95%. We discussed the current development of mHealth with 50 related experts and engineers from health authorities and a medical information company. SPSS 13.0 was used for statistical analyses. Results After detailed analyses of the questionnaire data, several findings were evident: first, most citizens and patients were unclear about their health conditions (64.5%, 147/228) and were interested in receiving a mobile app as a tool to manage their health and medical needs (71.1%, 162/228). Patients in different outpatient departments had different opinions regarding online registration. Conversely, the main problems for outpatients were long waiting times (66.4%, 148/223) and difficulties in making appointments (46.5%, 106/228), and they also worried about payments and Internet problems when using a mobile app for appointment reservations. Furthermore, as the main service target of mHealth is the health management of the general population, we first need to solve the associated interoperability and data security problems associated with such apps. Conclusions This study provides insight into the health and medical requirements of smartphone apps, and draws attention to some of the challenges and opportunities of mHealth. We suggest several value-added features and characteristics that app developers should take into consideration when developing health and medical-related apps. The findings also highlight some major challenges that require further consideration and research to ensure that these apps meet the core needs of patients and aid the development of the health information system in Liaoning Province, China.
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Affiliation(s)
- Hehua Zhang
- Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China
| | - Han Zhang
- Department of Medical Informatics, China Medical University, Shenyang, Liaoning, China
| | - Xiaoning Wang
- Department of Medical Informatics, China Medical University, Shenyang, Liaoning, China
| | - Zuosen Yang
- Health Information Center of Liaoning Province, Shenyang, Liaoning, China
| | - Yuhong Zhao
- Shengjing Hospital of China Medical University, China Medical University, Liaoning, Shenyang, China
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Staccini P, Fernandez-Luque L. Health Social Media and Patient-Centered Care: Buzz or Evidence? Findings from the Section "Education and Consumer Health Informatics" of the 2015 Edition of the IMIA Yearbook. Yearb Med Inform 2017; 10:160-3. [PMID: 26293862 DOI: 10.15265/iy-2015-032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To summarize the 2014 state of the art in the areas related to consumer health informatics and social media. METHODS We conducted a systematic review of articles published in 2014 in PubMed with a predefined set of queries. We identified 439 articles relevant for the review. The two section editors independently screened those papers taking into account their relevance to the topics covered by the section. In a second step, they jointly selected the 20 most representative papers as candidate best papers. Candidate best papers were then submitted for full review and scoring by external reviewers. Based on the scoring, section editors together with the IMIA Yearbook editorial board selected the four best papers published in 2014 in consumer health informatics. RESULTS Helping patients acquire a healthier lifestyle is a crucial part of patient empowerment. In this line of work, new studies are exploring the efficacy of online health interventions for patient behavioral change. The special case of smoking cessation for consumers with low socio-economic status is particularly noticeable. Another study has explored how an online intervention can reduce the anxiety of women who experience an abnormal mammography. The team of PatientsLikeMe has studied how online support groups could play a role in the quality of life of organ transplant recipients. The patient perspective of online forums' users is also analyzed in the domain of anticoagulation therapy. CONCLUSIONS Online health interventions, many of them using social media, have confirmed their potential to impact consumer behavioral change. However, there are still many methodological issues that need to be addressed in order to prove cost-effectiveness.
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Affiliation(s)
- P Staccini
- Pr Pascal Staccini, 1INSERM UMR 912 SESSTIM, IRIS Dept, UFR Médecine,, Université Nice-Sophia Antipolis, 28 avenue de Valombrose, 06107 Nice cedex 2, France, E-mail:
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Guendelman S, Broderick A, Mlo H, Gemmill A, Lindeman D. Listening to Communities: Mixed-Method Study of the Engagement of Disadvantaged Mothers and Pregnant Women With Digital Health Technologies. J Med Internet Res 2017; 19:e240. [PMID: 28679489 PMCID: PMC5517821 DOI: 10.2196/jmir.7736] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 04/26/2017] [Accepted: 04/27/2017] [Indexed: 12/17/2022] Open
Abstract
Background US health care providers are increasingly demanding patient engagement with digital health technologies to enroll in care, access personal health information, communicate with providers, and monitor their own health. Such engagement may be difficult for disadvantaged populations who may have limited health literacy, time constraints, or competing priorities. Objective We aimed to understand the extent of adoption and use of digital health tools and to identify key perceived psychological motivators of technology use among disadvantaged first-time pregnant women and mothers of young children. Methods We recruited women from health organizations serving low-income communities in the Midwest and on the East and West coasts. A total of 92 women participated in 14 focus groups. During each session, we administered worksheets that measured 3 utilization outcomes: the number of recent Web-based health-seeking activities, current use of digital health-management practices (eg, accessing personal health information, communicating with providers, and scheduling appointments), and potential adoption of digital health-management tools among low users or nonusers. Responses to the worksheets and to a pre-focus group survey on demographics, technology access, and motivators of use were examined to create user profiles. Separate regression models identified the motivators (eHealth literacy, internal health orientation, and trust in digital information) associated with these outcomes. Qualitative data were incorporated to illustrate the worksheet responses. Results Whereas 97% of the participants reported that they had searched for health information on the Internet in the past year, 42% did not engage in digital health-management practices. Among the low users and nonusers, 49% expressed interest in future adoption of digital health tools. Web-based health information-seeking activities were associated with digital health-management practices (P<.001). When controlling for covariates, eHealth literacy was positively correlated with the number of Web-based health-seeking activities (beta=.03, 95% CI 0.00-0.07). However, an internal health orientation was a much stronger correlate of digital health-management practices (beta=.13, 95% CI 0.02-0.24), whereas trust in digital information increased the odds of potential adoption (vs no adoption) in adjusted models (OR 5.21, 95% CI 0.84-32.53). Demographic characteristics were not important drivers of digital health use and few differences distinguished use among mothers and pregnant women. Conclusions Seeking health information on the Internet may be an important gateway toward engaging in digital health-management practices. Notably, different consumer motivators influence digital health tool use. The relative contributions of each must be explored to design tools and interventions that enhance competencies for the management of self and child health among disadvantaged mothers and pregnant women. Unless we address disparities in digital health tool use, benefits from their use will accrue predominantly to individuals with the resources and skills to use technology effectively.
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Affiliation(s)
- Sylvia Guendelman
- Maternal and Child Health, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Andrew Broderick
- Center for Innovation and Technology in Public Health, Public Health Institute, Oakland, CA, United States
| | - Hmellisa Mlo
- Maternal and Child Health, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Alison Gemmill
- Department of Demography, University of California, Berkeley, Berkeley, CA, United States
| | - David Lindeman
- CITRIS Health Initiative, The Center for Information Technology Research in the Interest of Society (CITRIS) and the Banatao Institute, Berkeley, CA, United States
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Lewis J, Snyder M, Hyatt-Knorr H. Marking 15 years of the Genetic and Rare Diseases Information Center. ACTA ACUST UNITED AC 2017; 2:77-88. [PMID: 29152459 PMCID: PMC5685198 DOI: 10.3233/trd-170011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND: The Genetic and Rare Diseases Information Center (GARD), a program of the National Center for Advancing Translational Sciences, was established in 2002 to assist the public in finding reliable, timely, and easy-to-understand information about genetic and/or rare diseases in English or Spanish. OBJECTIVE: A review of longitudinal data on GARD inquiries from 2002 to 2016 and assessment of the results of two user satisfaction surveys were conducted to understand the demographics and needs of GARD customers over time. METHODS: Since 2002, GARD has collected anonymized data while responding to questions received via e-mail, website, telephone, fax, letter, or TTY. Between 2002 and 2016 GARD received a total of 60,106 inquiries. User satisfaction surveys were conducted in 2006 and 2014, in which users self-selected to participate. RESULTS: The annual number of inquiries has risen steadily since 2002. Inquiries are overwhelmingly from educated female patients, family, and friends seeking disease-specific information, treatment options, referrals, and research studies. Most users report satisfaction with the experience. CONCLUSIONS: Rare disease patients and their families face challenges in finding information about their symptoms or diagnosis, prognosis, treatment options, significance for family members, and research opportunities. Lack of available clinical expertise can leave patients, their family, and friends with little choice but to become knowledgeable on their own. GARD fills a critical need by providing the public with vetted, evidence-based information that empowers people to engage in their own health care and seek research studies of relevance.
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Affiliation(s)
| | | | - Henrietta Hyatt-Knorr
- National Center for Advancing Translational Sciences, Office of Rare Diseases Research, National Institutes of Health, Bethesda, MD, USA
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Ruppel EH, Karpman HE, Delk CE, Merryman M. Online maternity information seeking among lesbian, bisexual, and queer women. Midwifery 2017; 48:18-23. [DOI: 10.1016/j.midw.2017.02.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 02/23/2017] [Accepted: 02/25/2017] [Indexed: 10/20/2022]
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Latulippe K, Hamel C, Giroux D. Social Health Inequalities and eHealth: A Literature Review With Qualitative Synthesis of Theoretical and Empirical Studies. J Med Internet Res 2017; 19:e136. [PMID: 28450271 PMCID: PMC5427250 DOI: 10.2196/jmir.6731] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 02/09/2017] [Accepted: 03/02/2017] [Indexed: 01/08/2023] Open
Abstract
Background eHealth is developing rapidly and brings with it a promise to reduce social health inequalities (SHIs). Yet, it appears that it also has the potential to increase them. Objectives The general objective of this review was to set out how to ensure that eHealth contributes to reducing SHIs rather than exacerbating them. This review has three objectives: (1) identifying characteristics of people at risk of experiencing social inequality in health; (2) determining the possibilities of developing eHealth tools that avoid increasing SHI; and (3) modeling the process of using an eHealth tool by people vulnerable to SHI. Methods Following the EPPI approach (Evidence for Policy and Practice of Information of the Institute of Education at the University of London), two databases were searched for the terms SHIs and eHealth and their derivatives in titles and abstracts. Qualitative, quantitative, and mixed articles were included and evaluated. The software NVivo (QSR International) was employed to extract the data and allow for a metasynthesis of the data. Results Of the 73 articles retained, 10 were theoretical, 7 were from reviews, and 56 were based on empirical studies. Of the latter, 40 used a quantitative approach, 8 used a qualitative approach, 4 used mixed methods approach, and only 4 were based on participatory research-action approach. The digital divide in eHealth is a serious barrier and contributes greatly to SHI. Ethnicity and low income are the most commonly used characteristics to identify people at risk of SHI. The most promising actions for reducing SHI via eHealth are to aim for universal access to the tool of eHealth, become aware of users’ literacy level, create eHealth tools that respect the cultural attributes of future users, and encourage the participation of people at risk of SHI. Conclusions eHealth has the potential to widen the gulf between those at risk of SHI and the rest of the population. The widespread expansion of eHealth technologies calls for rigorous consideration of interventions, which are not likely to exacerbate SHI.
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Affiliation(s)
- Karine Latulippe
- Department of Studies of Teaching and Learning, Laval University, Québec, QC, Canada
| | - Christine Hamel
- Department of Studies of Teaching and Learning, Laval University, Québec, QC, Canada
| | - Dominique Giroux
- Faculté de médecine, Département de réadaptation, Laval University, Québec, QC, Canada.,Centre d'Excellence du Vieillissement de Québec, Chu de Québec, Québec, QC, Canada
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Nădăşan V. The Quality of Online Health-Related Information – an Emergent Consumer Health Issue. ACTA MEDICA MARISIENSIS 2016. [DOI: 10.1515/amma-2016-0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
The Internet has become one of the main means of communication used by people who search for health-related information. The quality of online health-related information affects the users’ knowledge, their attitude, and their risk or health behaviour in complex ways and influences a substantial number of users in their decisions regarding diagnostic and treatment procedures.
The aim of this review is to explore the benefits and risks associated with using the Internet as a source of health-related information; the relationship between the quality of the health-related information available on the Internet and the potential risks; the multiple conceptual components of the quality of health-related information; the evaluation criteria for quality health-related information; and the main approaches and initiatives that have been implemented worldwide to help improve users’ access to high-quality health-related information.
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Arsenault M, Blouin MJ, Guitton MJ. Information quality and dynamics of patients' interactions on tonsillectomy web resources. Internet Interv 2016; 4:99-104. [PMID: 30135795 PMCID: PMC6096116 DOI: 10.1016/j.invent.2016.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/27/2016] [Accepted: 05/07/2016] [Indexed: 11/19/2022] Open
Abstract
Information technologies have drastically altered the way patients gather health-related information. By analysing web resources on tonsillectomy, we expose information quality and dynamics of patients' interactions in the online continuum. Readability was assessed using Flesch Reading Ease (FRE), Flesch Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), and Gunning Fog Index (GFI). Comprehensibility and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT). Metrics of forums included author characteristics (level of disclosure, gender, age, avatar image, etc.), posts' motive (community support vs. medical information) and content (word count, emoticon use, number of replies, etc.). Analysis of 6 professional medical websites, of 10 health information portals, and of 3 discussion forums totalizing 1369 posts on 358 threads, from January 1, 2007 to December 31, 2014, reveals that online resources exceed understandability recommendations. Women were more present on online health forums (68.2% of authors disclosing their gender) and invested themselves more in their avatar. Authors replying were significantly older than authors of original posts (39.7 ± 0.8 years vs. 29.2 ± 0.9 years, p < 0.001). The degree of self-disclosure was inversely proportional to the requests for medical information (p < 0.001). Men and women were equally seeking medical information (men: 74.0%, women: 77.0%) and community support (men: 65.7%, women: 70.4%), however women responded more supportively (women 86.2%, men 59.1%, p < 0.001). The dynamics of patients' interactions used to overcome accessibility difficulties encountered is complex. This work outlines the necessity for comprehensible medical information to adequately answer patients' needs.
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Affiliation(s)
- Marianne Arsenault
- Faculty of Medicine, Laval University, Quebec City, QC, Canada
- Institut Universitaire en Santé Mentale de Québec, Quebec City, QC, Canada
| | - Marie Julie Blouin
- Faculty of Medicine, Laval University, Quebec City, QC, Canada
- Centre Hospitalier Universitaire de Québec (CHUQ), Quebec City, QC, Canada
| | - Matthieu J. Guitton
- Faculty of Medicine, Laval University, Quebec City, QC, Canada
- Institut Universitaire en Santé Mentale de Québec, Quebec City, QC, Canada
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Lam W, Dawson A, Fowler C. The Health Literacy of Hong Kong Chinese Parents with Preschool Children in Seasonal Influenza Prevention: A Multiple Case Study at Household Level. PLoS One 2015; 10:e0143844. [PMID: 26624284 PMCID: PMC4666465 DOI: 10.1371/journal.pone.0143844] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 10/03/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Health literacy influences individual and family health behaviour, health services use, and ultimately health outcomes and health care costs. In Hong Kong, people are at risk of seasonal influenza infection twice a year for three-month periods. Seasonal influenza is significantly associated with an increased number of hospitalized children. There is no research that provides an understanding of parents' health knowledge and their access to health information concerning seasonal influenza, nor their capacity to effectively manage influenza episodes in household. Such knowledge provides valuable insight into enhancing parents' health literacy to effectively communicate health messages to their children and support healthy behaviour development through role modelling. METHODS A multiple case study was employed to gain a multifaceted understanding of parents' health literacy regarding seasonal influenza prevention. Purposive intensity sampling was adopted to recruit twenty Hong Kong Chinese parents with a healthy three-to-five year old preschool child from three kindergartens. A content analysis was employed to categorize, tabulate and combine data to address the propositions of the study. Comprehensive comparisons were made across cases to reveal the commonalities and differences. RESULTS Four major themes were identified: inadequate parents' knowledge and reported skills and practices related to seasonal influenza prevention; parental knowledge seeking and exchange practices through social connection; parents' approaches to health information and limited enabling environments including shortage of health resources and uneven resource allocation for health promotion. CONCLUSIONS The findings recommend that community health professionals can play a critical role in increasing parents' functional, interactive and critical health literacy; important elements when planning and implementing seasonal influenza health promotion.
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Affiliation(s)
- Winsome Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- * E-mail:
| | - Angela Dawson
- Faculty of Health, University of Technology, Sydney, Australia
| | - Cathrine Fowler
- Faculty of Health, University of Technology, Sydney, Australia
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Sandefer RH, Westra BL, Khairat SS, Pieczkiewicz DS, Speedie SM. Determinants of Consumer eHealth Information Seeking Behavior. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2015; 2015:1121-1129. [PMID: 26958251 PMCID: PMC4765703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access.
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