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Castro A, Lalonde-LeBlond G, Freitas Z, Arnaert A, Bitzas V, Kildea J, Moffatt K, Phillips D, Wiseblatt L, Hall AJ, Després V, Tsimicalis A. In-Home Respite Care Services Available to Families With Palliative Care Needs in Quebec: Novel Digital Environmental Scan. JMIR Nurs 2024; 7:e53078. [PMID: 38625735 PMCID: PMC11061788 DOI: 10.2196/53078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/12/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Caregiving dyads in palliative care are confronted with complex care needs. Respite care services can be highly beneficial in alleviating the caregiving burden, supporting survivorship and dying at home. Yet, respite care services are difficult to locate and access in the province of Quebec, Canada, particularly when navigating ubiquitous sources of online health information of varying quality. OBJECTIVE This project aimed to (1) compile a list of at-home palliative respite care services in Quebec, Canada; (2) describe key accessibility features for each respite care service; (3) identify accessibility gaps and opportunities; and (4) describe a novel method for conducting environmental scans using internet search engines, internet-based community health databases, and member checking. METHODS A novel environmental scan methodology using 2 internet-based targeted databases and 1 internet search engine was conducted. Results were screened and data were extracted, descriptively analyzed, and geographically schematized. RESULTS A total of 401 services were screened, and 52 at-home respite care services specific to palliative populations were identified, compiled, and analyzed. These respite care services were characterized by various types of assistance, providers, fees, and serviced geographical regions. Accessibility was explored through the lens of service amenability, availability, eligibility, and compatibility. The data revealed important barriers to accessing respite care services, such as a lack of readily available information on service characteristics, limited availability, and a time-consuming, technical search process for potential respite care users and clinicians to identify appropriate services. CONCLUSIONS Both methodological and contextual knowledge have been gained through this environmental scan. Few methodologies for conducting internet-based environmental scans have been clearly articulated, so we applied several learnings from other scans and devised a methodology for conducting an environmental scan using the mixed methods of internet search engines, internet-based community health databases, and member checking. We have carefully reported our methods, so that others conducting community health environmental scans may replicate our process. Furthermore, through this scan, we identified assorted respite care services and pinpointed needs in the provision of these services. The findings highlighted that more easily accessible and centralized information about respite care services is needed in Quebec. The data will enable the creation of a user-friendly tool to share with community support services across Quebec and ultimately help alleviate the added burden caregivers and clinicians face when looking for respite care services in fragmented and complex digital spaces.
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Affiliation(s)
- Aimee Castro
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | - Zelda Freitas
- Professional Practice Directorate of Rehabilitation and Multidisciplinary Services, CIUSSS West-Central Montreal, Montreal, QC, Canada
- School of Social Work, McGill University, Montreal, QC, Canada
| | - Antonia Arnaert
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | - Vasiliki Bitzas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Geriatrics and Palliative Care, CIUSSS West-Central Montreal, Montreal, QC, Canada
| | - John Kildea
- Medical Physics Unit, McGill University, Montreal, QC, Canada
| | - Karyn Moffatt
- School of Information Studies, McGill University, Montreal, QC, Canada
| | - Devon Phillips
- Palliative Care McGill, McGill University, Montreal, QC, Canada
| | | | - Audrey-Jane Hall
- Palliative Home-Care Society of Greater Montreal, Montreal, QC, Canada
| | - Véronique Després
- St-Raphaël Palliative Care Home and Day Centre, Montreal, QC, Canada
| | - Argerie Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Nursing Research, Shriners Hospitals for Children-Canada, Montreal, QC, Canada
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Baffsky R, Koshiba C, Muna EL, Maua RF, Ivers R, Peden AE. Assessing violence and injury prevention plans, strategies and indicators in eighteen Pacific Islands countries: an environmental scan. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 44:100985. [PMID: 38226330 PMCID: PMC10788529 DOI: 10.1016/j.lanwpc.2023.100985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 01/17/2024]
Abstract
Background Similar to many other resource poor settings, due to competing priorities, injury is often neglected in the Pacific Islands despite being a prevalent cause of death and disability. This study identifies, and synthesises existing plans and strategies, and assesses progress against indicators for the prevention of violence and injury in 18 Pacific Islands nations to identify gaps and highlight opportunities. Methods An environmental scan of known government repositories and Google Advanced was conducted to identify publicly available documents describing/evaluating national-level injury prevention strategies and plans in the Pacific Islands. Data were extracted on the strategy/plan, country, government department responsible, indicators and related progress. Findings We identified 44 relevant documents. Most were published in more resourced countries (e.g., Fiji, Cook Islands) and described strategies/plans relating to traffic injury, injury from natural disaster and/or intimate partner violence. No strategies/plans to prevent injury mechanisms of drowning, falls, suffocation, burns, or electrocution were identified. Progress against only one indicator was reported for road traffic injury in the Commonwealth of the Northern Mariana Islands. Interpretation This study suggests that there would be benefit in Pacific Islands nations to develop more robust data systems to assess progress against indicators of existing strategies and plans for traffic-injury, natural disaster and intimate partner violence. Development of strategies and implementation plans to address neglected injury areas such as drowning and falls which account for a significant burden of injury in the Pacific Islands is also recommended. Funding This work was funded by the World Health Organization Regional Office for the Western Pacific (RG 221962).
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Affiliation(s)
- Rachel Baffsky
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Candace Koshiba
- Prevention Unit, Division of Behavioural Health, Ministry of Health and Health Services, Palau
| | - Esther L. Muna
- Commonwealth Healthcare Corporation, Saipan, MP, Northern Mariana Islands
| | | | - Rebecca Ivers
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
| | - Amy E. Peden
- School of Population Health, UNSW Sydney, Samuels Building, F25, Samuel Terry Ave, Kensington, NSW, Australia
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Cunningham C, Sung H, Benoit J, Conway J, Scott SD. Multimedia Knowledge Translation Tools for Parents About Childhood Heart Failure: Environmental Scan. JMIR Pediatr Parent 2022; 5:e34166. [PMID: 35311676 PMCID: PMC8981009 DOI: 10.2196/34166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/18/2022] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Childhood heart failure is a factor in many hospital admissions each year. It can impose a steep learning curve for parents who need to learn the key information to care for their child at home. In this study, we conducted an environmental scan to identify and assess web-based knowledge translation tools about childhood heart failure for parent audiences developed within North America. OBJECTIVE The aim of this study is to inventory tools publicly available to parents about childhood heart failure from popular web-based venues, assess how each tool communicates health information, and explore how they were developed. METHODS Our search strategy included two commonly used multimedia-based platforms: two app stores (Google Play and Apple App Store) and one search engine (Advanced Google Search). Common search terms were used, and results were uploaded to Microsoft Excel for screening between 2 reviewers. The inclusion criteria for the tools were as follows: content focused on educating parents about their child's heart failure, developed in the English language, and originating within Canada and the United States. A total of 2 reviewers screened the app store and internet search results for relevant tools. Each tool was assessed using the Suitability Assessment of Materials (SAM), a validated tool that objectively assesses the suitability of how health information is communicated to a particular audience. Key informants who were involved in tool development were identified and invited for a qualitative interview using a semistructured format to provide data about the development process. Key themes were identified in the semistructured interview process. RESULTS Frequencies and SAM percent ratings of eligible tools were reported. No apps exist for parents relating to pediatric heart failure. Overall, 17 relevant internet tools were identified, and their suitability was assessed for the parent audience. Most tools scored well in layout and type, but they scored lower in readability and graphics. Qualitative interviews with key informants revealed three key themes: timely and introductory knowledge, credible and trustworthy knowledge, and challenges and evolution in knowledge. CONCLUSIONS This is the first environmental scan looking for parent tools relating to childhood heart failure in Canada and the United States. Findings from this study reveal that there are no apps on this topic and there is a small number of tools for parents on the internet (n=17). Using the SAM, no tools scored in the superior range, and further work in knowledge translation strategies needs to be done in this area to improve more effective education to parents and caregivers who have a child with heart failure. These findings will inform the development of a new resource on children's heart failure that targets parents and caregiver audiences.
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Affiliation(s)
| | - Hyelin Sung
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - James Benoit
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Conway
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Shannon D Scott
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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Chan M, Scott SD, Campbell A, Elliott SA, Brooks H, Hartling L. Research- and health-related youth advisory groups in Canada: An environmental scan with stakeholder interviews. Health Expect 2021; 24:1763-1779. [PMID: 34288282 PMCID: PMC8483214 DOI: 10.1111/hex.13316] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Engaging youth throughout the research process improves research quality and outcomes. Youth advisory groups provide one way for youth to express their opinions on relevant issues. OBJECTIVE This study aimed to identify research- and health-related youth advisory groups ('groups') in Canada and understand the best practices of these groups. METHODS Google searches and supplementary methods were used to identify relevant groups in Canada. Group information was extracted from websites or through interviews with key informants. RESULTS We identified 40 groups. Groups were commonly part of a hospital/healthcare facility, nonprofit/health organization or research group. The majority focused on a specific content area, most commonly, mental health. Over half the groups advised on health services. Members' ages ranged from 9 to 35 years. The number of members ranged from 5 to 130. Interviews (n = 12) identified seven categories relating to group practices: (a) group purpose/objectives, (b) group development, (c) group operations, (d) group structure, (e) adult involvement, (f) membership and recruitment and (g) group access. Challenges and facilitators to the success of groups were described within the following themes: (a) retaining engagement, (b) creating a safe environment and (c) putting youth in positions of influence. Advice and recommendations were provided regarding the development of a new group. CONCLUSION This study provides a comprehensive overview of research- and health-related youth advisory groups in Canada. This information can be used to identify groups that stakeholders could access as well as inform the development of a new group. PATIENT OR PUBLIC CONTRIBUTION Youth advisory group representatives were interviewed as part of the study.
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Affiliation(s)
- Michelle Chan
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Centre for Health EvidenceUniversity of AlbertaEdmontonAlbertaCanada
| | - Shannon D. Scott
- Faculty of Nursing, ECHO ResearchUniversity of AlbertaEdmontonAlbertaCanada
| | - Alyson Campbell
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Sarah A. Elliott
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Centre for Health EvidenceUniversity of AlbertaEdmontonAlbertaCanada
| | - Hannah Brooks
- Faculty of NursingUniversity of AlbertaEdmontonAlbertaCanada
| | - Lisa Hartling
- Department of Pediatrics, Faculty of Medicine and Dentistry, Alberta Research Centre for Health EvidenceUniversity of AlbertaEdmontonAlbertaCanada
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Karunaratne S, Harris IA, Trevena L, Horsley M, Fajardo M, Solomon M. Online Decision Aids for Knee Arthroplasty: An Environmental Scan. JBJS Rev 2021; 9:01874474-202104000-00006. [PMID: 33830958 DOI: 10.2106/jbjs.rvw.20.00088] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Knee arthroplasty is a high-risk, resource-intensive procedure that should be reserved for patients in whom the benefit will outweigh the risks. The provision of high-quality, publicly available decision aids can help patients to balance the benefits against the harms of treatments and to assist informed decision-making. The aim of this study was to identify and evaluate the content and readability of freely available knee arthroplasty decision aids. METHODS A systematic search using an environmental scan methodology of publicly available online materials was performed in December 2018. Included materials were assessed for quality using the International Patient Decision Aid Standards instrument (IPDASi), understandability and actionability from a patient's perspective using the Patient Education Materials Assessment Tool (PEMAT), and readability grade level using the Flesch-Kincaid Grade Level and the Gunning Fog Index. RESULTS Of 761 online materials screened, 26 decision aids were identified. Only 18 (69%) may be considered to meet criteria to be defined as a decision aid and 4 (15%) met criteria suggesting that the material did not introduce potential harmful bias according to the IPDASi. The mean score (and standard deviation) for all decision aids was 74% ± 12% for understandability and 44% ± 19% for actionability using the PEMAT. Readability indices indicated a mean minimum reading level of Grade 10 (10.8 ± 2.5). No decision aid included a wait-and-see option. CONCLUSIONS Few high-quality decision aids exist for patients considering knee arthroplasty and none include a wait-and-see option. Many do not provide actionable options and are pitched at above-average reading levels. Developers need to address these issues to encourage high-quality decision-making, especially for those with low health literacy.
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Affiliation(s)
- Sascha Karunaratne
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Ian A Harris
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health (I.A.H.) and Sydney School of Public Health (L.T. and M.F.), Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndal Trevena
- Institute for Musculoskeletal Health (I.A.H.) and Sydney School of Public Health (L.T. and M.F.), Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Horsley
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael Fajardo
- Institute for Musculoskeletal Health (I.A.H.) and Sydney School of Public Health (L.T. and M.F.), Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Paskins Z, Torres Roldan VD, Hawarden AW, Bullock L, Meritxell Urtecho S, Torres GF, Morera L, Espinoza Suarez NR, Worrall A, Blackburn S, Chapman S, Jinks C, Brito JP. Quality and effectiveness of osteoporosis treatment decision aids: a systematic review and environmental scan. Osteoporos Int 2020; 31:1837-1851. [PMID: 32500301 DOI: 10.1007/s00198-020-05479-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
Decision aids (DAs) are evidence-based tools that support shared decision-making (SDM) implementation in practice; this study aimed to identify existing osteoporosis DAs and assess their quality and efficacy; and to gain feedback from a patient advisory group on findings and implications for further research. We searched multiple bibliographic databases to identify research studies from 2000 to 2019 and undertook an environmental scan (search conducted February 2019, repeated in March 2020). A pair of reviewers, working independently selected studies for inclusion, extracted data, evaluated each trial's risk of bias, and conducted DA quality assessment using the International Patient Decision Aid Standards (IPDAS). Public contributors (patients and caregivers with experience of osteoporosis and fragility fractures) participated in discussion groups to review a sample of DAs, express preferences for a new DA, and discuss plans for development of a new DA. We identified 6 studies, with high or unclear risk of bias. Across included studies, use of an osteoporosis DA was reported to result in reduced decisional conflict compared with baseline, increased SDM, and increased accuracy of patients' perceived fracture risk compared with controls. Eleven DAs were identified, of which none met the full set of IPDAS criteria for certification for minimization of bias. Public contributors expressed preferences for encounter DAs that are individualized to patients' own needs and risk. Using a systematic review and environmental scan, we identified 11 decision aids to inform patient decisions about osteoporosis treatment and 6 studies evaluating their effectiveness. Use of decision aids increased accuracy of risk perception and shared decision-making but the decision aids themselves fail to comprehensively meet international quality standards and patient needs, underpinning the need for new DA development.
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Affiliation(s)
- Z Paskins
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.
- Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership Trust, Stoke-on-Trent, ST6 7AG, UK.
| | - V D Torres Roldan
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - A W Hawarden
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
- Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership Trust, Stoke-on-Trent, ST6 7AG, UK
| | - L Bullock
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - S Meritxell Urtecho
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - G F Torres
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L Morera
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - N R Espinoza Suarez
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - A Worrall
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - S Blackburn
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - S Chapman
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, ST5 5BG, UK
| | - C Jinks
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - J P Brito
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
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Early ML, Kumar P, Marcell AV, Lawson C, Christianson M, Pecker LH. Literacy assessment of preimplantation genetic patient education materials exceed national reading levels. J Assist Reprod Genet 2020; 37:1913-1922. [PMID: 32472448 PMCID: PMC7468013 DOI: 10.1007/s10815-020-01837-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/17/2020] [Indexed: 12/28/2022] Open
Abstract
PURPOSE In vitro fertilization with preimplantation genetic testing (IVF+PGT-M) reduces the risk of having a child affected by a heritable condition, yet only one-third of eligible patients are aware of this reproductive option. Access to education materials written at appropriate literacy levels could raise patients' awareness, but there is a mismatch between patient reading ability and the literacy demand of most materials. This study aimed to systematically identify written education materials on IVF+PGT-M and evaluate their literacy levels. We hypothesized that materials would fail to meet standards set by the Joint Commission and Centers for Disease Control and Prevention (CDC). METHODS To identify patient education materials about IVF+PGT-M from academic databases and public-facing sources, an environmental scan was performed. Materials were analyzed using three validated scales: Simple Measure of Gobbledygook, Patient Education Materials Assessment Tool, and Clear Communication Index. RESULTS Seventeen patient education materials about IVF+PGT-M were identified from patient education databases, a consumer search engine, and professional organizations. The median reading level was 14.5 grade, median understandability was 74.2%, and median comprehensibility was 73.3%. CONCLUSIONS For most American adults, materials about IVF+PGT-M are not readable, understandable, or clear. The Joint Commission requires patient education materials be written at or below 5th grade reading level and the CDC recommends a 90% minimum score for comprehensibility. No evaluated material met these guidelines. Patient education materials that exceed average American literacy skills may perpetuate disparities in the utilization of IVF+PGT-M. Materials that communicate this complicated subject at an understandable level are needed.
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Affiliation(s)
- Macy L Early
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Priyanka Kumar
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Arik V Marcell
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Baltimore, MD, USA
| | - Cathleen Lawson
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Gynecology and Obstetrics, Baltimore, MD, USA
| | - Mindy Christianson
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Gynecology and Obstetrics, Baltimore, MD, USA.,Division of Reproductive Endocrinology/Infertility, Lutherville, MD, USA
| | - Lydia H Pecker
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Gynecology and Obstetrics, Baltimore, MD, USA.,Division of Hematology, Department of Medicine, Baltimore, MD, USA
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8
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Turin TC, Chowdhury N, Ferdous M, Vaska M, Rumana N, Dahal R, Rahman N, Chowdhury MZI. Health and well-being literacy initiatives focusing on immigrant communities: an environmental scan protocol to identify "what works and what does not". Syst Rev 2020; 9:84. [PMID: 32312314 PMCID: PMC7168966 DOI: 10.1186/s13643-020-01340-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Most of the major cities in the developed western countries are characterized by an increasing multiculturalism brought by the immigrant population. The immigrant communities face challenges in the new environment with their health and wellness related unmet needs. It is imperative to find sustainable ways to empower these diverse communities to champion their health and wellness. Community-based health and wellness literacy initiatives (CBHWLI) focusing on immigrant communities can be an important step towards citizen empowerment in this regard. The aim of the present environmental scan is to identify the key factors that might impact a CBHWLI in immigrant communities in Canada in order to facilitate the process in practice and identify the competencies and training required for its implementation. METHODS This study will gather information from existing literature and online sources as well as will capture expert and lay perspectives on the factors that can impact the effectiveness and sustainability of CBHWLIs through conducting a comprehensive environmental scan: (i) a systematic scoping review of published literature and grey literature, (ii) a comprehensive Internet search, (iii) key informant interviews, and (iv) community consultation. Specific methodological and analytical frameworks will guide each step. ETHICS AND DISSEMINATION This study is the first step in establishing a practical base for developing CBHWLI implementation research. Once the initial findings have been generated, the second step will involve inviting experts to provide their input. We first plan to disseminate the results of our scoping review and Internet scan through meetings with key stakeholders, to be followed by journal publications and conference or workshop presentations. Ethical approval is not required for the scoping review or Internet scan; however, approval to conduct interviews with key informants and community consultations in the second stage of the study will be sought from the Conjoint Health Research Ethics Board.
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Affiliation(s)
- Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada. .,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| | - Nashit Chowdhury
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Mahzabin Ferdous
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, G012F, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Marcus Vaska
- Knowledge Resource Service, Tom Baker Cancer Centre, Alberta Health Services, 1331-29 St. NW, Calgary, AB, T2N 4N2, Canada
| | - Nahid Rumana
- Sleep Center, Foothills Medical Center, University of Calgary, 1403-29 St NW, Calgary, AB, T2N 2TN, Canada
| | - Rudra Dahal
- Community Based Citizen Researcher, Calgary, AB, Canada
| | - Nafiza Rahman
- Community Based Citizen Researcher, Calgary, AB, Canada
| | - Mohammad Z I Chowdhury
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
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Fajardo MA, Weir KR, Bonner C, Gnjidic D, Jansen J. Availability and readability of patient education materials for deprescribing: An environmental scan. Br J Clin Pharmacol 2019; 85:1396-1406. [PMID: 30848837 PMCID: PMC6595308 DOI: 10.1111/bcp.13912] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/27/2019] [Accepted: 02/28/2019] [Indexed: 12/31/2022] Open
Abstract
AIMS To identify and evaluate content and readability of freely available online deprescribing patient education materials (PEMs). METHODS Systematic review of PEMs using MEDLINE, Embase, CINAHL, PsycINFO and The Cochrane Library of Systematic Reviews from inception to 25 September 2017 to identify PEMs. Additionally, deprescribing researchers and health professionals were surveyed to identify additional materials. Known repositories of materials were searched followed by a systematic Google search (22-28 January 2018). Materials were evaluated using an approach informed by the Patient Education Material Assessment Tool and the International Patient Decision Aids Standards Inventory. Readability of text-based materials was assessed using the US-based Gunning-Fog Index and Flesch-Kincaid Grade level. RESULTS Forty-eight PEMs were identified. PEMs addressing deprescribing of medications for symptom control (81%) were most common. Preventative medications were rarely addressed and material (39%) focused on older people. Only 37% of PEMs provided information about both potential benefits (e.g. reducing risk of side effects) and harms (e.g. withdrawal symptoms, increased risk of disease) of deprescribing, while 40% focussed on benefits only. Readability indices indicated an average minimum reading level of Grade 12. Option Grids and Decision Aids (mean reading level below Grade 10) were most suitable for people with average literacy levels. CONCLUSIONS Over 1/3 of deprescribing PEMs present potential benefits and harms of deprescribing indicating most of the freely available materials are not balanced. Most PEMs are pitched above average reading levels making them inaccessible for low health literacy populations.
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Affiliation(s)
- Michael Anthony Fajardo
- Sydney School of Public Health, ASK‐GP Centre of Research ExcellenceThe University of SydneyNSWAustralia
| | - Kristie Rebecca Weir
- Sydney School of Public Health, ASK‐GP Centre of Research ExcellenceThe University of SydneyNSWAustralia
- Wiser Health CareThe University of SydneySydneyNSWAustralia
- Sydney Health Literacy Lab, Sydney School of Public HealthThe University of SydneyNSWAustralia
| | - Carissa Bonner
- Sydney School of Public Health, ASK‐GP Centre of Research ExcellenceThe University of SydneyNSWAustralia
- Wiser Health CareThe University of SydneySydneyNSWAustralia
- Sydney Health Literacy Lab, Sydney School of Public HealthThe University of SydneyNSWAustralia
| | - Danijela Gnjidic
- School of Pharmacy and Charles Perkins CentreThe University of SydneySydneyNSWAustralia
| | - Jesse Jansen
- Sydney School of Public Health, ASK‐GP Centre of Research ExcellenceThe University of SydneyNSWAustralia
- Wiser Health CareThe University of SydneySydneyNSWAustralia
- Sydney Health Literacy Lab, Sydney School of Public HealthThe University of SydneyNSWAustralia
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Donnelly KZ, Elwyn G, Theiler R, Thompson R. Promoting or Undermining Quality Decision Making? A Qualitative Content Analysis of Patient Decision Aids Comparing Surgical and Medication Abortion. Womens Health Issues 2019; 29:414-423. [PMID: 31266679 DOI: 10.1016/j.whi.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/09/2019] [Accepted: 05/24/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To understand, describe, and compare the content of patient decision aids on surgical and medication abortion, including 1) attributes used to describe each method, 2) approaches to clarify patients' values, 3) language used to describe each method, and 4) language used to frame women's decision-making role. STUDY DESIGN We analyzed 49 decision aids identified through a previous systematic review and environmental scan. We used summative content analysis for objectives 1 and 2 and directed content analysis for objectives 3 and 4. RESULTS We identified 37 method attributes. Overall, the attributes privileged medical over practical and emotional information. One decision aid included an explicit values clarification approach, and others included implicit approaches, which varied in length, information consistency, and organization. We identified four themes-information consistency, subjective claims, emotive or ambiguous descriptions, and medication abortion as not a real abortion-related to the methods' descriptions. We identified three themes-agency in choice, unclear emphasis on women's preferences, and endorsement of clinic services-related to women's decision-making role. Of the nine tools that listed factors influencing women's decision making, patient preferences was often listed last. CONCLUSIONS Early abortion method decision aids presented a broad range of information and typically framed the method choice as the woman's. However, their emphasis on medical attributes, use of inconsistent information, and, at times, biased presentation of methods may undermine quality decision making. We recommend adapting an existing decision aid or designing a novel tool based on the content and language that women find most acceptable.
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Affiliation(s)
- Kyla Z Donnelly
- The Dartmouth Centers for Health and Aging, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire
| | - Regan Theiler
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - Rachel Thompson
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Fajardo MA, Durayb B, Zhong H, Trevena L, Traeger A, Bonner C. Online Decision Aids for Knee Osteoarthritis and Low Back Pain: An Environmental Scan and Evaluation. Med Decis Making 2019; 39:327-334. [DOI: 10.1177/0272989x19844720] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Musculoskeletal conditions are leading causes of disability. Management options are plentiful, but the current evidence base suggests many are ineffective or unproven. Online decision aids can help support patients make informed health care choices. However, there are little data on the quality of online decision aids for common musculoskeletal conditions such as knee or low back pain. Purpose. To identify all publicly available online decision aids for knee osteoarthritis and low back pain and evaluate them against the International Patient Decision Aids Standards Inventory (IPDASi). Data Sources. Google Australia. Study selection. Two reviewers independently screened websites for inclusion and assessed the quality of included online decision aids between April and May 2018. Included online decision aids were free, provided information about knee osteoarthritis or low back pain, and written in English. Online decision aids that required payment, targeted health professionals, addressed rheumatoid arthritis, or addressed a screening decision were excluded. Data Extraction. IPDASi Version 4. Data Synthesis. Twenty-five online decision aids were identified: 15 knee osteoarthritis and 10 low back pain. Only 3 online decision aids (12%) provided a “wait-and-see” option. Nineteen (75%) met IPDASi criteria to be considered a decision aid and 3 (12%) met IPDASi criteria to state that the online decision aid was unbiased. Limitations. Dynamic nature of Google searches may not be replicable easily. Conclusions. Few good-quality online decision aids are available for people with knee osteoarthritis or low back pain. Most online decision aids failed to explicitly provide a wait-and-see option, suggesting a bias toward intervention. These online decision aids would benefit from explicitly highlighting a wait-and-see option to support informed choice.
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Affiliation(s)
- Michael Anthony Fajardo
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, University of Sydney, NSW, Australia
| | - Bandar Durayb
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Ministry of Health, Saudi Arabia
| | - Haoxi Zhong
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Lyndal Trevena
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, University of Sydney, NSW, Australia
| | - Adrian Traeger
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Institute for Musculoskeletal Health, Sydney, Australia
| | - Carissa Bonner
- School of Public Health, University of Sydney, Sydney, NSW, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, University of Sydney, NSW, Australia
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Bonner C, Patel P, Fajardo MA, Zhuang R, Trevena L. Online decision aids for primary cardiovascular disease prevention: systematic search, evaluation of quality and suitability for low health literacy patients. BMJ Open 2019; 9:e025173. [PMID: 30872547 PMCID: PMC6429890 DOI: 10.1136/bmjopen-2018-025173] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES Recent guideline changes for cardiovascular disease (CVD) prevention medication have resulted in calls to implement shared decision-making rather than arbitrary treatment thresholds. Less attention has been paid to existing tools that could facilitate this. Decision aids are well-established tools that enable shared decision-making and have been shown to improve CVD prevention adherence. However, it is unknown how many CVD decision aids are publicly available for patients online, what their quality is like and whether they are suitable for patients with lower health literacy, for whom the burden of CVD is greatest. This study aimed to identify and evaluate all English language, publicly available online CVD prevention decision aids. DESIGN Systematic review of public websites in August to November 2016 using an environmental scan methodology, with updated evaluation in April 2018. The decision aids were evaluated based on: (1) suitability for low health literacy populations (understandability, actionability and readability); and (2) International Patient Decision Aids Standards (IPDAS). PRIMARY OUTCOME MEASURES Understandability and actionability using the validated Patient Education Materials Assessment Tool for Printed Materials (PEMAT-P scale), readability using Gunning-Fog and Flesch-Kincaid indices and quality using IPDAS V.3 and V.4. RESULTS A total of 25 unique decision aids were identified. On the PEMAT-P scale, the decision aids scored well on understandability (mean 87%) but not on actionability (mean 61%). Readability was also higher than recommended levels (mean Gunning-Fog index=10.1; suitable for grade 10 students). Four decision aids met criteria to be considered a decision aid (ie, met IPDAS qualifying criteria) and one sufficiently minimised major bias (ie, met IPDAS certification criteria). CONCLUSIONS Publicly available CVD prevention decision aids are not suitable for low literacy populations and only one met international standards for certification. Given that patients with lower health literacy are at increased risk of CVD, this urgently needs to be addressed.
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Affiliation(s)
- Carissa Bonner
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
| | - Pinika Patel
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
| | - Michael Anthony Fajardo
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ruixuan Zhuang
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lyndal Trevena
- School of Public Health, The University of Sydney, Camperdown, New South Wales, Australia
- Ask, Share, Know: Rapid Evidence for General Practice Decisions Centre for Research Excellence, The University of Sydney, Camperdown, New South Wales, Australia
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Fajardo MA, Balthazaar G, Zalums A, Trevena L, Bonner C. Favourable understandability, but poor actionability: An evaluation of online type 2 diabetes risk calculators. PATIENT EDUCATION AND COUNSELING 2019; 102:467-473. [PMID: 30389187 DOI: 10.1016/j.pec.2018.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/09/2018] [Accepted: 10/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The study aim was to identify all freely available online diabetes risk calculators and to evaluate their suitability for patients with low health literacy. METHODS Online diabetes risk calculators were identified by an environmental scan. The Patient Education Material Assessment Tool for Printable Materials was used to determine understandability and actionability scores. A high-risk profile was used to compare the risk results obtained with each calculator. RESULTS Thirty-five risk calculators were identified; 51% had no described model, 23% reported absolute risk and 31% used visual aids. The estimated risk for the same profile ranged from low to very high. The mean understandability score was 79% (SD = 19%) and the mean actionability score was 42% (SD = 30%). CONCLUSIONS Online diabetes risk calculators are generally understandable, but not very actionable, and may not be completely suitable for use by patients with low health literacy. The estimated risk is highly variable depending on the underlying model used for the calculation. PRACTICE IMPLICATIONS Patients and healthcare providers need to exercise caution when selecting a diabetes risk calculator.
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Affiliation(s)
- Michael Anthony Fajardo
- The University of Sydney, School of Public Health, Sydney, Australia; The University of Sydney, Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, Discipline of General Practice, The University of Sydney, Australia.
| | - Guy Balthazaar
- The University of Sydney, School of Public Health, Sydney, Australia
| | - Alexandra Zalums
- The University of Sydney, School of Public Health, Sydney, Australia
| | - Lyndal Trevena
- The University of Sydney, School of Public Health, Sydney, Australia; The University of Sydney, Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, Discipline of General Practice, The University of Sydney, Australia
| | - Carissa Bonner
- The University of Sydney, School of Public Health, Sydney, Australia; The University of Sydney, Ask, Share, Know: Rapid Evidence for General Practice Decision (ASK-GP), Centre for Research Excellence, Discipline of General Practice, The University of Sydney, Australia
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Abstract
OBJECTIVES To assess the degree of readability and the length of the package leaflets of biosimilars. SETTING The package leaflets analysed were downloaded from the European Medicines Agency (EMA) website. PARTICIPANTS The study sample included the package leaflets written in English of all the biosimilars that were authorised by the EMA on 31 August 2017, and whose content was available via the internet on that date (n=35). DESIGN This was a cross-sectional analytical study. The readability of the package leaflets of all biosimilars authorised by the EMA in August 2017 was determined applying the Flesch and Flesch-Kincaid formulas. The influence of the following variables on the readability and length was also analysed: package leaflet section, type of biosimilar, date of first authorisation of the biosimilar and type of medicine. RESULTS A considerable variation of the package leaflets length was found (3154±803). The readability of all the package leaflets overtook the recommended value for health-related written materials taking into account Flesch-Kincaid Index, and none of the package leaflets were easy to understand according to the Flesch Index. Statistically significant differences (p<0.05) were observed between the sections of package leaflets in readability indices and length. The most difficult sections to understand were those related with the therapeutic indication of medicine and the possible side effects. CONCLUSIONS Package leaflets for authorised biosimilars may not fulfil the function for which they were designed. The competent organisations could be informed about the possible negative effect on the use of this type of medicines.
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Affiliation(s)
- María Ángeles Piñero-López
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Carlos Figueiredo-Escribá
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Pilar Modamio
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Cecilia F Lastra
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Eduardo L Mariño
- Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
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Serious Choices: A Protocol for an Environmental Scan of Patient Decision Aids for Seriously Ill People at Risk of Death Facing Choices about Life-Sustaining Treatments. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 11:97-106. [PMID: 28825182 DOI: 10.1007/s40271-017-0268-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Seriously ill people at high risk of death face difficult decisions, especially concerning the extent of medical intervention. Given the inherent difficulty and complexity of these decisions, the care they receive often does not align with their preferences. Patient decision aids that educate individuals about options and help them construct preferences about life-sustaining care may reduce the mismatch between the care people say they want and the care they receive. The quantity and quality of patient decision aids for those at high risk of death, however, are unknown. OBJECTIVE This protocol describes an approach for conducting an environmental scan of life-sustaining treatment patient decision aids for seriously ill patients, identified online and through informant analysis. We intend for the outcome to be an inventory of all life-sustaining treatment patient decision aids for seriously ill patients currently available (either publicly or proprietarily) along with information about their content, quality, and known use. METHODS We will identify patient decision aids in a three-step approach (1) mining previously published systematic reviews; (2) systematically searching online and in two popular app stores; and (3) undertaking a key informant survey. We will screen and assess the quality of each patient decision aid identified using the latest published draft of the U.S. National Quality Forum National Standards for the Certification of Patient Decision Aids. Additionally, we will evaluate readability via readable.io and content via inductive content analysis. We will also use natural language processing to assess the content of the decision aids. DISCUSSION Researchers increasingly recognize the environmental scan as an optimal method for studying real-world interventions, such as patient decision aids. This study will advance our understanding of the availability, quality, and use of decision aids for life-sustaining interventions targeted at seriously ill patients. We also aim to provide patients, their families, and friends, along with their clinicians, a broad set of resources for making life-sustaining treatment decisions. Although we intend to capture all patient decision aids for the seriously ill in our review, we anticipate the possibility that we may miss some decision aids. In addition to publishing our findings in an academic journal, we plan to post our inventory online in an easy-to-read format for public and clinical consumption.
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Finnigan-Fox G, Matlock DD, Tate CE, Knoepke CE, Allen LA. Hospice, She Yelped: Examining the Quantity and Quality of Decision Support Available to Patient and Families Considering Hospice. J Pain Symptom Manage 2017; 54:916-921.e1. [PMID: 28818629 DOI: 10.1016/j.jpainsymman.2017.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/29/2017] [Accepted: 08/03/2017] [Indexed: 11/28/2022]
Abstract
CONTEXT Whether to engage hospice is one of the most difficult medical decisions patients and families make. Meanwhile, misperceptions about hospice persist. Within this context, the breadth and depth of patient decision support materials for hospice are unknown. OBJECTIVES The objective of this study was to identify available patient decision aids (PtDAs) relating information about hospice care and compare that information with the informational needs expressed by real-world health care consumers. METHODS First, the research team conducted an environmental scan of available PtDAs that included hospice as a treatment option and met six basic criteria defined by the International Patient Decision Aid Standards. Second, laypersons conducted an organic Web search for information regarding hospice, followed by a semi-structured interview eliciting perceptions of the available information. The setting was the University of Colorado Health Care System. Participants included 20 laypersons aged 18 years or older. RESULTS The environmental scan identified 7PtDAs that included hospice. No PtDAs were designed primarily around hospice; rather, hospice was referenced under the umbrella of another treatment option. The layperson search identified information distinct from the scan; no participant accessed any of the above 7PtDAs. Many participants found the available online material confusing and biased, while failing to provide clear information on cost and lacking desired patient and caregiver testimonials. CONCLUSION We found no formal PtDA designed primarily to help patients/families contemplating hospice. Furthermore, accessible online information about hospice does not appear to meet patient and caregiver decisional needs. These findings support the development and dissemination of high-quality decision support materials for hospice.
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Affiliation(s)
- Grace Finnigan-Fox
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, Colorado, USA
| | - Dan D Matlock
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, Colorado, USA; Division of Geriatrics, Aurora, Colorado, USA
| | - Channing E Tate
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, Colorado, USA; Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Christopher E Knoepke
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, Colorado, USA
| | - Larry A Allen
- Adult and Child Center for Health Outcomes Research and Delivery Science, Aurora, Colorado, USA; Division of Cardiology, University of Colorado School of Medicine, Aurora, Colorado, USA.
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Donnelly KZ, Elwyn G, Thompson R. Quantity over quality-Findings from a systematic review and environmental scan of patient decision aids on early abortion methods. Health Expect 2017; 21:316-326. [PMID: 28881071 PMCID: PMC5750699 DOI: 10.1111/hex.12617] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2017] [Indexed: 12/25/2022] Open
Abstract
Background The availability and effectiveness of decision aids (DAs) on early abortion methods remain unknown, despite their potential for supporting women's decision making. Objective To describe the availability, impact and quality of DAs on surgical and medical early abortion methods for women seeking induced abortion. Search strategy For the systematic review, we searched MEDLINE, Cochrane Library, CINAHL, EMBASE and PsycINFO. For the environmental scan, we searched Google and App Stores and consulted key informants. Inclusion criteria For the systematic review, we included studies evaluating an early abortion method DA (any format and language) vs a comparison group on women's decision making. DAs must have met the Stacey et al (2014). Cochrane review definition of DAs. For the environmental scan, we included English DAs developed for the US context. Data extraction and synthesis We extracted study and DA characteristics, assessed study quality using the Effective Practice and Organization of Care risk of bias tool and assessed DA quality using International Patient Decision Aid Standards (IPDAS). Results The systematic review identified one study, which found that the DA group had higher knowledge and felt more informed. The evaluated DA met few IPDAS criteria. In contrast, the environmental scan identified 49 DAs created by non‐specialists. On average, these met 28% of IPDAS criteria for Content, 22% for Development and 0% for Effectiveness. Conclusions Research evaluating DAs on early abortion methods is lacking, and although many tools are accessible, they demonstrate suboptimal quality. Efforts to revise existing or develop new DAs, support patients to identify high‐quality DAs and facilitate non‐specialist developers' adoption of best practices for DA development are needed.
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Affiliation(s)
- Kyla Z Donnelly
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
| | - Rachel Thompson
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, NH, USA
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Carlson NS. Current Resources for Evidence-Based Practice, September/October 2016. J Obstet Gynecol Neonatal Nurs 2016; 45:e57-66. [DOI: 10.1016/j.jogn.2016.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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