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Chu JTW, Wilson H, Cai CZ, McCormack JC, Newcombe D, Bullen C. Technologies for Supporting Individuals and Caregivers Living With Fetal Alcohol Spectrum Disorder: Scoping Review. JMIR Ment Health 2024; 11:e51074. [PMID: 38994826 PMCID: PMC11259581 DOI: 10.2196/51074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 07/13/2024] Open
Abstract
Background Fetal alcohol spectrum disorder (FASD) is a common developmental disability that requires lifelong and ongoing support but is often difficult to find due to the lack of trained professionals, funding, and support available. Technology could provide cost-effective, accessible, and effective support to those living with FASD and their caregivers. Objective In this review, we aimed to explore the use of technology available for supporting people living with FASD and their caregivers. Methods We conducted a scoping review to identify studies that included technology for people with FASD or their caregivers; focused on FASD; used an empirical study design; were published since 2005; and used technology for assessment, diagnosis, monitoring, or support for people with FASD. We searched MEDLINE, Web of Science, Scopus, Embase, APA PsycINFO, ACM Digital Library, JMIR Publications journals, the Cochrane Library, EBSCOhost, IEEE, study references, and gray literature to find studies. Searches were conducted in November 2022 and updated in January 2024. Two reviewers (CZC and HW) independently completed study selection and data extraction. Results In total, 17 studies exploring technology available for people with FASD showed that technology could be effective at teaching skills, supporting caregivers, and helping people with FASD develop skills. Conclusions Technology could provide support for people affected by FASD; however, currently there is limited technology available, and the potential benefits are largely unexplored.
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Affiliation(s)
- Joanna Ting Wai Chu
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Centre for Arts and Social Transformation, Faculty of Education and Social Work, The University of Auckland, Auckland, New Zealand
- Centres for Addiction Research, Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Holly Wilson
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Cynthia Zhiyin Cai
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Jessica C McCormack
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
- Sensory Neuroscience Lab, Food Science, University of Otago, Dunedin, New Zealand
| | - David Newcombe
- Centres for Addiction Research, Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
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te Braake E, Grünloh C, Tabak M. Shifting Responsibilities: Developing a Pan-European Service Model for an eHealth Technology Supporting Self-Management of People with Chronic Obstructive Pulmonary Disease and Comorbidities. Int J Chron Obstruct Pulmon Dis 2024; 19:175-192. [PMID: 38249825 PMCID: PMC10800113 DOI: 10.2147/copd.s432568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/15/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Active participation of patients in their care via self-management is an important pillar to manage chronic conditions. Self-management education and continuous support are needed to improve patients' confidence to take such active role. One way to do this is through eHealth technologies. However, those technologies can only be successful when actively used in daily practice and when integrated in overall care. Therefore, this study investigated how a self-management eHealth technology could be implemented that emphasises the active role of patients in their care. Methods The service modelling method was utilized as implementation strategy. The design process consisted of five phases with salient stakeholders and consortium members of a European project to develop the service model. Studies with salient stakeholders were carried out in three different countries (Italy, Estonia, the Netherlands). A combination between face-to-face and online methods facilitated the participatory design process. Results Due to the pan-European context, different stakeholders in the three countries were identified. Research nurses and case managers were not yet established in practice but once implemented, expected to contribute to optimal implementation. During service modelling, a crucial step was revealed: providing self-management training before technology use to let patient familiarise with the concept of taking an active role. As HCPs felt that they were not necessarily equipped to guide patients in terms of self-management, they also should have access to such self-management training. Conclusion By demonstrating a way for implementation while emphasising patients' active role, we also showed the complexity of the method in two ways. First, by demonstrating the fine line between the descriptive and prescriptive model. Thus, showcasing the need to recognize that prescriptive models may be hampered by the delay in changing work practices. Second, by highlighting the importance of identifying country-specific differences in the pan-European context, revealing that service modelling is not a one-size-fits-all approach.
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Affiliation(s)
- Eline te Braake
- Roessingh Research and Development, Enschede, the Netherlands
- University of Twente, Biomedical Signals and System Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, Enschede, the Netherlands
| | - Christiane Grünloh
- Roessingh Research and Development, Enschede, the Netherlands
- University of Twente, Biomedical Signals and System Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, Enschede, the Netherlands
| | - Monique Tabak
- University of Twente, Biomedical Signals and System Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, Enschede, the Netherlands
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Raquel Costa-Brito A, Bovolini A, Rúa-Alonso M, Vaz C, Francisco Ortega-Morán J, Blas Pagador J, Vila-Chã C. Home-based exercise interventions delivered by technology in older adults: A scoping review of technological tools usage. Int J Med Inform 2024; 181:105287. [PMID: 37972483 DOI: 10.1016/j.ijmedinf.2023.105287] [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: 07/01/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Despite technology-based systems being considered promising tools to stimulate and increase physical function at home, most older adults are unfamiliar with technology, which may pose some difficulties. Technology-related parameters, such as adherence, acceptance, and acceptability, are crucial to achieving higher efficacy levels of home-based exercise interventions delivered by technology. In this scoping review, we aimed to revise the use of home-based technological tools to improve physical function in the older population, focusing on the user's experience and perspective. Methods This scoping review was conducted following PRISMA guidelines. The search was conducted in April 2022 and updated in April 2023. A total of 45 studies were included in the review. Results Most studies (95.5%) met the technology usage levels defined by the research team or reported satisfactory technology usage levels. Positive health-related outcomes were reported in 80% of studies. Although the existence of guidelines to correctly define and use measures associated with technology use, including adherence, acceptance and acceptability, some terms are still being used interchangeably. Some concerns related to the lack of an international consensus regarding technology usage measures and the exclusion of older adults who did not own or have previous experience with technology in a large percentage of the included studies may have limited the results obtained. Conclusions Altogether, home-based exercise interventions delivered through technology were associated with positive health-related outcomes in older adults, and technology usage levels are considered satisfactory. Older adults are willing and able to use technology autonomously if adequate support is provided.
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Affiliation(s)
| | - Antonio Bovolini
- Polytechnic of Guarda, Guarda, Portugal; Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal
| | - María Rúa-Alonso
- Polytechnic of Guarda, Guarda, Portugal; Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal; Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain
| | | | | | - J Blas Pagador
- Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Carolina Vila-Chã
- Polytechnic of Guarda, Guarda, Portugal; Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal.
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Palonen M, Turja T, Castano de la Rosa R, Ilomäki S, Kaasalainen T, Kivimäki Rantanen K, Pelsmakers S, Ruusuvuori J, Valtonen A, Kaunonen M. Learning from fall-related interventions for older people at home: A scoping review. Geriatr Nurs 2023; 54:76-82. [PMID: 37713947 DOI: 10.1016/j.gerinurse.2023.08.014] [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: 05/29/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/17/2023]
Abstract
This scoping review aims to provide a better understanding about the fall-related interventions, and the conditions which stand out as effective in decreasing fall risks of older people at home. A total of 28 peer-reviewed papers were included when they reported interventions with an incidence of falls or fall-risk as a primary outcome for older people, focusing on the home environment, from 8 databases. Qualitative examination was complemented by quantitative risk ratio analysis where it was feasible. The interventions regarding incidence of falls had a mean risk rate of 0.75; moreover, interventions using multiple strategies were found relatively successful. The interventions regarding fall risk had a mean hazard rate of 0.66. A considerable number of no-effect ratios were evident. Combining education, home assessment or improvement, and use of technology with implementation by health service experts appears to be the most promising intervention strategy to reduce falls.
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Affiliation(s)
- Mira Palonen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland.
| | - Tuuli Turja
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
| | | | - Sakari Ilomäki
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
| | - Tapio Kaasalainen
- Faculty of Built Environment, Unit of Architecture, Tampere University, Tampere, Finland
| | | | - Sofie Pelsmakers
- Faculty of Built Environment, Unit of Architecture, Tampere University, Tampere, Finland
| | - Johanna Ruusuvuori
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
| | - Annika Valtonen
- Faculty of Social Sciences, Unit of Social Research, Tampere University, Tampere, Finland
| | - Marja Kaunonen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland; The Well-being Services County of Pirkanmaa, Hospital services, Tampere, Finland
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Davoody N, Eghdam A, Koch S, Hägglund M. Evaluation of an Electronic Care and Rehabilitation Planning Tool With Stroke Survivors With Aphasia: Usability Study. JMIR Hum Factors 2023; 10:e43861. [PMID: 37067848 PMCID: PMC10152385 DOI: 10.2196/43861] [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: 10/27/2022] [Revised: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Patients with chronic illnesses with physical and cognitive disabilities, particularly stroke survivors with aphasia, are often not involved in design and evaluation processes. As a consequence, existing eHealth services often do not meet the needs of this group of patients, which has resulted in a digital divide. OBJECTIVE The aim of this study was to examine the effectiveness and user satisfaction of an electronic care and rehabilitation planning tool from the perspective of stroke survivors with aphasia. This would help us gain knowledge on how such a tool would need to be adapted for these patients for further development. METHODS Usability tests were conducted with 9 postdischarge stroke survivors with aphasia. Effectiveness was measured using task-based tests, and user satisfaction was studied through qualitative interviews at the end of each test. All tests were audio recorded, and each test lasted approximately 1 hour. The data were analyzed using qualitative content analysis. As the tool can be used by stroke survivors either independently or with some support from their next of kin or care professionals, the research group decided to divide the participants into 2 groups. Group 1 did not receive any support during the tests, and group 2 received some minor support from the moderator. RESULTS The results showed that the care and rehabilitation planning tool was not effective for stroke survivors with aphasia, as many participants in group 1 did not accomplish the tasks successfully. Despite several usability problems and challenges in using the tool because of patients' disabilities, the participants were positive toward using the tool and found it useful for their care and rehabilitation journey. CONCLUSIONS There is a need to involve patients with chronic illnesses more in the design and evaluation processes of health information systems and eHealth services. eHealth services and health information systems designed for this group of patients should be more adaptable and flexible to provide them with appropriate functionalities and features, meet their needs, and be useful and easy to use. In addition, the design and evaluation processes should be adapted, considering the challenges of this patient group.
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Affiliation(s)
- Nadia Davoody
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Aboozar Eghdam
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Sabine Koch
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Maria Hägglund
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Villa-García L, Davey V, Peréz LM, Soto-Bagaria L, Risco E, Díaz P, Kuluski K, Giné-Garriga M, Castellano-Tejedor C, Inzitari M. Co-designing implementation strategies to promote remote physical activity programs in frail older community-dwellers. Front Public Health 2023; 11:1062843. [PMID: 36960372 PMCID: PMC10028273 DOI: 10.3389/fpubh.2023.1062843] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
Background The "AGIL Barcelona (AGILBcn)" community-based integrated care program is a multicomponent healthy aging intervention for frail older adults. In this context, the present study aimed to identify implementation strategies to optimize the accessibility, acceptability, and adaptability of mobile health (mhealth) interventions to enhance physical activity in frail older adults, and to prioritize action points according to their importance and feasibility, through a co-design process. Material and methods A mixed methods approach was used. In the qualitative phase, a method adapted from the World Café was applied in 6 virtual groups to identify strategies to facilitate the virtual physical activity program. In the quantitative phase, prioritization and feasibility of the strategies was analyzed through surveys. Strategies were ranked based on priority vs. feasibility, revealing if strategies should either be: implemented first; if possible; taken into account for future consideration; or directly disregarded. The convenience sample included older adults (n = 7), community professionals (n = 9) and health professionals (n = 13). Qualitative data were analyzed by summative content analysis and quantitative data by nonparametric descriptive analyses. Results A total of 27 strategies were identified and grouped into four categories: general strategies for reducing barriers; specific strategies for facilitating the use of a digital application; specific strategies for facilitating participation in virtual exercise groups; and specific strategies for facilitating external support. According to the ranking of strategies, the first ones to be implemented included: digital literacy, digital capability assessment, family technology support, weekly telephone follow-up by professionals, personalizing exercises, and virtual exercises in small groups. Conclusion The active participation of all stakeholders enabled us to identify potential strategies for implementing person-oriented technology in physical activity programs and for engaging older adults.
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Affiliation(s)
- Lorena Villa-García
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Doctorate Program, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- QIDA, Sabadell, Spain
- *Correspondence: Lorena Villa-García
| | - Vanessa Davey
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Laura M. Peréz
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Luis Soto-Bagaria
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Ester Risco
- Nursing Research Group, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Nursing Department, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pako Díaz
- Centre d'Atenció Primària Bordeta-Magòria, Barcelona, Spain
| | - Kerry Kuluski
- Bridgepoint Collaboratory for Research and Innovation, Bridgepoint Health, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Maria Giné-Garriga
- Department of Sport Sciences, Faculty of Psychology, Education and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
- Department of Physical Therapy, Faculty of Health Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Carmina Castellano-Tejedor
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Marco Inzitari
- Research Group on Aging, Frailty and Care Transitions in Barcelona, Parc Sanitari Pere Virgili and Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
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Khasawneh A, Kratzke I, Adapa K, Marks L, Mazur L. Effect of Notes' Access and Complexity on OpenNotes' Utility. Appl Clin Inform 2022; 13:1015-1023. [PMID: 36104159 PMCID: PMC9605819 DOI: 10.1055/a-1942-6889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/11/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Health care providers are now required to provide their patients access to their consultation and progress notes. Early research of this concept, known as "OpenNotes," showed promising results in terms of provider acceptability and patient adoption, yet objective evaluations relating to patients' interactions with the notes are limited. OBJECTIVES To assess the effect of the complexity level of notes and number of accesses (initial read vs. continuous access) on the user's performance, perceived usability, cognitive workload, and satisfaction with the notes. METHODS We used a 2*2 mixed subjects experimental design with two independent variables: (1) note's complexity at two levels (simple vs. complex) and (2) number of accesses to notes at two levels (initial vs. continuous). Fifty-three participants were randomly assigned to receive a simple versus complex radiation oncology clinical note and were tested on their performance for understanding the note content after an initial read, and then with continuous access to the note. Performance was quantified by comparing each participant's answers to the ones developed by the research team and assigning a score of 0 to 100 based on participants' understanding of the notes. Usability, cognitive workload, and satisfaction scores of the notes were quantified using validated tools. RESULTS Performance for understanding was significantly better in simple versus complex notes with continuous access (p = 0.001). Continuous access to the notes was also positively associated with satisfaction scores (p = 0.03). The overall perceived usability, cognitive workload, and satisfaction scores were considered low for both simple and complex notes. CONCLUSION Simplifying notes can improve understanding of notes for patients/families. However, perceived usability, cognitive workload, and satisfaction with even the simplified notes were still low. To make notes more useful for patients and their families, there is a need for dramatic improvements to the overall usability and content of the notes.
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Affiliation(s)
- Amro Khasawneh
- Industrial Engineering Department, School of Engineering, Mercer University, Macon, Georgia, United States
| | - Ian Kratzke
- Department of Surgery, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States
| | - Karthik Adapa
- Department of Radiation Oncology, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States
| | - Lawrence Marks
- Department of Radiation Oncology, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States
| | - Lukasz Mazur
- Department of Radiation Oncology, School of Medicine, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States
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