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Makabe S, Kume Y, Kamata T, Apikomonkon H, Griffiths J, Takagai J, Akagawa Y, Andoh H, Ito T, Singha-Dong N. Health Promotion Awareness in Barbershops and Salons: An International Cross-Sectional Survey in Japan and Thailand. J Community Health 2021; 45:768-774. [PMID: 32040693 DOI: 10.1007/s10900-020-00792-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Aging societies are a worldwide concern, as people are living longer than ever before. The success of the "barbershop project" in improving community health in the USA suggests that the aging issue can be tackled using this method even in Asia. Nevertheless, the health promotion awareness of barbers/stylists has barely been reported in Asia. This study aimed to identify the health promotion awareness of barbers and stylists in Japan and Thailand. An international cross-sectional survey was conducted between March and December 2017. Questionnaire contents included the "current status of existing health-promotion-related services," "awareness of contribution to maintaining people's health," and "awareness of collaboration with health care professionals." Participants were 99 Japanese and 101 Thai shop owners. In Japan, more health-promotion-related services were already provided through shops, and health care awareness was higher than in Thailand. In both countries, some shops were willing to collaborate with health care professionals. In Japan, "barbers/stylists have consultation opportunities with health care professionals," "health-related leaflets are provided," "development of therapy/care," and "barbershops/salons become a bridge between communities and hospitals" were mentioned as ideas for collaboration. In conclusion, barbers/stylists are highly interested in health due to the direct connection between beauty and health. Collaboration between barbershops/salons and health care professionals is possible, especially in Japan due to its super-aging society. Further development of the barbershop/salon project is needed.
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Affiliation(s)
- Sachiko Makabe
- Department of Clinical Nursing, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Yu Kume
- Department of Occupational Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | | | - Hataichanok Apikomonkon
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Jiranan Griffiths
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Junko Takagai
- Department of Clinical Nursing, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Yuko Akagawa
- Department of Clinical Nursing, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Hideaki Andoh
- Department of Clinical Nursing, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Tomoko Ito
- Department of Clinical Nursing, Akita University Graduate School of Health Sciences, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Naruemol Singha-Dong
- Institute of Nursing, Suranaree University of Technology, Nakhon Ratchasima, Thailand
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Peipert JD, Lad T, Khosla PG, Garcia SF, Hahn EA. A Low Literacy, Multimedia Health Information Technology Intervention to Enhance Patient-Centered Cancer Care in Safety Net Settings Increased Cancer Knowledge in a Randomized Controlled Trial. Cancer Control 2021; 28:10732748211036783. [PMID: 34565193 PMCID: PMC8481731 DOI: 10.1177/10732748211036783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I-III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings. Each patient was assessed for outcomes at 4 timepoints: after starting treatment (baseline), during treatment, immediately after treatment, and at follow-up assessment. The primary outcomes were health beliefs, cancer knowledge, self-efficacy, and satisfaction with communication about cancer and its treatments. Health-related quality of life (HRQOL) was a secondary outcome. A total of 129 patients participated in the study (65 intervention and 64 control), and approximately 50% of these completed the study. Patients randomized to receive the CancerHelp-TT program had a significantly larger increase in their cancer knowledge in comparison to those randomized to the control arm (effect size = .48, P = .05). While effect sizes for differences between randomized groups in self-efficacy, health beliefs, HRQOL, and satisfaction with communication were small (.10-.48), there was a consistent trend that participants in the intervention group showed larger increases over time in all outcomes compared to the control group. The CancerHelp-TT software was favorably rated by intervention participants. The CancerHelp-TT program showed promise to increase vulnerable cancer patients' cancer knowledge and adaptive health beliefs and attitudes. However, vulnerable patients may need additional interventional support in settings outside cancer clinics.
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Affiliation(s)
- John D. Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Thomas Lad
- John H. Stroger, Jr. Hospital, Chicago, IL, USA
| | | | - Sofia F. Garcia
- Department of Medical Social Sciences and Center for Patient-Centered Outcomes, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth A. Hahn
- Department of Medical Social Sciences and Center for Patient-Centered Outcomes, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Maramba ID, Jones R, Austin D, Edwards K, Meinert E, Chatterjee A. The Role of Health Kiosks: A Scoping Review (Preprint). JMIR Med Inform 2020; 10:e26511. [PMID: 35348457 PMCID: PMC9006133 DOI: 10.2196/26511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/05/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health kiosks are publicly accessible computing devices that provide access to services, including health information provision, clinical measurement collection, patient self–check-in, telemonitoring, and teleconsultation. Although the increase in internet access and ownership of smart personal devices could make kiosks redundant, recent reports have predicted that the market will continue to grow. Objective We seek to clarify the current and future roles of health kiosks by investigating the settings, roles, and clinical domains in which kiosks are used; whether usability evaluations of health kiosks are being reported, and if so, what methods are being used; and what the barriers and facilitators are for the deployment of kiosks. Methods We conducted a scoping review using a bibliographic search of Google Scholar, PubMed, and Web of Science databases for studies and other publications between January 2009 and June 2020. Eligible papers described the implementation as primary studies, systematic reviews, or news and feature articles. Additional reports were obtained by manual searching and querying the key informants. For each article, we abstracted settings, purposes, health domains, whether the kiosk was opportunistic or integrated with a clinical pathway, and whether the kiosk included usability testing. We then summarized the data in frequency tables. Results A total of 141 articles were included, of which 134 (95%) were primary studies, and 7 (5%) were reviews. Approximately 47% (63/134) of the primary studies described kiosks in secondary care settings. Other settings included community (32/134, 23.9%), primary care (24/134, 17.9%), and pharmacies (8/134, 6%). The most common roles of the health kiosks were providing health information (47/134, 35.1%), taking clinical measurements (28/134, 20.9%), screening (17/134, 12.7%), telehealth (11/134, 8.2%), and patient registration (8/134, 6.0%). The 5 most frequent health domains were multiple conditions (33/134, 24.6%), HIV (10/134, 7.5%), hypertension (10/134, 7.5%), pediatric injuries (7/134, 5.2%), health and well-being (6/134, 4.5%), and drug monitoring (6/134, 4.5%). Kiosks were integrated into the clinical pathway in 70.1% (94/134) of studies, opportunistic kiosks accounted for 23.9% (32/134) of studies, and in 6% (8/134) of studies, kiosks were used in both. Usability evaluations of kiosks were reported in 20.1% (27/134) of papers. Barriers (e.g., use of expensive proprietary software) and enablers (e.g., handling of on-demand consultations) of deploying health kiosks were identified. Conclusions Health kiosks still play a vital role in the health care system, including collecting clinical measurements and providing access to web-based health services and information to those with little or no digital literacy skills and others without personal internet access. We identified research gaps, such as training needs for teleconsultations and scant reporting on usability evaluation methods.
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Affiliation(s)
| | - Ray Jones
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Daniela Austin
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Katie Edwards
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Edward Meinert
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
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Mosher ZA, Hudson PW, Lee SR, Perez JL, Arguello AM, McGwin G, Theiss SM, Ponce BA. Check-in Kiosks in the Outpatient Clinical Setting: Fad or the Future? South Med J 2020; 113:134-139. [PMID: 32123929 DOI: 10.14423/smj.0000000000001078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Check-in kiosks are increasingly used in health care. This project aims to assess the effects of kiosk use upon check-in duration, point of service (POS) financial returns, and patient satisfaction. METHODS Six kiosks were implemented in a large academic orthopedic clinic, and check-in duration for 8.5 months following implementation and POS returns for 10.5 months before and after implementation were analyzed. Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey and self-devised surveys recorded patient satisfaction. RESULTS Cumulatively, 28,636 kiosk-based patient encounters were analyzed. Compared with historical norms, check-in duration decreased 2 minutes, 47 seconds (P < 0.001). Daily gross and individual POS returns increased $532.13 and $1.89, respectively (P < 0.001). Satisfaction surveys were completed by 719 of 1376 consecutive patients (52% response rate), revealing 12% improvement (P < 0.001), but Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey responses demonstrated no change (P = 0.146, 0.928, and 0.336). CONCLUSIONS Kiosks offer to reduce check-in duration and increase POS revenue without negatively affecting patient satisfaction.
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Affiliation(s)
- Zachary A Mosher
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Parke W Hudson
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sung R Lee
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jorge L Perez
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Alexandra M Arguello
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerald McGwin
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steven M Theiss
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Brent A Ponce
- From the Department of Orthopaedic Surgery, University of Alabama at Birmingham, and the Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
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Tarver WL, Haggstrom DA. The Use of Cancer-Specific Patient-Centered Technologies Among Underserved Populations in the United States: Systematic Review. J Med Internet Res 2019; 21:e10256. [PMID: 31012855 PMCID: PMC6658273 DOI: 10.2196/10256] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 12/11/2022] Open
Abstract
Background In the United States, more than 1.6 million new cases of cancer are estimated to be diagnosed each year. However, the burden of cancer among the US population is not shared equally, with racial and ethnic minorities and lower-income populations having a higher cancer burden compared with their counterparts. For example, African Americans have the highest mortality rates and shortest survival rates for most cancers compared with other racial or ethnic groups in the United States. A wide range of technologies (eg, internet-based [electronic health, eHealth] technologies, mobile [mobile health, mHealth] apps, and telemedicine) available to patients are designed to improve their access to care and empower them to participate actively in their care, providing a means to reduce health care disparities; however, little is known of their use among underserved populations. Objective The aim of this study was to systematically review the current evidence on the use of cancer-specific patient-centered technologies among various underserved populations. Methods Computer-based search was conducted in the following academic databases: (1) PubMed (cancer subset), (2) MEDLINE, (3) PsycINFO, and (4) CINAHL. We included studies that were peer-reviewed, published in the English language, and conducted in the United States. Each study was individually assessed for relevance, with any disagreements being reconciled by consensus. We used a 3-step inclusion process in which we examined study titles, abstracts, and full-text papers for assessment of inclusion criteria. We systematically extracted information from each paper meeting our inclusion criteria. Results This review includes 71 papers that use patient-centered technologies that primarily targeted African Americans (n=31), rural populations (n=14), and Hispanics (n=12). A majority of studies used eHealth technologies (n=41) finding them to be leading sources of cancer-related health information and significantly improving outcomes such as screening among nonadherent individuals and increasing knowledge about cancer and cancer screening. Studies on mHealth found that participants reported overall favorable responses to receiving health information via short message service (SMS) text message; however, challenges were experienced with respect to lack of knowledge of how to text among some participants. More complex mobile technologies (eg, a tablet-based risk assessment tool) were also found favorable to use and acceptable among underserved populations; however, they also resulted in more significant barriers, for example, participants expressed concerns regarding security and unfamiliarity with the technology and preferred further instruction and assistance in its use. Conclusions There is a growing body of literature exploring patient-centered technology and its influence on care of underserved populations. In this review, we find that these technologies seem to be effective, especially when tailored, in improving patient and care-related outcomes. Despite the potential of patient-centered technologies and the receptivity of underserved populations, challenges still exist with respect to their effective use and usability.
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Affiliation(s)
- Will L Tarver
- VA Health Services Research and Development, Center for Health Information & Communication, Richard L Roudebush VA Medical Center, Indianapolis, IN, United States.,Department of Health Policy & Management, Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States
| | - David A Haggstrom
- VA Health Services Research and Development, Center for Health Information & Communication, Richard L Roudebush VA Medical Center, Indianapolis, IN, United States.,Division of General Internal Medicine and Geriatrics, School of Medicine, Indiana University, Indianapolis, IN, United States.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, United States
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Nan X, Daily K, Richards A, Holt C, Wang MQ, Tracy K, Qin Y. The role of trust in health information from medical authorities in accepting the HPV vaccine among African American parents. Hum Vaccin Immunother 2018; 15:1723-1731. [PMID: 30396312 PMCID: PMC6746524 DOI: 10.1080/21645515.2018.1540825] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/01/2018] [Accepted: 10/20/2018] [Indexed: 10/27/2022] Open
Abstract
This research examines how and why trust in health information from medical authorities (i.e., doctors or health care professionals and government health agencies) predicts acceptance of the HPV vaccine for one's child among African American parents. A survey of African American parents recruited from community venues revealed that low trust in health information from government health agencies was associated with less favorable attitudes and intentions toward vaccinating their child against HPV. Trust in health information from a doctor or health care professional did not predict vaccine acceptance. Mediation analyses indicated that the relationship between trust in health information from government health agencies and vaccine acceptance was partially mediated by perceived vaccine efficacy. Implications of the findings on communicating to the African American community about the HPV vaccine are discussed.
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Affiliation(s)
- Xiaoli Nan
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Kelly Daily
- Strategic Communication (M.A.), La Salle University, Philadelphia, PA, USA
| | - Adam Richards
- Bob Schieffer College of Communication, Texas Christian University, Fort Worth, TX, USA
| | - Cheryl Holt
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Min Qi Wang
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Kate Tracy
- Department of Communication, University of Maryland, College Park, MD, USA
| | - Yan Qin
- Department of Communication, University of Maryland, College Park, MD, USA
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Appalasamy JR, Tha KK, Quek KF, Ramaiah SS, Joseph JP, Md Zain AZ. The effectiveness of culturally tailored video narratives on medication understanding and use self-efficacy among stroke patients: A randomized controlled trial study protocol. Medicine (Baltimore) 2018; 97:e10876. [PMID: 29851804 PMCID: PMC6393048 DOI: 10.1097/md.0000000000010876] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 05/05/2018] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION A substantial number of the world's population appears to end with moderate to severe long-term disability after stroke. Persistent uncontrolled stroke risk factor leads to unpredicted recurrent stroke event. The increasing prevalence of stroke across ages in Malaysia has led to the adaptation of medication therapy adherence clinic (MTAC) framework. The stroke care unit has limited patient education resources especially for patients with medication understanding and use self-efficacy. Nevertheless, only a handful of studies have probed into the effectiveness of video narrative at stroke care centers. METHOD This is a behavioral randomized controlled trial of patient education intervention with video narratives for patients with stroke lacking medication understanding and use self-efficacy. The study will recruit up to 200 eligible stroke patients at the neurology tertiary outpatient clinic, whereby they will be requested to return for follow-up approximately 3 months once for up to 12 months. Consenting patients will be randomized to either standard patient education care or intervention with video narratives. The researchers will ensure control of potential confounding factors, as well as unbiased treatment review with prescribed medications only obtained onsite. RESULTS The primary analysis outcomes will reflect the variances in medication understanding and use self-efficacy scores, as well as the associated factors, such as retention of knowledge, belief and perception changes, whereas stroke risk factor control, for example, self-monitoring and quality of life, will be the secondary outcomes. DISCUSSION AND CONCLUSION The study should be able to determine if video narrative can induce a positive behavioral change towards stroke risk factor control via enhanced medication understanding and use self-efficacy. This intervention is innovative as it combines health belief, motivation, and role model concept to trigger self-efficacy in maintaining healthy behaviors and better disease management. TRIAL REGISTRATION ACTRN (12618000174280).
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Affiliation(s)
| | - Kyi Kyi Tha
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
| | - Kia Fatt Quek
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
| | | | | | - Anuar Zaini Md Zain
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia
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Samal J, Prasad BM, Jonalgadda S, Vegendela S, Chadha SS. Kiosk: An Innovative Client Centric Approach to Tuberculosis Prevention and Care. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/jtr.2018.62014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gleason-Comstock J, Streater A, Ager J, Goodman A, Brody A, Kivell L, Paranjpe A, Vickers J, Mango L, Dawood R, Levy P. Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol. BMC Emerg Med 2015; 15:38. [PMID: 26691646 PMCID: PMC4687379 DOI: 10.1186/s12873-015-0052-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/24/2015] [Indexed: 01/13/2023] Open
Abstract
Background Persistently elevated blood pressure (BP) is a leading risk factor for cardiovascular disease development, making effective hypertension management an issue of considerable public health importance. Hypertension is particularly prominent among African Americans, who have higher disease prevalence and consistently lower BP control than Whites and Hispanics. Emergency departments (ED) have limited resources for chronic disease management, especially for under-served patients dependent upon the ED for primary care, and are not equipped to conduct follow-up. Kiosk-based patient education has been found to be effective in primary care settings, but little research has been done on the effectiveness of interactive patient education modules as ED enhanced discharge for an under-served urban minority population. Methods/Design Achieving Blood Pressure Control Through Enhanced Discharge (AchieveBP) is a behavioral RCT patient education intervention for patients with a history of hypertension who have uncontrolled BP at ED discharge. The project will recruit up to 200 eligible participants at the ED, primarily African-American, who will be asked to return to a nearby clinical research center for seven, thirty and ninety day visits, with a 180 day follow-up. Consenting participants will be randomized to either an attention-control or kiosk-based interactive patient education intervention. To control for potential medication effects, all participants will be prescribed similar, evidenced-based anti-hypertensive regimens and have their prescription filled onsite at the ED and during visits to the clinic. The primary target endpoint will be success in achieving BP control assessed at 180 days follow-up post-ED discharge. The secondary aim will be to assess the relationship between patient activation and self-care management. Discussion The AchieveBP trial will determine whether using interactive patient education delivered through health information technology as ED enhanced discharge with subsequent education sessions at a clinic is an effective strategy for achieving short-term patient management of BP. The project is innovative in that it uses the ED as an initial point of service for kiosk-based health education designed to increase BP self-management. It is anticipated findings from this translational research could also be used as a resource for patient education and follow-up with hypertensive patients in primary care settings. Trial registration ClinicalTrials.gov Registration Number: NCT02069015. Registered February 19, 2014.
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Affiliation(s)
- Julie Gleason-Comstock
- Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, 3939 Woodward Ave., 48201, Detroit, MI, USA. .,Cardiovascular Research Institute, School of Medicine, Wayne State University, 421 E. Canfield St., 48201, Detroit, MI, USA. .,Center for Urban Studies, Wayne State University, 5700 Cass Ave., 48202, Detroit, MI, USA.
| | - Alicia Streater
- Center for Urban Studies, Wayne State University, 5700 Cass Ave., 48202, Detroit, MI, USA.
| | - Joel Ager
- Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, 3939 Woodward Ave., 48201, Detroit, MI, USA.
| | - Allen Goodman
- Department of Economics, Wayne State University, 656 W. Kirby St., 2074 FAB, 48202, Detroit, MI, USA.
| | - Aaron Brody
- Department of Emergency Medicine, Wayne State University, 4201 St. Antoine, UHC-6G, 48201, Detroit, MI, USA.
| | - Laura Kivell
- Center for Urban Studies, Wayne State University, 5700 Cass Ave., 48202, Detroit, MI, USA.
| | - Aniruddha Paranjpe
- Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, 3939 Woodward Ave., 48201, Detroit, MI, USA.
| | - Jasmine Vickers
- Department of Family Medicine & Public Health Sciences, School of Medicine, Wayne State University, 3939 Woodward Ave., 48201, Detroit, MI, USA. .,Cardiovascular Research Institute, School of Medicine, Wayne State University, 421 E. Canfield St., 48201, Detroit, MI, USA.
| | - LynnMarie Mango
- Department of Emergency Medicine, Wayne State University, 4201 St. Antoine, UHC-6G, 48201, Detroit, MI, USA.
| | - Rachelle Dawood
- Department of Emergency Medicine, Wayne State University, 4201 St. Antoine, UHC-6G, 48201, Detroit, MI, USA.
| | - Phillip Levy
- Cardiovascular Research Institute, School of Medicine, Wayne State University, 421 E. Canfield St., 48201, Detroit, MI, USA. .,Department of Emergency Medicine, Wayne State University, 4201 St. Antoine, UHC-6G, 48201, Detroit, MI, USA.
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Livaudais-Toman J, Karliner LS, Tice JA, Kerlikowske K, Gregorich S, Pérez-Stable EJ, Pasick RJ, Chen A, Quinn J, Kaplan CP. Impact of a primary care based intervention on breast cancer knowledge, risk perception and concern: A randomized, controlled trial. Breast 2015; 24:758-66. [PMID: 26476466 PMCID: PMC4698352 DOI: 10.1016/j.breast.2015.09.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/06/2015] [Accepted: 09/22/2015] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To estimate the effects of a tablet-based, breast cancer risk education intervention for use in primary care settings (BreastCARE) on patients' breast cancer knowledge, risk perception and concern. METHODS From June 2011-August 2012, we enrolled women from two clinics, aged 40-74 years with no personal breast cancer history, and randomized them to the BreastCARE intervention group or to the control group. All patients completed a baseline telephone survey and risk assessment (via telephone for controls, via tablet computer in clinic waiting room prior to visit for intervention). All women were categorized as high or average risk based on the Referral Screening Tool, the Gail model or the Breast Cancer Surveillance Consortium model. Intervention patients and their physicians received an individualized risk report to discuss during the visit. All women completed a follow-up telephone survey 1-2 weeks after risk assessment. Post-test comparisons estimated differences at follow-up in breast cancer knowledge, risk perception and concern. RESULTS 580 intervention and 655 control women completed follow-up interviews. Mean age was 56 years (SD = 9). At follow-up, 73% of controls and 71% of intervention women correctly perceived their breast cancer risk and 22% of controls and 24% of intervention women were very concerned about breast cancer. Intervention patients had greater knowledge (≥75% correct answers) of breast cancer risk factors at follow-up (24% vs. 16%; p = 0.002). In multivariable analysis, there were no differences in correct risk perception or concern, but intervention patients had greater knowledge ([OR] = 1.62; 95% [CI] = 1.19-2.23). CONCLUSIONS A simple, practical intervention involving physicians at the point of care can improve knowledge of breast cancer without increasing concern. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT01830933.
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Affiliation(s)
- Jennifer Livaudais-Toman
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Leah S Karliner
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey A Tice
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Karla Kerlikowske
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; General Internal Medicine Section, Department of Veterans Affairs, San Francisco, CA, USA
| | - Steven Gregorich
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Eliseo J Pérez-Stable
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Rena J Pasick
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Alice Chen
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA
| | - Jessica Quinn
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Celia P Kaplan
- Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA; Medical Effectiveness Research Center for Diverse Populations, Department of Medicine, Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
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Dempsey AF, Maertens J, Beaty B, O'Leary ST. Characteristics of users of a tailored, interactive website for parents and its impact on adolescent vaccination attitudes and uptake. BMC Res Notes 2015; 8:739. [PMID: 26625932 PMCID: PMC4665955 DOI: 10.1186/s13104-015-1721-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 11/19/2015] [Indexed: 12/05/2022] Open
Abstract
Background We examined the characteristics of parents using an iPad-based intervention about vaccines, and its impact on vaccination attitudes and behavior. Methods Interventions were implemented in three primary care clinics from June 2012–September 2013. Baseline and follow up surveys assessed vaccination attitudes and intentions. Medical records were used to examine adolescent vaccine uptake. Results During the study, 42 parents viewed tailored educational content. Users were generally positive about vaccines, though one out of five worried that vaccines caused more harm than good. Among the 16 parents completing the post-intervention survey, there was a slightly higher, non-statistically significant, mean vaccination intention after viewing the website than prior to viewing it for three of the four adolescent vaccines (all except tetanus–diphtheria–acellular pertussis). Using the intervention did not increase the likelihood of adolescent vaccination. Conclusions Providing educational material via iPads in clinic waiting rooms does not appear to be an effective strategy for engaging parents about vaccines. Overall, parents’ interaction with TeenVaxScene was low, and had little impact on their vaccination attitudes and beliefs. However, use of TeenVaxScene did not appear to worsen parents’ attitudes about vaccines. New and creative ideas for engaging parents to use such educational materials are needed.
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Affiliation(s)
- Amanda F Dempsey
- Adult and Child Center for Outcomes Research and Dissemination Science (ACCORDS), 13199 East Montview Blvd, Suite 300, Aurora, CO, 80045, USA.
| | - Julie Maertens
- Adult and Child Center for Outcomes Research and Dissemination Science (ACCORDS), 13199 East Montview Blvd, Suite 300, Aurora, CO, 80045, USA.
| | - Brenda Beaty
- Adult and Child Center for Outcomes Research and Dissemination Science (ACCORDS), 13199 East Montview Blvd, Suite 300, Aurora, CO, 80045, USA.
| | - Sean T O'Leary
- Adult and Child Center for Outcomes Research and Dissemination Science (ACCORDS), 13199 East Montview Blvd, Suite 300, Aurora, CO, 80045, USA. Sean.O'
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12
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Luque JS, Ross L, Gwede CK. Qualitative systematic review of barber-administered health education, promotion, screening and outreach programs in African-American communities. J Community Health 2014; 39:181-90. [PMID: 23913106 DOI: 10.1007/s10900-013-9744-3] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The barbershop has been portrayed as a culturally appropriate venue for reaching Black men with health information and preventive health screenings to overcome institutional and socio-cultural barriers. The purpose of this review is to synthesize the peer-reviewed literature on barbershop-based health programs to provide lessons learned for researchers and practitioners. A literature search was conducted to identify articles for the review. Inclusion criteria specified that studies had to be based in the United States and reported about research where barbers were either being assessed for the feasibility of their participation or recruited to administer health education/screening outreach or research activities. The literature search produced 901 unique bibliographic records from peer-reviewed publications. After eliminating articles not meeting the inclusion criteria, 35 articles remained for full-text review. The final article sample consisted of 16 articles for complete abstraction to assess characteristics of studies, role and training of barbers, outcomes targeted, effectiveness, and key findings. All barbershop-based studies reviewed targeted Black men in urban settings. Common study designs were cross-sectional studies, feasibility studies, needs assessments, and one-shot case studies. Barber administered interventions addressed primarily prostate cancer and hypertension, and barbers provided health education, screening, and referrals to health care. Nonintervention studies focused mostly on surveying or interviewing barbers for assessing the feasibility of future interventions. Barbershops are a culturally appropriate venue for disseminating health education materials in both print and media formats. Barbershops are also acceptable venues for training barbers to conduct education and screening. In studies where barbers received training, their knowledge of various health conditions increased significantly and knowledge gains were sustained over time. They were also able to increase knowledge and promote positive health behaviors among their customers, but these outcomes were variable and not consistently documented.
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Affiliation(s)
- John S Luque
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460-8015, USA,
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13
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Joshi A, Trout K. The role of health information kiosks in diverse settings: a systematic review. Health Info Libr J 2014; 31:254-73. [PMID: 25209260 DOI: 10.1111/hir.12081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 08/01/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Public access computing through computer kiosks placed in clinical and community settings may help bridge the digital health information divide. OBJECTIVE The objective was to examine the current utilisation of computer based health information kiosks in diverse settings. Further, the objective was to examine the locations for health kiosks, kiosk features, application of theoretical framework in the design and development of health kiosks and the outcomes assessed. METHODS A search was conducted using Pubmed and CINAHL with articles published from January 2005 to January 2012. The articles that focused on the use of computer based health information kiosks in community and clinical settings. RESULTS The majority of the 31 articles included in this study were conducted in urban settings (90%; n = 28), clinical settings (58%; n = 18) and focused on child safety (19%; n = 6). Computer-based tailoring was utilised in majority of the studies (77%; n = 24). However, limited studies described the theoretical frameworks to facilitate this tailoring (42%; n = 13). CONCLUSIONS The results suggest that health information kiosks are a feasible medium to disseminate health information among various users in clinical and community settings, with high acceptance and satisfaction by users. Theoretical driven interventions are needed to examine long term impacts of health information kiosks especially in rural and underserved populations.
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Affiliation(s)
- Ashish Joshi
- Center for Global Health and Development and Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center in Omaha, Omaha, NE, USA
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14
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Linnan LA, D'Angelo H, Harrington CB. A literature synthesis of health promotion research in salons and barbershops. Am J Prev Med 2014; 47:77-85. [PMID: 24768037 PMCID: PMC4517428 DOI: 10.1016/j.amepre.2014.02.007] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 01/31/2014] [Accepted: 02/24/2014] [Indexed: 11/19/2022]
Abstract
CONTEXT Barbershops and beauty salons are located in all communities and frequented by diverse groups of people, making them key settings for addressing health disparities. No studies have reviewed the growing body of literature describing studies promoting health in these settings. This review summarized the literature related to promoting health within barbershops and beauty salons to inform future approaches that target diverse populations in similar settings. EVIDENCE ACQUISITION We identified and reviewed published research articles describing formative research, recruitment, and health-related interventions set in beauty salons and barbershops. PubMed and other secondary search engines were searched in 2010 and again in 2013 for English-language papers indexed from 1990 through August 2013. The search yielded 113 articles, 71 of which were formerly reviewed, and 54 were eligible for inclusion. EVIDENCE SYNTHESIS Included articles were categorized as formative research (n=27); recruitment (n=7); or intervention (n=20). Formative research studies showed that owners, barbers/stylists, and their customers were willing participants, clarifying the feasibility of promoting health in these settings. Recruitment studies demonstrated that salon/shop owners will join research studies and can enroll customers. Among intervention studies, level of stylist/barber involvement was categorized. More than 73.3% of intervention studies demonstrated statistically significant results, targeted mostly racial/ethnic minority groups and focused on a variety of health topics. CONCLUSIONS Barbershops and beauty salons are promising settings for reaching populations most at risk for health disparities. Although these results are encouraging, more rigorous research and evaluation of future salon- and barbershop-based interventions are needed.
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Affiliation(s)
- Laura A Linnan
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina.
| | - Heather D'Angelo
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Cherise B Harrington
- Department of Prevention and Community Health, School of Public Health and Health Services, The George Washington University, Washington DC
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15
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Kreuter MW, McBride TD, Caburnay CA, Poor T, Thompson VLS, Alcaraz KI, Eddens KS, Rath S, Perkins H, Casey C. What can health communication science offer for ACA implementation? Five evidence-informed strategies for expanding Medicaid enrollment. Milbank Q 2014; 92:40-62. [PMID: 24597555 DOI: 10.1111/1468-0009.12040] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
CONTEXT Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage. METHODS From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA. FINDINGS We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps. CONCLUSIONS Health communication science can inform the development and execution of strategies to increase the public's understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.
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Affiliation(s)
- Matthew W Kreuter
- Health Communication Research Laboratory, Washington University in St. Louis; Brown School of Social Work, Washington University in St. Louis
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16
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Stoll CRT, Roberts S, Cheng MR, Crayton EV, Jackson S, Politi MC. Barriers to mammography among inadequately screened women. HEALTH EDUCATION & BEHAVIOR 2014; 42:8-15. [PMID: 24722216 DOI: 10.1177/1090198114529589] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Mammography use has increased over the past 20 years, yet more than 30% of women remain inadequately screened. Structural barriers can deter individuals from screening, however, cognitive, emotional, and communication barriers may also prevent mammography use. This study sought to identify the impact of number and type of barriers on mammography screening status, and to examine whether number and type of barriers are different for never-screened and off-schedule women. A total of 182 women aged 40 years or older completed a computer kiosk facilitated survey as part of a larger patient navigator intervention. Logistic regression analysis indicated that breast cancer knowledge predicted whether a woman had ever had a mammogram (odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.02-1.06, p = .0003), while the number of emotional, structural, and communication barriers predicted whether a woman was on-schedule for mammograms (OR = 0.79, 95% CI = 0.65-0.95, p = .0127). The results suggest that to increase the use of mammography at recommended regular intervals, interventions should be tailored toward current screening status.
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Affiliation(s)
- Carolyn R T Stoll
- Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Summer Roberts
- Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | - Meng-Ru Cheng
- Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
| | | | | | - Mary C Politi
- Washington University in St. Louis, School of Medicine, St. Louis, MO, USA
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Abstract
BACKGROUND Streamlining the triage process is the key in improving emergency department (ED) workflow. Our objective was to determine if parents of pediatric ED patients in, low-literacy, inner-city hospital, who used the audio-assisted bilingual (English/Spanish) self-triage kiosk, were able to enter their child's medical history data using a touch screen panel with greater speed and accuracy than routine nurse-initiated triage. METHODS Parent/child dyads visiting the pediatric ED for nonurgent conditions (February to April 2012) were randomized prospectively to self-triage kiosk group (n = 200) and standard nurse triage group (n = 200). Both groups underwent routine nurse-initiated triage that included verbal elicitation of basic medical history and manual entry into patients' electronic medical records. RESULTS The kiosk user was a parent in 88.5% of the cases, a patient (range, 11-17 years) in 9.5% of the cases, and a proxy user (sibling or friend) in 2% of the cases. Language choice for kiosk use was equally distributed (English vs Spanish, 50.5% vs 49.5%). The mean (SD) time to enter medical history data by the kiosk group was significantly shorter than the standard nurse triage group (94.38 [38.61] vs 126.72 [62.61] seconds; P < 0.001). Significant inverse relationship was observed between parent education level and kiosk usage time (r = -0.26; P < 0.001). The mean inaccuracies were significantly lower for kiosk group (P < 0.05) in areas of medical, medication and immunization histories, and total discrepancy score. CONCLUSIONS Kiosk triage enabled users to enter basic medical triage history data quickly and accurately in an ED setting with future potential for its wider use in improving ED workflow efficiency.
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Gleason-Comstock JA, Streater A, Jen KLC, Artinian NT, Timmins J, Baker S, Joshua B, Paranjpe A. Consumer health information technology in an adult public health primary care clinic: a heart health education feasibility study. PATIENT EDUCATION AND COUNSELING 2013; 93:464-471. [PMID: 23948646 DOI: 10.1016/j.pec.2013.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 07/11/2013] [Accepted: 07/14/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To explore the feasibility and short term outcomes of using an interactive kiosk integrated into office flow to deliver health information in a primary care clinic. METHODS Fifty-one adults with BMI ≥25 were randomly assigned to use a kiosk with attached devices to receive a six-week healthy eating/weight monitoring (intervention) or general health/BP monitoring (attention-control) program. Outcomes were measured at baseline, 8 weeks (post) and three month follow-up. RESULTS Participants completed an average of 2.73 weekly sessions, with transportation and time given as limiting factors. They found the kiosk easy to use (97%), liked the touchscreen (94%), and would use the kiosk again (81%). Although there were no differences between groups, the 27 completing all assessments showed reduced weight (p=.02), and decreased systolic (p=.01) and diastolic BP (p<.001) at follow-up. Although healthy eating behaviors increased, the change was not statistically significant. CONCLUSION Using a kiosk within a clinic setting is a feasible method of providing health information and self-monitoring. Multi-session educational content can provide beneficial short-term outcomes in overweight adults. PRACTICE IMPLICATIONS A kiosk with attached peripherals in a clinic setting is a viable adjunct to provider education, particularly in medically underserved areas.
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Affiliation(s)
- Julie A Gleason-Comstock
- Department of Family Medicine & Public Health Services and Center for Urban Studies, Wayne State University, Detroit, USA.
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Joshi A, Mehta S, Grover A, Talati K, Malhotra B, Puricelli Perin DM. Knowledge, attitude, and practices of individuals to prevent and manage metabolic syndrome in an Indian setting. Diabetes Technol Ther 2013; 15:644-53. [PMID: 23937641 DOI: 10.1089/dia.2012.0309] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Patients' knowledge, attitudes, and behavior play a large role in preventing and managing the risk factors making up metabolic syndrome (MetS). MetS is associated with increased morbidity and mortality per the World Health Organization criteria. The objective of the study was to examine the current health literacy levels, risk perceptions about MetS, and associated management challenges in diverse Indian settings. SUBJECTS AND METHODS This cross-sectional study was performed during the period of April-May 2012 by enrolling 125 individuals at risk of MetS from urban, rural, and slum settings in India. A convenience sample was recruited from primary care clinics. In-depth interviews were conducted using ground theory and framework analysis. Individuals 30 years old and above with confirmed diagnosis of obesity, type 2 diabetes mellitus, hypertension, or hypercholesterolemia and willing to participate in the in-depth interviews were included in the study. Individuals involved in other research studies were excluded. RESULTS Difficulty in understanding healthcare information was commonly reported, especially in rural and slum settings. Only 10% of the individuals perceived lifestyle behaviors as a risk factor of acquiring MetS. Significant disparities were seen among urban, rural, and slum individuals about using diet and exercise as means to manage their MetS. Individuals in slum and rural settings were rarely advised about diet and exercise approaches to manage MetS. Access to appropriate information and direction from the healthcare professionals is lacking. CONCLUSIONS Different perceptions about MetS and its varied management approaches exist across the three settings. An urgent need exists to develop interactive health education programs that can enhance self-management approaches to meet the growing burden of MetS by providing access to right information applicable to individuals living in diverse Indian settings.
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Affiliation(s)
- Ashish Joshi
- Center for Global Health and Development, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
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Stellefson ML, Hanik BW, Chaney BH, Chaney DJ. Challenges for Tailored Messaging in Health Education. AMERICAN JOURNAL OF HEALTH EDUCATION 2013. [DOI: 10.1080/19325037.2008.10599054] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Michael L. Stellefson
- a Department of Health and Kinesiology , Texas A∓M University , MS 4243, College Station , TX , 77843
| | - Bruce W. Hanik
- b Department of Health and Kinesiology , Texas A&M University , MS 4243, College Station , TX , 77843
| | - Beth H. Chaney
- c Department of Health Education and Promotion , East Carolina University , 201 Christenbury Gym, Greenville , NC , 27858
| | - Don J. Chaney
- d Department of Health Education and Promotion , East Carolina University , 110g Christenbury, Greenville , NC , 27858
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Elzarrad MK, Eckstein ET, Glasgow RE. Applying chronic illness care, implementation science, and self-management support to HIV. Am J Prev Med 2013; 44:S99-107. [PMID: 23253770 DOI: 10.1016/j.amepre.2012.09.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 09/04/2012] [Accepted: 09/19/2012] [Indexed: 10/27/2022]
Affiliation(s)
- M Khair Elzarrad
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland 20852, USA
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22
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Explaining and improving breast cancer information acquisition among African American women in the Deep South. South Med J 2012; 105:294-9. [PMID: 22665151 DOI: 10.1097/smj.0b013e318255d8aa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population. METHODS Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi. RESULTS Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources. CONCLUSIONS It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South.
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Greiner KA, Geana MV, Epp A, Watson A, Filippi M, Daley CM, Engelman KK, James AS, Campbell M. A computerized intervention to promote colorectal cancer screening for underserved populations: theoretical background and algorithm development. Technol Health Care 2012; 20:25-35. [PMID: 22297711 PMCID: PMC4086405 DOI: 10.3233/thc-2011-0653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The aim of this exploratory study was to assess factors deemed by patients as "important" as they planned and considered undergoing colorectal cancer (CRC) screening, and to use this data to design a computer-delivered intervention to promote screening. METHODS Fifty participants 50 years or older, not up-to-date with current recommended CRC screening guidelines, were recruited from a primary care clinic. A semi-structured interview focused on aspects of preparing for colorectal cancer screening was administered; after transcription, researchers used triangulation and consensus to identify relevant themes and concepts. RESULTS Four main themes were identified that dealt with issues important for both FOBT and colonoscopy planning: personal concerns, reminders, communication with healthcare providers and obtaining test results. FOBT specific themes included: sample collection and return. For colonoscopy screening, themes included: scheduling, intervention questions, colonoscopy preparation, and transportation. These can be classified as barrier, process and accessory themes. The developed computer-administered implementation intentions algorithm addressed all the identified concerns in a planned and sequential manner, in order to facilitate planning for CRC screening. CONCLUSIONS The results of this study suggest that appropriate reminders, explanations of procedures, and patient understanding of temporary life disruptions, help patients develop and accept a detailed screening plan.
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Affiliation(s)
- K. Allen Greiner
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Mugur V. Geana
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA
- William Allen White School of Journalism and Mass Communications, University of Kansas, Lawrence, KS, USA
| | - Aaron Epp
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Angela Watson
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA
| | - Melissa Filippi
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christine Makosky Daley
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kimberly K. Engelman
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Aimee S. James
- Department of Surgery, Washington University, St. Louis, MO, USA
| | - Marci Campbell
- Department of Nutrition, School of Public Health, University of North Carolina Chapel Hill, NC, USA
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Abstract
OBJECTIVES Consumer empowerment in health and rapid change in health information and communication technologies have their roots in broader social trends. This article reviews the activities at the intersection of consumer empowerment and technology. DATA SOURCES Technical reports, white papers, books, journal articles, and Web sites. CONCLUSION Social trends are visible in the integration of information and communication technologies into health care, in both searching for and sharing information on the Internet, in the use of social media to create new types of interactions with family, providers, and peers, and in the e-patient, who integrates these new roles and new technologies. IMPLICATIONS FOR NURSING PRACTICE Changes in both patients and technology will impact oncology nursing practice as new, patient-centered, interactions emerge.
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Dearing JW, Kreuter MW. Designing for diffusion: how can we increase uptake of cancer communication innovations? PATIENT EDUCATION AND COUNSELING 2010; 81 Suppl:S100-10. [PMID: 21067884 PMCID: PMC3000559 DOI: 10.1016/j.pec.2010.10.013] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Revised: 10/04/2010] [Accepted: 10/06/2010] [Indexed: 05/15/2023]
Abstract
OBJECTIVE The best innovations in cancer communication do not necessarily achieve uptake by researchers, public health and clinical practitioners, and policy makers. This paper describes design activities that can be applied and combined for the purpose of spreading effective cancer communication innovations. METHODS A previously developed Push-Pull-Infrastructure Model is used to organize and highlight the types of activities that can be deployed during the design phase of innovations. Scientific literature about the diffusion of innovations, knowledge utilization, marketing, public health, and our experiences in working to spread effective practices, programs, and policies are used for this purpose. RESULTS Attempts to broaden the reach, quicken the uptake, and facilitate the use of cancer communication innovations can apply design activities to increase the likelihood of diffusion. Some simple design activities hold considerable promise for improving dissemination and subsequent diffusion. CONCLUSION Augmenting current dissemination practices with evidence-based concepts from diffusion science, marketing science, and knowledge utilization hold promise for improving results by eliciting greater market pull. PRACTICE IMPLICATIONS Inventors and change agencies seeking to spread cancer communication innovations can experience more success by explicit consideration of design activities that reflect an expanded version of the Push-Pull-Infrastructure Model.
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Affiliation(s)
- James W Dearing
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO 80237-8066, USA.
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Joshi A, Weng W, Lichenstein R, Arora M, Sears A. Prospective tracking of a pediatric emergency department e-kiosk to deliver asthma education. Health Informatics J 2010; 15:282-95. [PMID: 20007653 DOI: 10.1177/1460458209345899] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study objective was to describe the prospective use of an interactive Patient Education and Motivation Tool (PEMT) placed within a pediatric emergency department (ED). A touch screen computer was utilized to deliver asthma education to children and their parents/guardians during their acute asthma visit between November 2006 and April 2007. Ninety-nine participants were enrolled in this prospective non-randomized pre-post study. PEMT comprised three key components: screening, learning and evaluation. The tool tracked the date the system was used, user characteristics, asthma knowledge, amount of time spent on each screen, and navigational patterns of individuals using the program. The results showed that baseline asthma knowledge had positive association with age and negative association with time spent in the learning module. There was negative association between age and time spent in the learning module. Thus PEMT was effective in improving the asthma knowledge of young patients and those having lower baseline knowledge.
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Affiliation(s)
- Ashish Joshi
- Department of Information Systems, University of Maryland-Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, USA.
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Yost KJ, Webster K, Baker DW, Jacobs EA, Anderson A, Hahn EA. Acceptability of the talking touchscreen for health literacy assessment. JOURNAL OF HEALTH COMMUNICATION 2010; 15 Suppl 2:80-92. [PMID: 20845195 PMCID: PMC3269098 DOI: 10.1080/10810730.2010.500713] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Self-administration of a multimedia health literacy measure in clinic settings is a novel concept. Demonstrated ease of use and acceptability will help predicate the future value of this strategy. We previously demonstrated the acceptability of a "Talking Touchscreen" for health status assessment. For this study, we adapted the touchscreen for self-administration of a new health literacy measure. Primary care patients (n = 610) in clinics for underserved populations completed health status and health literacy questions on the Talking Touchscreen and participated in an interview. Participants were 51% women, 10% age 60+, 67% African American, 18% without a high school education, and 14% without any prior computer experience. The majority (93%) had no difficulty using the touchscreen, including those who were computer-naive (87%). Most rated the screen design as very good or excellent (72%), including computer-naive patients (71%) and older patients (75%). Acceptability of the touchscreen did not differ by health literacy level. The Talking Touchscreen was easy to use and acceptable for self-administration of a new health literacy measure. Self-administration should reduce staff burden and costs, interview bias, and feelings of embarrassment by those with lower literacy. Tools like the Talking Touchscreen may increase exposure of underserved populations to new technologies.
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Affiliation(s)
- Kathleen J. Yost
- Mayo Clinic Department of Health Sciences Research Rochester, MN
| | - Kimberly Webster
- Northwestern University Feinberg School of Medicine Department of Medical Social Sciences Chicago, IL
| | - David W. Baker
- Northwestern University Feinberg School of Medicine Department of Internal Medicine Chicago, IL
| | - Elizabeth A. Jacobs
- John H. Stroger Hospital of Cook County & Rush University Medical Center Division of General Medicine and Primary Care Chicago, IL
| | - Andy Anderson
- NorthShore University HealthSystem Department of Medicine Evanston, IL
| | - Elizabeth A. Hahn
- Northwestern University Feinberg School of Medicine Department of Medical Social Sciences Chicago, IL
- Corresponding author Northwestern University Feinberg School of Medicine Department of Medical Social Sciences 710 N. Lake Shore Drive, Room725 Chicago, IL 60611 (312) 503-9804
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Alcaraz KI, Kreuter MW, Bryan RP. Use of GIS to identify optimal settings for cancer prevention and control in African American communities. Prev Med 2009; 49:54-7. [PMID: 19422844 PMCID: PMC2812800 DOI: 10.1016/j.ypmed.2009.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2008] [Revised: 04/21/2009] [Accepted: 04/24/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Rarely have Geographic Information Systems (GIS) been used to inform community-based outreach and intervention planning. This study sought to identify community settings most likely to reach individuals from geographically localized areas. METHOD An observational study conducted in an urban city in Missouri during 2003-2007 placed computerized breast cancer education kiosks in seven types of community settings: beauty salons, churches, health fairs, neighborhood health centers, Laundromats, public libraries and social service agencies. We used GIS to measure distance between kiosk users' (n=7297) home ZIP codes and the location where they used the kiosk. Mean distances were compared across settings. RESULTS Mean distance between individuals' home ZIP codes and the location where they used the kiosk varied significantly (p<0.001) across settings. The distance was shortest among kiosk users in Laundromats (2.3 mi) and public libraries (2.8 mi) and greatest among kiosk users at health fairs (7.6 mi). CONCLUSION Some community settings are more likely than others to reach highly localized populations. A better understanding of how and where to reach specific populations can complement the progress already being made in identifying populations at increased disease risk.
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Affiliation(s)
- Kassandra I Alcaraz
- Health Communication Research Laboratory, Washington University in St. Louis, St. Louis, MO 63112, USA.
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The role of health kiosks in 2009: literature and informant review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:1818-55. [PMID: 19578463 PMCID: PMC2705220 DOI: 10.3390/ijerph6061818] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Accepted: 06/08/2009] [Indexed: 11/20/2022]
Abstract
Kiosks can provide patients with access to health systems in public locations, but with increasing home Internet access their usefulness is questioned. A literature and informant review identified kiosks used for taking medical histories, health promotion, self assessment, consumer feedback, patient registration, patient access to records, and remote consultations. Sited correctly with good interfaces, kiosks can be used by all demographics but many ‘projects’ have failed to become routine practice. A role remains for: (a) integrated kiosks as part of patient ‘flow’, (b) opportunistic kiosks to catch people’s attention. Both require clear ‘ownership’ to succeed.
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Lustria MLA, Cortese J, Noar SM, Glueckauf RL. Computer-tailored health interventions delivered over the Web: review and analysis of key components. PATIENT EDUCATION AND COUNSELING 2009; 74:156-173. [PMID: 18947966 DOI: 10.1016/j.pec.2008.08.023] [Citation(s) in RCA: 339] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2008] [Revised: 08/10/2008] [Accepted: 08/30/2008] [Indexed: 05/27/2023]
Abstract
OBJECTIVE This systematic review explores how computer-tailored, behavioral interventions implemented and delivered via the Web have been operationalized in a variety of settings. METHODS Computer-tailored, online behavioral intervention studies published from 1996 to early 2007 were selected and reviewed by two independent coders. RESULTS Of 503 studies screened, 30 satisfied the selection criteria. The level of sophistication of these interventions varied from immediate risk/health assessment, tailored web content to full-blown customized health programs. The most common variables for tailoring content were health behaviors and stages of change. Message tailoring was achieved through a combination mechanisms including: feedback, personalization and adaptation. CONCLUSIONS Tailored, self-guided health interventions delivered via the Web to date have involved a great diversity of features and formats. While some programs have been relatively brief and simple, others have involved complex, theory-based tailoring with iterative assessment, tools for development of self-regulatory skills, and various mechanisms for providing feedback. PRACTICE IMPLICATIONS Our ability to fully optimize the use of computer-assisted tailoring will depend on the development of empirically based guidelines for tailoring across populations, health foci, health behaviors and situations. Further outcome research is needed to enhance our understanding of how and under what conditions computer-tailoring leads to positive health outcomes in online behavioral interventions.
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Affiliation(s)
- Mia Liza A Lustria
- College of Information, Florida State University, 270 Louis Shores Building, Tallahassee, FL 32306-2100, United States.
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Abstract
This article reviews the contribution and potential of widely used health behavior theories in research designed to understand and redress the disproportionate burden of breast cancer borne by diverse race/ethnic, immigrant, and low-income groups associated with unequal use of mammography. We review the strengths and limitations of widely used theories and the extent to which theory contributes to the understanding of screening disparities and informs effective intervention. The dominant focus of most theories on individual cognition is critically assessed as the abstraction of behavior from its social context. Proposed alternatives emphasize multilevel ecological approaches and the use of anthropologic theory and methods for more culturally grounded understandings of screening behavior. Common and alternative treatments of fatalism exemplify this approach, and descriptive and intervention research exemplars further highlight the integration of screening behavior and sociocultural context.
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Affiliation(s)
- Rena J Pasick
- Comprehensive Cancer Center, University of California, San Francisco, CA 94143-0981, USA.
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Pomerantz KL, Muhammad AA, Downey S, Kind T. Connecting for health literacy: health information partners. Health Promot Pract 2008; 11:79-88. [PMID: 18544664 DOI: 10.1177/1524839908318166] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes a community-based health information partnership to address health literacy and health information inequalities in marginalized communities. Public health, medical, literacy, and library practitioners promote health literacy through outreach, training, and professional development activities in community settings. They create learning environments for people to develop the necessary knowledge and skills to better understand health information and health policy so they can make decisions concerning personal and community health. Outreach activities focus on visits to neighborhood health centers, health fairs, health exhibits at union meetings and conferences; training programs involve hands-on, peer-led computer classes for people living with HIV and for the general public; and professional development programs connect librarians, health providers, public health workers, and literacy teachers in joint planning and learning. Several learners currently participate in and lead community health education programs and HIV advocacy. The coalition's strength develops from strongly shared objectives, an absence of territoriality, and a core active leadership group.
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Affiliation(s)
- Karyn L Pomerantz
- Health Information Partners and instructor at The George Washington University School of Public Health and Health Services, Washington, DC, USA.
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Franks P, Fiscella K. Reducing disparities downstream: prospects and challenges. J Gen Intern Med 2008; 23:672-7. [PMID: 18214626 PMCID: PMC2324139 DOI: 10.1007/s11606-008-0509-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Revised: 12/04/2007] [Accepted: 01/04/2008] [Indexed: 10/22/2022]
Abstract
Addressing upstream or fundamental causes (such as poverty, limited education, and compromised healthcare access) is essential to reduce healthcare disparities. But such approaches are not sufficient, and downstream interventions, addressing the consequences of those fundamental causes within the context of any existing health system, are also necessary. We present a definition of healthcare disparities and two key principles (that healthcare is a social good and disparities in outcomes are a quality problem) that together provide a framework for addressing disparities downstream. Adapting the chronic care model, we examine a hierarchy of three domains for interventions (health system, provider-patient interactions, and clinical decision making) to reduce disparities downstream and discuss challenges to implementing the necessary changes.
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Affiliation(s)
- Peter Franks
- Center for Healthcare Policy and Research, Department of Family and Community Medicine, University of California at Davis, Sacramento, CA USA
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY USA
- Department of Community and Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY USA
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Translation of an evidence-based tailored childhood injury prevention program. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2008; 14:177-84. [PMID: 18287925 DOI: 10.1097/01.phh.0000311897.03573.cc] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes the process of translating Safe n' Sound, a computer-based program for parents of young children, for a general clinic environment. Safe n' Sound is designed to reduce the risk of unintentional childhood injuries, the leading cause of death among children older than 1 year in the United States. The evidence-based program produces tailored information for parents and their healthcare provider about burns, falls, poisoning, drowning, suffocations, choking prevention, and car safety. To offer Safe n' Sound to a broader audience, we translated the program from the form used for efficacy testing to a stand-alone application. Notable steps in this translation included (1) conducting an organizational assessment to determine the needs of the clinic staff and feasibility of implementation, (2) modifying the program to reduce length, prioritize risk areas, and update content, (3) repackaging the program to minimize cost and space requirements, and (4) developing promotional and instructional materials. Factors contributing to the success of this effort include strong collaborative partnerships, the relative advantage of Safe n' Sound over traditional materials, the modifiable design of the program, and the support of the clinic staff and providers. Challenges and areas for future work are discussed.
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Using dissemination research to identify optimal community settings for tailored breast cancer information kiosks. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2008; 14:160-9. [PMID: 18287923 DOI: 10.1097/01.phh.0000311895.57831.02] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Selecting appropriate community channels or settings for delivering evidence-based health promotion programs can be critical to successful dissemination. This article describes how five criteria--accessibility, opportunity, appropriateness, reach, and specificity--were applied in identifying and comparing seven community settings as host sites for a tailored breast cancer education computer kiosk for African American women. METHODS Data were gathered from 10,306 kiosk uses in 92 beauty salons, churches, neighborhood health centers, laundromats, social service agencies, health fairs, and public libraries between June 2003 and March 2007. FINDINGS Of the seven settings, only laundromats were found to provide both high reach (ie, frequent kiosk use) and high specificity (ie, a large proportion of users with no health insurance, unaware of where to get a mammogram, reporting no recent mammogram and barriers to getting one, and having little knowledge about breast cancer and mammography). CONCLUSIONS Systematic, data-based evaluations of potential dissemination channels can help identify optimal settings for cancer control interventions.
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Matthews PH, Darbisi C, Sandmann L, Galen R, Rubin D. Disseminating Health Information and Diabetes Care for Latinos Via Electronic Information Kiosks. J Immigr Minor Health 2008; 11:520-6. [DOI: 10.1007/s10903-008-9134-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Accepted: 03/20/2008] [Indexed: 10/22/2022]
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Jerant A, Kravitz RL, Rooney M, Amerson S, Kreuter M, Franks P. Effects of a tailored interactive multimedia computer program on determinants of colorectal cancer screening: a randomized controlled pilot study in physician offices. PATIENT EDUCATION AND COUNSELING 2007; 66:67-74. [PMID: 17156968 DOI: 10.1016/j.pec.2006.10.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Revised: 10/06/2006] [Accepted: 10/22/2006] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Screening reduces colorectal cancer (CRC) mortality and is cost-effective, yet uptake is suboptimal. We developed and evaluated a personally tailored interactive multimedia computer program (IMCP) to encourage CRC screening. METHODS Randomized controlled pilot trial evaluating the effects of the personally tailored CRC screening IMCP as compared with a non-tailored IMCP ("electronic leaflet") control. The IMCP was tailored to patient preference, self-efficacy, barriers, and readiness and deployed in busy primary care offices before scheduled doctor visits. Main outcomes were: CRC screening knowledge, self-efficacy, benefits and barriers, and stage of readiness. RESULTS We enrolled 54 subjects; software glitches occurred in 5, leaving 49 subjects for analysis. In adjusted analyses, compared with control, the experimental group had a significant increase in CRC screening self-efficacy (p=0.049), a significantly greater likelihood of moving to a more advanced stage of readiness for screening (p=0.034), a trend toward fewer perceived barriers to screening (p=0.149), and no difference in perceived benefits or knowledge of screening. CONCLUSION Our personally tailored IMCP was significantly more effective than control in bolstering CRC screening readiness and self-efficacy. PRACTICE IMPLICATIONS If further streamlined, personally tailored IMCPs might be usefully deployed in busy primary care offices to improve uptake of CRC screening.
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Affiliation(s)
- Anthony Jerant
- Department of Family and Community Medicine (DF&CM), University of California Davis (UCD) School of Medicine (SOM), 4860 Y Street, Suite 2300, Sacramento, CA 95817, United States.
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