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Park SE, Pinto RM. Factors that Influence Co-production among Student Interns, Consumers, and Providers of Social and Public Health Services: Implications for Interprofessional Collaboration and Training. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:71-83. [PMID: 34488568 PMCID: PMC8665028 DOI: 10.1080/19371918.2021.1974638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Providers of public health and social services ("providers") develop and deliver services by engaging in interprofessional collaboration (IPC), from seeking external advice to making referrals and linkages to various social and public health services. Providers collaborate with consumers of social and public health services ("consumers") and student interns (e.g., social work, public health) to explore, determine, and deliver relevant services through a process referred to as co-production. Both IPC and co-production are widespread strategies with the potential to improve service accessibility and quality. However, the intersection of co-production and IPC remains understudied. This study examines factors that influence co-production in IPC among service providers, consumers, and student interns. We used cross-sectional survey data from an NIMH-funded study, including 379 providers in 36 HIV-service organizations in New York City. We examined the relationships between providers' perspectives on co-production in IPC and multiple provider- and organization-level variables using random-effects logistic regression. Most respondents said that consumers and students in their agency participate in IPC on the issues that concern them. Providers who perceive greater flexibility in the IPC process were more likely to agree that their organizations' providers co-produced IPC. Organizational service offerings (i.e., multilingual services, a comprehensive range of services), job positions, and full-time employment status were strong predictors of co-production. Our findings indicate that intentional and inclusive models of flexible IPC are needed. Fostering co-production in the HIV service field requires more institutional support and incentives for organizations, providers, and student interns. Implications for research and practice are discussed.
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Tran SHN, Weaver RG, Manns BJ, Saunders-Smith T, Campbell T, Ivers N, Hemmelgarn BR, Tonelli M, Pannu R, Campbell DJT. Factors Affecting the Reception of Self-Management Health Education: A Cross-Sectional Survey Assessing Perspectives of Lower-Income Seniors with Cardiovascular Conditions. Patient Prefer Adherence 2022; 16:971-981. [PMID: 35422615 PMCID: PMC9005130 DOI: 10.2147/ppa.s351459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/11/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Self-management education and support (SMES) programs can prevent adverse chronic disease outcomes, but factors modifying their reception remain relatively unexplored. We examined how perceptions of an SMES program were influenced by the mode of delivery, and co-receipt of a paired financial benefit. METHODS AND PATIENTS Using a cross-sectional survey, we evaluated the perceived helpfulness of a SMES program among 446 low-income seniors at high risk for cardiovascular events in Alberta, Canada. Secondary outcomes included frequency of use, changes in perspectives on health, satisfaction with the program, and comprehensibility of the material. Participants received surveys after engaging with the program for at least 6 months. We used modified Poisson regression to calculate relative risks. Open-ended questions were analyzed inductively. RESULTS The majority of participants reported that the SMES program was helpful (>80%). Those who also received the financial benefit (elimination of medication copayments) were more likely to report that the SMES program was helpful (RR 1.24, 95% CI 1.11-1.39). Those who received the program electronically were more likely to use the program weekly (RR 1.51, 1.25-1.84). Both those who received the intervention electronically (RR 1.18, 1.06-1.33), and those who also received copayment elimination (RR 1.17, 1.05-1.31) were more likely to state that the program helped change their perspectives on health. CONCLUSION When designing SMES programs, providing the option for electronic delivery appears to promote greater use for seniors. The inclusion of online-delivery and co-receipt of tangible benefits when designing an SMES program for seniors results in favorable reception and could facilitate sustained adherence to health behavior recommendations. Participants also specifically expressed that what they enjoyed most was that the SMES program was informative, helpful, engaging, and supportive.
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Affiliation(s)
- Sophia H N Tran
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert G Weaver
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Braden J Manns
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Noah Ivers
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Women’s College Hospital, Toronto, ON, Canada
| | | | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Raj Pannu
- Emergence Creative, New York, NY, USA
| | - David J T Campbell
- Department of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Cardiac Sciences, University of Calgary, Calgary, AB, Canada
- Correspondence: David JT Campbell, Tel +1 403-210-9511, Email
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Rief JJ, Hamm ME, Zickmund SL, Nikolajski C, Lesky D, Hess R, Fischer GS, Weimer M, Clark S, Zieth C, Roberts MS. Using Health Information Technology to Foster Engagement: Patients' Experiences with an Active Patient Health Record. HEALTH COMMUNICATION 2017; 32:310-319. [PMID: 27223684 DOI: 10.1080/10410236.2016.1138378] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Personal health records (PHRs) typically employ "passive" communication strategies, such as non-personalized medical text, rather than direct patient engagement in care. Currently there is a call for more active PHRs that directly engage patients in an effort to improve their health by offering elements such as personalized medical information, health coaches, and secure messaging with primary care providers. As part of a randomized clinical trial comparing "passive" with "active" PHRs, we explore patients' experiences with using an "active" PHR known as HealthTrak. The "passive" elements of this PHR included problem lists, medication lists, information about patient allergies and immunizations, medical and surgical histories, lab test results, health reminders, and secure messaging. The active arm included all of these elements and added personalized alerts delivered through the secure messaging platform to patients for services coming due based on various demographic features (including age and sex) and chronic medical conditions. Our participants were part of the larger clinical trial and were eligible if they had been randomized to the active PHR arm, one that included regular personalized alerts. We conducted focus group discussions on the benefits of this active PHR for patients who are at risk for cardiovascular disease. Forty-one patients agreed to participate and were organized into five separate focus group sessions. Three main themes emerged from the qualitatively analyzed focus groups: participants reported that the active PHR promoted better communication with providers; enabled them to more effectively partner with their providers; and helped them become more proactive about tracking their health information. In conclusion, patients reported improved communication, partnership with their providers, and a sense of self-management, thus adding insights for PHR designers hoping to address low adoption rates and other patient barriers to the development and use of the technology.
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Affiliation(s)
- John J Rief
- a Department of Communication and Rhetorical Studies , Duquesne University
| | - Megan E Hamm
- b Qualitative, Evaluation and Stakeholder Engagement Services, Center for Research on Health Care , University of Pittsburgh
| | - Susan L Zickmund
- c Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Division of General Internal Medicine, Department of Medicine , University of Pittsburgh School of Medicine, University of Pittsburgh
| | - Cara Nikolajski
- d Center for Research on Health Care , University of Pittsburgh
| | - Dan Lesky
- e University of Pittsburgh School of Medicine , University of Pittsburgh
| | - Rachel Hess
- f Departments of Population Health Sciences and Internal Medicine , University of Utah
| | - Gary S Fischer
- g Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , University of Pittsburgh
| | - Melissa Weimer
- d Center for Research on Health Care , University of Pittsburgh
| | - Sunday Clark
- h Department of Emergency Medicine , Weill Cornell Medical College
| | - Caroline Zieth
- d Center for Research on Health Care , University of Pittsburgh
| | - Mark S Roberts
- g Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine , University of Pittsburgh
- i Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health , University of Pittsburgh
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