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Boss RD, Maddox K, Thorndike D, Keppel K, Batson L, Smith B, Weaver MS, Munoz-Blanco S. Building clinician-parent partnerships to improve care for chronically critically Ill children: A pilot project. PATIENT EDUCATION AND COUNSELING 2024; 122:108152. [PMID: 38232672 DOI: 10.1016/j.pec.2024.108152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/05/2024] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Multicenter pilot to assess feasibility, acceptability, and educational value of videos for families and clinicians regarding unique inpatient challenges of pediatric chronic critical illness. METHODS Videos were developed for 3 hospitalization timepoints: 1) chronic critical illness diagnosis, 2) transfers, 3) discharge. Parents of hospitalized children, and interdisciplinary clinicians, were recruited to watch videos and complete surveys. RESULTS 33 parents (16 English-speaking, 17 Spanish-speaking) and 34 clinicians participated. Enrollment was better for families than clinicians (78% vs. 43%). Video acceptability was high: families and clinicians endorsed verisimilitude of depicted hospitalization challenges for chronic critical illness. All families felt the videos would help other families, all clinicians felt they would help other clinicians. Families gained expectations for the hospital course, discovered resources for hospitalization challenges, and learned there are other families in similar situations. Clinicians learned to recognize chronic critical illness, and how families experience hospitalizations, transfers, and discharges. CONCLUSION Educational videos about pediatric chronic critical illness were overall feasible, acceptable, and educational for hospitalized families and clinicians. PRACTICE IMPLICATIONS Just-in-time hospital education about pediatric chronic critical illness is valuable to families and clinicians; next steps are to assess potential to reduce gaps in care of children with chronic critical illness.
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Affiliation(s)
- Renee D Boss
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA; Johns Hopkins Berman Institute of Bioethics, 1801 Ashland Ave, Baltimore, MD 21287 USA.
| | - Katherine Maddox
- The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
| | - Dorte Thorndike
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 USA
| | - Kristopher Keppel
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | - Lora Batson
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205 USA
| | - Brandon Smith
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA
| | | | - Sara Munoz-Blanco
- Johns Hopkins School of Medicine, 600 N. Wolfe St, Baltimore, MD 21287 USA; The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390 USA
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Zhang W, Mei Z, Feng Z, Li B. Effects of a nurse-led eHealth programme on functional outcomes and quality of life of patients with stroke: a pooled analysis of randomized controlled trials. Front Public Health 2024; 12:1395270. [PMID: 38737865 PMCID: PMC11082325 DOI: 10.3389/fpubh.2024.1395270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Background Stroke remains a leading cause of disability worldwide. Nurse-led eHealth programs have emerged as a potentially effective strategy to improve functional outcomes and quality of life in stroke survivors. However, the variability of study designs and outcomes measured across trials necessitates a pooled analysis to comprehensively assess the efficacy of these interventions. This protocol outlines the methodology for a pooled analysis that aims to synthesize evidence from randomized controlled trials (RCTs) evaluating nurse-led eHealth interventions for stroke patients. Methods and analysis This pooled analysis will be conducted according to the PRISMA guidelines. We will include RCTs that evaluate nurse-led eHealth programs and report on functional outcomes or quality of life in stroke patients. Comprehensive searches of electronic databases including Pubmed, EMBASE, the Cochrane Library, CINAHL, and PsycINFO will be conducted with a predefined search strategy. Study selection will involve screening titles and abstracts, followed by full-text review using explicit inclusion and exclusion criteria. Data extraction will be undertaken independently by two reviewers. The risk of bias will be assessed through the Cochrane Risk of Bias tool. Additionally, the quality of evidence for each outcome will be evaluated using the GRADE approach. Meta-analyses will be performed using random-effects models, and heterogeneity will be quantified using the I2 statistic. Subgroup and sensitivity analyses will explore potential sources of heterogeneity. Discussion and conclusions This pooled analysis is poised to provide a nuanced understanding of the effectiveness of nurse-led eHealth programs in stroke rehabilitation, leveraging a thorough methodological framework and GRADE tool to ensure robustness and reliability of evidence. The investigation anticipates diverse improvements in patient outcomes, underscoring the potential of personalized, accessible eHealth interventions to enhance patient engagement and treatment adherence. Despite the challenges posed by the heterogeneity of interventions and rapid technological advancements, the findings stand to influence clinical pathways by integrating eHealth into standard care, if substantiated by the evidence. Our study's depth and methodological rigor possess the potential to initiate changes in healthcare policy, advocating for the adoption of eHealth and subsequent investigations into its cost-efficiency. Ultimately, we aim to contribute rich, evidence-based insights into the burgeoning field of digital health, offering a foundational assessment of its applications in stroke care. Our data is expected to have a lasting impact, not only guiding immediate clinical decisions but also shaping the trajectory of future healthcare strategies in stroke recovery. Systematic review registration Identifier (CRD42024520100: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=520100).
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Affiliation(s)
- Wei Zhang
- Department of Neurology, Xinxiang Central Hospital, The Fourth Affiliated Hospital of Xinxiang Medical College, Xinxiang, China
| | - Zubing Mei
- Department of Anorectal Surgery, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Anorectal Disease Institute of Shuguang Hospital, Shanghai, China
| | - Zaibang Feng
- Department of Rehabilitation Medicine and Physiotherapy, Changhai Hospital, Naval Military Medical University, Shanghai, China
| | - Bin Li
- Department of Neurosurgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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3
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Sakamoto M, Ishikawa H, Suzuki A. Evaluation of Parents' Use of a Child Health Care Information App and Their Health Literacy: Cross-Sectional Study. JMIR Pediatr Parent 2024; 7:e48478. [PMID: 38623727 PMCID: PMC11034361 DOI: 10.2196/48478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 04/17/2024] Open
Abstract
Background Recently, digital media, including internet websites and smartphone apps, have become popular resources for parents in searching for child health care information. Higher health literacy among parents in obtaining adequate health care information and making proper decisions may lead to improved child health outcomes and a reduction in the burden on health care professionals. However, few studies have examined the association between the provision of child health care information apps and parents' health literacy. Objective This study aims to evaluate whether parents' use of an app that provides child health care information is associated with their health care knowledge, their health literacy, and emergency room visits for their children. Methods Participants were recruited during checkups for their 1.5-year-old children at health centers within Saku City in 2022. Parents who agreed to participate were included in this study; individuals were excluded if they were not the mother or father of the child or did not have a smartphone. Participants were asked if they had used the Oshiete-Doctor app, which was distributed by Saku City free of charge to improve the home nursing skills of parents and guardians. Sociodemographic data of parents and children, data on health care knowledge about children, data on the frequency of emergency room visits in the past 6 months, and health literacy scores (HLSs) of parents (measured with the HLS-EU-Q47 [European Health Literacy Survey Questionnaire]) were collected from participants in this cross-sectional survey. Univariable and multivariable analyses were conducted to examine the associations of app use with health care knowledge, health literacy, and emergency room visits. Results In total, 251 respondents completed the survey (response rate: 251/267, 94%). Although the proportion of health care workers was significantly higher among app users than among non-app users (P=.005), no other participant attributes were significantly associated with the use of the app. The proportions of participants with higher health care knowledge and participants with higher total HLSs were significantly higher among app users than among non-app users (P=.001 and P=.003, respectively). After adjusting for potentially confounding covariates, these proportions were still significantly higher among app users than among non-app users (P=.02 and P=.007, respectively). Emergency room visits were significantly more frequent among app users than among non-app users (P=.007) in the univariable analysis, but the association was not significant (P=.07) after adjusting for sociodemographic variables. Conclusions This study showed a significant association between parents' use of a child health care information app and higher child health care knowledge and health literacy. The use of the app may lead to more appropriate health decisions and behaviors in children's health care. Future studies are needed to evaluate the association between app use and emergency room visits.
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Affiliation(s)
| | - Hirono Ishikawa
- Teikyo University Graduate School of Public Health, Tokyo, Japan
| | - Asuka Suzuki
- Teikyo University Graduate School of Public Health, Tokyo, Japan
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4
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Garcia Valencia OA, Thongprayoon C, Miao J, Suppadungsuk S, Krisanapan P, Craici IM, Jadlowiec CC, Mao SA, Mao MA, Leeaphorn N, Budhiraja P, Cheungpasitporn W. Empowering inclusivity: improving readability of living kidney donation information with ChatGPT. Front Digit Health 2024; 6:1366967. [PMID: 38659656 PMCID: PMC11039889 DOI: 10.3389/fdgth.2024.1366967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
Background Addressing disparities in living kidney donation requires making information accessible across literacy levels, especially important given that the average American adult reads at an 8th-grade level. This study evaluated the effectiveness of ChatGPT, an advanced AI language model, in simplifying living kidney donation information to an 8th-grade reading level or below. Methods We used ChatGPT versions 3.5 and 4.0 to modify 27 questions and answers from Donate Life America, a key resource on living kidney donation. We measured the readability of both original and modified texts using the Flesch-Kincaid formula. A paired t-test was conducted to assess changes in readability levels, and a statistical comparison between the two ChatGPT versions was performed. Results Originally, the FAQs had an average reading level of 9.6 ± 1.9. Post-modification, ChatGPT 3.5 achieved an average readability level of 7.72 ± 1.85, while ChatGPT 4.0 reached 4.30 ± 1.71, both with a p-value <0.001 indicating significant reduction. ChatGPT 3.5 made 59.26% of answers readable below 8th-grade level, whereas ChatGPT 4.0 did so for 96.30% of the texts. The grade level range for modified answers was 3.4-11.3 for ChatGPT 3.5 and 1-8.1 for ChatGPT 4.0. Conclusion Both ChatGPT 3.5 and 4.0 effectively lowered the readability grade levels of complex medical information, with ChatGPT 4.0 being more effective. This suggests ChatGPT's potential role in promoting diversity and equity in living kidney donation, indicating scope for further refinement in making medical information more accessible.
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Affiliation(s)
- Oscar A. Garcia Valencia
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Charat Thongprayoon
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Jing Miao
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Supawadee Suppadungsuk
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand
| | - Pajaree Krisanapan
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
- Division of Nephrology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
- Division of Nephrology, Department of Internal Medicine, Thammasat University Hospital, Pathum Thani, Thailand
| | - Iasmina M. Craici
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Caroline C. Jadlowiec
- Division of Transplant Surgery, Department of Surgery, Mayo Clinic, Phoenix, AZ, United States
| | - Shennen A. Mao
- Division of Transplant Surgery, Department of Transplant, Mayo Clinic, Jacksonville, FL, United States
| | - Michael A. Mao
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Napat Leeaphorn
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Pooja Budhiraja
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Phoenix, AZ, United States
| | - Wisit Cheungpasitporn
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, United States
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5
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Swierad EM, Rausch JC, Sawyer V, Drucker G, Williams O. "The Design and Acceptability of a Hip Hop Themed Integrated Nutrition Math Curriculum for Minoritized 5th Grade Students Using the Multisensory Multilevel Health Education Model". Health Promot Pract 2024:15248399241240431. [PMID: 38533745 DOI: 10.1177/15248399241240431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
Digital technology creates new opportunities to design multisensory learning experiences. Evidence suggests that digital innovation can greatly benefit health education, including nutrition programs. The COVID-19 pandemic disrupted the education sector, forcing schools to modify standard practices from exclusively in-person delivery to online or blended learning. Digitalized curriculums became particularly useful as an Emergency Remote Teaching tool. This article focuses on developing and implementing a multimedia, multisensory, and scalable Hip-Hop Healthy Eating and Living in Schools (H.E.A.L.S.) Nutrition-Math Curriculum (NMC). NMC comprises 20 lessons-music-based multimedia resources used in the classroom or at home. Fourteen lessons represent self-directed online modules (asynchronous learning) hosted on a Learning Management System (LMS) called "Gooru." The remaining six lessons are teacher-facilitated (in person or using Zoom) review sessions (synchronous learning). The article discusses (1) the development of NMC through the lens of the Multisensory Multilevel Health Education Model (MMHEM), (2) the high acceptability of NMC evaluated using a mixed-methods design among minoritized fifth-grade students attending an after-school program, and (3) the students' completion and mastery rates of the NMC modules based on LMS data. Multimedia nutrition education programs integrated with common core curriculum content, such as NMC, may be a promising avenue for disseminating health education to minoritized children living in New York City and similar high fast-food density cities.
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Affiliation(s)
| | - John C Rausch
- Columbia University Irving Medical Center, New York, NY, USA
| | - Vanessa Sawyer
- Columbia University Irving Medical Center, New York, NY, USA
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Krenn C, Semlitsch T, Zipp C, Lengauer S, Shao L, Schreck T, Bedek M, Kupfer C, Albert D, Kubicek B, Siebenhofer A, Jeitler K. Customization options in consumer health information materials on type-2 diabetes mellitus-an analysis of modifiable features in different types of media. Front Public Health 2024; 12:1252244. [PMID: 38450136 PMCID: PMC10915235 DOI: 10.3389/fpubh.2024.1252244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction The understanding of health-related information is essential for making informed decisions. However, providing health information in an understandable format for everyone is challenging due to differences in consumers' health status, disease knowledge, skills, and preferences. Tailoring health information to individual needs can improve comprehension and increase health literacy. Objective The aim of our research was to analyze the extent to which consumers can customize consumer health information materials (CHIMs) for type-2 diabetes mellitus through various media types. Methods We conducted a comprehensive search for various CHIMs across various media types, such as websites, apps, videos, and printed or printable forms. A representative sample of CHIMs was obtained for analysis through blocked randomization across the various media types. We conducted a quantitative content analysis to determine the frequency of user-centered customization options. Cross-comparisons were made to identify trends and variations in modifiable features among the media. Results In our representative sample of 114 CHIMs, we identified a total of 24 modifiable features, which we grouped into five main categories: (i) language, (ii) text, (iii) audiovisual, (iv) presentation, and (v) medical content. Videos offered the most customization opportunities (95%), while 47% of websites and 26% of apps did not allow users to tailor health information. None of the printed or printable materials provided the option to customize the information. Overall, 65% of analyzed CHIMs did not allow users to tailor health information according to their needs. Conclusion Our results show that CHIMs for type-2 diabetes mellitus could be significantly improved by providing more customization options for users. Further research is needed to investigate the effectiveness and usability of these options to enhance the development and appropriate provision of modifiable features in health information.
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Affiliation(s)
- Cornelia Krenn
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Thomas Semlitsch
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Carolin Zipp
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
| | - Stefan Lengauer
- Institute of Computer Graphics and Knowledge Visualization, Graz University of Technology, Graz, Austria
| | - Lin Shao
- Institute of Computer Graphics and Knowledge Visualization, Graz University of Technology, Graz, Austria
- Fraunhofer Austria Center for Data Driven Design, Graz, Austria
| | - Tobias Schreck
- Institute of Computer Graphics and Knowledge Visualization, Graz University of Technology, Graz, Austria
| | - Michael Bedek
- Institute of Psychology, University of Graz, Graz, Austria
| | - Cordula Kupfer
- Institute of Psychology, University of Graz, Graz, Austria
| | | | | | - Andrea Siebenhofer
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
- Institute of General Practice, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Klaus Jeitler
- Institute of General Practice and Evidence-based Health Services Research, Medical University of Graz, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
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7
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Melhem SJ, Kayyali R. Multilayer framework for digital multicomponent platform design for colorectal survivors and carers: a qualitative study. Front Public Health 2023; 11:1272344. [PMID: 38115846 PMCID: PMC10728820 DOI: 10.3389/fpubh.2023.1272344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
Background The advent of eHealth services offers the potential to support colorectal cancer (CRC) survivors and their informal caregivers (ICs), yet research into user needs and design requirements remains scant. This exploratory qualitative study addresses this knowledge gap by focusing on the development of a Digital Multicomponent Platform (DMP) designed to provide comprehensive support to these populations. Aims The objective of this research is to use qualitative methodologies to identify key user needs and design requirements for eHealth services. It seeks to propose and apply a multi-tiered framework for creating a DMP that encapsulates the needs of CRC survivors and their ICs. Methods Skype-based focus groups (FGs) were utilized to gather qualitative data from CRC survivors and ICs. This approach served to elicit crucial themes integral to the design of the DMP. A multi-tiered framework was subsequently developed to integrate user-centered design (UCD) principles and requirements with predetermined outcomes, eHealth services, and IT infrastructure. Results The first stage of the analysis identified five crucial themes: (1) the importance of healthcare system interaction via eHealth, (2) interaction between healthcare providers and peers, (3) lifestyle and wellness considerations, (4) platform content and user interface requirements, (5) caregiver support. The second stage analysis applied the multi-tiered framework, to determine the DMP that was conceptualized from these themes, underscores the significance of personalized content, caregiver involvement, and integration with electronic health records (EHRs). Conclusion The study offers novel insights into the design and development of digital supportive care interventions for CRC survivors and their caregivers. The results highlight the utility of user-centered design principles, the significance of personalized content and caregiver involvement, and the need for a unified health data platform that promotes communication among patients, healthcare providers, and peers. This multi-tiered framework could serve as a prototype for future eHealth service designs.
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Affiliation(s)
- Samar J. Melhem
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University London, Kingston upon Thames, Surrey, United Kingdom
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Zanobini P, Bonaccorsi G, Giusti M, Minardi V, Possenti V, Masocco M, Garofalo G, Mereu G, Cecconi R, Lorini C. Health literacy and breast cancer screening adherence: results from the population of Tuscany, Italy. Health Promot Int 2023; 38:daad177. [PMID: 38146742 DOI: 10.1093/heapro/daad177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Mammographic screening can reduce breast cancer (BC) mortality in women. In Italy, although attendance rates increased recently, they are still far from the recommended levels internationally. Inadequate health literacy (HL) may be a reason for poor awareness and/or knowledge about the importance of completing cancer screening. This study examined the relationship between HL, other sociodemographic determinants, and their influence on participation in both opportunistic and organized BC screenings among women aged 50-69 in Tuscany. The study analyzed 2017-2019 data from the Tuscan population subsample in the Italian Behavioral Risk Factor Surveillance System PASSI (Progressi delle Aziende Sanitarie per la Salute in Italia). HL was assessed using the Italian version of the six-item European Health Literacy Survey Questionnaire (HLS-EU-Q6). Among the 2250 interviewees, 75.3% underwent the organized BC screening and 9.4% on voluntary basis. Although to a different extent, HL was significantly associated to compliance rates with both opportunistic and organized screenings. Among sociodemographic factors, only occupational status was associated with opportunistic screening attendance rates. As expected, being invited by letter resulted to be strongly associated with participation to organized screening programs and the medical advice predicts for participating to both opportunistic and organized screening. This study highlights the relevant role that HL plays in BC, opportunistic and organized, screening adherence in a universal healthcare system. To increase BC screening participation rates, healthcare systems would benefit by implementing interventions for improved HL at population level or within healthcare organizations.
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Affiliation(s)
- Patrizio Zanobini
- Department of Health Sciences, University of Florence, Viale Morgagni 48, 50134 Florence, Italy
| | - Guglielmo Bonaccorsi
- Department of Health Sciences, University of Florence, Viale Morgagni 48, 50134 Florence, Italy
| | - Martina Giusti
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134 Florence, Italy
| | - Valentina Minardi
- Centro Nazionale per la Prevenzione delle Malattie e la Promozione della Salute, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Valentina Possenti
- Centro Nazionale per la Prevenzione delle Malattie e la Promozione della Salute, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Maria Masocco
- Centro Nazionale per la Prevenzione delle Malattie e la Promozione della Salute, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Giorgio Garofalo
- Department of Prevention, Azienda Unità Sanitaria Locale (AUSL) Toscana Centro, Piazza Santa Maria Nuova 1, 50122 Florence, Italy
| | - Giovanna Mereu
- Department of Prevention, Azienda Unità Sanitaria Locale (AUSL) Toscana Centro, Piazza Santa Maria Nuova 1, 50122 Florence, Italy
| | - Rossella Cecconi
- Department of Prevention, Azienda Unità Sanitaria Locale (AUSL) Toscana Centro, Piazza Santa Maria Nuova 1, 50122 Florence, Italy
| | - Chiara Lorini
- Department of Health Sciences, University of Florence, Viale Morgagni 48, 50134 Florence, Italy
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Kuriakose Kuzhiyanjal AJ, Nigam GB, Antoniou GA, Farraye FA, Cross RK, Limdi JK. Management of Inflammatory Bowel Disease Using E-health Technologies: A Systematic Review and Meta-Analysis. J Crohns Colitis 2023; 17:1596-1613. [PMID: 37099723 PMCID: PMC10637047 DOI: 10.1093/ecco-jcc/jjad075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Indexed: 04/28/2023]
Abstract
BACKGROUND AND AIMS Technological advances have provided innovative, adaptive, and responsive models of care for inflammatory bowel diseases [IBD]. We conducted a systematic review to compare e-health interventions with standard care in management of IBD. METHODS We searched electronic databases for randomised, controlled trials [RCT] comparing e-health interventions with standard care for patients with IBD. Effect measures were standardised mean difference [SMD], odds ratio [OR], or rate ratio [RR], calculated using the inverse variance or Mantel-Haenszel statistical method and random-effects models. Version 2 of the Cochrane tool was used to assess the risk of bias. The certainty of evidence was appraised with the GRADE framework. RESULTS Fourteen RCTs [n = 3111; 1754 e-health and 1357 controls] were identified. The difference in disease activity scores (SMD 0.09, 95% confidence interval [CI]: -0.09-0.28) and clinical remission (odds ratio [OR] 1.12, 95% CI: 0.78-1.61) between e-health interventions and standard care were not statistically significant. Higher quality of life [QoL] [SMD 0.20, 95% CI: 0.05-0.35) and IBD knowledge [SMD 0.23, 95% CI: 0.10-0.36] scores were noted in the e-health group, and self-efficacy levels [SMD -0.09, 95% CI: -0.22-0.05] were comparable. E-health patients had fewer office [RR 0.85, 95% CI: 0.78-0.93] and emergency [RR 0.70, 95% CI: 0.51- 0.95] visits, with no statistically significant difference in endoscopic procedures, total health care encounters, corticosteroid use, and IBD related hospitalisation or surgery. The trials were judged to be at high risk of bias or to have some concerns for disease remission. The certainty of evidence was moderate or low. CONCLUSION E-health technologies may have a role in value-based care in IBD.
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Affiliation(s)
- Anish J Kuriakose Kuzhiyanjal
- Northern Care Alliance NHS Foundation Trust, Division of Gastroenterology-Section of IBD, Manchester, UK; and. Edgehill University, Ormskirk, UK
| | - Gaurav B Nigam
- Translational Gastroenterology Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; and Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, UK
| | - George A Antoniou
- Department of Vascular and Endovascular Surgery, Manchester University NHS Foundation Trust, Manchester, UK; and Division of Cardiovascular Sciences, School of Medical Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Francis A Farraye
- Mayo Clinic, Division of Gastroenterology and Hepatology, Jacksonville, FL, USA
| | - Raymond K Cross
- University of Maryland School of Medicine, Division of Gastroenterology & Hepatology, Baltimore, MD, USA
| | - Jimmy K Limdi
- Northern Care Alliance NHS Foundation Trust, Division of Gastroenterology-Section of IBD, Manchester, UK; and Manchester Academic Health Sciences, University of Manchester, Manchester, UK
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10
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Milanti A, Chan DNS, Parut AA, So WKW. Determinants and outcomes of eHealth literacy in healthy adults: A systematic review. PLoS One 2023; 18:e0291229. [PMID: 37792773 PMCID: PMC10550189 DOI: 10.1371/journal.pone.0291229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND eHealth has shown many benefits in health promotion and disease prevention. For engaging in and taking advantage of eHealth, eHealth literacy is essential. This systematic review aims to summarise and examine the existing evidence on determinants and outcomes of eHealth literacy in healthy adults. METHODS We searched the relevant peer-reviewed articles published in English in six databases: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library and ProQuest. The inclusion criteria of the review were: 1) studies examining 'eHealth literacy', which refers to the ability to search, select, judge and apply online health information to address or solve health problems and to improve wellbeing; 2) the type of study included observational and experimental studies, mixed method studies or qualitative studies; 3) the participants were healthy adults; 4) the main outcomes were the determinants (i.e. influencing or associated factors) and outcomes (i.e. benefits and disadvantages) of eHealth literacy. Articles were assessed by two reviewers using the Joanna Briggs Institute critical appraisal tool. A conceptual model to map the determinants and outcomes of eHealth literacy in healthy adults into the non-modifiable, individual, social and community networks and structural layers was developed to classify the identified determinants and outcomes. RESULTS Forty-four studies were included in this review, of which 43 studies were cross-sectional and one was qualitative. eHealth literacy determinants included age, sex, literacy factors, socioeconomic factors and language. eHealth literacy outcomes included better general health promotion behavior, COVID-19 preventive behaviors, psychological wellbeing, social support, self-rated health and health service utilisation. CONCLUSIONS Our results showed that eHealth literacy has multi-layered determinants and positive outcomes. Different strategies at different policy levels are needed to improve the eHealth literacy levels of healthy adults.
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Affiliation(s)
- Ariesta Milanti
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
| | - Dorothy Ngo Sheung Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
| | | | - Winnie Kwok Wei So
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong, China
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Krasuska M, Davidson EM, Beune E, Jenum AK, Gill JM, Stronks K, van Valkengoed IG, Diaz E, Sheikh A. A Culturally Adapted Diet and Physical Activity Text Message Intervention to Prevent Type 2 Diabetes Mellitus for Women of Pakistani Origin Living in Scotland: Formative Study. JMIR Form Res 2023; 7:e33810. [PMID: 37713245 PMCID: PMC10541642 DOI: 10.2196/33810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2022] [Accepted: 01/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Individuals of South Asian origin are at an increased risk of developing type 2 diabetes mellitus (T2DM) compared with other ethnic minority groups. Therefore, there is a need to develop interventions to address, and reduce, this heightened risk. OBJECTIVE We undertook formative work to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. METHODS We used a stepwise approach that was informed by the Six Steps in Quality Intervention Development framework, which consisted of gathering evidence through literature review and focus groups (step 1), developing a program theory for the intervention (step 2), and finally developing the content of the text messages and an accompanying delivery plan (step 3). RESULTS In step 1, we reviewed 12 articles and identified 3 key themes describing factors impacting on diet and physical activity in the context of T2DM prevention: knowledge on ways to prevent T2DM through diet and physical activity; cultural, social, and gender norms; and perceived level of control and sense of inevitability over developing T2DM. The key themes that emerged from the 3 focus groups with a total of 25 women were the need for interventions to provide "friendly encouragement," "companionship," and a "focus on the individual" and also for the text messages to "set achievable goals" and include "information on cooking healthy meals." We combined the findings of the focus groups and literature review to create 13 guiding principles for culturally adapting the text messages. In step 2, we developed a program theory, which specified the main determinants of change that our text messages should aim to enhance: knowledge and skills, sense of control, goal setting and planning behavior, peer support, and norms and beliefs guiding behavior. In step 3, we used both the intervention program theory and guiding principles to develop a set of 73 text messages aimed at supporting a healthy diet and 65 text messages supporting increasing physical activity. CONCLUSIONS We present a theory-based approach to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. This study outlines an approach that may also be applicable to the development of interventions for other ethnic minority populations in diverse settings. There is now a need to build on this formative work and undertake a feasibility trial of a text message-based diet and physical activity intervention to prevent T2DM for women of Pakistani origin living in Scotland.
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Affiliation(s)
- Marta Krasuska
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma M Davidson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Erik Beune
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jason Mr Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Irene Gm van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
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12
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Dong Q, Liu T, Liu R, Yang H, Liu C. Effectiveness of Digital Health Literacy Interventions in Older Adults: Single-Arm Meta-Analysis. J Med Internet Res 2023; 25:e48166. [PMID: 37379077 PMCID: PMC10365623 DOI: 10.2196/48166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/23/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND In a world of rapid digital technology development, the lack of digital health literacy (DHL) among older people cannot be ignored. DHL is becoming an essential competency that can facilitate the health status and health management of older adults. DHL interventions that are feasible and appropriate can be implemented on a large scale through the health care system for older people. OBJECTIVE The purpose of this meta-analysis was to assess the effectiveness of DHL interventions for older adults. METHODS English publications in PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to November 20, 2022. Two reviewers independently completed the data extraction and quality assessment. Review Manager (version 5.4; Cochrane Informatics & Technology Services) software was used for all meta-analyses. RESULTS A total of 7 studies, including 2 randomized controlled trials and 5 quasi-experimental studies, involving 710 older adults were considered eligible. The main outcome was scores on the eHealth Literacy Scale, and secondary outcomes were knowledge, self-efficacy, and skills. Quasi-experimental studies compared baseline and postintervention outcomes, while randomized controlled trials compared pre- and postintervention outcomes in the intervention group. Of the 7 studies, 3 used face-to-face instruction, while 4 adopted web-based interventions. Among them, 4 of the interventions were conducted using theoretical guidance, while 3 were not. Intervention duration varied from 2 to 8 weeks. In addition, the studies included were all conducted in developed countries, mainly in the United States. Pooled analysis presented that DHL interventions had positive effects on eHealth literacy efficacy (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001). Subgroup analysis revealed that DHL interventions that chose face-to-face teaching (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), were guided by a conceptual framework (standardized mean difference 1.15, 95% CI 0.46 to 1.84; P=.001), and were sustained over 4 weeks (standardized mean difference 1.1, 95% CI 0.46 to 1.84; P=.001) had a more significant effect. Moreover, the outcomes showed considerable gains in knowledge (standardized mean difference 0.93, 95% CI 0.54 to 1.31; P<.001) and self-efficacy (standardized mean difference 0.96, 95% CI 0.16 to 1.77; P=.02). No statistically significant effect was found for skills (standardized mean difference 0.77, 95% CI -0.30 to 1.85; P=.16). The small number of studies, variable study quality, and heterogeneity are some limitations of this review. CONCLUSIONS DHL interventions have positive effects on the health status and health management of older adults. Practical and effective DHL interventions are crucial for the use of modern digital information technology in managing the health of older people. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42023410204; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=410204.
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Affiliation(s)
- Qian Dong
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Ting Liu
- School of Nursing, Qingdao University, Qingdao, Shandong Province, China
| | - Ran Liu
- Jinan Blood Center, Jinan, Shandong Province, China
| | - Hongxia Yang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
| | - Cuiping Liu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, China
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Penn N, Laron M. Use and barriers to the use of telehealth services in the Arab population in Israel: a cross sectional survey. Isr J Health Policy Res 2023; 12:21. [PMID: 37221598 DOI: 10.1186/s13584-023-00569-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/30/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Studies conducted in Israel and in other countries show that minority populations typically underuse telehealth services notwithstanding the advantages inherent in the use of these services. The goal of this study was to examine telehealth use patterns and the barriers to the use of telehealth services in the Arab population in Israel, which is a culturally and ethnically varied minority population with a unique language and culture. METHODS A telephone survey was conducted among a representative sample of the adult Arab population in Israel from October 29 to November 4, 2020. Of the randomly sampled 1,192 adult Israeli Arabs 501 participants responded to the entire questionnaire, representing a response rate of 42%. RESULTS The study found that the majority of the adult Arab population in Israel faced no technology or Internet accessibility barriers. Thus, the majority of adult Israeli Arabs (87%) use the Internet on a daily basis and have smartphones (96%) and an Internet connection (93%). However, although they have high technology and Internet accessibility, their use of telehealth services is mostly a telephone appointment with a doctor (66%). At the same time, significantly lower use rates were found with regard to advanced telehealth services delivered through the Internet, e.g., consultation with a health care provider by email or chat (34%) or video chat (8%) and ordering of medications (14%). It was found that Arab Christians are more likely to use digital services than Arab Muslims, even when background characteristics are statistically controlled. Lack of awareness was found to be the major barrier to the use of telehealth services, specifically advanced services such as ordering of medications (23%) and video medical consultation (15%). A high rate of women cited the unmet need for the discreet provision of telehealth services as a barrier to their use of the services. It was also found that the majority of the adult Arab population had no objection in principle to the use of email or chat (75%) or video chat (51%) for consultation with a health care provider. It was further found that facilitating factors promoting the use of telehealth services include previous acquaintance with the health care provider, a stable internet infrastructure, the provision of the services in the Arabis language, guidance in the use of the service, a recommendation by a health care provider, and the participation of a family member in the online medical consultation. CONCLUSIONS The study findings highlight the need for the provision of accessible and customized telehealth services for minority populations. Whether delivered over the phone or through the Internet, the services have to be culturally (for Muslims and Christians) and linguistically (Arabic) adapted, guidance in the use of the services should be provided, and service marketing should be tailored to the target minority population. Specific solutions should be developed for the discreet provision of telehealth services for women, maintaining their privacy in online consultation with a health care provider, while the option of having a family member participate in the online medical consultation should be clearly indicated. In addition, awareness of telehealth services should be enhanced through promotional activities culturally adapted to the Arab society, for instance, through recommendation by the family doctor.
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Affiliation(s)
- Nadav Penn
- Health Policy Team, The Myers-JDC-Brookdale Institute, JDC Hill, POB 3886, 9103702, Jerusalem, Israel
| | - Michal Laron
- Health Policy Team, The Myers-JDC-Brookdale Institute, JDC Hill, POB 3886, 9103702, Jerusalem, Israel.
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Purcell DJ, Cavanaugh G, Thomas-Purcell KB, Caballero J, Waldrop D, Ayala V, Davenport R, Ownby RL. e-Health Literacy Scale, Patient Attitudes, Medication Adherence, and Internal Locus of Control. Health Lit Res Pract 2023; 7:e80-e88. [PMID: 37162255 PMCID: PMC10169461 DOI: 10.3928/24748307-20230417-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Health literacy is related to a variety of health outcomes, including disease control, health-related quality of life, and risk for death. Few studies have investigated the relation of electronic health literacy (e-health literacy) to outcomes or the mechanism by which they may be related. METHODS Secondary data were drawn from participants in a larger study on chronic disease self-management who were age 40 years and older, had at least one chronic health condition and a health literacy score of 8th grade or below on the validated short form of the Rapid Estimate of Adult Literacy in Medicine. Participants completed the e-Health Literacy Scale (eHEALS), the Multidimensional Health Locus of Control scale, a modified version of the Attitudes Toward Health Care Providers Scale (ATHCPS), the Wake Forest Physician Trust Scale (WFPTS), and the Gonzalez-Lu adherence questionnaire. Hypothesized relations were evaluated in a bootstrapped path analytic model using the Mplus statistical software. KEY RESULTS Participants included 334 individuals (mean age: 57.5 years; 173 women and 161 men) with Black, Indigenous, and People of Color accounting for 83.3% of the participants and White individuals making up 16.7% of the participants. Model results showed that after controlling for age, education, gender, and race, the eHEALS score was significantly related to the ATHCPS and WFPTS but not to the Gonzalez-Lu adherence questionnaire (p < .05). The eHEALS score was significantly related to the Multidimensional Health Locus of Control scale. Analysis of indirect effects showed that a portion of the relation between e-health literacy and patient attitude and adherence was mediated by internal locus of control (all p < .05). CONCLUSIONS In this study, e-health literacy was related to important patient attitude and behavior variables via locus of control. This finding has implications for the importance of improving patients' ability to use the internet to access and effectively use health information. [HLRP: Health Literacy Research and Practice. 2023;7(2):e80-e88.].
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Versluis A, Le TM, Houben GF, Knulst AC, Van Os-Medendorp H. Accidental allergic reactions to food in adolescents and adults: An overview of the factors involved and implications for prevention. FRONTIERS IN ALLERGY 2023; 4:1062049. [PMID: 36970066 PMCID: PMC10036762 DOI: 10.3389/falgy.2023.1062049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/21/2023] [Indexed: 03/12/2023] Open
Abstract
Accidental allergic reactions to food are one of the major problems in adult patients diagnosed with food allergy. Such reactions occur frequently, are often severe and are associated with higher medical and non-medical costs. The aim of this Perspective is to provide insight into the different factors involved in the occurrence of accidental allergic reactions and to present an overview of practical implications for effective preventive measures. Several factors affect the occurrence of accidental reactions. These factors are related to the patient, health care, or food. The most important patient-related factors are age, social barriers to disclosing their allergy and non-adherence to the elimination diet. With regards to healthcare, the degree to which clinical practice is tailored to the individual patient is an important factor. The major food-related factor is the absence of adequate precautionary allergen labeling (PAL) guidelines. Since many factors are involved in accidental allergic reactions, different preventive strategies are needed. It is highly recommended that health care be tailored to the individual patient, with regard to education about the elimination diet, support on behavioral and psychosocial aspects, usage of shared decision-making and taking into account health literacy. In addition, it is crucial that steps are taken to improve policies and guidelines for PAL.
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Affiliation(s)
- Astrid Versluis
- Department of Dermatology and Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- Correspondence: Astrid Versluis Harmieke Van Os-Medendorp
| | - Thuy-My Le
- Department of Dermatology and Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- Center for Translational Immunology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
| | - Geert F. Houben
- Center for Translational Immunology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- TNO, Netherlands Organization for Applied Scientific Research, Utrecht, Netherlands
| | - André C. Knulst
- Department of Dermatology and Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
- Center for Translational Immunology, University Medical Centre Utrecht, University Utrecht, Utrecht, Netherlands
| | - Harmieke Van Os-Medendorp
- School of Health, Saxion University of Applied Sciences, Enschede, Netherlands
- Correspondence: Astrid Versluis Harmieke Van Os-Medendorp
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Matchanova A, Woods SP, Neighbors C, Medina LD, Podell K, Beltran-Najera I, Alex C, Babicz MA, Thompson JL. Are accuracy discernment and sharing of COVID-19 misinformation associated with older age and lower neurocognitive functioning? CURRENT PSYCHOLOGY 2023:1-13. [PMID: 37359606 PMCID: PMC9991876 DOI: 10.1007/s12144-023-04464-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/10/2023]
Abstract
The online proliferation of COVID-19 misinformation led to adverse health and societal consequences. This study investigated possible differences in COVID-19 headline accuracy discernment and online sharing of COVID-19 misinformation between older and younger adults, as well as the role of individual differences in global cognition, health literacy and verbal IQ. Fifty-two younger (18-35 years old) and fifty older adults (age 50 and older) completed a neurocognitive battery, health literacy and numeracy measures, and self-report questionnaires via telephone. Participants also completed a social media headline-sharing experiment (Pennycook et al., Psychological science, 31(7), 770-780, 2020) in which they were presented with true and false COVID-19 headlines about which they indicated: 1) the likelihood that they would share the story on social media; and 2) the factual accuracy of the story. A repeated measures multivariate analysis of variance controlling for gender and race/ethnicity showed no effects of age (p = .099) but a significant interaction between actual COVID-19 headline accuracy and the likelihood of sharing (p < .001), such that accuracy was more strongly related to sharing false headlines (r = -.64) versus true headlines (r = -.43). Moreover, a higher likelihood of sharing false COVID-19 headlines was associated with lower verbal IQ and numeracy skills in older adults (rs = -.51--.40) and with lower verbal IQ, numeracy, and global cognition in younger adults (rs = -.66--.60). Findings indicate that headline accuracy judgements, numeracy, and verbal IQ are important contributors to sharing COVID-19 misinformation in both older and younger adults. Future work might examine the benefits of psychoeducation for improving health and science literacy for COVID-19. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-023-04464-w.
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Affiliation(s)
- Anastasia Matchanova
- Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX 77004 USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX 77004 USA
| | - Clayton Neighbors
- Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX 77004 USA
| | - Luis D. Medina
- Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX 77004 USA
| | - Kenneth Podell
- Department of Neurology, Methodist Hospital, Houston, TX USA
| | - Ilex Beltran-Najera
- Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX 77004 USA
| | | | - Michelle A. Babicz
- Mental Health and Behavioral Science Service, James A. Haley Veterans’ Hospital, Tampa, FL USA
| | - Jennifer L. Thompson
- Department of Psychology, University of Houston, 3695 Cullen Blvd, 126 Heyne Bldg (Ste. 239d), Houston, TX 77004 USA
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Vazquez CE, Xie B, Shiroma K, Charness N. Individualistic Versus Collaborative Learning in an eHealth Literacy Intervention for Older Adults: Quasi-Experimental Study. JMIR Aging 2023; 6:e41809. [PMID: 36757773 PMCID: PMC9951071 DOI: 10.2196/41809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/23/2022] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Older adults tend to have insufficient health literacy, which includes eHealth literacy-the ability to access, assess, and use digital health information. Interventions using methods such as collaborative learning (CL) and individualistic learning (IL) may be effective in addressing older adults' low eHealth literacy, but little is known about the short- and long-term effects of CL versus IL on older adults' eHealth literacy. OBJECTIVE The objective of this study was to use a 3 × 2 × 3 mixed factorial design to examine older adults' learning with CL versus IL for eHealth literacy. METHODS Older adults (N=466; mean age 70.5, SD 7.2; range 60-96 years) from diverse racial and ethnic groups were randomly assigned to either the CL or IL group (233/466, 50% in each). The intervention consisted of 4 weeks of training in 2-hour sessions held twice a week. Using ANOVA and multiple regression, we focused on the main effects of learning condition and interaction between learning condition and previous computer experience. Learning method (CL or IL) and previous computer experience (experienced, new, or mixed) were between-subject variables, and time of measurement (pretest measurement, posttest measurement, and 6-month follow-up) was the within-subject variable. Primary outcome variables were eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills. Control variables were age, sex, education, health status, race and ethnicity, income, primary language, and previous health literacy. RESULTS eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills improved significantly (P<.001 in all cases) from before to after the intervention. From postintervention measurement to 6-month follow-up, there was a significant interaction between learning condition and previous computer experience based on 1 outcome measure, computer and web operation skills (F2,55=3.69; P=.03). To maintain computer and web operation skills 6 months after the intervention, it was more effective for people with little to no previous computer experience to learn individually, whereas for people with more previous computer experience, it was more effective to learn collaboratively. From postintervention measurement to 6-month follow-up, statistically significant decreases were found in 3 of the 5 outcome measures: eHealth literacy efficacy, computer and web knowledge, and basic computer and web operation skills (P<.001 for all 3 cases). CONCLUSIONS Older adults' eHealth literacy can be improved through effective intervention, and the IL or CL condition may have little effect on short-term outcomes. However, to maintain long-term benefits, it may be best to learn collaboratively with others who have similar previous computer experience. eHealth literacy is multidimensional, with some components retained better over time. Findings suggest a need for resources to provide continuous training or periodic boosting to maintain intervention gains.
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Affiliation(s)
| | - Bo Xie
- School of Nursing, The University of Texas at Austin, Austin, TX, United States
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Kristina Shiroma
- School of Information, The University of Texas at Austin, Austin, TX, United States
| | - Neil Charness
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Campanozzi LL, Gibelli F, Bailo P, Nittari G, Sirignano A, Ricci G. The role of digital literacy in achieving health equity in the third millennium society: A literature review. Front Public Health 2023; 11:1109323. [PMID: 36891330 PMCID: PMC9986277 DOI: 10.3389/fpubh.2023.1109323] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/02/2023] [Indexed: 02/22/2023] Open
Abstract
Healthcare in the third millennium is largely delivered through systems involving the use of the technological devices and services, foremost among them telemedicine. For the adequate delivery of digital medicine services, however, it is necessary for users to be digitally literate, that is, able to consciously make use of technology. In order to understand how relevant digital literacy is in determining the effectiveness of e-Health services, we performed a traditional literature review on 3 major databases by combining the terms "Digital Literacy" and "Computer Literacy" with the terms "Telemedicine" and "Telehealth". Starting from an initial library of 1,077 papers, we selected 38 articles. At the outcome of the search, we found that digital literacy is a pivotal element in conditioning the effectiveness of telemedicine and digital medicine services in general, however, with some limitations.
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Affiliation(s)
| | - Filippo Gibelli
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Paolo Bailo
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Giulio Nittari
- Telemedicine and Telepharmacy Centre, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Ascanio Sirignano
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
| | - Giovanna Ricci
- Section of Legal Medicine, School of Law, University of Camerino, Camerino, Italy
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MARTINS AMEDBL, SANTOS AMR, ALENCAR GP, SOUZA JGS, SOARES MAA, MARTINS MBL, SILVEIRA MF, MAIA MB, FARIAS PKS, FERREIRA RC, PINTO RA, CRESPO TS, FERREIRA EFE. Psychometric properties of an oral health literacy scale for people living with diabetes. Braz Oral Res 2023; 37:e022. [PMID: 37018804 DOI: 10.1590/1807-3107bor-2023.vol37.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 04/04/2022] [Indexed: 04/05/2023] Open
Abstract
This study evaluated the construct validity of the instrument Oral Health Literacy among diabetics. A probabilistic random sample of 239 diabetics from an infinite population answered the 10 items of the questionnaire. The structural validity was assessed by confirmatory factor analysis and goodness of fit, chi-square per degrees of freedom ratio (X2/df), comparative fit index (CFI), goodness-of-fit index (GFI), and root-mean-square error of approximation (RMSEA). Internal consistency was estimated by the average variance extracted (AVE) and composite reliability (CR). The scores were dichotomized with the upper limit of the 95% confidence interval as the cutoff point. The three-dimensional model presented good quality parameters (X2 /df = 2.459; CFI = 0.988; TLI = 0.981) and poor RMSEA (0.078). Internal consistency was adequate; AVE for the Access, Understand/appraise, and Apply subscales were 0.831, 0.981, and 0.954 and the CR for these subscales were 0.893, 0.962, and 0.822, respectively. Inadequate literacy ranged from 41.8 to 48.1%. The three-dimensional model identified (access, understand/appraise, and apply) showed structural validity, good internal consistency, and understandability.
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Ronteltap A, Bukman AJ, Nagelhout GE, Hermans RCJ, Hosper K, Haveman-Nies A, Lupker R, Bolman CAW. Digital health interventions to improve eating behaviour of people with a lower socioeconomic position: a scoping review of behaviour change techniques. BMC Nutr 2022; 8:145. [PMID: 36482430 PMCID: PMC9733085 DOI: 10.1186/s40795-022-00635-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 11/10/2022] [Indexed: 12/13/2022] Open
Abstract
Specific approaches are needed to reach and support people with a lower socioeconomic position (SEP) to achieve healthier eating behaviours. There is a growing body of evidence suggesting that digital health tools exhibit potential to address these needs because of its specific features that enable application of various behaviour change techniques (BCTs). The aim of this scoping review is to identify the BCTs that are used in diet-related digital interventions targeted at people with a low SEP, and which of these BCTs coincide with improved eating behaviour. The systematic search was performed in 3 databases, using terms related to e/m-health, diet quality and socioeconomic position. A total of 17 full text papers were included. The average number of BCTs per intervention was 6.9 (ranged 3-15). BCTs from the cluster 'Goals and planning' were applied most often (25x), followed by the clusters 'Shaping knowledge' (18x) and 'Natural consequences' (18x). Other frequently applied BCT clusters were 'Feedback and monitoring' (15x) and 'Comparison of behaviour' (13x). Whereas some BCTs were frequently applied, such as goal setting, others were rarely used, such as social support. Most studies (n = 13) observed a positive effect of the intervention on eating behaviour (e.g. having breakfast) in the low SEP group, but this was not clearly associated with the number or type of applied BCTs. In conclusion, more intervention studies focused on people with a low SEP are needed to draw firm conclusions as to which BCTs are effective in improving their diet quality. Also, further research should investigate combinations of BCTs, the intervention design and context, and the use of multicomponent approaches. We encourage intervention developers and researchers to describe interventions more thoroughly, following the systematics of a behaviour change taxonomy, and to select BCTs knowingly.
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Affiliation(s)
- Amber Ronteltap
- grid.438049.20000 0001 0824 9343Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA Utrecht, The Netherlands
| | - Andrea J. Bukman
- grid.438049.20000 0001 0824 9343Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences Utrecht, P.O. box 12011, 3501 AA Utrecht, The Netherlands
| | - Gera E. Nagelhout
- IVO Research Institute, The Hague, The Netherlands ,grid.5012.60000 0001 0481 6099Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Roel C. J. Hermans
- grid.5012.60000 0001 0481 6099Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands ,grid.491176.c0000 0004 0395 4926Netherlands Nutrition Centre, The Hague, The Netherlands
| | | | - Annemien Haveman-Nies
- grid.4818.50000 0001 0791 5666Consumption and Healthy Lifestyles Group, Wageningen University & Research, Wageningen, The Netherlands
| | - Remko Lupker
- grid.36120.360000 0004 0501 5439Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
| | - Catherine A. W. Bolman
- grid.36120.360000 0004 0501 5439Faculty of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
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Li Y, Babazono A, Jamal A, Liu N, Fujita T, Zhao R, Maeno Y, Su Y, Liang L, Yao L. The impact of lifestyle guidance intervention on health outcomes among Japanese middle-aged population with metabolic syndrome: A regression discontinuity study. Soc Sci Med 2022; 314:115468. [PMID: 36327638 DOI: 10.1016/j.socscimed.2022.115468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 09/28/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Metabolic syndrome (MetS) prevalence has increased globally with considerable morbidity and economic burden at both individual and national levels. Japan is the first and only country that has introduced a nationwide lifestyle guidance intervention program to manage and control MetS. We conducted a quasi-experiment approach-regression discontinuity design-to evaluate the impact of this intervention on health outcomes at the population level. We retrospectively collected data of adults aged ≥35 years who participated in health checkups in 2015. Age in 2015 was used as the assignment variable, and an age of 40 years old was the threshold because those with MetS aged ≥40 were required to receive lifestyle guidance intervention. Among 26,772 MetS adults, those who received the intervention had significant reductions in obesity measurements (bodyweight, waist circumference, and body mass index [BMI]) after 1 year of this intervention. Blood pressure was also significantly reduced in men after 1 year of undertaking the intervention. The results were similar when including demographic, socioeconomic, and behavioral covariates and using alternative functional forms to estimate the impact, or when bandwidths around intervention thresholds were changed. Our results showed that lifestyle guidance intervention for MetS has an important impact on weight loss and blood pressure reduction at the population level. This intervention could address the high burden of obesity and cardiovascular diseases in Japan and other countries with an unmet need for MetS prevention and management.
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Affiliation(s)
- Yunfei Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan; Department of Health Care Administration & Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Akira Babazono
- Department of Health Care Administration & Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aziz Jamal
- Health Administration Program, Faculty of Business & Management, Universiti Teknologi MARA, Selangor, Malaysia.
| | - Ning Liu
- Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Takako Fujita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Rui Zhao
- National Center for Medicine and Technology Assessment, China National Health Development Research Center, Beijing, China
| | - Yukari Maeno
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ya Su
- Shanghai Jiao Tong University, School of Nursing, Shanghai, China
| | - Lifan Liang
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Lan Yao
- School of Medicine & Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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22
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Hasannejadasl H, Roumen C, Smit Y, Dekker A, Fijten R. Health Literacy and eHealth: Challenges and Strategies. JCO Clin Cancer Inform 2022; 6:e2200005. [DOI: 10.1200/cci.22.00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Given the impact of health literacy (HL) on patients' outcomes, limited health literacy is a major barrier to improve cancer care globally. HL refers to the degree in which an individual is able to acquire, process, and comprehend information in a way to be actively involved in their health decisions. Previous research found that almost half of the population in developed countries have difficulties in understanding health-related information. With the gradual shift toward the shared decision making process and digital transformation in oncology, the need for addressing low HL issues is crucial. Decision making in oncology is often accompanied by considerable consequences on patients' lives, which requires patients to understand complex information and be able to compare treatment methods by considering their own values. How health information is perceived by patients is influenced by various factors including patients' characteristics and the way information is presented to patients. Currently, identifying patients with low HL and simple data visualizations are the best practice to help patients and clinicians in dealing with limited health literacy. Furthermore, using eHealth, as well as involving HL mediators, supports patients to make sense of complex information.
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Affiliation(s)
- Hajar Hasannejadasl
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Cheryl Roumen
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Yolba Smit
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andre Dekker
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Rianne Fijten
- Department of Radiation Oncology (MAASTRO), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
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23
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Ross HM, Hosman L, Baikie B, Blau E, Simpson CJ. SolarSPELL health and education: global solutions with local impacts. JOURNAL OF GLOBAL HEALTH REPORTS 2022. [DOI: 10.29392/001c.38734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background People in remote regions of developing nations have poor health outcomes with lower life expectancy and quality of life compared to higher-resourced areas. Remote communities typically lack stable access to high-quality health services. International humanitarian and development organizations including the United States Peace Corps have a longstanding history of delivering critical services. However, limited infrastructure including access to reliable electricity or internet restricts development workers’ ability to provide effective health services to rural communities. Technology that enhances health education and service delivery in remote communities may improve health outcomes by impacting health knowledge and behavior. Methods We partnered with U.S. Peace Corps to provide portable, solar-powered educational learning libraries (SolarSPELL; www.solarspell.org) to remote communities in Pacific Island nations beginning in 2015 with Peace Corps Vanuatu educational volunteers and expanded in 2017 to include health volunteers (SolarSPELL Health). We conducted ethnographic observation and interviews with Vanuatu Peace Corps volunteers, Ministry of Health officials, and local residents of rural communities. We then conducted a comprehensive evidence review to identify current best practices for assessing and treating the most common conditions. We designed simple 2-page documents with assessment and treatment guidelines, reflecting evidence-based best practices, local culture, and resource availability. Each document was accompanied by a whiteboard video featuring simple drawings and narration designed for Peace Corps volunteers and local community members. Results We report on findings from a pilot study focused on education for treating low back pain. Preliminary findings indicate significantly increased knowledge for Peace Corps volunteers (p<.01), along with non-significantly increased self-efficacy scores (p=.169). Interview data indicate high levels of satisfaction with the SolarSPELL technology, and widespread community utilization among Peace Corps volunteers and community residents. Conclusions Tailored health content on the SolarSPELL platform increases knowledge about critical health topics among Peace Corps volunteers in under-resourced rural communities. The platform and education may have a positive impact on self-efficacy. However, high baseline levels of self-efficacy noted among Peace Corps volunteers may explain the failure to reach statistically significant increases in self-efficacy scores. This finding merits further study. Future work includes measuring individual and community health outcomes, quality of life, and cost benefit resulting from reductions in lost work and transfers for advanced health services. We plan continued implementation and content expansion of SolarSPELL Health in Vanuatu and additional global sites.
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Affiliation(s)
- Heather M. Ross
- School for the Future of Innovation in Society; Edson College of Nursing and Health Innovation, Arizona State University, Tempe, USA
| | - Laura Hosman
- School for the Future of Innovation in Society, Arizona State University, Tempe, USA
| | - Bruce Baikie
- School for the Future of Innovation in Society, Arizona State University, Tempe, USA
| | - Emily Blau
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, USA
| | - Carol J. Simpson
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, USA
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Albrecht J, Stark AL, Dongas E, Wrona KJ, Dockweiler C. Hosting an Online World Café to Develop an Understanding of Digital Health Promoting Settings from a Citizen's Perspective-Methodological Potentials and Challenges. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9969. [PMID: 36011601 PMCID: PMC9408369 DOI: 10.3390/ijerph19169969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/29/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Brown and Isaacs' World Café is a participatory research method to make connections to the ideas of others. During the SARS-CoV-2 pandemic and the corresponding contact restrictions, only digital hostings of World Cafés were possible. This article aims to present and reflect on the potentials and challenges of hosting online World Cafés and to derive recommendations for other researchers. Via Zoom and Conceptboard, three online World Cafés were conducted in August 2021. In the World Cafés, the main focus was on the increasing digitization in settings in the context of health promotion and prevention from the perspective of setting members of educational institutions, leisure clubs, and communities. Between 9 and 13 participants participated in three World Cafés. Hosting comprises the phases of design and preparation, realisation, and evaluation. Generally, hosting an online World Café is a suitable method for participatory engagement, but particular challenges have to be overcome. Overall café hosts must create an equal participation environment by ensuring the availability of digital devices and stable internet access. The event schedule must react flexibly to technical disruptions and varying participation numbers. Further, compensatory measures such as support in the form of technical training must be implemented before the event. Finally, due to the higher complexity of digitalisation, roles of participants and staff need to be distributed and coordinated.
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Affiliation(s)
- Joanna Albrecht
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, 57076 Siegen, Germany
| | - Anna Lea Stark
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, 57076 Siegen, Germany
| | - Eleana Dongas
- Department Demography and Health, School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
| | - Kamil J. Wrona
- Faculty of Health, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany
- Faculty of Engineering and Mathematics, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany
| | - Christoph Dockweiler
- Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, 57076 Siegen, Germany
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25
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Wang X, Luan W. Research progress on digital health literacy of older adults: A scoping review. Front Public Health 2022; 10:906089. [PMID: 35991040 PMCID: PMC9389004 DOI: 10.3389/fpubh.2022.906089] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022] Open
Abstract
With the rapid development of digital health today, the lack of digital health literacy in older adults is an urgent problem. It is crucial that older adults adapt to the digital reform in medical treatment, pension, health management, and other fields. Therefore, we reviewed the current development status of digital health literacy among older adults. A total of 47 articles were included in this scoping review. Our findings revealed that research on digital health literacy in older adults is still in its infancy. Further development is warranted especially in terms of assessment tools and intervention methods.
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Affiliation(s)
- Xinxin Wang
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Wei Luan
- Department of VIP Service, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Wei Luan
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26
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Flynn AC, Suleiman F, Windsor‐Aubrey H, Wolfe I, O'Keeffe M, Poston L, Dalrymple KV. Preventing and treating childhood overweight and obesity in children up to 5 years old: A systematic review by intervention setting. MATERNAL & CHILD NUTRITION 2022; 18:e13354. [PMID: 35333450 PMCID: PMC9218326 DOI: 10.1111/mcn.13354] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/25/2022] [Accepted: 03/07/2022] [Indexed: 01/01/2023]
Abstract
The prevalence of childhood obesity is increasing worldwide with long-term health consequences. Effective strategies to stem the rising childhood obesity rates are needed but systematic reviews of interventions have reported inconsistent effects. Evaluation of interventions could provide more practically relevant information when considered in the context of the setting in which the intervention was delivered. This systematic review has evaluated diet and physical activity interventions aimed at reducing obesity in children, from birth to 5 years old, by intervention setting. A systematic review of the literature, consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed. Three electronic databases were searched from 2010 up to December 2020 for randomised controlled trials aiming to prevent or treat childhood obesity in children up to 5 years old. The studies were stratified according to the setting in which the intervention was conducted. Twenty-eight studies were identified and included interventions in childcare/school (n = 11), home (n = 5), community (n = 5), hospital (n = 4), e-health (n = 2) and mixed (n = 1) settings. Thirteen (46%) interventions led to improvements in childhood obesity measures, including body mass index z-score and body fat percentage, 12 of which included both parental/family-based interventions in conjunction with modifying the child's diet and physical activity behaviours. Home-based interventions were identified as the most effective setting as four out of five studies reported significant changes in the child's weight outcomes. Interventions conducted in the home setting and those which included parents/families were effective in preventing childhood obesity. These findings should be considered when developing optimal strategies for the prevention of childhood obesity.
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Affiliation(s)
- Angela C. Flynn
- Department of Women and Children's HealthKing's College LondonLondonUK
- Department of Nutritional Sciences, School of Life Course SciencesKing's College LondonLondonUK
| | - Fatma Suleiman
- Department of Nutritional Sciences, School of Life Course SciencesKing's College LondonLondonUK
| | - Hazel Windsor‐Aubrey
- Department of Nutritional Sciences, School of Life Course SciencesKing's College LondonLondonUK
| | - Ingrid Wolfe
- Department of Women and Children's HealthKing's College LondonLondonUK
- Institute for Women and Children's HealthKing's Health Partners'LondonUK
| | - Majella O'Keeffe
- School of Food and Nutritional SciencesUniversity College CorkCorkIreland
| | - Lucilla Poston
- Department of Women and Children's HealthKing's College LondonLondonUK
- Institute for Women and Children's HealthKing's Health Partners'LondonUK
| | - Kathryn V. Dalrymple
- Department of Women and Children's HealthKing's College LondonLondonUK
- Institute for Women and Children's HealthKing's Health Partners'LondonUK
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27
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da Silva Teixeira R, Garcia de Siqueira Galil A, Cupertino AP, Cartujano-Barrera F, Basile Colugnati FA. Effectiveness of a smoking cessation decision-making electronic tool ( Pare de Fumar Conosco): A randomized clinical trial. Health Informatics J 2022; 28:14604582221105450. [DOI: 10.1177/14604582221105450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is an underutilization of smoking cessation treatment among patients with chronic conditions, which indicates a need for new strategies to engage them. Web-based smoking cessation decision-making tools can be beneficial. This study assessed the effectiveness of the Pare de Fumar Conosco software at increasing engagement to smoking cessation counseling groups among Brazilian smokers with chronic conditions. Clinical trial participants were randomized to Pare de Fumar Conosco or standard of care. Engagement in the smoking cessation counseling group was the primary outcome. Secondary outcomes included motivation level, cessation rate, completion, and treatment adherence. The t-tests and Chi-square analyzed baseline differences between groups and the Poisson models, the effects of the intervention. Engagement rates were higher in the Pare de Fumar Conosco (IR=2.22; 95% CI: 1.06 - 4.63) concerning the standard of care. Pare de Fumar Conosco group was more adherent to treatment over time (6.4% versus 4.2% in the final week). Cessation rate was 26.3% in standard care and 23.1% in Pare de Fumar Conosco. Both interventions maintained significant motivation levels to quit smoking. The Pare de Fumar Conosco intervention effectively increases the engagement in the smoking cessation counseling groups. There is a need to improve the smoking cessation rate.
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Affiliation(s)
| | | | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, USA
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28
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Yeung AWK, Kulnik ST, Parvanov ED, Fassl A, Eibensteiner F, Völkl-Kernstock S, Kletecka-Pulker M, Crutzen R, Gutenberg J, Höppchen I, Niebauer J, Smeddinck JD, Willschke H, Atanasov AG. Research on Digital Technology Use in Cardiology: Bibliometric Analysis. J Med Internet Res 2022; 24:e36086. [PMID: 35544307 PMCID: PMC9133979 DOI: 10.2196/36086] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/11/2022] Open
Abstract
Background Digital technology uses in cardiology have become a popular research focus in recent years. However, there has been no published bibliometric report that analyzed the corresponding academic literature in order to derive key publishing trends and characteristics of this scientific area. Objective We used a bibliometric approach to identify and analyze the academic literature on digital technology uses in cardiology, and to unveil popular research topics, key authors, institutions, countries, and journals. We further captured the cardiovascular conditions and diagnostic tools most commonly investigated within this field. Methods The Web of Science electronic database was queried to identify relevant papers on digital technology uses in cardiology. Publication and citation data were acquired directly from the database. Complete bibliographic data were exported to VOSviewer, a dedicated bibliometric software package, and related to the semantic content of titles, abstracts, and keywords. A term map was constructed for findings visualization. Results The analysis was based on data from 12,529 papers. Of the top 5 most productive institutions, 4 were based in the United States. The United States was the most productive country (4224/12,529, 33.7%), followed by United Kingdom (1136/12,529, 9.1%), Germany (1067/12,529, 8.5%), China (682/12,529, 5.4%), and Italy (622/12,529, 5.0%). Cardiovascular diseases that had been frequently investigated included hypertension (152/12,529, 1.2%), atrial fibrillation (122/12,529, 1.0%), atherosclerosis (116/12,529, 0.9%), heart failure (106/12,529, 0.8%), and arterial stiffness (80/12,529, 0.6%). Recurring modalities were electrocardiography (170/12,529, 1.4%), angiography (127/12,529, 1.0%), echocardiography (127/12,529, 1.0%), digital subtraction angiography (111/12,529, 0.9%), and photoplethysmography (80/12,529, 0.6%). For a literature subset on smartphone apps and wearable devices, the Journal of Medical Internet Research (20/632, 3.2%) and other JMIR portfolio journals (51/632, 8.0%) were the major publishing venues. Conclusions Digital technology uses in cardiology target physicians, patients, and the general public. Their functions range from assisting diagnosis, recording cardiovascular parameters, and patient education, to teaching laypersons about cardiopulmonary resuscitation. This field already has had a great impact in health care, and we anticipate continued growth.
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Affiliation(s)
- Andy Wai Kan Yeung
- Division of Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.,Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Stefan Tino Kulnik
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Emil D Parvanov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Translational Stem Cell Biology, Research Institute of the Medical University of Varna, Varna, Bulgaria
| | - Anna Fassl
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Fabian Eibensteiner
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Division of Pediatric Nephrology and Gastroenterology, Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Sabine Völkl-Kernstock
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Maria Kletecka-Pulker
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute for Ethics and Law in Medicine, University of Vienna, Vienna, Austria
| | - Rik Crutzen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Johanna Gutenberg
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Isabel Höppchen
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,Center for Human Computer Interaction, Paris Lodron University Salzburg, Salzburg, Austria
| | - Josef Niebauer
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria.,University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg, Salzburg, Austria.,REHA Zentrum Salzburg, Salzburg, Austria
| | - Jan David Smeddinck
- Ludwig Boltzmann Institute for Digital Health and Prevention, Salzburg, Austria
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| | - Atanas G Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.,Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
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Turmaine K, Dumas A, Chevreul K. Conditions for the Successful Integration of an eHealth Tool "StopBlues" Into Community-Based Interventions in France: Results From a Multiple Correspondence Analysis. J Med Internet Res 2022; 24:e30218. [PMID: 35451977 PMCID: PMC9077507 DOI: 10.2196/30218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 09/23/2021] [Accepted: 10/29/2021] [Indexed: 11/30/2022] Open
Abstract
Background For over a decade, digital health has held promise for enabling broader access to health information, education, and services for the general population at a lower cost. However, recent studies have shown mixed results leading to a certain disappointment regarding the benefits of eHealth technologies. In this context, community-based health promotion represents an interesting and efficient conceptual framework that could help increase the adoption of digital health solutions and facilitate their evaluation. Objective To understand how the local implementation of the promotion of an eHealth tool, StopBlues (SB), aimed at preventing psychological distress and suicide, varied according to local contexts and if the implementation was related to the use of the tool. Methods The study was nested within a cluster-randomized controlled trial that was conducted to evaluate the effectiveness of the promotion, with before and after observation (NCT03565562). Data from questionnaires, observations, and institutional sources were collected in 27 localities where SB was implemented. A multiple correspondence analysis was performed to assess the relations between context, type of implementation and promotion, and use of the tool. Results Three distinct promotion patterns emerged according to the profiles of the localities that were associated with specific SB utilization rates. From highest to lowest utilization rates, they are listed as follows: the privileged urban localities, investing in health that implemented a high-intensity and digital promotion, demonstrating a greater capacity to take ownership of the project; the urban, but less privileged localities that, in spite of having relatively little experience in health policy implementation, managed to implement a traditional and high-intensity promotion; and the rural localities, with little experience in addressing health issues, that implemented low-intensity promotion but could not overcome the challenges associated with their local context. Conclusions These findings indicate the substantial influence of local context on the reception of digital tools. The urban and socioeconomic status profiles of the localities, along with their investment and pre-existing experience in health, appear to be critical for shaping the promotion and implementation of eHealth tools in terms of intensity and use of digital communication. The more digital channels used, the higher the utilization rates, ultimately leading to the overall success of the intervention. International Registered Report Identifier (IRRID) RR2-10.1186/s13063-020-04464-2
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Affiliation(s)
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, Inserm, Paris, France
| | - Karine Chevreul
- Université Paris Cité, ECEVE, UMR 1123, Inserm, Paris, France.,Assistance Publique-Hôpitaux de Paris, URC Eco Ile-de-France, Paris, France, Paris, France.,Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, Paris, France
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- See Authors' Contributions,
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De Groot K, Douma J, Paans W, Francke AL. Patient participation in electronic nursing documentation: An interview study among home-care patients. Health Expect 2022; 25:1508-1516. [PMID: 35384167 PMCID: PMC9327866 DOI: 10.1111/hex.13492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 01/04/2022] [Accepted: 03/24/2022] [Indexed: 11/27/2022] Open
Abstract
Background Patients are increasingly expected to take an active role in their own care. Participation in nursing documentation can support patients to take this active role since it provides opportunities to express care needs and preferences. Yet, patient participation in electronic nursing documentation is not self‐evident. Objective To explore how home‐care patients perceive their participation in electronic nursing documentation. Methods Semi‐structured interviews were conducted with 21 home‐care patients. Interview transcripts were analysed in an iterative process based on the principles of reflexive inductive thematic analysis. Results We identified a typology with four patient types: ‘high need, high ability’, ‘high need, low ability’, ‘low need, high ability’ and ‘low need, low ability’. Several patients felt a need for participation because of their personal interest in health information. Others did not feel such a need since they trusted nurses to document the information that is important. Patients' ability to participate increased when they could read the documentation and when nurses helped them by talking about the documentation. Barriers to patients' ability to participate were having no electronic devices or lacking digital skills, a lack of support from nurses and the poor usability of electronic patient portals. Conclusion Patient participation in electronic nursing documentation varies between patients since home‐care patients differ in their need and ability to participate. Nurses should tailor their encouragement of patient participation to individual patients' needs and abilities. Furthermore, they should be aware of their own role and help patients to participate in the documentation. Patient or Public Contribution Home‐care patients were involved in the interviews.
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Affiliation(s)
- Kim De Groot
- Departement of Nursing Care and Elderly Care, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.,Thebe Wijkverpleging (Home-Care Organisation), Tilburg, The Netherlands
| | - Judith Douma
- Nursing Science, Programme in Clinical Health Sciences, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Wolter Paans
- Research Group Nursing Diagnostics, Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Department of Critical Care, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anneke L Francke
- Departement of Nursing Care and Elderly Care, Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Hurmuz MZ, Jansen-Kosterink SM, Hermens HJ, van Velsen L. Game not over: Explaining older adults' use and intention to continue using a gamified eHealth service. Health Informatics J 2022; 28:14604582221106008. [PMID: 35653268 DOI: 10.1177/14604582221106008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gamification within eHealth services can increase eHealth adoption. However, little is known about factors affecting adoption of gamified eHealth among older adults. In this study, we sought to explain the (continued) use of a gamified eHealth service among older adults (55+). METHODS Participants used a gamified eHealth service, focusing on falls prevention, for 4 weeks and completed a post-test questionnaire based on the Technology Acceptance Model. We used Partial Least Squares Structural Equation Modeling to analyse our data. RESULTS Seventy-two older adults participated with a mean age of 65.1 years (SD = 7.0). Our results show that first, perceived ease of use affected use of the service (use duration: β = 0.303, R2 = 0.130, and use frequency: β = 0.304, R2 = 0.107). Second, perceived usefulness affected the intention to continue using the service (β = 0.754, R2 = 0.640). Third, use of the service did not predict the intention to continue using it. Furthermore, enjoyment affected perceived usefulness (β = 0.783, R2 = 0.563) and aesthetics affected perceived ease of use (β = 0.634, R2 = 0.652). CONCLUSIONS This study refutes the expected relation between use and intention to continue use a gamified eHealth service. Additionally, we learned that using theoretical approaches focusing on technology acceptance, are not suitable for explaining (continued) use of gamified eHealth services.
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Affiliation(s)
- Marian Zm Hurmuz
- eHealth Department, Roessingh Research and Development, Enschede, The Netherlands
| | | | - Hermie J Hermens
- Biomedical Signal and Systems Group, 3230University of Twente, Enschede, The Netherlands
| | - Lex van Velsen
- Biomedical Signal and Systems Group, 3230University of Twente, Enschede, The Netherlands
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Moran O, Doyle J, Giggins O, McHugh L, Gould E, Smith S, Gavin S, Sojan N, Boyle G. Efficacy of a Digital Acceptance and Commitment Therapy Intervention for the Improvement of Self-management Behaviors and Psychological Flexibility in Adults With Cardiac Disease: Protocol for a Single Case Experimental Design. JMIR Res Protoc 2022; 11:e33783. [PMID: 35363156 PMCID: PMC9015764 DOI: 10.2196/33783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Research indicates that the management of distress levels in those with cardiac disease is not only important for improving quality of life and functioning but also critical for condition management; adherence to treatment; and, ultimately, disease prognosis and progression. Acceptance and commitment therapy (ACT) has consistently demonstrated positive long-term outcomes across a wide array of conditions, including chronic illness. However, most empirical investigations conducted to date have also involved in-person therapy, which can be difficult to access, particularly for those dealing with the demands of chronic disease. OBJECTIVE The objective of our research is to evaluate a digital ACT intervention for improving self-management behaviors and distress levels in those with cardiac conditions. METHODS The digital ACT intervention will be delivered via a digital health self-management platform over 6 sessions. This will involve a randomized, multiple baseline, single case experimental design with approximately 3 to 15 adults with cardiac disease. The independent variable for each participant will be the pre-post intervention phase. The dependent variables will be a daily self-report measure of psychological flexibility as well as objective measures of condition self-management (eg, blood pressure readings) and engagement with the app (eg, completing guided mindfulness). One-to-one qualitative interviews will also be conducted to further examine participants' experiences with using the intervention and what factors contribute to or impede successful outcomes. RESULTS Participant recruitment and data collection began in October 2021, and it is projected that the study findings will be available for dissemination by spring 2022. CONCLUSIONS The findings will be discussed in terms of how a digital ACT intervention can best meet the needs of cardiac patients. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/33783.
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Affiliation(s)
- Orla Moran
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Julie Doyle
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Oonagh Giggins
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Evelyn Gould
- Harvard Medical School, Boston, MA, United States
| | - Suzanne Smith
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Shane Gavin
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Nisanth Sojan
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
| | - Gordon Boyle
- NetwellCASALA, Dundalk Institute of Technology, Dundalk, Ireland
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Blee SM, Facdol J, Dixon MD, Master V, Switchenko JM, Pentz RD. Dissemination of validated health literacy videos: A tailored approach. Cancer Med 2022; 11:1678-1687. [PMID: 35107221 PMCID: PMC8986138 DOI: 10.1002/cam4.4572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 12/05/2021] [Accepted: 12/20/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Previously, we showed that chemotherapy terminology is difficult for patients to understand. Therefore, we developed short videos explaining key terminology and though proven effective, they will only be helpful if appropriately disseminated. Therefore, we aimed to determine the best dissemination method at three different healthcare settings. METHODS With consent, we interviewed healthcare workers from (1) an academic cancer center, Winship Cancer Institute (Winship) serving higher SES patients, (2) an inner-city, safety-net hospital Grady Memorial (GMH), (3) clinics serving rural Georgia, from the Winship Community Network (Network). All interviews were transcribed and analyzed using a semantic content analysis method. Suggested dissemination plans were then implemented. RESULTS Twenty-two Winship, 11 GMH, and 4 Network healthcare workers were interviewed. Seventy-two percent (n = 8) of the GMH and 100% (n = 4) of Network healthcare workers felt that the best place for patients to view the videos was in the clinic, compared to 27% (n = 6) of the Winship clinicians. 68% (n = 15) of the Winship clinicians stated an app would be the most useful format, compared to 27% (n = 3) at GMH, and 0% at Network sites. Video viewing increased after dissemination plans were implemented. CONCLUSION Educational materials explaining oncology treatment terminology enhance patient understanding, yet without proper dissemination, these tools may never reach the intended patient population. Our study shows that dissemination plans need to be tailored to each individual patient population, with rural and lower SES patients needing to view the videos during clinic visits, and patients of more means viewing them using technology at home.
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Affiliation(s)
- Shannon M Blee
- Emory University Winship Cancer Institute, Atlanta, Georgia, USA
| | | | - Margie D Dixon
- Emory University Winship Cancer Institute, Atlanta, Georgia, USA.,Emory University School of Medicine, Atlanta, Georgia, USA
| | - Viraj Master
- Emory University Winship Cancer Institute, Atlanta, Georgia, USA.,Emory University School of Medicine, Atlanta, Georgia, USA
| | | | - Rebecca D Pentz
- Emory University Winship Cancer Institute, Atlanta, Georgia, USA.,Emory University School of Medicine, Atlanta, Georgia, USA
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McIntosh C, Elvin A, Smyth W, Birks M, Nagle C. Health Promotion, Health Literacy and Vaccine Hesitancy: The Role of Humanoid Robots. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221078515. [PMID: 35341351 PMCID: PMC8961352 DOI: 10.1177/00469580221078515] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The use of humanoid robot technologies within global healthcare settings is rapidly evolving; however, the potential of robots in health promotion and health education is not established. The aim of this study was to explore the impact of a social humanoid robot on individuals' knowledge of influenza (flu) prevention and attitudes towards influenza vaccination. A multi-methods approach involving pre and post-test questions and interviews was used. The study was undertaken in a publicly funded tertiary level hospital in northern Queensland, Australia. Of the 995 participants, the majority were visitors (53.07%). The mean age of the participants was 42.25 (SD=19.54) years. Based on the three knowledge questions that were posed at the two-point interactions of participants with the humanoid robot 'Pepper', the results showed that there was a significant difference in the correct responses pre- and post-test regarding the best way to avoid getting the flu (Exact McNemar significance probability <.0001), how long the flu virus can live outside the human body (p <.0001) and the length of time for handwashing to be effective against spreading germs (p <.0001). The results also showed that there was a significant difference in attitudes associated with influenza vaccination when pre-test was compared to post-test (p=.0019). Interaction of the participants with the humanoid robot demonstrated immediate knowledge gains and attitudinal change that suggests that humanoid robots may be an important intervention for health promotion in prevention of influenza and other respiratory viruses.
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Affiliation(s)
- Christine McIntosh
- Townsville Hospital and Health
Service,100 Angus Smith Drive, Douglas QLD Australia
| | - Anne Elvin
- Townsville Hospital and Health
Service,100 Angus Smith Drive, Douglas QLD Australia
| | - Wendy Smyth
- Townsville Hospital and Health
Service,100 Angus Smith Drive, Douglas QLD Australia
- James Cook University, Centre for Nursing and Midwifery Research, Townsville, QLD
Australia
| | - Melanie Birks
- James Cook University, Centre for Nursing and Midwifery Research, Townsville, QLD
Australia
| | - Cate Nagle
- Townsville Hospital and Health
Service,100 Angus Smith Drive, Douglas QLD Australia
- James Cook University, Centre for Nursing and Midwifery Research, Townsville, QLD
Australia
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35
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Bardus M, Keriabian A, Elbejjani M, Al-Hajj S. Assessing eHealth literacy among internet users in Lebanon: A cross-sectional study. Digit Health 2022; 8:20552076221119336. [PMID: 35968030 PMCID: PMC9373133 DOI: 10.1177/20552076221119336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/25/2022] [Indexed: 12/31/2022] Open
Abstract
Objective Assessing the level of eHealth literacy in a population is essential to
designing appropriate public health interventions. This study aimed to
assess eHealth literacy among adult internet users in Lebanon, recruited
through social media and printed materials. The study examined the
relationship between internet use, perceived eHealth literacy, and
sociodemographic characteristics. Methods A cross-sectional study based on a web-based questionnaire was conducted
between January and May 2020. The survey assessed internet use and eHealth
literacy using the homonymous scale (eHEALS) in English and Arabic.
Cronbach's alpha and factor analyses were used to evaluate eHEALS’
psychometric properties. A generalized linear model was used to identify
factors predicting the eHEALS. Results A total of 2715 respondents were recruited mostly through Facebook (78%) and
printed materials (17%). Most respondents completed the survey in English
(82%), were aged 30 ± 11 years, female (60%), Lebanese (84%), unmarried
(62%), employed (54%), and with a graduate-level education (53%). Those who
completed the eHEALS questionnaire (n = 2336) had a
moderate eHealth literacy (M = 28.7,
SD = 5.5). eHEALS was significantly higher among older
females with a high education level, recruited from Facebook, Instagram, or
ResearchGate, and perceived the Internet as a useful and important source of
information. Conclusions Future internet-delivered public health campaigns in Lebanon should account
for moderate-to-low levels of eHealth literacy and find ways to engage older
males with low education levels representing neglected segments (e.g.
Syrians). To be more inclusive, campaigns should reach neglected population
segments through non-digital, community-based outreach activities.
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Affiliation(s)
- Marco Bardus
- Institute of Applied Health Research, University of Birmingham, Edgbaston, UK
- Department of Health Promotion & Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Arda Keriabian
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Martine Elbejjani
- Clinical Research Institute & Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Samar Al-Hajj
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Moran O, Doyle J, Smith S, Giggins O, Dinsmore J. Investigating the needs and concerns of older adults with multimorbidity and their healthcare professionals for conceivable digital psychotherapeutic interventions. Digit Health 2022; 8:20552076221089097. [PMID: 35646383 PMCID: PMC9131374 DOI: 10.1177/20552076221089097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/06/2022] [Indexed: 11/15/2022] Open
Abstract
Multimorbidity, defined as the concurrent experience of more than one chronic health condition in an individual, affects ∼65% of people over 65 and 85% of those over 85 years old with 30% of those also experiencing mental health concerns. This can lead to reduced quality of life and functioning as well as poorer outcomes in terms of condition management, adherence to treatment, and ultimately disease prognosis and progression. Digital health interventions offer a viable means of condition self-management, as well as psychological support, particularly for those who may have difficulty accessing in-person services. To best meet the needs of older adults with multimorbidity, deeper insights are needed into their specific concerns and issues around condition management, particularly with regard to distress in relation to managing one's condition. The present study aimed to explore this using one-to-one qualitative interviews and focus groups with people with chronic health conditions and healthcare professionals. Participants were 11 older adults with multimorbidity (4 males; mean age: M = 72.7 years) and 14 healthcare professionals including five clinical nurse specialists, four pharmacists, two general practitioners, one occupational therapist, one speech and language therapist and one dietician. Thematic analysis was used to identify key themes, which included: patient feelings of anxiety or worry leading to an unwillingness to access essential information; the various mental health challenges faced by those with multimorbidity; the importance of personal values in providing motivation; and the importance of social support. Findings are discussed in relation to the potential development of transdiagnostically applicable digital interventions for the management of distress in those with multimorbidity.
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Affiliation(s)
- Orla Moran
- NetwellCASALA, Dundalk Institute of Technology, Co. Louth, Ireland
| | - Julie Doyle
- NetwellCASALA, Dundalk Institute of Technology, Co. Louth, Ireland
| | - Suzanne Smith
- NetwellCASALA, Dundalk Institute of Technology, Co. Louth, Ireland
| | - Oonagh Giggins
- NetwellCASALA, Dundalk Institute of Technology, Co. Louth, Ireland
| | - John Dinsmore
- Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin, School of Nursing and Midwifery, Dublin 2, Ireland
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Jiang S, Hong YA. Clinical trial participation in America: The roles of eHealth engagement and patient-provider communication. Digit Health 2021; 7:20552076211067658. [PMID: 34925874 PMCID: PMC8679028 DOI: 10.1177/20552076211067658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/01/2021] [Indexed: 11/18/2022] Open
Abstract
Objective Public participation in a clinical trial is the foundation of clinical
research and the cornerstone for the discovery of new treatment and
improving health outcomes. This study aims to examine how eHealth
engagement, patient–provider communication, and clinical trial knowledge are
associated with clinical trial participation in the United States. Methods Data were drawn from the Health Information National Trends Survey Iteration
5 Cycle 4 conducted in 2020. The sample included 3865 American adults aged
18 years and above. Path analysis using structural equation modeling and
hierarchical linear regression was performed to examine the effects of
eHealth engagement and patient–provider communication on clinical trial
participation. Results About 5% of American adults have ever participated in a clinical trial.
Younger adults, males, minorities, and people with lower education, less
clinical trial knowledge, and less eHealth engagement were less likely to
participate. After controlling for demographic variables, we found that more
eHealth engagement led to a better knowledge of clinical trials, which was
strongly associated with participation. Further, patient-centered
communication did not directly lead to clinical trial participation;
instead, it positively moderated the relationship between clinical trial
knowledge and participation. Conclusions The national survey data indicate that American participation in clinical
trials remains low and a significant disparity exists. Within the context of
the eHealth movement, it is critical to implement targeted interventions to
improve clinical trial knowledge, address the digital divide, and enhance
patient-centered communication.
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Affiliation(s)
- Shaohai Jiang
- Department of Communications and New Media, National University of Singapore, Singapore.,Both authors contribute equally
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, USA.,Both authors contribute equally
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User-Guided Design of a Digital Tool for Health Promotion and Radiation Protection: Results from an Internet Needs Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212007. [PMID: 34831763 PMCID: PMC8621715 DOI: 10.3390/ijerph182212007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/26/2022]
Abstract
Background: Digital tools can be powerful and effective in connecting people with life-saving and health-promoting support when facing a health crisis. To develop a digital application for radiation protection and health promotion for evacuees returning home after the Fukushima nuclear accident, we conducted a needs assessment survey and explored the association of people’s eHealth literacy (eHL) level with their digital tool knowledge, attitudes, and practice (KAP). Methods: From 339 responses to an online survey, data from 264 lay persons were analyzed. The KAP items were those used in a prior EU project, and eHL levels were assessed with a Japanese version of the eHealth Literacy Scale. Results: Multivariable analyses showed significant associations between eHL and the digital tool KAP for radiation protection (knowledge: adjusted odds ratio (aOR) = 1.10; attitude: 1.06; practice: 1.10) and for health promotion (knowledge: aOR = 1.13; attitude: 1.06; practice: 1.16). Conclusions: People with a higher eHL had a more positive KAP. For those with a lower eHL, we are formulating easy-to-understand explanations to promote the utilization of the digital tool and enthusiasm for future community-oriented digital tools.
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Chong MS, Sit JWH, Karthikesu K, Chair SY. Effectiveness of technology-assisted cardiac rehabilitation: A systematic review and meta-analysis. Int J Nurs Stud 2021; 124:104087. [PMID: 34562846 DOI: 10.1016/j.ijnurstu.2021.104087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 08/06/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objectives of this review were to identify different technology-assisted interventions in cardiac rehabilitation, to explore and examine the effectiveness of technology-assisted cardiac rehabilitation. DESIGN A systematic review and meta-analysis. METHODS A systematic search was performed on six electronic databases: CINALH Complete, Cochrane Library, PubMed, MEDLINE via OvidSP, British Nursing Index and PsycINFO to identify randomised controlled trials from 2010 to 2020. Selection of studies was performed by screening the titles, abstracts and full texts, and two reviewers independently and critically appraised the included studies using the revised Cochrane risk of bias tool for randomized trials (RoB 2). RESULTS Nine randomised controlled trials met the inclusion criteria; five studies with some bias concerns related to allocation concealment (n = 2) and measurement of outcome (n = 4), and four studies were of low risk of bias. The pooled effect size showed comparable effectiveness between technology-assisted cardiac rehabilitation and conventional/centre-based cardiac rehabilitation on modifiable coronary risk factors (systolic and diastolic blood pressure, total cholesterol, p>0.05), psychological outcomes (anxiety: SMD 0.25, 95% CI -0.11 to 0.62, p = 0.17 and depression: SMD 0.09, 95% CI -0.16 to 0.35, p = 0.47). Narrative synthesis was performed for adherence to prescribed exercise sessions in cardiac rehabilitation. No significant adverse events occurred. The adverse events that did occur were self-reported, mostly unrelated to the interventions with technology and the number of events was comparable between both groups. Inconsistent results were found across the studies. This review revealed lack of self-efficacy and behaviour change theories/strategies, and educational emphasis among studies. CONCLUSIONS The results in the meta-analysis have indicated that technology-assisted cardiac rehabilitation demonstrated comparable results to conventional/centre-based cardiac rehabilitation. Technology-assisted cardiac rehabilitation is a potential alternative not only to remove cardiac rehabilitation barriers but also in the midst of current prolonged pandemic. Future studies on technology-assisted cardiac rehabilitation with the emphasis behavior change theories/strategies and education are required.
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Affiliation(s)
- Mei Sin Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR.
| | - Janet Wing Hung Sit
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Karthijekan Karthikesu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
| | - Sek Ying Chair
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR
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40
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The Field of “Public Health” as a Component of Sustainable Development—Poland Compared to the European Union. SUSTAINABILITY 2021. [DOI: 10.3390/su131810351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of the article is to analyse selected indicators of sustainable development in the field of “public health”, especially those related to health and health-related inequalities. The article focuses on the analysis of indicators in the field of “public health” presented by Eurostat. These indicators were presented in terms of averages and medians. Moreover, the paper indicates the amount of funds allocated for prevention in health care. In addition, the cluster method was used to identify EU countries similar to each other in terms of the leading indicator of sustainable development (SD). The study was conducted using annual data for 2010–2019 for Poland as compared to other EU countries. The study used data from the Eurostat and OECD databases. In almost all of the analysed countries, in relation to the demographic and health situation, there is a close link between the financial situation, health and inequalities in health-related fields. Patients’ sense of safety has decreased in Poland, which is the result of the growing consumption of health services and emerging problems with the availability of health care services as well as environmental pollution. Among others, the percentage of people with health problems and low income has increased. Although the percentage of unmet needs resulting from income inequalities has decreased over the past year in the analysed groups of countries, it is still high in Poland. The low level of expenditure on prevention makes these difficulties even more severe. In summary, capturing changes in indicators describing public health in the context of its impact on sustainable development plays a key role in balancing out inequalities in the EU countries and in managing a common policy.
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Wu JJY, Ahmad N, Samuel M, Logan S, Mattar CNZ. The Influence of Web-Based Tools on Maternal and Neonatal Outcomes in Pregnant Adolescents or Adolescent Mothers: Mixed Methods Systematic Review. J Med Internet Res 2021; 23:e26786. [PMID: 34435961 PMCID: PMC8430830 DOI: 10.2196/26786] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 06/12/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pregnant adolescent women increasingly seek support during pregnancy and the puerperium through digital platforms instead of the traditional support system of family, friends, and the community. However, it is uncertain whether digital, web-based tools are reliable and effective in providing information to the user on a variety of topics such as fetal development, pregnancy outcomes, delivery, and breastfeeding to improve maternal and infant outcomes. OBJECTIVE We aimed to identify web-based tools designed to promote knowledge, attitudes, and skills of pregnant adolescents or adolescent mothers and determine the efficacy of such web-based tools compared with conventional resources in promoting good pregnancy and infant outcomes. METHODS A systematic search was conducted using Medline, Scopus, CINAHL, and PsycINFO for articles published from January 2004 to November 2020 to identify randomized trials and observational studies that evaluated digital, web-based platforms to deliver resources to pregnant adolescents. All articles written in the author's languages were included. Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. Risk of bias in each study was assessed using appropriate tools recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and the Joanna Briggs Institute. We adopted a qualitative synthesis and presented the results in a narrative format due to the heterogenous nature of the studies. RESULTS Seven articles met the inclusion criteria and were analyzed. The majority of the studies were graded to be of low to moderate risk for bias. The research methodologies represented were varied, ranging from randomized (n=1) and nonrandomized controlled trials (n=1) and prospective cohort studies (n=1) to mixed methods studies (n=1) and longitudinal surveys (n=3). Four studies included active web-based interventions, and 3 described exposure to web-based tools, including the use of social media and/or other internet content. Web-based tools positively influenced treatment-seeking intentions (intervention 17.1%, control 11.5%, P=.003) and actual treatment-seeking behavior for depression among postpartum adolescents (intervention 14.1%, control 6.5%, P<.001). In contrast, readily available information on the internet may leave adolescents with increased anxiety. The critical difference lies in information curated by health care professionals specifically to address targeted concerns versus self-acquired data sourced from various websites. CONCLUSIONS Despite almost universal web use, few studies have used this platform for health promotion and disease prevention. Social media interventions or web-based tools have the potential to positively influence both maternal and infant outcomes in adolescent pregnancy, but there is a need for more well-conducted studies to demonstrate the effectiveness of these support programs. The vastness of the information available on the web limits the ability of health care professionals to monitor or control sources of information sought by patients. Thus, it is important to create professionally curated platforms to prevent or limit exposure to potentially misleading or harmful information on the internet while imparting useful knowledge to the user. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42020195854; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195854.
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Affiliation(s)
- Jania J Y Wu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nurulhuda Ahmad
- Department of Obstetrics and Gynaecology, National University of Singapore, Singapore, Singapore
| | - Miny Samuel
- Research Support Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Susan Logan
- Department of Obstetrics and Gynaecology, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Citra N Z Mattar
- Department of Obstetrics and Gynaecology, National University of Singapore, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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eHealth Literacy, Awareness of Pandemic Infectious Diseases, and Healthy Lifestyle in Middle School Students. CHILDREN-BASEL 2021; 8:children8080699. [PMID: 34438590 PMCID: PMC8391837 DOI: 10.3390/children8080699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 11/20/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented public health crisis worldwide. This pandemic has led to the spread of online misinformation, closure of schools, postponement of re-opening of schools, and restrictions on healthy outdoor activities. These, in turn, have caused a disruption in the daily life of middle school students. This study aimed to identify the relationships between eHealth literacy, awareness of pandemic infectious diseases, and healthy lifestyle in middle school students. For this purpose, we conducted a descriptive, correlational study in two cities in the capital of South Korea. A total of 138 middle school students completed self-reported questionnaires about eHealth literacy, awareness of pandemic infectious diseases, and healthy lifestyle. Middle school students displayed moderate levels of eHealth literacy (3.72 ± 0.97), awareness of pandemic infectious diseases (3.33 ± 0.92), and healthy lifestyle (2.98 ± 0.72). Positive correlations were found between eHealth literacy and awareness of pandemic infectious diseases (r = 0.44, p < 0.001), between eHealth literacy and healthy lifestyle (r = 0.52, p < 0.001), and between awareness of pandemic infectious diseases and healthy lifestyle (r = 0.38, p < 0.001). These findings suggest that eHealth literacy may be an important aspect of increasing the awareness about pandemic infectious diseases and forming healthy lifestyle habits in Korean middle school students during the COVID-19 pandemic.
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Leader AE, Capparella LM, Waldman LB, Cammy RB, Petok AR, Dean R, Shimada A, Yocavitch L, Rising KL, Garber GD, Worster B, Dicker AP. Digital Literacy at an Urban Cancer Center: Implications for Technology Use and Vulnerable Patients. JCO Clin Cancer Inform 2021; 5:872-880. [PMID: 34428075 PMCID: PMC8807016 DOI: 10.1200/cci.21.00039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/01/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE eHealth literacy, or the ability to seek, find, understand, and appraise health information from electronic sources, has become increasingly relevant in the era of COVID-19, when so many aspects of patient care became dependent on technology. We aimed to understand eHealth literacy among a diverse sample of patients with cancer and discuss ways for health systems and cancer centers to ensure that all patients have access to high-quality care. METHODS A cross-sectional survey of patients with cancer and caregivers was conducted at an NCI-designated cancer center to assess access to the Internet, smartphone ownership, use of mobile apps, willingness to engage remotely with the health care team, and use of the patient portal. Descriptive statistics and bivariate analyses were used to assess frequencies and significant differences between variables. RESULTS Of 363 participants, 55% (n = 201) were female, 71% (n = 241) identified as non-Hispanic White, and 29% (n = 85) reported that their highest level of education was a high school diploma. Most (90%, n = 323) reported having access to the Internet and most (82%, n = 283) reported owning a smartphone. Younger patients or those with a college degree were significantly more likely to own a smartphone, access health information online, know how to download an app on their own, have an interest in communicating with their health care team remotely, or have an account on the electronic patient portal. CONCLUSION As cancer centers increasingly engage patients through electronic and mobile applications, patients with low or limited digital literacy may be excluded, exacerbating current cancer health disparities. Patient-, provider- and system-level technology barriers must be understood and mitigated.
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Affiliation(s)
- Amy E Leader
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Lisa M Capparella
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Lauren B Waldman
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Rebecca B Cammy
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Alison R Petok
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Rebecca Dean
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA
| | - Ayako Shimada
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Liana Yocavitch
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Kristin L Rising
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Gregory D Garber
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Brooke Worster
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
| | - Adam P Dicker
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA
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Ng JYM, Lim TW, Tarib N, Ho TK. Effect of educational progressive web application on patient's oral and denture knowledge and hygiene: A randomised controlled trial. Health Informatics J 2021; 27:14604582211035821. [PMID: 34325550 DOI: 10.1177/14604582211035821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to evaluate the effect of a novel progressive web application (PWA) on the patient's oral and denture knowledge and hygiene. Fifty-two removable partial denture wearers were randomised to receive education using the PWA, or verbal instructions accompanied by demonstration of hygienic procedures. Changes in the participants' knowledge score, plaque index, gingival index and denture plaque was evaluated during a follow-up period of 3 months. The participants' acceptance of PWA was explored through usage logs and a feedback form. Both groups showed significant improvement in knowledge scores, oral and denture hygiene indices (p < 0.001) after education. The PWA group demonstrated significantly lower gingival index score than control (p = 0.008) at the third month review. In conclusion, there is potential of using mobile application in educating elderly patients and the PWA is a viable option for providing post-denture delivery instructions.
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Affiliation(s)
| | | | - Natasya Tarib
- KPJ KL Dental Centre, KPJ Tawakkal Health Centre, Kuala Lumpur
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45
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El Benny M, Kabakian-Khasholian T, El-Jardali F, Bardus M. Application of the eHealth Literacy Model in Digital Health Interventions: Scoping Review. J Med Internet Res 2021; 23:e23473. [PMID: 34081023 PMCID: PMC8212628 DOI: 10.2196/23473] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/20/2020] [Accepted: 04/14/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Digital health interventions (DHIs) are increasingly being adopted globally to address various public health issues. DHIs can be categorized according to four main types of technology: mobile based, web based, telehealth, and electronic health records. In 2006, Norman and Skinner introduced the eHealth literacy model, encompassing six domains of skills and abilities (basic, health, information, scientific, media, and computer) needed to effectively understand, process, and act on health-related information. Little is known about whether these domains are assessed or accounted for in DHIs. OBJECTIVE This study aims to explore how DHIs assess and evaluate the eHealth literacy model, describe which health conditions are addressed, and which technologies are used. METHODS We conducted a scoping review of the literature on DHIs, based on randomized controlled trial design and reporting the assessment of any domain of the eHealth literacy model. MEDLINE, CINAHL, Embase, and Cochrane Library were searched. A duplicate selection and data extraction process was performed; we charted the results according to the country of origin, health condition, technology used, and eHealth literacy domain. RESULTS We identified 131 unique DHIs conducted in 26 different countries between 2001 and 2020. Most DHIs were conducted in English-speaking countries (n=81, 61.8%), delivered via the web (n=68, 51.9%), and addressed issues related to noncommunicable diseases (n=57, 43.5%) or mental health (n=26, 19.8%). None of the interventions assessed all six domains of the eHealth literacy model. Most studies focused on the domain of health literacy (n=96, 73.2%), followed by digital (n=19, 14.5%), basic and media (n=4, 3%), and information and scientific literacy (n=1, 0.7%). Of the 131 studies, 7 (5.3%) studies covered both health and digital literacy. CONCLUSIONS Although many selected DHIs assessed health or digital literacy, no studies comprehensively evaluated all domains of the eHealth literacy model; this evidence might be overlooking important factors that can mediate or moderate the effects of these interventions. Future DHIs should comprehensively assess the eHealth literacy model while developing or evaluating interventions to understand how and why interventions can be effective.
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Affiliation(s)
- Mariam El Benny
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Tamar Kabakian-Khasholian
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Marco Bardus
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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Gross C, Schachner T, Hasl A, Kohlbrenner D, Clarenbach CF, Wangenheim FV, Kowatsch T. Personalization of Conversational Agent-Patient Interaction Styles for Chronic Disease Management: Two Consecutive Cross-sectional Questionnaire Studies. J Med Internet Res 2021; 23:e26643. [PMID: 33913814 PMCID: PMC8190651 DOI: 10.2196/26643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/12/2021] [Accepted: 04/14/2021] [Indexed: 01/18/2023] Open
Abstract
Background Conversational agents (CAs) for chronic disease management are receiving increasing attention in academia and the industry. However, long-term adherence to CAs is still a challenge and needs to be explored. Personalization of CAs has the potential to improve long-term adherence and, with it, user satisfaction, task efficiency, perceived benefits, and intended behavior change. Research on personalized CAs has already addressed different aspects, such as personalized recommendations and anthropomorphic cues. However, detailed information on interaction styles between patients and CAs in the role of medical health care professionals is scant. Such interaction styles play essential roles for patient satisfaction, treatment adherence, and outcome, as has been shown for physician-patient interactions. Currently, it is not clear (1) whether chronically ill patients prefer a CA with a paternalistic, informative, interpretive, or deliberative interaction style, and (2) which factors influence these preferences. Objective We aimed to investigate the preferences of chronically ill patients for CA-delivered interaction styles. Methods We conducted two studies. The first study included a paper-based approach and explored the preferences of chronic obstructive pulmonary disease (COPD) patients for paternalistic, informative, interpretive, and deliberative CA-delivered interaction styles. Based on these results, a second study assessed the effects of the paternalistic and deliberative interaction styles on the relationship quality between the CA and patients via hierarchical multiple linear regression analyses in an online experiment with COPD patients. Patients’ sociodemographic and disease-specific characteristics served as moderator variables. Results Study 1 with 117 COPD patients revealed a preference for the deliberative (50/117) and informative (34/117) interaction styles across demographic characteristics. All patients who preferred the paternalistic style over the other interaction styles had more severe COPD (three patients, Global Initiative for Chronic Obstructive Lung Disease class 3 or 4). In Study 2 with 123 newly recruited COPD patients, younger participants and participants with a less recent COPD diagnosis scored higher on interaction-related outcomes when interacting with a CA that delivered the deliberative interaction style (interaction between age and CA type: relationship quality: b=−0.77, 95% CI −1.37 to −0.18; intention to continue interaction: b=−0.49, 95% CI −0.97 to −0.01; working alliance attachment bond: b=−0.65, 95% CI −1.26 to −0.04; working alliance goal agreement: b=−0.59, 95% CI −1.18 to −0.01; interaction between recency of COPD diagnosis and CA type: working alliance goal agreement: b=0.57, 95% CI 0.01 to 1.13). Conclusions Our results indicate that age and a patient’s personal disease experience inform which CA interaction style the patient should be paired with to achieve increased interaction-related outcomes with the CA. These results allow the design of personalized health care CAs with the goal to increase long-term adherence to health-promoting behavior.
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Affiliation(s)
- Christoph Gross
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Theresa Schachner
- Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Andrea Hasl
- Department of Educational Sciences, University of Potsdam, Potsdam, Germany.,International Max Planck Research School on the Life Course, Berlin, Germany
| | - Dario Kohlbrenner
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland.,Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | | | - Forian V Wangenheim
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland.,Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Development of a Secure Website to Facilitate Information Sharing in Families at High Risk of Bowel Cancer-The Familyweb Study. Cancers (Basel) 2021; 13:cancers13102404. [PMID: 34065728 PMCID: PMC8155923 DOI: 10.3390/cancers13102404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/04/2021] [Accepted: 05/10/2021] [Indexed: 11/22/2022] Open
Abstract
Simple Summary Families with an inherited high risk of bowel cancer may struggle to share information about their diagnosis. This means that relatives are not always aware of their increased risk of cancer or able to access screening for the early detection of cancer. Through this study, we aimed to help such families by creating a website where patients could share confidential information with their relatives securely online. Following a survey and telephone interviews with affected individuals, the content of the website was developed to suit the needs of families. Website function was tested with patients to check feasibility and acceptability. Most participants wanted more information to support their adaptation to the diagnosis and help inform their relatives. This study demonstrates how health professionals can improve access to genetic testing and cancer screening in families at high risk of cancer, thus reducing morbidity and mortality. Abstract Individuals with pathogenic variants in genes predisposing to bowel cancer are encouraged to share this information within their families. Close relatives at 50% risk can have access to bowel cancer surveillance. However, many relatives remain unaware of their vulnerability or have insufficient information. We investigated the feasibility and acceptability of using a secure website to support information sharing within families at high risk of bowel cancer. Patients (n = 286) answered an anonymous cross-sectional survey, with 14 participating in telephone interviews. They reported that the diagnosis had a profound effect on them and their family relationships, and consequently desired more support from health professionals. Website content was created in response to the preferences of survey and interview participants. Reactions to the website from 12 volunteers were captured through remote usability testing to guide further refinement of the website. Participants welcomed the opportunity to store and share personal information via the website and wanted more information and help informing their relatives about the diagnosis. Important website topics were: healthy lifestyle; genetic testing; and how to talk to children about the diagnosis. A website providing online access to confidential documents was both feasible and acceptable and could translate into increased uptake of cancer surveillance, resulting in lower morbidity and mortality in these families.
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Hong KJ, Park NL, Heo SY, Jung SH, Lee YB, Hwang JH. Effect of e-Health Literacy on COVID-19 Infection-Preventive Behaviors of Undergraduate Students Majoring in Healthcare. Healthcare (Basel) 2021; 9:healthcare9050573. [PMID: 34066120 PMCID: PMC8151528 DOI: 10.3390/healthcare9050573] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 12/23/2022] Open
Abstract
This study examined and verified the level of e-health literacy (e-HL) and infection preventive behaviors related to COVID-19 among undergraduate students majoring in healthcare. An online survey was conducted with 274 university students majoring in nursing, clinical pathology, and occupational therapy in South Korea. The e-HL consisted of functional, communicational, and critical literacy, and preventive behaviors were based on the Prevention Guideline on Droplet Infection. The mean score for e-HL was 3.62, with nursing students obtaining the highest scores. The overall e-HL score and the scores on its three sub-dimensions were related to infection-preventive behaviors. Moreover, e-HL affected infection-preventive behaviors (p < 0.001). Findings from this study highlight the necessity of education for improving the e-HL of undergraduate students majoring in healthcare to strengthen infection-preventive behaviors and protect patients from infectious diseases.
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Seljelid B, Varsi C, Solberg Nes L, Øystese KA, Børøsund E. A Digital Patient-Provider Communication Intervention (InvolveMe): Qualitative Study on the Implementation Preparation Based on Identified Facilitators and Barriers. J Med Internet Res 2021; 23:e22399. [PMID: 33830063 PMCID: PMC8294341 DOI: 10.2196/22399] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/09/2020] [Accepted: 03/18/2021] [Indexed: 01/15/2023] Open
Abstract
Background Chronic health conditions are affecting an increasing number of individuals, who experience various symptoms that decrease their quality of life. Digital communication interventions that enable patients to report their symptoms have been shown to positively impact chronic disease management by improving access to care, patient-provider communication, clinical outcomes, and health-related quality of life. These interventions have the potential to prepare patients and health care providers (HCPs) before visits and improve patient-provider communication. Despite the recent rapid development and increasing number of digital communication interventions that have shown positive research results, barriers to realizing the benefits offered through these types of interventions still exist. Objective The aim of this study is to prepare for the implementation of a digital patient-provider communication intervention in the daily workflow at 2 outpatient clinics by identifying potential determinants of implementation using the Consolidated Framework for Implementation Research (CFIR) to tailor the use of digital communication intervention to the intended context and identify key aspects for an implementation plan. Methods A combination of focus groups, workshops, and project steering committee meetings was conducted with HCPs (n=14) and patients (n=2) from 2 outpatient clinics at a university hospital. The CFIR was used to guide data collection and analysis. Transcripts, written minutes, and notes were analyzed and coded into 5 CFIR domains using thematic analysis. Results Data were examined and analyzed into 18 CFIR constructs relevant to the study purpose. On the basis of the identified determinants, important intervention tailoring includes adjustments to the digital features and adjustments to fit the clinical workflow and a decision to conduct a future pilot study. Furthermore, it was decided to provide the intervention to patients as early as possible in their disease trajectory, with tailored information about its use. Key aspects for the implementation plan encompassed maintaining the identified engagement and positive attitude, involving key stakeholders in the implementation process, and providing the needed support and training. Conclusions This study offers insight into the involvement of stakeholders in the tailoring and implementation planning of a digital communication intervention in clinical practice. Stakeholder involvement in the identification of implementation facilitators and barriers can contribute to the tailoring of digital communication interventions and how they are used and can also inform systematic and targeted implementation planning.
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Affiliation(s)
- Berit Seljelid
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cooperation, Patient Education and Equivalent Health Services, CEO's Staff, Oslo University Hospital, Oslo, Norway
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Lise Solberg Nes
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatry & Psychology, College of Medicine & Science, Mayo Clinic, Rochester, MN, United States
| | - Kristin Astrid Øystese
- Section of Specialized Endocrinology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.,Department of Medical Biochemistry, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
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Wu Q, Huang Y, van Velthoven MH, Wang W, Zhang Y. Trends in complementary feeding practices and caregivers' feeding knowledge among children aged 6-23 months: Repeated cross-sectional surveys in rural Qinghai China 2012-18. J Glob Health 2021; 11:08003. [PMID: 33828848 PMCID: PMC8021074 DOI: 10.7189/jogh.11.08003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Appropriate infant and young child feeding is the basis for child survival, growth and development. The aim of this study was to investigate trends in complementary feeding practices and caregivers’ feeding knowledge among children from 2012 to 2018 in Huzhu County, Qinghai Province, China. Methods This study took place during and after a controlled interventional evaluation trial in Qinghai Province, China, which aimed to evaluate the effectiveness of community-based nutrient-dense complementary food supplements (YingYangBao) combined with dietary counseling on improving 6-23 month-old children's health status. We conducted four representative cross-sectional surveys on caregivers of children aged 6-23 months in Huzhu County, Qinghai Province, China (baseline survey for the trial (N = 1804) in August 2012, end-line survey for the trial (N = 2186) in August 2014, follow-up survey 1 (N = 496) in January 2016, and follow-up survey 2 (N = 754) in July 2018). In all surveys we used the same questionnaire to collect household information, infant feeding practices and caregivers’ feeding knowledge. Results During the trial period (2012-2014), the proportion of children aged 6-8 months that introduced (semi-) solid food increased from 86.1% to 96.3% (P < 0.0001), however, there was a downward trend from 2014 to 2018 (P = 0.0014 for trend). The prevalence of minimum dietary diversity also increased from 51.4% at 2012 baseline survey to 57.5% at 2014 endline survey (P = 0.0004), but the upward trend did not maintain from 2014 to 2018 (P = 0.7863 for trend). The minimum dietary frequency, the minimum acceptable diet, and continued breastfeeding at one year were nearly unchanged from 2012 to 2018 (P = 0.9529, P = 0.7602 and P = 0.6013 for trend, respectively), remaining around 30%, 10% and 20% respectively in the four surveys. Caregivers’ feeding knowledge on the duration of exclusive breastfeeding and introduction of semi or solid foods at 6-8 months increased from 2012 to 2018 (18.6% to 39.5%, 43.2% to 64.3%, respectively). Conclusion This study showed that the sustainability of community-based YYB and dietary counseling program was suboptimal. We suggest that multiple information delivery channels such as smartphones and the Internet should be explored as a supplement to existing channels for delivering counseling information. Trial registration ChiCTRPRC12002444.
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Affiliation(s)
- Qiong Wu
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yiwen Huang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | | | - Wei Wang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
| | - Yanfeng Zhang
- Department of Integrated Early Childhood Development, Capital Institute of Pediatrics, Beijing, China
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