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Wähnke L, Dose C, Klemp MT, Mühlenmeister J, Plück J, Döpfner M. The Relationship Between Symptom Change and Use of a Web-Based Self-Help Intervention for Parents of Children With Externalizing Behavior Disorders: Exploratory Study. JMIR Pediatr Parent 2024; 7:e54051. [PMID: 39231431 PMCID: PMC11411226 DOI: 10.2196/54051] [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: 11/01/2023] [Revised: 04/18/2024] [Accepted: 07/11/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Web-based self-help (WASH) has been found to be effective in the treatment of child externalizing behavior disorders. However, research on the associations of caregivers' use of WASH and symptom changes of child externalizing behaviors is lacking. OBJECTIVE This study examined the longitudinal and reciprocal associations between the use of WASH by caregivers of children with externalizing behavior disorders and their children's externalizing behavior symptoms. METHODS Longitudinal data of 276 families from 2 intervention conditions of a randomized controlled trial (either unguided or supported by a therapist over the phone) were analyzed. Caregiver- and clinician-rated child externalizing behavior symptoms were assessed before (T1), in the middle (T2), and after the 6-month WASH intervention (T3). Additionally, 2 indicators of the caregivers' use of the WASH intervention were considered: number of log-ins (frequency) and the percentage of completed material (intensity). Associations of caregivers' use during early (T1-T2) and late (T2-T3) treatment with child externalizing behavior symptoms were analyzed using path analyses (structural equation modeling). RESULTS Frequency and intensity of use were higher during the first 3 months than during the next 3 months of the intervention period. The number of log-ins at early treatment was significantly but weakly associated with caregiver-reported child externalizing behavior symptoms in the long term (T3). Moreover, caregiver-reported child externalizing severity at T2 predicted the number of log-ins in the late treatment. The results were not replicated when considering the percentage of completed material as a measure of use or when considering clinician ratings of child externalizing behavior symptoms. CONCLUSIONS The findings provide the first, albeit weak, evidence for longitudinal associations between caregivers' use of WASH and improvements in caregiver-rated child externalizing behavior symptoms. However, as the associations were rather weak and could not be replicated across different rater perspectives and operationalizations of use, further research is needed to better understand these relations and their interplay with other putative influence factors (eg, quality of the implementation of the interventions, changes in parenting behaviors). TRIAL REGISTRATION German Clinical Trials Register DRKS00013456; https://www.drks.de/DRKS00013456. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-020-2481-0.
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Affiliation(s)
- Laura Wähnke
- School for Child and Adolescent Cognitive Behavior Therapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
| | - Christina Dose
- School for Child and Adolescent Cognitive Behavior Therapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
| | - Marie-Theres Klemp
- School for Child and Adolescent Cognitive Behavior Therapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
| | - Judith Mühlenmeister
- School for Child and Adolescent Cognitive Behavior Therapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
| | - Julia Plück
- School for Child and Adolescent Cognitive Behavior Therapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- School for Child and Adolescent Cognitive Behavior Therapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, The University of Cologne, Cologne, Germany
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Jansen C, Bäuerle A, Jahre LM, Kocol D, Krakowczyk J, Geiger S, Dörrie N, Skoda EM, Teufel M. Needs and Demands for e-Health Interventions in Patients Attending a Psychosomatic Outpatient Clinic: A Baseline Assessment for a User-Centered Design Approach. Telemed J E Health 2024; 30:e1747-e1756. [PMID: 38436236 DOI: 10.1089/tmj.2023.0360] [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: 03/05/2024] Open
Abstract
Objective: Increased utilization of e-health services can help to meet shortages of psychotherapeutic treatment. e-Health interventions can be effective if tailored according to the individual needs and demands of the target group. To gather comprehensive data for the development of a user-centered e-health intervention, a cross-sectional study was conducted among a heterogeneous cohort of 309 patients seeking treatment or consultation at psychosomatic university hospital in a densely populated region of Germany. Methods: Sociodemographic data, psychometric dimensions of mental burden, as well as needs and demands regarding an e-health intervention were assessed. A descriptive statistical analysis and a cluster analysis were performed to examine distribution of preferences and differences based on level of burden regarding needs and demands for e-health interventions. Results: Two hundred thirty-nine (N = 239) participants were included in the final data analysis. Among this primarily urban target group smartphone availability was favored by 77.8% of the participants. The cluster analysis revealed significant differences dependent on mental burden. 75.2% of participants with a high mental burden preferred longer interventions of 1-4 months compared with 49% in the low burden group, which also considered short interventions of up to 1 month (46%). Differences were also identified for content preferences and daily-life integration and were consistent irrespective of the initial reason for consultation. Conclusion: The findings of this study can provide a foundational framework for developing user-centered psychosomatic interventions. The potential relationship between individual burden and individual needs and demands highlights the crucial role of preliminary research to tailor interventions to effectively address diverse needs and preferences.
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Affiliation(s)
- Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Lisa Maria Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Dilara Kocol
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Julia Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Sheila Geiger
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany
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Colburn DA. The Impact of Telehealth Expansion on Health Care Utilization, Access, and Outcomes During the Pandemic: A Systematic Review. Telemed J E Health 2024; 30:1401-1410. [PMID: 38100326 DOI: 10.1089/tmj.2023.0440] [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: 12/17/2023] Open
Abstract
Introduction: The COVID-19 pandemic brought unprecedented change to the health care industry, including a large and rapid shift to providing care through telehealth technologies. Although the expansion of telehealth services was successful in continuing to provide patients with care while preventing the spread of disease, it is less clear how patient sociodemographic characteristics influenced telehealth use during this time. This study aims to systematically review the published literature on demographic differences in telehealth access, utilization, and health outcomes among a variety of adult patient types in the United States. Methods: Litcovid, PubMed, Web of Science, and MEDLINE databases were searched, resulting in a final sample of n = 32 studies. Results: Results found that studies could be categorized as addressing at least one of eight different areas of inquiry: sociodemographic differences in telehealth use (1) during and (2) before the pandemic, telehealth use versus nonuse (3) during and (4) before the pandemic, (5) telehealth modality, (6) satisfaction with telehealth, (7) outcomes associated with telehealth use, and (8) perceived or actual access to telehealth services. Discussion: Findings are robust across included studies with respect to racial, age, and socioeconomic differences in telehealth utilization and health outcomes, reflecting sociodemographic differences in health care access, utilization, and outcomes more broadly that persist despite this expansion of telehealth services owing to COVID-19. Additional findings across studies are summarized and areas for future research are discussed.
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Affiliation(s)
- Deirdre A Colburn
- Crimes against Children Research Center, University of New Hampshire, Durham, New Hampshire, USA
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Wähnke L, Plück J, Bodden M, Ernst A, Klemp MT, Mühlenmeister J, Döpfner M. Acceptance and utilization of web-based self-help for caregivers of children with externalizing disorders. Child Adolesc Psychiatry Ment Health 2024; 18:40. [PMID: 38528607 DOI: 10.1186/s13034-024-00724-0] [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: 08/27/2023] [Accepted: 02/27/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Web-based self-help interventions for parents of children with ADHD and other externalizing disorders have been proven to be effective. In order to recommend individualized and optimized interventions, a better understanding of the acceptance and utilization of this innovative treatment approach is needed. Previous research has frequently employed subjective reports of utilization, but the validity of these studies may be limited. METHODS Data from the German WASH study were used. Participants (n = 276) were randomly assigned to the intervention condition (a) web-based self-help or (b) web-based self-help with optional telephone-based support calls. Data collection took place at baseline (T1) and 12 weeks later (T2). Utilization data were tracked using a log file generated for each participant at T2. Prediction models were calculated using CART (Classification and Regression Trees), a method known mostly from the field of machine learning. RESULTS Acceptance, of the intervention as defined in this paper was very high on objective (89.4% have taken up the intervention) and subjective measures (91.4% reported having used the intervention and 95.3% reported they would recommend the intervention to a friend). The average number of logins corresponded to recommendations. Predictors of acceptance and predictors of utilization were similar and included, e.g., child's externalizing symptoms, parental psychopathology, and above all additional telephone-based support by counselors. CONCLUSIONS Through a detailed identification of acceptance and utilization, and the predictors thereof, we were able to gain a better understanding of the acceptance and utilization of web-assisted self-help for a parent management intervention in the treatment of children with ADHD and ODD. These findings can be used to recommend web-based interventions to particularly suitable families. It should be noted that some form of support is required for an intensive engagement with the content of the program. TRIAL REGISTRATION The protocol of the study (German Clinical Trials Register DRKS00013456 conducted on January 3rd, 2018) was approved by the Ethics Committee of the University Hospital, Cologne.
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Affiliation(s)
- Laura Wähnke
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Julia Plück
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Mikel Bodden
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Angela Ernst
- Institute of Medical Statistics and Computational Biology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Marie-Theres Klemp
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Judith Mühlenmeister
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Manfred Döpfner
- School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Bauernschmidt D, Wittmann J, Hirt J, Meyer G, Bieber A. The Implementation Success of Technology-Based Counseling in Dementia Care: Scoping Review. JMIR Aging 2024; 7:e51544. [PMID: 38271050 PMCID: PMC10853855 DOI: 10.2196/51544] [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: 08/03/2023] [Revised: 11/07/2023] [Accepted: 11/21/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Implementing technology-based counseling as a complex intervention in dementia care poses challenges such as adaptation to stakeholders' needs and limited resources. While studies have examined the effectiveness of technology-based counseling, its successful implementation remains largely unexplored. OBJECTIVE We aimed to review the knowledge about the implementation success of technology-based counseling interventions for people with dementia and their informal caregivers. METHODS We conducted a scoping review and systematically searched CINAHL, the Cochrane Library including the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, and Web of Science Core Collection databases (April 2021) in combination with citation searching and web searching (November 2021). Studies reporting on technology-based counseling interventions for people with dementia or their informal caregivers were included, irrespective of the design. We used the conceptual framework for implementation outcomes to operationalize implementation success and applied the outcomes acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability as categories to inform data extraction. We identified dimensions within the categories and synthesized results narratively and graphically. RESULTS We included 52 publications reporting on 27 technology-based counseling interventions. The studies were conducted in 9 countries and published between 1993 and 2021. As the design of the included studies varied, the number of participants and the type of data reported varied as well. The intervention programs were heterogeneous and ranged from single counseling interventions (such as helpline services) to counseling as part of a multicomponent program. Telephone, email, videoconferencing, social media (respectively chats), and web-based platforms were used for delivering counseling. We found data on appropriateness for all interventions and data on acceptability for most interventions, describing aspects such as consumer-perceived usefulness and helpfulness of services, as well as satisfaction. Information on the other categories of adoption, feasibility, fidelity, implementation cost, penetration, and sustainability was fragmented. CONCLUSIONS The scope and depth of information on conceptual categories of the implementation success of technology-based counseling for people with dementia and informal caregivers varied. The data only partially covered the concept of implementation success, which highlights the need for a systematic evaluation accompanying the implementation. The application of theoretical approaches for implementation and adherence to the framework for developing and evaluating complex interventions are required to promote the implementation of complex interventions and to comprehensively assess implementation success. TRIAL REGISTRATION PROSPERO CRD42021245473; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=245473.
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Affiliation(s)
- Dorothee Bauernschmidt
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Janina Wittmann
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Julian Hirt
- Center for Dementia Care, Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Gabriele Meyer
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute of Health and Nursing Science, University Medicine Halle, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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Wennerberg C, Hellström A, Schildmeijer K, Ekstedt M. Effects of Web-Based and Mobile Self-Care Support in Addition to Standard Care in Patients After Radical Prostatectomy: Randomized Controlled Trial. JMIR Cancer 2023; 9:e44320. [PMID: 37672332 PMCID: PMC10512115 DOI: 10.2196/44320] [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: 11/16/2022] [Revised: 06/09/2023] [Accepted: 07/21/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Prostate cancer is a common form of cancer that is often treated with radical prostatectomy, which can leave patients with urinary incontinence and sexual dysfunction. Self-care (pelvic floor muscle exercises and physical activity) is recommended to reduce the side effects. As more and more men are living in the aftermath of treatment, effective rehabilitation support is warranted. Digital self-care support has the potential to improve patient outcomes, but it has rarely been evaluated longitudinally in randomized controlled trials. Therefore, we developed and evaluated the effects of digital self-care support (electronic Patient Activation in Treatment at Home [ePATH]) on prostate-specific symptoms. OBJECTIVE This study aimed to investigate the effects of web-based and mobile self-care support on urinary continence, sexual function, and self-care, compared with standard care, at 1, 3, 6, and 12 months after radical prostatectomy. METHODS A multicenter randomized controlled trial with 2 study arms was conducted, with the longitudinal effects of additional digital self-care support (ePATH) compared with those of standard care alone. ePATH was designed based on the self-determination theory to strengthen patients' activation in self-care through nurse-assisted individualized modules. Men planned for radical prostatectomy at 3 county hospitals in southern Sweden were included offline and randomly assigned to the intervention or control group. The effects of ePATH were evaluated for 1 year after surgery using self-assessed questionnaires. Linear mixed models and ordinal regression analyses were performed. RESULTS This study included 170 men (85 in each group) from January 2018 to December 2019. The participants in the intervention and control groups did not differ in their demographic characteristics. In the intervention group, 64% (53/83) of the participants used ePATH, but the use declined over time. The linear mixed model showed no substantial differences between the groups in urinary continence (β=-5.60; P=.09; 95% CI -12.15 to -0.96) or sexual function (β=-.12; P=.97; 95% CI -7.05 to -6.81). Participants in the intervention and control groups did not differ in physical activity (odds ratio 1.16, 95% CI 0.71-1.89; P=.57) or pelvic floor muscle exercises (odds ratio 1.51, 95% CI 0.86-2.66; P=.15). CONCLUSIONS ePATH did not affect postoperative side effects or self-care but reflected how this support may work in typical clinical conditions. To complement standard rehabilitation, digital self-care support must be adapted to the context and individual preferences for use and effect. TRIAL REGISTRATION ISRCTN Registry ISRCTN18055968; https://www.isrctn.com/ISRCTN18055968. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11625.
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Affiliation(s)
- Camilla Wennerberg
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Department of Surgery, Region Kalmar County, Kalmar, Sweden
| | - Amanda Hellström
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | | | - Mirjam Ekstedt
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
- Department of Learning, Management, Informatics and Ethics, Karolinska Institutet, Stockholm, Sweden
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Izadi R, Bahrami MA, Khosravi M, Delavari S. Factors affecting the acceptance of tele-psychiatry: a scoping study. Arch Public Health 2023; 81:131. [PMID: 37443137 DOI: 10.1186/s13690-023-01146-8] [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: 04/17/2023] [Accepted: 07/02/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND In today's digital world, providing services through telemedicine has become an essential issue in health systems, and the Covid-19 pandemic has made this necessity even more apparent. On the other hand, mental health services are needed more than ever, and their nature makes their delivery via telemedicine more feasible than other specialized services. This study aimed to determine the factors affecting the acceptance of telemedicine among users of this technology in the field of mental health. METHODS This article is a scoping review based on the PRISMA guidelines and without any time limit until June 20, 2022. The search was performed in PubMed, Scopus, Web of Science, and PsycINFO databases using keywords related to the three fields of telemedicine, acceptance, and mental disorders. Two authors independently selected the studies based on inclusion and exclusion criteria. Then the data were collected using a data extraction form, and finally, the results were determined using the content analysis method. RESULTS Five main factors affect the acceptance of telemedicine among users of this technology in the field of mental health: perceived effectiveness, users' understanding of the effects of telemedicine on the quality and outcomes of care delivery, technological aspects, organizational change capacity, the nature of the disease and psychological and psychosocial factors. These main factors are associated with 21 related sub-factors. CONCLUSIONS Revealing the factors affecting the acceptance of telemedicine among recipients and providers of services, as key actors in health systems, can help managers and policymakers to successfully implement telemedicine in the less-regarded field of mental health, especially in the early stages.
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Affiliation(s)
- Reyhane Izadi
- Department of Health Care Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Amin Bahrami
- Health Human Resources Research Center, School of health management and information sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Khosravi
- Department of Health Care Management, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, School of health management and information sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Alam MZ, Khanam L. Understanding the determinants of adoption of mHealth services among older women’s perspective in Bangladesh. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2023. [DOI: 10.1108/ijphm-05-2021-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Purpose
The purpose of this study was to explore the factors affecting adoption of mHealth services among the older women in Bangladesh. As this portion of the total population is rapidly increasing in Dhaka City.
Design/methodology/approach
Using the technology acceptance model as a theoretical framework, this study introduces perceived reliability, price value and technology anxiety as new factor reflecting the user’s reliability, beliefs and monetary concerns in the acceptance of mHealth services. A structured survey was conducted to collect the required data from convenience sampling of 271 mHealth end users from Dhaka city in Bangladesh.
Findings
The study confirmed that perceived usefulness, perceived reliability; price value and technology anxiety had a significant impact on mHealth adoption. Ease of use did not influence on the adoption of mHealth services.
Originality/value
To the best of the authors’ knowledge, this study is one of the first to investigate the determinant of mHealth adoption among older Women. Moreover, the insights from this study could benefit mHealth services providers and policymakers in implementing more effective marketing strategies to increase the acceptability of mHealth services.
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Daniore P, Nittas V, Gille F, von Wyl V. Promoting participation in remote digital health studies: An expert interview study. Digit Health 2023; 9:20552076231212063. [PMID: 38025101 PMCID: PMC10644759 DOI: 10.1177/20552076231212063] [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: 04/13/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Remote digital health studies are on the rise and promise to reduce the operational inefficiencies of in-person research. However, they encounter specific challenges in maintaining participation (enrollment and retention) due to their exclusive reliance on technology across all study phases. Objective The goal of this study was to collect experts' opinions on how to facilitate participation in remote digital health studies. Method We conducted 13 semi-structured interviews with principal investigators, researchers, and software developers who had recent experiences with remote digital health studies. Informed by the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, we performed a thematic analysis and mapped various approaches to successful study participation. Results Our analyses revealed four themes: (1) study planning to increase participation, where experts suggest that remote digital health studies should be planned based on adequate knowledge of what motivates, engages, and disengages a target population; (2) participant enrollment, highlighting that enrollment strategies should be selected carefully, attached to adequate support, and focused on inclusivity; (3) participant retention, with strategies that minimize the effort and complexity of study tasks and ensure that technology is adapted and responsive to participant needs, and (4) requirements for study planning focused on the development of relevant guidelines to foster participation in future studies. Conclusions Our findings highlight the significant requirements for seamless technology and researcher involvement in enabling high remote digital health study participation. Future studies can benefit from collected experiences and the development of guidelines to inform planning that balances participant and scientific requirements.
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Affiliation(s)
- Paola Daniore
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - Vasileios Nittas
- Department of Behavioral and Social Sciences, Brown University, Providence, USA
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Felix Gille
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
| | - Viktor von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- Digital Society Initiative, University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Signorelli GR, Monteiro-Guerra F, Rivera-Romero O, Núñez-Benjumea FJ, Fernández-Luque L. Breast Cancer Physical Activity Mobile Intervention: Early Findings From a User Experience and Acceptability Mixed Methods Study. JMIR Form Res 2022; 6:e32354. [PMID: 35731554 PMCID: PMC9260535 DOI: 10.2196/32354] [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: 07/23/2021] [Revised: 04/03/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Physical activity (PA) is the most well-established lifestyle factor associated with breast cancer (BC) survival. Even women with advanced BC may benefit from moderate PA. However, most BC symptoms and treatment side effects are barriers to PA. Mobile health coaching systems can implement functionalities and features based on behavioral change theories to promote healthier behaviors. However, to increase its acceptability among women with BC, it is essential that these digital persuasive systems are designed considering their contextual characteristics, needs, and preferences. OBJECTIVE This study aimed to examine the potential acceptability and feasibility of a mobile-based intervention to promote PA in patients with BC; assess usability and other aspects of the user experience; and identify key considerations and aspects for future improvements, which may help increase and sustain acceptability and engagement. METHODS A mixed methods case series evaluation of usability and acceptability was conducted in this study. The study comprised 3 sessions: initial, home, and final sessions. Two standardized scales were used: the Satisfaction with Life Scale and the International Physical Activity Questionnaire-Short Form. Participants were asked to use the app at home for approximately 2 weeks. App use and PA data were collected from the app and stored on a secure server during this period. In the final session, the participants filled in 2 app evaluation scales and took part in a short individual interview. They also completed the System Usability Scale and the user version of the Mobile App Rating Scale. Participants were provided with a waist pocket, wired in-ear headphones, and a smartphone. They also received printed instructions. A content analysis of the qualitative data collected in the interviews was conducted iteratively, ensuring that no critical information was overlooked. RESULTS The International Physical Activity Questionnaire-Short Form found that all participants (n=4) were moderately active; however, half of them did not reach the recommended levels in the guidelines. System Usability Scale scores were all >70 out of 100 (72.5, 77.5, 95, and 80), whereas the overall user version of the Mobile App Rating Scale scores were 4, 4.3, 4.4, and 3.6 out of 5. The app was perceived to be nice, user-friendly, straightforward, and easy to understand. Recognition of achievements, the possibility of checking activity history, and the rescheduling option were positively highlighted. Technical difficulties with system data collection, particularly with the miscount of steps, could make users feel frustrated. The participants suggested improvements and indicated that the app has the potential to work well for survivors of BC. CONCLUSIONS Early results presented in this study point to the potential of this tool concept to provide a friendly and satisfying coaching experience to users, which may help improve PA adherence in survivors of BC.
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Affiliation(s)
| | - Francisco Monteiro-Guerra
- The Insight Centre for Data Analytics, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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11
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Boemo T, Socastro A, Blanco I, Martin-Garcia O, Pacheco-Romero AM, Rodríguez-Carvajal R, Sanchez-Lopez A. A Novel Experience Sampling Method Tool Integrating Momentary Assessments of Cognitive Biases: Two Compliance, Usability, and Measurement Reactivity Studies. JMIR Form Res 2022; 6:e32537. [PMID: 35343900 PMCID: PMC9002591 DOI: 10.2196/32537] [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: 07/31/2021] [Revised: 12/16/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Experience sampling methods (ESMs) are increasingly being used to study ecological emotion dynamics in daily functioning through repeated assessments taken over several days. However, most of these ESM approaches are only based on self-report assessments, and therefore, studies on the ecological trajectories of their underlying mechanisms are scarce (ie, cognitive biases) and require evaluation through experimental tasks. We developed a novel ESM tool that integrates self-report measures of emotion and emotion regulation with a previously validated app-based cognitive task that allows for the assessment of underlying mechanisms during daily functioning. OBJECTIVE The objective of the study is to test this new tool and study its usability and the possible factors related to compliance with it in terms of latency and missing responses. Among the compliance predictors, we considered psychological and time-related variables, as well as usability, measurement reactivity, and participants' satisfaction with the tool. METHODS We conducted 2 extensive ESM studies-study 1 (N=84; a total of 3 assessments per day for 5 days) and study 2 (N=135; a total of 3 assessments per day for 10 days). RESULTS In both studies, participants found the tool highly usable (average usability score >81). By using mixed regression models, we found both common and specific results for the compliance predictors. In both study 1 and study 2, latency was significantly predicted by the day (P<.001 and P=.003, respectively). Participants showed slower responses to the notification as the days of the study progressed. In study 2 but not in study 1, latency was further predicted by individual differences in overload with the use of the app, and missing responses were accounted for by individual differences in stress reactivity to notifications (P=.04). Thus, by using a more extensive design, participants who experienced higher overload during the study were characterized by slower responses to notifications (P=.01), whereas those who experienced higher stress reactivity to the notification system were characterized by higher missing responses. CONCLUSIONS The new tool had high levels of usability. Furthermore, the study of compliance is of enormous importance when implementing novel ESM methods, including app-based cognitive tasks. The main predictors of latency and missing responses found across studies, specifically when using extensive ESM protocols (study 2), are methodology-related variables. Future research that integrates cognitive tasks in ESM designs should take these results into consideration by performing accurate estimations of participants' response rates to facilitate the optimal quality of novel eHealth approaches, as in this study.
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Affiliation(s)
| | | | - Ivan Blanco
- Autonoma University of Madrid, Madrid, Spain
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12
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Rochat J, Ehrler F, Siebert JN, Ricci A, Garretas Ruiz V, Lovis C. Usability Testing of a Patient-Centered Mobile Health App for Supporting and Guiding the Pediatric Emergency Department Patient Journey: Mixed Methods Study. JMIR Pediatr Parent 2022; 5:e25540. [PMID: 35289754 PMCID: PMC8965675 DOI: 10.2196/25540] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/18/2021] [Accepted: 12/21/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Patient experience in emergency departments (EDs) remains often suboptimal and can be a source of stress, particularly in pediatric settings. In an attempt to support patients and their families before, during, and after their visit to a pediatric ED, a mobile health (mHealth) app was developed by a multidisciplinary team based on patient-centered care principles. OBJECTIVE This study aims to evaluate the usability (effectiveness, efficiency, and satisfaction) of a new mHealth app, InfoKids, by potential end users through usability testing. METHODS The app was assessed through an in-laboratory, video-recorded evaluation in which participants had to execute 9 goal-oriented tasks, ranging from account creation to the reception of a diagnostic sheet at the end of the emergency care episode. Effectiveness was measured based on the task completion rate, efficiency on time on task, and user satisfaction according to answers to the System Usability Scale questionnaire. Think-aloud usability sessions were also transcribed and analyzed. Usability problems were rated for their severity and categorized according to ergonomic criteria. RESULTS A total of 17 parents participated in the study. The overall completion rate was 97.4% (149/153). Overall, they reported good effectiveness, with the task successfully completed in 88.2% (135/153) of cases (95% CI 83%-93%). Each task, with the exception of the first, created difficulties for some participants but did not prevent their completion by most participants. Users reported an overall good to excellent perceived usability of the app. However, ergonomic evaluation identified 14 usability problems occurring 81 time. Among these, 50% (7/14) were serious as their severity was rated as either major or catastrophic and indicated areas of improvements for the app. Following the suggested usability improvements by participants, mitigation measures were listed to further improve the app and avoid barriers to its adoption. CONCLUSIONS Usability of the InfoKids app was evaluated as good to excellent by users. Areas of improvement were identified, and mitigation measures were proposed to inform its development toward a universal app for all ED patients visiting a digitalized institution. Its contribution could also be useful in paving the way for further research on mobile apps aimed at supporting and accompanying patients in their care episodes, as research in this area is scarce.
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Affiliation(s)
- Jessica Rochat
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Frédéric Ehrler
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Johan N Siebert
- Department of Pediatric Emergency Medicine, Geneva Children's Hospital, University Hospitals of Geneva, Geneva, Switzerland
| | - Arnaud Ricci
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Victor Garretas Ruiz
- Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
| | - Christian Lovis
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Medical Information Sciences, University Hospitals of Geneva, Geneva, Switzerland
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13
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Choo CC, Tan YZ, Zhang MWB. A Smartphone App for Attentional Bias Retraining in Smokers: Mixed Methods Pilot Study. JMIR Form Res 2022; 6:e22582. [PMID: 34982037 PMCID: PMC8764608 DOI: 10.2196/22582] [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: 07/16/2020] [Revised: 12/10/2020] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoking is a global health threat. Attentional bias influences smoking behaviors. Although attentional bias retraining has shown benefits and recent advances in technology suggest that attentional bias retraining can be delivered via smartphone apps, there is a paucity of research on this topic. OBJECTIVE This study aims to address this gap by exploring the use of attentional bias retraining via a novel smartphone app using a mixed methods pilot study. In the quantitative phase, it is hypothesized that participants in the training group who undertake attentional bias retraining via the app should have decreased levels of attentional bias, subjective craving, and smoking frequency, compared with those in the control group who do not undertake attentional bias retraining. The qualitative phase explores how the participants perceive and experience the novel app. METHODS In all, 10 adult smokers (3 females and 7 males) between the ages of 26 and 56 years (mean 34.4 years, SD 9.97 years) were recruited. The participants were randomly allocated to the training and control groups. In weeks 1 and 3, participants from both groups attempted the standard visual probe task and rated their smoking frequency and subjective craving. In week 2, the participants in the training group attempted the modified visual probe task. After week 3, participants from both groups were interviewed about their views and experiences of the novel app. RESULTS The results of the quantitative analysis did not support this study's hypothesis. The qualitative data were analyzed using thematic analysis. The results yielded 5 themes: ease, helpfulness, unhelpful aspects, barriers, and refinement. CONCLUSIONS Findings from the qualitative study were consistent with those from previous studies on health-related smartphone apps. The qualitative results were helpful in understanding the user perspectives and experiences of the novel app, indicating that future research in this innovative area is necessary.
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Affiliation(s)
- Carol C Choo
- College of Healthcare Sciences, Division of Tropical Health and Medicine, James Cook University, Queensland, Australia
| | - Yi Zhuang Tan
- Department of Psychology, James Cook University, Singapore, Singapore
| | - Melvyn W B Zhang
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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14
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Sztramko R, Levinson AJ, Wurster AE, Jezrawi R, Sivapathasundaram B, Papaioannou A, Cowan D, St Onge J, Marr S, Patterson C, Woo T, Mosca L, Lokker C. Online Educational Tools for Caregivers of People with Dementia: A Scoping Literature Review. Can Geriatr J 2021; 24:351-366. [PMID: 34912490 PMCID: PMC8629496 DOI: 10.5770/cgj.24.506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Informal caregivers of people with dementia provide the majority of health-based care to people with dementia. Providing this care requires knowledge and access to resources, which caregivers often do not receive. We set out to evaluate the effect of online educational tools on informal caregiver self-efficacy, quality of life, burden/stress, depression, and anxiety, and to identify effective processes for online educational tool development. METHODS We conducted a scoping review of articles on online educational interventions for informal caregivers of people with dementia searching CINAHL, MEDLINE, EMBASE, and PubMed from 1990 to March 2018, with an updated search conducted in 2020. The identified articles were screened and the data were charted. RESULTS 33 articles that reported on 24 interventions were included. There is some evidence that online interventions improve caregiver-related outcomes such as self-efficacy, depression, dementia knowledge, and quality of life; and decrease caregiver burden. Common findings across the studies included the need for tailored, stage-specific information applicable to the caregiver's situation and the use of psychosocial techniques to develop the knowledge components of the interventions. CONCLUSION We demonstrate the importance of having caregivers and health-care professionals involved at all stages of tool conceptualization and development. Online tools should be evaluated with robust trials that focus on how increased knowledge and development approaches affect caregiver-related outcomes.
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Affiliation(s)
- Richard Sztramko
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Anthony J. Levinson
- Division of e-Learning Innovation, Faculty of Health Sciences, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Andrea E. Wurster
- GERAS Centre, St. Peter’s Hospital, Hamilton
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON
| | - Rita Jezrawi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON
| | | | - Alexandra Papaioannou
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON
| | - David Cowan
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Joye St Onge
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Sharon Marr
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Christopher Patterson
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Tricia Woo
- Division of Geriatric Medicine, Department of Medicine, McMaster University, Hamilton
- GERAS Centre, St. Peter’s Hospital, Hamilton
| | - Lori Mosca
- Division of e-Learning Innovation, Faculty of Health Sciences, McMaster University, Hamilton
| | - Cynthia Lokker
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON
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15
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Einfluss akzeptanzfördernder Interventionen auf die Nutzung einer Online-Selbsthilfe. PSYCHOTHERAPEUT 2021. [DOI: 10.1007/s00278-021-00530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Zusammenfassung
Hintergrund
Trotz wachsender empirischer Evidenz zur Wirksamkeit in der Behandlung psychischer Erkrankungen sind internetbasierte Interventionen (IBI) mit geringen Akzeptanz- und hohen Abbruchraten konfrontiert. Akzeptanzfördernde Interventionen (AFI) stellen eine vielversprechende Maßnahme dar, um die Akzeptanz zukünftiger Nutzer*innen zu verbessern. Die Wirksamkeit von AFI auf die Adhärenz, die maßgeblichen Einfluss auf die Wirksamkeit von IBI hat, wurde bisher in nur wenigen empirischen Untersuchungen überprüft.
Ziel der Arbeit (Fragestellung)
Ziel der vorliegenden Untersuchung ist die Überprüfung des Einflusses einer AFI auf die Akzeptanz, die initiale Nutzung und die Adhärenz des transdiagnostischen psychodynamischen Online-Selbsthilfeprogramms „Die Kraft der eigenen Emotionen nutzen (KEN-Online)“.
Material und Methoden
Es wurden Routinedaten von 231 Patient*innen ausgewertet, die während ihrer (teil‑)stationären Behandlung im Rahmen einer ins Routinesetting integrierten AFI das Angebot bekommen haben, KEN-Online behandlungsbegleitend zu nutzen. Im Kohortendesign werden Patient*innen, die an einer AFI teilgenommen haben, mit einer historischen Kontrollgruppe von Patient*innen verglichen, die dieses Angebot nicht erhielten. Zudem wird der Zusammenhang zwischen der Einstellung und der Akzeptanz des Programms in der Untersuchungsgruppe (mit AFI) überprüft.
Ergebnisse
Sowohl die Akzeptanz als auch die initiale Nutzung von KEN-Online waren um knapp 20 % höher (jeweils p < 0,01) unter den Teilnehmenden der AFI-Gruppe, verglichen mit der Kontrollgruppe. In Bezug auf die Adhärenz von KEN-Online zeigte sich ein kleiner Unterschied dahingehend, dass Teilnehmende der Kontrollgruppe signifikant (p < 0,05) mehr Einheiten abgeschlossen haben als Teilnehmende der Interventionsgruppe. Allerdings war der Anteil der „completer“ von KEN-Online mit 13,4 % insgesamt sehr gering. Ein Einfluss der Einstellung auf die Akzeptanz wurde nicht nachgewiesen.
Diskussion
Die vorliegende Untersuchung zeigt, dass AFI dazu beitragen können, die Akzeptanz und initiale Nutzung von IBI zu fördern, indem Patient*innen der (teil‑)stationären Routineversorgung standardisiert und strukturiert über die Intervention informiert werden. Hinsichtlich der Förderung der Adhärenz sind jedoch zusätzliche Maßnahmen erforderlich.
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16
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Serwe KM, Walmsley ALE. The effectiveness of telehealth for a caregiver wellness program. J Telemed Telecare 2021:1357633X21994009. [PMID: 34233538 DOI: 10.1177/1357633x21994009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study compared outcomes of a telehealth and in-person delivered caregiver wellness program called Powerful Tools for Caregivers (PTC). METHODS A total of 11 pairs of PTC class leaders delivered in-person and telehealth PTC classes. Caregiver participants completed a health-related questionnaire one week before, one week after, and six months after completing the program. A split-plot, mixed-design analysis of variance (ANOVA) and t tests were used to examine attendance and health-related outcome measures: depression as measured by the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), caregiver experience as measured by the Bakas Caregiving Outcomes scale (BCOS), caregiver self-efficacy, and number of negative self-care behaviors. RESULTS A total of 72 caregivers attended PTC in-person and 42 attended via telehealth.Mean attendance was 4.97 ± 1.21 for the in-person group and 5.21 ± 0.071 for the telehealth group, with no significant difference between delivery formats t(112) = 1.074, p = 0.285; 23 caregivers completed all three assessment periods for ANOVA. Interaction of group and time was non-significant for all outcome measures and the main effect of group was only significant for CESD-R scores at pre-PTC assessment, indicating that there were no differences between the two delivery formats for outcomes at post test or six months. The effect of time was significant for all outcome measures, indicating both in-person and telehealth participants improved on health-related outcomes over time. DISCUSSION Telehealth is an effective delivery format for PTC - a traditionally in-person caregiver wellness program. This trial was registered [ClinicalTrials.gov identifier: NCT03800238].
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Affiliation(s)
- Katrina M Serwe
- Occupational Therapy, Concordia University Wisconsin, Mequon, WI, USA
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17
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Heinsch M, Wyllie J, Carlson J, Wells H, Tickner C, Kay-Lambkin F. Theories Informing eHealth Implementation: Systematic Review and Typology Classification. J Med Internet Res 2021; 23:e18500. [PMID: 34057427 PMCID: PMC8204232 DOI: 10.2196/18500] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 10/22/2020] [Accepted: 04/15/2021] [Indexed: 01/23/2023] Open
Abstract
Background Theory-guided approaches to implementation science have informed translation efforts and the acceptance of eHealth (digital health) interventions in clinical care. However, there is scarce evidence on which theories are best suited to addressing the inherent complexity of eHealth implementation. Objective The objectives of this systematic review are to identify theories that inform and explain eHealth implementation and to classify these theories using the typology by Sovacool and Hess for theories of sociotechnical change. Methods An electronic search was conducted in the PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Sociological Source Ultimate, Web of Science, ABI/INFORM, EBSCO, and ProQuest databases in June 2019. Studies were included if they were published between 2009 and June 2019; were written in English; reported on empirical research, regardless of study or publication type; reported on one or more theories in the context of eHealth implementation; and were published in a peer-reviewed journal. A total of 2 reviewers independently assessed the titles, abstracts, and full texts. Theories identified were classified using a typology for theories of sociotechnical change, which was considered a useful tool for ordering and analyzing the diverse theoretical approaches as a basis for future theory building. Results Of the 13,101 potentially relevant titles, 119 studies were included. The review identified 36 theories used to explain implementation approaches in eHealth. The most commonly used approaches were the Technology Acceptance Model (TAM) (n=33) and the Unified Theory of Acceptance and Use of Technology (UTAUT) (n=32). These theories were primarily concerned with individual and interpersonal elements of eHealth acceptance. Less common were theories that reflect the various disorderly social processes and structural dimensions of implementation, such as the normalization process theory (n=17) and the structuration theory (n=6). Conclusions Theories currently informing the implementation of eHealth interventions predominantly focus on predicting or explaining end-user acceptance. Theoretical perspectives that capture the dense and intricate relationships and structures required to enact sustainable change are less well represented in the eHealth literature. Given the growing acknowledgment of the inherent complexity of eHealth implementation, future research should develop and test models that recognize and reflect the multidimensional, dynamic, and relational nature of this process.
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Affiliation(s)
- Milena Heinsch
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia.,School of Humanities and Social Science, The University of Newcastle, Callaghan, Australia
| | - Jessica Wyllie
- Newcastle Business School, The University of Newcastle, Callaghan, Australia
| | - Jamie Carlson
- Newcastle Business School, The University of Newcastle, Callaghan, Australia
| | - Hannah Wells
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia
| | - Campbell Tickner
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia
| | - Frances Kay-Lambkin
- Centre for Brain and Mental Health Priority Research Centre, The University of Newcastle, Callaghan, Australia
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18
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Romero-Mas M, Ramon-Aribau A, de Souza DLB, Cox AM, Gómez-Zúñiga B. Improving the Quality of Life of Family Caregivers of People with Alzheimer's Disease through Virtual Communities of Practice: A Quasiexperimental Study. Int J Alzheimers Dis 2021; 2021:8817491. [PMID: 33884204 PMCID: PMC8041528 DOI: 10.1155/2021/8817491] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 11/19/2022] Open
Abstract
Caring for a person with dementia burdens family caregivers, and there is a close negative relationship between this burden and their quality of life (QoL). Research suggests that caregivers' main needs are information and training about the disease and support from others experiencing the same situation, and Internet interventions hold considerable promise for meeting these needs. Virtual communities of practice (VCoPs) are Internet frameworks to share knowledge where members collaborate and achieve a sense of trust in the community. This paper seeks to evaluate the impact of participating in a VCoP (developed through an App) on the QoL of caregivers to people with Alzheimer's. Results show QoL before and after the intervention changed significantly. The impact of VCoP on caregivers' overall QoL is moderated by age and relation with the person with Alzheimer's, specifically those over 65, and spouses. VCoPs allow interaction and knowledge sharing among caregivers which provide them mainly with information and support from peers helping them to meet their needs. Furthermore, caregivers' QoL did not decrease when their relative deteriorated functionally, which could be due to the participation in VCoP. Although we found significant pre- and post differences in caregivers' health literacy, we must report the ambiguous result that this variable only impacts on QoL's physical domain. Participants also reported that they had a positive experience because the App was perceived to be a useful tool, because they could manage their own participation and they met peers and felt less lonely. Results suggest that participation in a VCoP impacts positively on caregivers' QoL.
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Affiliation(s)
- Montse Romero-Mas
- Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Spain
| | - Anna Ramon-Aribau
- Universitat de Vic-Universitat Central de Catalunya (UVic-UCC), Spain
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19
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Jaschinski C, Ben Allouch S, Peters O, Cachucho R, van Dijk JAGM. Acceptance of Technologies for Aging in Place: A Conceptual Model. J Med Internet Res 2021; 23:e22613. [PMID: 33787505 PMCID: PMC8047804 DOI: 10.2196/22613] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/06/2020] [Accepted: 01/17/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Older adults want to preserve their health and autonomy and stay in their own home environment for as long as possible. This is also of interest to policy makers who try to cope with growing staff shortages and increasing health care expenses. Ambient assisted living (AAL) technologies can support the desire for independence and aging in place. However, the implementation of these technologies is much slower than expected. This has been attributed to the lack of focus on user acceptance and user needs. OBJECTIVE The aim of this study is to develop a theoretically grounded understanding of the acceptance of AAL technologies among older adults and to compare the relative importance of different acceptance factors. METHODS A conceptual model of AAL acceptance was developed using the theory of planned behavior as a theoretical starting point. A web-based survey of 1296 older adults was conducted in the Netherlands to validate the theoretical model. Structural equation modeling was used to analyze the hypothesized relationships. RESULTS Our conceptual model showed a good fit with the observed data (root mean square error of approximation 0.04; standardized root mean square residual 0.06; comparative fit index 0.93; Tucker-Lewis index 0.92) and explained 69% of the variance in intention to use. All but 2 of the hypothesized paths were significant at the P<.001 level. Overall, older adults were relatively open to the idea of using AAL technologies in the future (mean 3.34, SD 0.73). CONCLUSIONS This study contributes to a more user-centered and theoretically grounded discourse in AAL research. Understanding the underlying behavioral, normative, and control beliefs that contribute to the decision to use or reject AAL technologies helps developers to make informed design decisions based on users' needs and concerns. These insights on acceptance factors can be valuable for the broader field of eHealth development and implementation.
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Affiliation(s)
- Christina Jaschinski
- Research Group Technology, Health & Care, Saxion University of Applied Sciences, Enschede, Netherlands
| | - Somaya Ben Allouch
- Digital Life, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Oscar Peters
- Saxion University of Applied Sciences, Enschede, Netherlands
| | - Ricardo Cachucho
- Leiden Institute of Advanced Computer Science (LIACS), Leiden University, Leiden, Netherlands
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20
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Miguel Cruz A, Daum C, Comeau A, Salamanca JDG, McLennan L, Neubauer N, Liu L. Acceptance, adoption, and usability of information and communication technologies for people living with dementia and their care partners: a systematic review. Disabil Rehabil Assist Technol 2020; 18:443-457. [PMID: 33378627 DOI: 10.1080/17483107.2020.1864671] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This review aims to examine the instruments, approaches, scales, or assessment tools used to evaluate technology acceptance, technology adoption, and usability of information and communication technologies (ICTs) for people living with dementia and their care partners. METHODS A systematic literature review was conducted. Studies that explored the use of instruments, approaches, scales, or assessment tools to evaluate the technology acceptance and usability of ICTs for people living with dementia and their care partners were identified through five databases: Medline, EMBASE, CINAHL, Web of Science, and Scopus. RESULTS We included 74 out of 2182 papers. The most common scales used included the System Usability Scale (SUS) (11%), the ISONORM 9241/10 Questionnaire (4%), and the Post-Study System Usability Questionnaire (PSSUQ) (4%). Most (59%) of the included approaches, however, were bespoke (i.e., created by the authors for a particular study) and were not named. The approaches or tools used to assess technology acceptance, technology adoption, and usability of ICTs that applied to people living with dementia had an average of 15 items and used an average of 5.23 scale points. CONCLUSION There is no clear, standardised approach for assessing the technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners. The findings of this review may be used by academics to design and implement improved and more consistent assessment tools to assess technology acceptance, technology adoption, and usability of ICTs for people living with dementia and their care partners.IMPLICATIONS FOR REHABILITATIONThe number of ICTs for people with dementia and their care partners that can be used for rehabilitation is increasingThe most commonly recognized assessment tools used in this study were the SUS, ISONORM 9241/10, and PSSUQ questionnaires.For the custom assessment tools, the average number of items included in this study was 15 with five-point bidirectional labelling.There is no clear, standardized approach for assessing the technology acceptance, technology adoption, or usability of ICTs for people with dementia and their care partners.
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Affiliation(s)
- Antonio Miguel Cruz
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Glenrose Rehabilitation Research, Innovation & Technology (GRRIT) Hub, Glenrose Rehabilitation Hospital, Edmonton, Canada.,Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Christine Daum
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Aidan Comeau
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - Juan David Guevara Salamanca
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Department of Sociology, Faculty of Arts, University of Alberta, Edmonton, Canada
| | | | - Noelannah Neubauer
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.,Faculty of Health, University of Waterloo, Waterloo, Canada
| | - Lili Liu
- Faculty of Health, University of Waterloo, Waterloo, Canada
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Bartels SL, van Knippenberg RJM, Köhler S, Ponds RW, Myin-Germeys I, Verhey FRJ, de Vugt ME. The necessity for sustainable intervention effects: lessons-learned from an experience sampling intervention for spousal carers of people with dementia. Aging Ment Health 2020; 24:2082-2093. [PMID: 31368355 DOI: 10.1080/13607863.2019.1647130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Caring for a person with dementia can be challenging over the years. To support family carers throughout their entire caregiving career, interventions with a sustained effectivity are needed. A novel 6-week mobile health (mHealth) intervention using the experience sampling method (ESM) showed positive effects on carers' well-being over a period of 2 months after the intervention. In this study, the effects after 6 months of the selfsame intervention were examined to evaluate the sustainability of positive intervention effects. METHOD The 6-week mHealth intervention consisted of an experimental group (ESM self-monitoring and personalized feedback), a pseudo-experimental group (ESM self-monitoring without feedback), and a control group (providing regular care without ESM self-monitoring or feedback). Carers' sense of competence, mastery, and psychological complaints (depression, anxiety and perceived stress) were evaluated pre- and post-intervention as well as at two follow-up time points. The present study focuses on the 6-month follow-up data (n = 50). RESULTS Positive intervention effects on sense of competence, perceived stress, and depressive symptoms were not sustained over 6-month follow-up. CONCLUSION The benefits of this mHealth intervention for carers of people living with dementia were not sustained over a long time. Similarly, other psychosocial interventions for carers of people with dementia rarely reported long-lasting effects. In order to sustainably contribute to carers' well-being, researchers and clinicians should continuously ensure flexible adjustment of the intervention and consider additional features such as ad-hoc counseling options and booster sessions. In this regard, mHealth interventions can offer ideally suited and unique opportunities.
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Affiliation(s)
- Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Rosalia J M van Knippenberg
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Rudolf W Ponds
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Inez Myin-Germeys
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
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Söling S, Köberlein-Neu J, Müller BS, Dinh TS, Muth C, Pfaff H, Karbach U. From sensitization to adoption? A qualitative study of the implementation of a digitally supported intervention for clinical decision making in polypharmacy. Implement Sci 2020; 15:82. [PMID: 32958010 PMCID: PMC7507604 DOI: 10.1186/s13012-020-01043-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/09/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Formative evaluation of the implementation process for a digitally supported intervention in polypharmacy in Germany. Qualitative research was conducted within a cluster randomized controlled trial (C-RCT). It focused on understanding how the intervention influences behavior-related outcomes in the prescription and medication review process. METHODS/SETTING Twenty-seven general practitioners (GPs) were included in the study in the two groups of the C-RCT, the intervention, and the wait list control group. Behavior-related outcomes were investigated using three-step data analysis (content analytic approach, documentary method, and design of a model of implementation pathways). RESULTS Content analysis showed that physicians were more intensely aware of polypharmacy-related risks, described positive learning effects of the digital technology on their prescribing behavior, and perceived a change in communication with patients and pharmacists. Conversely, they felt uncertain about their own responsibility when prescribing. Three main dimensions were discovered which influenced adoption behavior: (1) the physicians' interpretation of the relevance of pharmaceutical knowledge provided by the intervention in changing decision-making situations in polypharmacy; (2) their medical code of ethics for clinical decision making in the context of progressing digitalization; and (3) their concepts of evidence-based medicine on the basis of professional experiences with polypharmacy in primary care settings. In our sample, both simple and complex pathways from sensitization to adoption were observed. The resulting model on adoption behavior includes a paradigmatic description of different pathways and a visualization of different observed levels and applied methodological approaches. We assumed that the GP habitus can weaken or strengthen interventional effects towards intervention uptake. This formative evaluation strategy is beneficial for the identification of behavior-related implementation barriers and facilitators. CONCLUSION Our analyses of the adoption behavior of a digitally supported intervention in polypharmacy revealed both simple and complex pathways from awareness to adoption, which may impact the implementation of the intervention and therefore, its effectiveness. Future consideration of adoption behavior in the planning and evaluation of digitally supported interventions may enhance uptake and support the interpretation of effects. TRIAL REGISTRATION NCT03430336 , 12 February 2018.
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Affiliation(s)
- Sara Söling
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Department of Health Services Research, University of Cologne, Cologne, Germany.
| | - Juliane Köberlein-Neu
- Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | | | - Truc Sophia Dinh
- Institute of General Practice, Goethe University, Frankfurt, Germany
| | - Christiane Muth
- Institute of General Practice, Goethe University, Frankfurt, Germany
| | - Holger Pfaff
- Institute for Medical Sociology, Health Services Research and Rehabilitation Science, Department of Health Services Research, University of Cologne, Cologne, Germany
| | - Ute Karbach
- Department Sociology in Rehabilitation, Faculty of Rehabilitation Sciences, Technical University Dortmund, Dortmund, Germany
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Gamification as an approach to improve resilience and reduce attrition in mobile mental health interventions: A randomized controlled trial. PLoS One 2020; 15:e0237220. [PMID: 32877425 PMCID: PMC7467300 DOI: 10.1371/journal.pone.0237220] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 07/20/2020] [Indexed: 01/17/2023] Open
Abstract
Forty percent of all general-practitioner appointments are related to mental illness, although less than 35% of individuals have access to therapy and psychological care, indicating a pressing need for accessible and affordable therapy tools. The ubiquity of smartphones offers a delivery platform for such tools. Previous research suggests that gamification-turning intervention content into a game format-could increase engagement with prevention and early-stage mobile interventions. This study aimed to explore the effects of a gamified mobile mental health intervention on improvements in resilience, in comparison with active and inactive control conditions. Differences between conditions on changes in personal growth, anxiety and psychological wellbeing, as well as differences in attrition rates, were also assessed. The eQuoo app was developed and published on all leading mobile platforms. The app educates users about psychological concepts including emotional bids, generalization, and reciprocity through psychoeducation, storytelling, and gamification. In total, 358 participants completed in a 5-week, 3-armed (eQuoo, "treatment as usual" cognitive behavioral therapy journal app, no-intervention waitlist) randomized controlled trial. Relevant scales were administered to all participants on days 1, 17, and 35. Repeated-measures ANOVA revealed statistically significant increases in resilience in the test group compared with both control groups over 5 weeks. The app also significantly increased personal growth, positive relations with others, and anxiety. With 90% adherence, eQuoo retained 21% more participants than the control or waitlist groups. Intervention delivered via eQuoo significantly raised mental well-being and decreased self-reported anxiety while enhancing adherence in comparison with the control conditions. Mobile apps using gamification can be a valuable and effective platform for well-being and mental health interventions and may enhance motivation and reduce attrition. Future research should measure eQuoo's effect on anxiety with a more sensitive tool and examine the impact of eQuoo on a clinical population.
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Lin J, Wurst R, Paganini S, Hohberg V, Kinkel S, Göhner W, Ramsenthaler C, Fuchs R. A group- and smartphone-based psychological intervention to increase and maintain physical activity in patients with musculoskeletal conditions: study protocol for a randomized controlled trial ("MoVo-App"). Trials 2020; 21:502. [PMID: 32513291 PMCID: PMC7278049 DOI: 10.1186/s13063-020-04438-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 05/20/2020] [Indexed: 11/26/2022] Open
Abstract
Abstract Background Interventions designed to increase the level of physical activity are crucial in the treatment of patients with musculoskeletal conditions. The psychological group-based intervention MoVo-LISA based on the Motivation-Volition (MoVo) Process Model has been shown to effectively promote physical activity. The aim of this study is to evaluate whether a MoVo-based app (MoVo-App) subsequent to MoVo-LISA during orthopedic inpatient care can support people to increase and maintain their amount of physical activity. Methods/design In this parallel-group randomized controlled trial, patients with musculoskeletal disorders will be randomized to either (a) a combination of the group-based intervention program MoVo-LISA to promote physical activity plus the MoVo-App or (b) the group-based intervention program alone without the app. The intervention group will receive the MoVo-App after discharge from inpatient rehabilitation. They receive help to increase and maintain their level of physical activity (initiated by the group program) by tracking their health goals, activity plans, major barriers, and barrier management that were developed during the group-based program. We will recruit 224 initially minimally active participants during orthopedic rehabilitation care. Outcomes are assessed at clinic admission; discharge; 6 weeks; and 3 (post-treatment), 6, and 12 months after discharge (follow-up). The primary outcome is sport activity (active/inactive and minutes of activity) at 6-month follow-up. Secondary outcomes are movement activity, cognitive mediators of behavioral change (e.g., self-efficacy, action planning), and health-related variables (e.g., pain intensity, depression). To evaluate intervention effects, linear mixed effects models (both on intention-to-treat basis with an additional per-protocol analysis) will be conducted with each outcome variable and with time as the within-subjects factor and group as the between-subjects factor, along with all two-way interactions and accounting for covariates as fixed effects. Discussion This is the first evaluation of the effectiveness of an app in combination with a face-to-face group intervention to promote physical activity. The approach of using an app in addition to an effective face-to-face intervention program, both based on the MoVo model, might sustain positive intervention effects introduced in routine health care. Trial registration The trial “A group- and smartphone-based psychological intervention to increase physical activity in patients with musculoskeletal conditions: A randomized controlled trial” is registered at the World Health Organization International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS), DRKS00014814. Registered on 18 October 2018; URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00014814.
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Affiliation(s)
- Jiaxi Lin
- Department of Psychiatry and Psychotherapy Medical Center, Freiburg, Germany
| | - Ramona Wurst
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
| | - Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany.
| | - Vivien Hohberg
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
| | - Stephan Kinkel
- Schwarzwaldkliniken Bad Krozingen, Bad Krozingen, Germany
| | - Wiebke Göhner
- Department of Health Psychology, Catholic University of Applied Sciences, Freiburg, Germany
| | - Christina Ramsenthaler
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
| | - Reinhard Fuchs
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Schwarzwaldstrasse 175, 79117, Freiburg, Germany
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Appel L, Peisachovich E, Sinclair D, Jokel R, Da Silva C. SafeHome: A Serious Game to Promote Safe Environments for Persons Living with Dementia. Cureus 2020; 12:e6949. [PMID: 32076588 PMCID: PMC7015112 DOI: 10.7759/cureus.6949] [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] [Indexed: 11/23/2022] Open
Abstract
The dementia epidemic continues to affect families across Canada. The number of persons living with dementia (PLWD) is projected to reach 1.1 million over the next 20 years, placing further financial and resource constraints on the Canadian healthcare system. Caregiver education is vital in ensuring the quality of life and safety for PLWD and can increase the time they are able to live at home, which is correlated with positive outcomes for both PLWD and their caregivers, and a reduction in system costs. However, current educational support often requires individuals to travel to local, urban service care centers and educational content is often provided in English, which can exacerbate the difficulties faced by marginalized caregivers (e.g., immigrants and those living in rural settings) who are caring for PLWD. To address this issue, a team of researchers developed a serious game called “SafeHome” that teaches safety strategies by having players identify and rectify potential hazards in the home setting that may negatively impact on PLWD outcomes, such as falls. A usability study was conducted using an adapted, validated questionnaire and semi-structured focus groups to better understand users’ experience and obtain suggestions for the SafeHome serious game improvement. Results indicated that 80% of the participants were satisfied with the activities provided through SafeHome. All participants (n = 13) made recommendations for improving the usability, functionality, and comprehensiveness of the educational content. This feedback will inform future iterations of SafeHome and add valuable contributions to the growing literature on innovative e-learning resources that support PLWD and their caregivers.
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Affiliation(s)
- Lora Appel
- Medical Education and Simulation, York University, Toronto, CAN
| | | | - Don Sinclair
- Medical Education and Simulation, York University, Toronto, CAN
| | - Regina Jokel
- Neurology, Baycrest Health Sciences, Toronto, CAN
| | - Celina Da Silva
- Medical Education and Simulation, York University, Toronto, CAN
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Alam MZ, Hoque MR, Hu W, Barua Z. Factors influencing the adoption of mHealth services in a developing country: A patient-centric study. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2020. [DOI: 10.1016/j.ijinfomgt.2019.04.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Alam MZ, Hu W, Hoque MR, Kaium MA. Adoption intention and usage behavior of mHealth services in Bangladesh and China. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2020. [DOI: 10.1108/ijphm-03-2019-0023] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper was to explore the comparative influential factors affecting the behavioral intention and actual usage of mHealth services in two distinct national environments, i.e. China and Bangladesh, in relation to the international expansion of mHealth services.
Design/methodology/approach
In this study, widely accepted Unified Theory of Acceptance and Use of Technology (UTAUT) with two additional variables, i.e. Perceived Reliability and Price Value have been selected as a theoretical framework. Primary data were collected from existing mHealth users among generation Y in both China and Bangladesh. A total of 296 and 250 questionnaires were deemed as usable for data analysis for Bangladesh and China, respectively.
Findings
Performance expectancy and social influence had significant impact on the adoption intention of mHealth services for both countries. Effort expectancy and price value were insignificant factors for Bangladesh, whereas facilitating condition and perceived reliability were insignificant for China.
Practical implications
The insights from this study could benefit mHealth services providers and those policymakers who seek to enter the Chinese and the Bangladeshi healthcare market. The dimensions identified in the study are based on a full assessment of mHealth usages experiences. Global service providers can use the dimensions identified by the paper to better assess their service performance on an international level.
Originality/value
The paper is unique in that it is one of the first cross-country examinations of influential factors affecting the adoption of mHealth services in two different countries. This study confirms the applicability of extended UTAUT model in the context of mHealth services among the generation Y in developing countries such as China and Bangladesh.
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Hussein T, Chauhan PK, Dalmer NK, Rudzicz F, Boger J. Exploring interface design to support caregivers' needs and feelings of trust in online content. J Rehabil Assist Technol Eng 2020; 7:2055668320968482. [PMID: 33343921 PMCID: PMC7727054 DOI: 10.1177/2055668320968482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 09/15/2020] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Family caregivers of people living with dementia require a range of accurate, current, and reliable information throughout the care trajectory. Much of this information is available online, however it can be difficult for caregivers to identify and decide what content is relevant to them. Little is known about how online design cues impact family caregivers' decision to assess how trustworthy information is and whether to engage with it. METHODS Our exploratory research focused on the interface design of CARE-RATE, an online search tool intended to support more effective information searches for family caregivers seeking dementia care-related resources. Data from focus groups were coupled with design literature to inform the development of three mockups that were evaluated by seven dementia caregiver experts. RESULTS Participants preferred a search bar design because of its simplicity, familiarity, and functionality. Design elements that impact trust included logos from reputable organizations, transparency of content author, and ratings from other caregivers. CONCLUSION Feelings of trust regarding information, including the ability to ascertain trustworthiness, is a major aspect of caregivers' willingness to engage with online content. Transparency and familiarity appear to be key elements that impact caregivers' trust in online information, which agrees with current web design research.
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Affiliation(s)
- Thana Hussein
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Preet K Chauhan
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Nicole K Dalmer
- Department of Health Aging & Society, McMaster University, Hamilton, ON, Canada
| | - Frank Rudzicz
- Department of Computer Science, University of Toronto, Toronto, ON, Canada
| | - Jennifer Boger
- Department of Systems Design Engineering, University of Waterloo, Waterloo, ON, Canada
- Research Institute for Aging, Waterloo, ON
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Henshall C, Davey Z, Jacelon C, Martin C. A usability study to test the effectiveness, efficiency and simplicity of a newly developed Internet-based Exercise-focused Health App for Lung cancer survivors (iEXHALE): Protocol paper. Health Informatics J 2019; 26:1431-1442. [PMID: 31631739 DOI: 10.1177/1460458219882268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The Internet-based Exercise-focused Health App for Lung cancer survivors (iEXHALE) is a mobile web app being developed to provide lung cancer survivors with an algorithm-based, tailor-made, self-management programme to inform their exercise choices and improve symptom severity. The aim of this protocol paper is to detail the plan for conducting the usability study to test the effectiveness, efficiency and simplicity of an exercise-focused self-management mobile web app for lung cancer survivors. The mixed methods study will consist of three consecutive phases, each interspersed with elements of data analysis and app prototype redevelopment. The study will take place in Oxford, United Kingdom. Ethical approvals have been obtained. The study will contribute to lung cancer survivorship research and is important in the app developmental process. This study contributes to the international forum for the exchange of practice, innovation and research, increases transparency in mobile health developmental processes and contributes to the methodological evidence base.
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Lattie EG, Adkins EC, Winquist N, Stiles-Shields C, Wafford QE, Graham AK. Digital Mental Health Interventions for Depression, Anxiety, and Enhancement of Psychological Well-Being Among College Students: Systematic Review. J Med Internet Res 2019; 21:e12869. [PMID: 31333198 PMCID: PMC6681642 DOI: 10.2196/12869] [Citation(s) in RCA: 270] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/29/2019] [Accepted: 06/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND College students are increasingly reporting common mental health problems, such as depression and anxiety, and they frequently encounter barriers to seeking traditional mental health treatments. Digital mental health interventions, such as those delivered via the Web and apps, offer the potential to improve access to mental health treatment. OBJECTIVE This study aimed to review the literature on digital mental health interventions focused on depression, anxiety, and enhancement of psychological well-being among samples of college students to identify the effectiveness, usability, acceptability, uptake, and adoption of such programs. METHODS We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (registration number CRD42018092800), and the search strategy was conducted by a medical research librarian in the following databases: MEDLINE (Ovid), EMBASE (Elsevier), PsycINFO (EbscoHost), the Cochrane Library (Wiley), and Web of Science (Thomson Reuters) from the date of inception to April 2019. Data were synthesized using a systematic narrative synthesis framework, and formal quality assessments were conducted to address the risk of bias. RESULTS A total of 89 studies met the inclusion criteria. The majority of interventions (71/89, 80%) were delivered via a website, and the most common intervention was internet-based cognitive behavioral therapy (28, 31%). Many programs (33, 37%) featured human support in the form of coaching. The majority of programs were either effective (42, 47%) or partially effective (30, 34%) in producing beneficial changes in the main psychological outcome variables. Approximately half of the studies (45, 51%) did not present any usability or acceptability outcomes, and few studies (4, 4%) examined a broad implementation of digital mental health interventions on college campuses. Quality assessments revealed a moderate-to-severe risk of bias in many of the studies. CONCLUSIONS Results suggest that digital mental health interventions can be effective for improving depression, anxiety, and psychological well-being among college students, but more rigorous studies are needed to ascertain the effective elements of these interventions. Continued research on improving the user experience of, and thus user engagement with, these programs appears vital for the sustainable implementation of digital mental health interventions on college campuses.
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Affiliation(s)
- Emily G Lattie
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Elizabeth C Adkins
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Nathan Winquist
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Q Eileen Wafford
- Galter Health Sciences Library and Learning Center, Northwestern University, Chicago, IL, United States
| | - Andrea K Graham
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
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Guisado-Fernández E, Giunti G, Mackey LM, Blake C, Caulfield BM. Factors Influencing the Adoption of Smart Health Technologies for People With Dementia and Their Informal Caregivers: Scoping Review and Design Framework. JMIR Aging 2019; 2:e12192. [PMID: 31518262 PMCID: PMC6716546 DOI: 10.2196/12192] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/13/2018] [Accepted: 03/11/2019] [Indexed: 01/22/2023] Open
Abstract
Background Smart Health technologies (s-Health technologies) are being developed to support people with dementia (PwD) and their informal caregivers at home, to improve care and reduce the levels of burden and stress they experience. However, although s-Health technologies have the potential to facilitate this, the factors influencing a successful implementation in this population are still unknown. Objective The aim of this study was to review existing literature to explore the factors influencing PwD and their informal caregivers’ adoption of s-Health technologies for home care. Methods Following the Arksey and O’Malley methodology, this study is a scoping review providing a narrative description of the scientific literature on factors influencing s-Health technology adoption for PwD and their informal caregivers. A search was conducted using PubMed, the Cochrane library, the IEEE library, and Scopus. Publications screening was conducted by 2 researchers based on inclusion criteria, and full-text analysis was then conducted by 1 researcher. The included articles were thematically analyzed by 2 researchers to gain an insight into factors influencing adoption that PwD and their informal caregivers have to encounter when using s-Health technologies. Relevant information was identified and coded. Codes were later discussed between the researchers for developing and modifying them and for achieving a consensus, and the researchers organized the codes into broader themes. Results Emerging themes were built in a way that said something specific and meaningful about the research question, creating a list of factors influencing the adoption of s-Health technologies for PwD and their informal caregivers, including attitudinal aspects, ethical issues, technology-related challenges, condition-related challenges, and identified gaps. A design framework was created as a guide for future research and innovation in the area of s-Health technologies for PwD and their informal caregivers: DemDesCon for s-Health Technologies. DemDesCon for s-Health Technologies addresses 4 domains to consider for the design and development of s-Health technologies for this population: cognitive decline domain, physical decline domain, social domain, and development domain. Conclusions Although s-Health technologies have been used in health care scenarios, more work is needed for them to fully achieve their potential for use in dementia care. Researchers, businesses, and public governments need to collaborate to design and implement effective technology solutions for PwD and their informal caregivers, but the lack of clear design guidelines seems to be slowing the process. We believe that the DemDesCon framework will provide them with the guidance and assistance needed for creating meaningful devices for PwD home care and informal caregivers, filling a much-needed space in the present knowledge gap.
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Affiliation(s)
- Estefanía Guisado-Fernández
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland.,Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
| | | | - Laura M Mackey
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
| | - Catherine Blake
- University College Dublin School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
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Chen JI, Mastarone GL, Ambrosino SA, Anzalone N, Carlson KF, Dobscha SK, Teo AR. Evaluation of the Safety and Design of Community Internet Resources for Veteran Suicide Prevention. CRISIS 2019; 40:347-354. [PMID: 30935244 DOI: 10.1027/0227-5910/a000590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Recent data show many veterans who die by suicide are not currently engaged in mental health care. Veterans frequently use the Internet for health information and may look online for community resources when in distress. However, little is known about their design characteristics. Aim: To evaluate the design and content of community, veteran suicide prevention websites. Method: Community websites focused on veteran suicide prevention were gathered through Internet searches using standardized search terms. Websites that met the inclusion criteria (n = 9) were evaluated for adherence to suicide safe messaging, usability, readability, and credibility heuristics. Interrater reliability was evaluated using kappa statistics. Descriptive statistics were used to describe website features. Results: Community websites tended to provide help-seeking information, safe messaging, and community activities. However, no websites provided information on lethal means safety or references to signal credibility. Limitations: The sample was small and only included English-language websites, and focused on veteran-oriented, community websites. Conclusion: Community suicide prevention websites focused on veterans could be improved through increased readability, credibility, and provision of lethal means safety information.
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Affiliation(s)
- Jason I Chen
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Ginnifer L Mastarone
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Santisia A Ambrosino
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA
| | - Nicole Anzalone
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA
| | - Kathleen F Carlson
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Steven K Dobscha
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Alan R Teo
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
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Woo K, Tark A, Baik D, Dowding D. Informal Caregiver Decision-Making Factors Associated With Technology Adoption and Use in Home Healthcare: A Systematic Scoping Review. Home Healthc Now 2019; 37:328-336. [PMID: 31688467 DOI: 10.1097/nhh.0000000000000811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Technology systems to alleviate the burden of caregiving are increasing in use. The home is a unique place where chronic disease management is often performed by informal caregivers, yet how caregivers make decisions about adopting a specific technology has not been thoroughly explored. This systematic scoping review mapped evidence on decision-making factors associated with technology adoption and use by caregivers of patients receiving care at home. We followed the recommendations developed by members of the Joanna Briggs Institute. Four electronic databases (PubMed, Medline, CINAHL, and Embase) were searched using both medical subject headings (MeSH terms) and key words. A total of six papers were included for data synthesis. Factors such as information, comprehension, motivation, time, perceived burden, and perceived caregiving competency were found to affect adoption of technology. There are other factors uniquely springing from the patient and technology, as well as shared issues between caregivers and patient, and caregivers and technology. Although some factors depend on technology type and patient diagnosis, there were some common factors across the research. Those factors can be carefully considered in referring technology use for caregivers. More focused study in this underinvestigated area is much needed.
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Affiliation(s)
- Kyungmi Woo
- Kyungmi Woo, PhD, RN, is a Postdoctoral Research Fellow, School of Nursing, Columbia University, New York, New York. Aluem Tark, MPhil, FNP, is a Postdoctoral Research Fellow, School of Nursing, University of Iowa, Iowa City, Iowa. Dawon Baik, PhD, RN, is an Assistant Professor, College of Nursing, University of Colorado, Aurora, Colorado. Dawn Dowding, PhD, RN, FAAN, is a Professor in Clinical Decision Making, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
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Wysocki T, Pierce J, Caldwell C, Aroian K, Miller L, Farless R, Hafezzadeh I, McAninch T, Lee JM. A Web-Based Coping Intervention by and for Parents of Very Young Children With Type 1 Diabetes: User-Centered Design. JMIR Diabetes 2018; 3:e16. [PMID: 30559089 PMCID: PMC6307695 DOI: 10.2196/diabetes.9926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/08/2018] [Accepted: 06/15/2018] [Indexed: 12/13/2022] Open
Abstract
Background Management of type 1 diabetes (T1D) among children aged <6 years is exceptionally challenging for parents and caregivers. Metabolic and psychosocial outcomes among very young children with T1D (YC-T1D) are tightly associated with their parents’ ability to meet these challenges. There is scant research testing interventions targeting these issues and few resources to equip health care providers with feasible and effective coping strategies for these parents. User-centered design (UCD) of a continuously accessible Web-based resource could be a mechanism for helping parents of YC-T1D cope more effectively with the complex challenges they face by providing them with information, solutions, and emotional support. Objective The objectives of this paper are to (1) describe the application of UCD principles to the development of a Web-based coping intervention designed by and for parents of very young children (<6 years old) with T1D; (2) illustrate the use of crowdsourcing methods in obtaining the perspectives of parents, health care providers, and Web development professionals in designing and creating this resource; and (3) summarize the design of an ongoing randomized controlled trial (RCT) that is evaluating the effects of parental access to this resource on pertinent child and parent outcomes. Methods This paper illustrates the application of UCD principles to create a Web-based coping resource designed by and for parents of YC-T1D. A Web-based Parent Crowd, a Health Care Provider Crowd, and a Focus Group of minority parents provided input throughout the design process. A formal usability testing session and design webinars yielded additional stakeholder input to further refine the end product. Results This paper describes the completed website and the ongoing RCT to evaluate the effects of using this Web-based resource on pertinent parent and child outcomes. Conclusions UCD principles and the targeted application of crowdsourcing methods provided the foundation for the development, construction, and evaluation of a continuously accessible, archived, user-responsive coping resource designed by and for parents of YC-T1D. The process described here could be a template for the development of similar resources for other special populations that are enduring specific medical or psychosocial distress. The ongoing RCT is the final step in the UCD process and is designed to validate its merits.
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Affiliation(s)
- Tim Wysocki
- Nemours Children's Specialty Care, Center for Health Care Delivery Science, Nemours Children's Health System, Jacksonville, FL, United States
| | - Jessica Pierce
- Nemours Children's Hospital, Center for Health Care Delivery Science, Nemours Children's Health System, Orlando, FL, United States
| | - Cindy Caldwell
- Nemours Children's Specialty Care, Center for Health Care Delivery Science, Nemours Children's Health System, Jacksonville, FL, United States
| | - Karen Aroian
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Louis Miller
- eCity Interactive, Inc, Philadelphia, PA, United States
| | | | | | - Terri McAninch
- Nemours Foundation, Department of Marketing and Communication, Nemours Children's Health System, Jacksonville, FL, United States
| | - Joyce M Lee
- Child Health Evaluation Research, Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
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Liao Y, Schembre S. Acceptability of Continuous Glucose Monitoring in Free-Living Healthy Individuals: Implications for the Use of Wearable Biosensors in Diet and Physical Activity Research. JMIR Mhealth Uhealth 2018; 6:e11181. [PMID: 30355561 PMCID: PMC6231900 DOI: 10.2196/11181] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/10/2018] [Accepted: 09/27/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Wearable sensors have been increasingly used in behavioral research for real-time assessment and intervention purposes. The rapid advancement of biomedical technology typically used in clinical settings has made wearable sensors more accessible to a wider population. Yet the acceptability of this technology for nonclinical purposes has not been examined. OBJECTIVE The aim was to assess the acceptability of wearing a continuous glucose monitor (CGM) device among a sample of nondiabetic individuals, and to compare the acceptability of a CGM between a mobile diet tracking app (MyFitnessPal) and an accelerometer. METHODS A total of 30 nondiabetic adults went through a 7-day observational study. They wore a CGM sensor, tracked their diet and physical activity using the CGM receiver and MyFitnessPal, and wore an accelerometer on their waist. After the monitoring period, they completed a 10-item survey regarding acceptability of each of the study tools. Two-tailed paired-sample t tests were conducted to examine whether the summary acceptability scores were comparable between the CGM sensor/receiver and MyFitnessPal/accelerometer. RESULTS More than 90% of the study participants agreed that the CGM sensor and receiver were easy to use (28/30 and 27/30, respectively), useful (28/30 and 29/30, respectively), and provided relevant information that was of interest to them (27/30 and 28/30, respectively). The summary acceptability scores (out of a 5-point Likert scale) were mean 4.06 (SD 0.55) for the CGM sensor, mean 4.05 (SD 0.58) for the CGM receiver, mean 4.10 (SD 0.68) for MyFitnessPal, and mean 3.73 (SD 0.76) for the accelerometer. CONCLUSIONS The high acceptability of using a CGM from this study suggests a great potential for using CGMs in nondiabetic adults in research settings. Although potential selection bias might contribute to the high acceptability in this study, the continued advancements in wearable sensor technology will make the barriers to tracking and collecting personal physiological data more and more minimal.
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Affiliation(s)
- Yue Liao
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan Schembre
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- Department of Family and Community Medicine, College of Medicine-Tucson, University of Arizona, Tucson, AZ, United States
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Lin J, Faust B, Ebert DD, Krämer L, Baumeister H. A Web-Based Acceptance-Facilitating Intervention for Identifying Patients' Acceptance, Uptake, and Adherence of Internet- and Mobile-Based Pain Interventions: Randomized Controlled Trial. J Med Internet Res 2018; 20:e244. [PMID: 30131313 PMCID: PMC6123541 DOI: 10.2196/jmir.9925] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/26/2018] [Accepted: 05/12/2018] [Indexed: 02/01/2023] Open
Abstract
Background Internet- and mobile-based interventions are effective for the treatment of chronic pain. However, little is known about patients’ willingness to engage with these types of interventions and how the uptake of such interventions can be improved. Objective The aim of this study was to identify people’s acceptance, uptake, and adherence (primary outcomes) with regard to an internet- and mobile-based intervention for chronic pain and the influence of an information video as an acceptance-facilitating intervention (AFI). Methods In this randomized controlled trial with a parallel design, we invited 489 individuals with chronic pain to participate in a Web-based survey assessing the acceptance of internet- and mobile-based interventions with the offer to receive an unguided internet- and mobile-based intervention for chronic pain after completion. Two versions of the Web-based survey (with and without AFI) were randomly sent to two groups: one with AFI (n=245) and one without AFI (n=244). Participants who completed the Web-based survey with or without AFI entered the intervention group or the control group, respectively. In the survey, the individuals’ acceptance of pain interventions, measured with a 4-item scale (sum score ranging from 4 to 20), predictors of acceptance, sociodemographic and pain-related variables, and physical and emotional functioning were assessed. Uptake rates (log in to the intervention) and adherence (number of completed modules) to the intervention was assessed 4 months after intervention access. To examine which factors influence acceptance, uptake rate, and adherence in the internet- and mobile-based interventions, we conducted additional exploratory subgroup analyses. Results In total, 57 (intervention group) and 58 (control group) participants in each group completed the survey and were included in the analyses. The groups did not differ with regard to acceptance, uptake rate, or adherence (P=.64, P=.56, P=.75, respectively). Most participants reported moderate (68/115, 59.1%) to high (36/115, 31.3%) acceptance, with 9.6% (11/115) showing low acceptance (intervention group: mean 13.91, SD 3.47; control group: mean 13.61, SD 3.50). Further, 67% (38/57, intervention group) and 62% (36/58, control group) had logged into the intervention. In both groups, an average of 1.04 (SD 1.51) and 1.14 (SD 1.90) modules were completed, respectively. Conclusions The informational video was not effective with regard to acceptance, uptake rate, or adherence. Despite the high acceptance, the uptake rate was only moderate and adherence was remarkably low. This study shows that acceptance can be much higher in a sample participating in an internet- and mobile-based intervention efficacy trial than in the target population in routine health care settings. Thus, future research should focus not only on acceptance and uptake facilitating interventions but also on ways to influence adherence. Further research should be conducted within routine health care settings with more representative samples of the target population. Trial Registration German Clinical Trial Registration DRKS00006183; http://www.drks.de/drks_web/navigate.do ?navigationId=trial.HTML&TRIAL_ID=DRKS00006183 (Archived by WebCite at http://www.webcitation.org/70ebHDhne)
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Affiliation(s)
- Jiaxi Lin
- Institute of Psychiatry, Psychology & Neuroscience, Health Psychology Department, King's College London, London, United Kingdom.,Institute of Sports and Sport Science, Department of Sport Psychology, University of Freiburg, Freiburg, Germany
| | - Bianca Faust
- Rehabilitation-Center Todtmoos, Clinic Wehrawald, Todtmoos, Germany
| | - David Daniel Ebert
- Clinical Psychology and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Lena Krämer
- Institute of Psychology, Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Harald Baumeister
- Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Ulm, Ulm, Germany
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Mellikeche S, Boussekey O, Martin G, Campoy E, Lajonchère JP, Degoulet P. Evaluation of the unified model of information systems continuance (UMISC) in two hospital environments. Int J Med Inform 2018; 117:66-81. [PMID: 30032967 DOI: 10.1016/j.ijmedinf.2018.06.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 05/11/2018] [Accepted: 06/03/2018] [Indexed: 12/14/2022]
Abstract
CONTEXT The deployment and long-term acceptance of clinical information systems (CISs) are faced with multiple difficulties. They include insufficient quality of the systems in place and resistance to the multiple changes they induce in care processes. Permanent evaluation of deployed solutions is a prerequisite to their continuous improvement. OBJECTIVE The purpose of this study was twofold: (1) To validate the post-adoption unified model of information systems continuance (UMISC) progressively developed at the Georges Pompidou University Hospital (HEGP) in Paris (internal validation); and (2) To compare, using the same evaluation model, the results observed at HEGP with those of the Saint-Joseph Hospital Group (HPSJ), another Paris acute care institution (external validation). METHODS The UMISC post-adoption model is built around nine dimensions: end-user characteristics, social norm (SN), IS quality (ISQ), facilitating conditions (FC), perceived usefulness (PU), confirmation of expectations (CE), profession-adjusted use (PAU), satisfaction (SAT), and continuance intention (CI). Two semi-quantitative evaluation surveys were performed at HEGP in 2014 and 2015, and one at HPSJ in 2015. Statistical analysis included multiple regression analysis and structural equation modeling (SEM). RESULTS The analysis concerned 459 responders, 264 at HEGP and 195 at HPSJ. UMISC indicators, with the exception of SN, are superior at HEGP than at HPSJ, which had a shorter CIS anteriority than HEGP. In SEM analysis, the UMISC model explained 25% and 40% of the CIS use, 92% and 93% of health professionals' satisfaction, and 72% and 71% of continuance intention at HEGP and HPSJ, respectively. Seventeen of the 21 tested UMISC hypotheses were supported in at least one of the two sites. CONCLUSION The UMISC evaluation model can be used as a comparison and explanatory model of CIS use, satisfaction and continuance intention in post-CIS adoption situations that become prevalent in current electronic hospitals.
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Affiliation(s)
- Samir Mellikeche
- Georges Pompidou University Hospital (HEGP), Paris, France; Inserm-UMRS 1138, CRC, Team 22, Paris, France; Paris Descartes University, Paris, France.
| | | | | | - Eric Campoy
- DRM (UMR-CNRS 7088), PSL-Paris Dauphine University, Paris, France
| | | | - Patrice Degoulet
- Georges Pompidou University Hospital (HEGP), Paris, France; Inserm-UMRS 1138, CRC, Team 22, Paris, France; Paris Descartes University, Paris, France.
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Yeager CM, Shoji K, Luszczynska A, Benight CC. Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study. JMIR Ment Health 2018; 5:e29. [PMID: 29636323 PMCID: PMC5938690 DOI: 10.2196/mental.9449] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/03/2018] [Accepted: 02/12/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. OBJECTIVE The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. METHODS Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. RESULTS The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). CONCLUSIONS Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.
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Affiliation(s)
- Carolyn M Yeager
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Kotaro Shoji
- Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Aleksandra Luszczynska
- Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,SWPS University of Social Sciences & Humanities, Wroclaw, Poland
| | - Charles C Benight
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
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Sin J, Henderson C, Spain D, Cornelius V, Chen T, Gillard S. eHealth interventions for family carers of people with long term illness: A promising approach? Clin Psychol Rev 2018; 60:109-125. [PMID: 29429856 DOI: 10.1016/j.cpr.2018.01.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 11/29/2017] [Accepted: 01/31/2018] [Indexed: 12/22/2022]
Abstract
Family carers of people who have long term illness often experience physical and mental health morbidities, and burden. While there is good evidence to suggest that carers benefit from psychosocial interventions, these have primarily been delivered via face-to-face individual or group-formats. eHealth interventions offer a novel, accessible and self-paced approach to care delivery. Whether these are effective for carers' wellbeing has been little explored. This paper reports the first comprehensive systematic review in this area. A total of 78 studies, describing 62 discrete interventions, were identified. Interventions commonly aimed to promote carers' knowledge, self-efficacy, caregiving appraisal, and reduce global health morbidities. Interventions were offered to carers of people with a wide range of long term illness; dementia has been the most researched area, as reported in 40% of studies. Clinical and methodological heterogeneity in interventions precluded meta-analyses, and so data were analysed narratively. The most popular approach has comprised psychoeducational interventions delivered via an enriched online environment with supplementary modes of communication, such as network support with professionals and peers. Overall, carers appreciate the flexibility and self-paced nature of eHealth interventions, with high rates of satisfaction and acceptability. More studies using robust designs are needed to extend the evidence base.
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Affiliation(s)
- Jacqueline Sin
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK; School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, Reading RG6 6AL, England, UK.
| | - Claire Henderson
- Health Service & Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
| | - Debbie Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, England, UK.
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Imperial College London, Stadium House, 68 Wood Lane, London W12 7RH, England, UK.
| | - Tao Chen
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, England, UK.
| | - Steve Gillard
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London SW17 0RE, England, UK.
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Pyykkő I, Manchaiah V, Kentala E, Levo H, Juhola M. Internet-Based Self-Help for Ménière's Disease: Details and Outcome of a Single-Group Open Trial. Am J Audiol 2017; 26:496-506. [PMID: 29049634 DOI: 10.1044/2017_aja-16-0068] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 05/16/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE In this article, we present the details and the pilot outcome of an Internet-based self-help program for Ménière's disease (MD). METHOD The Norton-Kaplan model is applied to construct a strategic, person-focused approach in the enablement process. The program assesses the disorder profile and diagnosis. In the therapeutic component of the program, the participant defines vision and time frame, inspects confounding factors, determines goals, establishes a strategy, and starts to work on the important problems caused by the disorder. The program works interactively, utilizes collaboration with significant others, and enhances positive thinking. Participants took part in an Internet-based self-help program. Data were collected interactively using open-ended and structured questionnaires on various disease-specific and general health aspects. The pilot outcome of 41 patients with MD was evaluated. RESULTS The analysis of the pilot data showed statistically significant improvement in their general health-related quality of life (p < .001). Also, the outcome of the Posttraumatic Growth Inventory (Cann et al., 2010) showed small to moderate change as a result of the intervention. CONCLUSIONS The Internet-based self-help program can be helpful in the rehabilitation of patients with MD to supplement medical therapy.
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Affiliation(s)
- Ilmari Pyykkő
- Hearing and Balance Research Unit, Department of Otolaryngology, University of Tampere, Finland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Swedish Institute for Disability Research, Department of Behavioral Sciences and Learning, Linköping University, Sweden
- Audiology India, Karnataka, Mysore
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
| | - Erna Kentala
- Department of Otolaryngology, University of Helsinki, Finland
| | - Hilla Levo
- Department of Otolaryngology, University of Helsinki, Finland
| | - Martti Juhola
- School of Information Sciences, University of Tampere, Finland
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Stoll R, Pina A, Gary K, Amresh A. Usability of a Smartphone Application to Support the Prevention and Early Intervention of Anxiety in Youth. COGNITIVE AND BEHAVIORAL PRACTICE 2017; 24:393-404. [PMID: 29056845 PMCID: PMC5648068 DOI: 10.1016/j.cbpra.2016.11.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Anxiety disorders are among the most common psychiatric problems in youth, fail to spontaneously remit, and place some youth at risk for additional behavioral and emotional difficulties. Efforts to target anxiety have resulted in evidence-based interventions but the resulting prevention effects are relatively small, often weakening over time. Mobile health (mHealth) tools could be of use to strengthen the effects of anxiety prevention efforts. Although a large number of mHealth apps have been developed, few have been evaluated in terms of usability prior to clinical effectiveness testing. Because usability is one of the main barriers to mHealth usage and adoption, the objective of this research was to evaluate the usability of a smartphone application (app) corresponding to an indicated prevention and early intervention targeting youth anxiety. To accomplish this, 132 children (M age = 9.65; 63% girls) and 45 service providers (M age = 29.13, 87% female) rated our app along five established dimensions of usability (ease of use, ease of learning, quality of support information, satisfaction, and stigma) using a standardized group-based testing protocol. Findings showed that the app was highly and positively rated by both youth and providers, with some variations (lower ratings when errors occurred). Path analyses findings also showed that system understanding was significantly related to greater system satisfaction, but that such relation occurred through the quality of support information offered by the app.
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Milward J, Deluca P, Drummond C, Watson R, Dunne J, Kimergård A. Usability Testing of the BRANCH Smartphone App Designed to Reduce Harmful Drinking in Young Adults. JMIR Mhealth Uhealth 2017; 5:e109. [PMID: 28790022 PMCID: PMC5566629 DOI: 10.2196/mhealth.7836] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 12/02/2022] Open
Abstract
Background Electronic screening and brief intervention (eSBI) apps demonstrate potential to reduce harmful drinking. However, low user engagement rates with eSBI reduce overall effectiveness of interventions. As “Digital Natives,” young adults have high expectations of app quality. Ensuring that the design, content, and functionality of an eSBI app are acceptable to young adults is an integral stage to the development process. Objective The objective of this study was to identify usability barriers and enablers for an app, BRANCH, targeting harmful drinking in young adults. Methods The BRANCH app contains a drinking diary, alcohol reduction goal setting functions, normative drinking feedback, and information on risks and advice for cutting down. The app includes a social feature personalized to motivate cutting down and to promote engagement with a point-based system for usage. Three focus groups were conducted with 20 users who had tested the app for 1 week. A detailed thematic analysis was undertaken. Results The first theme, “Functionality” referred to how users wanted an easy-to-use interface, with minimum required user-input. Poor functionality was considered a major usability barrier. The second theme, “Design” described how an aesthetic with minimum text, clearly distinguishable tabs and buttons and appealing infographics was integral to the level of usability. The final theme, “Content” described how participants wanted all aspects of the app to be automatically personalized to them, as well as providing them with opportunities to personalize the app themselves, with increased options for social connectivity. Conclusions There are high demands for apps such as BRANCH that target skilled technology users including young adults. Key areas to optimize eSBI app development that emerged from testing BRANCH with representative users include high-quality functionality, appealing aesthetics, and improved personalization.
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Affiliation(s)
- Joanna Milward
- Addictions Department, King's College London, London, United Kingdom
| | - Paolo Deluca
- Addictions Department, King's College London, London, United Kingdom
| | - Colin Drummond
- Addictions Department, King's College London, London, United Kingdom
| | - Rod Watson
- Health Innovation Network, London, United Kingdom
| | - Jacklyn Dunne
- Addictions Department, King's College London, London, United Kingdom
| | - Andreas Kimergård
- Addictions Department, King's College London, London, United Kingdom
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Serwe KM, Hersch GI, Pancheri K. Feasibility of Using Telehealth to Deliver the "Powerful Tools for Caregivers" Program. Int J Telerehabil 2017; 9:15-22. [PMID: 28814991 PMCID: PMC5546558 DOI: 10.5195/ijt.2017.6214] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Caregivers report poorer health and wellness than the general population and identify numerous barriers to their attending programs to improve health and wellness. The purpose of this study was to explore the feasibility of employing a telehealth delivery method to enhance access to caregiver wellness programs. This article presents the quantitative results of a mixed methods feasibility study of translating the Powerful Tools for Caregivers (PTC) program to a telehealth delivery format. Four unpaid family caregivers of older adults participated in a telehealth delivered PTC program, a wellness program with established outcomes in the in-person environment. The program was delivered using synchronous videoconferencing methods. High class attendance and a high median total average Telehealth Usability Questionnaire score of 5.7 indicated the telehealth delivery method was feasible. This research suggests that telehealth is a feasible delivery format for a caregiver program traditionally delivered in an in-person format.
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Affiliation(s)
- Katrina M Serwe
- DEPARTMENT OF OCCUPATIONAL THERAPY, SCHOOL OF HEALTH PROFESSIONS, CONCORDIA UNIVERSITY, MEQUON, WISCONSIN, USA
| | - Gayle I Hersch
- SCHOOL OF OCCUPATIONAL THERAPY, TEXAS WOMAN'S UNIVERSITY, HOUSTON, TEXAS, USA
| | - Karen Pancheri
- NELDA STARK COLLEGE OF NURSING, TEXAS WOMAN'S UNIVERSITY, HOUSTON, TEXAS, USA
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van Rosmalen-Nooijens K, Lo Fo Wong S, Prins J, Lagro-Janssen T. Young People, Adult Worries: Randomized Controlled Trial and Feasibility Study of the Internet-Based Self-Support Method "Feel the ViBe" for Adolescents and Young Adults Exposed to Family Violence. J Med Internet Res 2017; 19:e204. [PMID: 28606893 PMCID: PMC5484793 DOI: 10.2196/jmir.6004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 11/04/2016] [Accepted: 03/14/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents and young adults (AYAs) are of special interest in a group of children exposed to family violence (FV). Past-year prevalence of exposure to FV is known to be highest in AYAs and has severe consequences. Peer support is an effective approach to behavior change and the Internet is considered suitable as a mode of delivery. OBJECTIVE The study aimed to evaluate both effectiveness and feasibility of a randomized controlled trial (RCT) and feasibility study of the Internet-based self-support method "Feel the ViBe" (FtV) using mixed-methods approach to fully understand the strengths and weaknesses of a new intervention. METHODS AYAs aged 12-25 years and exposed to FV were randomized in an intervention group (access to FtV + usual care) and a control group (minimally enhanced usual care) after they self-registered themselves. From June 2012 to July 2014, participants completed the Impact of Event Scale (IES) and Depression (DEP) and Anxiety (ANX) subscales of the Symptom CheckList-90-R (SCL-90) every 6 weeks. The Web Evaluation Questionnaire was completed after 12 weeks. Quantitative usage data were collected using Google analytics and content management system (CMS) logs and data files. A univariate analysis of variance (UNIANOVA) and mixed model analysis (intention-to-treat [ITT], complete case) were used to compare groups. Pre-post t tests were used to find within-group effects. Feasibility measures structurally address the findings. The CONsolidated Standards Of Reporting Trials of Electronic and Mobile HEalth Applications and onLine TeleHealth (CONSORT-EHEALTH) checklist was closely followed. RESULTS In total, 31 out of 46 participants in the intervention group and 26 out of 47 participants in the control group started FtV. Seventeen participants (intervention: n=8, control: n=9) completed all questionnaires. Mixed model analysis showed significant differences between groups on the SCL-90 DEP (P=.04) and ANX (P=.049) subscales between 6 and 12 weeks after participation started. UNIANOVA showed no significant differences. Pre-post paired sample t tests showed significant improvements after 12 weeks for the SCL-90 DEP (P=.03) and ANX (P=.046) subscales. Reported mean Web-based time per week was 2.83 with a session time of 36 min. FtV was rated a mean 7.47 (1-10 Likert scale) with a helpfulness score of 3.16 (1-5 Likert scale). All participants felt safe. Two-thirds of the intervention participants started regular health care. CONCLUSIONS No changes on the IES were found. SCL-90 DEP and ANX showed promising results; however, the calculated sample size was not reached (n=18). FtV functions best as a first step for adolescents and young adults in an early stage of change. FtV can be easily implemented without extensive resources and fits best in the field of public health care or national governmental care. TRIAL REGISTRATION Netherlands National Trial Register (NTR): NTR3692; http://www.trialregister.nl/trialreg/admin/ rctview.asp?TC=3692 (Archived by WebCite at http://www.webcitation.org/6qIeKyjA4).
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Affiliation(s)
- Karin van Rosmalen-Nooijens
- Gender & Women's Health, Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
| | - Sylvie Lo Fo Wong
- Gender & Women's Health, Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
| | - Judith Prins
- Department of Medical Psychology, Radboud university medical center, Nijmegen, Netherlands
| | - Toine Lagro-Janssen
- Gender & Women's Health, Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
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Wasilewski MB, Stinson JN, Cameron JI. Web-based health interventions for family caregivers of elderly individuals: A Scoping Review. Int J Med Inform 2017; 103:109-138. [PMID: 28550996 DOI: 10.1016/j.ijmedinf.2017.04.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 03/14/2017] [Accepted: 04/09/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND For the growing proportion of elders globally, aging-related illnesses are primary causes of morbidity causing reliance on family members for support in the community. Family caregivers experience poorer physical and mental health than their non-caregiving counterparts. Web-based interventions can provide accessible support to family caregivers to offset declines in their health and well-being. Existing reviews focused on web-based interventions for caregivers have been limited to single illness populations and have mostly focused on the efficacy of the interventions. We therefore have limited insight into how web-based interventions for family caregiver have been developed, implemented and evaluated across aging-related illness. OBJECTIVES To describe: a) theoretical underpinnings of the literature; b) development, content and delivery of web-based interventions; c) caregiver usage of web-based interventions; d) caregiver experience with web-based interventions and e) impact of web-based interventions on caregivers' health outcomes. METHODS We followed Arksey and O'Malley's methodological framework for conducting scoping reviews which entails setting research questions, selecting relevant studies, charting the data and synthesizing the results in a report. RESULTS Fifty-three publications representing 32 unique web-based interventions were included. Over half of the interventions were targeted at dementia caregivers, with the rest targeting caregivers to the stroke, cancer, diabetes and general frailty populations. Studies used theory across the intervention trajectory. Interventions aimed to improve a range of health outcomes for caregivers through static and interactive delivery methods Caregivers were satisfied with the usability and accessibility of the websites but usage was generally low and declined over time. Depression and caregiver burden were the most common outcomes evaluated. The interventions ranged in their impact on health and social outcomes but reductions in perception of caregiver burden were consistently observed. CONCLUSIONS Caregivers value interactive interventions that are tailored to their unique needs and the illness context. However, usage of the interventions was sporadic and declined over time, indicating that future interventions should address stage-specific needs across the caregiving trajectory. A systematic review has the potential to be conducted given the consistency in caregiver burden and depression as outcomes.
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Affiliation(s)
| | | | - Jill I Cameron
- Rehabilitation Sciences Institute, University of Toronto, Canada; Department of Occupational Science & Occupational Therapy, University of Toronto, Canada.
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Price M, van Stolk-Cooke K, Ward HL, O’Keefe M, Gratton J, Skalka C, Freeman K. Tracking post-trauma psychopathology using mobile applications: A usability study. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2017; 2:41-48. [PMID: 29109968 PMCID: PMC5669390 DOI: 10.1007/s41347-016-0008-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Trauma exposure markedly increases risk for psychopathology including posttraumatic stress disorder (PTSD). Understanding the course by which PTSD develops after a traumatic event is critical to enhancing early intervention. Although prior work has explored the course of PTSD symptoms in the subsequent months, relatively few studies have explored the course of symptoms in the acute post-trauma period, defined as the 30 days after a traumatic event. A key challenge to conducting such studies is the lack of efficient means to collect data that does not impose significant burden on the participant during this time. The present study evaluated the use of a mobile phone application to collect symptom data during the acute post trauma period. Data was obtained from 23 individuals who experienced a Criterion A traumatic event and were recruited from the Emergency Department of a Level 1 Trauma Center. Participants completed 44.93% of daily assessments across a 30-day period. Responses rates were uncorrelated with PTSD symptoms or depression symptoms at 1-month and 3-month posttrauma. Participants reported that the surveys were moderately helpful and posed minimal burden. These findings suggest that mobile applications can be used to learn about the course of post-trauma recovery.
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Affiliation(s)
- Matthew Price
- Department of Psychological Science, University of Vermont
| | | | - Hannah L. Ward
- Department of Psychological Science, University of Vermont
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47
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Radovic A, Vona PL, Santostefano AM, Ciaravino S, Miller E, Stein BD. Smartphone Applications for Mental Health. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2017; 19:465-70. [PMID: 27428034 DOI: 10.1089/cyber.2015.0619] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Many adolescents and adults do not seek treatment for mental health symptoms. Smartphone applications (apps) may assist individuals with mental health concerns in alleviating symptoms or increasing understanding. This study seeks to characterize apps readily available to smartphone users seeking mental health information and/or support. Ten key terms were searched in the Apple iTunes and Google Play stores: mental health, depression, anxiety, schizophrenia, bipolar, trauma, trauma in schools, post traumatic stress disorder (PTSD), child trauma, and bullying. A content analysis of the first 20 application descriptions retrieved per category was conducted. Out of 300 nonduplicate applications, 208 (70%) were relevant to search topic, mental health or stress. The most common purported purpose for the apps was symptom relief (41%; n = 85) and general mental health education (18%; n = 37). The most frequently mentioned approaches to improving mental health were those that may benefit only milder symptoms such as relaxation (21%; n = 43). Most app descriptions did not include information to substantiate stated effectiveness of the application (59%; n = 123) and had no mention of privacy or security (89%; n = 185). Due to uncertainty of the helpfulness of readily available mental health applications, clinicians working with mental health patients should inquire about and provide guidance on application use, and patients should have access to ways to assess the potential utility of these applications. Strategic policy and research developments are likely needed to equip patients with applications for mental health, which are patient centered and evidence based.
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Affiliation(s)
- Ana Radovic
- 1 Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,2 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Pamela L Vona
- 3 School of Social Work, University of Southern California , Los Angeles, California
| | | | - Samantha Ciaravino
- 1 Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,2 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
| | - Elizabeth Miller
- 1 Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania.,2 Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine , Pittsburgh, Pennsylvania
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Griebel L, Kolominsky-Rabas P, Schaller S, Siudyka J, Sierpinski R, Papapavlou D, Simeonidou A, Prokosch HU, Sedlmayr M. Acceptance by laypersons and medical professionals of the personalized eHealth platform, eHealthMonitor. Inform Health Soc Care 2016; 42:232-249. [DOI: 10.1080/17538157.2016.1237953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lena Griebel
- Chair of Medical Informatics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Peter Kolominsky-Rabas
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Sandra Schaller
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Jakub Siudyka
- Kardiosystem Sp. z.o.o., Medicalgorithmics S.A., Warsaw, Poland
| | | | | | | | - Hans-Ulrich Prokosch
- Chair of Medical Informatics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
- University Hospital Erlangen, Erlangen, Germany
| | - Martin Sedlmayr
- Chair of Medical Informatics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
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49
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Older People Using e-Health Services—Exploring Frequency of Use and Associations with Perceived Benefits for Spouse Caregivers. INFORMATICS 2016. [DOI: 10.3390/informatics3030015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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50
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Schaller S, Marinova-Schmidt V, Setzer M, Kondylakis H, Griebel L, Sedlmayr M, Graessel E, Maler JM, Kirn S, Kolominsky-Rabas PL. Usefulness of a Tailored eHealth Service for Informal Caregivers and Professionals in the Dementia Treatment and Care Setting: The eHealthMonitor Dementia Portal. JMIR Res Protoc 2016; 5:e47. [PMID: 27050401 PMCID: PMC4822652 DOI: 10.2196/resprot.4354] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 09/11/2015] [Accepted: 01/04/2016] [Indexed: 12/02/2022] Open
Abstract
Background The European eHealthMonitor project (eHM) developed a user-sensitive and interactive Web portal for the dementia care setting called the eHM Dementia Portal (eHM-DP). It aims to provide targeted support for informal caregivers of persons with dementia and professionals. Objective The objective of this study was to assess the usefulness and impact of the eHM-DP service in the dementia care setting from two user perspectives: informal caregivers and professionals. Methods The evaluation study was conducted from June to September 2014 and followed a before-after, user-participatory, mixed-method design with questionnaires and interviews. The used intervention was the eHM-DP: an interactive Web portal for informal caregivers and professionals that was tested for a 12-week period. Primary outcomes for caregivers included empowerment, quality of life, caregiver burden, decision aid, as well as perceived usefulness and benefits of the eHM-DP. Primary outcomes for professionals involved decision aid, perceived usefulness, and benefits of the eHM-DP. Results A total of 25 informal caregivers and 6 professionals used the eHM-DP over the 12-week study period. Both professionals and informal caregivers indicated perceived benefits and support by the eHM-DP. In total, 65% (16/25) of informal caregivers would use the eHM-DP if they had access to it. Major perceived benefits were individualized information acquisition, improved interaction between informal caregivers and professionals, access to support from home, and empowerment in health-related decisions (PrepDM Score: 67.9). Professionals highlighted the improved treatment and care over the disease course (83%, 5/6) and improved health care access for people living in rural areas (67%, 4/6). However, there was no improvement in caregiver burden (Burden Scale for Family Caregivers) and quality of life (EuroQol-5D-5L) over the study period. Conclusions Our study provides insight into the different user perspectives on an eHealth support service in the dementia treatment and care setting. These results are of importance for future developments and the uptake of eHealth solutions in the dementia domain and reinforce the importance of early user involvement. Turning to the primary target of the eHM-DP service, our findings suggest that the eHM-DP service proved to be a valuable post-diagnostic support service, in particular for the home-based care setting. Further research on a larger scale is needed to enhance the implementation in existing health care infrastructures.
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Affiliation(s)
- Sandra Schaller
- Interdisciplinary Centre for Health Technology Assessment (HTA) and Public Health, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany.
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