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Bhawra J, Elsahli N, Patel J. Applying Digital Technology to Understand Human Experiences of Climate Change Impacts on Food Security and Mental Health: Scoping Review. JMIR Public Health Surveill 2024; 10:e54064. [PMID: 39042453 DOI: 10.2196/54064] [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: 10/28/2023] [Revised: 02/25/2024] [Accepted: 05/26/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The global impact of climate change ranges from intense heatwaves to extreme weather events that endanger entire ecosystems and people's way of life. Adverse climate change events place undue stress on food and health systems, with consequences for human food security and mental health status. Ubiquitous digital devices, such as smartphones, have the potential to manage existing and emerging climate-related crises, given their ability to enable rapid response, instant communication, and knowledge sharing. OBJECTIVE This scoping review aimed to identify digital apps being used to capture or address climate change impacts on food security and mental health to inform the development of a digital citizen science initiative. METHODS A scoping review was conducted using 3 peer-reviewed databases (PubMed, IEEE Xplore, and Web of Science) and manual gray literature searches of relevant organizational (ie, governmental and nonprofit) websites to identify articles and reports published between January 2012 and July 2023. Three separate searches were conducted in each database to identify digital apps focused on climate change and (1) food security, (2) mental health, and (3) food security and mental health. Two reviewers conducted initial screening, with a third reviewer resolving any discrepancies. Articles focused on climate change impacts on wildlife or agriculture (ie, not human food security) were excluded. Full-text screening was conducted for shortlisted articles, and a final data abstraction table was generated, summarizing key app features, contextual factors, and participant involvement. RESULTS From the 656 records screened, 14 digital apps met the inclusion criteria. The food security apps (n=7, 50%) aimed to capture traditional knowledge to preserve food systems, conduct food security assessments, and aid users in decreasing food insecurity risk. The mental health apps (n=7, 50%) assessed climate change-related stress and provided users with coping strategies following adverse weather events. No digital apps examined the intersection of climate change, food security, and mental health. Key app features included user-to-user communication (n=5, 36%), knowledge databases (n=5, 36%), data collection and analysis (n=3, 21%), gamification (n=1, 7%), and educational resources (n=2, 14%) to address climate change impacts on food security or mental health. In total, 3 approaches to participant involvement were used across studies, including contributory (n=1, 7%), collaborative (n=1, 7%), and cocreative (n=1, 7%) approaches, to ensure the relevance and use of digital apps. CONCLUSIONS Most digital apps identified provided a service to citizens to either prevent adverse climate change-related health impacts or manage these effects following an acute event or a natural disaster. The capacity of ubiquitous digital tools to enable near real-time communication, the involvement of various stakeholder groups, and their ability to share relevant educational resources in a timely manner are important for developing tailored climate change adaptation and mitigation strategies across jurisdictions.
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Affiliation(s)
- Jasmin Bhawra
- CHANGE Research Lab, School of Occupational and Public Health, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada
| | - Nadine Elsahli
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | - Jamin Patel
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
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Lee YC, Yu-Chieh Ho S, Tan TH, Ho CH, Tsai KT, Yang PC, Hsu CC, Lin HJ, Wang CT, Huang CC. Implementation of a novel computer assisted telephone follow-up model for older patients after emergency department discharge in an Asian population. Aging Clin Exp Res 2024; 36:147. [PMID: 39023663 PMCID: PMC11258097 DOI: 10.1007/s40520-024-02796-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 06/21/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND While the impact of telephone follow-up (TFU) for older emergency department (ED) patients is controversial, its effects on the Asian population remain uncertain. In this study, we evaluated the effectiveness of a novel computer assisted TFU model specifically for this demographic. METHODS At a Taiwanese tertiary medical center, we developed a TFU protocol that included a referral and case management system within the ED hospital information system. We provided TFU to older discharged patients between April 1, 2021, and May 31, 2021. We compared this cohort with a non-TFU cohort of older ED patients and analyzed demographic characteristics and post-ED discharge outcomes. RESULTS The TFU model was successfully implemented, with 395 patients receiving TFU and 191 without TFU. TFU patients (median age: 76 years, male proportion: 48.9%) differed from non-TFU patients (median age: 74 years, male proportion: 43.5%). Compared with the non-TFU cohort, the multivariate logistic regression analysis revealed that the TFU cohort had a lower total medical expenditure < 1 month (adjusted odds ratio [AOR]: 0.32; 95% CI: 0.21 - 0.47 for amounts exceeding 5,000 New Taiwan Dollars), and higher satisfaction (AOR: 2.80; 95% CI: 1.46 - 5.36 for scores > 3 on a five-point Likert Scale). However, the TFU cohort also had a higher risk of hospitalization < 1 month (AOR: 2.50; 95% CI: 1.31 - 4.77) compared to the non-TFU cohort. CONCLUSION Computer-assisted TFU appears promising. Further research involving a larger number of patients and validation in other hospitals is necessary to bolster the evidence and extend the findings to a broader context.
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Affiliation(s)
- Yen-Chiang Lee
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan
| | - Sam Yu-Chieh Ho
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan
| | - Tian-Hoe Tan
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan
- Department of Senior Welfare and Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Kang-Ting Tsai
- Department of Senior Welfare and Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
- Division of Geriatrics and Gerontology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
| | - Pei-Chi Yang
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan
| | - Chien-Chin Hsu
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen university, Kaohsiung, Taiwan
| | - Hung-Jung Lin
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan
- School of Medicine, College of Medicine, National Sun Yat-sen university, Kaohsiung, Taiwan
- Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Ti Wang
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.
| | - Chien-Cheng Huang
- Department of Emergency Medicine, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.
- School of Medicine, College of Medicine, National Sun Yat-sen university, Kaohsiung, Taiwan.
- Department of Emergency Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Sharkiya SH, Hag AM. Environmental and contextual factors influencing e-health use among older adults: A rapid review. Int J Med Inform 2024; 187:105448. [PMID: 38615510 DOI: 10.1016/j.ijmedinf.2024.105448] [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: 11/26/2023] [Revised: 04/02/2024] [Accepted: 04/07/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION E-health services offer potential benefits for healthcare delivery, especially for older adults, yet their adoption remains suboptimal due to various barriers. Understanding the environmental and contextual factors influencing e-health use among this demographic is crucial for enhancing their health outcomes. AIM This rapid review aims to explore the various environmental and contextual factors affecting the use of e-health among older adults, focusing on identifying strategies to enhance acceptance and usefulness. METHODS Adhering to PRISMA guidelines, a mixed-methods rapid review was conducted following the Joanna Briggs Institute (JBI) guidelines. Databases including MEDLINE, EMBASE, Web of Science, Scopus, and Google Scholar were searched. Quantitative data were qualitized for integration with qualitative data, and a thematic analysis was performed on the assembled data. FINDINGS A total of 11 studies met the inclusion criteria, encompassing five cross-sectional surveys, four qualitative studies, one longitudinal study, and one Discrete Choice Experiment. The thematic analysis revealed five key themes: social influence and norms, environmental and infrastructure factors, economic factors and cost considerations, family and caregiver support, and organizational support and culture. CONCLUSION The review highlights the need for e-health solutions that enhance social support, are adaptable to diverse living environments, address economic barriers with cost-effective solutions, and are culturally sensitive to effectively engage older adults.
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Affiliation(s)
- Samer H Sharkiya
- DAROT Medical Center for Rehabilitation and Geriatrics in Israel, Israel.
| | - Anat M Hag
- Occupational Therapy Interventions for Older Adults and Memory Enhancement, Israel
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Yi M, Hui Y, Hu L, Zhang W, Wang Z. The Experiences and Perceptions of Older Adults with Multimorbidity Toward E-Health Care: A Qualitative Evidence Synthesis. Telemed J E Health 2024. [PMID: 38920002 DOI: 10.1089/tmj.2024.0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024] Open
Abstract
Background: Given the growing population of older adults globally, e-Health plays an indispensable role in the chronic disease management of multimorbidity. However, qualitative evidence that synthesizes the experiences of older adults with multimorbidity using e-Health service is currently lacking. The objective was to explore the experiences and perceptions of e-Health care in community-based settings among the older adults with multimorbidity. Methods: Seven electronic databases including PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, China National Knowledge Infrastructure, and Chinese BioMedical Literature were searched, and the search was limited to studies from inception to September 1, 2023. Screening, data extraction, and quality appraisal were conducted independently by two reviewers. Thomas and Harden's thematic synthesis methodology was applied to synthesize the original themes. The methodological quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research, and the confidence of synthesized themes was evaluated by the Confidence in the Evidence from Reviews of Qualitative Research approaches. Results: Ten studies with moderate methodological quality met eligibility criteria and were included finally. Studies were conducted in four countries with 235 participants who were living with multiple chronic conditions. Among the 10 included studies, 37 credible findings were extracted and interpreted into 3 synthesized themes and 12 subthemes: (1) advantages and benefits perceived during e-Health service, (2) multidimensional challenges and negative experience posed by e-Health service, and (3) preferences, suggestions, and expectations for future e-Health improvement. The confidence in the majority of the three final synthesized themes was rated between "low" and "moderate" scales. Conclusions: The findings of this study provide new insights into implementing tailored e-Health care for older adults with multimorbidity. Further research should emphasize on realizing the potential value of e-Health service based on users' needs and perspectives to promote age-friendliness in geriatric practice.
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Affiliation(s)
- Mo Yi
- School of Nursing, Peking University, Beijing, China
| | - Yuwen Hui
- School of Nursing, Peking University, Beijing, China
| | - Litian Hu
- School of Nursing, Peking University, Beijing, China
| | - Wenmin Zhang
- School of Nursing, Peking University, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
- Peking University Health Science Centre for Evidence-based Nursing: A JBI Centre of Excellence, Beijing, China
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Ng BP, Hawkins GT, Massey M, LaManna JB, Park C. Digital Divide Among Beneficiaries and Medicare Diabetes Prevention Program. Am J Prev Med 2024:S0749-3797(24)00216-2. [PMID: 38909662 DOI: 10.1016/j.amepre.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/17/2024] [Accepted: 06/17/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Successful delivery of the virtual Medicare Diabetes Prevention Program (MDPP) is influenced by a beneficiary's access to a computer and use of the Internet. METHODS Using the 2020 nationally representative Medicare Current Beneficiary Survey Public Use File, a three-level categorical dependent variable was created: (1) has a computer AND uses Internet, (2) has a computer OR uses Internet, and (3) has no access to either (reference group). A survey-weighted multinomial logit model was performed in 2023 to examine associations between socio-demographics, comorbidities, and computer access and Internet use. RESULTS Of study beneficiaries aged ≥65 years with BMI≥25 kg/m2 and no history of diabetes (n=3,875), 70.8% had a computer AND used Internet; 14.3% had a computer OR used Internet; and 14.9% had no computer AND did not use Internet. Hispanics and non-Hispanic Blacks (OR=0.28, 95% CI [0.17-0.43]) were less likely than non-Hispanic Whites to have a computer AND use Internet. Beneficiaries with less education ( CONCLUSIONS Approximately 30% of potentially MDPP-eligible beneficiaries (representing ∼6 million beneficiaries) lacked full digital access. Efforts to encourage enrollment in the virtual MDPP must address digital disparities for beneficiaries at-risk for type 2 diabetes.
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Affiliation(s)
- Boon Peng Ng
- College of Nursing, University of Central Florida, Orlando, Florida; Disability, Aging and Technology Cluster, University of Central Florida, Orlando, Florida.
| | | | - McKayla Massey
- College of Medicine, University of Central Florida, Orlando, Florida
| | | | - Chanhyun Park
- College of Pharmacy, The University of Texas at Austin, Austin, Texas
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Tops L, Cromboom ML, Tans A, Deschodt M, Vandenbulcke M, Vermandere M. Healthcare providers' perception of caring for older patients with depression and physical multimorbidity: insights from a focus group study. BMC PRIMARY CARE 2024; 25:223. [PMID: 38907355 PMCID: PMC11193270 DOI: 10.1186/s12875-024-02447-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/23/2024] [Indexed: 06/23/2024]
Abstract
BACKGROUND The caretaking process for older adults with depression and physical multimorbidity is complex. Older patients with both psychiatric and physical illnesses require an integrated and comprehensive approach to effectively manage their care. This approach should address common risk factors, acknowledge the bidirectional relationship between somatic and mental health conditions, and integrate treatment strategies for both aspects. Furthermore, active engagement of healthcare providers in shaping new care processes is imperative for achieving sustainable change. OBJECTIVE To explore and understand the needs and expectations of healthcare providers (HCPs) concerning the care for older patients with depression and physical multimorbidity. METHODS Seventeen HCPs who work with the target group in primary and residential care participated in three focus group interviews. A constructivist Grounded Theory approach was applied. The results were analyzed using the QUAGOL guide. RESULTS Participants highlighted the importance of patient-centeredness, interprofessional collaboration, and shared decision-making in current healthcare practices. There is also a need to further emphasize the advantages and risks of technology in delivering care. Additionally, HCPs working with this target population should possess expertise in both psychiatric and somatic care to provide comprehensive care. Care should be organized proactively, anticipating needs rather than reacting to them. Healthcare providers, including a dedicated care manager, might consider collaborating, integrating their expertise instead of operating in isolation. Lastly, effective communication among HCPs, patients, and their families is crucial to ensure high-quality care delivery. CONCLUSION The findings stress the importance of a comprehensive approach to caring for older adults dealing with depression and physical comorbidity. These insights will fuel the development of an integrated care model that caters to the needs of this population.
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Affiliation(s)
- Laura Tops
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Mei Lin Cromboom
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Anouk Tans
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Mieke Deschodt
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Competence Center of Nursing, University Hospitals Leuven, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - Mieke Vermandere
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
- University Psychiatric Center, KU Leuven, Leuven, Belgium.
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Solaiman B. Legal and Ethical Considerations of Artificial Intelligence for Residents in Post-Acute and Long-Term Care. J Am Med Dir Assoc 2024; 25:105105. [PMID: 38909630 DOI: 10.1016/j.jamda.2024.105105] [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: 01/03/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/25/2024]
Abstract
This article proposes a framework for examining the ethical and legal concerns for using artificial intelligence (AI) in post-acute and long-term care (PA-LTC). It argues that established frameworks on health, AI, and the law should be adapted to specific care contexts. For residents in PA-LTC, their social, psychological, and mobility needs should act as a gauge for examining the benefits and risks of integrating AI into their care. Using those needs as a gauge, 4 areas of particular concern are identified. First, the threat that AI poses to the autonomy of residents can undermine their core needs. Second, how discrimination and bias in algorithmic decision-making can undermine Medicare coverage for PA-LTC, causing doctors' recommendations to be ignored and denying residents the care they are entitled to. Third, privacy rules concerning data use may undermine developers' ability to train accurate AI systems, limiting their usefulness in PA-LTC contexts. Fourth, the importance of obtaining consent before AI is used and discussions about how that care should continue if there are concerns about an ongoing decline in cognition. Together, these considerations elevate existing frameworks and adapt them to the context-specific case of PA-LTC. It is hoped that future research will examine the legal implications of these matters in each of these specific cases.
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Affiliation(s)
- Barry Solaiman
- HBKU, College of Law, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar.
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Baer NR, Grissmer NV, Schenk L, Wortmann HR, Warschburger P, Gisch UA. Practicing Interoceptive Sensitivity as a Couple: A Mixed-Methods Acceptance Analysis of a Dyadic vs. Single Pilot Randomized Controlled Trial. Nutrients 2024; 16:1949. [PMID: 38931304 PMCID: PMC11206497 DOI: 10.3390/nu16121949] [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: 04/30/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Training interoceptive sensitivity (IS) might be a first step in effectively promoting intuitive eating (IE). A dyadic interoception-based pilot randomized controlled trial was conducted to increase IE among couples aged 50+. The training consisted of three exercises, a Body Scan (BS), a hunger exercise (HU), and a satiety (SA) exercise. This study explored how spouses accepted the (dyadic vs. single) training. In a mixed-methods convergence design, the findings of a survey (n = 68 couples) and focus groups (n = 4) were synthesized. Moderate general acceptance (e.g., regarding feasibility and low burden) and a hierarchical gradient in favor of the BS (e.g., pleasantness and improved sleep quality) emerged. Barriers concerned a perceived lack of the exercises' usefulness and a limited understanding of the training purpose. A wish for regular feedback and exchange with the study stuff and other participants was expressed. Spousal training involvement was experienced as being rather beneficial. Previously harmonized dietary practices and daily routines appeared as constructive pre-conditions for the joint training. This study highlights the potential and implications of training couples in IS. Future interventions should involve a regular exchange and closer guidance by study staff to promote a better understanding of the processes and goals of IS and IE.
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Affiliation(s)
- Nadja-R. Baer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Noemi Vanessa Grissmer
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Liane Schenk
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Institute for Medical Sociology and Rehabilitation Science, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Hanna R. Wortmann
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Petra Warschburger
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
| | - Ulrike A. Gisch
- NutriAct—Competence Cluster Nutrition Research Berlin-Potsdam, 14558 Nuthetal, Germany; (N.V.G.); (L.S.); (H.R.W.); (P.W.); (U.A.G.)
- Counseling Psychology, Department of Psychology, University of Potsdam, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany
- Department of Nutritional Psychology, Institute of Nutritional Science, Justus Liebig University Giessen, Senckenbergstr. 3, 35390 Giessen, Germany
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Suárez-González A, Savage SA, Alladi S, Amaral-Carvalho V, Arshad F, Camino J, Caramelli P, Comas-Herrera A, Cook J, Cooper C, García Díaz L, Grasso SM, Jokel R, Lavoie M, León T, Priya T, Ramos Franco T, Taylor-Rubin C, Townsend R, Thöne-Otto A, Slachevsky A, Volkmer A, Weidner W, O’Connor CMC. Rehabilitation Services for Young-Onset Dementia: Examples from High- and Low-Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:790. [PMID: 38929036 PMCID: PMC11203756 DOI: 10.3390/ijerph21060790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/05/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
The WHO Dementia Global Action Plan states that rehabilitation services for dementia are required to promote health, reduce disability, and maintain quality of life for those living with dementia. Current services, however, are scarce, particularly for people with young-onset dementia (YOD). This article, written by an international group of multidisciplinary dementia specialists, offers a three-part overview to promote the development of rehabilitation services for YOD. Firstly, we provide a synthesis of knowledge on current evidence-based rehabilitative therapies for early-onset Alzheimer's disease (EOAD), behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and posterior cortical atrophy (PCA). Secondly, we discuss the characteristics of rehabilitation services for YOD, providing examples across three continents for how these services can be embedded in existing settings and the different roles of the rehabilitation multidisciplinary team. Lastly, we conclude by highlighting the potential of telehealth in making rehabilitation services more accessible for people with YOD. Overall, with this paper, we aim to encourage clinical leads to begin introducing at least some rehabilitation into their services, leveraging existing resources and finding support in the collective expertise of the broader multidisciplinary dementia professional community.
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Affiliation(s)
- Aida Suárez-González
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London (UCL), London WC1N 3BG, UK
| | - Sharon A Savage
- School of Psychological Sciences, College of Engineering, Science and Environment, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560030, India
| | - Viviane Amaral-Carvalho
- Departamento de Neurologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, SP, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560030, India
| | - Julieta Camino
- Institute of Health and Social Care, London South Bank University, London SE1 0AA, UK
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TQ, UK
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, MG, Brazil
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London WC2A 2AZ, UK
| | - Julia Cook
- Herefordshire and Worcestershire Health and Care NHS Trust, Worcester WR5 1JR, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London EC1M 6BQ, UK
| | - Laura García Díaz
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada
| | - Stephanie M. Grasso
- Department of Speech, Language and Hearing Sciences, University of Texas, Austin, TX 78712-1069, USA
| | - Regina Jokel
- Rotman Research Institute, Toronto, ON M6A 2X8, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Baycrest Health Sciences, Toronto, ON M6A 2E1, Canada
| | - Monica Lavoie
- Chaire de Recherche sur les Aphasies Primaires Progressives—Fondation de la Famille LEMAIRE, CHU de Québec-Université Laval, Québec, QC G1V 0A6, Canada;
| | - Tomás León
- Memory Unit, Neurology Department, Memory and Neuropsychiatric Center (CMYN), Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago 7500922, Chile
- Department of Psychiatry and Global Brain Health Institute, Trinity College, D02 K104 Dublin, Ireland
| | - Thomas Priya
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India;
| | - Teresita Ramos Franco
- Memory Unit, Neurology Department, Memory and Neuropsychiatric Center (CMYN), Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago 7500922, Chile
| | - Cathleen Taylor-Rubin
- Speech Pathology Department, War Memorial Hospital, Sydney, NSW 2024, Australia
- School of Psychological Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | | | - Angelika Thöne-Otto
- Clinic for Cognitive Neurology, University Hospital Leipzig, 04103 Leipzig, Germany
- Max-Planck Institute for Human Cognitive and Brain Sciences, 04103 Leipzig, Germany
| | - Andrea Slachevsky
- Memory Unit, Neurology Department, Memory and Neuropsychiatric Center (CMYN), Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago 7500922, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago 7500922, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopatology Program—Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago 7500922, Chile
- Neurology and Psychiatry Department, Clínica Alemana-Universidad Desarrollo, Santiago 7650568, Chile
| | - Anna Volkmer
- Division of Psychology and Language Sciences, University College London (UCL), London WC1H 0AP, UK
| | - Wendy Weidner
- Alzheimer’s Disease International, London SE1 4PU, UK
| | - Claire MC O’Connor
- Centre for Positive Ageing, HammondCare, Sydney, NSW 2170, Australia
- School of Psychology, Faculty of Sciences, University of New South Wales, Sydney, NSW 2052, Australia
- Neuroscience Research Australia, Sydney, NSW 2031, Australia
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10
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Boekhout JM, Hut R, Lechner L, Peels DA. " I Don't Believe in Age; I Believe in Staying Enthusiastic": An Exploratory Qualitative Study into Recruitment Strategies Stimulating Middle-Aged and Older Adults to Join Physical Activity Interventions. Geriatrics (Basel) 2024; 9:80. [PMID: 38920436 PMCID: PMC11202473 DOI: 10.3390/geriatrics9030080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/05/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
Many middle-aged and older adults (MAOAs) do not engage in sufficient physical activity (PA), despite its well-documented benefits for healthy aging. Existing PA interventions often fail to reach or engage the target population effectively. This study investigates MAOAs' preferences for recruitment strategies to optimize the reach and uptake of PA interventions, thereby enhancing their impact on healthy aging and public health. Qualitative interviews were conducted with 39 MAOA participants (69% female, mean age = 69.46, SD = 7.07), guided by McGuire's Theory on Persuasive Communication. Factors related to the source, message content, channel, receiver characteristics and target behavior of recruitment strategies were analyzed. Our findings suggest a preference for trustworthy sources (e.g., healthcare professionals over commercial entities) and positive, non-ageist messaging. MAOAs vary in their channel preferences but emphasize the importance of personalization. Despite heterogeneity, MAOAs commonly perceive themselves as sufficiently active, indicating a need for improved knowledge on what constitutes sufficient PA, as well as easy enrollment or trying out interventions. Tailoring recruitment strategies to diverse MAOA segments based on age seems crucial for effective engagement. Future research could explore quantitative research into how communication factors relate to various target population characteristics.
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Affiliation(s)
- Janet M. Boekhout
- Department of Health Psychology, Faculty of Psychology, Open University of The Netherlands, 6401 DL Heerlen, The Netherlands; (R.H.); (L.L.); (D.A.P.)
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11
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Bullock GS, Duncan P, McMurtrie E, Henry K, Graves BF, Lake AR, McDonough CM. Feasibility of Implementing Patient-Reported and Physical Performance Measures to Identify and Manage Fall Risk in Older Adults Within a Secondary Fracture Clinic. J Appl Gerontol 2024; 43:745-754. [PMID: 38113230 DOI: 10.1177/07334648231220481] [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: 12/21/2023] Open
Abstract
The purpose of this study was to assess the feasibility of implementing both electronic and in-person assessments to assess falls risk in an older adult secondary fracture clinic. Electronic data capture feasibility was defined as the proportion of patients that completed the electronic questionnaires prior to their clinic visit. In-clinic feasibility was defined in two ways: (1) the proportion of patients that consented to participate at their clinic visit; (2) time to complete testing. Patients were contacted electronically through their health system portal for electronic consent. Patients were invited to complete consent, the STopping Elderly Accidents, Deaths, and Injuries (STEADI) falls risk assessment tool, and the visual analog scale (VAS) for pain. The Short Physical Performance Battery (SPPB) was performed at the clinic visit. A total of 310 patients were contacted electronically. No patients (0%) provided consent through their health portal. Of the 310 patients, 200 (65%) consented in person (Ineligible: 67 [21%]; Declined: 43 [14%]), resulting in an 82% response rate. In-person data collection took a median of 38.48 (Range: 12.34-54.30) minutes to complete. It was not feasible to contact and collect older adult patient data electronically prior to clinic; but, was feasible to obtain these patient-reported outcomes and physical performance data in person.
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Affiliation(s)
- Garrett S Bullock
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Pamela Duncan
- Department of Neurology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Emily McMurtrie
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kaitlin Henry
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Chicago Medical School, Rosalind Franklin University, Chicago, IL, USA
| | - Benjamin F Graves
- Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anne R Lake
- Fracture Liaison Clinic, Atrium Health Wake Forest Baptist, Winston-Salem, NC, USA
| | - Christine M McDonough
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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12
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Gaudine A, Parsons K, Smith-Young J. Older Adults' Experiences with Remote Care for Specialized Health Service During the COVID-19 Pandemic: A Descriptive Qualitative Study. Can J Aging 2024; 43:257-265. [PMID: 37869900 DOI: 10.1017/s0714980823000636] [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: 10/24/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic necessitated a rapid uptake of remote health care services. This qualitative descriptive study was designed to gain an understanding of older adults' experiences of remote care (telephone or online video conference appointments) for specialized health services during the COVID-19 pandemic. Twenty-one older adults (ages 65 years and older; 8 men and 13 women) living in eastern Canada participated in a semi-structured telephone interview. Data were analysed using qualitative content analysis. The vast majority of older adults were overall satisfied with their remote experiences of specialist care. Advantages to remote care for specialized services included convenience, safety during the pandemic, comfort, efficiency, and ease of visit. Disadvantages included communication not as effective, feeling depersonalized or disembodied, missing the human relationship, and wanting reassurance of physical assessment. It is important that health professionals understand the disadvantages for older adults of remote care visits in order to mitigate them.
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Affiliation(s)
- Alice Gaudine
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Karen Parsons
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Joanne Smith-Young
- Faculty of Nursing, Memorial University of Newfoundland, St. John's, NL, Canada
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13
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Aldis R, Rosenfeld LC, Mulvaney-Day N, Lanca M, Zona K, Lam JA, Asfour J, Meltzer JC, Leff HS, Fulwiler C, Wang P, Progovac AM. Determinants of remote measurement-based care uptake in a safety net outpatient psychiatry department as part of learning health system transition. Learn Health Syst 2024; 8:e10416. [PMID: 38883875 PMCID: PMC11176570 DOI: 10.1002/lrh2.10416] [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: 10/31/2023] [Revised: 02/20/2024] [Accepted: 02/26/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Behavioral measurement-based care (MBC) can improve patient outcomes and has also been advanced as a critical learning health system (LHS) tool for identifying and mitigating potential disparities in mental health treatment. However, little is known about the uptake of remote behavioral MBC in safety net settings, or possible disparities occurring in remote MBC implementation. Methods This study uses electronic health record data to study variation in completion rates at the clinic and patient level of a remote MBC symptom measure tool during the first 6 months of implementation at three adult outpatient psychiatry clinics in a safety net health system. Provider-reported barriers to MBC adoption were also measured using repeated surveys at one of the three sites. Results Out of 1219 patients who were sent an MBC measure request, uptake of completing at least one measure varied by clinic: General Adult Clinic, 38% (n = 262 of 696); Substance Use Clinic, 28% (n = 73 of 265); and Transitions Clinic, 17% (n = 44 of 258). Compared with White patients, Black and Portuguese or Brazilian patients had lower uptake. Older patients also had lower uptake. Spanish language of care was associated with much lower uptake at the patient level. Significant patient-level disparities in uptake persisted after adjusting for the clinic, mental health diagnoses, and number of measure requests sent. Providers cited time within visits and bandwidth in their workflow as the greatest consistent barriers to discussing MBC results with patients. Conclusions There are significant disparities in MBC uptake at the patient and clinic level. From an LHS data infrastructure perspective, safety net health systems may need to address the need for possible ways to adapt MBC to better fit their populations and clinical needs, or identify targeted implementation strategies to close data gaps for the identified disparity populations.
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Affiliation(s)
- Rajendra Aldis
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Lisa C Rosenfeld
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Norah Mulvaney-Day
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Margaret Lanca
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Kate Zona
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Jeffrey A Lam
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Julia Asfour
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Public Health and Community Medicine Tufts University School of Medicine Boston Massachusetts USA
| | - Jonah C Meltzer
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Public Health and Community Medicine Tufts University School of Medicine Boston Massachusetts USA
| | - H Stephen Leff
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Carl Fulwiler
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Philip Wang
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
| | - Ana M Progovac
- Cambridge Health Alliance Department of Psychiatry Cambridge Massachusetts USA
- Harvard Medical School Department of Psychiatry Boston Massachusetts USA
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14
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Teh PL, Kwok AOJ, Cheong WL, Lee S. Insights Into the Use of a Digital Healthy Aging Coach (AGATHA) for Older Adults From Malaysia: App Engagement, Usability, and Impact Study. JMIR Form Res 2024; 8:e54101. [PMID: 38772022 PMCID: PMC11132589 DOI: 10.2196/54101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/21/2024] [Accepted: 04/29/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Digital inclusion is considered a pivotal social determinant of health, particularly for older adults who may face significant barriers to digital access due to physical, sensory, and social limitations. Avatar for Global Access to Technology for Healthy Aging (AGATHA) is a virtual healthy aging coach developed by the World Health Organization to address these challenges. Designed as a comprehensive virtual coach, AGATHA comprises a gamified platform that covers multiple health-related topics and modules aimed at fostering user engagement and promoting healthy aging. OBJECTIVE The aim of this study was to explore the perception and user experience of Malaysian older adults in their interactions with the AGATHA app and its avatar. The focus of this study was to examine the engagement, usability, and educational impact of the app on health literacy and digital skills. METHODS We performed a qualitative study among adults 60 years and older from suburban and rural communities across six states in Malaysia. Participants were purposefully recruited to ensure representation across various socioeconomic and cultural backgrounds. Each participant attended a 1-hour training session to familiarize themselves with the interface and functionalities of AGATHA. Subsequently, all participants were required to engage with the AGATHA app two to three times per week for up to 2 weeks. Upon completion of this trial phase, an in-depth interview session was conducted to gather detailed feedback on their experiences. RESULTS Overall, the participants found AGATHA to be highly accessible and engaging. The content was reported to have a comprehensive structure and was delivered in an easily understandable and informative manner. Moreover, the participants found the app to be beneficial in enhancing their understanding pertaining to health-related issues in aging. Some key feedback gathered highlighted the need for increased interactive features that would allow for interaction with peers, better personalization of content tailored to the individual's health condition, and improvement in the user-experience design to accommodate older users' specific needs. Furthermore, enhancements in decision-support features within the app were suggested to better assist users in making health decisions. CONCLUSIONS The prototype digital health coaching program AGATHA was well received as a user-friendly tool suitable for beginners, and was also perceived to be useful to enhance older adults' digital literacy and confidence. The findings of this study offer important insights for designing other digital health tools and interventions targeting older adults, highlighting the importance of a user-centered design and personalization to improve the adoption of digital health solutions among older adults. This study also serves as a useful starting point for further development and refinement of digital health programs aimed at fostering an inclusive, supportive digital environment for older adults.
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Affiliation(s)
- Pei-Lee Teh
- School of Business, Monash University Malaysia, Subang Jaya, Malaysia
| | - Andrei O J Kwok
- School of Business, Monash University Malaysia, Subang Jaya, Malaysia
| | - Wing Loong Cheong
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
| | - Shaun Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
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15
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Lemos M, Henriques AR, Lopes DG, Mendonça N, Victorino A, Costa A, Arriaga M, Gregório MJ, de Sousa R, Canhão H, Rodrigues AM. Usability and Utility of a Mobile App to Deliver Health-Related Content to an Older Adult Population: Pilot Noncontrolled Quasi-Experimental Study. JMIR Form Res 2024; 8:e46151. [PMID: 38758585 PMCID: PMC11160343 DOI: 10.2196/46151] [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: 02/01/2023] [Revised: 10/31/2023] [Accepted: 12/04/2023] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard, we developed a mobile app called DigiAdherence for an older adult population, which consisted of easy-to-access short videos and messages, to improve health-related knowledge among them and prevent common health conditions, such as falls, polypharmacy, treatment adherence, nutritional problems, and physical inactivity. OBJECTIVE This study aimed to assess the usability and utility of the DigiAdherence app among Portuguese older adults 65 years or older. METHODS In this pilot noncontrolled quasi-experimental study, older adults who were patients at the primary health care center in Portimão, Portugal, and owned a smartphone or tablet were recruited. Participants were assessed at baseline, given access to the DigiAdherence app for 1 month, and assessed again immediately after 30 days (first assessment) and 60 days after stopping the use of the app (second assessment). App usability and utility (primary outcomes) were analyzed in the first follow-up assessment using a structured questionnaire with 8 items. In the second follow-up assessment, our focus was on knowledge acquired through the app. Secondary outcomes such as treatment adherence and health-related quality of life were also assessed. RESULTS The study included 26 older adults. Most participants rated the different functionalities of the app positively and perceived the app as useful, attractive, and user-friendly (median score of 6 on a 7-point Likert scale). In addition, after follow-up, participants reported having a sense of security and greater knowledge in preventing falls (16/24, 67%) and managing therapies and polypharmacy (16/26, 62%). CONCLUSIONS The DigiAdherence mobile app was useful and highly accepted by older adults, who developed more confidence regarding health-related knowledge. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/29675.
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Affiliation(s)
- Marta Lemos
- Unidade de Saúde Pública do ACES Algarve II - Barlavento, Centro de Saúde de Portimão, Portimão, Portugal
| | - Ana Rita Henriques
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - David Gil Lopes
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Nuno Mendonça
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - André Victorino
- Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Costa da Caparica, Almada, Portugal
| | - Andreia Costa
- Direção-Geral de Saúde, Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisboa, Portugal
- Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisboa, Portugal
| | - Miguel Arriaga
- Direção-Geral de Saúde, Lisboa, Portugal
- Catolica Research Centre for Psychological, Family and Social Wellbeing, Lisboa, Portugal
| | - Maria João Gregório
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
- Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal
- Programa Nacional para a Promoção da Alimentação Saudável, Direção-Geral da Saúde, Lisboa, Portugal
| | - Rute de Sousa
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Helena Canhão
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana M Rodrigues
- CHRC, NOVA Medical School, NMS, Universidade NOVA de Lisboa, Lisboa, Portugal
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De Santis KK, Kirstein M, Kien C, Griebler U, McCrabb S, Jahnel T. Online dissemination of Cochrane reviews on digital health technologies: a cross-sectional study. Syst Rev 2024; 13:133. [PMID: 38750593 PMCID: PMC11095012 DOI: 10.1186/s13643-024-02557-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 05/05/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND This cross-sectional study investigated the online dissemination of Cochrane reviews on digital health technologies. METHODS We searched the Cochrane Database of Systematic Reviews from inception up to May 2023. Cochrane reviews with any population (P), intervention or concept supported by any digital technology (I), any or no comparison (C), and any health outcome (O) were included. Data on review characteristics (bibliographic information, PICO, and evidence quality) and dissemination strategies were extracted and processed. Dissemination was assessed using review information on the Cochrane website and Altmetric data that trace the mentions of academic publications in nonacademic online channels. Data were analysed using descriptive statistics and binary logistic regression analysis. RESULTS Out of 170 records identified in the search, 100 Cochrane reviews, published between 2005 and 2023, were included. The reviews focused on consumers (e.g. patients, n = 86), people of any age (n = 44), and clinical populations (n = 68). All reviews addressed interventions or concepts supported by digital technologies with any devices (n = 73), mobile devices (n = 17), or computers (n = 10). The outcomes focused on disease treatment (n = 56), health promotion and disease prevention (n = 27), or management of care delivery (n = 17). All reviews included 1-132 studies, and half included 1-10 studies. Meta-analysis was performed in 69 reviews, and certainty of evidence was rated as high or moderate for at least one outcome in 46 reviews. In agreement with the Cochrane guidelines, all reviews had a plain language summary (PLS) that was available in 3-14 languages. The reviews were disseminated (i.e. mentioned online) predominantly via X/Twitter (n = 99) and Facebook (n = 69). Overall, 51 reviews were mentioned in up to 25% and 49 reviews in 5% of all research outputs traced by Altmetric data. Dissemination (i.e. higher Altmetric scores) was associated with bibliographic review characteristics (i.e. earlier publication year and PLS available in more languages), but not with evidence quality (i.e. certainty of evidence rating, number of studies, or meta-analysis performed in review). CONCLUSIONS Online attention towards Cochrane reviews on digital health technologies is high. Dissemination is higher for older reviews and reviews with more PLS translations. Measures are required to improve dissemination of Cochrane reviews based on evidence quality. SYSTEMATIC REVIEW REGISTRATION The study was prospectively registered at the Open Science Framework ( https://osf.io/mpw8u/ ).
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Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, 28359, Germany.
| | - Mathia Kirstein
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, 28359, Germany
| | - Christina Kien
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
| | - Ursula Griebler
- Department for Evidence-Based Medicine and Evaluation, University for Continuing Education Krems, Krems, Austria
| | - Sam McCrabb
- Faculty of Health and Medicine, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Tina Jahnel
- Department of Health Services Research, Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
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Schnoor K, Talboom-Kamp EPWA, Hajtić M, Chavannes NH, Versluis A. Facilitators of and Barriers to the Use of a Digital Self-Management Service for Diagnostic Testing: Focus Group Study With Potential Users. JMIR Hum Factors 2024; 11:e45115. [PMID: 38728071 PMCID: PMC11127139 DOI: 10.2196/45115] [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: 01/30/2023] [Revised: 01/02/2024] [Accepted: 03/20/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Health care lags in digital transformation, despite the potential of technology to improve the well-being of individuals. The COVID-19 pandemic has accelerated the uptake of technology in health care and increased individuals' willingness to perform self-management using technology. A web-based service, Directlab Online, provides consumers with direct digital access to diagnostic test packages, which can digitally support the self-management of health. OBJECTIVE This study aims to identify the facilitators, barriers, and needs of Directlab Online, a self-management service for web-based access to diagnostic testing. METHODS A qualitative method was used from a potential user's perspective. The needs and future needs for, facilitators of, and barriers to the use of Directlab Online were evaluated. Semistructured focus group meetings were conducted in 2022. Two focus groups were focused on sexually transmitted infection test packages and 2 were focused on prevention test packages. Data analysis was performed according to the principles of the Framework Method. The Consolidated Framework for Implementation Research was used to categorize the facilitators and barriers. RESULTS In total, 19 participants, with a mean age of 34.32 (SD 14.70) years, participated in the focus groups. Important barriers were a lack of privacy information, too much and difficult information, and a commercial appearance. Important facilitators were the right amount of information, the right kind of tests, and the involvement of a health care professional. The need for a service such as Directlab Online was to ensure its availability for users' health and to maintain their health. CONCLUSIONS According to the participants, facilitators and barriers were comprehension of the information, the goal of the website, and the overall appearance of the service. Although the service was developed in cocreation with health care professionals and users, the needs did not align. The users preferred understandable and adequate, but not excessive, information. In addition, they preferred other types of tests to be available on the service. For future research, it would be beneficial to focus on cocreation between the involved medical professionals and users to develop, improve, and implement a service such as Directlab Online.
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Affiliation(s)
- Kyma Schnoor
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Esther P W A Talboom-Kamp
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
- Zuyderland, Sittard-Geleen, Netherlands
| | - Muamer Hajtić
- Department of Medical informatics, University of Amsterdam, Amsterdam, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Center, Leiden, Netherlands
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18
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Malkowski OS, Townsend NP, Kelson MJ, Foster CEM, Western MJ. Socio-economic inequalities in the breadth of internet use before and during the COVID-19 pandemic among older adults in England. PLoS One 2024; 19:e0303061. [PMID: 38722879 PMCID: PMC11081243 DOI: 10.1371/journal.pone.0303061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Understanding digital exclusion in older adults during the COVID-19 pandemic could help tailor responses to future outbreaks. This cohort study used data from older adults aged 60+ years in England who participated in wave nine (2018/2019) of the main English Longitudinal Study of Ageing (ELSA) survey, and/or wave one of the ELSA COVID-19 sub-study (June/July 2020). Using latent class analysis and latent transition analysis, we aimed to identify distinct subgroups of older adults characterised by different patterns of internet use pre- and intra-pandemic, explore the extent to which individuals remained in the same subgroup or transitioned to a different subgroup during the COVID-19 pandemic, and examine longitudinal associations of socio-economic factors (education, occupational class, and wealth) with latent class membership. Preliminary tests showed that the types of internet activities differed between men and women; therefore, subsequent analyses were stratified by biological sex. Three clusters (low, medium, and high) were identified in male participants at both timepoints. Among female participants, three clusters were distinguished pre-pandemic and two (low versus high) during the pandemic. The latent classes were characterised by participants' breadth of internet use. Higher education, occupational class, and wealth were associated with greater odds of membership in the medium and/or high classes, versus the low class, in men and women. A high degree of stability in latent class membership was observed over time. However, men experienced a stark decrease in online health information-seeking. Our results highlight that inequality regarding the range of functional and social opportunities provided by the internet prevailed during the pandemic. Policymakers should ensure that digital access and upskilling initiatives are equitable for all.
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Affiliation(s)
- Olivia S. Malkowski
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, United Kingdom
| | - Nick P. Townsend
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Mark J. Kelson
- Department of Mathematics, Institute of Data Science and Artificial Intelligence, University of Exeter, Exeter, United Kingdom
| | - Charlie E. M. Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Max J. Western
- Department for Health, Centre for Motivation and Health Behaviour Change, University of Bath, Bath, United Kingdom
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19
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Sien SW, Kobekyaa FK, Puts M, Currie L, Tompson M, Hedges P, McGrenere J, Mariano C, Haase KR. Tailored Self-Management App to Support Older Adults With Cancer and Multimorbidity: Development and Usability Testing. JMIR Aging 2024; 7:e53163. [PMID: 38717806 PMCID: PMC11112470 DOI: 10.2196/53163] [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: 09/29/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Globally, cancer predominates in adults aged older than 60 years, and 70% of older adults have ≥1 chronic condition. Cancer self-management interventions can improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multimorbidity. Despite growing evidence of digital health tools in cancer care, there is a paucity of theoretically grounded digital self-management supports for older adults. Many apps for older adults have not been co-designed with older adults to ensure that they are tailored to their specific needs, which would increase usability and uptake. OBJECTIVE We aim to report on the user evaluations of a self- and symptom-management app to support older adults living with cancer and multimorbidity. METHODS This study used Grey's self-management framework, a design thinking approach, and involved older adults with lived experiences of cancer to design a medium-fidelity app prototype. Older adults with cancer or caregivers were recruited through community organizations or support groups to participate in co-designing or evaluations of the app. Data from interviews were iteratively integrated into the design process and analyzed using descriptive statistics and thematic analyses. RESULTS In total, 15 older adults and 3 caregivers (n=18) participated in this study: 10 participated (8 older adults and 2 caregivers) in the design of the low-fidelity prototype, and 10 evaluated (9 older adults and 1 caregiver) the medium-fidelity prototype (2 older adults participated in both phases). Participants emphasized the importance of tracking functions to make sense of information across physical symptoms and psychosocial aspects; a clear display; and the organization of notes and reminders to communicate with care providers. Participants also emphasized the importance of medication initiation or cessation reminders to mitigate concerns related to polypharmacy. CONCLUSIONS This app has the potential to support the complex health care needs of older adults with cancer, creating a "home base" for symptom management and support. The findings from this study will position the researchers to conduct feasibility testing and real-world implementation.
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Affiliation(s)
- Sang-Wha Sien
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | | | - Martine Puts
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Leanne Currie
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Margaret Tompson
- Saskatchewan Center for Patient Oriented Research, Saskatoon, SK, Canada
| | | | - Joanna McGrenere
- Department of Computer Science, University of British Columbia, Vancouver, BC, Canada
| | | | - Kristen R Haase
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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20
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Kikkenborg J, Magelund E, Riise MS, Kayser L, Terp R. Knowledge, Skills, and Experience With Technology in Relation to Nutritional Intake and Physical Activity Among Older Adults at Risk of Falls: Semistructured Interview Study. JMIR Hum Factors 2024; 11:e52575. [PMID: 38717810 PMCID: PMC11112469 DOI: 10.2196/52575] [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: 09/08/2023] [Revised: 03/04/2024] [Accepted: 03/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND More than one-third of older adults (aged ≥65 y) experience falls every year. The prevalent modifiable risk factors for falling are malnutrition and physical inactivity, among others. The involvement of older adults in the prevention of falls can decrease injuries, hospitalizations, and dependency on health care professionals. In this regard, eHealth can support older adults' self-management through more physical activity and adequate food intake. eHealth must be tailored to older adults' needs and preferences so that they can reap its full benefits. Therefore, it is necessary to gain insight into the knowledge, skills, and mindset of older adults living at home who are at risk of falls regarding eHealth. OBJECTIVE This qualitative study aims to explore older adults' use of everyday digital services and technology and how they acquire knowledge about and manage their nutritional intake and physical activity in relation to their health. METHODS Semistructured interviews were conducted with 15 older adults (n=9, 60% women; n=6, 40% men; age range 71-87 y) who had all experienced falls or were at risk of falling. These individuals were recruited from a geriatric outpatient clinic. The interviews were analyzed using deductive content analysis based on a modification of the Readiness and Enablement Index for Health Technology framework. RESULTS The qualitative data showed that the informants' social networks had a positive impact on their self-management, use of technology, and mindset toward nutritional intake and physical activity. Although the informants generally lived active lives, they all lacked knowledge about how their food intake influenced their physical health, including their risk of falling. Another finding was the large diversity in the use of technology among the informants, which was related to their mindset toward technology. CONCLUSIONS Older adults can use technology for everyday purposes, but some need additional introduction and support to be able to use it for managing their health. They also need to learn about the importance of proper nutritional intake and physical activity in preventing falls. Older adults need a more personalized introduction to technology, nutrition, and physical activity in their contact with health professionals.
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Affiliation(s)
- Julie Kikkenborg
- Department of Clinical Physiology & Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Emma Magelund
- Department of Clinical Physiology & Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Maria Silke Riise
- Department of Clinical Physiology & Nuclear Medicine, Rigshospitalet, Copenhagen, Denmark
| | - Lars Kayser
- Section of Health Service Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Terp
- Department of Internal Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark
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21
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Yadeta TA, Mohamed A, Behir K, Alemu A, Balis B, Debella A, Letta S. Knowledge, perceived needs of continuous professional's development, and associated factors among healthcare workers in East Ethiopia: a multi-health facility-based cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:497. [PMID: 38702745 PMCID: PMC11069212 DOI: 10.1186/s12909-024-05486-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/29/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND The Ethiopian Ministry of Health (EMOH) has recently introduced a Continuous Professional Development (CPD) program for healthcare workers to ensure they maintain the necessary competencies to meet the community's health needs. However, there is limited information on healthcare workers' knowledge and perceived need for CPD. This study aims to assess healthcare workers' CPD knowledge, perceived needs, and factors associated with these in eastern Ethiopia. METHODS A health facility-based cross-sectional quantitative study was conducted from September 1, 2022, to October 30, 2022. Health facilities and study participants were selected using a simple random sampling technique. A total of 731 healthcare professionals were randomly selected. Data was collected using a self-administered questionnaire developed from national CPD guidelines. Data analysis was performed using the STATA statistical package version 14. A logistic regression model was used to assess the association between predictors and the outcome variable. Adjusted odds ratios with 95% confidence intervals were calculated to determine the strength of the association. A p-value < 0.05 was considered statistically significant. RESULTS In this study, 731 healthcare workers participated. Among them, 65.80% (95% CI: 62.35%, 69.24%) had knowledge of CPD, and 79.48% (CI95% 76.54, 82.41) expressed a strong perceived need for CPD. Female healthcare workers [AOR: 0.54 (95% CI: 0.37, 0.78)] and lack of internet access [AOR: 0.68 (95% CI: 0.47-0.97)] were predictors of knowledge of CPD. Age above 35 [AOR: 0.39 (95% CI: 0.17, 0.91)] and being female [AOR: 0.59 (95% CI: 0.40-0.87)] were predictors of a strong perceived need for CPD. CONCLUSION The study found that there was a low level of knowledge about Continuing Professional Development among healthcare workers. The perceived needs of healthcare workers varied. It is important for health sectors and stakeholders to prioritize developing strategies that address knowledge gaps, particularly among female healthcare workers, improve access to the Internet for CPD resources, and address the diverse needs of professionals for effective CPD implementation.
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Affiliation(s)
- Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia.
| | - Ahmed Mohamed
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kerimo Behir
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bikila Balis
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia
| | - Shiferaw Letta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. Box. 235, Harar, Ethiopia
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22
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Quach S. What's Next in MHealth Apps in Rehabilitation: Re-Directing Our Attention to Evaluating Quality. Physiother Can 2024; 76:157-159. [PMID: 38725605 PMCID: PMC11078248 DOI: 10.3138/ptc-2023-76-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Shirley Quach
- From the: School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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23
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Zafar SN, Hazlewood G, Dhiman K, Charlton A, Then KL, Dempsey E, Lester R, Hoens AM, Lacaille D, Barnabe C, Rankin J, Mosher D, Barber CEH. "How are you?" Perspectives From Patients and Health Care Providers of Text Messaging to Support Rheumatoid Arthritis Care: A Thematic Analysis. ACR Open Rheumatol 2024; 6:276-286. [PMID: 38376004 PMCID: PMC11089442 DOI: 10.1002/acr2.11652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE Patients with rheumatoid arthritis (RA) may need to access rheumatology care between scheduled visits. WelTel is a virtual care platform that supports secure two-way text-messaging between patients and their health care team. The objective of the present study was to explore perspectives and experiences of health care providers (HCPs) and patients related to the use of WelTel as an adjunct to routine care. METHODS Seventy patients with RA were enrolled in a six-month WelTel pilot project launched in September 2021. Patients received monthly "How are you?" text message check-ins and could message their health care team during clinic hours to request health advice. The current project is a qualitative study of the WelTel pilot. A subgroup of pilot participants was purposively sampled and invited to participate in interviews. A thematic analysis of transcripts was conducted using a deductive approach leveraging quality of care domains. RESULTS Thirteen patients (62% female, mean age 62 years, 10 White) completed interviews. Patients' views suggested that text messaging with the rheumatology team supported high-quality care across multiple quality domains including patient-centeredness, timeliness, efficiency, safety, effectiveness, equity, and appropriateness. Seven HCPs (57.1% female, one pharmacist and six rheumatologists) completed interviews. HCPs' perspectives varied based on their experience with the WelTel platform. Additional themes reported by HCPs included perceived increased workload and burnout. CONCLUSIONS Patients with RA perceived text-based messaging as supporting high-quality care. The impact of increased communications on HCP burnout and workload requires consideration, and future studies should evaluate the effect of texting on patient outcomes.
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Affiliation(s)
- Saania N. Zafar
- University of Calgary, Calgary, Alberta, Canada, and Arthritis Research CanadaVancouverBritish ColumbiaCanada
| | - Glen Hazlewood
- University of Calgary and Alberta Health Services, Calgary, Alberta, Canada, and Arthritis Research CanadaVancouverBritish ColumbiaCanada
| | | | | | - Karen L. Then
- Alberta Health Services and University of CalgaryCalgaryAlbertaCanada
| | - Erika Dempsey
- Alberta Health Services and University of CalgaryCalgaryAlbertaCanada
| | - Richard Lester
- University of British Columbia and WelTel IncVancouverBritish ColumbiaCanada
| | - Alison M. Hoens
- Arthritis Research Canada and University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Diane Lacaille
- Arthritis Research Canada and University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Cheryl Barnabe
- University of Calgary and Alberta Health Services, Calgary, Alberta, Canada, and Arthritis Research CanadaVancouverBritish ColumbiaCanada
| | - James Rankin
- University of Calgary, Calgary, Alberta, Canada, and Thompson Rivers UniversityKamloopsBritish ColumbiaCanada
| | - Dianne Mosher
- Alberta Health Services and University of CalgaryCalgaryAlbertaCanada
| | - Claire E. H. Barber
- University of Calgary and Alberta Health Services, Calgary, Alberta, Canada, and Arthritis Research CanadaVancouverBritish ColumbiaCanada
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24
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Thomas J, Almidani L, Swenor BK, Varadaraj V. Digital Technology Use Among Older Adults With Vision Impairment. JAMA Ophthalmol 2024; 142:445-452. [PMID: 38573612 PMCID: PMC11099681 DOI: 10.1001/jamaophthalmol.2024.0467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/25/2024] [Indexed: 04/05/2024]
Abstract
Importance Telehealth has the potential to improve health for older adults, but many access disparities exist, including for those with vision impairment (VI). Objective To examine the associations between VI and digital technology access measures in US older adults. Design, Setting, and Participants This was a cross-sectional study that included Medicare beneficiaries 65 years and older. Beneficiary data were obtained from the National Health and Aging Trends Study (NHATS) 2021; data collection was conducted from June 2020 through January 2021. Data were analyzed September 2023. Exposure VI, measured on categorical (distance and near VI [>0.30 logMAR], contrast sensitivity impairment [CSI; <1.55 logCS], and any VI [distance VI, near VI, or CSI]), and continuous (distance and near acuity [logMAR] and contrast sensitivity [logCS]) scales. Main Outcomes Self-reported outcomes of digital technology access from the technological environment component of the NHATS. Results Of the 2822 Medicare beneficiaries (mean [SD] age, 78.5 [5.6] years; 1605 female [54.7%]) included in this study, patients self-identified with the following race and ethnicity categories (weighted percentages): 575 non-Hispanic Black (8.0%), 132 Hispanic (7.0%), 2019 non-Hispanic White (81.7%), and 63 non-Hispanic other race (3.4%), which included American Indian, Alaska Native, Asian, multiracial, Native Hawaiian, Pacific Islander, or other specified race. A total of 1077 of 2822 patients (32.3%) had any VI. In multivariable logistic regression models, older adults with any VI had lower odds of having or knowing how to use a cellphone (odds ratio [OR], 0.58; 95% CI, 0.38-0.88), computer (OR, 0.61; 95% CI, 0.47-0.79), or tablet (OR, 0.68, 95% CI = 0.54-0.85) than peers without VI. In other models, near VI was associated with lower odds of having and knowing how to use a phone (OR, 0.56; 95% CI, 0.36-0.87), computer (OR, 0.57; 95% CI, 0.44-0.75), or tablet (OR, 0.65; 95% CI, 0.52-0.81) compared with no near VI. CSI was associated with lower odds of having and knowing how to use a phone (OR, 0.66; 95% CI, 0.45-0.99) or computer (OR, 0.72; 95% CI, 0.55-0.93) compared with no CSI. Distance VI was only associated with lower odds of having and knowing how to use a cellphone (OR, 0.63; 95% CI, 0.41-0.95). Any VI and individual categorical VI measures were not associated with other outcomes of digital health- and nonhealth-related experiences. Similar associations were noted when vision was examined on a continuous scale. However, worse distance acuity (per 0.1 logMAR) was associated with being less likely to visit with family or friends on a video call (OR, 0.91; 95% CI, 0.84-0.98) and to order or refill prescriptions online (OR, 0.90; 95% CI, 0.83-0.97). Conclusions and Relevance Results suggest that older US adults with VI were less likely to have access to digital technology than peers without VI, although no differences were noted in the report of digital health- and nonhealth-related activities. These findings highlight the potential for inequities that may arise in telehealth for older adults with VI and the necessity to develop strategies to improve accessibility of telemedicine for all.
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Affiliation(s)
- Jonathan Thomas
- Texas A&M School of Medicine, Bryan, Texas
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Louay Almidani
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bonnielin K. Swenor
- Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Varshini Varadaraj
- Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, Maryland
- Johns Hopkins University School of Nursing, Baltimore, Maryland
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25
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Quach S. Que nous réservent les applis de santé mobile en réadaptation – se concentrer sur l’évaluation de la qualité. Physiother Can 2024; 76:160-162. [PMID: 38725591 PMCID: PMC11078243 DOI: 10.3138/ptc-2023-76-2.fr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Affiliation(s)
- Shirley Quach
- From the: École des sciences de la réadaptation, Faculté des sciences de la santé, Université McMaster, Hamilton, Ontario, Canada
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26
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Lai YK, Ye JF, Ran Q, Ao HS. Internet-based eHealth technology for emotional well-being among the older adults with a family cancer history: full mediation effects of health information self-efficacy and cancer fatalism. BMC Psychol 2024; 12:232. [PMID: 38664857 PMCID: PMC11046909 DOI: 10.1186/s40359-024-01701-0] [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: 09/21/2023] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Older adults with a family cancer history (FCH) face an increased cancer risk, which may adversely impact their emotional well-being. Internet-based eHealth technologies (IETs) provide a potential solution to this challenge. This study examines the influence of using IETs on the emotional well-being of older adults with FCH. It also delves into the mediating pathways through health information self-efficacy and cancer fatalism. METHODS This study conducted a mediation analysis using data from the Health Information National Trends Survey (HINTS 6) collected from March 2022 to November 2022, focusing on older adults with FCH who had previously searched for cancer-related information (N = 1,280). RESULTS In the mediation model, no positive direct associations between IETs usage and emotional well-being were found. Only health information self-efficacy and cancer fatalism were found to mediate the relationship between IETs usage and emotional well-being serially (β = 0.007, 95% CI [0.003, 0.012]). CONCLUSIONS The findings inform health information professionals and healthcare practitioners on enhancing the impact of IETs usage on individual health information self-efficacy, which mitigates cancer fatalism, contributing to better emotional well-being in the digital era.
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Affiliation(s)
- Yuyuan Kylie Lai
- Institute of Collaborative Innovation, University of Macau, Macao, China
- Department of Communication, University of Macau, Macao, China
| | | | - Qiawen Ran
- China Petroleum Pipeline Engineering CO., LTD. International, Hebei, China
| | - Harris Song Ao
- Department of Communication, University of Macau, Macao, China.
- University of Macau Avenida da Universidade, Room 1001, N21, Research Building, Taipa, Macao.
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27
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Ferraz LT, Santos AJT, Lorenzi LJ, Frohlich DM, Barley E, Castro PC. Design considerations for the migration from paper to screen-based media in current health education for older adults: a scoping review. BMJ Open 2024; 14:e078647. [PMID: 38604627 PMCID: PMC11015264 DOI: 10.1136/bmjopen-2023-078647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/28/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES To map the current use of paper-based and/or screen-based media for health education aimed at older people. DESIGN A scoping review was reported following the Preferred Reporting Items of Systematic Reviews and Meta-analyses for Scoping Reviews checklist. DATA SOURCES The search was carried out in seven databases (Scopus, Web of Science, Embase, Medline, CINAHL, ACM Guide to Computing Literature, PsycINFO), with studies available from 2012 to the date of the search in 2022, in English, Portuguese, Italian or Spanish. In addition, Google Scholar was searched to check the grey literature. The terms used in the search strategy were older adults, health education, paper and screen-based media, preferences, intervention and other related terms. ELIGIBILITY CRITERIA Studies included were those that carried out health education interventions for older individuals using paper and/or screen-based media and that described barriers and/or facilitators to using these media. DATA EXTRACTION AND SYNTHESIS The selection of studies was carried out by two reviewers. A data extraction form was developed with the aim of extracting and recording the main information from the studies. Data were analysed descriptively using Bardin's content analysis. RESULTS The review included 21 studies that carried out health education interventions with different purposes, the main ones being promotion of physical activity, hypertension prevention and psychological health. All 21 interventions involved screen-based media on computers, tablets, smartphones and laptops, while only 4 involved paper-based media such as booklets, brochures, diaries, flyers and drawings. This appears to reflect a transition from paper to screen-based media for health education for the older population, in research if not in practice. However, analysis of facilitators and barriers to using both media revealed 10 design factors that could improve or reduce their use, and complementarity in their application to each media type. For example, screen-based media could have multimedia content, additional functionality and interactivity through good interaction design, but have low accessibility and require additional learning due to complex interface design. Conversely, paper-based media had static content and low functionality but high accessibility and availability and a low learning cost. CONCLUSIONS We recommend having improved screen-based media design, continued use of paper-based media and the possible combination of both media through the new augmented paper technology. REGISTRATION NUMBER Open Science Framework (DOI: 10.17605/OSF.IO/GKEAH).
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Affiliation(s)
| | | | - Lorena Jorge Lorenzi
- Postgraduate Program in Bioengineering, University of São Paulo, São Carlos, Brazil
| | | | - Elizabeth Barley
- Mental Health Sciences and Nursing, University of Surrey, Guildford, UK
| | - Paula Costa Castro
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
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28
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Zou X, Sun P, Chen M, Nan J, Gao J, Huang X, Hou Y, Jiang Y. Experience of Older Patients with COPD Using Disease Management Apps: A Qualitative Study. Healthcare (Basel) 2024; 12:802. [PMID: 38610224 PMCID: PMC11011793 DOI: 10.3390/healthcare12070802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Digital medicine is developing in the management of chronic diseases in older people, but there is still a lack of information on the use of disease management apps in older patients with COPD. This study aims to explore the views and experience of older patients with COPD on disease management apps to provide a basis for the development and promotion of apps for geriatric diseases. (2) Methods: A descriptive qualitative research method was used. Older patients with COPD (N = 32) with experience using disease management apps participated in semi-structured interviews. Thematic analysis was used to analyze the data. (3) Results: Seven themes were defined: (a) feeling curious and worried when facing disease management apps for the first time; (b) actively overcoming barriers to use; (c) gradually becoming independent by continuous online learning; (d) feeling safe in the virtual environment; (e) gradually feeling new value in online interactions; (f) relying on disease management apps under long-term use; (g) expecting disease management apps to meet personalized needs. (4) Conclusions: The adoption and use of disease management apps by older people is a gradual process of acceptance, and they can obtain a wide range of benefits in health and life.
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Affiliation(s)
| | | | | | | | | | | | | | - Yuyu Jiang
- Research Office of Chronic Disease Management and Rehabilitation, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China; (X.Z.); (P.S.); (M.C.); (J.N.); (J.G.); (X.H.); (Y.H.)
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29
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Choe E, Poleon S, Thomas T, Racette L. The association between perceived cause of glaucoma and illness perceptions. Front Med (Lausanne) 2024; 11:1363732. [PMID: 38638934 PMCID: PMC11024309 DOI: 10.3389/fmed.2024.1363732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Purpose The perceived cause of disease is an important factor that has been linked with treatment outcomes but has not been fully assessed in primary open-angle glaucoma (POAG). This study assessed the accuracy of patients' perceived cause of POAG and identified associations between accuracy, illness perceptions, medication adherence, and quality of life (QoL). Methods The Brief Illness Perception Questionnaire (BIPQ) was used to assess illness perceptions and asked patients to rank the three most important causes of their disease in order of importance. POAG risk factors recognized by the American Academy of Ophthalmology were used to code responses as accurate or inaccurate based on the following three methods: (1) coding any reported cause, regardless of rank, (2) coding only the first-ranked cause, and (3) coding and weighting all reported causes. Medication adherence was measured electronically. QoL was measured using the Glaucoma Quality of Life questionnaire. Mann-Whitney U test was used to detect differences in illness perceptions, medication adherence, and QoL between accuracy groups. Results A total of 97 patients identified a cause of their POAG and were included in this analysis. A higher proportion of patients reported an accurate cause (86.6% using method 1, 78.4% using method 2, and 79.4% using method 3; all p < 0.001). Mean medication adherence was 86.0% ± 17.8 and was similar across accuracy groups (all p > 0.05). Using method 2 (p = 0.045) and method 3 (p = 0.028), patients who reported an accurate cause of their POAG believed that their illness would last for a longer time compared to patients who reported an inaccurate cause. Method 3 also revealed that patients who reported an accurate cause of their POAG had lower perceived understanding of their illness (p = 0.048) compared to patients who reported an inaccurate cause. There were no differences in QoL between accuracy groups (all p > 0.05). Conclusion This study highlights the association between perceived cause of POAG and illness perceptions related to knowledge level and POAG duration. Future studies should assess associations between perceived cause of disease and other critical dimensions of illness perception.
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Affiliation(s)
| | | | | | - Lyne Racette
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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30
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Oh KM, Inoue M, Koizumi N, Beran K, Lee JAA. Chronic Health Conditions and Patient Portal Use in Caregivers of People With Alzheimer's Disease and Related Dementias. J Appl Gerontol 2024; 43:363-373. [PMID: 37982671 DOI: 10.1177/07334648231210677] [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: 11/21/2023] Open
Abstract
This study aimed to investigate both chronic health conditions and the utilization of patient portals, focusing particularly on caregivers responsible for individuals with Alzheimer's disease and related dementias (ADRD). Data from the Health Information National Trends Survey 2018-2020 were analyzed, involving a sample of 304 family and unpaid caregivers of individuals with ADRD. Among caregivers of individuals with ADRD, 77.6% had at least one chronic disease. A significant proportion (46.6%) of ADRD caregivers had never accessed their patient portals. The limited utilization of patient portals among caregivers responsible for individuals with ADRD, particularly those with lower education, advanced age, and few chronic conditions, becomes apparent due to challenges associated with digital literacy and discomfort with computers. Recognizing the crucial role caregivers play for individuals with ADRD and their health risks, there's a need for tailored training to enhance their health management skills and caregiving capabilities.
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Affiliation(s)
| | | | | | | | - Jung-Ah Anna Lee
- Sue & Bill Gross School of Nursing, University of California, Irvine, CA, USA
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Chao SM, Wang ML, Fang YW, Lin ML, Chen SF. Mobile Apps for Patients with Peritoneal Dialysis: Systematic App Search and Evaluation. Healthcare (Basel) 2024; 12:719. [PMID: 38610142 PMCID: PMC11011774 DOI: 10.3390/healthcare12070719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Peritoneal dialysis (PD) is one type of renal replacement therapy. If patients have problems during the dialysis process, healthcare providers may not be able assist the patients immediately. mHealth can provide patients with information and help them to solve problems in real-time, potentially increasing their willingness to choose PD. OBJECTIVE The objectives of this study were to conduct a comprehensive review of free mobile applications for patients with PD on the Internet and to recommend suitable mobile applications to facilitate patient self-management and health. METHODS We conducted a systematic search for PD mobile applications on Google Play and the Apple iTunes Store from 3 to 16 June 2023. RESULTS A total of 828 identifiable mobile applications were initially identified, and ultimately, 21 met the inclusion criteria. The Mobile App Rating Scale (MARS) assessment of the applications revealed the highest score in the functionality domain, followed by the aesthetics, information, app-specific, subjective quality, and engagement domains, respectively. In the comprehensive self-management of PD, the highest percentage was related to disease-related information. CONCLUSION The findings of this study suggest that some applications, with the highest quality, can be recommended to patients for use in English or traditional Chinese.
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Affiliation(s)
- Shu-Mei Chao
- Department of Nursing, School of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (M.-L.L.)
| | - Ming-Ling Wang
- International Ph.D. Program in Gerontology and Long-Term Care, School of Nursing, Taipei Medical University, Taipei 110301, Taiwan;
| | - Yu-Wen Fang
- Department of Nursing, School of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (M.-L.L.)
| | - Mei-Ling Lin
- Department of Nursing, School of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (M.-L.L.)
| | - Shu-Fen Chen
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
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Gerber S, Silver RE, Das SK, Greene SS, Dix SR, Ramirez I, Morcos CL, Dao MC, Ceglia L, Roberts SB. Development and Feasibility of an eHealth Diabetes Prevention Program Adapted for Older Adults-Results from a Randomized Control Pilot Study. Nutrients 2024; 16:930. [PMID: 38612963 PMCID: PMC11154527 DOI: 10.3390/nu16070930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
Lifestyle programs that reduce health risks and support weight loss (WL) in older adults face adherence and attendance challenges due to reduced energy requirements, impaired mobility, lack of transportation, and low social support. Tailored lifestyle and weight management programs are needed to better support healthy aging for older adults. Here, we developed and piloted an age-adapted, remotely delivered modification of the Diabetes Prevention Program (DPP). The modification includes age-appropriate goals, visuals, and examples; flexible dietary composition; remote classroom and fitness-monitoring technology; and standardized online classroom materials employing pedagogical and behavior change theory. The modifications were designed to safeguard fidelity and to boost adherence, engagement, and knowledge integration, with the convenience of a fully remote WL program for diverse older adults. Six-month pilot data are presented from older adults (55-85 years, body mass index (BMI) 27-39.9 kg/m2, N = 20) randomly allocated to an online DPP intervention with weight, diet, and activity monitored remotely, or into a waitlisted control. The intervention achieved 100% attendance and adherence to self-monitoring. The intervention group mean (±SD) body weight change was -9.5% (±4.1); 90% lost ≥ 5%. By contrast, the control group gained 2.4% (±1.8). Once thought incompatible with older adults, remote interventions are feasible for older adults and can support fidelity, adherence, engagement, and clinically significant WL. Standardized materials are provided for future implementation.
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Affiliation(s)
- Suzannah Gerber
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Rachel E. Silver
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Sai Krupa Das
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Savana S. Greene
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Sadie R. Dix
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Isabella Ramirez
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Christina L. Morcos
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Maria Carlota Dao
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH 03824, USA;
| | - Lisa Ceglia
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA 02111, USA
| | - Susan B. Roberts
- Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Rd., Hanover, NH 03755, USA;
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Li S, Du Y, Miao H, Sharma K, Li C, Yin Z, Brimhall B, Wang J. Understanding Heterogeneity in Individual Responses to Digital Lifestyle Intervention Through Self-Monitoring Adherence Trajectories in Adults With Overweight or Obesity: Secondary Analysis of a 6-Month Randomized Controlled Trial. J Med Internet Res 2024; 26:e53294. [PMID: 38506903 PMCID: PMC10993111 DOI: 10.2196/53294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/01/2024] [Accepted: 01/31/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Achieving clinically significant weight loss through lifestyle interventions for obesity management is challenging for most individuals. Improving intervention effectiveness involves early identification of intervention nonresponders and providing them with timely, tailored interventions. Early and frequent self-monitoring (SM) adherence predicts later weight loss success, making it a potential indicator for identifying nonresponders in the initial phase. OBJECTIVE This study aims to identify clinically meaningful participant subgroups based on longitudinal adherence to SM of diet, activity, and weight over 6 months as well as psychological predictors of participant subgroups from a self-determination theory (SDT) perspective. METHODS This was a secondary data analysis of a 6-month digital lifestyle intervention for adults with overweight or obesity. The participants were instructed to perform daily SM on 3 targets: diet, activity, and weight. Data from 50 participants (mean age: 53.0, SD 12.6 y) were analyzed. Group-based multitrajectory modeling was performed to identify subgroups with distinct trajectories of SM adherence across the 3 SM targets. Differences between subgroups were examined for changes in clinical outcomes (ie, body weight, hemoglobin A1c) and SDT constructs (ie, eating-related autonomous motivation and perceived competence for diet) over 6 months using linear mixed models. RESULTS Two distinct SM trajectory subgroups emerged: the Lower SM group (21/50, 42%), characterized by all-around low and rapidly declining SM, and the Higher SM group (29/50, 58%), characterized by moderate and declining diet and weight SM with high activity SM. Since week 2, participants in the Lower SM group exhibited significantly lower levels of diet (P=.003), activity (P=.002), and weight SM (P=.02) compared with the Higher SM group. In terms of clinical outcomes, the Higher SM group achieved a significant reduction in body weight (estimate: -6.06, SD 0.87 kg; P<.001) and hemoglobin A1c (estimate: -0.38, SD 0.11%; P=.02), whereas the Lower SM group exhibited no improvements. For SDT constructs, both groups maintained high levels of autonomous motivation for over 6 months. However, the Lower SM group experienced a significant decline in perceived competence (P=.005) compared with the Higher SM group, which maintained a high level of perceived competence throughout the intervention (P=.09). CONCLUSIONS The presence of the Lower SM group highlights the value of using longitudinal SM adherence trajectories as an intervention response indicator. Future adaptive trials should identify nonresponders within the initial 2 weeks based on their SM adherence and integrate intervention strategies to enhance perceived competence in diet to benefit nonresponders. TRIAL REGISTRATION ClinicalTrials.gov NCT05071287; https://clinicaltrials.gov/study/NCT05071287. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1016/j.cct.2022.106845.
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Affiliation(s)
- Shiyu Li
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Yan Du
- School of Nursing, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Hongyu Miao
- College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Kumar Sharma
- Center for Precision Medicine, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Chengdong Li
- College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Zenong Yin
- Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, United States
| | - Bradley Brimhall
- Department of Pathology and Laboratory Medicine, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Jing Wang
- College of Nursing, Florida State University, Tallahassee, FL, United States
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Beltzer A, Kölle J, Gil Miró M, Pleus S, Krauss C, Haug C, Safary E, Vetter B, Freckmann G. Benefits of Usability Evaluation in the Development Process of Diabetes Technologies Using the Example of a Continuous Glucose Monitoring System Prototype. J Diabetes Sci Technol 2024:19322968241238146. [PMID: 38477255 DOI: 10.1177/19322968241238146] [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] [Indexed: 03/14/2024]
Abstract
BACKGROUND Usability engineering analyzes the interaction between the intended users and a device. Its implementation is mandatory for manufacturers to obtain regulatory approval for the European market. The aim of this evaluation was assessing the role of usability testing in the development process. For this purpose, a continuous glucose monitoring (CGM) device under development was investigated to determine whether it could be used safely and effectively by the intended users. METHODS Conduct of the usability testing was based on the international standard IEC 62366-1. Medical device use of CGM-experienced and non-experienced users (n = 15 each) was observed without initial training in use scenarios containing 18 tasks. The success rate of task completion was determined and the System Usability Scale (SUS) score was calculated from a questionnaire. A prototype of the FiberSense CGM System (EyeSense GmbH, Großostheim, Germany), comprising of a single-use sensor and a reusable detector, was investigated. RESULTS Most use errors made by both user groups were related to ease of handling of the reusable detectors. The SUS scores achieved in this study were below the pre-defined SUS score acceptance criterion of ≥68. The most frequently mentioned reason for use errors was an incomprehensible and non-chronological instructions for use (IFU). CONCLUSIONS The evaluation provides valuable insights on how to improve usability of the prototype device and demonstrates the value of conducting structured usability testing prior to product finalization. The results reflected areas for improvement of the user interface, mainly by restructuring the IFU, provision of an additional leaflet, and device training prior to use.
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Affiliation(s)
- Anne Beltzer
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Julia Kölle
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Marta Gil Miró
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Stefan Pleus
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Collin Krauss
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | - Cornelia Haug
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
| | | | | | - Guido Freckmann
- Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany
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Chao SM, Pan CK, Wang ML, Fang YW, Chen SF. Functionality and Usability of mHealth Apps in Patients with Peritoneal Dialysis: A Systematic Review. Healthcare (Basel) 2024; 12:593. [PMID: 38470704 PMCID: PMC10930967 DOI: 10.3390/healthcare12050593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
mHealth has been utilized in the care of patients with chronic kidney disease, allowing the collection of patient health-related data, offering disease-related information, enabling the tracking and recording of biochemical parameters, and enabling communication with healthcare providers in real time through applications. mHealth may improve the health outcomes in patients with peritoneal dialysis. This systematic review aimed to summarize evidence regarding the functionality and usability of mHealth apps in patients with peritoneal dialysis. We conducted a comprehensive literature review, searching in five databases, including CINAHL, Cochrane, PsycINFO, PubMed, and Web of Science, to retrieve titles and abstracts related to peritoneal dialysis and mHealth applications for PRISMA recommendations from January 2013 to December 2023. Overall, 11 studies met all the inclusion criteria. The functionality of mHealth apps included inform, instruct, record, display, guide, remind/alert, and communicate. Most of the apps have multifunctionality. The usability was categorized into three aspects: efficiency (self-efficacy and usability), satisfaction, and effectiveness (underwent kidney transplantation and switched to hemodialysis, rehospitalization, peritonitis rate, infection rates at exit sites, mortality, fluid overload, inadequate solute clearance, biochemical values, quality of life, consumer quality index, and technology readiness). Generally, outcomes in the intervention group had better effects compared to those in the control group. Multifunctional mHealth apps show a good potential in improving the efficiency, satisfaction, and effectiveness for patients compared to traditional care. Future research should include more studies and participants to explore and verify the long-term effectiveness of mHealth apps.
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Affiliation(s)
- Shu-Mei Chao
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (C.-K.P.)
| | - Chao-Kuei Pan
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan; (S.-M.C.); (C.-K.P.)
| | - Ming-Ling Wang
- School of Nursing, International Ph. D Program in Gerontology and Long-Term Care, Taipei Medical University, Taipei 110301, Taiwan;
| | - Yu-Wen Fang
- Department of Health Administration, Tzu Chi University of Science and Technology, Hualien 970302, Taiwan
| | - Shu-Fen Chen
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
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Turcotte S, Bouchard C, Rousseau J, DeBroux Leduc R, Bier N, Kairy D, Dang-Vu TT, Sarimanukoglu K, Dubé F, Bourgeois Racine C, Rioux C, Shea C, Filiatrault J. Factors influencing older adults' participation in telehealth interventions for primary prevention and health promotion: A rapid review. Australas J Ageing 2024; 43:11-30. [PMID: 38014903 DOI: 10.1111/ajag.13244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To identify facilitators and barriers to older adults' participation in telehealth interventions for primary prevention and health promotion. METHODS Relevant articles were searched using keywords in Embase and MEDLINE. Study characteristics, type of telehealth interventions and technology involved, as well as facilitators and barriers to their use, were extracted from selected articles. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model was used to organise data. RESULTS A total of 24 articles (pertaining to 20 studies) were included. Nine facilitators and 11 barriers influencing the participation in telehealth interventions for primary prevention and health promotion among older adults were identified. The most recurrent facilitators were related to the individual's performance expectancy and effort expectancy, as well as the presence of a social dimension associated with the intervention (i.e. having a good relationship with the other participants in the program). The two most prevalent barriers were also related to effort expectancy and performance expectancy, followed by barriers related to the inherent characteristics of the technology and older adults' health condition. Experience, age and gender were also found to moderate technology use and acceptance. CONCLUSIONS This rapid review highlights the importance of adopting a holistic perspective when designing telehealth interventions aimed at preventive and health promotion purposes among older adults.
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Affiliation(s)
- Samuel Turcotte
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - Camille Bouchard
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Jacqueline Rousseau
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - Roxane DeBroux Leduc
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - Nathalie Bier
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - Dahlia Kairy
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Thien Thanh Dang-Vu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Concordia University, Montréal, Québec, Canada
| | - Kami Sarimanukoglu
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - François Dubé
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - Chanaelle Bourgeois Racine
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Camille Rioux
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Carolann Shea
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
| | - Johanne Filiatrault
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
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Kha R, Wen Q, Bender N, Jones C, Gopinath B, Macniven R, Tang D. Understanding barriers and enablers to participation in a proposed online lifestyle intervention for older adults with age-related macular degeneration to guide programme implementation. J Health Psychol 2024; 29:317-331. [PMID: 37840275 PMCID: PMC10958751 DOI: 10.1177/13591053231204722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Age-related macular degeneration (AMD) is a blinding condition associated with depression, loneliness and unhealthy lifestyle behaviours which drives AMD progression. We have proposed the first online lifestyle intervention for AMD, called Movement, Interaction and Nutrition for Greater Lifestyles in the Elderly (MINGLE) to promote positive lifestyle changes and reduce loneliness. This qualitative grounded-theory study explored enablers and barriers to future participation in MINGLE for older adults with AMD. Thirty-one participants were interviewed and thematic analysis revealed nine themes. Enablers to participation were: socialising and learning about AMD, motivation to improve health, programme accessibility and structure. Barriers were: lack of time, technology, limited knowledge regarding holistic interventions, vision-related issues, mobility and negative perception of group interactions. These factors must be considered when developing lifestyle interventions for AMD patients to maximise participation. Supporting technology use and raising awareness about benefits of healthy lifestyle behaviours for AMD may help overcome these barriers.
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Affiliation(s)
| | | | | | | | | | - Rona Macniven
- Macquarie University, Australia
- UNSW Sydney, Australia
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Money A, Hall A, Harris D, Eost-Telling C, McDermott J, Todd C. Barriers to and Facilitators of Older People's Engagement With Web-Based Services: Qualitative Study of Adults Aged >75 Years. JMIR Aging 2024; 7:e46522. [PMID: 38416543 PMCID: PMC10938227 DOI: 10.2196/46522] [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: 02/14/2023] [Revised: 05/22/2023] [Accepted: 12/05/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has accelerated the shift toward the digital provision of many public services, including health and social care, public administration, and financial and leisure services. COVID-19 services including test appointments, results, vaccination appointments and more were primarily delivered through digital channels to the public. Many social, cultural, and economic activities (appointments, ticket bookings, tax and utility payments, shopping, etc) have transitioned to web-based platforms. To use web-based public services, individuals must be digitally included. This is influenced by 3 main factors: access (whether individuals have access to the internet), ability (having the requisite skills and confidence to participate over the web), and affordability (ability to pay for infrastructure [equipment] and data packages). Many older adults, especially those aged >75 years, are still digitally excluded. OBJECTIVE This study aims to explore the views of adults aged >75 years on accessing public services digitally. METHODS We conducted semistructured qualitative interviews with a variety of adults aged ≥75 years residing in Greater Manchester, United Kingdom. We also interviewed community support workers. Thematic analysis was used to identify the key themes from the data. RESULTS Overall, 24 older adults (mean age 81, SD 4.54 y; 14/24, 58% female; 23/24, 96% White British; and 18/24, 75% digitally engaged to some extent) and 2 support workers participated. A total of five themes were identified as key in understanding issues around motivation, engagement, and participation: (1) "initial motivation to participate digitally"-for example, maintaining social connections and gaining skills to be able to connect with family and friends; (2) "narrow use and restricted activity on the web"-undertaking limited tasks on the web and in a modified manner, for example, limited use of web-based public services and selected use of specific services, such as checking but never transferring funds during web-based banking; (3) "impact of digital participation on well-being"-choosing to go to the shops or general practitioner's surgery to get out of the house and get some exercise; (4) "the last generation?"-respondents feeling that there were generational barriers to adapting to new technology and change; and (5) "making digital accessible"-understanding the support needed to keep those engaged on the web. CONCLUSIONS As we transition toward greater digitalization of public services, it is crucial to incorporate the perspectives of older people. Failing to do so risks excluding them from accessing services they greatly rely on and need.
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Affiliation(s)
- Annemarie Money
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Alex Hall
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Danielle Harris
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Charlotte Eost-Telling
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Jane McDermott
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, The University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Bertolazzi A, Quaglia V, Bongelli R. Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review. BMC Public Health 2024; 24:506. [PMID: 38365698 PMCID: PMC10873991 DOI: 10.1186/s12889-024-18036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging. METHODS This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT). RESULTS Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors. CONCLUSION The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.
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Affiliation(s)
- Alessia Bertolazzi
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy.
| | - Valeria Quaglia
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
| | - Ramona Bongelli
- Department of Political Science, Communication and International Relations, University of Macerata, Don Minzoni street, 22, 62100, Macerata, Italy
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Zhu D, Al Mahmud A, Liu W. Examining behaviour change techniques (BCTs) in technology-based interventions for enhancing social participation in people with mild cognitive impairment (MCI) or dementia: a scoping review protocol. BMJ Open 2024; 14:e078188. [PMID: 38341213 PMCID: PMC10862279 DOI: 10.1136/bmjopen-2023-078188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Technology-based interventions have improved the social participation of older adults with mild cognitive impairment (MCI) or dementia. Nevertheless, how these interventions modify social participation remains to be seen, and what efficient behaviour change techniques (BCTs) have been used. As such, this study aims to conduct a scoping review, identifying the features and BCTs behind technology-based interventions that improve social participation for individuals with MCI or dementia. METHODS AND ANALYSIS The scoping review method will be used to search journal articles from electronic databases, such as PsycINFO, PubMed, MEDLINE, Web of Science, Scopus and reference lists. Following the population, concept and context structure, this study focuses on adults over 60 diagnosed with MCI or dementia. It delves into technology-based interventions, specifically focusing on BCTs, features and overall effectiveness for improving social participation. The research considers contextual factors, exploring the diverse settings where these interventions are used, including homes, healthcare facilities and community centres. This approach aims to provide nuanced insights into the impact of technology-based interventions on social participation in the targeted demographic. Two authors will independently screen titles, abstracts and full texts using Covidence software. Disagreements will be resolved through consensus or a third reviewer, and reasons for exclusion will be documented. We will conduct a detailed analysis of BCTs to pinpoint effective strategies applicable to future technology-based intervention designs. Through this scoping review, we aim to provide valuable insights that guide the direction of future research. Specifically, we seek to inform the development of effective technology-based interventions tailored to support social participation for people with MCI or dementia. ETHICS AND DISSEMINATION Ethical approval is not necessary, as this review will use available articles from electronic databases. The outcome of the study will be published in a peer-reviewed journal. PROTOCOL REGISTRATION NUMBER: https://osf.io/tkzuf/.
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Affiliation(s)
- Di Zhu
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Victoria, Australia
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Centre for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Abdullah Al Mahmud
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Wei Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Centre for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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Schäfer SK, von Boros L, Schaubruch LM, Kunzler AM, Lindner S, Koehler F, Werner T, Zappalà F, Helmreich I, Wessa M, Lieb K, Tüscher O. Digital interventions to promote psychological resilience: a systematic review and meta-analysis. NPJ Digit Med 2024; 7:30. [PMID: 38332030 PMCID: PMC10853230 DOI: 10.1038/s41746-024-01017-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
Societies are exposed to major challenges at an increasing pace. This underscores the need for preventive measures such as resilience promotion that should be available in time and without access barriers. Our systematic review summarizes evidence on digital resilience interventions, which have the potential to meet these demands. We searched five databases for randomized-controlled trials in non-clinical adult populations. Primary outcomes were mental distress, positive mental health, and resilience factors. Multilevel meta-analyses were performed to compare intervention and control groups at post-intervention and follow-up assessments. We identified 101 studies comprising 20,010 participants. Meta-analyses showed small favorable effects on mental distress, SMD = -0.24, 95% CI [-0.31, -0.18], positive mental health, SMD = 0.27, 95% CI [0.13, 0.40], and resilience factors, SMD = 0.31, 95% CI [0.21, 0.41]. Among middle-aged samples, older age was associated with more beneficial effects at follow-up, and effects were smaller for active control groups. Effects were comparable to those of face-to-face interventions and underline the potential of digital resilience interventions to prepare for future challenges.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany.
- Department of Clinical Psychology, Psychotherapy and Diagnostics - Child and Adolescent Psychology and Psychotherapy, Technische Universität Braunschweig, Braunschweig, Germany.
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | | | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Friederike Koehler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
- Centre of Excellence in Music, Mind, Body and Brain, University of Jyväskylä, Jyväskylä, Finland
| | - Tabea Werner
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | | | | | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University Mainz, Mainz, Germany
- Institute for Molecular Biology, Johannes Gutenberg University Mainz, Mainz, Germany
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Dawson R, Gilchrist H, Pinheiro M, Nelson K, Bowes N, Sherrington C, Haynes A. Experiences of Older Adults, Physiotherapists, and Aged Care Staff in the TOP UP Telephysiotherapy Program: Interview Study of the TOP UP Interventions. JMIR Aging 2024; 7:e53010. [PMID: 38324369 PMCID: PMC10882472 DOI: 10.2196/53010] [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: 09/22/2023] [Revised: 11/19/2023] [Accepted: 12/18/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Telehealth provides opportunities for older adults to access health care. However, limited research exists on the use of telehealth within aged care services, particularly regarding physiotherapy-led fall prevention and mobility programs. Understanding the experiences and interactions of older adults, physiotherapists, and aged care service providers is crucial for the scale-up and sustainability of such essential programs. The TOP UP study, a hybrid type 1 effectiveness-implementation randomized controlled trial in aged care, used a supported multidisciplinary telephysiotherapy model to motivate older adults to engage in exercises to improve mobility and reduce falls. OBJECTIVE This qualitative substudy aims to achieve 2 primary objectives: to describe the experiences and acceptability of the TOP UP intervention for older people, physiotherapists, and aged care support workers and managers and to gain an in-depth understanding of program implementation. METHODS A purposive recruitment strategy was used to select 18 older adults who participated in the TOP UP intervention, ensuring variation in age, gender, residential status (home or residential aged care), geographic location, and cognitive levels. In addition, 7 physiotherapists, 8 aged care support workers, and 6 managers from 7 different aged care provider partners participated in this study. Semistructured interviews were conducted to explore stakeholders' experiences with the TOP UP program, gather suggestions for improvement, and obtain insights for the future implementation of similar telephysiotherapy programs. The interview framework and coding processes were informed by behavior changes and implementation frameworks. Data were analyzed using an abductive approach, informed by 2 behavioral change theories (Capability, Opportunity, Motivation, and Behavior Model and Self-Determination Theory) and the Nonadoption, Abandonment and Challenges to the Scale-Up, Spread and Sustainability of Health and Care Technologies framework. RESULTS All participants (n=39) reported high levels of acceptability for the TOP UP program and cited multiple perceived benefits. The thematic analysis generated 6 main themes: telephysiotherapy expands opportunity; tailored physiotherapy care with local support enhances motivation; engaging, older adult-friendly educational resources build capability; flexible reablement approach fosters autonomy; telephysiotherapy is safe, effective, and acceptable for many; and organizational commitment is required to embed telehealth. The motivation to exercise was enhanced by Zoom's convenience, use of tailored web-based exercise resources, and companionable local support. CONCLUSIONS This study highlights the inherent value of telephysiotherapy in aged care, emphasizing the need for investment in staff training, local support, and older adult-friendly resources in future telephysiotherapy iterations. TOP UP represents a convenient and flexible web-based care model that empowers many older adults to receive sustainable, high-quality care precisely when and where they need it. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN 1261000734864; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621000734864.
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Affiliation(s)
- Rik Dawson
- Institute for Musculoskeletal Health, Sydney Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Camperdown, Australia
| | - Heidi Gilchrist
- Institute for Musculoskeletal Health, Sydney Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Camperdown, Australia
| | - Marina Pinheiro
- Institute for Musculoskeletal Health, Sydney Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Camperdown, Australia
| | | | | | - Cathie Sherrington
- Institute for Musculoskeletal Health, Sydney Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Camperdown, Australia
| | - Abby Haynes
- Institute for Musculoskeletal Health, Sydney Musculoskeletal Health, Sydney Local Health District, The University of Sydney, Camperdown, Australia
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Forouzandeh F, Alexander K, Forman DE, Kirkpatrick JN, Rich MW, Zieman S, Wenger NK. Cardiovascular Disease in the Older Adult: Where Are We 4 Decades Later? JACC. ADVANCES 2024; 3:100820. [PMID: 38435451 PMCID: PMC10906817 DOI: 10.1016/j.jacadv.2023.100820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/09/2023] [Accepted: 11/20/2023] [Indexed: 03/05/2024]
Abstract
The 1986 Bethesda Conference on Cardiovascular Disease (CVD) in the Elderly, co-chaired by Drs. Nanette Wenger, Frank Marcus, and Robert O'Rourke, delineated the anticipated social, political, ethical, economic and technological impact of an aging population on the incidence, prevalence, and management of CVD in the US and worldwide. In the ensuing 4 decades, older patients have come to comprise an increasingly large proportion of the CVD population, and there has been an explosion of research in all aspects of CVD affecting older adults. Correspondingly, Geriatric Cardiology is now an established field within cardiovascular medicine. In this communication, we provide a focused update on intersections between CVD and geriatrics from basic science to clinical practice, a review of major advances in diagnosis and treatment of older adults with CVD, and a preview of future research directions in the still evolving field of geriatric cardiology.
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Affiliation(s)
- Farshad Forouzandeh
- University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Karen Alexander
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Daniel E. Forman
- Divisions of Geriatrics and Cardiology, Department of Medicine, VA Pittsburgh Healthcare System, University of Pittsburgh, and the Pittsburgh Geriatrics, Research, Education, and Clinical Center (GRECC), Pittsburgh, Pennsylvania, USA
| | - James N. Kirkpatrick
- Division of Cardiology, Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, Washington, USA
| | - Michael W. Rich
- Division of Cardiology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Susan Zieman
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Nanette K. Wenger
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Emory Heart and Vascular Center, Emory Women’s Heart Center, Atlanta, Georgia, USA
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Nguyen-Truong CKY, Wuestney K, Leung H, Chiu C, Park M, Chac C, Fritz RL. Toward Sustaining Web-Based Senior Center Programming Accessibility With and for Older Adult Immigrants: Community-Based Participatory Research Cross-Sectional Study. Asian Pac Isl Nurs J 2024; 8:e49493. [PMID: 38277216 PMCID: PMC10858412 DOI: 10.2196/49493] [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: 05/30/2023] [Revised: 11/29/2023] [Accepted: 12/13/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, many community-based organizations serving Asian Americans pivoted to provide web-based care and social services. Asian American community leaders in the United States Pacific Northwest, including Asian Health & Service Center expressed that there are older immigrant adults who experienced backlash from discrimination, fear, and anxiety owing in part to anti-Asian hate and isolation, including from infection precautions. Pivoting supported staying safe from COVID-19 transmission and anti-Asian hate crimes. OBJECTIVE This study aims to examine the readiness of diverse groups of older Asian American immigrant adults (Chinese, Koreans, and Vietnamese) to use a web-based senior center, including technology access and telehealth use, and to identify the psychosocial health impacts that a web-based senior center could be positioned to meet. METHODS A community-based participatory research approach was used to conduct a cross-sectional survey study in an Asian-based health and service center in 2022. We selected surveys from the National Institutes of Health-supported PhenX Toolkit. Analyses were performed using R software. RESULTS There was an 88.2% (216/245) response rate. Overall, 39.8% (86/216) of participants were Chinese, 25% (54/216) were Korean, and 24.5% (53/216) were Vietnamese. There were significant group differences in mobile data plans (P=.0005). Most had an unlimited mobile data plan (38/86, 44% Chinese; 39/54, 72% Koreans; 25/53, 47% Vietnamese). Significant group differences existed regarding whether they started using a new electronic device to communicate with friends or family after the COVID-19 outbreak (P=.0005); most were Korean participants (31/54, 57%). For written text and audio or video apps, most Chinese participants used WeChat (65/85, 76%; 57/84, 68%, respectively), most Koreans used KakaoTalk (49/54, 91%; 49/54, 91%, respectively), and most Vietnamese used Facebook Messenger for written text (32/50, 64%) and Apple Face Time (33/50, 66%) or Facebook Messenger (31/50, 62%) for audio or video. Significant group differences existed regarding whether to try telehealth (P=.0005); most Vietnamese expressed that they would never consider it (41/53, 77%). Significant group differences existed regarding how well they were able to concentrate (χ22=44.7; P<.0001); Chinese participants reported a greater inability (median 5, IQR 4-6). With regard to difficulties in life experiences (χ22=51; P<.0001), the median was 6 (IQR 5-7) for the Vietnamese group. Significant group differences existed in having had a family/household member's salary, hours, and contracts reduced (P=.0005) and having had a family/household member or friend fallen physically ill (P=.0005)-most Vietnamese (15/53, 28%) and Korean participants (10/53, 19%). CONCLUSIONS To build an efficacious, web-based senior center with web-based care and social service options, more older adults need access to the internet and education about using technology-enabled communication devices. Addressing the unique psychosocial impacts of the COVID-19 pandemic on each group could improve health equity. The strength of the participating older adults was observed and honored.
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Affiliation(s)
- Connie Kim Yen Nguyen-Truong
- Nursing and Systems Science Department, College of Nursing in Vancouver, Washington State University, Vancouver, WA, United States
| | - Katherine Wuestney
- PhD in Nursing Program, College of Nursing, Spokane Health Sciences, Washington State University, Spokane, WA, United States
| | - Holden Leung
- Asian Health & Service Center, Portland, OR, United States
| | - Chenya Chiu
- Asian Health & Service Center, Portland, OR, United States
| | - Maria Park
- Asian Health & Service Center, Portland, OR, United States
| | - Christina Chac
- Asian Health & Service Center, Portland, OR, United States
| | - Roschelle Lynette Fritz
- Nursing and Systems Science Department, College of Nursing in Vancouver, Washington State University, Vancouver, WA, United States
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Bergschöld JM, Gunnes M, Eide AH, Lassemo E. Characteristics and Range of Reviews About Technologies for Aging in Place: Scoping Review of Reviews. JMIR Aging 2024; 7:e50286. [PMID: 38252472 PMCID: PMC10845034 DOI: 10.2196/50286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/25/2023] [Accepted: 10/30/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND It is a contemporary and global challenge that the increasing number of older people requiring care will surpass the available caregivers. Solutions are needed to help older people maintain their health, prevent disability, and delay or avoid dependency on others. Technology can enable older people to age in place while maintaining their dignity and quality of life. Literature reviews on this topic have become important tools for researchers, practitioners, policy makers, and decision makers who need to navigate and access the extensive available evidence. Due to the large number and diversity of existing reviews, there is a need for a review of reviews that provides an overview of the range and characteristics of the evidence on technology for aging in place. OBJECTIVE This study aimed to explore the characteristics and the range of evidence on technologies for aging in place by conducting a scoping review of reviews and presenting an evidence map that researchers, policy makers, and practitioners may use to identify gaps and reviews of interest. METHODS The review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Literature searches were conducted in Web of Science, PubMed, and Scopus using a search string that consisted of the terms "older people" and "technology for ageing in place," with alternate terms using Boolean operators and truncation, adapted to the rules for each database. RESULTS A total of 5447 studies were screened, with 344 studies included after full-text screening. The number of reviews on this topic has increased dramatically over time, and the literature is scattered across a variety of journals. Vocabularies and approaches used to describe technology, populations, and problems are highly heterogeneous. We have identified 3 principal ways that reviews have dealt with populations, 5 strategies that the reviews draw on to conceptualize technology, and 4 principal types of problems that they have dealt with. These may be understood as methods that can inform future reviews on this topic. The relationships among populations, technologies, and problems studied in the reviews are presented in an evidence map that includes pertinent gaps. CONCLUSIONS Redundancies and unexploited synergies between bodies of evidence on technology for aging in place are highly likely. These results can be used to decrease this risk if they are used to inform the design of future reviews on this topic. There is a need for an examination of the current state of the art in knowledge on technology for aging in place in low- and middle-income countries, especially in Africa.
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Affiliation(s)
| | - Mari Gunnes
- Department of Health, SINTEF Digital, Trondheim, Norway
| | - Arne H Eide
- Department of Health, SINTEF Digital, Oslo, Norway
| | - Eva Lassemo
- Department of Health, SINTEF Digital, Trondheim, Norway
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Bachofner Y, Seifert A, Sepahniya S, Fabian C. Exploring online health information seeking and sharing among older adults: a mini-review about acceptance, potentials, and barriers. Front Digit Health 2024; 6:1336430. [PMID: 38313862 PMCID: PMC10834747 DOI: 10.3389/fdgth.2024.1336430] [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: 11/10/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024] Open
Abstract
Online health information seeking (OHIS) is understood by health care, health promotion, and disease prevention experts as a resource for healthy aging. It is particularly relevant for older adults since this population can benefit significantly from the accessibility and convenience of online health platforms and health information. Nevertheless, empirical findings regarding the acceptance, potentials, and barriers of OHIS among older adults are limited. This mini-review aims to explore the level of acceptance of OHIS, including passive reading of information and active interactions with peers, among the older population. Furthermore, it examines the potentials and barriers associated with such practices. The findings ultimately emphasize the evolving landscape of internet health information exploration among older adults and the potential advantages and challenges that may arise, especially in the context of active interactions with peers.
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Affiliation(s)
- Yves Bachofner
- Institute for Social Work and Health, School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Alexander Seifert
- Institute for Integration and Participation, School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Samin Sepahniya
- Institute for Social Work and Health, School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
| | - Carlo Fabian
- Institute for Social Work and Health, School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Olten, Switzerland
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Amirpour A, Eckerblad J, Bergman L, Nilsson U. Comparing analog and digital neurocognitive tests with older adults: a study of the ISPOCD battery vs. a digital test battery from Mindmore. BMC Geriatr 2024; 24:34. [PMID: 38191318 PMCID: PMC10775484 DOI: 10.1186/s12877-023-04648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/29/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Delayed neurocognitive recovery and neurocognitive disorder are common postoperative complications among older adults. The assessment of these complications traditionally relies on analog neurocognitive tests, predominantly using the test battery from the ISPOCD-study as the standard approach. However, analog tests are time-consuming and necessitate trained staff which poses limitations. The potential availability of a digital neurocognitive test as an alternative to the ISPOCD remains unknown. We conducted a comparative study between the analog test battery from ISPOCD and the self-administrated digital test battery developed by Mindmore. METHODS We conducted a crossover study with 50 cognitively healthy older adults ≥ 60 years of age recruited in Stockholm Sweden, between February and April 2022. The primary outcome focused on measuring comparability between the two test batteries. Our secondary outcomes included assessing participants' perceptions and attitudes about the tests with qualitative interviews and their usability experiences. RESULTS Fifty older adults, mean age 76, female 56%, with a university or college degree 48% participated in the study. The sub tests in two test batteries demonstrated a medium-large correlation (r = 0.3-0.5), except for one measure. For four out of six measures, significant differences were found with medium to large effect sizes, ranging from 0.57-1.43. Two categories were recognized in the qualitative analysis: self-competing in a safe environment, and experience with technology. Participants expressed feeling safe and at ease during the assessment, with some preferring the digital test over the analog. Participants reported a high level of usability with the digital test and a majority participants (n = 47) reported they would undergo the digital test for a potential future surgery. CONCLUSIONS The digital test battery developed by Mindmore offers several advantages, including rapid access to test results, easy comprehension, and use for participants, thereby increased accessibility of cognitive screening. TRIAL REGISTRATION NUMBER NCT05253612; ClinicalTrials.gov, 24/02/2022.
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Affiliation(s)
- Anahita Amirpour
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden.
| | - Jeanette Eckerblad
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden
| | - Lina Bergman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden
| | - Ulrica Nilsson
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, C4, 141 83, Stockholm, Sweden
- Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
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AshaRani PV, Tan YWB, Samari E, Wang P, Cetty L, Satghare P, Verma SK, Tang C, Subramaniam M. The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model. Digit Health 2024; 10:20552076241247194. [PMID: 38698830 PMCID: PMC11064748 DOI: 10.1177/20552076241247194] [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] [Accepted: 03/27/2024] [Indexed: 05/05/2024] Open
Abstract
Background Telehealth services ensure the delivery of healthcare services to a wider range of consumers through online platforms. Nonetheless, the acceptance and uptake of telehealth remain elusive. This study aims to understand the (a) uptake and (b) acceptability of telemedicine, (c) if therapeutic alliance mediates the relationship between the frequency of consultations with clinicians and the uptake of telemedicine in patients with early psychosis, and (d) role of education in moderating the relationship between therapeutic alliance and the uptake of telemedicine for their mental healthcare. Methods A convenience sample of outpatients (n = 109) seeking treatment for early psychosis and their care providers (n = 106) were recruited from a tertiary psychiatric care centre. Sociodemographic and clinical characteristics, therapeutic alliance (Working Alliance Inventory), and telemedicine use were captured through self-administered surveys. The moderated mediation analysis was performed using PROCESS macro 3.4.1 with therapeutic alliance and level of education as the mediating and moderating factors, respectively. Results The acceptance of telemedicine was high (possibly will use: 47.7%; definitely will use: 26.6%) whilst the uptake was low (11%). Therapeutic alliance mediated the relationship between the frequency of consultation and the uptake of telemedicine (β: 0.326; CI: 0.042, 0.637). This effect was moderated by the level of education (β: -0.058; p < 0.05). Conclusion Therapeutic alliance mediates the relationship between the frequency of consultations and the uptake of telemedicine services with the level of education moderating this mediation. Focusing on the patients with lower education to improve their telemedicine knowledge and therapeutic alliance might increase the uptake.
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Affiliation(s)
- PV AshaRani
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Swapna K Verma
- Department of Psychosis, Duke-NUS Medical School, Singapore, Singapore
- Early Psychosis Intervention Programme, Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Early Psychosis Intervention Programme, Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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49
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Boateng EA, Agyapomah R, Amankwaa I, Dzomeku VM, Peprah LO. Perspectives of Family Caregivers on Healthcare Provided to Older Adults With Hypertension and/or Diabetes Mellitus in Ghana. Gerontol Geriatr Med 2024; 10:23337214241261534. [PMID: 38899054 PMCID: PMC11186387 DOI: 10.1177/23337214241261534] [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: 03/06/2024] [Revised: 05/05/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
This study explored the perspectives of family caregivers of older adults with hypertension and/or diabetes mellitus on the care provided to their kin when they visit the hospital. A qualitative research approach was used to conduct the study using family members providing informal care for older adults with hypertension and/or diabetes mellitus at a teaching hospital in Ghana. A total of 20 participants were purposively sampled, interviewed, and data was analyzed using reflexive thematic analysis. Family caregivers mainly had perceptions that their older adult kin had poor interactions with the healthcare system because of some healthcare workers' negative attitudes, inadequate facilities at the clinics, and lack of geriatric care services at the facility. This notwithstanding, family caregivers also derived some benefits from accompanying their kin to the hospital. Practice and education in gerontological nursing must be employed to pragmatically meet the unique healthcare needs of older adults in Ghana with a focus on geriatrics units and standalone programs of study to prepare specialized healthcare professionals to provide comprehensive services to older adults. For a thorough understanding of issues of older adult care in the country, their perspectives on this subject should also be explored in future studies.
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50
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Raquel Costa-Brito A, Bovolini A, Rúa-Alonso M, Vaz C, Francisco Ortega-Morán J, Blas Pagador J, Vila-Chã C. Home-based exercise interventions delivered by technology in older adults: A scoping review of technological tools usage. Int J Med Inform 2024; 181:105287. [PMID: 37972483 DOI: 10.1016/j.ijmedinf.2023.105287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Despite technology-based systems being considered promising tools to stimulate and increase physical function at home, most older adults are unfamiliar with technology, which may pose some difficulties. Technology-related parameters, such as adherence, acceptance, and acceptability, are crucial to achieving higher efficacy levels of home-based exercise interventions delivered by technology. In this scoping review, we aimed to revise the use of home-based technological tools to improve physical function in the older population, focusing on the user's experience and perspective. Methods This scoping review was conducted following PRISMA guidelines. The search was conducted in April 2022 and updated in April 2023. A total of 45 studies were included in the review. Results Most studies (95.5%) met the technology usage levels defined by the research team or reported satisfactory technology usage levels. Positive health-related outcomes were reported in 80% of studies. Although the existence of guidelines to correctly define and use measures associated with technology use, including adherence, acceptance and acceptability, some terms are still being used interchangeably. Some concerns related to the lack of an international consensus regarding technology usage measures and the exclusion of older adults who did not own or have previous experience with technology in a large percentage of the included studies may have limited the results obtained. Conclusions Altogether, home-based exercise interventions delivered through technology were associated with positive health-related outcomes in older adults, and technology usage levels are considered satisfactory. Older adults are willing and able to use technology autonomously if adequate support is provided.
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Affiliation(s)
| | - Antonio Bovolini
- Polytechnic of Guarda, Guarda, Portugal; Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal
| | - María Rúa-Alonso
- Polytechnic of Guarda, Guarda, Portugal; Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal; Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruna, A Coruña, Spain
| | | | | | - J Blas Pagador
- Jesús Usón Minimally Invasive Surgery Centre, Cáceres, Spain
| | - Carolina Vila-Chã
- Polytechnic of Guarda, Guarda, Portugal; Research Center in Sports Sciences, Health Sciences, and Human Development, Vila Real, Portugal.
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