Fantastic perspectives and where to find them: involving patients and citizens in digital health research

Adopting a learning pathway approach to patient partnership in telehealth: A proof of concept

Background

Amidst the acceleration of digital health deployment in the province of Québec, the need to clarify the role of patients and caregivers was deemed essential to guide the deployment of telehealth strategies. A patient learning pathway (PLP) approach to patient and caregiver engagement was developed, containing knowledge, abilities, and skills mobilized by patients and caregivers at key moments of the life course with an illness, as well as emerging educational needs.

Objective

The objective of the current paper is to present the innovative PLP approach to patient and caregiver engagement in telehealth by applying it to three medical specialties within the context of the Québec healthcare system: dermatology, oncology, and mental health/psychiatry.

Methods

The PLP methodology is constituted of five chronological phases: 1) identification and engagement of main stakeholders; 2) exploration; 3) recruitment of patient and caregiver partners; 4) co-development of PLP first draft; and 5) validation and consensus building regarding competencies.

Results

Three PLPs (dermatology, oncology, and mental health/psychiatry) have already been mapped using this participatory approach, showing that the proposed PLP approach to patient and caregiver engagement in telehealth is feasible.

Conclusions

Mapping patient and caregiver competencies organized throughout patients' life course with an illness can lead to a highly operationalizable tool, which relevant stakeholders can use in a way that promotes patient self-management, shared decision-making, and empowerment.

Innovation

The five-step PLP methodology developed proposes an innovative and structured approach to partnership with patients and caregivers in telehealth by outlining their roles throughout their life course with an illness.

The reception of public health messages during the COVID-19 pandemic

Understanding the reception of public health messages in public-facing communications is of key importance to health agencies in managing crises, pandemics, and other health threats. Established public health communications strategies including self-efficacy messaging, fear appeals, and moralising messaging were all used during the Coronavirus pandemic. We explore the reception of public health messages to understand the efficacy of these established messaging strategies in the COVID-19 context. Taking a community-focussed approach, we combine a corpus linguistic analysis with methods of wider engagement, namely, a public survey and interactions with a Public Involvement Panel to analyse this type of real-world public health discourse.

Our findings indicate that effective health messaging content provides manageable instructions, which inspire public confidence that following the guidance is worthwhile. Messaging that appeals to the audience's morals or fears in order to provide a rationale for compliance can be polarising and divisive, producing a strongly negative emotional response from the public and potentially undermining social cohesion. Provenance of the messaging alongside text-external political factors also have an influence on messaging uptake. In addition, our findings highlight key differences in messaging uptake by audience age, which demonstrates the importance of tailored communications and the need to seek public feedback to test the efficacy of messaging with the relevant demographics. Our study illustrates the value of corpus linguistics to public health agencies and health communications professionals, and we share our recommendations for improving the public health messaging both in the context of the ongoing pandemic and for future novel and re-emerging infectious disease outbreaks.

Lessons Learned from the Implementation of a Person-Centred Digital Health Platform in Cancer Care

The SARS-CoV-2 (COVID-19) pandemic has accelerated the development and use of digital health platforms to support individuals with health-related challenges. This is even more frequent in the field of cancer care as the global burden of the disease continues to increase every year. However, optimal implementation of these platforms into the clinical setting requires careful planning and collaboration. An implementation project was launched between the Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Centre-Ouest-de-I'Île-de-Montreal and BELONG-Beating Cancer Together-a person-centred cancer navigation and support digital health platform. The goal of the project was to implement content and features specific to the CIUSSS, to be made available exclusively for individuals with cancer (and their caregivers) treated at the institution. Guided by Structural Model of Interprofessional Collaboration, we report on implementation processes involving diverse stakeholders including clinicians, hospital administrators, researchers and local community/patient representatives. Lessons learned include earlier identification of shared goals and clear expectations, more consistent reliance on virtual means to communicate among all involved, and patient/caregiver involvement in each step to ensure informed and shared decision making.