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Kan K, Morales L, Shah A, Simmons E, Barrera L, Massey L, List G, Gupta RS. Digital Technology Characteristics and Literacy Among Families With Children With Asthma: Cross-Sectional Study. JMIR Pediatr Parent 2023; 6:e48822. [PMID: 38031428 DOI: 10.2196/48822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/27/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Background The use of digital technology in pediatric asthma management has emerged as a potential tool for improving asthma management. However, the use of digital tools has the potential to contribute to the inequitable delivery of asthma care because of existing social factors associated with asthma disparities. Our study focused on parents' chosen language and sociodemographic factors that might shape the use of digital technology in asthma self-management. Objective This study aims to estimate and compare patient, family, and technology-related characteristics by parents' chosen language (English or Spanish) and compare a digital literacy measure by sociodemographic factors. Methods Survey data were collected from July to December 2021 from parents of children with asthma who were seen by a Chicago pediatric health system pulmonary provider. Questions assessed patient and family characteristics, digital technology use, and digital literacy, measured using the validated eHealth Literacy Scale (eHEALS). Chi-square tests and multivariable logistic regression were used for comparisons, and Kruskal-Wallis tests were used for comparing median eHEALS scores by social characteristics. Results Of the 197 parents surveyed, 24.4% (n=49) of parents identified as a race categorized as other, 37.1% (n=67) as White, and 38.6% (n=75) as Black; 47.2% (n=93) identified as Hispanic/Latino/Latina. Additionally, 79.7% (n=157) of parents preferred English, and 20.3% (n=40) preferred Spanish. English-speaking parents were more likely to report having a data plan for their smartphone (117/157, 74.5%) or high-speed internet (138/157, 87.9%) compared to Spanish-speaking parents (smartphone: 23/40, 58%; P=.03; internet: 27/40, 68%; P=.002). Compared with Spanish-speaking parents, English-speaking parents were less likely to report having a lot or some concern about paying for internet (28/40, 70% vs 83/157, 52.9%; P=.046) or about data privacy (35/40, 88% vs 105/157, 67.5%; P=.01). Digital literacy scores differed significantly by race, income, education level, and language. In a multivariable model, language was not a significant factor for having high-speed internet service (P=.12) or concern about paying for internet at home (P=.60), but it was a significant factor for concerns about data privacy (P=.04). Conclusions The significant differences in technology-related characteristics suggest that digital connectivity, affordability, and data privacy may also be important factors in considering digital technology use in asthma care.
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Affiliation(s)
- Kristin Kan
- Division of Advanced General Pediatrics and Primary Care, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Food Allergy and Asthma Research, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Mary Ann & J Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Lu Morales
- Mary Ann & J Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Avani Shah
- Division of Pulmonary and Sleep Medicine, Feinberg School of Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Emily Simmons
- Division of Pulmonary and Sleep Medicine, Feinberg School of Medicine, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Leonardo Barrera
- Mary Ann & J Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Liana Massey
- Mary Ann & J Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Greta List
- Brown University, Providence, RI, United States
| | - Ruchi S Gupta
- Division of Advanced General Pediatrics and Primary Care, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
- Center for Food Allergy and Asthma Research, Institute of Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Rangraz Jeddi F, Nabovati E, Mobayen M, Akbari H, Feizkhah A, Osuji J, Bagheri Toolaroud P. Health care needs, eHealth literacy, use of mobile phone functionalities, and intention to use it for self-management purposes by informal caregivers of children with burns: a survey study. BMC Med Inform Decis Mak 2023; 23:236. [PMID: 37872538 PMCID: PMC10591411 DOI: 10.1186/s12911-023-02334-w] [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: 12/07/2022] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND This study aimed to assess health care needs, electronic health literacy, mobile phone usage, and intention to use it for self-management purposes by informal caregivers of children with burn injuries. METHODS This cross-sectional research was carried out in 2021 with 112 informal caregivers of children with burns in a burn center in the north of Iran. The data collection tools were questionnaires that included the participants' demographics, their E-Health Literacy, their current mobile phone usage, and their desires for mobile phone use for burn care services. RESULTS Most informal caregivers had smartphones (83.0%) and Internet access (81.3%). Most participants occasionally used phone calls (63.4%), the Internet (45.5%), and social media (42.9) to receive information about psychosocial disorders, infection control, wound care, pain, itch, physical exercise, and feeding. Most participants have never used some of the mobile phone functionalities to receive burn-related information, such as applications/Software (99.1%) and e-mail (99.1%). Nevertheless, most informal caregivers desire to use mobile applications for self-management purposes in the future (88.4%). The mean eHealth literacy score was 25.01 (SD = 9.61). Informal caregivers who had higher education levels, access to the Internet, and lived in urban areas had higher eHealth literacy (P < 001). CONCLUSION The current research delivers beneficial information about the healthcare needs of informal caregivers and their preference to use mobile functionality to receive burns-related healthcare and rehabilitation information post-discharge. This information can help design and implement mobile health (mHealth) interventions to enhance the self-care skills of informal caregivers.
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Affiliation(s)
- Fatemeh Rangraz Jeddi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
| | - Ehsan Nabovati
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hossein Akbari
- Social Determinants of Health (SDH) Research Center, Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
- Department of Medical Physics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Joseph Osuji
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Ab, Canada
| | - Parissa Bagheri Toolaroud
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran.
- Department of Health Information Management & Technology, Kashan University of Medical Sciences, Kashan, Iran.
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Kanak MM, Fleegler EW, Chang L, Curt AM, Burdick KJ, Monuteaux MC, Deane M, Warrington P, Stewart AM. Mobile Social Screening and Referral Intervention in a Pediatric Emergency Department. Acad Pediatr 2023; 23:93-101. [PMID: 36075518 DOI: 10.1016/j.acap.2022.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/15/2022] [Accepted: 08/28/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Many families in pediatric emergency departments (PED) have unmet social needs, which may be detected and addressed with the use of a digital social needs intervention. Our objective was to characterize the feasibility and effectiveness of utilizing personal phones or a PED tablet for screening and referral to social services. METHODS We conducted a prospective single-arm intervention study using a convenience sample of caregivers and adult patients in an urban PED between May 2019 and October 2020. Participants chose either their personal phone or a PED-provided tablet to use an app, "HelpSteps." Participants self-selected need(s) then referrals to service agencies. Participants completed a 1-month follow-up. Clinicians were surveyed about screening and impact on visit. RESULTS Of 266 participants enrolled, 55% of participants elected to use their personal phone. Of all participants, 67% self-selected at least 1 health-related social need; 34% selected 3 or more. The top 3 "most important" needs were housing (14%), education (12%), and fitness (12%). At one month follow-up, 44% of participants reported their top need was "completely" or "somewhat" solved. For 95% of encounters, clinicians reported the intervention did not increase length of stay. CONCLUSIONS A mobile social needs intervention was feasible and effective at identifying and referring participants in the PED setting. While more than half of participants used their personal phones, several smartphone owners cited barriers and elected to use a tablet. Overall, participants found the app easy to use, appropriate for the PED, and the intervention had minimal impact on clinical flow.
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Affiliation(s)
- Mia M Kanak
- Children's Hospital Los Angeles (MM Kanak), Division of Emergency Medicine and Transport Medicine, Los Angeles, Calif.
| | - Eric W Fleegler
- Boston Children's Hospital (EW Fleegler, L Chang, MC Monuteaux, M Deane, and AM Stewart), Division of Emergency Medicine, Boston, Mass; Harvard Medical School (EW Fleegler, L Chang, AM Curt, MC Monuteaux, and A M Stewart), Boston, Mass
| | - Lawrence Chang
- Boston Children's Hospital (EW Fleegler, L Chang, MC Monuteaux, M Deane, and AM Stewart), Division of Emergency Medicine, Boston, Mass; Harvard Medical School (EW Fleegler, L Chang, AM Curt, MC Monuteaux, and A M Stewart), Boston, Mass
| | - Alexa M Curt
- Harvard Medical School (EW Fleegler, L Chang, AM Curt, MC Monuteaux, and A M Stewart), Boston, Mass
| | - Kendall J Burdick
- University of Massachusetts Medical School (KJ Burdick), Worcester, Mass
| | - Michael C Monuteaux
- Boston Children's Hospital (EW Fleegler, L Chang, MC Monuteaux, M Deane, and AM Stewart), Division of Emergency Medicine, Boston, Mass; Harvard Medical School (EW Fleegler, L Chang, AM Curt, MC Monuteaux, and A M Stewart), Boston, Mass
| | - Melissa Deane
- Boston Children's Hospital (EW Fleegler, L Chang, MC Monuteaux, M Deane, and AM Stewart), Division of Emergency Medicine, Boston, Mass
| | | | - Amanda M Stewart
- Boston Children's Hospital (EW Fleegler, L Chang, MC Monuteaux, M Deane, and AM Stewart), Division of Emergency Medicine, Boston, Mass; Harvard Medical School (EW Fleegler, L Chang, AM Curt, MC Monuteaux, and A M Stewart), Boston, Mass
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Doğan P, Karakul A, Akgül EA, Öztornaci BÖ, Sarı HY. [Examination of social media and technology use of mothers in breastfeeding period in a region of Turkey]. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32:306-315. [PMID: 36084997 DOI: 10.1016/j.enfcle.2021.12.008] [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: 04/12/2021] [Accepted: 12/10/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this study is to examine the social media and technology use of mothers during breastfeeding. METHOD Descriptive cross-sectional study. The study was carried out with mothers who brought their children for follow-up in the pediatric outpatient clinics of a public hospital, a university hospital and a private hospital located in Turkey. A questionnaire developed «ad hoc» was used for data collection. RESULTS The total sample consisted of 275 mothers (n = 275). Mothers participating in the study 89.8% of the mothers used social media, 86.5% sought on the reliability of the information on the internet, 73.8% used the medical information on the internet to decide on any case about breastfeeding and 66.9% of them used cell phone or computer during breastfeeding. A statistically significant difference was determined between the education level of the mothers and social media use (p < 0.05). It was determined that the mothers who were secondary school graduate and those with three or more children talked on a cell phone while breastfeeding. CONCLUSIONS Most of the mothers used social media and technology at a level limiting their interaction with their children. It is recommended to protect mothers from digital addiction and improve their digital literacy levels.
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Affiliation(s)
- Pınar Doğan
- Faculty of Health Science, Department of Pediatric Nursing, Izmir Katip Celebi University, Çiğli-Izmir, Turkey.
| | - Atiye Karakul
- Faculty of Health Sciences, Nursing Department, Tarsus University, Tarsus, Mersin, Turkey
| | - Esra Ardahan Akgül
- Faculty of Health Science, Department of Pediatric Nursing, Izmir Katip Celebi University, Çiğli-Izmir, Turkey
| | - Beste Özgüven Öztornaci
- Faculty of Health Science, Department of Pediatric Nursing, Izmir Katip Celebi University, Çiğli-Izmir, Turkey
| | - Hatice Yıldırım Sarı
- Faculty of Health Science, Department of Pediatric Nursing, Izmir Katip Celebi University, Çiğli-Izmir, Turkey
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Delemere E, Maguire R. Caregivers of children feel confident about using the internet for health information. Health Info Libr J 2022; 40:54-69. [PMID: 35396806 DOI: 10.1111/hir.12430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 10/17/2021] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Caregivers of children may rely on internet sources, health care providers, peers or family for health information. OBJECTIVE To examine the impact of sociodemographic factors on the use of the internet for health information by caregivers of children, and the impact on self-efficacy, effort and frustration. METHODS Using data from the 2019 Health Information National Trends Survey, the effects of information source on self-efficacy, effort and frustration was examined using the complex samples module of SPSS. RESULTS The internet was the most common source of health information for caregivers of children (n = 247), with high confidence, low frustration and effort reported. Younger, higher educated and higher income caregivers were significantly more likely to use the internet for health information. Information from Health Care Providers (HCPs) was associated with greater confidence, and information from peers associated with lesser effort and frustration. No significant effects on self-efficacy, effort or frustration for online health information was noted compared to other sources. CONCLUSIONS Efforts to reduce barriers to online health information may be required for some groups of caregivers, and health care providers may have a role to play in this.
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Affiliation(s)
- Emma Delemere
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Ireland
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6
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Doğan P, Karakul A, Akgül EA, Öztornaci BÖ, Sarı HY. Examination of social media and technology use of mothers in breastfeeding period in a region of Turkey. ENFERMERIA CLINICA 2022. [DOI: 10.1016/j.enfcli.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bryan MA, Evans Y, Morishita C, Midamba N, Moreno MA. Does the Narrative Voice Influence Parental Perceptions of Pediatrician Blogs? Acad Pediatr 2021; 21:139-148. [PMID: 32114088 DOI: 10.1016/j.acap.2020.02.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 02/15/2020] [Accepted: 02/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To determine parental perceptions of pediatrician blog posts by narrative voice. METHODS Three blog posts each on 2 topics (vaccines and sleep) were written by an established physician blogger and varied by narrative voice (personal, third person objective and mixed). Topics were chosen to be applicable to all parents. Blog posts were evaluated by a communications expert, 2 research investigators, and 3 parents to confirm differences in narrative voice. We sampled parents of children 0 to 18 years old in 4 primary and subspecialty care clinics, and 1 inpatient medical unit. Participants were randomized to read 2 blog posts (1 per topic) that varied by narrative voice. Participants rated their perceptions of the accuracy, reliability, and appeal for each blog posts on a 5-point Likert Scale. The Kruskal-Wallis test was used to compare the distribution of parental rankings for accuracy, reliability, and appeal. RESULTS The average participant age (n = 258) was 39.8 (SD 9.7), 83% were female. Blog posts written in the third person objective voice were rated as more accurate and reliable than those in the personal or mixed voice. There was effect modification by topic, with parents rating the sleep blog posts as more accurate than the vaccine blog posts. There was no difference in the appeal of information by narrative voice or topic of blog post. CONCLUSIONS The narrative voice used to convey information on pediatrician blog posts can influence reader perception of accuracy and reliability. Physician bloggers can enhance parental trust of their content using study findings.
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Affiliation(s)
- Mersine A Bryan
- Department of Pediatrics (MA Bryan), University of Washington School of Medicine, Seattle Children's Research Institute, Seattle, Wash.
| | - Yolanda Evans
- Department of Pediatrics (Y Evans), University of Washington School of Medicine, Seattle, Wash
| | | | - Nikita Midamba
- Seattle Children's Research Institute (N Midamba), Seattle, Wash
| | - Megan A Moreno
- Department of Pediatrics (MA Moreno), University of Wisconsin School of Medicine, Madison, Wis
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Jiang W, Magit AE, Carvalho D. Equal Access to Telemedicine during COVID-19 Pandemic: A Pediatric Otolaryngology Perspective. Laryngoscope 2020; 131:1175-1179. [PMID: 32969043 PMCID: PMC7537283 DOI: 10.1002/lary.29164] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/20/2022]
Abstract
Objectives/Hypothesis During the current COVID‐19 pandemic, the demand for direct‐to‐home telemedicine services has risen to an unprecedented level. Equal access to specialty care was assessed to identify potential barriers that may negatively impact telemedicine utilization. Study design Retrospective case series. Methods We examined the 6‐week period between March and May 2020 when the only access to nonurgent pediatric otolaryngology service was through telemedicine and compared it to in‐person visits during the same period in 2019. We compared patient demographics, including age, gender, preferred language, zip code of residence, and primary insurance plan. Results A total of 1,495 visits were conducted through telemedicine from March 23, 2020 to May 1, 2020, and 1983 in‐person visits were completed in 2019. There was no difference in patient age and gender. The proportions of Spanish‐speaking families were similar (15.8% in 2019 vs. 14.4% in 2020, P = .96). The percentage of Medi‐Cal‐insured patients (51.4% in 2019 vs. 49.8% in 2020, P = .73) and the mean poverty level (12.6% in 2019 vs. 12.2% in 2020, P = .38) also remained the same. Spanish‐speaking families were statistically more likely to require rescheduling of their telemedicine visits (17.2%) when compared to the overall rescheduling rate of 11.9% (P = .0083). Conclusions We were able to successfully provide access to telemedicine services to our vulnerable populations during the current COVID‐19 pandemic. Telemedicine is likely to remain an essential mode of delivering patient care going forward. It is important to evaluate and identify potential disparities to telemedicine access and proactively implement changes to address these barriers. Level of Evidence 4. Laryngoscope, 131:1175–1179, 2021
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Affiliation(s)
- Wen Jiang
- Division of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, California, U.S.A.,Department of Surgery, Division of Otolaryngology, University of California San Diego, San Diego, California, U.S.A
| | - Anthony E Magit
- Division of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, California, U.S.A.,Department of Surgery, Division of Otolaryngology, University of California San Diego, San Diego, California, U.S.A
| | - Daniela Carvalho
- Division of Pediatric Otolaryngology, Rady Children's Hospital, San Diego, California, U.S.A.,Department of Surgery, Division of Otolaryngology, University of California San Diego, San Diego, California, U.S.A
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Randomized Controlled Trial of Acute Illness Educational Intervention in the Pediatric Emergency Department: Written Versus Application-Based Education. Pediatr Emerg Care 2020; 36:e192-e198. [PMID: 30624425 DOI: 10.1097/pec.0000000000001719] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES The aim of this study was to determine the (1) feasibility, (2) demand, (3) acceptability, and (4) usefulness of a mobile health (mHealth) application (app) compared with a written intervention distributed in a pediatric emergency department (ED). METHODS This was a randomized controlled trial with parents of children 12 years or younger presenting to the ED for nonurgent complaints. Parents were randomized to receive a (1) low literacy pediatric health book with video, (2) pediatric mHealth app, (3) both 1 and 2, or (4) car-seat safety video and handout (control). Demand, acceptability, and usefulness were assessed at 1-, 3-, and 6-month follow-ups. Modified intention-to-treat analysis was completed for proportional data. RESULTS Ninety-eight parents completed randomization (83% approached). One or more follow-up was completed for 80.6% of parents. Only 57.1% downloaded the app. Parents used the app less than the book (35.1% vs 73.0%, P < 0.01), found the app to be harder to understand (26.0% vs 94.6%, P < 0.001) and less useful (37.8% vs 70.3%, P < 0.01), and were less likely to recommend the app to others (48.7% vs 100%, P < 0.01). No parent who received both book and app would prefer to have only the app; 88.9% of parents wanted either the book or both. CONCLUSIONS There was low demand for an mHealth app with parents who prefer, accept, and use the book more. Giving written health information to vulnerable populations in a pediatric ED has the capacity to empower parents with knowledge to care for a child and potentially decrease future nonurgent ED use with translation into a larger study.
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Bryan MA, Evans Y, Morishita C, Midamba N, Moreno M. Parental Perceptions of the Internet and Social Media as a Source of Pediatric Health Information. Acad Pediatr 2020; 20:31-38. [PMID: 31648059 DOI: 10.1016/j.acap.2019.09.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/24/2019] [Accepted: 09/28/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE 1) To evaluate differences in how parents use the Internet and social media for health information by child age. 2) To examine parental perceptions of health information on social media. METHODS We conducted a cross-sectional survey of parents of children 0 to 18 years seen in clinics and an inpatient medical unit. Survey questions focused on: patterns of Internet and social media use, for what topics, and parental ratings of the accuracy, reliability, and appeal of information from social media. Parents' responses were categorized by age of their youngest child in years (0-4, 5-11, 12-18). RESULTS A total of 258 parents completed the survey. The mean age was 39.8 years, 83% were female, 59% were white. The most common topics parents read about online were: sleep, mental health, and car safety. Nearly all parents (96%) used social media, with 68% using social media for health information. There were no significant differences in the proportion of parents who reported using social media for health information by child age. Only half of parents discussed information from social media with their physician. Parents of children age ≥5 years rated health information on social media as significantly more accurate than parents of younger children. There were no significant differences in ratings of reliability and appeal by child age. CONCLUSIONS Parents of children of all ages use social media for a variety of important topics related to child health. As many parents do not discuss it with their physician, there are missed opportunities for pediatricians to provide high-quality information.
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Affiliation(s)
- Mersine A Bryan
- Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Research Institute (MA Bryan), Seattle, Wash.
| | - Yolanda Evans
- Department of Pediatrics, University of Washington School of Medicine (Y Evans), Seattle, Wash
| | | | - Nikita Midamba
- Seattle Children's Research Institute (N Midamba), Seattle, Wash
| | - Megan Moreno
- Department of Pediatrics, University of Wisconsin School of Medicine (M Moreno), Madison, Wis
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11
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Meyers N, Glick AF, Mendelsohn AL, Parker RM, Sanders LM, Wolf MS, Bailey S, Dreyer BP, Velazquez JJ, Yin HS. Parents' Use of Technologies for Health Management: A Health Literacy Perspective. Acad Pediatr 2020; 20:23-30. [PMID: 30862511 PMCID: PMC6733672 DOI: 10.1016/j.acap.2019.01.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Parent use of technology to manage child health issues has the potential to improve access and health outcomes. Few studies have examined how parent health literacy affects usage of Internet and cell phone technologies for health management. METHODS Cross-sectional analysis of data collected as part of a randomized controlled experiment in 3 urban pediatric clinics. English- and Spanish-speaking parents (n = 858) of children ≤8 years answered questions regarding use of and preferences related to Internet and cell phone technologies. Parent health literacy was measured using the Newest Vital Sign. RESULTS The majority of parents were high Internet (70.2%) and cell phone (85.1%) users (multiple times a day). A total of 75.1% had limited health literacy (32.1% low, 43.0% marginal). Parents with higher health literacy levels had greater Internet and cell phone use (adequate vs low: adjusted odds ratio [AOR], 1.7 [confidence interval, 1.2-2.5]) and were more likely to use them for health management (AOR, 1.5 [confidence interval, 1.2-1.8]); those with higher health literacy levels were more likely to use the Internet for provider communication (adequate vs marginal vs low: 25.0% vs 18.0% vs 12.0%, P = .001) and health-related cell phone apps (40.6% vs 29.7% vs 16.4%, P < .001). Overall preference for using technology for provider communication was high (∼70%) and did not differ by health literacy, although Internet and cell phone apps were preferred by higher literacy parents; no differences were seen for texting. CONCLUSIONS Health literacy-associated disparities in parent use of Internet and cell phone technologies exist, but parents' desire for use of these technologies for provider communication was overall high and did not differ by health literacy.
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Affiliation(s)
- Nicole Meyers
- Pediatrics, NYU School of Medicine - Bellevue Hospital, New York, NY
| | | | - Alan L. Mendelsohn
- Pediatrics, NYU School of Medicine - Bellevue Hospital, New York, NY,Population Health, NYU School of Medicine, New York, NY
| | - Ruth M. Parker
- Medicine, Emory University School of Medicine, Atlanta, GA
| | - Lee M. Sanders
- Pediatrics, Stanford University School of Medicine, Palo Alto, CA
| | - Michael S. Wolf
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Stacy Bailey
- Division of General Internal Medicine and Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Benard P. Dreyer
- Pediatrics, NYU School of Medicine - Bellevue Hospital, New York, NY
| | | | - H. Shonna Yin
- Pediatrics, NYU School of Medicine - Bellevue Hospital, New York, NY,Population Health, NYU School of Medicine, New York, NY
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Real FJ, Beck AF, DeBlasio D, Zackoff M, Henize A, Xu Y, Davis D, Cruse B, Klein MD. Dose Matters: A Smartphone Application to Improve Asthma Control Among Patients at an Urban Pediatric Primary Care Clinic. Games Health J 2019; 8:357-365. [PMID: 31157983 DOI: 10.1089/g4h.2019.0011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective: As the most common chronic condition of childhood, asthma is a frequent target for family education. However, current educational strategies rarely tailor to learning style or literacy level. Thus, we developed and implemented a smartphone application (app) leveraging gamified features entitled CHANGE Asthma ("Clinic, Home, And on the Go Education for Asthma"). We subsequently assessed its impact on asthma control. Methods: Patients aged 4-11 years with a previously documented childhood asthma control test (C-ACT) score of <20, indicating poor control, were recruited to participate in this randomized control pilot study. The intervention group downloaded CHANGE Asthma; asthma control was assessed at enrollment and at follow-up. The changes in C-ACT score in both groups were compared using analysis of covariance (primary outcome). App usage was monitored for 4 months following download, and the relationship between usage time, and the change in C-ACT score was assessed via linear regression. Results: The control and intervention groups both included 20 caregivers with 75% of participants completing follow-up. Although C-ACT scores among intervention participants significantly improved at follow-up, compared to their own baseline (P = 0.04), the change of C-ACT score did not significantly differ from that of the control group (P = 0.78). Among the intervention participants, there was a positive, dose-dependent relationship between app usage time and positive change in C-ACT score (P = 0.03). Conclusion: Usage of a gamified app was associated with a dose-dependent improvement in asthma control over time, suggesting that further evaluation of apps for asthma education, and perhaps for other chronic conditions, is warranted.
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Affiliation(s)
- Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Andrew F Beck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Dominick DeBlasio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Matthew Zackoff
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Adrienne Henize
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - David Davis
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Bradley Cruse
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Melissa D Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.,Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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13
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McClure C, Cunningham M, Bull S, Berman S, Allison MA. Using Mobile Health to Promote Early Language Development: A Narrative Review. Acad Pediatr 2018; 18:850-854. [PMID: 30098442 DOI: 10.1016/j.acap.2018.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 06/13/2018] [Accepted: 07/23/2018] [Indexed: 12/21/2022]
Abstract
In this narrative review, we first present a brief overview of known disparities in children's language development based on socioeconomic status and efforts in the primary care setting to promote children's language development. Next, we define mobile health (m-health) and review the limited, published literature regarding the effectiveness of m-health interventions in promoting children's health, in general, and language development, in particular. Finally, we discuss the potential role of smartphone applications to increase parental behaviors that promote their children's language development, as well as challenges that should be addressed as the field of m-health continues to grow.
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Affiliation(s)
- Catherine McClure
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora
| | - Maureen Cunningham
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora; Center for Global Health , Colorado School of Public Health, Aurora
| | - Sheana Bull
- Department of Community and Behavioral Health , Colorado School of Public Health, Aurora; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) (M Allison), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora
| | - Stephen Berman
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora; Center for Global Health , Colorado School of Public Health, Aurora
| | - Mandy A Allison
- Department of Pediatrics , University of Colorado Anschutz Medical Campus, Aurora.
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14
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Real FJ, DeBlasio D, Rounce C, Henize AW, Beck AF, Klein MD. Opportunities for and Barriers to Using Smartphones for Health Education Among Families at an Urban Primary Care Clinic. Clin Pediatr (Phila) 2018; 57:1281-1285. [PMID: 29681167 DOI: 10.1177/0009922818772157] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mobile technology is omnipresent in society. Though studies suggest increased rates of smartphone accessibility, current access and barriers to smartphone usage at urban primary care clinics remains unclear. A self-administered survey was distributed to families presenting to an urban, underserved pediatric primary care clinic in spring 2017. Survey questions related to smartphone ownership and barriers to usage. A total of 273 parents completed the survey. Ninety-five percent of participants owned a smartphone. Fifty-eight percent of participants identified no barriers to smartphone usage. Among those who identified one or more barriers (n = 108), difficulties were primarily related to Wi-Fi access (46%), available phone memory (45%), existing phone data (28%), and discomfort with technology (11%). The majority of parents (59%) were interested in using a smartphone to learn about their child's health. In conclusion, there is opportunity to transform health education utilizing mobile devices, though disparities to usage should be considered.
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Affiliation(s)
- Francis J Real
- 1 University of Cincinnati, Cincinnati, OH, USA.,2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Dominick DeBlasio
- 1 University of Cincinnati, Cincinnati, OH, USA.,2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Cesarina Rounce
- 2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Adrienne W Henize
- 1 University of Cincinnati, Cincinnati, OH, USA.,2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Andrew F Beck
- 1 University of Cincinnati, Cincinnati, OH, USA.,2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Melissa D Klein
- 1 University of Cincinnati, Cincinnati, OH, USA.,2 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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15
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Jabour SM, Page A, Hall SF, Rodriguez L, Shields WC, Alvanzo AA. Information and Communication Technologies Interest, Access, and Use: Cross-Sectional Survey of a Community Sample of Urban, Predominantly Black Women. J Med Internet Res 2018; 20:e248. [PMID: 30108036 PMCID: PMC6113594 DOI: 10.2196/jmir.9962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/25/2018] [Accepted: 06/18/2018] [Indexed: 11/23/2022] Open
Abstract
Background Information and communication technologies (ICT) offer the potential for delivering health care interventions to low socioeconomic populations who often face barriers in accessing health care. However, most studies on ICT for health education and interventions have been conducted in clinical settings. Objective The aim of this study was to examine access to and use of mobile phones and computers, as well as interest in, using ICT for receipt of behavioral health information among a community sample of urban, predominately black, women with low socioeconomic status. Methods Participants (N=220) were recruited from hair salons and social service centers and completed audio-computer assisted self-interviews. Results The majority of the participants (212/220, 96.3%) reported use of a cell phone at least weekly, of which 89.1% (189/212) used smartphones and 62.3% (137/220) reported computer use at least weekly. Of the women included in the study, 51.9% (107/206) reported using a cell phone and 39.4% (74/188) reported using a computer to access health and/or safety information at least weekly. Approximately half of the women expressed an interest in receiving information about stress management (51%-56%) or alcohol and health (45%-46%) via ICT. Smartphone ownership was associated with younger age (odds ratio [OR] 0.92, 95% CI 0.87-0.97) and employment (OR 5.12, 95% CI 1.05-24.95). Accessing health and safety information weekly by phone was associated with younger age (OR 0.96, 95% CI 0.94-0.99) and inversely associated with higher income (OR 0.42, 95% CI 0.20-0.92). Conclusions Our findings suggest that ICT use, particularly smartphone use, is pervasive among predominantly black women with low socioeconomic status in urban, nonclinical settings. These results show that ICT is a promising modality for delivering health information to this population. Further exploration of the acceptability, feasibility, and effectiveness of using ICT to disseminate behavioral health education and intervention is warranted.
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Affiliation(s)
- Sarah M Jabour
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Alexis Page
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Seventy F Hall
- School of Social Work, University of Buffalo, Buffalo, NY, United States
| | - Lycinda Rodriguez
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX, United States
| | - Wendy C Shields
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Anika Ah Alvanzo
- Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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16
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Freeman BK, Coker TR. Six Questions for Well-Child Care Redesign. Acad Pediatr 2018; 18:609-619. [PMID: 29857062 DOI: 10.1016/j.acap.2018.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/02/2018] [Accepted: 05/11/2018] [Indexed: 02/07/2023]
Abstract
In the United States, well-child care has the goal of providing comprehensive care to children by addressing developmental, behavioral, psychosocial, and health issues through visits at recommended intervals. The preventive care needs of families can outpace the capacity of clinics and practices to provide it, necessitating a redesign of our well-child care system that aligns the structure of preventive care delivery with the needs of families. Here we focus on 6 questions (the what, when, who, why, how, and where) for well-child care redesign for infants and young children. By addressing these key questions and providing recommendations for advancing well-child care redesign in the clinical and research arenas, we hope to accelerate the process of well-child care redesign. In the current political and socioeconomic environment, continuing with well-child care "as usual" will mean that many families will find that their well-child care visits do not fully address the most pressing needs impacting children's health and well-being. It is time to implement and sustain real change in our system for preventive care.
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Affiliation(s)
- Brandi K Freeman
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo (Dr Freeman)
| | - Tumaini R Coker
- Department of Pediatrics, University of Washington School of Medicine, Center for Diversity and Health Equity, Seattle Children's Hospital, and Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Wash (Dr Coker)
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17
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Phan M, Hickey E, Beck AF, Klein MD, Real FJ. A "Smart" Way of Addressing Food Insecurity in the Digital Age. Pediatrics 2018; 142:peds.2018-1336. [PMID: 29907702 DOI: 10.1542/peds.2018-1336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/30/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
| | | | - Andrew F Beck
- Divisions of General and Community Pediatrics and.,Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Melissa D Klein
- Divisions of General and Community Pediatrics and.,Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Francis J Real
- Divisions of General and Community Pediatrics and.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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18
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Nuss H, Skizim M, Afaneh H, Miele L, Sothern M. Farmers' Market Utilization among Supplemental Nutrition Assistance Program Recipients in New Orleans, Louisiana: Preliminary Findings. Ethn Dis 2017; 27:295-302. [PMID: 29158654 PMCID: PMC5684773 DOI: 10.18865/ed.27.s1.295] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Farmers' markets are increasingly being promoted as a means to provide fresh produce to poor and underserved communities. However, farmers' market (FM) use remains low among low-income patrons. The purpose of our study was to examine FM awareness and use, grocery shopping behaviors, and internet use among Supplemental Nutrition Assistance Program (SNAP) recipients. Design A descriptive analysis of preliminary data was performed to evaluate quantitative baseline data among SNAP recipients between June and August 2016 in New Orleans, Louisiana (N=51). Data were collected via a 42-item online survey that included demographics, internet use, FM awareness and use, health information seeking behaviors and fruit and vegetable purchasing behaviors. Results Less than half of the survey respondents (n=24) had ever been to a FM. Local grocery stores and Wal-Mart were most used for purchasing fruits and vegetables (88% and 84%, respectively). The most common sources of healthy eating information were Women, Infants and Children (WIC) and the internet, frequently accessed via smartphones. More than 80% of participants were not aware that local FMs accepted electronic benefit transfer payments as a form of payment. Conclusion These results support the incorporation of promotional methodology that combines internet-based mobile technology and existing services (eg, WIC) as a viable strategy to improve farmers' market use among low-income populations. As most participants were not aware that participating FMs accept electronic benefit transfer payments, this fact should be emphasized in promotional material.
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Affiliation(s)
- Henry Nuss
- Louisiana State University Health, School of Public Health, New Orleans, LA
| | - Meg Skizim
- Louisiana State University Health, School of Public Health, New Orleans, LA
| | - Hasheemah Afaneh
- Louisiana State University Health, School of Public Health, New Orleans, LA
| | - Lucio Miele
- Louisiana State University School of Medicine, New Orleans, LA
| | - Melinda Sothern
- Louisiana State University Health, School of Public Health, New Orleans, LA
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19
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Fernandez N, Copenhaver DJ, Vawdrey DK, Kotchoubey H, Stockwell MS. Smartphone Use Among Postpartum Women and Implications for Personal Health Record Utilization. Clin Pediatr (Phila) 2017; 56:376-381. [PMID: 27798390 DOI: 10.1177/0009922816673438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Personal health records (PHRs) have the potential to improve incomplete health records. However, internet access through traditional methods may be limited for populations most at risk for fragmented care. A convenience sample of postpartum women at a community hospital and tertiary-care academic center in New York City completed a self-administered survey. Most (75.2%, n = 200) women approached participated. The majority (70.0%) were Latina, 53.5% were Spanish speakers, 23.4% were uninsured, and 41.6% were publicly insured. Smartphone ownership (85.6%) including a data plan (80.0%) was high. While insurance and educational level were associated with decreased odds of internet access at home, access via cellphone only differed by age. Nearly all (94%) women wanted PHR access and interest only differed by language. Even the minority (20.0%) of women with concerns, reported high (93.8%) interest. High smartphone ownership, use of phone for internet access, and interest in PHR access, suggest the potential of optimizing PHR use via mobile technologies.
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Affiliation(s)
- Nadira Fernandez
- 1 College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | | | - David K Vawdrey
- 1 College of Physicians and Surgeons, Columbia University, New York, NY, USA.,2 NewYork-Presbyterian Hospital, New York, NY, USA
| | | | - Melissa S Stockwell
- 1 College of Physicians and Surgeons, Columbia University, New York, NY, USA.,2 NewYork-Presbyterian Hospital, New York, NY, USA.,3 Mailman School of Public Health, Columbia University, New York, NY, USA
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20
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Borus J, Weas S, Fleegler E, Kahn J, Chan E. Email Isn't Just for Old People: Teen Acceptability of Internet Communication With Medical Providers. Clin Pediatr (Phila) 2016; 55:1350-1353. [PMID: 26637403 DOI: 10.1177/0009922815619369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Joshua Borus
- 1 Boston Children's Hospital, Boston, MA, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Sarah Weas
- 1 Boston Children's Hospital, Boston, MA, USA
| | - Eric Fleegler
- 1 Boston Children's Hospital, Boston, MA, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Jason Kahn
- 1 Boston Children's Hospital, Boston, MA, USA.,2 Harvard Medical School, Boston, MA, USA
| | - Eugenia Chan
- 1 Boston Children's Hospital, Boston, MA, USA.,2 Harvard Medical School, Boston, MA, USA
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21
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Mahajan V, Agarwal A, Azad C. Access and Acceptability of Digital Technology Amongst Caregivers/Parents in Government Sector. Indian J Pediatr 2016; 83:1203. [PMID: 27246827 DOI: 10.1007/s12098-016-2157-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 05/11/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Vidushi Mahajan
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, 160030, India.
| | - Aditi Agarwal
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, 160030, India
| | - Chandrika Azad
- Department of Pediatrics, Government Medical College and Hospital, Chandigarh, 160030, India
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22
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DeMeester RH, Lopez FY, Moore JE, Cook SC, Chin MH. A Model of Organizational Context and Shared Decision Making: Application to LGBT Racial and Ethnic Minority Patients. J Gen Intern Med 2016; 31:651-62. [PMID: 26988980 PMCID: PMC4870417 DOI: 10.1007/s11606-016-3608-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Shared decision making (SDM) occurs when patients and clinicians work together to reach care decisions that are both medically sound and responsive to patients' preferences and values. SDM is an important tenet of patient-centered care that can improve patient outcomes. Patients with multiple minority identities, such as sexual orientation and race/ethnicity, are at particular risk for poor SDM. Among these dual-minority patients, added challenges to clear and open communication include cultural barriers, distrust, and a health care provider's lack of awareness of the patient's minority sexual orientation or gender identity. However, organizational factors like a culture of inclusion and private space throughout the visit can improve SDM with lesbian, gay, bisexual, and transgender ("LGBT") racial/ethnic minority patients who have faced stigma and discrimination. Most models of shared decision making focus on the patient-provider interaction, but the health care organization's context is also critical. Context-an organization's structure and operations-can strongly influence the ability and willingness of patients and clinicians to engage in shared decision making. SDM is most likely to be optimal if organizations transform their contexts and patients and providers improve their communication. Thus, we propose a conceptual model that suggests ways in which organizations can shape their contextual structure and operations to support SDM. The model contains six drivers: workflows, health information technology, organizational structure and culture, resources and clinic environment, training and education, and incentives and disincentives. These drivers work through four mechanisms to impact care: continuity and coordination, the ease of SDM, knowledge and skills, and attitudes and beliefs. These mechanisms can activate clinicians and patients to engage in high-quality SDM. We provide examples of how specific contextual changes could make SDM more effective for LGBT racial/ethnic minority populations, focusing especially on transformations that would establish a safe environment, build trust, and decrease stigma.
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Affiliation(s)
- Rachel H. DeMeester
- Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
- Robert Wood Johnson Foundation Reducing Health Care Disparities Through Payment and Delivery System Reform Program Office, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
| | - Fanny Y. Lopez
- Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
| | - Jennifer E. Moore
- Institute for Medicaid Innovation, Washington, DC USA
- Department of Obstetrics & Gynecology, Medical School, University of Michigan, Ann Arbor, MI USA
| | - Scott C. Cook
- Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
- Robert Wood Johnson Foundation Reducing Health Care Disparities Through Payment and Delivery System Reform Program Office, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
| | - Marshall H. Chin
- Section of General Internal Medicine, Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
- Robert Wood Johnson Foundation Reducing Health Care Disparities Through Payment and Delivery System Reform Program Office, University of Chicago, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637 USA
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23
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Park E, Kim H, Steinhoff A. Health-Related Internet Use by Informal Caregivers of Children and Adolescents: An Integrative Literature Review. J Med Internet Res 2016; 18:e57. [PMID: 26940750 PMCID: PMC4796403 DOI: 10.2196/jmir.4124] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 06/17/2015] [Accepted: 08/18/2015] [Indexed: 11/13/2022] Open
Abstract
Background Internet-based health resources can support informal caregivers who are caring for children or adolescents with health care needs. However, few studies discriminate informal caregivers’ needs from those of their care recipients or those of people caring for adults. Objective This study reviews the literature of health-related Internet use among informal caregivers of children and adolescents. Methods A total of 17 studies were selected from literature searches conducted in 6 electronic databases: PubMed, Cochrane, CINAHL, PsycINFO, ERIC, and EMBASE. All databases searches were limited to articles published in the years 2004 to 2014 in peer-reviewed publications. Search terms consisted of “health-related Internet use,” “eHealth,” “Internet use for health-related purpose(s),” “Web-based resource(s),” and “online resources,” combined with informal caregiver (or “parents”) of “child,” “adolescent,” “student,” “youth,” and “teen.” The age range of the children receiving care was limited to younger than 22 years. Their informal caregivers were defined as persons (parents) who provided unpaid care or assistance to a child or an adolescent with health problems. Results Among 17 empirical studies, the majority of informal caregivers of children with medical issues were the parents. Quantitative studies (14/17, 77%) reported prevalence and predictors of health-related Internet use, while mixed-methods and qualitative studies (3/17, 24%) investigated informal caregiver perceptions of helpful health-related Internet use and barriers of use. The prevalence of health-related Internet use varied (11%-90%) dependent upon how health-related Internet use was operationalized and measured. Disease-specific information was used for decision making about treatment, while social support via virtual communities and email were used for informal caregiver emotional needs. A digital divide of Internet access was identified in lower educated minorities. Most studies had methodological challenges resulting from convenience sampling, cross-sectional surveys, lack of theoretical frameworks, or no clear definitions of health-related Internet use. Conclusions This study provides an important understanding of how family members use Internet-based information and support systems during child caregiving. Healthcare providers and policy makers should integrate family needs into their current practices and policies. Further rigorous research is required to design efficient and effective nursing interventions.
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Affiliation(s)
- Eunhee Park
- University of North Carolina at Greensboro, School of Nursing, Greensboro, NC, United States
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24
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Abstract
Social media tools such as blogs, microblogs, social networking sites, podcasts, and video-sharing sites are now ubiquitous. These tools enable instantaneous interactions with a global community of individuals, including medical professionals, learners, and patients. An understanding of social media tools and how they can be used by psychiatrists is increasingly important. This review defines some relevant social media terms and addresses challenges specific to the use of social media in psychiatry. Focused primarily on Twitter, one of the most commonly used social media tools, the review describes how Twitter is being used in non-psychiatric medical fields and highlights four current and/or potential uses of Twitter in psychiatry: (1) patient care and advocacy, (2) lifelong learning, (3) research data collection and collaboration, and (4) scholarly recognition and impact.
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25
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Rand CM, Blumkin A, Vincelli P, Katsetos V, Szilagyi PG. Parent Preferences for Communicating With Their Adolescent's Provider Using New Technologies. J Adolesc Health 2015; 57:299-304. [PMID: 26299557 DOI: 10.1016/j.jadohealth.2015.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/26/2015] [Accepted: 06/10/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Because adolescents make few health care visits, we assessed the views of parents of adolescents on various means to communicate with their adolescents' physicians about vaccine reminders and appointments, medication refills and test results-including phone, mail, e-mail, text messages, and personal health records (PHRs). METHODS We performed a cross-sectional survey of 400 parents of adolescents presenting to four pediatric offices (two urban, two suburban) in Rochester, NY in 2011 before vaccine reminders occurring in these practices. RESULTS Roughly half of parents (60% urban, 52% suburban, p = .11) were accepting of teens receiving their own vaccine reminders. Urban parents preferred communicating with the provider via telephone, whereas suburban parents preferred e-mail for most issues and a PHR for receipt of test results. In adjusted analyses, being younger was associated with preferring text message vaccine reminders (41 to <51 years: adjusted relative risk [aRR] = .8, p = .02; ≥51 years, aRR = .5, p < .001), and being a suburban parent was associated with preferring e-mail reminders (aRR = 1.6, p < .001). Those who were younger (41 to <51 years: aRR = .6, p = .007; ≥51 years: aRR = .4, p < .001) and suburban (aRR = 2.4, p < .001) were most likely to be interested in general use of a PHR. CONCLUSIONS Our study shows that some, but not all, parents are ready for electronic (text message, e-mail, PHR) communications for their adolescents' health care and that a parent age and socioeconomic divide exists. Providing options in the means in which parents communicate with an adolescent's provider is ideal.
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Affiliation(s)
- Cynthia M Rand
- Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York.
| | - Aaron Blumkin
- Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York
| | - Phyllis Vincelli
- Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York
| | - Viki Katsetos
- Department of Pediatrics, University of Rochester School of Medicine & Dentistry, Rochester, New York
| | - Peter G Szilagyi
- Department of Pediatrics, Mattel Children's Hospital, University of California, Los Angeles, Los Angeles, California
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26
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Smartphone applications in paediatric radiology: availability and authority. Pediatr Radiol 2015; 45:1293-302. [PMID: 25824959 DOI: 10.1007/s00247-015-3327-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/10/2015] [Accepted: 02/24/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. OBJECTIVES To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. MATERIALS AND METHODS The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. RESULTS Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. CONCLUSION All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families.
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Singh A, Wilkinson S, Braganza S. Smartphones and pediatric apps to mobilize the medical home. J Pediatr 2014; 165:606-10. [PMID: 24986454 DOI: 10.1016/j.jpeds.2014.05.037] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 05/09/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess digital access and mobile health in urban pediatric clinics by measuring demographics of smartphone ownership, primary uses of mobile devices by teens vs parents/caregivers, and interest levels in using smartphone health apps. STUDY DESIGN This cross-sectional survey studied teenagers and caregivers from 2 urban pediatric practices in Bronx, New York; 148 surveys were administered verbally in waiting rooms using a 24-item "iHealthNYC" questionnaire. A demonstration of smartphone health apps was then conducted and data analyzed using bivariate analysis and χ(2) statistics. RESULTS Overall, 84% of subjects were smartphone owners, with 57% using smartphones as their primary internet source. There was no statistical difference in smartphone ownership between age groups or demographics of sex, ethnicity, and socioeconomic status. Smartphone users had a mean 14.5 apps, with 70.4% accessing apps >3 times a day. The majority of participants stated interest in medical apps, although caregivers were significantly more motivated. Likewise, caregivers are more likely to search health topics via their phone (76.7% vs 47.9%, P < .01) and own medical apps vs teens (35.1% vs 16.9%, P = .02). CONCLUSION The prevalence of smartphone and app use in urban pediatric populations is high. With increased interest in mobile health, smartphones are an attractive modality for patient education, disease management, and streamlining health care communication in diverse settings, thus "mobilizing" the medical home. Further research is needed so that pediatricians can promote evidence-based apps, thus enabling patients to take ownership of their health.
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Affiliation(s)
- Arunjot Singh
- Department of Pediatrics, Children's Hospital at Montefiore - Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
| | - Sarah Wilkinson
- Department of Pediatrics, Children's Hospital at Montefiore - Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Sandra Braganza
- Department of Pediatrics, Children's Hospital at Montefiore - Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
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Cyrus JW. A Review of Recent Research on Internet Access, Use, and Online Health Information Seeking. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/15323269.2014.888630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mitchell SJ, Godoy L, Shabazz K, Horn IB. Internet and mobile technology use among urban African American parents: survey study of a clinical population. J Med Internet Res 2014; 16:e9. [PMID: 24418967 PMCID: PMC3906691 DOI: 10.2196/jmir.2673] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Revised: 07/16/2013] [Accepted: 07/22/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND There is considerable potential for mobile technologies to empower pediatric patients and families by improving their communication with health professionals. National surveys suggest minority parents frequently communicate via mobile technology, but it is uncertain how amenable they are to receiving health care information in this format. Although the low cost and far reach characteristics of mobile health (mHealth) technology makes it advantageous for communication with minority parents, data on acceptance are needed. OBJECTIVE The objective of the study was to determine utilization of mobile and Internet technology by African American parents in an urban, underserved population, and to assess their interest in receiving health information via text messaging or other technologies (eg, social media and the Internet). METHODS A survey was administered to parents of children aged 1-12 years covered by public insurance receiving care at 3 pediatric primary care centers in Washington, DC. RESULTS The African American sample (N=302) was composed of primarily single (75.8%, 229/302) mothers. Almost half had more than a high school education (47.7%, 144/302) and incomes above US $25,000 per year (43.0%, 130/302). Most (97.0%, 293/302) reported owning a cell phone, of which 91.1% (275/302) used it to text and 78.5% (237/302) used it to access the Internet. Most had service plans with unlimited text and data, but 26.5% (80/302) experienced service interruptions in the previous year. Home Internet access was more prevalent among those with higher income (86.2%, 112/130), but it was still relatively pervasive among lower income families (66.9%, 83/124). In adjusted logistic regression models, African American mothers with income greater than US $25,000 annually were 4 times as likely to own a tablet computer than their lower income counterparts. Of the participants, 80.8% (244/302) used social networking, primarily Facebook, and 74.2% (224/302) were interested in joining a social networking group about a health topic concerning their child. Although relatively few African American mothers (17.9%, 54/302) shared health information via texting, there was strong interest in receiving health information via mobile phones (87.4%, 264/302). There was no significant difference in Internet/mobile device use or interest in using these outlets to send/receive information about their children's health between parents of healthy children and parents of children with chronic health conditions. CONCLUSIONS Urban African American parents are active users of the Internet and mobile technology for social interactions, but they are less likely to use it for accessing or communicating health information. However, most parents expressed an interest in receiving health information or utilizing social networking to learn more about health topics. Mobile technology and social networks may be an underutilized method of providing health information to underserved minority populations.
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Affiliation(s)
- Stephanie J Mitchell
- Children's National Medical Center, Center for Translational Science, George Washington University School of Medicine, Washington, DC, United States
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