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Zimmermann M, Greenberg L, Breland JY. Engagement and Use of a Blended mHealth Intervention for Health Behavior Change. Int J Behav Med 2024; 31:284-291. [PMID: 37217635 DOI: 10.1007/s12529-023-10182-1] [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] [Accepted: 04/27/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Blended mHealth interventions (mHealth interventions including a facilitator) promote user engagement and increase effectiveness of health behavior change interventions. Little is known about how blended mHealth interventions are used outside the research context. METHODS In the present work, we characterized patterns of app use among users of a blended mHealth intervention in real-world conditions. Program users were Veterans Health Administration (VHA) primary care patients (n = 56) who received an invite code for a blended mHealth intervention between 2019 and 2021. Cluster analysis was used to examine user engagement with health coach visits and program features. RESULTS Of patients who received an invite code, 34% initiated the program. Most users were men (63%) and white (57%). The mean number of health conditions was 5 (68% with obesity). The mean age was 55. Cluster analysis suggested that most users did sustain engagement at either moderate (57%) or very high levels (13%). The remaining 30% of users were low engaged users. Users completing any health coach visit (about half) reported more overall engagement than their counterparts who did not. Weight was the most frequently tracked metric. Of users entering weights in the first and last month of the program (n = 18), the mean percent body weight change was 4.0% (SD = 3.6). CONCLUSIONS A blended mHealth intervention may be a scalable option to extend the reach of health behavior change interventions for those that use it. However, a significant portion of users do not initiate these interventions, choose not to use the health coach feature, or engage at lower levels. Future research should examine the role of health coaching visits in promoting sustained engagement.
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Affiliation(s)
- Martha Zimmermann
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA.
- Department of Psychiatry, UMass Chan Medical School, 222 Maple Ave, Shrewsbury, MA, 01545, USA.
| | - Lauren Greenberg
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
| | - Jessica Y Breland
- VA Palo Alto Health Care System, 795 Willow Road (MPD-152), Menlo Park, CA, 94025, USA
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Goldstein SP, Tovar A, Espel-Huynh HM, Cooksey Stowers K. Applying a Social Determinants of Health Framework to Guide Digital Innovations That Reduce Disparities in Chronic Disease. Psychosom Med 2023; 85:659-669. [PMID: 36800264 PMCID: PMC10439976 DOI: 10.1097/psy.0000000000001176] [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] [Indexed: 02/18/2023]
Abstract
ABSTRACT Chronic diseases are among the top causes of global death, disability, and health care expenditure. Digital health interventions (e.g., patient support delivered via technologies such as smartphones, wearables, videoconferencing, social media, and virtual reality) may prevent and mitigate chronic disease by facilitating accessible, personalized care. Although these tools have promise to reach historically marginalized groups, who are disproportionately affected by chronic disease, evidence suggests that digital health interventions could unintentionally exacerbate health inequities. This commentary outlines opportunities to harness recent advancements in technology and research design to drive equitable digital health intervention development and implementation. We apply "calls to action" from the World Health Organization Commission on Social Determinants of Health conceptual framework to the development of new, and refinement of existing, digital health interventions that aim to prevent or treat chronic disease by targeting intermediary, social, and/or structural determinants of health. Three mirrored "calls to action" are thus proposed for digital health research: a) develop, implement, and evaluate multilevel, context-specific digital health interventions; b) engage in intersectoral partnerships to advance digital health equity and social equity more broadly; and c) include and empower historically marginalized groups to develop, implement, and access digital health interventions. Using these "action items," we review several technological and methodological innovations for designing, evaluating, and implementing digital health interventions that have greater potential to reduce health inequities. We also enumerate possible challenges to conducting this work, including leading interdisciplinary collaborations, diversifying the scientific workforce, building trustworthy community relationships, and evolving health care and digital infrastructures.
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Affiliation(s)
- Stephanie P. Goldstein
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-4, Providence, RI 02912, USA
| | - Hallie M. Espel-Huynh
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI, 02903, USA
| | - Kristen Cooksey Stowers
- Allied Health Sciences, University of Connecticut, 358 Mansfield Rd, Storrs, CT 06269
- Rudd Center for Food Policy and Health, University of Connecticut, 1 Constitution Plaza, Hartford, CT 06103
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Ford KL, West AB, Bucher A, Osborn CY. Personalized Digital Health Communications to Increase COVID-19 Vaccination in Underserved Populations: A Double Diamond Approach to Behavioral Design. Front Digit Health 2022; 4:831093. [PMID: 35493533 PMCID: PMC9051039 DOI: 10.3389/fdgth.2022.831093] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/25/2022] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic exacerbated pre-existing health disparities. People of historically underserved communities, including racial and ethnic minority groups and people with lower incomes and educational attainments, experienced disproportionate premature mortality, access to healthcare, and vaccination acceptance and adoption. At the same time, the pandemic increased reliance on digital devices, offering a unique opportunity to leverage digital communication channels to address health inequities, particularly related to COVID-19 vaccination. We offer a real-world, systematic approach to designing personalized behavior change email and text messaging interventions that address individual barriers with evidence-based behavioral science inclusive of underserved populations. Integrating design processes such as the Double Diamond model with evidence-based behavioral science intervention development offers a unique opportunity to create equitable interventions. Further, leveraging behavior change artificial intelligence (AI) capabilities allows for both personalizing and automating that personalization to address barriers to COVID-19 vaccination at scale. The result is an intervention whose broad component library meets the needs of a diverse population and whose technology can deliver the right components for each individual.
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Talmont E, Vitale TR. Telehealth Readiness Assessment of Perinatal Nurses. Nurs Womens Health 2022; 26:86-94. [PMID: 35143778 DOI: 10.1016/j.nwh.2022.01.004] [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: 05/10/2021] [Revised: 09/22/2021] [Accepted: 12/01/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To assess telehealth readiness among perinatal nurses in New Jersey. DESIGN Cohort survey study. SETTING/LOCAL PROBLEM New Jersey was one of the hardest hit areas in the early months of the COVID-19 pandemic. Telehealth represented an opportunity to provide continuity of perinatal care at a time when health care was significantly disrupted. PARTICIPANTS Perinatal nurses in New Jersey. INTERVENTION/MEASUREMENTS The intervention was a five-part, 90-question online survey provided via e-mail invitation to New Jersey State Nursing Association members. Data were collected from June 25 to July 9, 2020. Descriptive statistics, frequency analyses, a Mann-Whitney test on nonparametric measures of groups by age, and a one-tailed t test were completed. Results of the Telehealth Readiness Assessment tool were calculated. Open-text responses were organized and used to illustrate the findings. RESULTS Fifty-two perinatal nurses responded to the survey. Twenty-two (42%) completed all 90 questions. Partial answers were accepted. Synchronous live telehealth expanded 66% in the wake of COVID-19. Results showed that 37% (n = 15) of participants used telehealth at work, and 27% (n = 11) used it in getting care for themselves or a family member (M = 2.0, SD = 0.86; one-tailed t test, p = .25). In comparing nervousness in using technology with age, scores for those younger than 45 years (Mdn = 3) and those older than 45 years (Mdn = 2) showed no statistically significant difference, U(n<45years = 15, n≥45 years = 17) = 11, z = -0.02, p < .83. Overall, 46% (n = 26) indicated that telehealth could be extremely helpful or very helpful in reducing health care disparities and improving quality. Overall, telehealth readiness was ranked almost ready. CONCLUSION A telehealth readiness assessment may identify barriers and opportunities that can predict success and failure. Nurses generally accept technology and believe that telehealth could be useful in reducing poor maternal health outcomes and health care disparities.
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Iyamu I, Gómez-Ramírez O, Xu AXT, Chang HJ, Watt S, Mckee G, Gilbert M. Challenges in the development of digital public health interventions and mapped solutions: Findings from a scoping review. Digit Health 2022; 8:20552076221102255. [PMID: 35656283 PMCID: PMC9152201 DOI: 10.1177/20552076221102255] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background “Digital public health” has emerged from an interest in integrating digital technologies into public health. However, significant challenges which limit the scale and extent of this digital integration in various public health domains have been described. We summarized the literature about these challenges and identified strategies to overcome them. Methods We adopted Arksey and O’Malley's framework (2005) integrating adaptations by Levac et al. (2010). OVID Medline, Embase, Google Scholar, and 14 government and intergovernmental agency websites were searched using terms related to “digital” and “public health.” We included conceptual and explicit descriptions of digital technologies in public health published in English between 2000 and June 2020. We excluded primary research articles about digital health interventions. Data were extracted using a codebook created using the European Public Health Association's conceptual framework for digital public health. Results and analysis Overall, 163 publications were included from 6953 retrieved articles with the majority (64%, n = 105) published between 2015 and June 2020. Nontechnical challenges to digital integration in public health concerned ethics, policy and governance, health equity, resource gaps, and quality of evidence. Technical challenges included fragmented and unsustainable systems, lack of clear standards, unreliability of available data, infrastructure gaps, and workforce capacity gaps. Identified strategies included securing political commitment, intersectoral collaboration, economic investments, standardized ethical, legal, and regulatory frameworks, adaptive research and evaluation, health workforce capacity building, and transparent communication and public engagement. Conclusion Developing and implementing digital public health interventions requires efforts that leverage identified strategies to overcome diverse challenges encountered in integrating digital technologies in public health.
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Affiliation(s)
- Ihoghosa Iyamu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Oralia Gómez-Ramírez
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- CIHR Canadian HIV Trials Network, Vancouver, BC, Canada
| | - Alice XT Xu
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Hsiu-Ju Chang
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Sarah Watt
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Geoff Mckee
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Mark Gilbert
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Gaudino M, Chikwe J, Bagiella E, Bhatt DL, Doenst T, Fremes SE, Lawton J, Masterson Creber RM, Sade RM, Zwischenberger BA. Methodological Standards for the Design, Implementation, and Analysis of Randomized Trials in Cardiac Surgery: A Scientific Statement From the American Heart Association. Circulation 2021; 145:e129-e142. [PMID: 34865513 DOI: 10.1161/cir.0000000000001037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Cardiac surgery presents specific methodological challenges in the design, implementation, and analysis of randomized controlled trials. The purposes of this scientific statement are to review key standards in cardiac surgery randomized trial design and implementation, and to provide recommendations for conducting and interpreting cardiac surgery trials. Recommendations include a careful evaluation of the suitability of the research question for a clinical trial, assessment of clinical equipoise, feasibility of enrolling a representative patient cohort, impact of practice variations on the safety and efficacy of the study intervention, likelihood and impact of crossover, and duration of follow-up. Trial interventions and study end points should be predefined, and appropriate strategies must be used to ensure adequate deliverability of the trial interventions. Every effort must be made to ensure a high completeness of follow-up; trial design and analytic techniques must be tailored to the specific research question and trial setting.
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Bakken S. Progress toward contextualized, persuasive, and integrated consumer information technologies for health. J Am Med Inform Assoc 2021; 28:2311-2312. [PMID: 34637521 DOI: 10.1093/jamia/ocab215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/23/2021] [Indexed: 01/12/2023] Open
Affiliation(s)
- Suzanne Bakken
- Department of Biomedical Informatics, School of Nursing, Data Science Institute, Columbia University, New York, New York, USA
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8
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Masterson Creber R, Spadaccio C, Dimagli A, Myers A, Taylor B, Fremes S. Patient-Reported Outcomes in Cardiovascular Trials. Can J Cardiol 2021; 37:1340-1352. [PMID: 33974992 PMCID: PMC8487900 DOI: 10.1016/j.cjca.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/31/2021] [Accepted: 04/11/2021] [Indexed: 12/25/2022] Open
Abstract
Patient-reported outcomes (PROs) are reports of a person's health status that provide a global perspective of patient well-being. PROs can be classified into 4 primary domains: global, mental, physical, and social health. In this descriptive review, we focus on how PROs can be used in cardiac clinical trials, with an emphasis on cardiac surgical trials for patients with coronary heart disease and heart failure. We also highlight ongoing challenges and provide specific suggestions and novel opportunities to advance cardiac clinical trials. Current challenges include the long-term measurement of PROs in clinical trials beyond 1 year, inconsistency in the choice of the outcome measures among studies, and the lack of measurement of PROs across multiple domains. Opportunities for advancement include measuring PROs using consumer health informatics tools, including returning information back to participants in formats that they can understand using visualization. Future opportunities include quantifying cohort-specific minimal clinically important differences for PROs.
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Affiliation(s)
- Ruth Masterson Creber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA.
| | - Cristiano Spadaccio
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Arnaldo Dimagli
- Bristol Heart Institute, University of Bristol, Bristol, United Kingdom
| | - Annie Myers
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Brittany Taylor
- School of Nursing, Columbia University, New York, New York, USA
| | - Stephen Fremes
- Sunnybrook Health Science, University of Toronto, Toronto, Ontario, Canada
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9
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Ezran M, Trude ACB, Hepworth AD, Black MM. Parent Website Engagement and Health Equity Implications in a Child Care-Based Wellness Intervention. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:654-662. [PMID: 33947627 PMCID: PMC8355035 DOI: 10.1016/j.jneb.2021.03.003] [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: 07/22/2020] [Revised: 02/28/2021] [Accepted: 03/07/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To evaluate demographic differences in parent website engagement in a child care-based wellness intervention. DESIGN Parent-reported demographic characteristics and observed website engagement were averaged by child care centers participating in the web-based intervention arm of a cluster randomized controlled trial of wellness interventions. SETTING AND PARTICIPANTS Parents of preschoolers in 17 Maryland child care centers. MAIN OUTCOME MEASURES Website engagement: (1) webpage views, (2) average time on webpage, and (3) intervention activity completion. INTERVENTION Parents received access to a website containing content on wellness-promoting topics (eg, parenting, nutrition, physical activity) and their child care center's activities. ANALYSIS Cross-sectional differences in website engagement by demographic characteristics were assessed using ANOVA. RESULTS Centers with a high proportion of parents who identified as other than non-Hispanic White and had less than a bachelor's degree had significantly fewer webpage views, and completed significantly fewer intervention activities compared with centers with parents who were predominantly non-Hispanic White and had more than a bachelor's degree. CONCLUSIONS AND IMPLICATIONS Demographic differences in parents' child care center website engagement represent disparities that could contribute to health inequities in parents' access to wellness-promoting material. Future efforts could identify factors that eliminate demographic disparities in parent engagement in web-based interventions.
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Affiliation(s)
- Marie Ezran
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Angela C B Trude
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | - Allison D Hepworth
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK
| | - Maureen M Black
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD; RTI International, Research Triangle Park, NC.
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Abstract
The COVID-19 pandemic has highlighted structural inequalities and racism promoting health disparities among communities of color. Taking cardiovascular disease as an example, we provide a framework for multidisciplinary efforts leveraging translational and epidemiologic approaches to decode the biological impacts of inequalities and racism and develop targeted interventions that promote health equity.
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Affiliation(s)
- Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, USA; Intramural Research Program, National Institute on Minority Health and Health Disparities, NIH, Bethesda, MD, USA.
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11
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Chen J, Wang Y. Social Media Use for Health Purposes: Systematic Review. J Med Internet Res 2021; 23:e17917. [PMID: 33978589 PMCID: PMC8156131 DOI: 10.2196/17917] [Citation(s) in RCA: 177] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 01/29/2021] [Accepted: 04/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background Social media has been widely used for health-related purposes, especially during the COVID-19 pandemic. Previous reviews have summarized social media uses for a specific health purpose such as health interventions, health campaigns, medical education, and disease outbreak surveillance. The most recent comprehensive review of social media uses for health purposes, however, was conducted in 2013. A systematic review that covers various health purposes is needed to reveal the new usages and research gaps that emerge in recent years. Objective This study aimed to provide a systematic review of social media uses for health purposes that have been identified in previous studies. Methods The researchers searched for peer-reviewed journal articles published between 2006 and 2020 in 12 databases covering medicine, public health, and social science. After coding the articles in terms of publication year, journal area, country, method, social media platform, and social media use for health purposes, the researchers provided a review of social media use for health purposes identified in these articles. Results This study summarized 10 social media uses for various health purposes by health institutions, health researchers and practitioners, and the public. Conclusions Social media can be used for various health purposes. Several new usages have emerged since 2013 including advancing health research and practice, social mobilization, and facilitating offline health-related services and events. Research gaps exist regarding advancing strategic use of social media based on audience segmentation, evaluating the impact of social media in health interventions, understanding the impact of health identity development, and addressing privacy concerns.
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Affiliation(s)
- Junhan Chen
- Department of Communication, University of Maryland, College Park, MD, United States
| | - Yuan Wang
- Department of Communication, University of Maryland, College Park, MD, United States
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12
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Strayhorn SM, Lewis-Thames MW, Carnahan LR, Henderson VA, Watson KS, Ferrans CE, Molina Y. Assessing the relationship between patient-provider communication quality and quality of life among rural cancer survivors. Support Care Cancer 2021; 29:1913-1921. [PMID: 32803725 PMCID: PMC7882640 DOI: 10.1007/s00520-020-05674-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE We explored relationships between patient-provider communication quality (PPCQ) and three quality of life (QOL) domains among self-identified rural cancer survivors: social well-being, functional well-being, and physical well-being. We hypothesized that high PPCQ would be associated with greater social and functional well-being, but be less associated with physical well-being, due to different theoretical mechanisms. METHODS All data were derived from the 2017-2018 Illinois Rural Cancer Assessment (IRCA). To measure PPCQ and QOL domains, we respectively used a dichotomous measure from the Medical Expenditure Panel Survey's Experience Cancer care tool (high, low/medium) and continuous measures from the Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS Our sample of 139 participants was largely female, non-Hispanic White, married, and economically advantaged. After adjusting for demographic and clinical variables, patients who reported high PPCQ exhibited greater social well-being (Std. β = 0.20, 95% CI: 0.03, 0.35, p = 0.02) and functional well-being (Std. β = 0.20, 95% CI: 0.05, 0.35, p = 0.03) than patients with low/medium PPCQ. No association was observed between PPCQ and physical well-being (Std. β = 0.06, 95% CI: - 2.51, 0.21, p = 0.41). Sensitivity analyses found similar, albeit attenuated, patterns. CONCLUSION Our findings aligned with our hypotheses. Future researchers should explore potential mechanisms underlying these differential associations. Specifically, PPCQ may be associated with social and functional well-being through interpersonal mechanisms, but may not be as associated with physical well-being due to multiple contextual factor rural survivors disproportionately face (e.g., limited healthcare access, economic hardship) and stronger associations with clinical factors.
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Affiliation(s)
- Shaila M Strayhorn
- University of Illinois at Chicago Institute for Health Research and Policy, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA
| | - Marquita W Lewis-Thames
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 N. St. Clair St., Chicago, IL, 60611, USA
- Center of Community Health, Northwestern University Feinberg School of Medicine, 750 N. Lake Shore Dr., Chicago, IL, 60611, USA
| | - Leslie R Carnahan
- University of Illinois at Chicago Center for Research on Women and Gender, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St., MC 923, Chicago, IL, USA
| | - Vida A Henderson
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St., MC 923, Chicago, IL, USA
- University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA
| | - Karriem S Watson
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St., MC 923, Chicago, IL, USA
- University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA
| | - Carol E Ferrans
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL, 60612, USA
| | - Yamilé Molina
- University of Illinois at Chicago Center for Research on Women and Gender, 1640 W. Roosevelt Rd., Chicago, IL, 60608, USA.
- Division of Community Health Sciences, School of Public Health, 1603 W. Taylor St., MC 923, Chicago, IL, USA.
- University of Illinois Cancer Center, 914 S. Wood St., Chicago, IL, 60612, USA.
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Veinot TC, Ancker JS, Bakken S. Health informatics and health equity: improving our reach and impact. J Am Med Inform Assoc 2021; 26:689-695. [PMID: 31411692 DOI: 10.1093/jamia/ocz132] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Health informatics studies the use of information technology to improve human health. As informaticists, we seek to reduce the gaps between current healthcare practices and our societal goals for better health and healthcare quality, safety, or cost. It is time to recognize health equity as one of these societal goals-a point underscored by this Journal of the American Medical Informatics Association Special Focus Issue, "Health Informatics and Health Equity: Improving our Reach and Impact." This Special Issue highlights health informatics research that focuses on marginalized and underserved groups, health disparities, and health equity. In particular, this Special Issue intentionally showcases high-quality research and professional experiences that encompass a broad range of subdisciplines, methods, marginalized populations, and approaches to disparities. Building on this variety of submissions and other recent developments, we highlight contents of the Special Issue and offer an assessment of the state of research at the intersection of health informatics and health equity.
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Affiliation(s)
- Tiffany C Veinot
- School of Information, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica S Ancker
- Division of Health Informatics, Department of Healthcare Policy & Research, Weill Cornell Medical College, New York, New York, USA
| | - Suzanne Bakken
- School of Nursing, Columbia University, New York, New York, USA.,Department of Biomedical Informatics, Columbia University, New York, New York, USA.,Data Science Institute, Columbia University, New York, New York, USA
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Warren CM, Turner PJ, Chinthrajah RS, Gupta RS. Advancing Food Allergy Through Epidemiology: Understanding and Addressing Disparities in Food Allergy Management and Outcomes. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2021; 9:110-118. [PMID: 33065370 PMCID: PMC7938932 DOI: 10.1016/j.jaip.2020.09.064] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 01/15/2023]
Abstract
Epidemiological studies have been pivotal in advancing understanding of the etiology of food allergy and in guiding the development of evidence-based guidelines for food allergy prevention and clinical management. In recent years, as research into the population-level distribution and determinants of food allergy has accumulated, data indicate that substantial differences in food allergy outcomes and management exist across racial/ethnic and other socioeconomic strata. This clinical commentary aims to provide a review of existing epidemiological studies and shed valuable light on the disparate burden of food allergy. Emerging methods to quantify environmental exposure and food allergy outcomes are detailed, as are specific areas in which future research is warranted. We also highlight the role that epidemiology plays in advancing health equity and provide a framework as to how it can effectively inform health policy at all phases of the policy cycle-from initial population health assessment to the evaluation and refinement of specific health policies (ie, national guidelines to promote earlier introduction of peanut-containing foods for allergy prevention).
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Affiliation(s)
- Christopher M Warren
- Center for Food Allergy and Asthma Research at the Northwestern University Feinberg School of Medicine, Chicago, Ill; Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Mountain View, Calif.
| | - Paul J Turner
- Section of Inflammation, Repair and Development, National Heart & Lung Institute, Imperial College London, London, United Kingdom; Discipline of Child and Adolescent Health, University of Sydney, Sydney, NSW, Australia
| | - R Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research at Stanford University, Mountain View, Calif
| | - Ruchi S Gupta
- Center for Food Allergy and Asthma Research at the Northwestern University Feinberg School of Medicine, Chicago, Ill; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill
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Tamura K, Vijayakumar NP, Troendle JF, Curlin K, Neally SJ, Mitchell VM, Collins BS, Baumer Y, Gutierrez-Huerta CA, Islam R, Turner BS, Andrews MR, Ceasar JN, Claudel SE, Tippey KG, Giuliano S, McCoy R, Zahurak J, Lambert S, Moore PJ, Douglas-Brown M, Wallen GR, Dodge T, Powell-Wiley TM. Multilevel mobile health approach to improve cardiovascular health in resource-limited communities with Step It Up: a randomised controlled trial protocol targeting physical activity. BMJ Open 2020; 10:e040702. [PMID: 33371027 PMCID: PMC7754642 DOI: 10.1136/bmjopen-2020-040702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Although physical activity (PA) reduces cardiovascular disease (CVD) risk, physical inactivity remains a pressing public health concern, especially among African American (AA) women in the USA. PA interventions focused on AA women living in resource-limited communities with scarce PA infrastructure are needed. Mobile health (mHealth) technology can increase access to PA interventions. We describe the development of a clinical protocol for a multilevel, community-based, mHealth PA intervention for AA women. METHODS AND ANALYSIS An mHealth intervention targeting AA women living in resource-limited Washington, DC communities was developed based on the socioecological framework for PA. Over 6 months, we will use a Sequential Multi-Assignment, Randomized Trial approach to compare the effects on PA of location-based remote messaging (named 'tailored-to-place') to standard remote messaging in an mHealth intervention. Participants will be randomised to a remote messaging intervention for 3 months, at which point the intervention strategy will adapt based on individuals' PA levels. Those who do not meet the PA goal will be rerandomised to more intensive treatment. Participants will be followed for another 3 months to determine the contribution of each mHealth intervention to PA level. This protocol will use novel statistical approaches to account for the adaptive strategy. Finally, effects of PA changes on CVD risk biomarkers will be characterised. ETHICS AND DISSEMINATION This protocol has been developed in partnership with a Washington, DC-area community advisory board to ensure feasibility and acceptability to community members. The National Institutes of Health Intramural IRB approved this research and the National Heart, Lung, and Blood Institute provided funding. Once published, results of this work will be disseminated to community members through presentations at community advisory board meetings and our quarterly newsletter. TRIAL REGISTRATION NUMBER NCT03288207.
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Affiliation(s)
- Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Nithya P Vijayakumar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - James F Troendle
- Office of Biostatistics Research, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kaveri Curlin
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sam J Neally
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Valerie M Mitchell
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Billy S Collins
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cristhian A Gutierrez-Huerta
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rafique Islam
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Briana S Turner
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Marcus R Andrews
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joniqua N Ceasar
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sophie E Claudel
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Kathryn G Tippey
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Shayne Giuliano
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Regina McCoy
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Jessica Zahurak
- University of North Carolina, Nutrition Obesity Research Center, Lineberger Comprehensive Cancer Center, Connected Health Applications and Interventions (CHAI) Core, Chapel Hill, North Carolina, USA
| | - Sharon Lambert
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Philip J Moore
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | | | - Gwenyth R Wallen
- National Institutes of Health Clinical Center, Nursing Department, Bethesda, Maryland, USA
| | - Tonya Dodge
- Department of Psychological and Brain Sciences, George Washington University, Washington, District of Columbia, USA
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
- Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
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Rao S, Segar MW, Bress AP, Arora P, Vongpatanasin W, Agusala V, Essien UR, Correa A, Morris AA, de Lemos JA, Pandey A. Association of Genetic West African Ancestry, Blood Pressure Response to Therapy, and Cardiovascular Risk Among Self-Reported Black Individuals in the Systolic Blood Pressure Reduction Intervention Trial (SPRINT). JAMA Cardiol 2020; 6:2773093. [PMID: 33185651 PMCID: PMC7666434 DOI: 10.1001/jamacardio.2020.6566] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/28/2020] [Indexed: 01/25/2023]
Abstract
IMPORTANCE Self-identified Black race is associated with higher hypertension prevalence and worse blood pressure (BP) control compared with other race/ethnic groups. The contribution of genetic West African ancestry to these racial disparities appears not to have been completely determined. OBJECTIVE To determine the association between the proportion of West African ancestry with the response to antihypertensive medication, BP control, kidney function, and risk of adverse cardiovascular (CV) events among self-identified Black individuals in the Systolic Blood Pressure Intervention Trial (SPRINT). DESIGN, SETTING, AND PARTICIPANTS This post hoc analysis of the SPRINT trial incorporated data from a multicenter study of self-identified Black participants with available West African ancestry proportion, estimated using 106 biallelic autosomal ancestry informative genetic markers. Recruitment started on October 20, 2010, and ended on August 20, 2015. Data were analyzed from May 2020 to September 2020. MAIN OUTCOMES AND MEASURES Trajectories of BP and kidney function parameters on follow-up of the trial were assessed across tertiles of the proportion of West African ancestry using linear mixed-effect modeling after adjustment for potential confounders. Multivariable adjusted Cox models evaluated the association of West African ancestry with the risk of composite CV events (nonfatal myocardial infarction, CV death, and heart failure event). RESULTS Among 2466 participants in the current analysis (1122 women [45.5%]; median West African ancestry, 81% [interquartile range, 73%-87%]), there were 120 composite CV events (4.9%) over a mean (SD) of 3.2 (0.9) years of follow-up. At baseline, mean (SD) high-density lipoprotein cholesterol levels were higher (tertile 3: 56.5 [15.0] mg/dL vs tertile 1: 54.2 [14.9] mg/dL; P = .006), smoking prevalence (never smoking: tertile 3: 367 [47.9%] vs tertile 1: 372 [42.2%]; P = .009) and mean (SD) Framingham Risk scores (tertile 3: 16.7 [9.7] vs tertile 1: 18.1 [10.2]; P = .01) were lower, and baseline BP was not different across increasing tertiles of West African ancestry. On follow-up, there was no evidence of differences in longitudinal trajectories of BP, kidney function parameters, or left ventricular mass (Cornell voltage by electrocardiogram) across tertiles of West African ancestry in either intensive or standard treatment arms. In adjusted Cox models, higher West African ancestry was associated with a lower risk of a composite CV event after adjustment for potential confounders (adjusted hazard ratio per 5% higher West African ancestry, 0.92 [95% CI, 0.85-0.99]). CONCLUSIONS AND RELEVANCE Among self-reported Black individuals enrolled in SPRINT, the trajectories of BP, kidney function, and left ventricular mass over time were not different across tertiles of the proportion of West African ancestry. A higher proportion of West African ancestry was associated with a modestly lower risk for CV events. These findings suggest that extrinsic and structural societal factors, more than genetic ancestry, may be the major drivers of the well-established racial disparity in cardiovascular health associated with hypertension.
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Affiliation(s)
- Shreya Rao
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Matthew W. Segar
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Adam P. Bress
- Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City
| | - Pankaj Arora
- Division of Cardiology, Department of Internal Medicine, University of Alabama at Birmingham
| | - Wanpen Vongpatanasin
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Vijay Agusala
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Utibe R. Essien
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Alanna A. Morris
- Division of Cardiology, Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - James A. de Lemos
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
| | - Ambarish Pandey
- Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas
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Martin CL, Kramer-Kostecka EN, Linde JA, Friend S, Zuroski VR, Fulkerson JA. Leveraging Interdisciplinary Teams to Develop and Implement Secure Websites for Behavioral Research: Applied Tutorial. J Med Internet Res 2020; 22:e19217. [PMID: 32965234 PMCID: PMC7542408 DOI: 10.2196/19217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/29/2020] [Accepted: 08/13/2020] [Indexed: 11/19/2022] Open
Abstract
Behavioral researchers are increasingly using interactive digital platforms, either as standalone or supplementary intervention tools, to facilitate positive changes in research participants’ health habits. Research-oriented interactive websites optimally offer a variety of participatory mediums, such as blogs, user-driven content, or health activities. Owing to the multidirectional features of interactive websites, and a corresponding need to protect research participants’ identity and data, it is paramount that researchers design ethical platforms that ensure privacy and minimize loss of anonymity and confidentiality. Authentication (ie, digital verification of one’s identity) of interactive sites is one viable solution to these concerns. Although previous publications have addressed ethical requirements related to authenticated platforms, few applied guidelines in the literature facilitate adherence to ethical principles and legally compliant study protocols during all phases of research website creation (feasibility, design, implementation, and maintenance). Notably, to remain compliant with ethical standards and study protocols, behavioral researchers must collaborate with interdisciplinary teams to ensure that the authenticated site remains secure and usable in all stages of the project. In this tutorial, we present a case study conducted at a large research university. Through iterative and practical recommendations, we detail lessons learned from collaborations with the Institutional Review Board, legal experts, and information technology teams. Although the intricacies of our applied tutorial may require adaptations based on each institution’s technological capacity, we are confident that the core takeaways are universal and thus useful to behavioral researchers creating ethically responsible and compliant interactive websites.
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Affiliation(s)
- Christie L Martin
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | | | - Jennifer A Linde
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Sarah Friend
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Vanessa R Zuroski
- Office of Information Technology, University of Minnesota, Minneapolis, MN, United States
| | - Jayne A Fulkerson
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
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Abstract
OBJECTIVES To survey international regulatory frameworks that serve to protect privacy of personal data as a human right as well as to review the literature regarding privacy protections and data ownership in mobile health (mHealth) technologies between January 1, 2016 and June 1, 2019 in order to identify common themes. METHODS We performed a review of relevant literature available in English published between January 1, 2016 and June 1, 2019 from databases including PubMed, Google Scholar, and Web of Science, as well as relevant legislative background material. Articles out of scope (as detailed below) were eliminated. We categorized the remaining pool of articles and discrete themes were identified, specifically: concerns around data transmission and storage, including data ownership and the ability to re-identify previously de-identified data; issues with user consent (including the availability of appropriate privacy policies) and access control; and the changing culture and variable global attitudes toward privacy of health data. RESULTS Recent literature demonstrates that the security of mHealth data storage and transmission remains of wide concern, and aggregated data that were previously considered "de-identified" have now been demonstrated to be re-identifiable. Consumer-informed consent may be lacking with regard to mHealth applications due to the absence of a privacy policy and/or to text that is too complex and lengthy for most users to comprehend. The literature surveyed emphasizes improved access control strategies. This survey also illustrates a wide variety of global user perceptions regarding health data privacy. CONCLUSION The international regulatory framework that serves to protect privacy of personal data as a human right is diverse. Given the challenges legislators face to keep up with rapidly advancing technology, we introduce the concept of a "healthcare fiduciary" to serve the best interest of data subjects in the current environment.
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Affiliation(s)
- Hannah K. Galvin
- Cambridge Health Alliance, Cambridge, MA, USA
- Tufts University School of Medicine, Boston, MA, USA
| | - Paul R. DeMuro
- Chief Legal Officer Health and Wellness, Royal Palm Companies, Miami, Florida
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Caceres BA, Turchioe MR, Pho A, Koleck TA, Creber RM, Bakken SB. Sexual Identity and Racial/Ethnic Differences in Awareness of Heart Attack and Stroke Symptoms: Findings From the National Health Interview Survey. Am J Health Promot 2020; 35:57-67. [PMID: 32551829 DOI: 10.1177/0890117120932471] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE Investigate sexual identity and racial/ethnic differences in awareness of heart attack and stroke symptoms. DESIGN Cross-sectional. SETTING 2014 and 2017 National Health Interview Survey. SAMPLE 54 326 participants. MEASURES Exposure measures were sexual identity (heterosexual, gay/lesbian, bisexual, "something else") and race/ethnicity. Awareness of heart attack and stroke symptoms was assessed. ANALYSIS Sex-stratified logistic regression analyses to examine sexual identity and racial/ethnic differences in awareness of heart attack and stroke symptoms. RESULTS Gay men were more likely than heterosexual men to identify calling 911 as the correct action if someone is having a heart attack (adjusted odds ratio [AOR] = 2.16, 95% CI: 1.18-3.96). The majority of racial/ethnic minority heterosexuals reported lower rates of awareness of heart attack and stroke symptoms than White heterosexuals. Hispanic sexual minority women had lower awareness of heart attack symptoms than White heterosexual women (AOR = 0.43, 95% CI: 0.25-0.74), whereas Asian sexual minority women reported lower awareness of stroke symptoms (AOR = 0.25, 95% CI: 0.08-0.80). Hispanic (AOR = 0.52, 95% CI: 0.33-0.84) and Asian (AOR = 0.35, 95% CI: 0.14-0.84) sexual minority men reported lower awareness of stroke symptoms than White heterosexual men. CONCLUSION Hispanic and Asian sexual minorities had lower rates of awareness of heart attack and stroke symptoms. Health information technology may be a platform for delivering health education and targeted health promotion for sexual minorities of color.
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Affiliation(s)
- Billy A Caceres
- Program for the Study of LGBT Health, 5798Columbia University School of Nursing, New York, NY, USA
| | | | - Anthony Pho
- 5798Columbia University School of Nursing, New York, NY, USA
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Influences of the Industry 4.0 Revolution on the Human Capital Development and Consumer Behavior: A Systematic Review. SUSTAINABILITY 2020. [DOI: 10.3390/su12104035] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Automation and digitalization, as long-term evolutionary processes, cause significant effects, such as the transformation of occupations and job profiles, changes to employment forms, and a more significant role for the platform economy, generating challenges for social policy. This systematic literature review aims to provide an overview of the research to date related to influences of the Industry 4.0 Revolution on human capital development and consumer behavior. A search on the Web of Science identified 160 papers that met the inclusion criteria. The major objectives aimed to identify: the main types of influences of the Industry 4.0 Revolution on human capital development and consumer behavior; the main opportunities and challenges for new directions in education associated with shifting the work environment; and the drivers for human capital development and consumer behavior through the lenses of the Industry 4.0 Revolution. The results revealed some key aspects for the development of human capital: information, new jobs, the Internet, technology, training, education, new skills, automation, communication, innovativeness, professionals, productivity, artificial intelligence, digitalization, e-recruitment, and the Internet of Things, as well as the main drivers of consumer behavior: information, e-commerce, digitalization, the Internet of Things, e-distribution, technology, digitalization, automation, personalized, performance, artificial intelligence, behavior intention, e-shopping, and data mining.
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Jackson CL, Powell-Wiley TM, Gaston SA, Andrews MR, Tamura K, Ramos A. Racial/Ethnic Disparities in Sleep Health and Potential Interventions Among Women in the United States. J Womens Health (Larchmt) 2020; 29:435-442. [PMID: 32096683 PMCID: PMC7097680 DOI: 10.1089/jwh.2020.8329] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
While essential for health and wellness, the various dimensions of sleep health are generally not equitably distributed across the population, and reasons for racial/ethnic sleep disparities are not fully understood. In this review, we describe racial/ethnic sleep disparities and subsequent implications for health from prior and recently conducted epidemiological and clinical studies as well as the potential sleep interventions presented at the 2018 Research Conference on Sleep and the Health of Women at the National Institutes of Health. Given the clear connection between sleep and poor health outcomes such as cardiovascular disease, we concluded that future studies are needed to focus on sleep health in general, sleep disorders such as insomnia and obstructive sleep apnea in particular, and disparities in both sleep health and sleep disorders among women using an intersectional framework. Future research should also integrate sleep into interventional research focused on women's health as these results could address health disparities by informing, for example, future mobile health (mHealth) interventions prioritizing women beyond the clinical setting.
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Affiliation(s)
- Chandra L. Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Sciences, Research Triangle Park, North Carolina
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Sciences, Bethesda, Maryland
| | - Tiffany M. Powell-Wiley
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Sciences, Bethesda, Maryland
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Symielle A. Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Sciences, Research Triangle Park, North Carolina
| | - Marcus R. Andrews
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
| | - Alberto Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida
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McAlearney AS, Walker DM, Gaughan A, Moffatt-Bruce S, Huerta TR. Helping Patients Be Better Patients: A Qualitative Study of Perceptions About Inpatient Portal Use. Telemed J E Health 2020; 26:1184-1187. [PMID: 31990635 DOI: 10.1089/tmj.2019.0198] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: As more hospitals introduce inpatient portals, it is increasingly important to understand their impact on patient experience and the care process. We conducted this study to learn from patients and care team members about their experience with an inpatient portal. Methods: We interviewed 120 patients and 433 care team members across a seven-hospital academic medical center that offers an inpatient portal to hospitalized patients. Interviewees were asked about their use of the inpatient portal and its impact on patient experience. Recorded interviews were transcribed and rigorously analyzed using both inductive and deductive methods. Results: We found that the inpatient portal was perceived to help patients be "better patients" by improving their ability to be informed about their health and by enabling them to be more involved in the care process. Care team members suggested portal use could be improved by addressing challenges with tablet administration, use of the patient education feature, and the functionality of the scheduling feature. Conclusions: Across interviewees, we found that inpatient portals were perceived to improve the hospital experience and increase empowerment for patients by offering information about care in a manner that allowed patients to join their care teams as active, participating members.
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Affiliation(s)
- Ann Scheck McAlearney
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Daniel M Walker
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Alice Gaughan
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Susan Moffatt-Bruce
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Timothy R Huerta
- Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, Ohio, USA
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
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Cooper DK, Wieling E, Pfeiffer A. Bioecological Implications of Narrative Exposure Therapy in Low-Resource Settings: Individual, Family, Community, and Socio-Political Contexts. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF FAMILY THERAPY 2019; 40:353-367. [PMID: 34334934 PMCID: PMC8323547 DOI: 10.1002/anzf.1392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Traumatic stress can have detrimental effects on individuals, families, and communities. Narrative Exposure Therapy (NET) is an evidence-based intervention for decreasing individuals' posttraumatic stress disorder (PTSD) symptoms and has been tested in some of the most challenging contexts, such as in post-conflict refugee camps. Although the focus of NET is on reducing individual PTSD symptoms, the impact of NET can be seen beyond the individual level. The purpose of this manuscript was to examine some of the ecological implications of using NET with trauma-affected populations in low-resource settings. We highlight select implications of NET that extend beyond the individual to systemic effects at the family, community, and sociopolitical levels using several case examples. Finally, we outline limitations and future directions for improving the delivery of NET in settings with limited resources.
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Affiliation(s)
| | - Elizabeth Wieling
- Department of Human Development and Family Science, University of Georgia
| | - Anett Pfeiffer
- vivo Outpatient Clinic for Survivors of Trauma and Torture in Uganda
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