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Jiao K, Ma J, Lin Y, Li Y, Yan Y, Cheng C, Jia W, Meng J, Wang L, Cao Y, Zhao Z, Yang X, Liao M, Kang D, Wang C, Ma W. Effectiveness of instant versus text messaging intervention on antiretroviral therapy adherence among men who have sex with men living with HIV. Digit Health 2024; 10:20552076241257447. [PMID: 38840657 PMCID: PMC11151765 DOI: 10.1177/20552076241257447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/09/2024] [Indexed: 06/07/2024] Open
Abstract
Objective This study aimed to compare the effectiveness of instant versus text messaging intervention (TMI) on antiretroviral therapy (ART) adherence among men who have sex with men (MSM) living with HIV. Methods This study was conducted in an infectious disease hospital of Jinan, China from October 2020 to June 2021, using non-randomized concurrent controlled design to compare the effectiveness of instant messaging intervention (IMI) versus TMI. The intervention strategies (health messaging, medication reminder, and peer education) and contents were consistent between the two groups, and the difference was service delivery method and type of information. The primary outcome was the proportion of achieving optimal ART adherence, defined as never missing any doses and delayed any doses more than 1 hour. Results A total of 217 participants (including 72 in TMI group and 145 in IMI group) were included in the study. The proportion of achieving optimal adherence was higher in IMI group than TMI group at the first follow-up (90.2% versus 77.6%, p = 0.021) and second follow-up (86.5% versus 76.6%, p = 0.083). The effect of IMI versus TMI on improving ART adherence was found not to be statistically significant (risk ratio (RR) = 1.93, 95% confidence interval (CI): 0.95-3.94) in complete-case analysis. However, when excluding participants who did not adhere to the interventions, a significant improvement was observed (RR = 2.77, 95%CI: 1.21-6.38). More participants in IMI group expressed highly rated satisfaction to the intervention services than those in TMI group (67.3% versus 50.0%). Conclusions The IMI demonstrated superior efficacy over TMI in improving ART adherence and satisfaction with intervention services. It is suggested that future digital health interventions targeting ART adherence should prioritize instant messaging with multimedia information in areas with Internet access. Trial registration The study was registered at the Chinese Clinical Trial Register (ChiCTR), with number [ChiCTR2000041282].
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Affiliation(s)
- Kedi Jiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jing Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yuxi Lin
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yijun Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yu Yan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Chunxiao Cheng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Wenwen Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jing Meng
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Lina Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yanwen Cao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhonghui Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xuan Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Meizhen Liao
- Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Dianmin Kang
- Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Chunmei Wang
- Department of AIDS/STD, Shandong Public Health Clinical Center, Jinan, Shandong, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Zhang L, Ni Z, Liu Y, Chen H. The effectiveness of e-health on reducing stigma, improving social support and quality of life among people living with HIV: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2023; 148:104606. [PMID: 37801937 DOI: 10.1016/j.ijnurstu.2023.104606] [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: 03/23/2023] [Revised: 08/21/2023] [Accepted: 09/11/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Many people living with HIV reported poor quality of life, which was primarily due to HIV-related stigma and the lack of social support. Compared with face-to-face interventions, e-health interventions are reported to have potential to help people living with HIV improve their adherence to antiretroviral therapy, promote their management of HIV and depressive symptoms. However, in the literature, the effectiveness of e-health interventions in helping people living with HIV reduce stigma, improve social support and quality of life is unclear. OBJECTIVE To examine the effectiveness of e-health interventions in reducing stigma and improving social support and quality of life among people living with HIV. DESIGN This study is a systematic review and meta-analysis of randomized controlled trials following the Cochrane Handbook guidelines and PRISMA2020. METHODS A comprehensive search was conducted from inception to 1st December 2022 in six databases: PubMed, CINAHL Plus with Full Text, PsycINFO (Ovid), Embase, Web of Science, and CENTRAL (Ovid), and an updated search took place on 11st June 2023. Two authors independently screened the studies and extracted the data. Cochrane's bias risk tool for randomized controlled trials was used to examine the methodological quality of the included studies. The intervention effect was estimated by calculating the standardized mean difference (SMD) and 95 % confidence interval (CI) using Review Manager 5.3. A sensitivity analysis was conducted to test the rigor of the pooled results using one-study-out method. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Nine studies met eligibility criteria and were included in this review. The results of the meta-analysis showed that e-health interventions could statistically significantly reduce stigma (SMD: -0.29, 95 % CI: [-0.48, -0.10], p = 0.002) and improve quality of life (SMD = 0.49, 95 % CI: [0.30, 0.68], P < 0.001), but had no significant effects on social support (SMD = -0.01, 95 % CI: [-0.48, 0.46] P = 0.96). CONCLUSIONS E-health interventions could reduce stigma and improve quality of life among people living with HIV. More studies are needed to further explore if e-health interventions can improve the social support for people living with HIV and investigate how to integrate e-health interventions into the existing health models to help people living with HIV treat and manage HIV/AIDS. REGISTRATION The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42022373299).
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Affiliation(s)
- Liao Zhang
- Department of Nursing, West China Hospital/West China School of Nursing, Sichuan University, PR China
| | - Zhao Ni
- Center for Interdisciplinary Research on AIDS (CIRA), Yale University, New Haven, CT, USA; School of Nursing, Yale University, New Haven, CT, USA
| | - Ying Liu
- Department of Nursing, West China Hospital/West China School of Nursing, Sichuan University, PR China
| | - Hong Chen
- Department of Nursing, West China Hospital/West China School of Nursing, Sichuan University, PR China.
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Hong YA, Shen K, Han HR, Ta Park V, Bagchi P, Lu HK, Chen H, Wang JHY. A WeChat-based Intervention, Wellness Enhancement for Caregivers (WECARE), for Chinese American Dementia Caregivers: Pilot Assessment of Feasibility, Acceptability, and Preliminary Efficacy. JMIR Aging 2023; 6:e42972. [PMID: 37018042 PMCID: PMC10131589 DOI: 10.2196/42972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/13/2023] [Accepted: 02/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Chinese American family caregivers of persons with dementia experience high rates of psychosocial distress and adverse health outcomes. Due to their immigrant and minority status, they face substantial obstacles to care and support, including stigma and misperception of dementia, limited knowledge and use of welfare and services, and poor social support. Few interventions have been developed or tested for this vulnerable population. OBJECTIVE This study aims to pilot-test the Wellness Enhancement for Caregivers (WECARE) intervention, a culturally tailored program delivered via WeChat, a social media app highly popular in the Chinese population. The 7-week WECARE was designed specifically for Chinese American dementia caregivers to improve their caregiving skills, reduce stress, and enhance psychosocial well-being. Feasibility, acceptability, and preliminary efficacy of the WECARE were assessed in this pilot. METHODS A total of 24 Chinese American family caregivers of persons with dementia were recruited for a pre-post 1-arm trial of the WECARE. By subscribing to the WECARE official account, participants received interactive multimedia programs on their WeChat account multiple times a week for 7 weeks. A backend database automatically delivered program components and tracked user activities. Three online group meetings were organized to facilitate social networking. Participants completed a baseline and a follow-up survey. Feasibility was assessed by the follow-up rate and curriculum completion rate; acceptability was assessed by user satisfaction and perceived usefulness of the program; and efficacy was assessed with pre-post differences in 2 primary outcomes of depressive symptoms and caregiving burden. RESULTS The intervention was completed by 23 participants with a retention rate of 96%. Most of them (n=20, 83%) were older than 50 years and the majority (n=17, 71%) were female. The backend database revealed that the mean curriculum completion rate was 67%. Participants also reported high rates of user satisfaction and perceived usefulness of the intervention and high ratings of weekly programs. The intervention led to significant improvement in participants' psychosocial health outcomes; their depressive symptoms reduced from 5.74 to 3.35 with an effect size of -0.89 and caregiving burden decreased from 25.78 to 21.96 with an effect size of -0.48. CONCLUSIONS This pilot study suggests that WeChat-based WECARE intervention was feasible and acceptable; it also demonstrated initial efficacy in improving psychosocial well-being in Chinese American dementia caregivers. Further research with a control group is needed to assess its efficacy and effectiveness. The study highlights the need for more culturally appropriate mobile health interventions for Chinese American family caregivers of persons with dementia.
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Affiliation(s)
- Y Alicia Hong
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, United States
| | - Kang Shen
- Department of Health Administration and Policy, College of Public Health, George Mason University, Fairfax, VA, United States
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Van Ta Park
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Pramita Bagchi
- Department of Statistics, George Mason University, Fairfax, VA, United States
| | - Huixing Kate Lu
- Chinese Culture and Community Service Center, Inc, Gaithersburg, MD, United States
| | - Hsiaoyin Chen
- Chinese Culture and Community Service Center, Inc, Gaithersburg, MD, United States
| | - Judy Huei-Yu Wang
- Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, United States
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Cai Z, Luo X, Xu X, Shi Z, Reis C, Sharma M, Hou X, Zhao Y. Effect of WeChat-based intervention on food safety knowledge, attitudes and practices among university students in Chongqing, China: a quasi-experimental study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:28. [PMID: 37020255 PMCID: PMC10074872 DOI: 10.1186/s41043-023-00360-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/01/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Food safety is of global importance and has been of concern in university settings in recent years. However, effective methods to conduct food safety education are limited. This study aims to evaluate the effects of an intervention on food safety knowledge, attitudes and practices (KAP) by social media, WeChat, among university students. METHODS A quasi-experimental study was conducted in Chongqing, China. Two departments were recruited randomly from a normal university and a medical university. One department from each university was randomly selected as the intervention group and the other as the control group. All freshmen students in each selected department were chosen to participate in this study. One thousand and twenty-three students were included at baseline, and 444 students completed the study. This intervention was conducted through food safety-related popular science articles with an average of three articles per week released by WeChat official accounts called "Yingyangren" for two months to the intervention group. No intervention was conducted in the control group. An independent t-test was used to test statistical differences in the food safety KAP scores between the two groups. A paired t-test was used to test statistical differences in the food safety KAP scores between before and after the intervention. And quantile regression analysis was conducted to explore the difference between the two groups across the quantile levels of KAP change. RESULTS After the intervention, compared with control group, participants in the intervention group did not score significant higher on knowledge (p = 0.98), attitude (p = 0.13), and practice (p = 0.21). And the scores of food safety knowledge and practices slightly improved after the intervention both in the intervention group (p = 0.01 and p = 0.01, respectively) and in the control group (p = 0.0003 and p = 0.0001, respectively). Additionally, the quantile regression analysis showed that the intervention had no effect on improving the food safety KAP scores. CONCLUSIONS The intervention using the WeChat official account had limited effects on improving the food safety KAP among the university students. This study was an exploration of food safety intervention using the WeChat official account; valuable experience can be provided for social media intervention in future study. TRIAL REGISTRATION ChiCTR-OCH-14004861.
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Affiliation(s)
- Zhengjie Cai
- Department of Nutrition and Food Hygiene, School of Public Health, Chongqing Medical University, No, 1 Yixueyuan Road, Yuzhong District, Chongqing, China
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, China
| | - Xinmiao Luo
- Songzi Center for Disease Control and Prevention, Jingzhou, Hubei, China
| | - Xianglong Xu
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health, Science Center, Xi'an, , Shaanxi, China
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Cesar Reis
- Department of Occupational Medicine, Kaiser Permanente-Southern California Medical Group, Los Angeles, USA
| | - Manoj Sharma
- Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, USA
| | - Xiaorong Hou
- Department of School of Medical and Information, Chongqing Medical University, No. 1 Yixueyuan Road, Yuzhong District, Chongqing, China.
| | - Yong Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Chongqing Medical University, No, 1 Yixueyuan Road, Yuzhong District, Chongqing, China.
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China.
- The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China.
- Chongqing Key Laboratory of Child Nutrition and Health, Chongqing, China.
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Sun L, Qu M, Chen B, Li C, Fan H, Zhao Y. Effectiveness of mHealth on Adherence to Antiretroviral Therapy in Patients Living With HIV: Meta-analysis of Randomized Controlled Trials. JMIR Mhealth Uhealth 2023; 11:e42799. [PMID: 36689267 PMCID: PMC9903184 DOI: 10.2196/42799] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/08/2022] [Accepted: 12/21/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The World Health Organization recommends that all adults with HIV adhere to antiretroviral therapy (ART). Good adherence to ART is beneficial to patients and the public. Furthermore, mHealth has shown promise in improving HIV medication adherence globally. OBJECTIVE The aim of this meta-analysis is to analyze the effectiveness of mHealth on adherence to antiretroviral therapy in patients living with HIV. METHODS Randomized controlled trials (RCTs) of the association between mHealth and adherence to ART published until December 2021 were searched in electronic databases. Odds ratios (ORs), weighted mean differences, and 95% CIs were calculated. This meta-analysis was performed using the Mantel-Haenszel method or the inverse variance test. We evaluated heterogeneity with the I2 statistic. If I2 was ≤50%, heterogeneity was absent, and a fixed effect model was used. If I2 was >50%, heterogeneity was present, and a random effects model was used. RESULTS A total of 2163 participants in 8 studies were included in this meta-analysis. All included studies were RCTs. The random effects model was used for a meta-analysis of the effects of various intervention measures compared to routine nursing; the outcome was not statistically significant (OR 1.54, 95% CI 0.99-2.38; P=.05). In the subgroups, only short messaging service (SMS)-based interventions significantly increased adherence to ART (OR 1.76, 95% CI 1.07-2.89; P=.03). Further analysis showed that only interactive or bidirectional SMS could significantly increase ART adherence (OR 1.69, 95% CI 1.22-2.34; P=.001). After combining the difference in CD4 cell count before and after the interventions, we concluded that there was no statistical heterogeneity among the studies (I2=0%; tau2=0.37; P=.95). CONCLUSIONS Interactive or bidirectional SMS can enhance intervention effects. However, whether mHealth can improve adherence to ART in patients with HIV needs further study. Owing to a lack of the required significant staff time, training, and ongoing supervision, there is still much more to do to apply mHealth to the clinical use of ART for patients living with HIV. TRIAL REGISTRATION PROSPERO CRD42022358774; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=358774.
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Affiliation(s)
- Liang Sun
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Mengbing Qu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bing Chen
- Sanmenxia Center for Disease Control and Prevention, Sanmenxia, China
| | - Chuancang Li
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Haohao Fan
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yang Zhao
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Qin H, Qiu Y, Ying M, Ren J. Evaluation of the health promotion effect of hepatitis B prevention and treatment in the Zhejiang demonstration area, China. BMC Public Health 2022; 22:2073. [PMCID: PMC9661761 DOI: 10.1186/s12889-022-14540-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
To investigate the health literacy level and health promotion effect of hepatitis B prevention and treatment in the demonstration area of Zhejiang Province.
Methods
The National Science and Technology Major Health Education Group took 6 demonstration areas in Zhejiang Province as the whole research site. After the sample size (N=2160 people) was determined, a multistage stratified cluster sampling method was used to conduct a questionnaire survey in 2018 (before health education) and 2019 (after health education). Stata 12 statistical software was used to analyse the status and improvement rate of hepatitis B health literacy of residents in the demonstration area before and after health education and compare the health promotion effects of different health intervention methods.
Results
Before and after health education, there was no significant difference in the basic information of the subjects (P>0.05). After the health education intervention, the level of hepatitis B health literacy of residents in the demonstration area increased by 11.8%, and the difference was statistically significant (P < 0.001). The awareness rate of hepatitis B transmission was low before health education but increased after health education. The form of "Internet +" health education may better improve the residents' health literacy level about hepatitis B prevention and treatment.
Conclusion
After health education, the level of health literacy of residents in the Zhejiang demonstration area about hepatitis B prevention and control significantly improved, but there is room for further improvement. In the future, targeted health education intervention should be carried out, and the health education mode of "Internet +" can achieve better results to effectively prevent and control hepatitis B.
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Jiao K, Wang C, Liao M, Ma J, Kang D, Tang W, Tucker JD, Ma W. A differentiated digital intervention to improve antiretroviral therapy adherence among men who have sex with men living with HIV in China: a randomized controlled trial. BMC Med 2022; 20:341. [PMID: 36210434 PMCID: PMC9549628 DOI: 10.1186/s12916-022-02538-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/23/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Antiretroviral therapy (ART) adherence is still suboptimal among some key populations, highlighting the need for innovative tailored strategies. This randomized controlled trial (RCT) aimed to evaluate the effect of a differentiated digital intervention on ART adherence among men who have sex with men (MSM) living with HIV in China. METHODS The two-armed parallel RCT was conducted at one HIV clinic in Jinan of China from October 19, 2020, to June 31, 2021. Men were referred by health providers to join the study and then choose one of three digital strategies-text message, only instant message, or instant message plus social media. They were assigned in a 1:1 ratio to the intervention arm or control arm using block randomization, and inside each arm, there were three groups depending on the type of delivering the message. The groups were divided according to participants' preferred digital strategies. The intervention arm received ART medication messages, medication reminders, peer education, and involved in online discussion. The control arm received messages on health behavior and nutrition. The primary outcome was self-reported optimal ART adherence, defined as not missing any doses and not having any delayed doses within a one-month period. Secondary outcomes included CD4 T cell counts, viral suppression, HIV treatment adherence self-efficacy, and quality of life. Intention-to-treat analysis with generalized linear mixed models was used to evaluate the intervention's effect. RESULTS A total of 576 participants were enrolled, including 288 participants assigned in the intervention arm and 288 assigned in the control arm. Most were ≤ 40 years old (79.9%) and initiated ART ≤ 3 years (60.4%). After intervention, the proportion of participants achieving optimal ART adherence in the intervention arm was higher than in the control arm (82.9% vs 71.1%). The differentiated digital intervention significantly improved ART adherence (RR = 1.74, 95%CI 1.21-2.50). Subgroup analysis showed one-to-one instant message-based intervention significantly improved ART adherence (RR = 2.40, 95% CI 1.39-4.17). CONCLUSIONS The differentiated digital intervention improved ART adherence among MSM living with HIV in China, which could be integrated into people living with HIV (PLWH) management and further promoted in areas where PLWH can access text messaging and instant messaging services. TRIAL REGISTRATION ChiCTR2000041282. Retrospectively registered on 23 December 2020.
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Affiliation(s)
- Kedi Jiao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Chunmei Wang
- Shandong Public Health Clinical Center, Jinan, Shandong, People's Republic of China
| | - Meizhen Liao
- Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China
| | - Jing Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Dianmin Kang
- Institution for AIDS/STD Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, People's Republic of China.
| | - Weiming Tang
- University of North Carolina Chapel Hill Project-China, Guangzhou, Guangdong, People's Republic of China.
| | - Joseph D Tucker
- University of North Carolina Chapel Hill Project-China, Guangzhou, Guangdong, People's Republic of China. .,Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.
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He X, Peng C, Xu Y, Zhang Y, Wang Z. Global Scientific Research Landscape on Medical Informatics From 2011 to 2020: Bibliometric Analysis. JMIR Med Inform 2022; 10:e33842. [PMID: 35451986 PMCID: PMC9073618 DOI: 10.2196/33842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/26/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022] Open
Abstract
Background With the emerging information and communication technology, the field of medical informatics has dramatically evolved in health care and medicine. Thus, it is crucial to explore the global scientific research landscape on medical informatics. Objective This study aims to present a visual form to clarify the overall scientific research trends of medical informatics in the past decade. Methods A bibliometric analysis of data retrieved and extracted from the Web of Science Core Collection (WoSCC) database was performed to analyze global scientific research trends on medical informatics, including publication year, journals, authors, institutions, countries/regions, references, and keywords, from January 1, 2011, to December 31, 2020. Results The data set recorded 34,742 articles related to medical informatics from WoSCC between 2011 and 2020. The annual global publications increased by 193.86% from 1987 in 2011 to 5839 in 2020. Journal of Medical Internet Research (3600 publications and 63,932 citations) was the most productive and most highly cited journal in the field of medical informatics. David W Bates (99 publications), Harvard University (1161 publications), and the United States (12,927 publications) were the most productive author, institution, and country, respectively. The co-occurrence cluster analysis of high-frequency author keywords formed 4 clusters: (1) artificial intelligence in health care and medicine; (2) mobile health; (3) implementation and evaluation of electronic health records; (4) medical informatics technology application in public health. COVID-19, which ranked third in 2020, was the emerging theme of medical informatics. Conclusions We summarize the recent advances in medical informatics in the past decade and shed light on their publication trends, influential journals, global collaboration patterns, basic knowledge, research hotspots, and theme evolution through bibliometric analysis and visualization maps. These findings will accurately and quickly grasp the research trends and provide valuable guidance for future medical informatics research.
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Affiliation(s)
- Xuefei He
- Department of Ophthalmology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China
| | - Cheng Peng
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yingxin Xu
- Information Center, The First Hospital of China Medical University, Shenyang, China
| | - Ye Zhang
- Information Center, The First Hospital of China Medical University, Shenyang, China
| | - Zhongqing Wang
- Information Center, The First Hospital of China Medical University, Shenyang, China
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Davis VH, Nixon SA, Murphy K, Cameron C, Bond VA, Hanass-Hancock J, Kimura L, Maimbolwa MC, Menon JA, Nekolaichuk E, Solomon P. How the Term 'Self-Management' is Used in HIV Research in Low- and Middle-Income Countries: A Scoping Review. AIDS Behav 2022; 26:3386-3399. [PMID: 35429310 DOI: 10.1007/s10461-022-03668-8] [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: 03/18/2022] [Indexed: 11/25/2022]
Abstract
This scoping review assessed how the term 'self-management' (SM) is used in peer-reviewed literature describing HIV populations in low- and middle-income countries (LMIC). This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. OVID Medline, Embase, CAB Abstracts, and EBSCO CINAHL, Scopus, and Cochrane Library were searched up to September 2021 for articles with SM in titles, key words, or abstracts. Two team members independently screened the titles and abstracts, followed by the full-text. A data extraction tool assisted with collecting findings. A total of 103 articles were included. Since 2015, there has been a 74% increase in articles that use SM in relation to HIV in LMIC. Fifty-three articles used the term in the context of chronic disease management and described it as a complex process involving active participation from patients alongside providers. Many of the remaining 50 articles used SM as a strategy for handling one's care by oneself, with or without the help of community or family members. This demonstrates the varied conceptualizations and uses of the term in LMIC, with implications for the management of HIV in these settings. Future research should examine the applicability of SM frameworks developed in high-income settings for LMIC.
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Affiliation(s)
- Victoria H Davis
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, M5T 3M6, Toronto, Ontario, Canada.
| | - Stephanie A Nixon
- Department of Physical Therapy, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kathleen Murphy
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Cathy Cameron
- International Centre for Disability and Rehabilitation, Toronto, Canada
| | - Virginia A Bond
- Global and Health Development Department, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Zambart, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Jill Hanass-Hancock
- School of Health Science, University of KwaZulu-Natal, Durban, South Africa
- Gender and Health Research Unit, South African Medical Research Council (SAMRC), Durban, South Africa
| | - Lauren Kimura
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - J Anitha Menon
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Erica Nekolaichuk
- Gerstein Science Information Centre, University of Toronto, Toronto, Canada
| | - Patricia Solomon
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
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10
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Yang S, Huang J, Ye L, Lin J, Xie Z, Guo B, Li Y, Liang B, Zheng Z, Lunze K, Abdullah AS, Liang H, Quintiliani LM. Factors Related to Smoking and Perceptions of a Behavioral Counseling and Messenger Service-Delivered Smoking Cessation Intervention for People with HIV in China: A Qualitative Study (Preprint). JMIR Form Res 2022; 6:e35923. [PMID: 36222795 PMCID: PMC9607887 DOI: 10.2196/35923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/14/2022] [Accepted: 08/15/2022] [Indexed: 11/20/2022] Open
Abstract
Background China, where half of the adult male population smoke tobacco, has one of the highest global burdens of smoking. Smoking rates are even higher among people with HIV. People with HIV can be affected by smoking in multiple ways, including more severe HIV-related symptoms and worse antiretroviral therapy treatment outcomes. However, smoking cessation services targeted for people with HIV are not routinely integrated into HIV care in China. Given the widespread mobile phone ownership, an exploration of factors related to smoking among people with HIV in China who smoke could inform the design and implementation of mobile smoking cessation interventions that target the needs of this vulnerable population. Objective This study aims to explore the perspectives of smoking, barriers and facilitators to quitting, and perceptions related to a smoking cessation intervention delivered through behavioral counseling sessions and brief daily messenger service (WeChat)–delivered messages. Methods We recruited people with HIV from the People’s 4th Hospital of Nanning, Guangxi, China, and conducted semistructured face-to-face interviews. All interviews were audio-recorded, transcribed verbatim in Chinese, and translated into English for data analysis. We conducted a thematic analysis using a codebook, which was guided by a team-based consensus approach to identify 5 main themes. We also explored themes according to the demographic groups. Results A total of 24 participants were enrolled in the study. The mean age was 37.2 (SD=13.5) years. The participants had lived with HIV for a mean of 2.4 years. The majority were male (18/24, 75%) and lived in urban or metropolitan settings (19/24, 79%). We identified five main themes: variable knowledge of the harms of smoking, both related and unrelated to HIV; willpower perceived as the primary quitting strategy; a duality of the effect of social factors on quitting; perceptions about optimal features of the smoking cessation intervention (eg, messages should be brief and most frequent during the first few weeks); and the largely negative impact of their HIV diagnosis on smoking behaviors. In addition, some themes differed according to participant demographic characteristics such as age, sex, and education level. Conclusions We identified barriers to and facilitators of smoking cessation among people with HIV in China by conducting semistructured qualitative interviews. Owing to the adverse impact of smoking on HIV outcomes, targeting cessation interventions to the unique needs and preferences of people with HIV in China may be needed to increase the effectiveness of future interventions. A pilot clinical trial will be conducted in the future to evaluate this behavioral counseling and brief daily messenger service (WeChat)–delivered messages approach among people with HIV who smoke in China.
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Affiliation(s)
- Shanyin Yang
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States
| | - Jiegang Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Nanning, Guangxi, China
| | - Jianyan Lin
- The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Zhiman Xie
- The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Baodong Guo
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Yanjun Li
- The Fourth People's Hospital of Nanning, Nanning, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Nanning, Guangxi, China
| | - Zhigang Zheng
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
| | - Karsten Lunze
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States
- Department of Medicine, Boston Univeristy School of Medicine, Boston, MA, United States
| | - Abu S Abdullah
- Department of Medicine, Boston Univeristy School of Medicine, Boston, MA, United States
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China
- Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Nanning, Guangxi, China
- Life Science Institute, Guangxi Medical University, Nanning, Guangxi, China
| | - Lisa M Quintiliani
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, United States
- Department of Medicine, Boston Univeristy School of Medicine, Boston, MA, United States
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11
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Lin B, Liu J, He W, Pan H, Ma Y, Zhong X. Effect of Reminder System on Pre-exposure Prophylaxis Adherence in Men Who Have Sex with Men: A Prospective Cohort Study Based on WeChat Intervention (Preprint). J Med Internet Res 2022; 24:e37936. [PMID: 35969436 PMCID: PMC9412721 DOI: 10.2196/37936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/16/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration
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Affiliation(s)
- Bing Lin
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
| | - Jiaxiu Liu
- School of Medical Informatics, Chongqing Medical University, Chongqing, China
| | - Wei He
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
| | - Haiying Pan
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
| | - Yingjie Ma
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
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12
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Guo Y, Li Y, Yu C, Xu H, Hong YA, Wang X, Zhang N, Zeng Y, Monroe-Wise A, Li L, Liu C, Cai W, Lin A. Long-term effects of a social media-based intervention, Run4Love, on depressive symptoms of people living with HIV: Three-year follow-up of a randomized controlled trial (Preprint). J Med Internet Res 2022; 24:e36809. [PMID: 35763324 PMCID: PMC9277532 DOI: 10.2196/36809] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background Emerging studies have shown the effectiveness of mobile health (mHealth) interventions in reducing depressive symptoms among people living with HIV. Most of these studies included only short-term follow-up, with limited data on long-term effects. Objective The purpose of this study is to assess the long-term effects of a randomized controlled trial called Run4Love on depressive symptoms among people living with HIV at 1-year and 3-year follow-ups. Methods A total of 300 people living with HIV with depressive symptoms were recruited and randomized to an intervention or a control group in Guangzhou, China, from September 2017 to January 2018. The intervention group received a 3-month Run4Love program, including adapted evidence-based cognitive behavioral stress management courses and exercise promotion via WeChat (Tencent), a popular social media app. The control group received usual care and a brochure on nutrition. The primary outcome was reduction in depressive symptoms, measured using the Center for Epidemiological Studies–Depression (CES-D) scale. Data used in this study were collected at baseline and at the 1-year and 3-year follow-ups. Generalized estimating equations were used to examine the group differences at 1-year and 3-year follow-ups. Results Approximately half of the participants completed the assessment at 1-year (149/300, 49.7%) and 3-year (177/300, 59%) follow-ups. At 1-year follow-up, participants in the intervention group reported significant reduction in depressive symptoms compared with the control group (CES-D: from 23.9 to 18.1 in the intervention group vs from 24.3 to 23.3 in the control group; mean −4.79, SD 13.56; 95% CI −7.78 to −1.81; P=.002). At 3-year follow-up, between-group difference in CES-D remained statistically significant (from 23.9 to 20.5 in the intervention group vs from 24.3 to 24.4 in the control group; mean −3.63, SD 13.35; 95% CI −6.71 to −0.54; P=.02). No adverse events were reported during the 3-year follow-up period. Conclusions The mHealth intervention, Run4Love, significantly reduced depressive symptoms among people living with HIV, and the intervention effects were sustained at 1-year and 3-year follow-ups. Further research is needed to explore the mechanisms of the long-term effects of mHealth interventions such as Run4Love and to implement these effective interventions among people living with HIV. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR-IPR-17012606 International Registered Report Identifier (IRRID) RR2-10.2196/10274
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Affiliation(s)
- Yan Guo
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Yingqi Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuanchuan Yu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - He Xu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Xiaolan Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Nanxiang Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yu Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Aliza Monroe-Wise
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Aihua Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Department of Health Service and Management, Guangzhou Xinhua University, Guangzhou, China
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13
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Li Y, Guo Y, Hong YA, Zeng Y, Monroe-Wise A, Zeng C, Zhu M, Zhang H, Qiao J, Xu Z, Cai W, Li L, Liu C. Dose-Response Effects of Patient Engagement on Health Outcomes in an mHealth Intervention: Secondary Analysis of a Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e25586. [PMID: 34982724 PMCID: PMC8767469 DOI: 10.2196/25586] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/04/2021] [Accepted: 11/12/2021] [Indexed: 12/16/2022] Open
Abstract
Background The dose–response relationship between patient engagement and long-term intervention effects in mobile health (mHealth) interventions are understudied. Studies exploring long-term and potentially changing relationships between patient engagement and health outcomes in mHealth interventions are needed. Objective This study aims to examine dose–response relationships between patient engagement and 3 psychosocial outcomes in an mHealth intervention, Run4Love, using repeated measurements of outcomes at baseline and 3, 6, and 9 months. Methods This study is a secondary analysis using longitudinal data from the Run4Love trial, a randomized controlled trial with 300 people living with HIV and elevated depressive symptoms to examine the effects of a 3-month mHealth intervention on reducing depressive symptoms and improving quality of life (QOL). We examined the relationships between patient engagement and depressive symptoms, QOL, and perceived stress in the intervention group (N=150) using 4–time-point outcome measurements. Patient engagement was assessed using the completion rate of course assignments and frequency of items completed. Cluster analysis was used to categorize patients into high- and low-engagement groups. Generalized linear mixed effects models were conducted to investigate the dose–response relationships between patient engagement and outcomes. Results The cluster analysis identified 2 clusters that were distinctively different from each other. The first cluster comprised 72 participants with good compliance to the intervention, completing an average of 74% (53/72) of intervention items (IQR 0.22). The second cluster comprised 78 participants with low compliance to the intervention, completing an average of 15% (11/72) of intervention items (IQR 0.23). Results of the generalized linear mixed effects models showed that, compared with the low-engagement group, the high-engagement group had a significant reduction in more depressive symptoms (β=−1.93; P=.008) and perceived stress (β=−1.72; P<.001) and an improved QOL (β=2.41; P=.01) over 9 months. From baseline to 3, 6, and 9 months, the differences in depressive symptoms between the 2 engagement groups were 0.8, 1.6, 2.3, and 3.7 points, respectively, indicating widening between-group differences over time. Similarly, between-group differences in QOL and perceived stress increased over time (group differences in QOL: 0.9, 1.9, 4.7, and 5.1 points, respectively; group differences in the Perceived Stress Scale: 0.9, 1.4, 2.3, and 3.0 points, respectively). Conclusions This study revealed a positive long-term dose–response relationship between patient engagement and 3 psychosocial outcomes among people living with HIV and elevated depressive symptoms in an mHealth intervention over 9 months using 4 time-point repeat measurement data. The high- and low-engagement groups showed significant and widening differences in depressive symptoms, QOL, and perceived stress at the 3-, 6-, and 9-month follow-ups. Future mHealth interventions should improve patient engagement to achieve long-term and sustained intervention effects. Trial Registration Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019
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Affiliation(s)
- Yiran Li
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Yan Guo
- Department of Medical Statistics, School of Public Health, Guangzhou, China.,Sun Yat-sen Center for Global Health, Guangzhou, China.,Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Yu Zeng
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Aliza Monroe-Wise
- Department of Global Health, University of Washington, Seattle, WA, United States
| | - Chengbo Zeng
- South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Mengting Zhu
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiaying Qiao
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Zhimeng Xu
- Department of Medical Statistics, School of Public Health, Guangzhou, China
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China
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14
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Lin B, Liu J, Ma Y, Zhong X. Factors influencing HIV testing and counselling services among men who have sex with men in Western China: a cross-sectional study based on Andersen’s Behavioral Model. Environ Health Prev Med 2022; 27:21. [PMID: 35644545 PMCID: PMC9251615 DOI: 10.1265/ehpm.22-00066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Men who have sex with men (MSM), as a marginal population, has been largely ignored by health service projects. We assessed the utilization of HIV testing and counselling services and its influencing factors based on Andersen’s Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation for these population. Method This was a cross-sectional study. A sample survey was conducted in Western China, and an anonymous self-administered questionnaire survey was conducted among MSM. Based on Andersen’s Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of HIV testing and counselling. Results There were 3184 valid questionnaires. In the survey of HIV health services, 82.85% MSM had HIV testing and 64.98% MSM had HIV counselling, respectively. Among the predisposing factor, age 25 years old and over was a facilitator of HIV testing and counselling, and ethnicity was a factor associated with HIV testing. Among the enabling factor, MSM living in urban were more likely to have access to testing and counselling services, and income was also linked to HIV testing. Among the need factor, a high level of HIV knowledge could promote testing and counselling, and a history of sexually transmitted diseases (STD) was a facilitator of testing. Conclusions HIV testing is widespread in Western China and higher than counselling service. MSM with high-risk characteristics should be identified as a priority in the future public health services.
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Affiliation(s)
- Bing Lin
- School of Public Health and Management, Research Center for Medicine and Social Development, Chongqing Medical University
| | - Jiaxiu Liu
- School of Medical Informatics, Chongqing Medical University
| | - Yingjie Ma
- School of Public Health and Management, Research Center for Medicine and Social Development, Chongqing Medical University
| | - Xiaoni Zhong
- School of Public Health and Management, Research Center for Medicine and Social Development, Chongqing Medical University
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15
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Bao Y, Wang C, Xu H, Lai Y, Yan Y, Ma Y, Yu T, Wu Y. Effect of mHealth intervention for pulmonary tuberculosis self-management based on the Integrated Theory of Health Behavior Change (ITHBC): a randomized controlled trial (Preprint). JMIR Public Health Surveill 2021; 8:e34277. [PMID: 35834302 PMCID: PMC9335179 DOI: 10.2196/34277] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 02/26/2022] [Accepted: 04/26/2022] [Indexed: 01/18/2023] Open
Abstract
Background Improving the health self-management level of patients with tuberculosis (TB) is significant for reducing drug resistance, improving the cure rate, and controlling the prevalence of TB. Mobile health (mHealth) interventions based on behavioral science theories may be promising to achieve this goal. Objective This study aims to explore and conduct an mHealth intervention based on the Integrated Theory of Health Behavior Change (ITHBC) in patients with pulmonary TB to increase their ability of self-care management. Methods A prospective randomized controlled study was conducted from May to November 2020. A total of 114 patients who were admitted consecutively to the TB clinic of Harbin Chest Hospital, China from May 2020 to August 2020 were recruited by convenience sampling. Patients were divided into the control group and intervention group, and all received a 3-month intervention. Patients in the intervention group and the control group received routine medical and nursing care in the TB clinic, including the supervision of their medications. In addition, pharmacist-assisted mHealth (WeChat) intervention based on the ITHBC theory about TB management was provided to the intervention group. The primary outcome was self-management behavior, while the secondary outcomes were TB awareness, self-efficacy, social support, and degree of satisfaction with health education. The outcomes were measured using web-based self-designed and standard questionnaires administered at baseline and at the end point of the study. Intergroup data were assessed using the Mann-Whitney U test, whereas intragroup data were assessed with the Wilcoxon test (for paired samples). Results A total of 112 patients (59 in intervention group and 53 in control group) completed the study. After the intervention, a statistically significant increase was noted in the scores of each item of self-care management behaviors compared with the scores at the baseline (P<.001) in the intervention group. The scores of all self-care management behaviors of the control group were lower than those of all self-care management behaviors in the intervention group (all P<.05), except for the item “cover your mouth and nose when coughing or sneezing” (P=.23) and item “wash hands properly” (P=.60), which had no statistically significant difference from those in the intervention group. Compared with those at baseline, TB knowledge awareness, self-efficacy, social support, and degree of satisfaction with health education in the intervention group increased significantly (P<.001), and the intervention group had significantly higher scores than the control group (P<.001). Conclusions mHealth intervention for TB self-management based on ITHBC could deepen the understanding of patients with TB about their disease and improve their objective initiative and self-care management behaviors, which were beneficial for promoting compliance behavior and quality of prevention and control for pulmonary TB. Trial Registration Chinese Clinical Trial Registry ChiCTR2200055557; https://tinyurl.com/4ray3xnw
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Affiliation(s)
- Yuhan Bao
- Health Clinic, Changzhou Institute of Technology, Changzhou, China
| | - Chunxiang Wang
- School of Sciences, Changzhou Institute of Technology, Changzhou, China
| | - Haiping Xu
- School of Pharmaceutical Sciences, Shandong University, Jinan, China
| | - Yongjie Lai
- School of Pharmaceutical Sciences, Shandong University, Jinan, China
| | - Yupei Yan
- Department of Humanities, Arts and Media, Changzhi Medical College, Changzhi, China
| | - Yuanyuan Ma
- School of Public Health, Shandong University, Jinan, China
| | - Ting Yu
- School of Public Health, Shandong University, Jinan, China
| | - Yibo Wu
- School of Public Health, Peking University, Beijing, China
- Key Research Base of Philosophy and Social Sciences in Shaanxi Province, Health Culture Research Center of Shaanxi, Xi'an, China
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16
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Ibeneme SC, Ndukwu SC, Myezwa H, Irem FO, Ezenwankwo FE, Ajidahun AT, Ezuma AD, Nnamani A, Onodugo O, Fortwengel G, Uwakwe VC. Effectiveness of mobile text reminder in improving adherence to medication, physical exercise, and quality of life in patients living with HIV: a systematic review. BMC Infect Dis 2021; 21:859. [PMID: 34425789 PMCID: PMC8381579 DOI: 10.1186/s12879-021-06563-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 08/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background Mobile text reminder (SMS) system is considered a viable strategy for targeting/facilitating healthy behavioural change including adherence to prescribed physical exercises (PE) and medication (antiretroviral therapy-ART) which should improve the quality of life (Qol) in people living with HIV/AIDS(PLWHA). Thus, the literature was appraised for evidence of SMS effectiveness in improving ART and PE adherence behaviours and QoL in PLWHA. Methods Eight databases–AMED, CINAHL, Cochrane Library, EMBASE, EMCARE, Ovid MEDLINE, PsycINFO, and PubMed-were searched up to December 2020, using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol.This review included only randomised control trials (RCTs) investigating the effectiveness of SMS in improving QoL or PE or ART adherence behaviour or a combination of these variables in PLWHA >18 years. Two independent reviewers determined the eligibility of the studies. Data were extracted and the quality of the study was assessed with the Physiotherapy Evidence Database (PEDro) tool. The primary outcomes were ART and PE adherence behaviours while the secondary outcome was QoL. Result A pooled estimate of effect was not calculated due to the heterogeneity of methods and outcome measures. Therefore, a narrative synthesis of ten studies that met the inclusion criteria (n = 1621 participants at study completion) comprising males/females, aged ≥ 18 years, was done. There was a significant improvement in ART adherence behaviour except in three underpowered studies. Only the SMS interventions that were developed using the Starks 3-steps Adherence model was associated with positive outcome. The only study that evaluated QoL was underpowered and reported no significant change while there were no RCTs on PE. Conclusion Effects of SMS intervention trends towards a significant improvement in ART adherence behaviour in PLWHA. It is plausible that SMS reminders developed using the broader framework of the interpersonal health behaviour theory(ies) may have positive outcome. Nevertheless, the observed heterogeneity in the methods/outcome measures warrants a cautious interpretation of the findings. There is a lack/paucity of RCTs and therefore no evidence in support of the effectiveness of SMS intervention in improving PE adherence and QoL. Registration number NPLASY202060016. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06563-0.
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Affiliation(s)
- Sam Chidi Ibeneme
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria. .,Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa. .,University of Nigeria Centre for Clinical Trials (UNNCET), Enugu Campus, Enugu, Nigeria.
| | - Sandra C Ndukwu
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Hellen Myezwa
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Franklin Onyedinma Irem
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Fortune Elochukwu Ezenwankwo
- Division of Exercise Science and Sports Medicine, University of Cape Town/Sports Science Institute of South Africa, Cape Town, South Africa
| | - Adedayo Tunde Ajidahun
- Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa
| | - Amarachi D Ezuma
- Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
| | - Amaka Nnamani
- Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Obinna Onodugo
- Department of Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Gerhard Fortwengel
- Fakultat III, Hochschule Hannover - University of Applied Sciences and Arts, Hannover, Germany
| | - Victor C Uwakwe
- Department of Medical Rehabilitation, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria
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17
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Yu Z, Liu Y, Yu Y, Han H, Li Y. The Study on Public-Interest Short Message Service (SMS) in China during the COVID-19 Pandemic: Mobile User Survey and Content Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7915. [PMID: 34360208 PMCID: PMC8345619 DOI: 10.3390/ijerph18157915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 01/13/2023]
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) has greatly threatened the global health system and triggered the public health emergency. In order to manage the COVID-19 pandemic, healthcare and prevention information have been delivered through omni-media channels (e.g., television, radio, social platform, etc.). As a traditional outlet, the short message service (SMS) can timely provide abundant anti-epidemic alerts to mobile users. In this paper, we aim to investigate mobile users' attitudes toward COVID-19 public-interest SMS sent from government authorities and then explore the insight from messaging texts collected between January and April 2020 in China. In general, respondents show a positive attitude towards content and the necessity of public-interest SMS during the pandemic. However, we find that gender and age differences not only affect content evaluation, but also influence reading and forwarding behaviors. For the necessity of SMS, it shows significant difference between the 18-25-year-old and over 40-year-old group, with the middle and elder group showing serious attitudes and giving higher remarks than the youth due to the habits of media usage. However no significant difference is presented between females and males. In terms of content, the category of topics and releasing institutions are analyzed, respectively. Due to the centralized responses and coordination of prevention and control in China, the messages from COVID-19 disposal organizations (e.g., municipal steering group and provincial CDC) account for more than 70% among four cities.
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Affiliation(s)
- Zhiyuan Yu
- School of Journalism and Communication, Shandong University, Jinan 250100, China; (Z.Y.); (Y.L.); (H.H.); (Y.L.)
| | - Yanghongyun Liu
- School of Journalism and Communication, Shandong University, Jinan 250100, China; (Z.Y.); (Y.L.); (H.H.); (Y.L.)
| | - Yongan Yu
- School of Physical Education, Shandong University, Jinan 250061, China
| | - Hongju Han
- School of Journalism and Communication, Shandong University, Jinan 250100, China; (Z.Y.); (Y.L.); (H.H.); (Y.L.)
| | - Yalin Li
- School of Journalism and Communication, Shandong University, Jinan 250100, China; (Z.Y.); (Y.L.); (H.H.); (Y.L.)
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18
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Fan Z, Yin W, Zhang H, Wang D, Fan C, Chen Z, Hu J, Ma D, Guo H. COVID-19 Information Dissemination Using the WeChat Communication Index: Retrospective Analysis Study. J Med Internet Res 2021; 23:e28563. [PMID: 34129515 PMCID: PMC8288647 DOI: 10.2196/28563] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/28/2021] [Accepted: 06/10/2021] [Indexed: 01/26/2023] Open
Abstract
Background The COVID-19 outbreak has tremendously impacted the world. The number of confirmed cases has continued to increase, causing damage to society and the economy worldwide. The public pays close attention to information on the pandemic and learns about the disease through various media outlets. The dissemination of comprehensive and accurate COVID-19 information that the public needs helps to educate people so they can take preventive measures. Objective This study aimed to examine the dissemination of COVID-19 information by analyzing the information released by the official WeChat account of the People’s Daily during the pandemic. The most-read COVID-19 information in China was summarized, and the factors that influence information dissemination were studied to understand the characteristics that affect its dissemination. Moreover, this was conducted in order to identify how to effectively disseminate COVID-19 information and to provide suggestions on how to manage public opinion and information governance during a pandemic. Methods This was a retrospective study based on a WeChat official account. We collected all COVID-19–related information, starting with the first report about COVID-19 from the People’s Daily and ending with the last piece of information about lifting the first-level emergency response in 34 Chinese provinces. A descriptive analysis was then conducted on this information, as well as on Qingbo Big Data’s dissemination index. Multiple linear regression was utilized to study the factors that affected information dissemination based on various characteristics and the dissemination index. Results From January 19 to May 2, 2020, the People’s Daily released 1984 pieces of information; 1621 were related to COVID-19, which mainly included headline news items, items with emotional content, and issues related to the pandemic’s development. By analyzing the dissemination index, seven information dissemination peaks were discerned. Among the three dimensions of COVID-19 information—media salience, content, and format—eight factors affected the spread of COVID-19 information. Conclusions Different types of pandemic-related information have varying dissemination power. To effectively disseminate information and prevent the spread of COVID-19, we should identify the factors that affect this dissemination. We should then disseminate the types of information the public is most concerned about, use information to educate people to improve their health literacy, and improve public opinion and information governance.
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Affiliation(s)
- Zina Fan
- School of Management, Weifang Medical University, Weifang, Shandong, China.,"Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, Shandong, China
| | - Wenqiang Yin
- School of Management, Weifang Medical University, Weifang, Shandong, China.,Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Han Zhang
- School of Management, Weifang Medical University, Weifang, Shandong, China.,"Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, Shandong, China
| | - Dandan Wang
- School of Management, Weifang Medical University, Weifang, Shandong, China.,"Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, Shandong, China
| | - Chengxin Fan
- School of Management, Weifang Medical University, Weifang, Shandong, China.,"Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, Shandong, China
| | - Zhongming Chen
- School of Management, Weifang Medical University, Weifang, Shandong, China.,Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Jinwei Hu
- School of Management, Weifang Medical University, Weifang, Shandong, China.,Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Dongping Ma
- School of Management, Weifang Medical University, Weifang, Shandong, China.,Collaborative Innovation Center of Social Risks Governance in Health, Shanghai, China
| | - Hongwei Guo
- School of Management, Weifang Medical University, Weifang, Shandong, China.,"Health Shandong" Collaborative Innovation Center for Severe Social Risk Prediction and Governance, Weifang, Shandong, China
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19
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Digital health for sexually transmitted infection and HIV services: a global scoping review. Curr Opin Infect Dis 2021; 33:44-50. [PMID: 31789695 DOI: 10.1097/qco.0000000000000619] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The current study aimed to review how digital health has been used for sexually transmitted infection (STI)/HIV prevention, testing, and treatment. RECENT FINDINGS A scoping review was conducted by searching five databases for peer-reviewed literature published between March 2018 to August 2019. 23 out of 258 studies met the inclusion criteria and were assessed. Six studies used digital platform to enhance STI/HIV prevention messaging; four studies found that digital health can provide vivid promotional information and has been instrumental in increasing the accessibility and acceptability of STI/HIV testing; three studies reported digital health provides a channel to understand and interpret the discourses on preexposure prophylaxis (PrEP) and increase PrEP uptake; three studies focused on refining big data algorithms for surveillance; four studies reported on how digital interventions could be used to optimize clinical interventions; and four studies found digital interventions can be used to assist mental health services. SUMMARY Digital health is a powerful and versatile tool that can be utilized in the production of high-quality, innovative strategies on STIs and HIV services. Future studies should consider focusing on strategies and implementations that leverage digital platforms for network-based interventions, in addition to recognizing the norms of individual digital intervention platforms.
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20
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Lee M, You M. Effects of COVID-19 Emergency Alert Text Messages on Practicing Preventive Behaviors: Cross-sectional Web-Based Survey in South Korea. J Med Internet Res 2021; 23:e24165. [PMID: 33544691 PMCID: PMC7909457 DOI: 10.2196/24165] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/23/2020] [Accepted: 02/04/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Sending emergency messages via mobile phone text messaging can be a promising communication tool to rapidly disseminate information and promote preventive behavior among the public during epidemic outbreaks. The battle to overcome COVID-19 is not yet over; thus, it is essential that the public practices preventive measures to prevent the spread of COVID-19. OBJECTIVE This study aimed to investigate the effectiveness of reading and obtaining information via emergency alert SMS text messages and their effects on the individual's practice of preventive behaviors during the early stages of the COVID-19 outbreak in South Korea. METHODS A cross-sectional web-based survey comprising 990 participants was conducted over 3 days (March 25-27, 2020). A multivariable logistic regression analysis revealed the sociodemographic factors that might influence the behavior of reading emergency alert text messages. A hierarchical linear regression model estimated the associations between reading emergency alert text messages for each precautionary behavior practiced against COVID-19. Additionally, the indirect effects of reading the text messages on each precautionary behavior via psychological factors (ie, perceived risk and response efficacy) were calculated. All data were weighted according to the 2019 Korea census data. RESULTS Overall, 49.2% (487/990) of the participants reported that they always read emergency alert text messages and visited the linked website to obtain more information. Factors such as female sex (odds ratio [OR] 1.68, 95% CI 1.28-2.21) and older age (30-39 years: OR 2.02, 95% CI 1.25-3.28; 40-49 years: OR 2.84, 95% CI 1.80-4.47; 50-59 years: OR 3.19, 95% CI 2.01-5.06; 60 years and above: OR 3.12, 95% CI 2.00-4.86 versus 18-29 years) were identified to be associated with a higher frequency of reading the text messages. Participants who always read the text messages practiced wearing facial masks (β=.074, P=.01) more frequently than those who did not. In terms of social distancing, participants who reported they always read the text messages avoided crowded places (β=.078, P=.01) and canceled or postponed social gatherings (β=.103, P<.001) more frequently than those who did not read the text messages. Furthermore, reading text messages directly and indirectly affected practicing precautionary behaviors, as the mediation effect of response efficacy between reading text messages and practicing preventive behaviors was significant. CONCLUSIONS Our findings suggest that emergency alert text messages sent to individuals' mobile phones are timely and effective strategies for encouraging preventive behavior in public. Sending emergency alert text messages to provide the public with accurate and reliable information could be positively considered by the health authorities, which might reduce the negative impact of infodemics.
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Affiliation(s)
- Minjung Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.,Office of Dental Education, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Myoungsoon You
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
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21
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Xiao Y, Shao Y, Na Z, Zhao W, Wang R, Fang S, Tan X, Shan L, Yu G, Wang J. A Systematic Review and Meta-analysis of Telephone-Based Therapy Targeting Depressive Symptoms Among Low-Income People Living with HIV. AIDS Behav 2021; 25:414-426. [PMID: 32809074 DOI: 10.1007/s10461-020-02999-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
People living with human immunodeficiency virus (PLWH) has been reported to have a high prevalence of depressive symptoms. Low-income populations account for a large proportion of PLWH, hence indicating a high level of depressive symptoms in low-income PLWH. Telephone-based therapy has been shown to be effective for treating PLWH's depressive symptoms, but its effects among low-income PLWH remain unclear. The purpose of this meta-analysis was to evaluate the effects of telephone-based therapy targeting depressive symptoms among low-income PLWH. Six databases (PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, VIP Database and Wanfang Data) were searched until May 2020 using search terms related to telephone-based therapy, depressive symptoms, and PLWH. Eight studies were included in the meta-analysis. Both postintervention effects (primary outcome) and long-term effects (secondary outcome) were evaluated using a random effects model. The meta-analysis revealed a small to moderate effect size (ĝ = - 0.29, 95% CI - 0.51, - 0.06) on reducing depressive symptom scores (Z = 2.51, p = 0.01) in telephone-based intervention group compared with the control group at postintervention. However, there was no statistically significant long-term effects (Z = 0.77, p = 0.44) at follow-up. For postintervention effects, calculation of the I2 index indicated moderate heterogeneity (I2 = 50%); sensitivity analysis and subgroup analysis were performed to explore the source of heterogeneity. Ethnic group was classified into minority and majority which refers to most of the population were ethnic minority and majority respectively. Between-group differences were found across ethnic groups. The results suggested that there was a slightly stronger effect of telephone-based therapy in low-income PLWH than among PLWH in general, but its long-term effect requires future investigation. The effects of the intervention were better among the ethnic majority subgroups of low-income PLWH. Treatment format and intervention duration might also influence the intervention effects. However, the overall quality of evidence was low and directly impacted on the interpretation of our results, suggesting that more high-quality random controlled trial (RCT)/longitudinal studies with less selection and detection bias, less inconsistency and less indirectness are needed when applying telephone-based therapy to low-income PLWH with depressive symptoms in further studies.
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22
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Lim E, Davis J, Siriwardhana C, Aggarwal L, Hixon A, Chen JJ. Racial/ethnic differences in health-related quality of life among Hawaii adult population. Health Qual Life Outcomes 2020; 18:380. [PMID: 33298089 PMCID: PMC7724821 DOI: 10.1186/s12955-020-01625-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background This study examined racial/ethnic differences in health-related quality of life (HRQOL) among adults and identified variables associated with HRQOL by race/ethnicity.
Methods This study was conducted under a cross-sectional design. We used the 2011–2016 Hawaii Behavioral Risk Factor Surveillance System data. HRQOL were assessed by four measures: self-rated general health, physically unhealthy days, mentally unhealthy days, and days with activity limitation. Distress was defined as fair/poor for general health and 14 days or more for each of the other three HRQOL measures. We conducted multivariable logistic regressions with variables guided by Anderson’s behavioral model on each distress measure by race/ethnicity. Results Among Hawaii adults, 30.4% were White, 20.9% Japanese, 16.8% Filipino, 14.6% Native Hawaiian and Pacific Islander (NHPI), 5.9% Chinese, 5.2% Hispanics, and 6.2% Other. We found significant racial/ethnic differences in the HRQOL measures. Compared to Whites, Filipinos, Japanese, NHPIs, and Hispanics showed higher distress rates in general health, while Filipinos and Japanese showed lower distress rates in the other HRQOL measures. Although no variables were consistently associated with all four HRQOL measures across all racial/ethnic groups, history of diabetes were significantly associated with general health across all racial/ethnic groups and history of depression was associated with at least three of the HRQOL measure across all racial/ethnic groups. Conclusions This study contributes to the literature on disparities in HRQOL and its association with other variables among diverse racial/ethnic subgroups. Knowing the common factors for HRQOL across different racial/ethnic groups and factors specific to different racial/ethnic groups will provide valuable information for identifying future public health priorities to improve quality of life and reduce health disparities.
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Affiliation(s)
- Eunjung Lim
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Medical Education Building, Suite 411, Honolulu, HI, 96813, USA.
| | - James Davis
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Medical Education Building, Suite 411, Honolulu, HI, 96813, USA
| | - Chathura Siriwardhana
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Medical Education Building, Suite 411, Honolulu, HI, 96813, USA
| | - Lovedhi Aggarwal
- Department of Family, Population & Preventive Medicine, Stony Brook University Medical Center, HSC L3, Rm 086, Stony Brook, NY, 11794-8036, USA.,Department of Family Medicine, John A. Burns School of Medicine, University of Hawaii, Family Medicine at the Physician Center at Mililani, 95-390 Kuahelani AVE, Mililani, HI, 96789, USA
| | - Allen Hixon
- Department of Family Medicine, John A. Burns School of Medicine, University of Hawaii, Family Medicine at the Physician Center at Mililani, 95-390 Kuahelani AVE, Mililani, HI, 96789, USA
| | - John J Chen
- Department of Quantitative Health Sciences, John A. Burns School of Medicine, University of Hawaii, 651 Ilalo Street, Medical Education Building, Suite 411, Honolulu, HI, 96813, USA
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23
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The Evaluation of the Effect of ICT in HIV Prevention in the General Population in China Based on an Information-Motivation-Behavioral Skill Model. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8786467. [PMID: 33178835 PMCID: PMC7644314 DOI: 10.1155/2020/8786467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/26/2020] [Accepted: 10/09/2020] [Indexed: 11/18/2022]
Abstract
Objectives With an increase in human immunodeficiency virus (HIV) infection, the application of information and communication technology (ICT) is considered as a helpful solution. The aim of this study is to evaluate the effect of ICT in HIV prevention in the general population based on an information-motivation-behavioral skill (IMB) model. Methods A national follow-up study on the evaluation of ICT on HIV health education effects before and after large sample intervention was conducted in 16 provinces of China. ICT was used to carry out a six-month educational program on the prevention of HIV for participants using the WeChat platform. The research group conducted a second questionnaire for participants to collect data and built the IMB model using Mplus 7.0 analysis software. Results A total of 997 questionnaires were sent, and 957 effective questionnaires were recovered, a recovery rate of 96.0%. Before the ICT intervention, the scores of information was 15.68 ± 3.28, of motivation was 14.47 ± 4.26, of behavior skills was 2.26 ± 1.08, and of condom use was 2.19 ± 1.15. After the ICT intervention, the scores for information (18.54 ± 2.48), motivation (16.06 ± 4.11), behavior skills (4.74 ± 1.04), and condom use (2.64 ± 1.15) improved significantly. ICT use had a significant regression effect on motivation (β = 0.237, P < 0.001), behavior skills (β = 0.997, P < 0.001), and information (β = 0.441, P < 0.001), while motivation (β = 0.196, P < 0.001), behavior skills (β = 0.207, P < 0.001), and information (β = 0.092, P < 0.001) had a significant regression effect on condom use. Conclusions The ICT intervention can not only improve information about HIV prevention, motivation, and behavior skills but also promote the use of condoms, so as to achieve the result of promoting behaviors that act to prevent AIDS within the general population.
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24
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Lee SB, Valerius J. mHealth Interventions to Promote Anti-Retroviral Adherence in HIV: Narrative Review. JMIR Mhealth Uhealth 2020; 8:e14739. [PMID: 32568720 PMCID: PMC7486676 DOI: 10.2196/14739] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 02/24/2020] [Accepted: 06/15/2020] [Indexed: 01/19/2023] Open
Abstract
Background Antiretrovirals (ARVs) are key in the management of HIV. Although no cure exists, ARVs help patients live healthy lives and prevent transmission to others. Adherence to complex regimens is paramount to outcomes and in avoiding the emergence of drug-resistant viruses. The goal of therapy is to reach an undetectable viral load. However, adherence is a common problem, stemming from issues such as mental health, chaotic home situations, and busy work schedules. Mobile health (mHealth) represents a new approach in improving medication adherence, and multiple studies have been performed in this area. Objective This study aims to review the current implementation of mHealth in the management of HIV among different groups of patients. Methods We used PubMed, Academic Search Elite, and 1 journal database with various search terms to review the current implementation of mHealth in HIV care. Results Titles and abstracts were screened, and 61 papers were identified and fully reviewed. The literature was divided into lower- and higher-income nations, as defined by the United Nations. A total of 20 studies with quantitative results were identified, with 10 being text- and SMS-based interventions (the majority of these being in lower-income countries) and 8 being smartphone-based apps (primarily in higher-income countries). The majority of these studies determined whether there was an effect on adherence or biochemical parameters (viral load and CD4 count). Various qualitative studies have also been conducted, and many have focused on determining the specific design of interventions that were successful (frequency of messaging, types of messages, etc) as well as priorities for patients with regard to mHealth interventions. Conclusions There seems to be a role of mHealth in the management of HIV in lower-income nations; however, the optimal design of an intervention needs to be delineated. In higher-income countries, where the 2 significant risk factors were injection drugs and men who have sex with men, the benefit was less clear, and more research is needed.
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Affiliation(s)
- Stephen B Lee
- Department of Medicine, Division of Infectious Diseases, University of Saskatchewan College of Medicine, Regina, SK, Canada.,Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, United States
| | - Joanne Valerius
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, United States
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25
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Cheng LJ, Kumar PA, Wong SN, Lau Y. Technology-Delivered Psychotherapeutic Interventions in Improving Depressive Symptoms Among People with HIV/AIDS: A Systematic Review and Meta-analysis of Randomised Controlled Trials. AIDS Behav 2020; 24:1663-1675. [PMID: 31587115 DOI: 10.1007/s10461-019-02691-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
With the increasing popularity of advanced technology, technology-delivered psychotherapeutic interventions (TPIs) may play a promising role in improving depressive symptoms among PLWHA. However, its effectiveness remains unclear. We aimed to synthesise the evidence of the effectiveness of TPIs in improving depressive symptoms of PLWHA using a meta-analytic approach. Seven databases were systematically searched for randomised controlled trials (RCTs) from the inception until August 14, 2018. Random-effects meta-analysis was adopted to assess effect size. Cochran's Q test and I2 were used to investigate the problem of heterogeneity. Sensitivity, subgroup analyses and meta-regression were performed. Of the 43,048 records identified, 14 RCTs were included. The meta-analysis revealed a small effect on reducing depressive symptom scores (d = 0.23, 95% CI - 0.39 to - 0.06) after TPIs. Random-effects meta-regression showed that publication year was a significant moderator (p = 0.013), whereby the latest trials had larger effect size in reducing the depressive symptoms than earlier trials. Our review suggested a possible future approach of utilising TPIs by means of mobile applications and internet-based interventions for PLWHA to reduce their depressive symptoms. This review highlighted the essential key features in designing future TPIs. The overall low-quality evidence suggested the need to conduct further high-quality.
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26
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Zhai P, Hayat K, Ji W, Li Q, Shi L, Atif N, Xu S, Li P, Du Q, Fang Y. Efficacy of Text Messaging and Personal Consultation by Pharmacy Students Among Adults With Hypertension: Randomized Controlled Trial. J Med Internet Res 2020; 22:e16019. [PMID: 32432556 PMCID: PMC7270845 DOI: 10.2196/16019] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/11/2019] [Accepted: 01/26/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Hypertension is one of the leading risk factors for ischemic heart diseases, and high rates of hypertension prevalence have either remained the same or increased in developing countries in recent years. Unfortunately, about 20% to 50% of patients with chronic diseases have been nonadherent to their drug therapy. SMS text messaging and pharmacy student-led consultations have the potential to help patients manage their blood pressure (BP). OBJECTIVE The aim of this study was to assess the effectiveness, feasibility, and acceptability of SMS text messaging and consultation to manage the BP of Chinese patients with hypertension. METHODS We conducted a two-arm cluster randomized controlled trial among patients with hypertension in Xi'an City, Shaanxi Province, China, and recruited 384 patients from 8 community health care centers. Patients were randomized into an intervention group to receive SMS text messages and consultations or into a control group to receive usual care for 3 months. We sent SMS text messages at 3-day intervals and collected data at baseline (including demographics, clinical outcomes, medication complexity, side effects, patient behavior, knowledge about hypertension, BP, and medication adherence) and the 3-month follow-up (including BP, medication adherence, and knowledge about hypertension). RESULTS We assessed 445 patients with hypertension and excluded 61 patients who were not eligible or who had not filled out their questionnaires. The mean age of the patients was 68.5 (SD 7.9) years in the intervention group and 69.4 (SD 9.7) years in the control group, and the sample was primarily female (265/384, 69.0%). Patients in the intervention group showed significant improvements in systolic BP (SBP; mean 134.5 mm Hg, SD 15.5 mm Hg vs mean 140.7 mm Hg, SD 15.2 mm Hg; P=.001), medication adherence (mean 7.4, SD 1.2 vs mean 7.0, SD 1.3; P=.04), and knowledge about hypertension (mean 6.3, SD 0.9 vs mean 5.9, SD 1.2; P=.004) compared with those in the control group. In measures of diastolic BP (DBP), the two arms showed nonsignificant improvements (mean 78.2 mm Hg, SD 9.0 mm Hg vs mean 77.2 mm Hg, SD 10.3 mm Hg; P=.06). In total, 176 patients had controlled BP at the 3-month follow-up (98 patients in the intervention group vs 78 patients in the control group), but it was nonsignificant (P=.08). CONCLUSIONS The use of SMS text messaging and consultation to manage SBP and improve medication adherence is effective, feasible, and acceptable among Chinese patients with hypertension, although a significant difference was not observed with regard to DBP. It is important to maximize the potential of SMS text messaging and consultation by increasing the feasibility and acceptance of mobile interventions and conduct a cost-effectiveness analysis on this method. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900026862; http://www.chictr.org.cn/showproj.aspx?proj=42717.
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Affiliation(s)
- Panpan Zhai
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China.,Institute of Pharmaceutical Sciences, University of Veternary and Animal Sciences, Lahore, Pakistan
| | - Wenjing Ji
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Qian Li
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Li Shi
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Naveel Atif
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Sen Xu
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Pengchao Li
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Qianqian Du
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University, Xi'an, China.,Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, China.,Shaanxi Center for Health Reform and Development Research, Xi'an Jiaotong University, Xi'an, China
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Wang F, Wang Z, Sun W, Yang X, Bian Z, Shen L, Pan W, Liu P, Chen X, Fu L, Zhang F, Luo D. Evaluating the Quality of Health-Related WeChat Public Accounts: Cross-Sectional Study. JMIR Mhealth Uhealth 2020; 8:e14826. [PMID: 32383684 PMCID: PMC7244997 DOI: 10.2196/14826] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 11/19/2019] [Accepted: 03/12/2020] [Indexed: 12/17/2022] Open
Abstract
Background As representatives of health information communication platforms accessed through mobile phones and mobile terminals, health-related WeChat public accounts (HWPAs) have a large consumer base in the Chinese-speaking world. However, there is still a lack of general understanding of the status quo of HWPAs and the quality of the articles they release. Objective The aims of this study were to assess the conformity of HWPAs to the Health on the Net Foundation Code of Conduct (HONcode) and to evaluate the suitability of articles disseminated by HWPAs. Methods The survey was conducted from April 23 to May 5, 2019. Based on the monthly (March 1-31, 2019) WeChat Index provided by Qingbo Big Data, the top 100 HWPAs were examined to evaluate their HONcode compliance. The first four articles published by each HWPA on the survey dates were selected as samples to evaluate their suitability. All materials were assessed by three raters. The materials were assessed using the HONcode checklist and the Suitability Assessment of Materials (SAM) score sheet. Data analysis was performed with SPSS version 17.0 (SPSS Inc, Chicago, IL, USA) and Excel version 2013 (Microsoft Inc, Washington DC, USA). Results A total of 93 HWPAs and 210 of their released articles were included in this study. For six of the eight principles, the 93 HWPAs nearly consistently did not meet the requirements of the HONcode. The HWPAs certified by Tencent Corporation (66/93, 71%) were generally slightly superior to those without such certification (27/93, 29%) in terms of compliance with HONcode principles. The mean SAM score for the 210 articles was 67.72 (SD 10.930), which indicated “adequate” suitability. There was no significant difference between the SAM scores of the articles published by certified and uncertified HWPAs (P=.07), except in the literacy requirements dimension (tdf=97=–2.418, P=.02). Conclusions The HWPAs had low HONcode conformity. Although the suitability of health information released by HWPAs was at a moderate level, there were still problems identified, such as difficulty in tracing information sources, excessive implicit advertisements, and irregular usage of charts. In addition, the low approval requirements of HWPAs were not conducive to improvement of their service quality.
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Affiliation(s)
- Fuzhi Wang
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China.,Project Team of Outstanding Young Teachers, Bengbu Medical College, Bengbu, China
| | - Zhuoxin Wang
- Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China.,School of Nursing, Bengbu Medical College, Bengbu, China
| | - Weiwei Sun
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Xiumu Yang
- The General Practice Medical Education and Development Center of Anhui Province, Bengbu Medical College, Bengbu, China
| | - Zhiwei Bian
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Lining Shen
- Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China.,School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Wei Pan
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Peng Liu
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Xingzhi Chen
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China
| | - Lianguo Fu
- Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China.,School of Public Health, Bengbu Medical College, Bengbu, China
| | - Fan Zhang
- School of Health Management, Bengbu Medical College, Bengbu, China
| | - Dan Luo
- School of Health Management, Bengbu Medical College, Bengbu, China.,Innovation Team of Health Information Management and Application Research (BYKC201913), Bengbu Medical College, Bengbu, China.,The General Practice Medical Education and Development Center of Anhui Province, Bengbu Medical College, Bengbu, China
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Wagenaar BH, Hammett WH, Jackson C, Atkins DL, Belus JM, Kemp CG. Implementation outcomes and strategies for depression interventions in low- and middle-income countries: a systematic review. Glob Ment Health (Camb) 2020; 7:e7. [PMID: 32346482 PMCID: PMC7176918 DOI: 10.1017/gmh.2020.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/07/2020] [Accepted: 01/22/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND We systematically reviewed implementation research targeting depression interventions in low- and middle-income countries (LMICs) to assess gaps in methodological coverage. METHODS PubMed, CINAHL, PsycINFO, and EMBASE were searched for evaluations of depression interventions in LMICs reporting at least one implementation outcome published through March 2019. RESULTS A total of 8714 studies were screened, 759 were assessed for eligibility, and 79 studies met inclusion criteria. Common implementation outcomes reported were acceptability (n = 50; 63.3%), feasibility (n = 28; 35.4%), and fidelity (n = 18; 22.8%). Only four studies (5.1%) reported adoption or penetration, and three (3.8%) reported sustainability. The Sub-Saharan Africa region (n = 29; 36.7%) had the most studies. The majority of studies (n = 59; 74.7%) reported outcomes for a depression intervention implemented in pilot researcher-controlled settings. Studies commonly focused on Hybrid Type-1 effectiveness-implementation designs (n = 53; 67.1), followed by Hybrid Type-3 (n = 16; 20.3%). Only 21 studies (26.6%) tested an implementation strategy, with the most common being revising professional roles (n = 10; 47.6%). The most common intervention modality was individual psychotherapy (n = 30; 38.0%). Common study designs were mixed methods (n = 27; 34.2%), quasi-experimental uncontrolled pre-post (n = 17; 21.5%), and individual randomized trials (n = 16; 20.3). CONCLUSIONS Existing research has focused on early-stage implementation outcomes. Most studies have utilized Hybrid Type-1 designs, with the primary aim to test intervention effectiveness delivered in researcher-controlled settings. Future research should focus on testing and optimizing implementation strategies to promote scale-up of evidence-based depression interventions in routine care. These studies should use high-quality pragmatic designs and focus on later-stage implementation outcomes such as cost, penetration, and sustainability.
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Affiliation(s)
- Bradley H. Wagenaar
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Wilson H. Hammett
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Courtney Jackson
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Dana L. Atkins
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Jennifer M. Belus
- Department of Psychology, University of Maryland, College Park, MD, USA
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Guo Y, Hong YA, Cai W, Li L, Hao Y, Qiao J, Xu Z, Zhang H, Zeng C, Liu C, Li Y, Zhu M, Zeng Y, Penedo FJ. Effect of a WeChat-Based Intervention (Run4Love) on Depressive Symptoms Among People Living With HIV in China: A Randomized Controlled Trial. J Med Internet Res 2020; 22:e16715. [PMID: 32044751 PMCID: PMC7058168 DOI: 10.2196/16715] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/26/2019] [Accepted: 12/31/2019] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND People living with HIV (PLWH) have high rates of depressive symptoms. However, only a few effective mental health interventions exist for this vulnerable population. OBJECTIVE The aim of this study was to assess the efficacy of a WeChat-based intervention, Run4Love, with a randomized controlled trial among 300 people living with HIV and depression (PLWHD) in China. METHODS We recruited PLWH from the HIV outpatient clinic in South China. Participants were screened based on the Center for Epidemiologic Studies-Depression (CES-D) scale. Those who scored 16 or higher were eligible to participate. A total of 300 eligible patients were enrolled. After obtaining informed consent from the participants, completion of a baseline survey, and collection of participants' hair samples for measuring cortisol, the participants were randomly assigned to an intervention or a control group in a 1:1 ratio. The intervention group received the Run4Love program, delivered via the popular social media app WeChat. Cognitive behavioral stress management courses and weekly reminders of exercise were delivered in a multimedia format. Participants' progress was monitored with timely and tailored feedback. The control group received usual care and a brochure on nutrition for PLWH. Data were collected at 3, 6, and 9 months. The primary outcome was depression, which was measured by a validated instrument. RESULTS Participants in the intervention and control groups were comparable at baseline; about 91.3% (139/150), 88.3% (132/150), and 86.7% (130/150) participants completed the 3-, 6-, and 9-month follow-ups, respectively. At the 3-month follow-up, a significant reduction in CES-D score was observed in the intervention group (from 23.9 to 17.7 vs from 24.3 to 23.8; mean difference=-5.77, 95% CI -7.82 to -3.71; P<.001; standard effect size d=0.66). The mean changes in CES-D score from baseline to the 6- and 9-month follow-ups between the two groups remained statistically significant. No adverse events were reported. CONCLUSIONS The WeChat-based mobile health (mHealth) intervention Run4Love significantly reduced depressive symptoms among PLWHD, and the effect was sustained. An app-based mHealth intervention could provide a feasible therapeutic option for many PLWHD in resource-limited settings. Further research is needed to assess generalizability and cost-effectiveness of this intervention. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-IPR-17012606; http://www.chictr.org.cn/showproj.aspx?proj=21019 (Archived by WebCite at https://www.webcitation.org/78Bw2vouF).
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Affiliation(s)
- Yan Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Migrant Health Policy, Guangzhou, China
- Sun Yat-sen Center for Global Health, Guangzhou, China
| | - Y Alicia Hong
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Weiping Cai
- Department of Infectious Diseases, Guangzhou Number Eight People's Hospital, Guangzhou, China
| | - Linghua Li
- Department of Infectious Diseases, Guangzhou Number Eight People's Hospital, Guangzhou, China
| | - Yuantao Hao
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
- Sun Yat-sen Center for Global Health, Guangzhou, China
| | - Jiaying Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhimeng Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hanxi Zhang
- National Center of AIDS/STD Control and Prevention, Beijing, China
| | - Chengbo Zeng
- South Carolina SmartState Center of Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Cong Liu
- Department of Infectious Diseases, Guangzhou Number Eight People's Hospital, Guangzhou, China
| | - Yiran Li
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Mengting Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yu Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, United States
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, United States
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Fan X, She R, Liu C, Zhong H, Lau JTF, Hao C, Li J, Hao Y, Li L, Gu J. Evaluation of smartphone APP-based case-management services among antiretroviral treatment-naïve HIV-positive men who have sex with men: a randomized controlled trial protocol. BMC Public Health 2020; 20:85. [PMID: 31959139 PMCID: PMC6971898 DOI: 10.1186/s12889-020-8171-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/07/2020] [Indexed: 01/06/2023] Open
Abstract
Background Men who have sex with men (MSM) are disproportionally affected by HIV in China. ‘Treatment as Prevention’ is a promising strategy for HIV prevention but requires adequate adherence. Mobile health (mHealth) may be an acceptable and feasible approach for service delivery, but there is little evidence supporting mHealth intervention for improving antiretroviral treatment adherence among HIV-infected MSM in low- and middle-income countries, including China. This study will aim to develop a smartphone application-based case-management service and compare its efficacy to standard care with regards to adherence, CD4, HIV viral load and psychosocial outcomes among MSM patients in Guangzhou, China. Methods A non-blinded 1:1 parallel-group randomised controlled trial will be conducted in Guangzhou Eighth People’s Hospital, with 300 MSM enrolled in each arm. Eligible MSM who are newly initiating ART will be randomly assigned to an intervention group (standard-of-care case management plus mHealth intervention) or a control group (standard-of-care case management). The development of the mHealth intervention will be based on the information–motivation–behavioural skills theory of ART adherence, and comprise four components: educational articles, one-to-one online communication with case managers, support-service information and hospital-visit reminders. Outcome measures will be collected at baseline and at months 1, 3, 6, and 12. The primary outcomes will be ART adherence and CD4 count at month 6. Secondary outcomes include HIV RNA, sexual behaviours, mental health status, illness perceptions, and quality of life. χ2 test and t-test will be used for between-group comparisons. Intervention effects will be evaluated using General estimating equation performed by SAS 9.0, on the principle of intention-to-treat. Structural equation modelling will be used to test potential mechanisms of intervention effect. Discussion This study is the first to explore the efficacy of mHealth intervention in the case management services targeted at HIV-infected MSM in low-and middle-income countries. Once proven effective, the innovative mHealth service could be integrated into the routine case management of PLWH. as well as be tailored to the patient management service for other chronic conditions. Trial registration ClinicalTrial.gov: NCT03860116; Registered on 1 March 2019.
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Affiliation(s)
- Xiaoyan Fan
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, People's Republic of China
| | - Rui She
- Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
| | - Cong Liu
- Infectious Disease Centre, Guangzhou Eighth People's Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Haidan Zhong
- Infectious Disease Centre, Guangzhou Eighth People's Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Joseph T F Lau
- Centre for Health Behaviours Research, School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, People's Republic of China.,Centre for Medical Anthropology and Behavioural Health, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Jinghua Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yuantao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, People's Republic of China.,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Linghua Li
- Infectious Disease Centre, Guangzhou Eighth People's Hospital, Guangzhou, Guangdong, People's Republic of China
| | - Jing Gu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong, People's Republic of China. .,Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
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Luo J, Dong X, Hu J. Effect of nursing intervention via a chatting tool on the rehabilitation of patients after Total hip Arthroplasty. J Orthop Surg Res 2019; 14:417. [PMID: 31818330 PMCID: PMC6902538 DOI: 10.1186/s13018-019-1483-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/22/2019] [Indexed: 11/23/2022] Open
Abstract
Background Nursing intervention following discharge is a long-term rehabilitation process that is essential for improving hip joint function and quality of life in affected patients. This study aimed to assess the effect of nursing intervention via WeChat on the rehabilitation of patients after total hip arthroplasty (THA). Methods We conducted a retrospective analysis of 232 patients who underwent THA at our hospital from January 2013 to October 2015. Of the 232 patients, 114 received nursing intervention via telephone (Group A), and 118 received nursing intervention via WeChat (Group B). Furthermore, the Harris hip score and Short-Form 36 (SF-36) health survey score were used to evaluate hip joint function and quality of life in patients in the two groups at discharge and 1, 3 and 6 months following discharge. Moreover, the functional independence measure was applied to assess the recovery of joint function in the patients. Results No significant difference was observed in the Harris hip score and the SF-36 health survey score between the two groups at discharge and 1 month following discharge (p > 0.05). However, the Harris hip score and SF-36 health survey score were lower in group A than in group B at 3 and 6 months following discharge (p < 0.05). Furthermore, no obvious difference was observed in terms of functional independence between the two groups at discharge (p > 0.05). However, more individuals were completely independent in group B than in group A at 1, 3 and 6 months following discharge (p < 0.05). Conclusions Nursing intervention via WeChat can improve the effect of rehabilitation after THA and promote the recovery of joint function in patients.
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Affiliation(s)
- Jing Luo
- Department of Nursing Administration, Honghui Hospital, Xi'an Jiaotong University College of Medicine, 555# You-yi East Road, Xi'an, 710054, Shaanxi, People's Republic of China
| | - Xiaohua Dong
- Department of Cardiovascular, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, People's Republic of China
| | - Jing Hu
- Department of Nursing Administration, Honghui Hospital, Xi'an Jiaotong University College of Medicine, 555# You-yi East Road, Xi'an, 710054, Shaanxi, People's Republic of China.
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Zhu X, Zhang W, Operario D, Zhao Y, Shi A, Zhang Z, Gao P, Perez A, Wang J, Zaller N, Yang C, Sun Y, Zhang H. Effects of a Mobile Health Intervention to Promote HIV Self-testing with MSM in China: A Randomized Controlled Trial. AIDS Behav 2019; 23:3129-3139. [PMID: 30852728 PMCID: PMC6733671 DOI: 10.1007/s10461-019-02452-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study tested a mobile health (mHealth) intervention program entitled WeTest, delivered via the WeChat mobile app, to promote oral HIV self-testing (HIVST) among MSM in Hefei, China. A total of 100 MSM participants enrolled, completed baseline assessment, were randomly assigned to intervention or control, and completed 6-month follow-up surveys. Intervention participants (n = 50) received two oral HIVST kits and access to WeTest, a private WeChat group which provided app-based messages and referrals to health services related to HIV. Control participants (n = 50) received two oral HIVST kits only. All participants received instructions to upload photographic results of their oral HIVST, which were sent to the project counselor via a secure WeChat online portal; immediate contact and referrals were made to any participants who tested HIV-positive. In GEE analyses adjusting for time effects and baseline confounders, intervention participants had significantly higher rates of HIV testing (adjusted rate ratio RR = 1.99, 95% confidence interval (CI) 1.07–3.84) and, in particular, higher rates of testing via oral HIVST (adjusted RR = 2.17, 95% CI 1.08–4.37) compared with the control group. Significant time effects were also found such that all participants, regardless of group allocation, had significantly higher rates of reporting consistent condom use with main partners (adjusted RR = 18.13, 95% CI 5.19–63.31) and with non-main partners (adjusted RR = 5.33, 95% CI 2.35–12.08). Findings from this study provide evidence for the feasibility, acceptability and preliminary effects of this mHealth approach to promoting oral HIVST among MSM in China.
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Linardon J, Cuijpers P, Carlbring P, Messer M, Fuller‐Tyszkiewicz M. The efficacy of app-supported smartphone interventions for mental health problems: a meta-analysis of randomized controlled trials. World Psychiatry 2019; 18:325-336. [PMID: 31496095 PMCID: PMC6732686 DOI: 10.1002/wps.20673] [Citation(s) in RCA: 331] [Impact Index Per Article: 66.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems. Smartphone interventions significantly outperformed control conditions in improving depressive (g=0.28, n=54) and generalized anxiety (g=0.30, n=39) symptoms, stress levels (g=0.35, n=27), quality of life (g=0.35, n=43), general psychiatric distress (g=0.40, n=12), social anxiety symptoms (g=0.58, n=6), and positive affect (g=0.44, n=6), with most effects being robust even after adjusting for various possible biasing factors (type of control condition, risk of bias rating). Smartphone interventions conferred no significant benefit over control conditions on panic symptoms (g=-0.05, n=3), post-traumatic stress symptoms (g=0.18, n=4), and negative affect (g=-0.08, n=5). Studies that delivered a cognitive behavior therapy (CBT)-based app and offered professional guidance and reminders to engage produced larger effects on multiple outcomes. Smartphone interventions did not differ significantly from active interventions (face-to-face, computerized treatment), although the number of studies was low (n≤13). The efficacy of app-supported smartphone interventions for common mental health problems was thus confirmed. Although mental health apps are not intended to replace professional clinical services, the present findings highlight the potential of apps to serve as a cost-effective, easily accessible, and low intensity intervention for those who cannot receive standard psychological treatment.
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Affiliation(s)
- Jake Linardon
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Per Carlbring
- Department of PsychologyStockholm UniversityStockholmSweden
| | - Mariel Messer
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia
| | - Matthew Fuller‐Tyszkiewicz
- School of PsychologyDeakin UniversityGeelongVictoriaAustralia,Center for Social and Early Emotional DevelopmentDeakin UniversityBurwoodVictoriaAustralia
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Yang X, Kovarik CL. A systematic review of mobile health interventions in China: Identifying gaps in care. J Telemed Telecare 2019; 27:3-22. [PMID: 31319759 DOI: 10.1177/1357633x19856746] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Mobile health has a promising future in the healthcare system in most developed countries. China's rapidly developing mobile technology infrastructure offers an unprecedented opportunity for wide adoption of mobile health interventions in the delivery of effective and timely healthcare services. However, there is little data on the current extent of the mobile health landscape in China. The aim of this study was to systematically review the existing mobile health initiatives in China, characterise the technology used, disease categories targeted, location of the end user (urban versus rural), and examine the potential effects of mobile health on health system strengthening in China. Furthermore, we identified gaps in development and evaluation of the effectiveness of mobile health interventions. METHODS A systematic review of the literature published from 18 December 2015 - 3 April 2019 was conducted and yielded 2863 articles from English and Chinese retrieval database and trial registries, including PubMed, EMBASE, China National Knowledge of Infrastructure and World Health Organization International Clinical Trials Registry Platform. Studies were included if they used mobile health to support patient healthcare outcomes. RESULTS A total of 1129 full-text articles were assessed and 338 were included in this study. The review found that most studies targeted client education and behaviour change via applications (apps) (65.4%), including WeChat, and text messaging (short text messages) (19.8%) to improve patient medical treatment outcomes such as compliance and appointment reminders. The most common disease-specific mobile health interventions focused primarily on chronic disease management and behaviour change in cardiology (13.3%), endocrinology/diabetes (12.1%), behavioural health (11.8%), oncology (11.2%) and neurology (6.8%). The mobile health interventions related to nutrition (0.6%) and chronic respiratory diseases (1.6%) are underrepresented in mobile health in comparison to the burden of disease in China. The majority (90.0%) of the mobile health interventions were conducted exclusively in urban areas, with few opportunities reaching rural populations. CONCLUSIONS Overall, mobile health has a promising future in China, with recent rapid growth in initiatives. The majority are focused on education and behaviour change in the realm of chronic diseases and target patients in urban areas. The imbalance in mobile health between the urban and rural areas, as well as between population disease spectrum and health service delivery, pose substantial dilemmas. However, mobile health may be redirected to correct this imbalance, possibly improving access to healthcare services, and filling the gaps in order to improve health equity for the underserved populations in China.
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Affiliation(s)
- Xiaoshi Yang
- Department of Social Medicine, China Medical University, P.R. China.,Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, USA
| | - Carrie L Kovarik
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, USA
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Zhai P, Li Q, Gillani AH, Hayat K, Shi L, Wang S, Peng F, Xu S, Du Q, Cao Z, Morisky DE, Fang Y. The impact of short message services and personal consultation by pharmacy students on medication adherence and blood pressure control: study protocol for a cluster randomized trial. Patient Prefer Adherence 2019; 13:627-636. [PMID: 31118586 PMCID: PMC6503648 DOI: 10.2147/ppa.s197858] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/13/2019] [Indexed: 11/30/2022] Open
Abstract
Purpose: Hypertension prevalence is mounting at a great pace in the People's Republic of China and poses a serious threat to health care systems. Medication nonadherence is one of the key factors in controlling high blood pressure. Our study uses two-arm cluster randomized controlled trial to investigate whether personal consultation by postgraduate pharmacy students and short message services (SMS) is effective in improving medication adherence and blood pressure control. Patients and methods: The trial will involve 384 treated patients in 8 community health care centers (CHCs). The 8 CHCs will be randomly assigned to intervention and control group in a ratio of 1:1. Patients in the intervention group will receive a personal consultation which identifies the barriers to medication adherence and SMS reminders which will be sent at 3-day intervals while patients in the control group will receive standard pharmaceutical care. Personal consultation by pharmacy students will be delivered at months 0 and 3. SMS messages will include educational information about normal blood pressure, complications of hypertension, salt intake, healthy diet, smoking cessation, regular exercise, weight control, antihypertensive medication schedule and treatment. Both groups will be followed for 6 months in order to compare their medication adherence and blood pressure at months 0, 3 and 6. The primary clinical outcome is the change in mean blood pressure and medication adherence measured at baseline, months 3 and 6. Secondary outcome is the proportion of patients reaching controlled blood pressure at months 3 and 6. Discussion: Pharmacy students led consultation will be conducted in the process of physical examination and SMS reminders which is at low cost, may be a feasible way to address the high prevalence of hypertension in the People's Republic of China.
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Affiliation(s)
- Panpan Zhai
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Qian Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Ali Hassan Gillani
- Department of Pharmacy, Yusra Institute of Pharmaceutical Sciences, Islamabad, Pakistan
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
- Institute of Pharmaceutical Sciences, University of Veternary and Animal Sciences, Lahore, Pakistan
| | - Li Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Siyi Wang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Fei Peng
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Sen Xu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Qianqian Du
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Zeyu Cao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Donald E Morisky
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA90095-1772, USA
| | - Yu Fang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, People's Republic of China
- Center for Drug Safety and Policy Research, Xi'an, People's Republic of China
- Shaanxi Center for Health Reform and Development Research, Xi’an Jiaotong University, Xi’an, People’s Republic of China
- Correspondence: Yu FangXi'an Jiaotong University, No.76 Yanta West Road, Xi’an710061, Shaanxi Province, People’s Republic of ChinaTel +86 298 265 5132Fax +86 298 265 5424Email
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Knoepke CE, Slack DH, Ingle MP, Matlock DD, Marzec LN. Quality of Medical Advice Provided Between Members of a Web-Based Message Board for Patients With Implantable Defibrillators: Mixed-Methods Study. JMIR Cardio 2018; 2:e11358. [PMID: 31758775 PMCID: PMC6834222 DOI: 10.2196/11358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/18/2022] Open
Abstract
Background Patients use Web-based medical information to understand medical conditions and treatments. A number of efforts have been made to understand the quality of professionally created content; however, none have described the quality of advice being provided between anonymous members of Web-based message boards. Objective The objective of this study was to characterize the quality of medical information provided between members of an anonymous internet message board addressing treatment with an implantable cardioverter-defibrillator (ICD). Methods We quantitatively analyzed 2 years of discussions using a mixed inductive-deductive framework, first, for instances in which members provided medical advice and, then, for the quality of the advice. Results We identified 82 instances of medical advice within 127 discussions. Advice covered 6 topical areas: (1) Device information, (2) Programming, (3) Cardiovascular disease, (4) Lead management, (5) Activity restriction, and (6) Management of other conditions. Across all advice, 50% (41/82) was deemed generally appropriate, 24% (20/82) inappropriate for most patients, 6% (5/82) controversial, and 20% (16/82) without sufficient context. Proportions of quality categories varied between topical areas. We have included representative examples. Conclusions The quality of advice shared between anonymous members of a message board regarding ICDs varied considerably according to topical area and the specificity of advice. This report provides a model to describe the quality of the available Web-based patient-generated material.
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Affiliation(s)
- Christopher E Knoepke
- Division of Cardiology, School of Medicine, University of Colorado, Denver, CO, United States.,Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado, Denver, CO, United States.,Data Science to Patient Value Initiative, School of Medicine, University of Colorado, Denver, CO, United States
| | - D Hogan Slack
- School of Medicine, University of Colorado, Denver, CO, United States
| | - M Pilar Ingle
- Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado, Denver, CO, United States
| | - Daniel D Matlock
- Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado, Denver, CO, United States.,Division of Geriatric Medicine, School of Medicine, University of Colorado, Denver, CO, United States.,Geriatric Research Education and Clinical Center, Veterans Affairs of Eastern Colorado, Denver, CO, United States
| | - Lucas N Marzec
- Division of Cardiology, School of Medicine, University of Colorado, Denver, CO, United States
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