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Solaiman B. Legal and Ethical Considerations of Artificial Intelligence for Residents in Post-Acute and Long-Term Care. J Am Med Dir Assoc 2024; 25:105105. [PMID: 38909630 DOI: 10.1016/j.jamda.2024.105105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 05/14/2024] [Accepted: 05/14/2024] [Indexed: 06/25/2024]
Abstract
This article proposes a framework for examining the ethical and legal concerns for using artificial intelligence (AI) in post-acute and long-term care (PA-LTC). It argues that established frameworks on health, AI, and the law should be adapted to specific care contexts. For residents in PA-LTC, their social, psychological, and mobility needs should act as a gauge for examining the benefits and risks of integrating AI into their care. Using those needs as a gauge, 4 areas of particular concern are identified. First, the threat that AI poses to the autonomy of residents can undermine their core needs. Second, how discrimination and bias in algorithmic decision-making can undermine Medicare coverage for PA-LTC, causing doctors' recommendations to be ignored and denying residents the care they are entitled to. Third, privacy rules concerning data use may undermine developers' ability to train accurate AI systems, limiting their usefulness in PA-LTC contexts. Fourth, the importance of obtaining consent before AI is used and discussions about how that care should continue if there are concerns about an ongoing decline in cognition. Together, these considerations elevate existing frameworks and adapt them to the context-specific case of PA-LTC. It is hoped that future research will examine the legal implications of these matters in each of these specific cases.
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Affiliation(s)
- Barry Solaiman
- HBKU, College of Law, Doha, Qatar; Weill Cornell Medicine, Doha, Qatar.
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2
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Brunner WM, Pullyblank K, Scribani MB, Krupa N, Wyckoff L. Remote delivery of self-management education workshops for adults with chronic pain, 2020-2021. Chronic Illn 2024; 20:360-368. [PMID: 37291805 DOI: 10.1177/17423953231181408] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES We intended to assess changes in pain-related outcomes among rural adults who completed 6-week self-management programs offered remotely during the COVID-19 pandemic. METHODS We offered the Chronic Pain Self-Management Program and Chronic Disease Self-Management Program between May 2020 and December 2021. Delivery mode options included 2½-hour weekly videoconference, mailed toolkit plus 1-hour weekly conference call, and mailed toolkit alone. We conducted pre- and post-workshop surveys including questions on patient activation, self-efficacy, depression and pain disability. We used paired t-tests to compare pre-post differences in outcomes among participants completing 4 or more sessions. RESULTS Among 218 adults reporting chronic pain, mean age was 57; 83.6% were female; and 49.5% participated via videoconference, 23.4% by phone and 27.1% via mailed toolkit alone. Completion rates were higher among phone (88.2%) versus videoconference (60.2%) workshop participants. Among completers, patient activation (mean change = 3.61, p = 0.01) and self-efficacy (mean change = 3.72, p < 0.0001) increased while depression scores (mean change = -1.03, p = 0.01), pain disability (mean change = -0.93, p = 0.003) and pain symptoms (mean change = -0.61, p = 0.001) decreased over the 6-week period. DISCUSSION Self-management programs offered remotely during the pandemic were successful in improving patient activation, self-efficacy, depression, pain disability, and pain symptoms among rural adults experiencing chronic pain.
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Affiliation(s)
- Wendy M Brunner
- Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Kristin Pullyblank
- Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Melissa B Scribani
- Center for Biostatistics, Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Nicole Krupa
- Center for Biostatistics, Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
| | - Lynae Wyckoff
- Center for Rural Community Health, Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA
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3
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Mey TM, Ogasawara K. Telehealth Consultation for Malaysian Citizens' Willingness to Pay Assessed by the Double-Bounded Dichotomous Choice Method. Malays J Med Sci 2024; 31:91-102. [PMID: 38456119 PMCID: PMC10917602 DOI: 10.21315/mjms2024.31.1.8] [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: 12/06/2022] [Accepted: 04/06/2023] [Indexed: 03/09/2024] Open
Abstract
Background Re-envisioning healthcare in technology tools includes robust utilisation of telehealth, improvement in access, quality, care efficiencies and cost-effectiveness of healthcare services. In reality, the technology's potential to transform healthcare may be limited by the ability to pay for it. This study aims to estimate Malaysian citizens' willingness to pay (WTP) for telehealth consultations and determine the factors contributing to it. This is vital to inform decision-making about expansion, preferences and deployment of a pricing strategy for telehealth services. Methods A random sample of 220 adult Malaysians was surveyed using social network services (SNS). Three different WTP bid arrays were identified and each respondent received a randomly drawn bid price. The WTP fee for using the telehealth consultation for 30 min was measured and estimated using a Double-Bounded Dichotomous Choice (DBDC) and the Random Utility Logit Model. Result The median WTP was estimated to be RM58 (JPY2,198), RM78 (JPY2,956) for 132 respondents' willingness to use telehealth consultation and RM26 (JPY985) for 51 respondents who were unwilling. Further analysis found that WTP is correlated with the perception and willingness of the respondents to use it. Conclusion Despite most respondents being willing to pay for telehealth consultations, sociodemographic characteristics and affordability influenced the process of making decisions about WTP for telehealth consultation. This finding suggests that the private sector can play a crucial role in the deployment of telehealth. However, there may be a need to consider affordability and how to increase access and use of telehealth services.
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Affiliation(s)
- Tan Mey Mey
- Graduate School of Health Sciences, School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Katsuhiko Ogasawara
- Graduate School of Health Sciences, School of Medicine, Hokkaido University, Hokkaido, Japan
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4
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Lee H, Choi JY, Kim SW, Ko KP, Park YS, Kim KJ, Shin J, Kim CO, Ko MJ, Kang SJ, Kim KI. Digital Health Technology Use Among Older Adults: Exploring the Impact of Frailty on Utilization, Purpose, and Satisfaction in Korea. J Korean Med Sci 2024; 39:e7. [PMID: 38193326 PMCID: PMC10782036 DOI: 10.3346/jkms.2024.39.e7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 10/24/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The importance of digital technology is increasing among older adults. In this study, the digital health technology utilization status, purpose, and satisfaction of older adults were investigated according to frailty. METHODS A face-to-face survey was conducted among adults aged 65 years or older. Frailty was defined using the Korean version of the fatigue, resistance, ambulation, illnesses, and loss of weight scale. RESULTS A total of 505 participants completed the survey, with 153 (30.3%) identified as pre-frail or frail and 352 (69.7%) as healthy. All respondents used smartphones; 440 (87.1%) were application users, and 290 (57.4%) were healthcare application users. Wearable devices were used by only 36 patients (7.1%). Pre-frail or frail respondents used social media more frequently than healthy respondents (19.4% vs. 7.4%, P < 0.001). Among the respondents, 319 (63.2%) were not able to install or delete the application themselves, and 277 (54.9%) stated that the application was recommended by their children (or partner). Pre-frail and frail respondents used more healthcare applications to obtain health information (P = 0.002) and were less satisfied with wearable devices (P = 0.02). CONCLUSION The usage rate of digital devices, including mobile phones among older adults in Korea is high, whereas that of wearable devices is low. There was a notable difference in the services used by pre-frail and frail respondents compared to healthy respondents. Therefore, when developing digital devices for pre-frail and frail older adults, it is crucial to incorporate customized services that meet their unique needs, particularly those services that they frequently use.
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Affiliation(s)
- Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Yeon Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sun-Wook Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang-Pil Ko
- Clinical Preventive Medicine Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yang Sun Park
- Devision of Geriatrics, Department of Internal Medicine, Yonsei University of College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Korea
| | - Kwang Joon Kim
- Devision of Geriatrics, Department of Internal Medicine, Yonsei University of College of Medicine, Seoul, Korea
- Institute for Innovation in Digital Healthcare, Yonsei University Health System, Seoul, Korea
| | - Jaeyong Shin
- Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chang Oh Kim
- Devision of Geriatrics, Department of Internal Medicine, Yonsei University of College of Medicine, Seoul, Korea
| | - Myung Jin Ko
- Silvia Health, Seoul, Korea
- Seoul National University College of Medicine, Seoul, Korea
| | | | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
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5
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Waller R, Paz Y, Himes MM, White LK, Rodriguez Y, Gorgone A, Luby J, Gerstein ED, Brady RG, Chaiyachati BH, Duncan A, Barzilay R, Kornfield SL, Burris HH, Seidlitz J, Parish-Morris J, Laney N, Gur RE, Njoroge WFM. Observations of Positive Parenting from Online Parent-Child Interactions at Age 1. PARENTING, SCIENCE AND PRACTICE 2024; 24:39-65. [PMID: 38188653 PMCID: PMC10766433 DOI: 10.1080/15295192.2023.2286454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Objective Brief, reliable, and cost-effective methods to assess parenting are critical for advancing parenting research. Design We adapted the Three Bags task and Parent Child Interaction Rating System (PCIRS) for rating online visits with 219 parent-child dyads (White, n = 104 [47.5%], Black, n = 115 [52.5%]) and combined the video data with survey data collected during pregnancy and when children were aged 1. Results The PCIRS codes of positive regard, stimulation of child cognitive development, and sensitivity showed high reliability across the three parent-child interaction tasks. A latent positive parenting factor combining ratings across codes and tasks showed good model fit, which was similar regardless of parent self-identified race or ethnicity, age, socioeconomic disadvantage, marital/partnered status, and parity, as well as methodological factors relevant to the online video assessment method (e.g., phone vs. laptop/tablet). In support of construct validity, observed positive parenting was related to parent-reported positive parenting and child socioemotional development. Finally, parent reports of supportive relationships in pregnancy, but not neighborhood safety or pandemic worries, were prospectively related to higher positive parenting observed at age 1. With the exception of older parental age and married/partnered status, no other parent, child, sociodemographic, or methodological variables were related to higher overall video exclusions across tasks. Conclusions PCIRS may provide a reliable approach to rate positive parenting at age 1, providing future avenues for developing more ecologically valid assessments and implementing interventions through online encounters that may be more acceptable, accessible, or preferred among parents of young children.
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Affiliation(s)
- Rebecca Waller
- Department of Psychology, University of Pennsylvania, Stephen A Levin Building, 425 S University Ave, Philadelphia, PA 19104, USA
| | | | | | | | | | | | - Joan Luby
- Washington University School of Medicine
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Vista FES, Tamondong-Lachica DR. A comparison of the characteristics of adult medicine patients seeking telemedicine consultations versus in-person consultations in a Philippine public hospital. Proc AMIA Symp 2023; 37:80-88. [PMID: 38173998 PMCID: PMC10761184 DOI: 10.1080/08998280.2023.2263255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/20/2023] [Indexed: 01/05/2024] Open
Abstract
Background Telemedicine employs the use of technology to increase access to health care. This is especially relevant in developing countries where accessibility is an important issue. In developed countries, studies have shown that despite greater availability and accessibility, there are still disparities in telemedicine use. In the Philippines, however, it is unknown what factors are related to telemedicine use since its underutilization precludes proper characterization of telemedicine patients. We sought to compare the characteristics of telemedicine patients and patients consulting in-person in the internal medicine outpatient department of a Philippine public hospital. Methods This is a retrospective descriptive study. Chart reviews were done for patients who consulted from May 2021 to July 2021. They were classified as either having telemedicine consults only or having in-person consults only. Each group was characterized and compared according to demographics, socioeconomic characteristics, health behaviors, and reasons for consultation. Results Unadjusted analyses showed that younger, single, or employed individuals were more likely to use telemedicine. However, in adjusted analyses, no demographic factors were associated with telemedicine use. Only the patient type and medical concern were significantly different between patient groups in this public hospital setting. New patients and those consulting for clearance/referral purposes or endocrine-related symptoms were more likely to seek teleconsults. Conclusions The findings showed which patients are more likely to use telemedicine in the Philippines. Continued telemedicine use for these patients should be explored to complement in-person medical care.
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Affiliation(s)
| | - Diana R. Tamondong-Lachica
- College of Medicine, University of the Philippines Manila, Manila, Philippines
- Department of Medicine, University of the Philippines Manila Philippine General Hospital, Manila, Philippines
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7
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Taghavi SE, Williams AP, Leavitt A, Hoeft A, Hall BC. Adolescent and Young Adult Communication Preferences. J Adolesc Young Adult Oncol 2023; 12:599-603. [PMID: 36383117 DOI: 10.1089/jayao.2022.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine adolescents and young adults preferred methods of communication by health care professionals and to identify whether this aligns/differs from overall preferred methods of social media use. Sixty-seven participants completed an electronic survey about their communication preferences. Forty-eight participants were patients and 19 were parents. Logistic regression and chi-square analysis were performed to predict social media use and communication preferences from predictors including age, gender, race, and treatment status. More research is needed to generalize these results, and future research could further evaluate the effectiveness of implementing health care interventions using preferred platforms.
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Affiliation(s)
- Sarah E Taghavi
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
| | | | - Antonia Leavitt
- Cook Children's Medical Center, Fort Worth, Texas, USA
- Fort Worth Adolescent Young Adult Oncology Coalition, Fort Worth, Texas, USA
| | - Alice Hoeft
- Cook Children's Medical Center, Fort Worth, Texas, USA
| | - Brittany C Hall
- UT Southwestern Moncrief Cancer Institute, Fort Worth, Texas, USA
- Fort Worth Adolescent Young Adult Oncology Coalition, Fort Worth, Texas, USA
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8
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Kim TN, Decuir M, Smith K, Medus C, Hedberg CW. Use of Online Consumer Complaint Forms to Enhance Complaint-Based Surveillance for Foodborne Illness Outbreaks in Minnesota. J Food Prot 2023; 86:100095. [PMID: 37100390 DOI: 10.1016/j.jfp.2023.100095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 04/28/2023]
Abstract
Foodborne illness complaint systems that collect consumer reports of illness following exposure at a food establishment or event are a primary tool for detecting outbreaks of foodborne illness. Approximately 75% of outbreaks reported to the national Foodborne Disease Outbreak Surveillance System are detected through foodborne illness complaints. The Minnesota Department of Health added an online complaint form to their existing statewide foodborne illness complaint system in 2017. During 2018-2021, online complainants tended to be younger than those who used traditional telephone hotlines (mean age 39 vs 46 years; p-value <0.0001), reported illnesses sooner following onset of symptoms (mean interval 2.9 vs 4.2 days; p-value = 0.003), and were more likely to still be ill at the time of the complaint (69% vs 44%; p-value <0.0001). However, online complainants were less likely to have called the suspected establishment to report their illness than those who used traditional telephone hotlines (18% vs 48%; p-value <0.0001). Of the 99 outbreaks identified by the complaint system, 67 (68%) were identified through telephone complaints alone, 20 (20%) through online complaints alone, 11 (11%) using a combination of both, and 1 (1%) through email alone. Norovirus was the most common outbreak etiology identified by both complaint system methods, accounting for 66% of outbreaks identified only via telephone complaints and 80% of outbreaks identified only via online complaints. Due to the COVID-19 pandemic in 2020, there was a 59% reduction in telephone complaint volume compared to 2019. In contrast, online complaints experienced a 25% reduction in volume. In 2021, the online method became the most popular complaint method. Although most outbreaks detected by complaints were reported by telephone complaints alone, adding an online form for complaint reporting increased the number of outbreaks detected.
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Affiliation(s)
- Thuy N Kim
- University of Minnesota School of Public Health.
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9
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Banerjee I, Robinson J. Future implications of telehealth for complex chronic disorders after COVID-19. Dev Med Child Neurol 2023; 65:446-447. [PMID: 36681660 DOI: 10.1111/dmcn.15519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/23/2023]
Affiliation(s)
- Indrajit Banerjee
- Department of Pharmacology, Sir Seewoosagur Ramgoolam Medical College, Mauritius
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10
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Dorfman CS, Stalls J, Lachman S, Shelby RA, Somers TJ, Oeffinger KC. Symptom Communication Preferences and Communication Barriers for Young Adult Cancer Survivors and Their Health Care Providers. J Adolesc Young Adult Oncol 2022; 11:506-517. [PMID: 35049386 PMCID: PMC9595618 DOI: 10.1089/jayao.2021.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Effective communication between young adult (YA; aged 18-39 years) cancer survivors and their health care providers is critical for managing post-treatment symptoms. Yet, little is known about YAs' and providers' preferences for and barriers to symptom communication, variables important for developing interventions to improve and optimize YA-provider communication. Methods: YA survivors (N = 21) and oncology providers (N = 11) rank ordered their preferred methods for symptom communication and top communication barriers. Interviews were conducted to obtain qualitative data (i.e., preferred methods for, barriers, and suggestions to improve symptom communication). Interviews were transcribed, and thematic qualitative analysis was used. Results: Sixty-two percent of YAs preferred communicating using the electronic messaging system affiliated with the medical record (MyChart), whereas providers (100%) preferred communicating during in-person clinic visits. Qualitative data from YAs pointed to benefits of MyChart, including ease of use and rapid responses. Providers acknowledged that, although efficient, high message volumes and expectations for rapid responses were barriers to MyChart. Providers described benefits of in-person visits, including visually assessing patients' concerns, providing immediate support, and more safely managing symptoms. Lack of time (48%) was YAs' top communication barrier, whereas providers endorsed patients not bringing up symptoms (64%). Qualitative data reflected patient-level (e.g., embarrassment/discomfort, lack of skills) and provider-level (e.g., forgetting to ask about a symptom) barriers. YAs and providers offered strategies to improve communication. Conclusion: Survivor- and provider-level communication interventions that account for YAs' and providers' differing communication preferences and directly address communication barriers unique to survivors' developmental stage may be necessary to improve symptom communication.
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Affiliation(s)
- Caroline S. Dorfman
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Juliann Stalls
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Sage Lachman
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina, USA
| | - Rebecca A. Shelby
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
| | - Kevin C. Oeffinger
- Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA
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Williams N, Haines T, Williams C, Bowles KA, Hill KD. Age Differences in Preferred Methods of Obtaining and Understanding Health Related Information During the COVID-19 Pandemic in Australia. Front Public Health 2022; 10:912188. [PMID: 35910912 PMCID: PMC9326317 DOI: 10.3389/fpubh.2022.912188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Methods of communications and the nature of messaging are critically important in influencing public behavior. The COVID-19 pandemic has resulted in major disruptions to all aspects of life globally and has triggered multiple approaches of health messaging to the general public to communicate COVID-19 preventative measures. This study aimed to identify: (1) differences between age groups in the main avenues used by people to obtain COVID-19 related information; and (2) whether age and information sources were associated with correct interpretation of government messaging relating to how people understand or interpret the terms “self-isolation” and “social distancing.” An online survey was conducted in 2020. Participants were aged over 18 years and grouped into age group decades. Differences in sources of COVID-19 information were compared visually between age groups. Logistic regression was used to determine whether age and each of the various methods of communication of COVID-19 information were independently associated with correct response to the self-isolation, or the social distancing statements. There were 3,300 survey respondents 85% female; age sub-groups: 18–29 (7.4%); 30–39 (10.6%); 40–49 (17.6%); 50–59 (22.9%); 60–69 (25.9%); 70–79 (13.9%); and 80+ (1.7%). People accessed public health messaging information from a wide variety of sources that changed as they aged (e.g., older people were more likely to be exposed to COVID-19 information via television news programs and less likely via social media platforms). Age was frequently associated with whether the message key terms were interpreted correctly or incorrectly, but in some cases, it promoted more correct responses whereas in others, fewer correct responses. There was no difference between being exposed to COVID-19 information via mainstream media, compared with social media, or compared with Government sources of information, in terms of whether COVID-19 messages were interpreted correctly. In order to improve future public health messaging, there is a need for multiple avenues of communication to meet the needs and preferences across and within age groups. Further investigation is warranted into the clarity of the content and method of delivery of public health messages, to ensure optimal understanding of public health messages by vulnerable populations and across the community.
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Affiliation(s)
- Nathan Williams
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
- *Correspondence: Nathan Williams
| | - Terry Haines
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
| | - Cylie Williams
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
| | - Kelly-Ann Bowles
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
- Department of Paramedicine, Monash University, Frankston, VIC, Australia
| | - Keith D. Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, VIC, Australia
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Gaffney HJ, Hamiduzzaman M. Factors that influence older patients’ participation in clinical communication within developed country hospitals and GP clinics: A systematic review of current literature. PLoS One 2022; 17:e0269840. [PMID: 35759474 PMCID: PMC9236261 DOI: 10.1371/journal.pone.0269840] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Engaging older adults in clinical communication is an essential aspect of high-quality elder care, patient safety and satisfaction in hospitals and GP clinics. However, the factors that influence older adults’ participation during their appointments with health professionals from the older patient’s perspective remain under-investigated.
Objectives
We aimed to fill this knowledge gap by reviewing research articles that have examined older patients’ involvement in clinical communication. In doing so, we hope to assist healthcare professionals and institutions in developing new strategies to improve older patients’ participation and engagement in clinical communication.
Methods
A systematic review of nine databases was conducted for studies reporting identified influences on older patients’ participation in clinical communication published from 2010. These studies were then subjected to thematic analysis for stratification.
Results
Twenty-one articles with a total of 36,797 participants were included and highlighted three major themes that influenced older patients’ participation in the clinical communication. The first theme identified includes accessibility to appointments, support, health information and person-centred care, highlighting that access to appointments, person centred care and health information significantly influences clinical communication participation. Relevant and understandable healthcare information identified that communication factors [i.e. tailored health information, health literacy and patient language barriers, and communication impairments] influences older patients’ participation. Older Patient perceptions of HCP credibility and trustworthiness highlighted how patient’s perceptions of health professionals influence their willingness to participate in clinical communications.
Conclusions and implications
This review demonstrates that there are several factors that contribute to insufficient or no participation of older patients in clinical communication in hospitals and GP clinics. These include accessibility to relevant and understandable health information, and the perceived health professional credibility and trustworthiness. Identifying ways to address these factors may improve patient participation, doctor-patient collaboration and overall health outcomes for older patients.
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Affiliation(s)
- Harry James Gaffney
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- * E-mail:
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Xu H, Bu Y, Liu M, Zhang C, Sun M, Zhang Y, Meyer E, Salas E, Ding Y. Team power dynamics and team impact: New perspectives on scientific collaboration using career age as a proxy for team power. J Assoc Inf Sci Technol 2022. [DOI: 10.1002/asi.24653] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Huimin Xu
- School of Information University of Texas at Austin Austin Texas USA
| | - Yi Bu
- Department of Information Management Peking University Beijing China
| | - Meijun Liu
- Institute for Global Public Policy Fudan University Shanghai China
| | - Chenwei Zhang
- Faculty of Education The University of Hong Kong Hong Kong China
| | - Mengyi Sun
- Department of Ecology and Evolutionary Biology University of Michigan Michigan USA
| | - Yi Zhang
- Faculty of Engineering and IT University of Technology Sydney New South Wales Australia
| | - Eric Meyer
- School of Information University of Texas at Austin Austin Texas USA
| | - Eduardo Salas
- Department of Psychological Science Rice University Houston Texas USA
| | - Ying Ding
- School of Information University of Texas at Austin Austin Texas USA
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Yang R, Zeng K, Jiang Y. Prevalence, Factors, and Association of Electronic Communication Use With Patient-Perceived Quality of Care From the 2019 Health Information National Trends Survey 5-Cycle 3: Exploratory Study. J Med Internet Res 2022; 24:e27167. [PMID: 35119369 PMCID: PMC8857700 DOI: 10.2196/27167] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/25/2021] [Accepted: 11/10/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Electronic communication (e-communication), referring to communication through electronic platforms such as the web, patient portal, or mobile phone, has become increasingly important, as it extends traditional in-person communication with fewer limitations of timing and locations. However, little is known about the current status of patients' use of e-communication with clinicians and whether the use is related to the better patient-perceived quality of care at the population level. OBJECTIVE The aim of this study was to explore the prevalence of and the factors associated with e-communication use and the association of e-communication use with patient-perceived quality of care by using the nationally representative sample of the 2019 Health Information National Trends Survey 5 (HINTS 5)-Cycle 3. METHODS Data from 5438 adult responders (mean age 49.04 years, range 18-98 years) were included in this analysis. Multiple logistic and linear regressions were conducted to explore responders' personal characteristics related to their use of e-communication with clinicians in the past 12 months and how their use was related to perceived quality of care. Descriptive analyses for e-communication use according to age groups were also performed. All analyses considered the complex survey design using the jackknife replication method. RESULTS The overall prevalence of e-communication use was 60.3%, with a significantly lower prevalence in older adults (16.6%) than that in <45-year-old adults (41%) and 45-65-year-old adults (42.4%). All percentages are weighted; therefore, absolute values are not shown. American adults who used e-communication were more likely to be high school graduates (odds ratio [OR] 1.95, 95% CI 1.14-3.34; P=.02), some college degree holders (OR 3.34, 95% CI 1.84-6.05; P<.001), and college graduates or more (OR 4.89, 95% CI 2.67-8.95; P<.001). Further, people who were females (OR 1.47, 95% CI 1.18-1.82; P=.001), with a household income ≥US $50,000 (OR 1.63, 95% CI 1.23-2.16; P=.001), with more comorbidities (OR 1.22, 95% CI 1.07-1.40; P=.004), or having a regular health care provider (OR 2.62, 95% CI 1.98-3.47; P<.001), were more likely to use e-communication. In contrast, those who resided in rural areas (OR 0.61, 95% CI 0.43-0.88; P=.009) were less likely to use e-communication. After controlling for the sociodemographics, the number of comorbidities, and relationship factors (ie, having a regular provider and trusting a doctor), e-communication use was found to be significantly associated with better perceived quality of care (β=.12, 95% CI 0.02-0.22; P=.02). CONCLUSIONS This study confirmed the positive association between e-communication use and patient-perceived quality of care and suggested that policy-level attention should be raised to engage the socially disadvantaged (ie, those with lower levels of education and income, without a regular health care provider, and living in rural areas) to maximize e-communication use and to support better patient-perceived quality of care among American adults.
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Affiliation(s)
- Rumei Yang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Kai Zeng
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
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15
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Tan YR, Tan MP, Khor MM, Hoh HB, Saedon N, Hasmukharay K, Tan KM, Chin AV, Kamaruzzaman SB, Ong T, Davey G, Khor HM. Acceptance of virtual consultations among older adults and caregivers in Malaysia: a pilot project during the COVID-19 pandemic. Postgrad Med 2021; 134:224-229. [PMID: 34758702 DOI: 10.1080/00325481.2021.2004792] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM The COVID-19 pandemic has disrupted the delivery of healthcare to vulnerable older adults, prompting the expansion of telemedicine usage. This study surveyed the acceptance of virtual medical consultations among older adults and caregivers within geriatric outpatient services in a tertiary hospital during the pandemic. METHODS A cross-sectional survey was conducted among caregivers and patients attending geriatric outpatient services in Kuala Lumpur, Malaysia. The survey measured the availability of equipment for virtual consultations, prior knowledge and experience of telemedicine and willingness to consult geriatricians through virtual technology, using the Unified Theory of Acceptance and Use of Technology (UTAUT) scale. RESULTS A total of 197 caregivers and 42 older patients with a mean age of 54.28(±13.22) and 75.62(±7.32) years respectively, completed the survey. 156(79.2%) of the caregivers were adult children accompanying patients. The mean UTAUT score was 65.97(±13.71) out of 90, with 66.64(±13.25) for caregivers and 62.79(±15.44) for older adults, suggesting a high acceptance of adopting virtual consultations in lieu of face-to-face care. The independent predictors of acceptance towards virtual consultation were: possession of an electronic device capable of video-communication, living with someone, living in a care home, weekly online banking usage and perceived familiarity with virtual platforms. CONCLUSION Caregivers and patients indicated a high level of acceptance of virtual medical consultations, which is likely facilitated by caregivers such as adult children or spouses at home or staff in care homes. To minimize the transmission of COVID-19 in a highly vulnerable group, virtual consultations are an acceptable alternative to face-to-face consultations for older people and their caregivers in our setting.
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Affiliation(s)
- Yi Ru Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Mei Mei Khor
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Sunway, Malaysia
| | | | - Nor'Izzati Saedon
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Kejal Hasmukharay
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Kit Mun Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Ai Vyrn Chin
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | | | - Terence Ong
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Gareth Davey
- Department of Social and Behavioral Sciences, Leeds Trinity University, Horsforth, Leeds, UK
| | - Hui Min Khor
- Department of Medicine, Faculty of Medicine, University of Malaya, Malaysia
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Clarke MA, Fruhling AL, Lyden EL, Tarrell AE, Bernard TL, Windle JR. The Role of Computer Skills in Personal Health Record Adoption Among Patients With Heart Disease: Multidimensional Evaluation of Users Versus Nonusers. JMIR Hum Factors 2021; 8:e19191. [PMID: 34309574 PMCID: PMC8367119 DOI: 10.2196/19191] [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: 05/05/2020] [Revised: 11/17/2020] [Accepted: 04/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background In the era of precision medicine, it is critical for health communication efforts to prioritize personal health record (PHR) adoption. Objective The objective of this study was to describe the characteristics of patients with heart disease that choose to adopt a PHR. Methods A total of 79 patients with chronic cardiovascular disease participated in this study: 48 PHR users and 31 nonusers. They completed 5 surveys related to their choice to use or not use the PHR: demographics, patient activation, medication adherence, health literacy, and computer self-efficacy (CSE). Results There was a significant difference between users and nonusers in the sociodemographic measure education (P=.04). There was no significant difference between users and nonusers in other sociodemographic measures: age (P=.20), sex (P=.35), ethnicity (P=.43), race (P=.42), and employment (P=.63). There was a significant difference between PHR users and PHR nonusers in CSE (P=.006). Conclusions In this study, we demonstrate that sociodemographic characteristics were not an important factor in patients’ use of their PHR, except for education. This study had a small sample size and may not have been large enough to detect differences between groups. Our results did demonstrate that there is a difference between PHR users and nonusers related to their CSE. This work suggests that incorporating CSE into the design of PHRs is critical. The design of patient-facing tools must take into account patients’ preferences and abilities when developing effective user-friendly health information technologies.
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Affiliation(s)
- Martina A Clarke
- School of Interdisciplinary Informatics, College of Information Science and Technology, University of Nebraska Omaha, Omaha, NE, United States.,Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - Ann L Fruhling
- School of Interdisciplinary Informatics, College of Information Science and Technology, University of Nebraska Omaha, Omaha, NE, United States
| | - Elizabeth L Lyden
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Alvin E Tarrell
- School of Interdisciplinary Informatics, College of Information Science and Technology, University of Nebraska Omaha, Omaha, NE, United States
| | - Tamara L Bernard
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States
| | - John R Windle
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, United States
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Mobile device use among inpatients on a psychiatric unit: A preliminary study. Psychiatry Res 2021; 297:113720. [PMID: 33540205 DOI: 10.1016/j.psychres.2021.113720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/11/2021] [Indexed: 11/22/2022]
Abstract
Few studies have investigated barriers to mobile phone use for health purposes among patients with serious mental illness. In an inpatient psychiatric adult sample, we examined: (a) patterns and perceptions of mobile phone use and (b) the role of psychiatric diagnoses on mobile phone use for mental health purposes. Participants completed questionnaires after using a psychometrically validated scale to determine capacity for consent. Descriptive analyses revealed that most participants owned a smartphone (94%), data plan (94%), and frequently accessed the internet (75%). Only 27% used their mobile phones daily for health purposes and 47% had used their mobile phone to access their electronic medical record (EMR). Participants with psychotic disorders were significantly less likely to have mobile access to their EMR and expressed difficulty in using a mobile app for mental health purposes; whereas participants with depressive disorders expressed low interest in using their mobile devices to monitor their mental health. Adult psychiatric inpatients may have access to and be willing to use mobile phones for purposes related to mental health. However, key barriers may include frequency of mobile phone use for health purposes and lack of mobile access to the EMR, particularly among those with psychotic disorders.
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Jaffe DH, Lee L, Huynh S, Haskell TP. Health Inequalities in the Use of Telehealth in the United States in the Lens of COVID-19. Popul Health Manag 2020; 23:368-377. [PMID: 32816644 DOI: 10.1089/pop.2020.0186] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The use of remote health care services, or telehealth, is a promising solution for providing health care to those unable to access care in person easily and thus helping to reduce health inequalities. The COVID-19 pandemic and resulting stay-at-home orders in the United States have created an optimal situation for the use of telehealth services for non-life-threatening health care use. A retrospective cohort study was performed using Kantar's Claritis™ database, which links insurance claims encounters (Komodo Health) with patient-reported data (Kantar Health, National Health & Wellness Survey). Logistic regression models (odds ratios [OR], 95% confidence intervals [CI]) examined predictors of telehealth versus in-person encounters. Adults ages ≥18 years eligible for payer-complete health care encounters in both March 2019 and March 2020 were identified (n = 35,376). Telehealth use increased from 0.2% in 2019 to 1.9% in 2020. In adjusted models of respondents with ≥1 health care encounter (n = 11,614), age, marital status, geographic residence (region; urban/rural), and presence of anxiety or depression were significant predictors of telehealth compared with in-person use in March 2020. For example, adults 45-46 years versus 18-44 years were less likely to use telehealth (OR 0.684, 95% CI: 0.561-0.834), and respondents living in urban versus rural areas were more likely to use telehealth (OR 1.543, 95% CI: 1.153-2.067). Substantial increases in telehealth use were observed during the onset of the COVID-19 pandemic in the United States; however, disparities existed. These inequalities represent the baseline landscape that population health management must monitor and address during this pandemic.
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Affiliation(s)
| | - Lulu Lee
- Health Division, Kantar, San Mateo, California, USA
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