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Wilkens J, Thulesius H, Ekman B. From office to digital primary care services: analysing income-related inequalities in utilization. Int J Equity Health 2024; 23:86. [PMID: 38689241 PMCID: PMC11061960 DOI: 10.1186/s12939-024-02184-6] [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] [Received: 01/29/2024] [Accepted: 04/22/2024] [Indexed: 05/02/2024] Open
Abstract
The use of digital technologies to deliver primary health care has increased over the past decade. While some technologies have been shown to be medically effective and efficient, the effects of digital primary care on the policy goal of equality in the use of such types of care have not been studied using large register data. The aim of this study was to analyse how digital contacts differ from officebased visits by income as an indicator of socioeconomic status. Specifically, we estimated differences in primary care utilization across income, factors of contribution to these inequalities, and applied a needs-based standardisation of utilization to estimate differences in equity.We used a purposively built consultation level dataset with 726 000 Swedish adult patients diagnosed with an infection, including clinical and sociodemographic variables. Applying concentration indexes (CI) and graphical illustrations we measured how the two types of services are distributed relative to income. We estimated how much of the inequalities were attributed to different sociodemographic factors by decomposing the concentration indexes. Standardised utilization for sex, age and comorbidity allowed for the estimation of horizontal inequity indexes for both types of services.Utilization by the two types of care showed large income inequalities. Office-based visits were propoor (CI -0.116), meaning lowincome patients utilized relatively more of these services, while digital contacts were prorich (CI 0.205). However, within the patient group who had at least one digital contact, the utilization was also propoor (CI -0,101), although these patients had higher incomes on average. The standardised utilization showed a smaller prorich digital utilization (CI 0.143), although large differences remained. Decomposing the concentration indexes showed that education level and being born in Sweden were strong attributes of prorich digital service utilization.The prorich utilization effects of digital primary care may risk undermining the policy goals of access and utilization to services regardless of socioeconomic status. As digital health technologies continue to expand, policy makers need to be aware of the risk.
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Affiliation(s)
- Jens Wilkens
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 20205.
| | - Hans Thulesius
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 20205
| | - Björn Ekman
- Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 20205
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Money A, Hall A, Harris D, Eost-Telling C, McDermott J, Todd C. Barriers to and Facilitators of Older People's Engagement With Web-Based Services: Qualitative Study of Adults Aged >75 Years. JMIR Aging 2024; 7:e46522. [PMID: 38416543 PMCID: PMC10938227 DOI: 10.2196/46522] [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: 02/14/2023] [Revised: 05/22/2023] [Accepted: 12/05/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has accelerated the shift toward the digital provision of many public services, including health and social care, public administration, and financial and leisure services. COVID-19 services including test appointments, results, vaccination appointments and more were primarily delivered through digital channels to the public. Many social, cultural, and economic activities (appointments, ticket bookings, tax and utility payments, shopping, etc) have transitioned to web-based platforms. To use web-based public services, individuals must be digitally included. This is influenced by 3 main factors: access (whether individuals have access to the internet), ability (having the requisite skills and confidence to participate over the web), and affordability (ability to pay for infrastructure [equipment] and data packages). Many older adults, especially those aged >75 years, are still digitally excluded. OBJECTIVE This study aims to explore the views of adults aged >75 years on accessing public services digitally. METHODS We conducted semistructured qualitative interviews with a variety of adults aged ≥75 years residing in Greater Manchester, United Kingdom. We also interviewed community support workers. Thematic analysis was used to identify the key themes from the data. RESULTS Overall, 24 older adults (mean age 81, SD 4.54 y; 14/24, 58% female; 23/24, 96% White British; and 18/24, 75% digitally engaged to some extent) and 2 support workers participated. A total of five themes were identified as key in understanding issues around motivation, engagement, and participation: (1) "initial motivation to participate digitally"-for example, maintaining social connections and gaining skills to be able to connect with family and friends; (2) "narrow use and restricted activity on the web"-undertaking limited tasks on the web and in a modified manner, for example, limited use of web-based public services and selected use of specific services, such as checking but never transferring funds during web-based banking; (3) "impact of digital participation on well-being"-choosing to go to the shops or general practitioner's surgery to get out of the house and get some exercise; (4) "the last generation?"-respondents feeling that there were generational barriers to adapting to new technology and change; and (5) "making digital accessible"-understanding the support needed to keep those engaged on the web. CONCLUSIONS As we transition toward greater digitalization of public services, it is crucial to incorporate the perspectives of older people. Failing to do so risks excluding them from accessing services they greatly rely on and need.
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Affiliation(s)
- Annemarie Money
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Alex Hall
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Danielle Harris
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Charlotte Eost-Telling
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Jane McDermott
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - Chris Todd
- School of Health Sciences, University of Manchester, Manchester, United Kingdom
- National Institute for Health and Care Research, Applied Research Collaboration Greater Manchester, Division of Nursing Midwifery and Social Work, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
- Manchester Institute for Collaborative Research on Ageing, The University of Manchester, Manchester, United Kingdom
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
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Adepoju OE, Singh M, Tipton M, Peperone G, Trujillo M, Ojinnaka C. Access to technology, internet usage, and online health information-seeking behaviors in a racially diverse, lower-income population. Front Public Health 2024; 12:1328544. [PMID: 38450126 PMCID: PMC10914988 DOI: 10.3389/fpubh.2024.1328544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/18/2024] [Indexed: 03/08/2024] Open
Abstract
Background This study examined access to technology, internet usage, and online health information-seeking behaviors, in a racially diverse, lower-income population. Methods Data were obtained via a cross-sectional survey of low-income communities in Houston, Los Angeles, and New York between April and August 2023. Binary responses to the following online health information-seeking behaviors, internet and technology access, were examined: using the internet to (i) understand a medical diagnosis, (ii) fill a prescription, (iii) schedule a healthcare appointment, (iv) email communication with a healthcare provider, and (v) access electronic health records and medical notes. Results 41% of survey respondents identified as non-Hispanic Black individuals, 33% as non-Hispanic White individuals, and 22% as Hispanic individuals. 69% reported a pre-tax annual household income of less than $35,000. 97% reported ownership/access to a smart device; 97% reported access to reliable internet. In the past year, only 59% reported using the internet to better understand their medical diagnosis, 36% reported filling a prescription online, 47% scheduled a medical appointment online, 47% viewed electronic health records online, and 56% emailed healthcare providers. Female sex, higher incomes, and having at least a bachelor's degree were significantly associated with all five online health information-seeking attributes. Conclusion Despite high technology adoption rates, we observed suboptimal online health information-seeking behaviors. This underutilization has potential adverse implications for healthcare access and use given the documented advantage of HIT. Efforts to increase health information-seeking behaviors should explore the identification of HIT barriers, and patient education to increase familiarity and usage in this population.
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Affiliation(s)
- Omolola E. Adepoju
- Department of Health Systems and Population Health Sciences, University of Houston, Houston, TX, United States
- Humana Integrated Health System Sciences Institutes, University of Houston, Houston, TX, United States
| | - Maya Singh
- Humana Integrated Health System Sciences Institutes, University of Houston, Houston, TX, United States
| | - Mary Tipton
- Department of Health Systems and Population Health Sciences, University of Houston, Houston, TX, United States
- Humana Integrated Health System Sciences Institutes, University of Houston, Houston, TX, United States
| | - Gerard Peperone
- Spring Branch Community Health Center, Houston, TX, United States
| | - Marlen Trujillo
- Spring Branch Community Health Center, Houston, TX, United States
| | - Chinedum Ojinnaka
- College of Health Solutions, Arizona State University, Tempe, AZ, United States
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Tarp K, Christiansen R, Bilberg R, Borkner S, Dalsgaard C, Folker MP, Nielsen AS. Nonuse of Blended Web-Based and Face-To-Face Cognitive Behavioral Therapy for Alcohol Use Disorder: Qualitative Study. JMIR Form Res 2024; 8:e45471. [PMID: 38349711 PMCID: PMC10900073 DOI: 10.2196/45471] [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: 01/03/2023] [Revised: 04/05/2023] [Accepted: 11/12/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The use of digital technologies for health care has been the focus of social studies, which have concentrated on the digital divide between individuals who use technology and those who do not-with the latter often being considered as individuals with shortcomings. In Denmark, 91% of the population have computers and 97 out of 100 families have internet access, indicating that lack of access to technology is not the primary reason for nonuse. Although previous studies have primarily focused on participants' perspectives of using internet-based treatment for alcohol use disorder (AUD), no study has investigated individuals' reasons to prefer face-to-face treatment over blended face-to-face and internet-based cognitive behavioral therapy (bCBT) for AUD among treatment-seeking populations. OBJECTIVE The aim of this qualitative study was to investigate the nonuse of bCBT among patients with AUD. Specifically, this study aims to explore patients' reasons for choosing not to receive treatment via this format. METHODS This study was conducted among Danish patients with AUD who were enrolled in the study "Blending internet treatment into conventional face-to-face treatment for alcohol use disorder (Blend-A)" but had not used bCBT. The participant group consisted of 11 patients with AUD: 3 women and 8 men. The age range of the participants was 29-78 years (mean 59 years). Individual semistructured interviews were conducted using cell phones to gather participants' reasons for not choosing bCBT. The interviews were recorded, transcribed, and analyzed using thematic analysis. Five authors performed the analysis in 3 steps: (1) two authors read the transcripts and coded themes from their immediate impression of the material, (2) one author provided feedback, which was used to group overlapping themes together or create new themes that better reflected the content, and (3) the remaining two authors provided feedback on the analysis to improve its structure, readability, and relevance to the research aim. RESULTS We found that the participants had various reasons for choosing face-to-face treatment over bCBT; these reasons were more related to personal matters and lesser to digital health literacy. We identified 4 themes related to personal matters for choosing face-to-face treatment over bCBT: (1) patients' need for attending sessions in person, (2) preference for verbal communication, (3) desire for immediate feedback, and (4) feeling more empowered and motivated with face-to-face sessions. CONCLUSIONS This study provides valuable insight into participants' perspectives on blended therapy for AUD and highlights the importance of considering personal factors when designing digital health interventions. Our study indicates that most of the participants choose not to use bCBT for AUD because they perceive such treatment formats as impersonal. Instead, they prefer direct communication with the therapist, including the ability to express and comprehend facial expressions and body language. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-021-03122-4.
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Affiliation(s)
- Kristine Tarp
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Research Unit of Digital Psychiatry, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Regina Christiansen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Psychiatric University Hospital - University Function, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Psychiatric University Hospital - University Function, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Department for Finance and Planning, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
| | - Simone Borkner
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Caroline Dalsgaard
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Marie Paldam Folker
- Research Unit of Digital Psychiatry, Centre for Digital Psychiatry, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Psychiatric University Hospital - University Function, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
- Brain Research Inter-Disciplinary Guided Excellence (BRIDGE), Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
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Puchades R, Said-Criado I. [Telemedicine in clinical practice: Barriers and risks]. Med Clin (Barc) 2024; 162:123-125. [PMID: 37985327 DOI: 10.1016/j.medcli.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 11/22/2023]
Affiliation(s)
- Ramón Puchades
- Servicio de Medicina Interna, Hospital Universitario La Paz, Madrid, España; Grupo de Trabajo de Medicina Digital de la Sociedad Española de Medicina Interna.
| | - Ismael Said-Criado
- Servicio de Urgencias, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España; Grupo de Trabajo de Medicina Digital de la Sociedad Española de Medicina Interna
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Heponiemi T, Kaihlanen AM, Virtanen L, Kainiemi E, Saukkonen P, Koponen P, Koskinen S, Elovainio M. The Mediating Role of Digital Competence in the Associations Between the Factors Affecting Healthcare Utilization and Access to Care. Int J Public Health 2024; 68:1606184. [PMID: 38250321 PMCID: PMC10796446 DOI: 10.3389/ijph.2023.1606184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Objectives: To examine with a population-based longitudinal survey design whether poor health, longstanding activity limitation, impaired cognitive functioning, mental distress, or loneliness predict poor access to healthcare and whether digital competence mediates these associations. Methods: The data were from the longitudinal FinHealth -survey gathered in Finland in 2017 and 2020 including 3,771 respondents (57.1% women). Linear regression analyses were used to examine the associations of factors affecting healthcare utilization with access to care adjusted for age, sex, and education. Counterfactual causal mediation framework was used to examine the mediating role of digital competence in the relationships among these factors and access to healthcare. Results: Factors affecting healthcare utilization were associated with poor access to care and these associations were partly mediated by low digital competence. Low digital competence mediated 12%, 9% and 8%, of the associations of impaired cognitive functioning, longstanding activity limitation, and loneliness with poor access to care, respectively. Conclusion: According to our results, one way to improve the access to healthcare among vulnerable groups could be to improve their digital competence.
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Affiliation(s)
| | | | - Lotta Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Emma Kainiemi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Seppo Koskinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marko Elovainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Nissinen S, Pesonen S, Toivio P, Sormunen E. Exploring the use, usefulness and ease of use of digital occupational health services: A descriptive correlational study of customer experiences. Digit Health 2024; 10:20552076241242668. [PMID: 38601187 PMCID: PMC11005500 DOI: 10.1177/20552076241242668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Objective This study examined the customer experiences of use, perceived usefulness and ease of use of digital occupational health (OH) services. Methods A cross-sectional study based on an electronic survey was conducted between December 2022 and January 2023. A total of 9871 OH customers responded to the survey. The sample was restricted to respondents who used digital OH services (n = 7275). An analysis of variance was run to test the relationships between respondents' characteristics and the rate of usefulness, and ease of use variables. Results The most commonly used digital services were appointment booking, access to health information recorded by professionals and prescription renewal, and the digital services provided by physicians and nurses. Respondents expressed quite high satisfaction with the digital services, but not as much with their usefulness and ease of use. Females, individuals under 50 years of age, those with higher education, working in white-collar or managerial positions and possessing proficient information and communication technology (ICT) skills gave the most positive evaluations regarding usefulness and ease of use. Conclusions There was a certain level of mixed experiences among respondents regarding the usefulness and ease of use of digital OH services. We can also conclude that individuals who possess the necessary ICT skills can more easily take full advantage of the available digital services. When customers are proficient in using digital services, they can confidently interact with professionals. Regardless of the user's age, gender, education or profession, it is crucial for service providers always to strive to improve the usability of digital services.
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Affiliation(s)
- Sari Nissinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Sanna Pesonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Erja Sormunen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Arumalla N, Chan CKD, Gibson M, Man YL, Adas MA, Norton S, Galloway JB, Garrood T. The Clinical Impact of Electronic Patient-Reported Outcome Measures in the Remote Monitoring of Inflammatory Arthritis: A Systematic Review and Meta-analysis. Arthritis Rheumatol 2023; 75:1892-1903. [PMID: 37204273 DOI: 10.1002/art.42559] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 04/28/2023] [Accepted: 05/05/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The inflammatory arthritides (IAs) make up a significant proportion of conditions followed up in rheumatology clinics. These patients require regular monitoring, but this is increasingly difficult with rising patient numbers and demand on clinics. Our objective is to evaluate the clinical impact of electronic patient-reported outcome measures (ePROMs) as a digital remote-monitoring intervention on disease activity, treatment decisions, and health care resource use in patients with IA. METHODS Five databases (MEDLINE, Embase, PubMed, Cochrane Library, and Web of Science) were searched, with randomized controlled trials and (nonrandomized) controlled clinical trials included, and meta-analysis and forest plots conducted for each outcome. Risk of bias was assessed using the Risk of Bias-2 tool and Risk of Bias in Nonrandomized Studies of Interventions. RESULTS Eight studies were included with a total of 4,473 patients, with seven studies assessing patients with rheumatoid arthritis. Compared with control, the disease activity in the ePROM group was lower (standardized mean difference [SMD] -0.15; 95% confidence interval [CI] -0.27 to -0.03) and rates of remission/low disease activity were higher (odds ratio1.65; 95% CI 1.02-2.68), but five of eight studies provided additional combined interventions (e.g., disease education). Fewer face to face visits were needed in the remote ePROM group (SMD -0.93; 95% CI -2.14-0.28). CONCLUSION Most studies were at high risk of bias with significant heterogeneity in design, but our results suggest there is an advantage in using ePROM monitoring in patients with IAs, with the potential for reduction in health care resource use without detrimental impact in disease outcomes.
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Affiliation(s)
| | | | | | - Yik L Man
- Lewisham and Greenwich NHS Trust, London, UK
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Srivastava D, Henschke C, Virtanen L, Lotman EM, Friebel R, Ardito V, Petracca F. Promoting the systematic use of real-world data and real-world evidence for digital health technologies across Europe: a consensus framework. HEALTH ECONOMICS, POLICY, AND LAW 2023; 18:395-410. [PMID: 37705236 DOI: 10.1017/s1744133123000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Despite the acceleration in the use of digital health technologies across different aspects of the healthcare system, the full potential of real-world data (RWD) and real-world evidence (RWE) arising from the technologies is not being utilised in decision-making. We examine current national efforts and future opportunities to systematically use RWD and RWE in decision-making in five countries (Estonia, Finland, Germany, Italy and the United Kingdom), and then develop a framework for promotion of the systematic use of RWD and RWE. A review assesses current national efforts, complemented with a three-round consensus-building exercise among an international group of experts (n1 = 44, n2 = 24, n3 = 24) to derive key principles. We find that Estonia and Finland have invested and developed digital health-related policies for several years; Germany and Italy are the more recent arrivals, while the United Kingdom falls somewhere in the middle. Opportunities to promote the systematic use of RWD and RWE were identified for each country. Eight building blocks principles were agreed through consensus, relating to policy scope, institutional role and data collection. Promoting post-market surveillance and digital health technology vigilance ought to rely on clarity in scope and data collection with consensus reached on eight principles to leverage RWD and RWE.
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Affiliation(s)
- Divya Srivastava
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Cornelia Henschke
- Deptartment of Health Care Management, Technische Universität Berlin, Berlin Centre for Health Economics Research (BerlinHECOR), Berlin, Germany
| | - Lotta Virtanen
- Welfare State Research and Reform Unit, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Eno-Martin Lotman
- Cardiac Intensive Care Unit, North Estonia Medical Centre, Tallinn, Estonia
| | - Rocco Friebel
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Vittoria Ardito
- Center for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milano, Italy
| | - Francesco Petracca
- Center for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milano, Italy
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Maeckelberghe E, Zdunek K, Marceglia S, Farsides B, Rigby M. The ethical challenges of personalized digital health. Front Med (Lausanne) 2023; 10:1123863. [PMID: 37404804 PMCID: PMC10316710 DOI: 10.3389/fmed.2023.1123863] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 05/09/2023] [Indexed: 07/06/2023] Open
Abstract
Personalized digital health systems (pHealth) bring together in sharp juxtaposition very different yet hopefully complementary moral principles in the shared objectives of optimizing health care and the health status of individual citizens while maximizing the application of robust clinical evidence through harnessing powerful and often complex modern data-handling technologies. Principles brought together include respecting the confidentiality of the patient-clinician relationship, the need for controlled information sharing in teamwork and shared care, benefitting from healthcare knowledge obtained from real-world population-level outcomes, and the recognition of different cultures and care settings. This paper outlines the clinical process as enhanced through digital health, reports on the examination of the new issues raised by the computerization of health data, outlines initiatives and policies to balance the harnessing of innovation with control of adverse effects, and emphasizes the importance of the context of use and citizen and user acceptance. The importance of addressing ethical issues throughout the life cycle of design, provision, and use of a pHealth system is explained, and a variety of situation-relevant frameworks are presented to enable a philosophy of responsible innovation, matching the best use of enabling technology with the creation of a culture and context of trustworthiness.
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Affiliation(s)
- Els Maeckelberghe
- Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Kinga Zdunek
- Health Education Unit, Medical University of Lublin, Lublin, Poland
| | - Sara Marceglia
- Faculty of Clinical Engineering, University of Trieste, Trieste, Italy
| | - Bobbie Farsides
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Michael Rigby
- School of Social, Political and Global Studies and School of Primary, Community and Social Care, Keele University, Keele, United Kingdom
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Yang S, Lee CJ, Beak J. Social Disparities in Online Health-Related Activities and Social Support: Findings from Health Information National Trends Survey. HEALTH COMMUNICATION 2023; 38:1293-1304. [PMID: 34865570 DOI: 10.1080/10410236.2021.2004698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
It is important to examine gaps in online health-related activities (OHAs) between socially advantaged and disadvantaged groups, considering that emerging information and communication technologies may bring about social disparities in their adoption and possibly expand preexisting health disparities. We thus examined whether digital divide occurs in the area of OHAs, including engagement with a very recent technology. To be more specific, we explored the effects of education, income, and race/ethnicity on OHAs, such as online health information seeking, social media use for health, and health information technologies (HITs) utilization. Moreover, given the importance of socio-contextual factors in digital divide, we examined how social support interacts with education, income, and race/ethnicity, and jointly influences OHAs. Using data from the 2017 Health Information National Trends Survey, we found the effects of education on several OHAs. Income only affected HITs utilization that had just started to diffuse across the U.S. society. We also identified reinforcing effects of social support and education on HITs utilization, and reinforcing effects of social support and income on online health information seeking. The implications of these findings for health communication and public health research were discussed.
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Affiliation(s)
- Soeun Yang
- Department of Communication, Seoul National University
| | - Chul-Joo Lee
- Department of Communication, Seoul National University
| | - Jiyen Beak
- Department of Communication, Seoul National University
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Taddei L, Mendicino F, Grande T, Mulé A, Micozzi R, Parini EG. Contributions of digital social research to develop Telemedicine in Calabria (Southern Italy): identification of inequalities in post-COVID-19. FRONTIERS IN SOCIOLOGY 2023; 8:1141750. [PMID: 37229283 PMCID: PMC10204871 DOI: 10.3389/fsoc.2023.1141750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/30/2023] [Indexed: 05/27/2023]
Abstract
The paper discusses the role that sociology and digital social research methods could play in developing E-health and Telemedicine, specifically after the COVID-19 pandemic, and the possibility of dealing with new pandemics. In this article, we will reflect on an interdisciplinary research pilot project carried out by a team of sociologists, medical doctors, and software engineers at The University of Calabria (Italy), to give a proof of concept of the importance to develop Telemedicine through the contribution of digital social research. We apply a web and app survey to administrate a structured questionnaire to a self-selected sample of the University Community. Digital social research has highlighted socioeconomic and cultural gaps that affect the perception of Telemedicine in the University Community. In particular, gender, age, educational, and professional levels influence medical choices and behaviors during Covid-19. There is often an unconscious involvement in Telemedicine (people use it but don't know it is Telemedicine), and an optimistic perception grows with age, education, professional, and income levels; equally important are the comprehension of digital texts and the effective use of Telemedicine. Limited penetration of technological advances must be addressed primarily by overcoming sociocultural and economic barriers and developing knowledge and understanding of digital environments. The key findings of this study could help direct public and educational policies to reduce existing gaps and promote Telemedicine in Calabria.
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Affiliation(s)
- Luciana Taddei
- Department of Political and Social Sciences, University of Calabria, Cosenza, Italy
| | | | - Teresa Grande
- Department of Political and Social Sciences, University of Calabria, Cosenza, Italy
| | | | | | - Ercole Giap Parini
- Department of Political and Social Sciences, University of Calabria, Cosenza, Italy
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Heponiemi T, Kainiemi E, Virtanen L, Saukkonen P, Sainio P, Koponen P, Koskinen S. Predicting Internet Use and Digital Competence Among Older Adults Using Performance Tests of Visual, Physical, and Cognitive Functioning: Longitudinal Population-Based Study. J Med Internet Res 2023; 25:e42287. [PMID: 37145836 DOI: 10.2196/42287] [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: 08/30/2022] [Revised: 11/22/2022] [Accepted: 03/15/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND The rapidly increasing role of the internet in obtaining basic services poses challenges, especially for older adults' capabilities of getting the services they need. Research on the predictors of older adults' internet use and digital competence is especially relevant given that people are living longer than before, and the age profile of many societies is changing rapidly. OBJECTIVE We aimed to examine the associations of objective measures of physical and cognitive impairment with the nonuse of the internet for services and low digital competence among older adults. METHODS A longitudinal population-based design was used that combined data from performance tests and self-rated questionnaires. Data were gathered in 2017 and 2020 among 1426 older adults aged between 70 and 100 years in Finland. Logistic regression analyses were used to examine the associations. RESULTS Those who had poor near (odds ratio [OR] 1.90, 95% CI 1.36-2.66) or distant vision (OR 1.81, 95% CI 1.21-2.71), restricted or failed abduction of upper arms (OR 1.81, 95% CI 1.28-2.85), and poor results from the word list memory (OR 3.77, 95% CI 2.65-5.36) or word list delayed recall (OR 2.12, 95% CI 1.48-3.02) tests had greater odds for nonuse of the internet for services than their counterparts. Moreover, those who had poor near (OR 2.18, 95% CI 1.57-3.02) or distant vision (OR 2.14, 95% CI 1.43-3.19), poor results from the chair stand test (OR 1.57, 95% CI 1.06-2.31), restricted or failed abduction of upper arms (OR 1.74, 95% CI 1.10-2.76), and poor results from the word list memory (OR 3.41, 95% CI 2.32-5.03) or word list delayed recall (OR 2.05, 95% CI 1.39-3.04) tests had greater odds of low digital competence than their counterparts. CONCLUSIONS According to our results, older adults' impaired physical and cognitive functioning may hamper their possibilities of accessing internet services such as digital health care services. Our results should be considered when planning digital health care services intended to be used by older adults; that is, digital solutions should also be suitable for older adults with impairments. Furthermore, face-to-face services should be provided for those who cannot use digital services, even if they are assisted properly.
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Affiliation(s)
| | - Emma Kainiemi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lotta Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Päivi Sainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Seppo Koskinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
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14
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Pu D, Palmer V, Greenstock L, Pigott C, Peeters A, Sanci L, Callisaya M, Browning C, Chapman W, Haines T. Identifying Public Healthcare Priorities in Virtual Care for Older Adults: A Participatory Research Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4015. [PMID: 36901031 PMCID: PMC10002071 DOI: 10.3390/ijerph20054015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED There has been increasing adoption and implementation of virtual healthcare in recent years, especially with COVID-19 impacting the world. As a result, virtual care initiatives may not undergo stringent quality control processes to ensure that they are appropriate to their context and meet sector needs. The two objectives of this study were to identify virtual care initiatives for older adults currently in use in Victoria and virtual care challenges that could be prioritised for further investigation and scale-up and to understand why certain virtual care initiatives and challenges are prioritised over others for investigation and scale-up. METHODS This project used an Emerging Design approach. A survey of public health services in the state of Victoria in Australia was first carried out, followed by the co-production of research and healthcare priorities with key stakeholders in the areas of primary care, hospital care, consumer representation, research, and government. The survey was used to gather existing virtual care initiatives for older adults and any associated challenges. Co-production processes consisted of individual ratings of initiatives and group-based discussions to identify priority virtual care initiatives and challenges to be addressed for future scale-up. Stakeholders nominated their top three virtual initiatives following discussions. RESULTS Telehealth was nominated as the highest priority initiative type for scaling up, with virtual emergency department models of care nominated as the highest priority within this category. Remote monitoring was voted as a top priority for further investigations. The top virtual care challenge was data sharing across services and settings, and the user-friendliness of virtual care platforms was nominated as the top priority for further investigation. CONCLUSIONS Stakeholders prioritised public health virtual care initiatives that are easy to adopt and address needs that are perceived to be more immediate (acute more so than chronic care). Virtual care initiatives that incorporate more technology and integrated elements are valued, but more information is needed to inform their potential scale-up.
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Affiliation(s)
- Dai Pu
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC 3199, Australia
- Monash Partners Academic Health Science Centre, Clayton, VIC 3168, Australia
| | - Victoria Palmer
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Louise Greenstock
- Western Alliance Academic Health Science Centre, Warrnambool, VIC 3280, Australia
| | - Cathie Pigott
- Monash Partners Academic Health Science Centre, Clayton, VIC 3168, Australia
| | - Anna Peeters
- Western Alliance Academic Health Science Centre, Warrnambool, VIC 3280, Australia
- Institute for Health Transformation, Deakin University, Melbourne, VIC 3125, Australia
| | - Lena Sanci
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Michele Callisaya
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC 3199, Australia
- Menzies Institute for Medical Research, College of Health and Medicine, University of Tasmania, Hobart, TAS 7000, Australia
| | - Colette Browning
- Institute of Health and Wellbeing, Federation University, Ballarat, VIC 3350, Australia
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT 2601, Australia
| | - Wendy Chapman
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC 3199, Australia
- Monash Partners Academic Health Science Centre, Clayton, VIC 3168, Australia
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Esposito S, Rosafio C, Antodaro F, Argentiero A, Bassi M, Becherucci P, Bonsanto F, Cagliero A, Cannata G, Capello F, Cardinale F, Chiriaco T, Consolaro A, Dessì A, Di Mauro G, Fainardi V, Fanos V, Guarino A, Li Calzi G, Lodi E, Maghnie M, Manfredini L, Malorgio E, Minuto N, Modena MG, Montori R, Moscatelli A, Patrone E, Pescio E, Poeta M, Ravelli A, Spelta M, Suppiej A, Vai S, Villa L, Zanini R, Botti R, Gaddi AV. Information and Training on the Use of Telemedicine in Pediatric Population: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP), and of the Syndicate of Family Pediatrician Doctors (SIMPeF). J Pers Med 2023; 13:jpm13020314. [PMID: 36836548 PMCID: PMC9958783 DOI: 10.3390/jpm13020314] [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: 12/26/2022] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Telemedicine has entered the daily lives of doctors, although the digital skills of healthcare professionals still remain a goal to be achieved. For the purpose of a large-scale development of telemedicine, it is necessary to create trust in the services it can offer and to favor their acceptance by healthcare professionals and patients. In this context, information for the patient regarding the use of telemedicine, the benefits that can be derived from it, and the training of healthcare professionals and patients for the use of new technologies are fundamental aspects. This consensus document is a commentary that has the aim of defining the information on and training aspects of telemedicine for pediatric patients and their caregivers, as well as pediatricians and other health professionals who deal with minors. For the present and the future of digital healthcare, there is a need for a growth in the skills of professionals and a lifelong learning approach throughout the professional life. Therefore, information and training actions are important to guarantee the necessary professionalism and knowledge of the tools, as well as a good understanding of the interactive context in which they are used. Furthermore, medical skills can also be integrated with the skills of various professionals (engineers, physicists, statisticians, and mathematicians) to birth a new category of health professionals responsible for building new semiotics, identifying criteria for predictive models to be integrated into clinical practice, standardizing clinical and research databases, and defining the boundaries of social networks and new communication technologies within health services.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
- Correspondence:
| | | | | | - Alberto Argentiero
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Marta Bassi
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | | | | | | | - Giulia Cannata
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Fabio Capello
- UO Territorial Pediatrics, Primary Care Department, AUSL Bologna, 40126 Bologna, Italy
| | - Fabio Cardinale
- Department of Pediatrics and Emergency, Pediatric Hospital Giovanni XXIII, University of Bari, 70124 Bari, Italy
| | - Tiziana Chiriaco
- Health Department, ASL Roma 3, 00125 Rome, Italy
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Alessandro Consolaro
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa,16126 Genoa, Italy
| | - Angelica Dessì
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | | | - Valentina Fainardi
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari, 09127 Cagliari, Italy
| | - Alfredo Guarino
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Giada Li Calzi
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Lodi
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Mohamad Maghnie
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Luca Manfredini
- Pediatric Pain and Palliative Care Service, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | | | - Nicola Minuto
- Department of Pediatrics, IRCCS Giannina Gaslini, 16147 Genoa, Italy
| | - Maria Grazia Modena
- P.A.S.C.I.A. Center (Heart Failure Care Program, Childhood Heart Diseases and Those at Risk), University of Modena and Reggio Emilia, AOU Polyclinic of Modena, 41124 Modena, Italy
| | - Rossano Montori
- Community Medicine and Primary Care, AUSL Modena, 41124 Modena, Italy
| | - Andrea Moscatelli
- UOC Anesthesia and Intensive Care, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Elisa Patrone
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | - Elena Pescio
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Marco Poeta
- Section of Pediatrics, Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Angelo Ravelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal-Child Sciences (DINOGMI), University of Genoa,16126 Genoa, Italy
- Scientific Directorate, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Maddalena Spelta
- Pediatric and Rheumatology Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Agnese Suppiej
- Pediatric Clinic, Department of Medical Sciences, University of Ferrara, 44124 Ferrara, Italy
| | - Sergio Vai
- Alma Mater University, 40126 Bologna, Italy
| | - Luca Villa
- UOSID Trial Center, IRCCS Giannina Gaslini Institute, 16147 Genoa, Italy
| | - Rinaldo Zanini
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Renato Botti
- General Management, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Antonio Vittorino Gaddi
- Center for Metabolic Diseases and Atherosclerosis, University of Bologna, 40126 Bologna, Italy
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Kainiemi E, Saukkonen P, Virtanen L, Vehko T, Kyytsönen M, Aaltonen M, Heponiemi T. Perceived benefits of digital health and social services among older adults: A population-based cross-sectional survey. Digit Health 2023; 9:20552076231173559. [PMID: 37312955 PMCID: PMC10259144 DOI: 10.1177/20552076231173559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/17/2023] [Indexed: 06/15/2023] Open
Abstract
Objective The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d) Internet use, were examined. Methods The present sample included 8019 respondents aged between 75 and 99 years. The inverse probability weighting method was used to correct for bias. Linear regression analyses were used to examine the associations. Results The ease of use of the services regardless of the time and location was perceived as the most beneficial. Convenient distance to local health or social services (parameter estimate = 0.15 [0.08-0.23]), good functional ability (PE = 0.08 [0.01-0.14]), good vision (PE = 0.15 [0.04-0.25]), ability to learn (PE = 0.05 [0.01-0.10]) and living with someone (PE = 0.08 [95% CI 0.04-0.13]) were associated with perceiving more benefits. In addition, access to the Internet (PE = 0.12 [0.06-0.19]) and independent use of the Internet (PE = 0.23 [0.17-0.29]) were associated with perceiving more benefits. Conclusions Older adults who are healthier, have a social relationship in their everyday life or have easier access to traditional services seem to perceive more benefits from digital health and social services. Digital services should be developed to correspond with special needs caused by disadvantages in health and the social environment. To facilitate the use of digital health and social services, more efforts should be made to enhance older adults' perceptions of their benefits.
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Affiliation(s)
- Emma Kainiemi
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Petra Saukkonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Lotta Virtanen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Maiju Kyytsönen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Mari Aaltonen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Tarja Heponiemi
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
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17
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Qadikolaei MR, Zali N, Soltani A. Spatiotemporal investigation of the digital divide, the case study of Iranian Provinces. ENVIRONMENT, DEVELOPMENT AND SUSTAINABILITY 2022; 26:1-16. [PMID: 36465591 PMCID: PMC9702755 DOI: 10.1007/s10668-022-02738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/22/2022] [Indexed: 06/17/2023]
Abstract
Many communities and territories in developing countries experience significant gaps in access to and use of information and communication technology (ICT), which is viewed as a major impediment to socioeconomic and health-related vulnerabilities. Geographic considerations, on the other hand, as well as variations in motivation for ICT usage and technology adoption within and across nations, as well as between cultures, have exacerbated the digital divide. This paper investigates disparities in access to and utilization of ICT in 31 Iranian provinces from 2011 to 2020. The research discovers evidence that family income and the number of R&D centers affected the formation of the digital divide, albeit the degree of the split has fluctuated through time and space. This study discovered that digital inequality is associated with social exclusion throughout Iranian regions, and it went on to try to better understand the underlying issues and potential solutions. In this regard, some policy avenues are suggested for government action, particularly for marginalized socioeconomic groups, such as the provision of infrastructure, training and skill augmentation, and the easing of digital services supplied by the government or private sector.
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Affiliation(s)
| | - Nader Zali
- Department of Urban Planning, University of Guilan, Raht, Iran
| | - Ali Soltani
- UniSA Business, University of South Australia, City West Campus, 5001 Australia
- Department of Urban Planning, Shiraz University, Shiraz, Iran
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18
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Ho HPY, Lai AYK, Kwok RYK, Kwok TO, Chow E, Yip T, Tang WY, Leung KW, Lam E, Lam KY, Tsui TSY, Lok WF, Yam PW, Wong SF, Wong CM, Cham KKW, Wong BYM, Ho SY, Wang MP, Lam TH. Use of Information and Communications Technology in Family Services and Its Perceived Benefits amid the COVID-19 Pandemic in Hong Kong-Jockey Club SMART Family-Link Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15634. [PMID: 36497706 PMCID: PMC9740009 DOI: 10.3390/ijerph192315634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/14/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION We examined information and communications technology (ICT) use in family services and its perceived benefits and barriers amid the COVID-19 pandemic in Hong Kong. METHODS We invited all family service social workers of 12 NGOs to complete an anonymous online questionnaire in May 2020 (Part A) and a management representative from each NGO to provide written feedback on ICT use in January 2021 (Part B). RESULTS In Part A, of 255 respondents (response rate: 67.3%), perceived ICT use in conducting programmes, groups, casework and preventive family programmes showed net increases of 33.9-54.5%; perceived ICT use in different work processes showed net increases of 18.8-48.6%. The three most common perceived benefits were "providing another option to service users" (74.2%), "more convenient service" (60.2%) and "maintaining normal service" (59.7%). In Part B, 12 management representatives consistently reported positive impacts of ICT use on family services. They shared actionable strategies (e.g., ICT skill-related training) and concerns about data privacy and management. CONCLUSIONS ICT use in family services markedly increased amid the COVID-19 pandemic in Hong Kong. It helped make the services more accessible especially when the pandemic restricted face-to-face services.
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Affiliation(s)
| | | | - Ricky Yu-Kwong Kwok
- Department of Electrical and Electronic Engineering, The University of Hong Kong, Hong Kong
- Hong Kong Metropolitan University, Hong Kong
| | - Tai-On Kwok
- Technology-Enriched Learning Initiative, The University of Hong Kong, Hong Kong
| | - Edward Chow
- Technology-Enriched Learning Initiative, The University of Hong Kong, Hong Kong
| | - Teresa Yip
- The Hong Kong Catholic Marriage Advisory Council, Hong Kong
| | - Wai-Yan Tang
- Hong Kong Sheng Kung Hui Welfare Council Limited, Hong Kong
| | | | | | | | | | | | - Pui-Wah Yam
- The Neighbourhood Advice-Action Council, Hong Kong
| | | | | | | | - Bonny Yee-Man Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong
| | - Sai-Yin Ho
- School of Public Health, The University of Hong Kong, Hong Kong
| | - Man-Ping Wang
- School of Nursing, The University of Hong Kong, Hong Kong
| | - Tai-Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong
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Costa-Cordella S, Grasso-Cladera A, Rossi A, Duarte J, Guiñazu F, Cortes CP. Internet-based peer support interventions for people living with HIV: A scoping review. PLoS One 2022; 17:e0269332. [PMID: 36040950 PMCID: PMC9426879 DOI: 10.1371/journal.pone.0269332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/18/2022] [Indexed: 11/18/2022] Open
Abstract
Peer support interventions for people living with HIV and AIDS (PLWHA) are effective, but their associated time and material costs for the recipient and the health system make them reachable for only a small proportion of PLWHA. Internet-based interventions are an effective alternative for delivering psychosocial interventions for PLWHA as they are more accessible. Currently, no reviews are focusing on internet-based interventions with peer support components. This scoping review aims to map the existing literature on psychosocial interventions for PLWHA based on peer support and delivered through the internet. We conducted a systematic scoping review of academic literature following methodological guidelines for scoping reviews, and 28 articles met our criteria. We summarized the main characteristics of the digital peer support interventions for PLWHA and how they implemented peer support in a virtual environment. Overall the reported outcomes appeared promising, but more robust evidence is needed.
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Affiliation(s)
- Stefanella Costa-Cordella
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Instituto Milenio Depresión y Personalidad (MIDAP), Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Aitana Grasso-Cladera
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Alejandra Rossi
- Centro de Estudios en Neurociencia Humana y Neuropsicología (CENHN), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
| | - Javiera Duarte
- Centro de Estudios en Psicología Clínica y Psicoterapia (CEPPS), Facultad de Psicología, Universidad Diego Portales, Santiago, Chile
- Instituto Milenio Depresión y Personalidad (MIDAP), Santiago, Chile
| | - Flavia Guiñazu
- Web Intelligence Centre, Facultad de Ingeniería Industrial, Universidad de Chile, Santiago, Chile
| | - Claudia P. Cortes
- Hospital Clínico San Borja Arriarán & Fundación Arriarán, Santiago, Chile
- Departamento de Medicina, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- * E-mail:
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Hannemann N, Babitsch B. Wahrgenommener Nutzen digitaler Gesundheitsapplikationen aus der
Perspektive von Nutzenden. DAS GESUNDHEITSWESEN 2022. [DOI: 10.1055/s-0042-1753765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Busse TS, Nitsche J, Kernebeck S, Jux C, Weitz J, Ehlers JP, Bork U. Approaches to Improvement of Digital Health Literacy (eHL) in the Context of Person-Centered Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148309. [PMID: 35886158 PMCID: PMC9316109 DOI: 10.3390/ijerph19148309] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 02/04/2023]
Abstract
The skills, knowledge and resources to search for, find, understand, evaluate and apply health information is defined as health literacy (HL). If individuals want to use health information from the Internet, they need Digital Health Literacy (eHL), which in addition to HL also includes, for example, media literacy. If information cannot be found or understood by patients due to low (e)HL, patients will not have the opportunity to make informed decisions. In addition, many health apps for self-management or prevention also require (e)HL. Thus, it follows that active participation in healthcare, in terms of Person-Centered Care (PCC) is only possible through (e)HL. Currently, there is a great need to strengthen these competencies in society to achieve increased empowerment of patients and their health. However, at the same time, there is a need to train and improve competencies in the field of healthcare professionals so that they can counsel and guide patients. This article provides an overview with a focus on HL and eHL in healthcare, shows the opportunities to adapt services and describes the possible handling of patients with low (e)HL. In addition, the opportunities for patients and healthcare professionals to improve (e)HL are highlighted.
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Affiliation(s)
- Theresa Sophie Busse
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (J.N.); (S.K.); (C.J.); (J.P.E.)
- Correspondence:
| | - Julia Nitsche
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (J.N.); (S.K.); (C.J.); (J.P.E.)
| | - Sven Kernebeck
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (J.N.); (S.K.); (C.J.); (J.P.E.)
| | - Chantal Jux
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (J.N.); (S.K.); (C.J.); (J.P.E.)
| | - Jürgen Weitz
- Department of GI-, Thoracic- and Vascular Surgery, Dresden Technical University, University Hospital Dresden, 01307 Dresden, Germany; (J.W.); (U.B.)
| | - Jan P. Ehlers
- Department of Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany; (J.N.); (S.K.); (C.J.); (J.P.E.)
- Vicepresident for Learning and Teaching, Witten/Herdecke University, 58455 Witten, Germany
| | - Ulrich Bork
- Department of GI-, Thoracic- and Vascular Surgery, Dresden Technical University, University Hospital Dresden, 01307 Dresden, Germany; (J.W.); (U.B.)
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22
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Korn S, Böttcher MD, Busse TS, Kernebeck S, Breucha M, Ehlers J, Kahlert C, Weitz J, Bork U. Use and Perception of Digital Health Technologies by Surgical Patients in Germany in the Pre-COVID-19 Era: Survey Study. JMIR Form Res 2022; 6:e33985. [PMID: 35594072 PMCID: PMC9166644 DOI: 10.2196/33985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This survey study investigates surgical patients' use and perception of digital health technologies in Germany in the pre-COVID-19 era. OBJECTIVE The objective of this study was to relate surgical patients' characteristics to the use and perception of several digital health technologies. METHODS In this single-center, cross-sectional survey study in the outpatient department of a university hospital in Germany, 406 patients completed a questionnaire with the following three domains: general information and use of the internet, smartphones, and general digital health aspects. Analyses were stratified by age group and highest education level achieved. RESULTS We found significant age-based differences in most of the evaluated aspects. Younger patients were more open to using new technologies in private and medical settings but had more security concerns. Although searching for information on illnesses on the web was common, the overall acceptance of and trust in web-based consultations were rather low, with <50% of patients in each age group reporting acceptance and trust. More people with academic qualifications than without academic qualifications searched for information on the web before visiting physicians (73/121, 60.3% and 100/240, 41.7%, respectively). Patients with academic degrees were also more engaged in health-related information and communication technology use. CONCLUSIONS These results support the need for eHealth literacy, health literacy, and available digital devices and internet access to support the active, meaningful use of information and communication technologies in health care. Uncertainties and a lack of knowledge exist, especially regarding telemedicine and the use of medical and health apps. This is especially pronounced among older patients and patients with a low education status.
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Affiliation(s)
- Sandra Korn
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Maximilian David Böttcher
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Theresa Sophie Busse
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Sven Kernebeck
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Michael Breucha
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jan Ehlers
- Didactics and Educational Research in Health Science, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Christoph Kahlert
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Jürgen Weitz
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT/UCC) Dresden, German Cancer Research Center (DKFZ), Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany
| | - Ulrich Bork
- Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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23
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Kainiemi E, Vehko T, Kyytsönen M, Hörhammer I, Kujala S, Jormanainen V, Heponiemi T. Factors Associated with Non-use of and Dissatisfaction with the National Patient Portal in Finland in the Era of COVID-19: A Population-based Cross-sectional Survey Study (Preprint). JMIR Med Inform 2022; 10:e37500. [PMID: 35404831 PMCID: PMC9037616 DOI: 10.2196/37500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 12/29/2022] Open
Abstract
Background In the abnormal circumstances caused by the COVID-19 pandemic, patient portals have supported patient empowerment and engagement by providing patients with access to their health care documents and medical information. However, the potential benefits of patient portals cannot be utilized unless the patients accept and use the services. Disparities in the use of patient portals may exacerbate the already existing inequalities in health care access and health outcomes, possibly increasing the digital inequality in societies. Objective The aim of this study is to examine the factors associated with nonuse of and dissatisfaction with the Finnish nationwide patient portal My Kanta Pages among the users of health care services during the COVID-19 outbreak. Several factors related to sociodemographic characteristics, health, and the use of health care services; experiences of guidance concerning electronic services; and digital skills and attitudes were evaluated. Methods A national population survey was sent using stratified sampling to 13,200 Finnish residents who had reached the age of 20 years. Data were collected from September 2020 to February 2021 during the COVID-19 pandemic. Respondents who had used health care services and the internet for transactions or for searching for information in the past 12 months were included in the analyses. Bivariate logistic regression analyses were used to examine the adjusted associations of respondent characteristics with the nonuse of My Kanta Pages and dissatisfaction with the service. The inverse probability weighting (IPW) method was applied in all statistical analyses to correct for bias. Results In total, 3919 (64.9%) of 6034 respondents were included in the study. Most respondents (3330/3919, 85.0%) used My Kanta Pages, and 2841 (85.3%) of them were satisfied. Nonusers (589/3919, 15%) were a minority among all respondents, and only 489 (14.7%) of the 3330 users were dissatisfied with the service. Especially patients without a long-term illness (odds ratio [OR] 2.14, 95% CI 1.48-3.10), those who were not referred to electronic health care services by a professional (OR 2.51, 95% CI 1.70-3.71), and those in need of guidance using online social and health care services (OR 2.26, 95% CI 1.41-3.65) were more likely nonusers of the patient portal. Perceptions of poor health (OR 2.10, 95% CI 1.51-2.93) and security concerns (OR 1.87, 95% CI 1.33-2.62) were associated with dissatisfaction with the service. Conclusions Patients without long-term illnesses, those not referred to electronic health care services, and those in need of guidance on the use of online social and health care services seemed to be more likely nonusers of the Finnish nationwide patient portal. Moreover, poor health and security concerns appeared to be associated with dissatisfaction with the service. Interventions to promote referral to electronic health care services by professionals are needed. Attention should be targeted to information security of the service and promotion of the public’s confidence in the protection of their confidential data.
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Affiliation(s)
- Emma Kainiemi
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Iiris Hörhammer
- Department of Industrial Engineering and Management, Aalto University, Espoo, Finland
| | - Sari Kujala
- Department of Computer Science, Aalto University, Espoo, Finland
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24
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Kaihlanen AM, Virtanen L, Buchert U, Safarov N, Valkonen P, Hietapakka L, Hörhammer I, Kujala S, Kouvonen A, Heponiemi T. Towards digital health equity - a qualitative study of the challenges experienced by vulnerable groups in using digital health services in the COVID-19 era. BMC Health Serv Res 2022; 22:188. [PMID: 35151302 PMCID: PMC8840681 DOI: 10.1186/s12913-022-07584-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background The COVID-19 pandemic has given an unprecedented boost to already increased digital health services, which can place many vulnerable groups at risk of digital exclusion. To improve the likelihood of achieving digital health equity, it is necessary to identify and address the elements that may prevent vulnerable groups from benefiting from digital health services. This study examined the challenges experienced by vulnerable groups in using digital health services during the COVID-19 pandemic. Methods Qualitative descriptive design was utilized. Semi-structured interviews were conducted between October 2020 and May 2021. The participants (N = 74) were older adults, migrants, mental health service users, high users of health services, and the unemployed. Qualitative content analysis with both inductive and deductive approach was used to analyze the data. Challenges related to the use of digital health services were interpreted through digital determinants of health from the Digital Health Equity Framework. Results For most of the participants the access to digital health services was hampered by insufficient digital, and / or local language skills. The lack of support and training, poor health, as well as the lack of strong e-identification or suitable devices also prevented the access. Digital services were not perceived to be applicable for all situations or capable of replacing face-to-face services due to the poor communication in the digital environment. Fears and the lack of trust regarding digital platforms were expressed as well as concerns related to the security of the services. Contact with a health care professional was also considered less personal and more prone to misunderstandings in the digital environment than in face-to-face services. Finally, digital alternatives were not always available as desired by participants, or participants were unaware of existing digital services and their value. Conclusion Several development needs in the implementation of digital health services were identified that could improve equal access to and benefits gained from digital services in the future. While digital health services are increasing, traditional face-to-face services will still need to be offered alongside the digital ones to ensure equal access to services. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07584-4.
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25
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A Digital Health Service for Elderly People with Balance Disorders and Risk of Falling: A Design Science Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031855. [PMID: 35162877 PMCID: PMC8835704 DOI: 10.3390/ijerph19031855] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/25/2022] [Accepted: 02/05/2022] [Indexed: 11/16/2022]
Abstract
In this study, a design science research methodology was used aiming at designing, implementing and evaluating a digital health service to complement the provision of healthcare for elderly people with balance disorders and risk of falling. An explanatory sequential mixed methods study allowed to identify and explore the dissatisfaction with electronic medical records and the opportunity for using digital health solutions. The suggested recommendations helped to elaborate and develop “BALANCE”, a digital service implemented on the METHIS platform, which was recently validated for remote monitoring of chronic patients in primary healthcare. “BALANCE” provides clinical and interactive data, questionnaire pre and post-balance rehabilitation, tutorial videos with balance exercises and patient-recorded videos of the exercises. This digital service was demonstrated, including five elderly patients with clinical recommendations for balance rehabilitation at home. Finally, the authors conducted two focus groups with the participants and their caregivers as well as with physicians. The focus groups aimed at exploring their satisfaction level, needs of adjustment in the “BALANCE” service and strategies for applicability. The digital healthcare service evaluation revealed a significant potential for clinical applicability of this digital solution for elderly people with balance disorders and risk of falling.
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26
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Tetri B, Juujärvi S. Self-Efficacy, Internet Self-Efficacy, and Proxy Efficacy as Predictors of the Use of Digital Social and Health Care Services Among Mental Health Service Users in Finland: A Cross-Sectional Study. Psychol Res Behav Manag 2022; 15:291-303. [PMID: 35210878 PMCID: PMC8857988 DOI: 10.2147/prbm.s340867] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/18/2022] [Indexed: 01/22/2023] Open
Abstract
Background The COVID-19 pandemic has accelerated the digitalization of services, but at the same time, some user groups are excluded due to a lack of digital skills. One of the vulnerable groups is people with mental health problems. It has previously been found that self-efficacy beliefs explain the use of digital technology, but the role of social support is largely unexamined. Bandura’s concept of proxy agency provides a useful concept to investigate the role of social support in using digital services. Objective The study investigates sources of social support and the effect of proxy agency, Internet efficacy, and self-efficacy beliefs on the intention to use digital health and social care services. Methods Participants (N = 121) were users in community-based mental health services who were recruited through four organizations in southern Finland for a cross-sectional study. The scales for proxy agency and intention to use services were developed for purpose of the study. The questionnaire also comprised self-efficacy and Internet efficacy scales. Quantitative data were analyzed using descriptive statistics and linear regression analysis. Results Both Internet self-efficacy and proxy efficacy (p < 0.001) predicted the intention to use digital health and social care services. Self-efficacy had an indirect positive effect on intention through Internet self-efficacy. Family members and friends were the main source of social support in using digital services. Conclusion Internet self-efficacy and proxy efficacy are important contributors to the intention to use digital health and social care services. Proxy agents may serve as facilitators to reduce the digital divide and promote the use of digital services by complementing individuals’ self-efficacy and Internet self-efficacy beliefs. It is important to develop different forms of social support, such as peer support, to enhance the quality of proxy agency. The limitations of proxy agency are discussed.
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Affiliation(s)
- Birgitta Tetri
- Laurea University of Applied Sciences, Vantaa, Finland
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
- Correspondence: Birgitta Tetri, Laurea University of Applied Sciences, Ratatie 22, Vantaa, 01300, Finland, Email
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27
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Al Knawy B, McKillop MM, Abduljawad J, Tarkoma S, Adil M, Schaper L, Chee A, Bates DW, Klag M, Lee U, Kozlakidis Z, Crooks G, Rhee K. Successfully Implementing Digital Health to Ensure Future Global Health Security During Pandemics: A Consensus Statement. JAMA Netw Open 2022; 5:e220214. [PMID: 35195701 DOI: 10.1001/jamanetworkopen.2022.0214] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Importance COVID-19 has highlighted widespread chronic underinvestment in digital health that hampered public health responses to the pandemic. Recognizing this, the Riyadh Declaration on Digital Health, formulated by an international interdisciplinary team of medical, academic, and industry experts at the Riyadh Global Digital Health Summit in August 2020, provided a set of digital health recommendations for the global health community to address the challenges of current and future pandemics. However, guidance is needed on how to implement these recommendations in practice. Objective To develop guidance for stakeholders on how best to deploy digital health and data and support public health in an integrated manner to overcome the COVID-19 pandemic and future pandemics. Evidence Review Themes were determined by first reviewing the literature and Riyadh Global Digital Health Summit conference proceedings, with experts independently contributing ideas. Then, 2 rounds of review were conducted until all experts agreed on the themes and main issues arising using a nominal group technique to reach consensus. Prioritization was based on how useful the consensus recommendation might be to a policy maker. Findings A diverse stakeholder group of 13 leaders in the fields of public health, digital health, and health care were engaged to reach a consensus on how to implement digital health recommendations to address the challenges of current and future pandemics. Participants reached a consensus on high-priority issues identified within 5 themes: team, transparency and trust, technology, techquity (the strategic development and deployment of technology in health care and health to achieve health equity), and transformation. Each theme contains concrete points of consensus to guide the local, national, and international adoption of digital health to address challenges of current and future pandemics. Conclusions and Relevance The consensus points described for these themes provide a roadmap for the implementation of digital health policy by all stakeholders, including governments. Implementation of these recommendations could have a significant impact by reducing fatalities and uniting countries on current and future battles against pandemics.
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Affiliation(s)
- Bandar Al Knawy
- King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | | | - Joud Abduljawad
- Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Sasu Tarkoma
- Department of Computer Science, University of Helsinki, Pietari Kalmin katu 5, 00014, Finland
| | - Mahmood Adil
- Royal College of Physicians of Edinburgh, Edinburgh, Scotland
| | - Louise Schaper
- Australasian Institute of Digital Health, Melbourne, Australia
| | - Adam Chee
- Smart Health Leadership Centre, National University of Singapore, Singapore
| | - David W Bates
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Michael Klag
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Uichin Lee
- Department of Knowledge Service Engineering, School of Computing, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - George Crooks
- Digital Health and Care Innovation Centre, Glasgow, United Kingdom
| | - Kyu Rhee
- CVS Health, Woonsocket, Rhode Island
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Abrahams M, O'Grady R, Prawitt J. Feasibility and acceptability of a mixed model digital study to explore the effect of a daily collagen peptide supplement on digestive symptoms in healthy females: findings from a pilot study. (Preprint). JMIR Form Res 2022; 6:e36339. [PMID: 35639457 PMCID: PMC9198822 DOI: 10.2196/36339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions Trial Registration
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29
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Effectiveness of Social Media-Based Interventions for the Promotion of Physical Activity: Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413018. [PMID: 34948628 PMCID: PMC8702047 DOI: 10.3390/ijerph182413018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 01/27/2023]
Abstract
A global target of the World Health Organization (WHO) is to reduce physical inactivity among all adults and adolescents by approximately fifteen percent by 2030. Social media could have an impact in this effort because of its enormous reach, potentially addressing underserved populations in need for physical activity (PA) interventions. This scoping review provides a broad overview of social media-based interventions and systematically maps the evidence regarding their effectiveness for PA promotion and other health outcomes. Scopus and Medline were searched using the terms “physical activity” and “social media” and the names of key social media platforms. Following the PRISMA guidelines for scoping reviews, abstracts and full texts were screened for eligibility. In total, 12,321 publications were identified and 53 met the inclusion criteria. The use of Facebook was most prevalent in PA interventions, followed by study-specific platforms. More than one third of the studies revealed positive effects regarding the promotion of PA. Additionally, social media-based interventions positively affected other physical dimensions of health (e.g., weight or blood pressure). Results pertaining to feasibility were heterogeneous. Social media seems to be a promising tool for increasing PA at the population level. Future studies should take the abundance of platforms into account and select social media platforms consciously.
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Rantanen T, Gluschkoff K, Silvennoinen P, Heponiemi T. The Associations Between Mental Health Problems and Attitudes Toward Web-Based Health and Social Care Services: Evidence From a Finnish Population-Based Study. J Med Internet Res 2021; 23:e28066. [PMID: 34546184 PMCID: PMC8493458 DOI: 10.2196/28066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The significance of web-based health and social care services has been highlighted in recent years. There is a risk that the digitalization of public services will reinforce the digital and social exclusion of vulnerable groups, such as individuals with mental health problems. OBJECTIVE This study aims to examine the associations between mental health problems and attitudes toward web-based health and social care services in the general population. The attitudes measured include lack of interest, perceived need for face-to-face encounters, and concern for safety. The study also evaluates whether sociodemographic characteristics (age, gender, education level, and poverty) modify these associations. METHODS Cross-sectional population-based data were collected from 4495 Finnish adults in 2017. Linear regression was used to examine the main effects and interactions of poor mental health and sociodemographic characteristics on attitudes toward web-based health and social care services. RESULTS The results show that mental health was associated with attitudes toward web-based health and social care services. Individuals with mental health problems were especially concerned about the safety of web-based services. Poor mental health was independently associated with negative attitudes toward web-based services over the effects of sociodemographic factors. Some of the associations between poor mental health and negative attitudes toward web-based services were stronger among older people and men. With regard to sociodemographic characteristics, particularly higher age, low education, and poverty were associated with negative attitudes toward web-based health and social care services. CONCLUSIONS Poor mental health is associated with negative attitudes toward web-based health and social care services and thus indirectly with exclusion. It seems that being older and being male both reinforce the link between poor mental health and exclusion. In supporting the digital inclusion of people with mental health problems, attention should be paid to guidance and counseling, reliability, and the user-friendliness of web-based services as well as to the prevention of poverty. In addition, it is essential to see web-based services as complementary to, and not a substitute for, face-to-face services.
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Affiliation(s)
- Teemu Rantanen
- Unit of Digital Education and Master Programmes, Laurea University of Applied Sciences, Vantaa, Finland
| | - Kia Gluschkoff
- Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Piia Silvennoinen
- Unit of Digital Education and Master Programmes, Laurea University of Applied Sciences, Vantaa, Finland
| | - Tarja Heponiemi
- Welfare State Research and Reform, Finnish Institute for Health and Welfare, Helsinki, Finland
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31
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Hannemann N, Götz NA, Schmidt L, Hübner U, Babitsch B. Patient connectivity with healthcare professionals and health insurer using digital health technologies during the COVID-19 pandemic: a German cross-sectional study. BMC Med Inform Decis Mak 2021; 21:250. [PMID: 34433452 PMCID: PMC8386151 DOI: 10.1186/s12911-021-01605-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/05/2021] [Indexed: 11/11/2022] Open
Abstract
Background Digital health technologies enable patients to make a personal contribution to the improvement of their health by enabling them to manage their health. In order to exploit the potential of digital health technologies, Internet-based networking between patients and health care providers is required. However, this networking and access to digital health technologies are less prevalent in sociodemographically deprived cohorts. The paper explores how the use of digital health technologies, which connect patients with health care providers and health insurers has changed during the COVID-19 pandemic. Methods The data from a German-based cross-sectional online study conducted between April 29 and May 8, 2020, were used for this purpose. A total of 1.570 participants were included in the study. Accordingly, the influence of sociodemographic determinants, subjective perceptions, and personal competencies will affect the use of online booking of medical appointments and medications, video consultations with providers, and the data transmission to health insurers via an app. Results The highest level of education (OR 1.806) and the presence of a chronic illness (OR 1.706) particularly increased the likelihood of using online booking. With regard to data transmission via an app to a health insurance company, the strongest increase in the probability of use was shown by belonging to the highest subjective social status (OR 1.757) and generation Y (OR 2.303). Furthermore, the results show that the higher the subjectively perceived restriction of the subjects' life situation was due to the COVID-19 pandemic, the higher the relative probability of using online booking (OR 1.103) as well as data transmission via an app to a health insurance company (OR 1.113). In addition, higher digital literacy contributes to the use of online booking (OR 1.033) and data transmission via an app to the health insurer (OR 1.034). Conclusions Socially determined differences can be identified for the likelihood of using digital technologies in health care, which persist even under restrictive conditions during the COVID-19 pandemic. Thus, the results indicate a digital divide with regard to the technologies investigated in this study.
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Affiliation(s)
- Niels Hannemann
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany.
| | - Nina-Alexandra Götz
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany
| | - Lisa Schmidt
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany
| | - Ursula Hübner
- Health Informatics Research Group, Hochschule Osnabrück, Albrechtstr. 30, 49076, Osnabrück, Germany
| | - Birgit Babitsch
- Department of New Public Health, Osnabrück University, Barbarastr. 22c, 49076, Osnabrück, Germany
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Alkureishi MA, Choo ZY, Lenti G, Castaneda J, Zhu M, Nunes K, Weyer G, Oyler J, Shah S, Lee WW. Clinician Perspectives on Telemedicine: Observational Cross-sectional Study. JMIR Hum Factors 2021; 8:e29690. [PMID: 34184994 PMCID: PMC8274680 DOI: 10.2196/29690] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Since the COVID-19 pandemic onset, telemedicine has increased exponentially across numerous outpatient departments and specialties. Qualitative studies examining clinician telemedicine perspectives during the pandemic identified challenges with physical examination, workflow concerns, burnout, and reduced personal connection with patients. However, these studies only included a relatively small number of physicians or were limited to a single specialty, and few assessed perspectives on integrating trainees into workflows, an important area to address to support the clinical learning environment. As telemedicine use continues, it is necessary to understand a range of clinician perspectives. OBJECTIVE This study aims to survey pediatric and adult medicine clinicians at the University of Chicago Medical Center to understand their telemedicine benefits and barriers, workflow impacts, and training and support needs. METHODS In July 2020, we conducted an observational cross-sectional study of University of Chicago Medical Center faculty and advanced practice providers in the Department of Medicine (DOM) and Department of Pediatrics (DOP). RESULTS The overall response rate was 39% (200/517; DOM: 135/325, 42%; DOP: 65/192, 34%); most respondents were physicians (DOM: 100/135, 74%; DOP: 51/65, 79%). One-third took longer to prepare for (65/200, 33%) and conduct (62/200, 32%) video visits compared to in-person visits. Male clinicians reported conducting a higher percentage of telemedicine visits by video than their female counterparts (P=.02), with no differences in the number of half-days per week providing direct outpatient care or supervising trainees. Further, clinicians who conducted a higher percentage of their telemedicine by video were less likely to feel overwhelmed (P=.02), with no difference in reported burnout. Female clinicians were "more overwhelmed" with video visits compared to males (41/130, 32% vs 12/64, 19%; P=.05). Clinicians 50 years or older were "less overwhelmed" than those younger than 50 years (30/85, 35% vs 23/113, 20%; P=.02). Those who received more video visit training modalities (eg, a document and webinar on technical issues) were less likely to feel overwhelmed by the conversion to video visits (P=.007) or burnt out (P=.009). In addition, those reporting a higher ability to technically navigate a video visit were also less likely to feel overwhelmed by video visits (P=.02) or burnt out (P=.001). The top telemedicine barriers were patient-related: lack of technology access, lack of skill, and reluctance. Training needs to be focused on integrating learners into workflows. Open-ended responses highlighted a need for increased support staff. Overall, more than half "enjoyed conducting video visits" (119/200, 60%) and wanted to continue using video visits in the future (150/200, 75%). CONCLUSIONS Despite positive telemedicine experiences, more support to facilitate video visits for patients and clinicians is needed. Further, clinicians need additional training on trainee education and integration into workflows. Further work is needed to better understand why gender and age differences exist. In conclusion, interventions to address clinician and patient barriers, and enhance clinician training are needed to support telemedicine's durability.
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Affiliation(s)
| | - Zi-Yi Choo
- Pritzker School of Medicine, Chicago, IL, United States
| | - Gena Lenti
- Pritzker School of Medicine, Chicago, IL, United States
| | | | - Mengqi Zhu
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Kenneth Nunes
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, United States
| | - George Weyer
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Julie Oyler
- Department of Medicine, University of Chicago, Chicago, IL, United States
| | - Sachin Shah
- Department of Medicine, University of Chicago, Chicago, IL, United States
- Department of Pediatrics, University of Chicago, Chicago, IL, United States
| | - Wei Wei Lee
- Department of Medicine, University of Chicago, Chicago, IL, United States
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Schiffer L, Gertges R, Nöhre M, Schieffer E, Tegtbur U, Pape L, de Zwaan M, Schiffer M. Use and preferences regarding internet-based health care delivery in patients with chronic kidney disease. BMC Med Inform Decis Mak 2021; 21:34. [PMID: 33522934 PMCID: PMC7848877 DOI: 10.1186/s12911-020-01375-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 12/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background and objectives Internet-based technologies play an increasingly important role in the management and outcome of patients with chronic kidney disease (CKD). The healthcare system is currently flooded with digital innovations and internet-based technologies as a consequence of the coronavirus disease 2019 (COVID-19) pandemic. However, information about the attitude of German CKD-patients with access to online tools towards the use of remote, internet-based interactions such as video conferencing, email, electronic medical records and apps in general and for health issues in particular, are missing. Design, setting, participants, and measurements To address the use, habits and willingness of CKD patients in handling internet-based technologies we conducted a nationwide cross-sectional questionnaire survey in adults with CKD. Results We used 380 questionnaires from adult CKD patients (47.6% on dialysis, 43.7% transplanted and 8.7% CKD before renal replacement therapy) for analysis. Of these 18.9% denied using the internet at all (nonusers). Nonusers were significantly older (74.4 years, SD 11.4) than users (54.5 years, SD 14.5, p < 0.001), had a lower educational level than users (≥ 12 years: 6.9% versus 47.1%, p < 0.001) and were more often on dialysis. Within the group of internet users only a minority (2.6%) was using video conferencing with their physician, only 11.7% stated that they were using email to report symptoms and 26.6% were using the internet to schedule appointments. Slightly more than one-third of internet users (35.1%) are concerned that their personal medical data are not safe when submitted via the internet. Conclusions Within our group of German CKD-patients we found that almost one out of five patients, especially older patients and patients with a lower educational level, did not use the internet at all. The majority of internet users reported in our survey that they have not used internet-based technologies within a medical context so far, but are willing to consider it. Therefore, it seems to be important to introduce and teach motivated CKD-patients the use and benefits of simple and safe internet-based health care technologies.
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Affiliation(s)
- Lena Schiffer
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl Neuberg Str. 1, 30625, Hannover, Germany. .,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany.
| | - Raoul Gertges
- Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Mariel Nöhre
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Elisabeth Schieffer
- Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany.,Department of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Uwe Tegtbur
- Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany.,Department of Sports Medicine, Hannover Medical School, Hannover, Germany
| | - Lars Pape
- Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Carl Neuberg Str. 1, 30625, Hannover, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
| | - Mario Schiffer
- Department of Nephrology, University Hospital, Friedrich-Alexander University, Erlangen, Germany.,Project Kidney Transplantation 360°, Hannover Medical School, Hannover, Germany
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Patients' Use and Perceptions of a Drug-Drug Interaction Database: A Survey of Janusmed Interactions. PHARMACY 2021; 9:pharmacy9010023. [PMID: 33478093 PMCID: PMC7838894 DOI: 10.3390/pharmacy9010023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/12/2021] [Accepted: 01/16/2021] [Indexed: 01/03/2023] Open
Abstract
Janusmed interactions is a drug-drug interactions (DDI) database available online for healthcare professionals (HCP) at all levels of the healthcare system including pharmacies. The database is aimed at HCP but is also open to the public for free, for those individuals who register for a personal account. The aim of this study was to investigate why and how patients use the database Janusmed interactions, how they perceive content and usability, and how they would react if they found an interaction. A web-based questionnaire was sent by email to all users who had registered for Janusmed interactions as a “patient” (n = 3219). A total of 406 patients completed the survey (response rate 12.6%). The study shows that there is an interest among patients to use a DDI database to check their own or a relative’s medication. The respondents found the database easy to use and perceive they understand the information aimed at HCP. Most patients stated they would talk to their HCP if they found an interaction and not adjust their treatment by themselves. However, the respondents in this study are actively searching for information and seem to have high health literacy. Thus, the findings are not generalizable for the general population.
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Calixte R, Rivera A, Oridota O, Beauchamp W, Camacho-Rivera M. Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186856. [PMID: 32961766 PMCID: PMC7559701 DOI: 10.3390/ijerph17186856] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/11/2022]
Abstract
National surveys of U.S. adults have observed significant increases in health-related internet use (HRIU), but there are documented disparities. The study aims to identify social and demographic patterns of health-related internet use among U.S. adults. Using data from the Health Information National Trends Survey (HINTS) 4 cycle 3 and HINTS 5 cycle 1, we examined HRIU across healthcare, health information seeking, and participation on social media. Primary predictors were gender, race/ethnicity, age, education, income, and nativity with adjustments for smoking and survey year. We used multivariable logistic regression with survey weights to identify independent predictors of HRIU. Of the 4817 respondents, 43% had used the internet to find a doctor; 80% had looked online for health information. Only 20% had used social media for a health issue; 7% participated in an online health support group. In multivariable models, older and low SES participants were significantly less likely to use the internet to look for a provider, use the internet to look for health information for themselves or someone else, and less likely to use social media for health issues. Use of the internet for health-related purposes is vast but varies significantly by demographics and intended use.
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Affiliation(s)
- Rose Calixte
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY 10031, USA; (R.C.); (O.O.); (W.B.)
| | - Argelis Rivera
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10027, USA;
| | - Olutobi Oridota
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY 10031, USA; (R.C.); (O.O.); (W.B.)
| | - William Beauchamp
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY 10031, USA; (R.C.); (O.O.); (W.B.)
| | - Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA
- Correspondence:
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