Community health programs delivered through information and communications technology in high-income countries: a scoping review (Preprint)

Sources of information on monkeypox virus infection. A systematic review with meta-analysis

BACKGROUND

Monkeypox (Mpox) virus infection is a topic of growing interest today because of its potential public health impact and concern about possible outbreaks. Reliable and up-to-date sources of information that provide accurate data on its transmission, symptoms, prevention, and treatment are essential for understanding and effectively addressing this disease. Therefore, the aim of the present study is to determine the prevalence of sources of information on Mpox virus infection.

METHODS

An exhaustive systematic review and meta-analysis was carried out using the information available in the PubMed, Scopus, Web of Science, Embase, and ScienceDirect databases up to August 3, 2023. The data were analyzed using R software version 4.2.3. The quality of the cross-sectional studies that formed part of this review was assessed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. In addition, a subgroup analysis was performed based on the study populations.

RESULTS

Through electronic searches of five databases, a total of 1833 studies were identified. Twenty-four cross-sectional articles were included, with a total sample of 35,959 participants from 34 countries. The pooled prevalence of each of the included information sources was: social networks reached 59% (95% CI: 50-68%; 29,146 participants; 22 studies; I2 = 100%; p < 0.01); the Internet was 61% (95% CI: 44-77%; 14,002 participants; 5 studies; I2 = 100%; p < 0.01), radio reached 10% (95% CI: 07-13%; 8917 participants; 4 studies; I2 = 93%; p < 0.01), television accounted for 24% (95% CI: 09-43%; 14,896 participants; 8 studies; I2 = 100%; p < 0.01), and the combination of radio and television accounted for 45% (95% CI: 31-60%; 4207 participants; 7 studies; I2 = 99%; p < 0.01); for newspapers, it was 15% (95% CI: 05-27%; 2841 participants; 6 studies; I2 = 99%; p < 0.01), friends and relatives accounted for 19% (95% CI: 12-28%; 28,470 participants; 19 studies; I2 = 100%; p < 0.01), the World Health Organization (WHO) accounted for 17% (95% CI: 07-29%; 1656 participants; 3 studies; I2 = 97%; p < 0.01), the Centers for Disease Control and Prevention (CDC) accounted for 10% (95% CI: 03-21%; 2378 participants; 3 studies; I2 = 98%; p < 0.01), and the combination of WHO and CDC websites accounted for 60% (95% CI: 48-72%; 1828 participants; 4 studies; I2 = 96%; p < 0.01), and finally, scientific articles and journals accounted for 24% (95% CI: 16-33%; 16,775 participants; 13 studies; I2 = 99%; p < 0.01).

CONCLUSION

The study suggests that people access a variety of information sources to gain knowledge about Mpox virus infection, with a strong emphasis on online sources such as social networks and the Internet. However, it is important to note that the quality and accuracy of information available from these sources can vary, underscoring the need to promote access to reliable and up-to-date information about this disease to ensure public health.

Paper promises: Peruvian frontline health workers' perspectives on mental health policies during COVID-19

Governments globally deployed various non-pharmacological public health measures to respond to the COVID-19 pandemic (i.e. lockdowns and suspension of transportation, amongst others); some of these measures had an influence on society's mental health. Specific mental health policies were therefore implemented to mitigate the potential mental health impact of the pandemic. We aimed to explore the implementation of mental health regulations adopted by the Peruvian health system by focusing on the care services at Community Mental Health Centres (CMHCs), based on the experiences of health workers. We conducted a phenomenological qualitative study to understand the implementation of mental health policies launched in Peru during the COVID-19 pandemic. Data were obtained from a document review of 15 national policy measures implemented during the pandemic (March 2020 to September 2021), and 20 interviews with health workers from CMHCs (September 2021 to February 2022). The analysis was conducted using thematic content analysis. Most implemented policies adapted CMHC care services to a virtual modality during the COVID-19 pandemic; however, various challenges and barriers were evidenced in the process, which prevented effective adaptation of services. Workers perceived that ineffective telemedicine use was attributed to a gap in access to technology at the CMHCs and also by users, ranging from limited access to technological devices to a lack of technological skills. Further, although mental health promotion and prevention policies targeting the community were proposed, CMHC staff reported temporary interruption of these services during the first wave. The disparity between what is stated in the regulations and the experiences of health workers is evident. Policies that focus on mental health need to provide practical and flexible methods taking into consideration both the needs of CMHCs and socio-cultural characteristics that may affect their implementation.

Using integrated knowledge translation to address a rurally based time-critical knowledge gap during the COVID-19 pandemic: a multimethods study in Victoria, Australia

OBJECTIVES

The aim of this study was to explore the intention of health professionals to use evidence generated through an integrated knowledge translation (iKT) activity undertaken during the COVID-19 pandemic to answer a time-critical research question about the delivery of community-based group programmes to rural clients via virtual technology, and describe the participating health professionals and researchers' perceptions of the iKT partnership.

DESIGN

Multimethod study incorporating qualitative and quantitative approaches.

SETTING

Two regional health services in Victoria (Australia).

PARTICIPANTS

26 allied health professionals (knowledge-partners) from eight disciplines across two regional health services and eight researchers from five Victorian universities.

INTERVENTION

An iKT approach was used to facilitate problem identification, evidence synthesis and adaption of evidence to the local context.

DATA COLLECTION AND ANALYSIS

Participants were invited to complete a survey (knowledge-partners) and undertake a semistructured interview (knowledge-partners and researchers) on their experiences. A process log of collaborative activities tracked the type of engagement activities, who attended and the outcomes. The survey and process log results were analysed descriptively, the interviews using thematic analysis and a comparison of results approach applied to evaluate similarities and differences in the perception of the partnership from separate data collection and analysis processes.

RESULTS

The survey indicated strong positive attitudes towards using research evidence in practice as well as strong intentions to use it in the future by knowledge-partners. Knowledge-partners indicated that their expertise was used in the research process, although there was greater collaboration in some steps of iKT. The context of COVID-19 facilitated collaboration between knowledge-partners and researchers through a sense of urgency and shared purpose. Rapid team development was a key mechanism that enabled iKT. Team participation was necessarily pragmatic and flexible in nature to facilitate knowledge-partner involvement. Participants suggested the iKT process was likely to result in greater end-user buy in and a powerful example of how to upskill health professionals without a significant impact on their day-to-day workload. This project was considered by knowledge-partners to be more likely to have an impact compared with other projects without a research partner.

CONCLUSIONS

This study highlights how researchers and knowledge-partners can work effectively and rapidly to address a time-sensitive problem of mutual interest. Establishing and nurturing rural-based researcher and knowledge-partner networks is key to enabling agile and timely responses to the changing evidence needs of the health system.

GATEKEEPER's Strategy for the Multinational Large-Scale Piloting of an eHealth Platform: Tutorial on How to Identify Relevant Settings and Use Cases

BACKGROUND

The World Health Organization's strategy toward healthy aging fosters person-centered integrated care sustained by eHealth systems. However, there is a need for standardized frameworks or platforms accommodating and interconnecting multiple of these systems while ensuring secure, relevant, fair, trust-based data sharing and use. The H2020 project GATEKEEPER aims to implement and test an open-source, European, standard-based, interoperable, and secure framework serving broad populations of aging citizens with heterogeneous health needs.

OBJECTIVE

We aim to describe the rationale for the selection of an optimal group of settings for the multinational large-scale piloting of the GATEKEEPER platform.

METHODS

The selection of implementation sites and reference use cases (RUCs) was based on the adoption of a double stratification pyramid reflecting the overall health of target populations and the intensity of proposed interventions; the identification of a principles guiding implementation site selection; and the elaboration of guidelines for RUC selection, ensuring clinical relevance and scientific excellence while covering the whole spectrum of citizen complexities and intervention intensities.

RESULTS

Seven European countries were selected, covering Europe's geographical and socioeconomic heterogeneity: Cyprus, Germany, Greece, Italy, Poland, Spain, and the United Kingdom. These were complemented by the following 3 Asian pilots: Hong Kong, Singapore, and Taiwan. Implementation sites consisted of local ecosystems, including health care organizations and partners from industry, civil society, academia, and government, prioritizing the highly rated European Innovation Partnership on Active and Healthy Aging reference sites. RUCs covered the whole spectrum of chronic diseases, citizen complexities, and intervention intensities while privileging clinical relevance and scientific rigor. These included lifestyle-related early detection and interventions, using artificial intelligence-based digital coaches to promote healthy lifestyle and delay the onset or worsening of chronic diseases in healthy citizens; chronic obstructive pulmonary disease and heart failure decompensations management, proposing integrated care management based on advanced wearable monitoring and machine learning (ML) to predict decompensations; management of glycemic status in diabetes mellitus, based on beat to beat monitoring and short-term ML-based prediction of glycemic dynamics; treatment decision support systems for Parkinson disease, continuously monitoring motor and nonmotor complications to trigger enhanced treatment strategies; primary and secondary stroke prevention, using a coaching app and educational simulations with virtual and augmented reality; management of multimorbid older patients or patients with cancer, exploring novel chronic care models based on digital coaching, and advanced monitoring and ML; high blood pressure management, with ML-based predictions based on different intensities of monitoring through self-managed apps; and COVID-19 management, with integrated management tools limiting physical contact among actors.

CONCLUSIONS

This paper provides a methodology for selecting adequate settings for the large-scale piloting of eHealth frameworks and exemplifies with the decisions taken in GATEKEEPER the current views of the WHO and European Commission while moving forward toward a European Data Space.

New Web-Based System for Recording Public Health Nursing Practices and Determining Best Practices: Protocol of an Exploratory Sequential Design

BACKGROUND

Digitalization and information and communication technology (ICT) promote effective, efficient individual and community care. Clinical terminology or taxonomy and its framework visualize individual patients' and nursing interventions' classifications to improve their outcomes and care quality. Public health nurses (PHNs) provide lifelong individual care and community-based activities while developing projects to promote community health. The linkage between these practices and clinical assessment remains tacit. Owing to Japan's lagging digitalization, supervisory PHNs face difficulties in monitoring each department's activities and staff members' performances and competencies. Randomly selected prefectural or municipal PHNs collect data on daily activities and required hours every 3 years. No study has adopted these data for public health nursing care management. PHNs need ICTs to manage their work and improve care quality; it may help identify health needs and suggest best public health nursing practices.

OBJECTIVE

We aim to develop and validate an electronic recording and management system for evaluating different public health nursing practice needs, including individual care, community-based activities, and project development, and for determining their best practices.

METHODS

We used a 2-phase exploratory sequential design (in Japan) comprising 2 phases. In phase 1, we developed the system's architectural framework and a hypothetical algorithm to determine the need for practice review through a literature review and a panel discussion. We designed a cloud-based practice recording system, including a daily record system and a termly review system. The panels included 3 supervisors who were prior PHNs at the prefectural or municipal government, and 1 was the executive director of the Japanese Nursing Association. The panels agreed that the draft architectural framework and hypothetical algorithm were reasonable. The system was not linked to electronic nursing records to protect patient privacy. Phase 2 validated each item through interviews with supervisory PHNs using a web-based meeting system. A nationwide survey was distributed to supervisory and midcareer PHNs across local governments.

RESULTS

This study was funded in March 2022 and approved by all ethics review boards from July to September and November 2022. Data collection was completed in January 2023. Five PHNs participated in the interviews. In the nationwide survey, responses were obtained from 177 local governments of supervisory PHNs and 196 midcareer ones.

CONCLUSIONS

This study will reveal PHNs' tacit knowledge about their practices, assess needs for different approaches, and determine best practices. Additionally, this study will promote ICT-based practices in public health nursing. The system will enable PHNs to record their daily activities and share them with their supervisors to reflect on and improve their performance, and the quality of care to promote health equity in community settings. The system will support supervisory PHNs in creating performance benchmarks for their staff and departments to promote evidence-based human resource development and management.

TRIAL REGISTRATION

UMIN-ICDR UMIN000049411; https://tinyurl.com/yfvxscfm.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/45342.

Community Health Nursing During the COVID-19 Pandemic in Korea: Consequences, Challenges, and Directions

PURPOSE

To explore the consequences, challenges, and future directions based on community health nurses' experiences during COVID-19.

DESIGN

Qualitative study. Four focus group interviews were conducted with 27 community health nurses.

FINDINGS

Three major themes emerged: 1) Coordination of roles and duties, 2) Identifying deterioration of patients' health and increasing demand for visits, and 3) Changing service delivery strategies: a testing ground for new services.

CONCLUSIONS

Community health nurses were essential public healthcare providers during the pandemic. The findings are informative for nurses and policy makers who can develop and suggest different services in the post-COVID era.