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Abdelraheem O, Salama M, Chun S. Impact of digital interventions and online health communities in patient activation: Systematic review and meta-analysis. Int J Med Inform 2024; 188:105481. [PMID: 38776718 DOI: 10.1016/j.ijmedinf.2024.105481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/04/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Study the efficacy of digital health interventions in enhancing patient activation and identify the distinct features of these interventions using the WHO classification system. METHODS Asystematic reviewand meta-analysis were carried out according to the PRISMA guidelines. A search was conducted in Scopus, PubMed, and ProQuest. Randomized controlled trials (RCT), quasi-randomized controlled trials, and before-and-after studies enrolling patients ≥ 18 years of age with the Patient Activation Measure (PAM) score measurement and contain digital intervention with any aspects of health education or health-related behavior were included. The Downs and Black quality assessment tool was used to assess the quality of the articles. RESULTS In the three different types of meta-analyses, implementing the intervention led to a PAM score increase (Mean Difference (M.D.)), ranging from a minimum of (MD = 0.2014, 95 % CI = 0.0871-0.3158) and a highly significant p-value 0.0006 to a maximum of (MD = 2.7882, 95 % CI = 1.5558-4.0206) and a p-value < .0001. While the M.D. score of 0.2014 may seem relatively low, it is enough to elevate the patient from one activation level to a higher one out of the four activation levels. CONCLUSION AND PRACTICE IMPLICATIONS The results suggest the effectiveness of digital health interventions on patient activation across diverse settings and contexts, implying potential generalizability. Using WHO classification, all examined digital interventions addressed the challenges of information, utilization, and efficiency in the health system, but not equity-related challenges. The study recognized online health communities (OHCs) as a subset of digital interventions that enhance patient activation through social support.
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Affiliation(s)
- Omnia Abdelraheem
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo 11835, Egypt
| | - Mohamed Salama
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo 11835, Egypt
| | - Sungsoo Chun
- Institute of Global Health and Human Ecology, The American University in Cairo, New Cairo 11835, Egypt.
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Schmidt CW, Borgnakke K, Frølich A, Kayser L. Preferences, Needs, and Values of Patients With Chronic Obstructive Pulmonary Disease Attending a Telehealth Service: Qualitative Interview Study. JMIR Hum Factors 2024; 11:e53131. [PMID: 38905629 PMCID: PMC11226923 DOI: 10.2196/53131] [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: 09/27/2023] [Revised: 04/29/2024] [Accepted: 05/24/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Digitally assisted health care services and technologies are gaining popularity. They assist patients in managing their conditions, thereby reducing the burden on health care staff. Digital health care enables individuals to receive care that is more tailored to their needs and preferences. When implemented properly, it can promote equity by considering each person's opportunities and limitations in the context of health care needs, preferences, values, and capabilities. OBJECTIVE This study aims to understand the needs, values, and preferences of individuals with chronic obstructive pulmonary disease (COPD) who are provided with a 24/7 digital health care service. Furthermore, we aim to understand the dynamics of the communities to which they belong and how these communities intersect. This will provide us with the essential knowledge to establish new methods of providing education, including the development of educational activities for health professionals to engage, train, and empower people living with COPD. METHODS The study included 7 informants diagnosed with COPD who received 24/7 digital health care service support from a regional project in Region Zealand, Denmark. The informants were visited 4 times during 2 months, including a "Hello" visit, a day with a semistructured interview, and 2 days with field observations. The informants participated in a semistructured interview, following participant observation and an ethnographic approach. The interview content was analyzed using an inductive methodology to categorize the empirical data. RESULTS Using the inductive approach, we identified 3 main categories related to the informants' needs, values, and preferences: (1) Health, (2) Value Creation, and (3) Resources. These 3 main categories were based on 9 subcategories: (1) health and barriers, (2) self-monitoring, (3) medication, (4) behavior, (5) motivation, (6) hobbies, (7) social networks, (8) health professionals, and (9) technology. These findings revealed that the informants placed value on maintaining their daily activities and preserving their sense of identity before the onset of COPD. Furthermore, they expressed a desire not to be defined by their COPD, as conversations about COPD often shifted away from the topic. CONCLUSIONS Digital health solutions and the health care professionals who offer them should prioritize the individuals they serve, considering their needs, values, and preferences rather than solely focusing on the medical condition. This approach ensures the highest level of daily living and empowerment for those living with long-term health conditions. The communities surrounding individuals must engage in constant interaction and collaboration. They should work together to incorporate people's needs, values, and preferences into future digital health services, thereby promoting empowerment and self-management. New educational programs aimed at developing the digital health service competencies of registered nurses should facilitate collaboration between the 2 communities. This collaboration is essential for supporting patients with long-term health conditions in their daily activities.
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Affiliation(s)
- Camilla Wong Schmidt
- Medical Department, Holbæk Sygehus, Region Zealand, Holbæk, Denmark
- Section of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Karen Borgnakke
- Section of Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Anne Frølich
- Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Region Zealand, Slagelse, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars Kayser
- Section of Health Services Research, University of Copenhagen, Copenhagen, Denmark
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Teckchandani TA, Shields RE, Andrews KL, Maguire KQ, Jamshidi L, Nisbet J, Afifi TO, Lix LM, Stewart SH, Sauer-Zavala S, Krakauer RL, Neary JP, Krätzig GP, Carleton RN. Trouble with the curve: the 90-9-1 rule to measure volitional participation inequalities among Royal Canadian Mounted Police cadets during training. Front Psychiatry 2024; 15:1297953. [PMID: 38863607 PMCID: PMC11165702 DOI: 10.3389/fpsyt.2024.1297953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/26/2024] [Indexed: 06/13/2024] Open
Abstract
Objective The Royal Canadian Mounted Police (RCMP) Study includes longitudinal multimodal assessments of RCMP cadets from pre-training (i.e., starting the Cadet Training Program [CTP]) to post-deployment and for five years thereafter. The data allow for investigating the multidimensionality of volitional participation in digital health data collection frameworks within serial data collection platforms and the impact of participation inequalities by classifying cadets using the 90-9-1 rule. By classifying cadets as Lurkers, Contributors, and Superusers formally described by the 90-9-1 rule, where 90% of actors do not participate, 9% seldom contribute, and 1% contribute substantially allows for the assessing of relationships between participation inequalities in self-monitoring behaviors as well as whether mental health disorder symptoms at pre-training (i.e., starting the CTP) were associated with subsequent participation. Methods Participants were asked to complete a Full Assessment prior to their training at CTP, as well as short daily surveys throughout their training. Participation frequency was described using a process where participants were rank ordered by the number of daily surveys completed and classified into one of three categories. Full assessment surveys completed prior to their training at CTP included screening tools for generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and panic disorder (PD). The Kruskal-Wallis H test was used to assess differences in participation rates between mental health disorder symptom screening groups for each measure at pre-training, and Spearman's Rho was used to test for associations amongst self-reported Full Assessment screening tool responses and the number of daily surveys completed during CTP. Results There were 18557 daily survey records collected from 772 participants. The rank-ordering of cadets by the number of daily surveys completed produced three categories in line with the 90-9-1 rule: Superusers who were the top 1% of cadets (n=8) and produced 6.4% of all recordings; Contributors who were the next 9% of cadets (n=68) and produced 49.2% of the recordings; and Lurkers who were the next 90% of cadets (n=695) and produced 44.4% of daily survey recordings. Lurkers had the largest proportion of positive screens for self-reported mental health disorders at pre-training. Conclusion The creation of highly individualized, population-based mental health injury programs has been limited by an incomplete understanding of the causal relationships between protective factors and mental health. Disproportionate rates of disengagement from persons who screen positive for mental health disorders further compounds the difficulty in understanding the relationships between training programs and mental health. The current results suggest persons with mental health challenges may be less likely to engage in some forms of proactive mental health training. The current results also provide useful information about participation, adherence, and engagement that can be used to inform evidence-based paradigm shifts in health-related data collection in occupational populations.
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Affiliation(s)
- Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Anxiety and Illness Behaviors Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Rachel L. Krakauer
- Anxiety and Illness Behaviors Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - J. Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, SK, Canada
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Anxiety and Illness Behaviors Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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Karampatakis GD, Wood HE, Griffiths CJ, Lea NC, Ashcroft RE, Day B, Walker N, Coulson NS, De Simoni A. Ethical and Information Governance Considerations for Promoting Digital Social Interventions in Primary Care. J Med Internet Res 2023; 25:e44886. [PMID: 37756051 PMCID: PMC10568391 DOI: 10.2196/44886] [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: 12/07/2022] [Revised: 04/28/2023] [Accepted: 07/31/2023] [Indexed: 09/28/2023] Open
Abstract
Promoting online peer support beyond the informal sector to statutory health services requires ethical considerations and evidence-based knowledge about its impact on patients, health care professionals, and the wider health care system. Evidence on the effectiveness of digital interventions in primary care is sparse, and definitive guidance is lacking on the ethical concerns arising from the use of social media as a means for health-related interventions and research. Existing literature examining ethical issues with digital interventions in health care mainly focuses on apps, electronic health records, wearables, and telephone or video consultations, without necessarily covering digital social interventions, and does not always account for primary care settings specifically. Here we address the ethical and information governance aspects of undertaking research on the promotion of online peer support to patients by primary care clinicians, related to medical and public health ethics.
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Affiliation(s)
- Georgios Dimitrios Karampatakis
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Helen E Wood
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Chris J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Nathan C Lea
- Department of Medical Informatics & Statistics, The European Institute for Innovation through Health Data, Ghent University Hospital, Ghent, Belgium
| | | | - Bill Day
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil S Coulson
- Medical School, Nottingham City Hospital, Nottingham, United Kingdom
| | - Anna De Simoni
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
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Neely S, Hao F. Diagnosis Disclosure and Peer-to-Peer Information Seeking Among COVID-19-Infected Social Media Users: Survey of US-Based Adults. JMIR Form Res 2023; 7:e48581. [PMID: 37669087 PMCID: PMC10509733 DOI: 10.2196/48581] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/04/2023] [Accepted: 07/28/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Research examining online health communities suggests that individuals affected by chronic health conditions can obtain valuable information and social support through participation in peer-to-peer web-based information exchanges, including information sharing and seeking behaviors. The risks and rewards of these same behaviors in the case of acute illnesses, such as COVID-19, are less well understood, though there is reason to believe that individuals with COVID-19 and other acute illnesses may accrue similar benefits. OBJECTIVE This study examines the propensity of American adults to disclose and discuss their COVID-19 diagnosis and symptoms on social media while actively infected with the SARS-CoV-2 virus, as well as to engage in peer-to-peer information seeking in order to better understand the illness that they are experiencing. Additionally, this study seeks to identify the motivations for these behaviors as well as their subsequent impacts on perceived social connectedness and health anxiety in patients with COVID-19. METHODS We conducted a representative survey of 2500 US-based adults using a sample purchased through an industry-leading market research provider. Participants were selected through a stratified quota sampling approach to ensure a representative sample of the US population. Balanced quotas were determined (by region of the country) for gender, age, race, ethnicity, and political affiliation. Responses were analyzed from 946 participants who reported having an active social media account and testing positive for COVID-19 at least once since the start of the pandemic. RESULTS The results show that only a small portion of social media users (166/946, 18%) chose to disclose and discuss their COVID-19 diagnosis while infected with the virus. However, among those who did, an overwhelming majority (206/251, 82%) said that doing so helped them feel more connected and supported while infected with the virus. A larger percentage of the 946 respondents (n=319, 34%) engaged in peer-to-peer information seeking while infected with COVID-19. Among those who did, a large majority (301/319, 94%) said that doing so was "helpful," but more than one-third (115/319, 36%) said that reading about other people's experiences made them "more worried" about having COVID-19, while 33% (108/319) said that it made them "less worried." Illness severity and political affiliation were significant predictors of both information sharing and seeking. CONCLUSIONS The findings suggest that the benefits (and risks) associated with online health communities are germane to patients with acute illnesses such as COVID-19. It is recommended that public health officials and health care providers take a proactive approach to cultivating professionally moderated forums supporting peer-to-peer engagement during future outbreaks of COVID-19 and other acute illnesses in order to improve patient outcomes and promote social support and connectedness among infected patients.
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Affiliation(s)
- Stephen Neely
- School of Public Affairs, University of South Florida, Tampa, FL, United States
| | - Feng Hao
- Department of Sociology, University of South Florida, Tampa, FL, United States
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Abdelraheem O, Sami DG, Salama M. Online Health Communities: an alternative feasible data registry tool for developing countries. Health Res Policy Syst 2023; 21:28. [PMID: 37024909 PMCID: PMC10077652 DOI: 10.1186/s12961-023-00976-w] [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: 12/27/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
Given the many challenges facing healthcare access in many developing countries and the added limitations observed in emergencies like COVID-19 pandemic, the authors here discuss an alternative and feasible approach to overcome all these limitations.
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Affiliation(s)
- Omnia Abdelraheem
- Institute of Global Health, and Human Ecology (I-GHHE), The American University in Cairo, Cairo, Egypt
| | - Diana G Sami
- Institute of Global Health, and Human Ecology (I-GHHE), The American University in Cairo, Cairo, Egypt
| | - Mohamed Salama
- Institute of Global Health, and Human Ecology (I-GHHE), The American University in Cairo, Cairo, Egypt.
- Faculty of Medicine, Mansoura University, Mansoura, Egypt.
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland.
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Shi J, Khoo Z. Online health community for change: Analysis of self-disclosure and social networks of users with depression. Front Psychol 2023; 14:1092884. [PMID: 37057164 PMCID: PMC10088863 DOI: 10.3389/fpsyg.2023.1092884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/23/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundA key research question with theoretical and practical implications is to investigate the various conditions by which social network sites (SNS) may either enhance or interfere with mental well-being, given the omnipresence of SNS and their dual effects on well-being.Method/processWe study SNS’ effects on well-being by accounting for users’ personal (i.e., self-disclosure) and situational (i.e., social networks) attributes, using a mixed design of content analysis and social network analysis.Result/conclusionWe compare users’ within-person changes in self-disclosure and social networks in two phases (over half a year), drawing on Weibo Depression SuperTalk, an online community for depression, and find: ① Several network attributes strengthen social support, including network connectivity, global efficiency, degree centralization, hubs of communities, and reciprocal interactions. ② Users’ self-disclosure attributes reflect positive changes in mental well-being and increased attachment to the community. ③ Correlations exist between users’ topological and self-disclosure attributes. ④ A Poisson regression model extracts self-disclosure attributes that may affect users’ received social support, including the writing length, number of active days, informal words, adverbs, negative emotion words, biological process words, and first-person singular forms.InnovationWe combine social network analysis with content analysis, highlighting the need to understand SNS’ effects on well-being by accounting for users’ self-disclosure (content) and communication partners (social networks).Implication/contributionAuthentic user data helps to avoid recall bias commonly found in self-reported data. A longitudinal within-person analysis of SNS’ effects on well-being is helpful for policymakers in public health intervention, community managers for group organizations, and users in online community engagement.
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Affiliation(s)
- Jiayi Shi
- School of Foreign Studies, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- *Correspondence: Jiayi Shi,
| | - Zhaowei Khoo
- School of Mathematical and Computer Sciences, Heriot-Watt University, Putrajaya, Malaysia
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Scott Duncan T, Engström J, Riggare S, Hägglund M, Koch S. Meeting the Burden of Self-management: Qualitative Study Investigating the Empowering Behaviors of Patients and Informal Caregivers. J Particip Med 2022; 14:e39174. [DOI: 10.2196/39174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/30/2022] [Accepted: 10/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Patient empowerment is an important concept and a movement toward person-centered care of patients with chronic conditions. Nevertheless, to date, most research on empowered patients or informal caregivers has been conducted from a narrow clinical perspective. Such research has mainly focused on how health care professionals can empower patients to increase self-care or compliance with treatment. Research on empowered patient and informal caregiver needs and self-empowering activities is scarce.
Objective
We aimed to explore empowering behaviors from a patient and informal caregiver perspective in the context of self-management and to understand how health care can support such behaviors better.
Methods
We used an exploratory, qualitative study design. A total of 15 semistructured interviews and 6 focus group interviews were conducted with 48 patients and informal caregivers. We analyzed the interviews using thematic analysis and used a directed content analysis to analyze the focus group interviews.
Results
A total of 14 patterns of empowering behaviors were identified that were characterized by several exploratory and influencing activities performed by the participants. The participants expressed a desire to be more active in their care than what is expected and supported by health care professionals. The participants also desired better support for activities imposed on them by health care professionals.
Conclusions
To enable a transformation of the health care system to better support self-empowering behaviors, there is a need to develop self-management approaches from a patient and informal caregiver perspective.
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Jake-Schoffman DE, Carrera Seoane M, Cooper K, Rajoria M, McVay MA. Engaging adults with obesity in organic online communities to support weight loss: a mixed methods pilot study. Psychol Health 2022:1-20. [PMID: 35726546 DOI: 10.1080/08870446.2022.2087073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/20/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Organic online communities have shown potential for aiding weight loss, but few adults use them. We sought to test strategies to encourage adults to select and engage in online communities for weight loss. DESIGN 4-week single-arm, mixed-methods pilot. MAIN OUTCOME MEASURES Quantitative and qualitative data on selection of online community, engagement with community, and engagement and satisfaction with tasks. RESULTS On average, participants (n = 25) were female (80.0%) and white (68.0%), 45.2 ± 18.1 years old, with a BMI of 36.2 ± 6.5 kg/m2. Selection of online community varied across participants (13 MyFitnessPal, 5 Facebook, 5 Reddit). In qualitative analyses, reasons for selection included experience with community, privacy considerations, and seeking people similar to them. Most tasks were fully or partially completed by a majority of participants (>80.0%). For most tasks, ∼50% of participants felt the task helped them with weight loss support. Variability in response was observed, especially between tasks that requested reading compared to posting/commenting in the community. Frequent reading of community content throughout the study was reported by >70.0% of participants, though posting/commenting was less frequent. Barriers to further engagement included concerns about privacy, judgement, and misinformation. CONCLUSIONS This study provides insights about strategies for engaging individuals in online health communities.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Montserrat Carrera Seoane
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Kellie Cooper
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Melinda Rajoria
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
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Kelly KJ, Doucet S, Luke A, Azar R, Montelpare W. Exploring the Use of a Facebook-Based Support Group for Caregivers of Children and Youth With Complex Care Needs: Qualitative Descriptive Study. JMIR Pediatr Parent 2022; 5:e33170. [PMID: 35671082 PMCID: PMC9214619 DOI: 10.2196/33170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 04/11/2022] [Accepted: 05/03/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Caregivers of children and youth with complex care needs (CCN) require substantial support to ensure the well-being of their families. Web-based peer-to-peer (P2P) support groups present an opportunity for caregivers to seek and provide timely informational and emotional support. Despite the widespread use of social media for health-related support across diverse patient and caregiver populations, it is unclear how caregivers of children and youth with CCN use and potentially benefit from these groups. OBJECTIVE The aim of this study is to explore the use of a web-based P2P support group for caregivers of children and youth with CCN in New Brunswick, Canada, and investigate factors related to its use by members. METHODS The study sample consisted of individuals who joined a closed Facebook group and an analysis of content published to the group. In phase 1, a Facebook group was developed in consultation with a patient and family advisory council, and members were recruited to the group. Phase 2 of this study consisted of an observation period during which posts and related interactions (ie, likes, loves, and comments) by members were collected. In phase 3, a web-based survey was distributed, and semistructured interviews were conducted with a subsample of group members. Survey and interview data were analyzed using thematic analysis. RESULTS A total of 108 caregivers joined the Facebook group between October 2020 and March 2021. There were 93 posts with 405 comments and 542 associated interactions (448/542, 82.7% likes and 94/542, 17.3% loves). Of these 93 posts, 37 (40%) were made by group members, and 56 (60%) were made by moderators. Of the 108 members, a subsample of 39 (36.1%) completed a web-based survey, and 14 (13%) participated in the interviews. Content analyses of posts by members revealed that inquiry (17/37, 46%), informational (15/37, 41%), and emotional posts (4/37, 11%) were the most common. Emotional posts received the highest number of interactions (median 24.5). In total, 5 themes emerged from the interviews related to the use of the group and mediating factors of interactions between group members: resource for information, altruistic contribution, varying level of engagement, perceived barriers to and facilitators of group activity, and moderators as contributing members. CONCLUSIONS These findings demonstrate that caregivers of children and youth with CCN seek geography-specific P2P support groups to meet informational and social support needs. This study contributes to the knowledge on how caregivers use Facebook groups to meet their support needs through moderate and passive engagement.
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Affiliation(s)
- Katherine Jennifer Kelly
- Health Centred Research Clinic, Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
| | - Shelley Doucet
- Centre for Research in Integrated Care, Department of Nursing and Health Sciences, University of New Brunswick Saint John, Saint John, NB, Canada
| | - Alison Luke
- Centre for Research in Integrated Care, Department of Nursing and Health Sciences, University of New Brunswick Saint John, Saint John, NB, Canada
| | - Rima Azar
- Psychobiology of Stress & Health Lab, Department of Psychology, Mount Alison University, Sackville, NB, Canada
| | - William Montelpare
- Health Centred Research Clinic, Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada
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Experiences of exercise in patients with asthma: qualitative analysis of discussions in a UK asthma online community. BJGP Open 2022; 6:BJGPO.2021.0162. [PMID: 35487580 DOI: 10.3399/bjgpo.2021.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/28/2021] [Accepted: 01/31/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Engagement with exercise in adults with asthma is suboptimal. Limited information is available regarding factors affecting engagement with exercise. AIM To explore experiences of exercise and linked unmet needs in adults with asthma. DESIGN & SETTING Qualitative thematic analysis of posts in a UK asthma online community, written between 2015 and 2020. METHOD Posts were identified using keywords searches. Posts in the 'Exercise' topic section were additionally included. Thematic analysis of posts was undertaken. RESULTS 143 relevant posts were analysed. 92 participants were identified through posts (11M, 33F, 48 gender not stated, aged 26-73 years). Emerging themes included: fear of experiencing asthma symptoms during exercise, lack of information about how to deal with symptoms, external barriers, emotional response, and involvement of healthcare providers. Environmental factors, concomitant life stressors, distrust of healthcare professionals and embarrassment of displaying asthma symptoms during exercise were barriers to engagement. Facilitators included experiencing positive health outcomes following exercise and positive discussions regarding exercise with healthcare professionals. Strategies participants developed to enable exercise were warming up, increasing reliever and preventer inhalers when exercising and finding exercises felt as enjoyable. CONCLUSION Future interventions to address fears of exercise-induced physical symptoms, and clear instructions on the use of inhalers when exercising are needed. Exploring patients' attitudes to exercise in clinical consultations, especially in primary care, may be beneficial.
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12
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Kilb M, Dickhäuser O, Mata J. A theory-based video intervention to enhance communication and engagement in online health communities: two experiments. Health Psychol Behav Med 2022; 10:199-228. [PMID: 35173999 PMCID: PMC8843193 DOI: 10.1080/21642850.2022.2032074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Online communities and social networking sites have great potential for supporting health behavior change. However, interventions vary greatly in participants’ engagement rates and, consequently, their effectiveness. Theory-based interventions in real-world contexts are needed to further increase engagement and effectiveness. Methods We experimentally tested whether a video intervention teaching Self-Determination-Theory-based communication strategies increases need-supportive communication strategy use over one week (Study 1, N = 76) and perceived need support, engagement, and goal attainment in a behavior change intervention supported by a forum-based online community (Study 2, N = 537). In Study 2, participants chose a goal (increasing either fruit or vegetable consumption or increasing moderate or vigorous physical activity) and joined an online community for 2 weeks. Data from both experiments were analyzed with mixed models and follow-up tests. Results In Study 1, participants in the intervention but not in the control group showed an increase in the number of need-supportive communication strategies used both immediately and one week after the intervention (condition × time interaction, partial η2 = 0.31). In Study 2, participants who watched the intervention video had a higher number of postings and reported a higher subjective forum use frequency (but not a higher number of logins) compared to participants who watched the control video. However, the effect on the subjective forum visit frequency was not robust. There were no intervention effects on perceived need support, goal attainment, or secondary outcomes. The results might be explained by low application of need-supportive communication strategies. Conclusion A brief video intervention may be a suitable, low-cost intervention to promote need-supportive communication strategy use, benefitting both engagement and behavior change. Future studies should incorporate additional means to further improve communication strategy uptake and engagement in online communities.
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Affiliation(s)
- Michael Kilb
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Oliver Dickhäuser
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Jutta Mata
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
- Mannheim Center for Data Science, University of Mannheim, Mannheim, Germany
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
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13
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Bulcock A, Hassan L, Giles S, Sanders C, Nenadic G, Campbell S, Dixon W. Public Perspectives of Using Social Media Data to Improve Adverse Drug Reaction Reporting: A Mixed-Methods Study. Drug Saf 2021; 44:553-564. [PMID: 33582973 PMCID: PMC8053157 DOI: 10.1007/s40264-021-01042-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 11/30/2022]
Abstract
Introduction Information on suspected adverse drug reactions (ADRs) voluntarily submitted by patients can be a valuable source of information for improving drug safety; however, public awareness of reporting mechanisms remains low. Whilst methods to automatically detect ADR mentions from social media posts using text mining techniques have been proposed to improve reporting rates, it is unclear how acceptable these would be to social media users. Objective The objective of this study was to explore public opinion about using automated methods to detect and report mentions of ADRs on social media to enhance pharmacovigilance efforts. Methods Users of the online health discussion forum HealthUnlocked participated in an online survey (N = 1359) about experiences with ADRs, knowledge of pharmacovigilance methods, and opinions about using automated data mining methods to detect and report ADRs. To further explore responses, five qualitative focus groups were conducted with 20 social media users with long-term health conditions. Results Participant responses indicated a low awareness of pharmacovigilance methods and ADR reporting. They showed a strong willingness to share health-related social media data about ADRs with researchers and regulators, but were cautious about automated text mining methods of detecting and reporting ADRs. Conclusions Social media users value public-facing pharmacovigilance schemes, even if they do not understand the current framework of pharmacovigilance within the UK. Ongoing engagement with users is essential to understand views, share knowledge and respect users’ privacy expectations to optimise future ADR reporting from online health communities. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-021-01042-6.
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Affiliation(s)
- Alexander Bulcock
- Health Education England, North West Deanery, UK
- Division of Musculoskeletal and Dermatological Sciences, Centre for Epidemiology Versus Arthritis, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Lamiece Hassan
- Division of Informatics, Imaging and Data Sciences, Centre for Health Informatics, The University of Manchester, Manchester, UK
| | - Sally Giles
- Division of Population Health, Health Services Research and Primary Care, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Caroline Sanders
- Division of Population Health, Health Services Research and Primary Care, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Goran Nenadic
- School of Computer Science, The University of Manchester, Manchester, UK
| | - Stephen Campbell
- Division of Population Health, Health Services Research and Primary Care, NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK
| | - Will Dixon
- Division of Musculoskeletal and Dermatological Sciences, Centre for Epidemiology Versus Arthritis, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
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14
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Srour-Alphonse P, Cvetkovski B, Azzi E, Rand C, Cheong LHM, Kritikos V, Bosnic-Anticevich S. Understanding the Influences Behind Parents' Asthma Decision-Making: A Qualitative Exploration of the Asthma Network of Parents with Children with Asthma. Pulm Ther 2021; 7:151-170. [PMID: 33569733 PMCID: PMC8137740 DOI: 10.1007/s41030-021-00145-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Interventions aimed at optimizing parents’ ability to manage their children’s asthma could be strengthened by better understanding the networks that influence these parents’ choices when managing asthma. This study aimed to explore the asthma networks of parents of children with asthma—specifically to gain insights into whom parents select to be within their networks and why; how individuals within parents’ networks influence the way in which they manage their children’s asthma medications, and factors driving the development of these networks. Methods A qualitative research methodology utilizing semi-structured interviews with parents of children with asthma was employed to fulfil the objectives of this study. Results Twenty-six face-to-face interviews with parents of children with asthma were conducted, recorded, and transcribed. Transcriptions were independently coded for concepts and themes by the research team. Asthma medications was a dominant theme identified, and revealed that parents actively sought advice and support from a series of complex and multidimensional relationships with people and resources in their health network. These not only included health care professionals (HCPs) but also personal connections, lay individuals, and resources. The composition and development of these asthma networks occurred over time and were determined by several key factors: satisfaction with their HCP provider; need for information; convenience; trust and support; self-confidence in management; and parents’ perceptions of their children’s asthma severity. Conclusions By exploring parents’ asthma network, this study uncovers the complex relationship between HCPs, family and friends of parents of children with asthma, and provides new insight into the intimate and parallel influence they have on parent’s decision-making.
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Affiliation(s)
- Pamela Srour-Alphonse
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia. .,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.
| | - Biljana Cvetkovski
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Elizabeth Azzi
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Cynthia Rand
- Pulmonary and Critical Care Medicine Department, John Hopkins University, Baltimore, MD, USA
| | - Lynn H M Cheong
- Faculty of Health, University of Canberra, Canberra, Australia
| | - Vicky Kritikos
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.,Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Sinthia Bosnic-Anticevich
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia.,Central Sydney Local Area Health District, Sydney, Australia
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15
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Lui CW, Wang Z, Wang N, Milinovich G, Ding H, Mengersen K, Bambrick H, Hu W. A call for better understanding of social media in surveillance and management of noncommunicable diseases. Health Res Policy Syst 2021; 19:18. [PMID: 33568155 PMCID: PMC7876784 DOI: 10.1186/s12961-021-00683-4] [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: 07/15/2020] [Accepted: 01/24/2021] [Indexed: 11/13/2022] Open
Abstract
Using social media for health purposes has attracted much attention over the past decade. Given the challenges of population ageing and changes in national health profile and disease patterns following the epidemiologic transition, researchers and policy-makers should pay attention to the potential of social media in chronic disease surveillance, management and support. This commentary overviews the evidence base for this inquiry and outlines the key challenges to research laying ahead. The authors provide concrete suggestions and recommendations for developing a research agenda to guide future investigation and action on this topic.
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Affiliation(s)
- Chi-Wai Lui
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Zaimin Wang
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Brisbane, QLD, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ning Wang
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Gabriel Milinovich
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hang Ding
- RECOVER Injury Research Centre, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, 4059, Australia
| | - Kerrie Mengersen
- ARC Centre of Excellence for the Mathematical and Statistical Frontiers, School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.
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16
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Bingham KS, Rozenbojm N, Chong‐East M, Touma Z. Exploring the Mental Health Needs of Persons With Autoimmune Diseases During the Coronavirus Disease 2019 Pandemic: A Proposed Framework for Future Research and Clinical Care. ACR Open Rheumatol 2021; 3:25-33. [PMID: 33314738 PMCID: PMC7811690 DOI: 10.1002/acr2.11205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022] Open
Abstract
Although the coronavirus disease 2019 (COVID-19) pandemic has been associated with increased psychological distress globally, it poses unique challenges to persons who are potentially more vulnerable to its effects, including patients with autoimmune disease. In this article, we review the published literature and media reports to determine factors that may contribute to mental health challenges in persons with autoimmune disease. We then explore existing mental health interventions that have been developed for use in COVID-19 and in patients with autoimmune disorders in general. We identified several potential contributors to psychological distress in patients with autoimmune disease during the pandemic, as follows: feelings of discrimination related to societal response to COVID-19, fear of infection and uncertainty related to immunosuppressive medication, diminished access to usual care and resources, previous health-related trauma, and the exacerbating effect of social isolation. Drawing from existing literature, we synthesize the identified evidence to develop a proposed framework for researching and managing mental health challenges in autoimmune disease during the pandemic and its aftermath.
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Affiliation(s)
| | | | | | - Zahi Touma
- Toronto Western Hospital and University of TorontoTorontoOntarioCanada
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17
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Xie LF, Itzkovitz A, Roy-Fleming A, Da Costa D, Brazeau AS. Understanding Self-Guided Web-Based Educational Interventions for Patients With Chronic Health Conditions: Systematic Review of Intervention Features and Adherence. J Med Internet Res 2020; 22:e18355. [PMID: 32788152 PMCID: PMC7473470 DOI: 10.2196/18355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 12/13/2022] Open
Abstract
Background Chronic diseases contribute to 71% of deaths worldwide every year, and an estimated 15 million people between the ages of 30 and 69 years die mainly because of cardiovascular disease, cancer, chronic respiratory diseases, or diabetes. Web-based educational interventions may facilitate disease management. These are also considered to be a flexible and low-cost method to deliver tailored information to patients. Previous studies concluded that the implementation of different features and the degree of adherence to the intervention are key factors in determining the success of the intervention. However, limited research has been conducted to understand the acceptability of specific features and user adherence to self-guided web interventions. Objective This systematic review aims to understand how web-based intervention features are evaluated, to investigate their acceptability, and to describe how adherence to web-based self-guided interventions is defined and measured. Methods Studies published on self-guided web-based educational interventions for people (≥14 years old) with chronic health conditions published between January 2005 and June 2020 were reviewed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Statement protocol. The search was performed using the PubMed, Cochrane Library, and EMBASE (Excerpta Medica dataBASE) databases; the reference lists of the selected articles were also reviewed. The comparison of the interventions and analysis of the features were based on the published content from the selected articles. Results A total of 20 studies were included. Seven principal features were identified, with goal setting, self-monitoring, and feedback being the most frequently used. The acceptability of the features was measured based on the comments collected from users, their association with clinical outcomes, or device adherence. The use of quizzes was positively reported by participants. Self-monitoring, goal setting, feedback, and discussion forums yielded mixed results. The negative acceptability was related to the choice of the discussion topic, lack of face-to-face contact, and technical issues. This review shows that the evaluation of adherence to educational interventions was inconsistent among the studies, limiting comparisons. A clear definition of adherence to an intervention is lacking. Conclusions Although limited information was available, it appears that features related to interaction and personalization are important for improving clinical outcomes and users’ experience. When designing web-based interventions, the selection of features should be based on the targeted population’s needs, the balance between positive and negative impacts of having human involvement in the intervention, and the reduction of technical barriers. There is a lack of consensus on the method of evaluating adherence to an intervention. Both investigations of the acceptability features and adherence should be considered when designing and evaluating web-based interventions. A proof-of-concept or pilot study would be useful for establishing the required level of engagement needed to define adherence.
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Affiliation(s)
- Li Feng Xie
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Alexandra Itzkovitz
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | - Amelie Roy-Fleming
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada
| | | | - Anne-Sophie Brazeau
- School of Human Nutrition, McGill University, Sainte-Anne-de-Bellevue, QC, Canada.,Montreal Diabetes Research Center, Montreal, QC, Canada
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18
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Panzarasa P, Griffiths CJ, Sastry N, De Simoni A. Social Medical Capital: How Patients and Caregivers Can Benefit From Online Social Interactions. J Med Internet Res 2020; 22:e16337. [PMID: 32720910 PMCID: PMC7420688 DOI: 10.2196/16337] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/14/2020] [Accepted: 03/30/2020] [Indexed: 11/13/2022] Open
Abstract
The rapid growth of online health communities and the increasing availability of relational data from social media provide invaluable opportunities for using network science and big data analytics to better understand how patients and caregivers can benefit from online conversations. Here, we outline a new network-based theory of social medical capital that will open up new avenues for conducting large-scale network studies of online health communities and devising effective policy interventions aimed at improving patients' self-care and health.
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Affiliation(s)
- Pietro Panzarasa
- School of Business and Management, Queen Mary University of London, London, United Kingdom
| | - Christopher J Griffiths
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, United Kingdom
| | - Nishanth Sastry
- Department of Computer Science, University of Surrey, Surrey, United Kingdom
| | - Anna De Simoni
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, London, United Kingdom
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19
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De Simoni A, Shah AT, Fulton O, Parkinson J, Sheikh A, Panzarasa P, Pagliari C, Coulson NS, Griffiths CJ. Superusers' Engagement in Asthma Online Communities: Asynchronous Web-Based Interview Study. J Med Internet Res 2020; 22:e18185. [PMID: 32573463 PMCID: PMC7381072 DOI: 10.2196/18185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/23/2020] [Accepted: 05/13/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Superusers, defined as the 1% of users who write a large number of posts, play critical roles in online health communities (OHCs), catalyzing engagement and influencing other users' self-care. Their unique online behavior is key to sustaining activity in OHCs and making them flourish. Our previous work showed the presence of 20 to 30 superusers active on a weekly basis among 3345 users in the nationwide Asthma UK OHC and that the community would disintegrate if superusers were removed. Recruiting these highly skilled individuals for research purposes can be challenging, and little is known about superusers. OBJECTIVE This study aimed to explore superusers' motivation to actively engage in OHCs, the difficulties they may face, and their interactions with health care professionals (HCPs). METHODS An asynchronous web-based structured interview study was conducted. Superusers of the Asthma UK OHC and Facebook groups were recruited through Asthma UK staff to pilot and subsequently complete the questionnaire. Open-ended questions were analyzed using content analysis. RESULTS There were 17 superusers recruited for the study (14 patients with asthma and 3 carers); the majority were female (15/17). The age range of participants was 18 to 75 years. They were active in OHCs for 1 to 6 years and spent between 1 and 20 hours per week reading and 1 and 3 hours per week writing posts. Superusers' participation in OHCs was prompted by curiosity about asthma and its medical treatment and by the availability of spare time when they were off work due to asthma exacerbations or retired. Their engagement increased over time as participants furthered their familiarity with the OHCs and their knowledge of asthma and its self-management. Financial or social recognition of the superuser role was not important; their reward came from helping and interacting with others. According to the replies provided, they showed careful judgment to distinguish what can be dealt with through peer advice and what needs input from HCPs. Difficulties were encountered when dealing with misunderstandings about asthma and its treatment, patients not seeking advice from HCPs when needed, and miracle cures or dangerous ideas. Out of 17 participants, only 3 stated that their HCPs were aware of their engagement with OHCs. All superusers thought that HCPs should direct patients to OHCs, provided they are trusted and moderated. In addition, 9 users felt that HCPs themselves should take part in OHCs. CONCLUSIONS Superusers from a UK-wide online community are highly motivated, altruistic, and mostly female individuals who exhibit judgment about the complexity of coping with asthma and the limits of their advice. Engagement with OHCs satisfies their psychosocial needs. Future research should explore how to address their unmet needs, their interactions with HCPs, and the potential integration of OHCs in traditional healthcare.
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Affiliation(s)
- Anna De Simoni
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
| | | | - Olivia Fulton
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Pietro Panzarasa
- School of Business and Management, Queen Mary University of London, London, United Kingdom
| | - Claudia Pagliari
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Neil S Coulson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Chris J Griffiths
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
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20
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Audrain-Pontevia AF, Menvielle L, Ertz M. Effects of Three Antecedents of Patient Compliance for Users of Peer-to-Peer Online Health Communities: Cross-Sectional Study. J Med Internet Res 2019; 21:e14006. [PMID: 31710295 PMCID: PMC6878099 DOI: 10.2196/14006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/06/2019] [Accepted: 08/31/2019] [Indexed: 01/02/2023] Open
Abstract
Background Over the past 50 years, patient noncompliance has appeared as a major public health concern and focus of a great deal of research because it endangers patient recovery and imposes a considerable financial burden on health care systems. Meanwhile, online health communities (OHCs) are becoming more common and are commonly used by individuals with health problems, and they may have a role in facilitating compliance. Despite this growing popularity, little is known about patient compliance predictors for OHCs’ users. Objective This study aimed to investigate the extent to which participating in OHCs may trigger higher levels of compliance. It identified 3 interrelated predictors that may affect patient compliance: patient empowerment gained through peer-to-peer OHCs, satisfaction with the physician, and commitment to the physician. Methods A Web-based survey tested the conceptual model and assessed the effects of patient empowerment gained through OHCs on patient satisfaction and commitment to the physician, as well as the effects of these 3 predictors on patient compliance with the proposed treatment. Members of peer-to-peer OHCs were asked to answer an online questionnaire. A convenience sample of 420 patients experiencing chronic illness and using peer-to-peer OHCs was surveyed in August 2018 in Québec, Canada. A path analysis using structural equation modeling tested the proposed relationships between the predictors and their respective paths on patient compliance. The mediation effects of these predictor variables on patient compliance were estimated with the PROCESS macro in SPSS. Results The findings indicated that patient empowerment gained through OHCs was positively related to patient commitment to the physician (beta=.69; P<.001) and patient compliance with the proposed treatment (beta=.35; P<.001). Patient commitment also positively influenced patient compliance (beta=.74; P<.001). Patient empowerment did not exert a significant influence on patient satisfaction with the physician (beta=.02; P=.76), and satisfaction did not affect compliance (beta=−.07; P=.05); however, patient satisfaction was positively related to patient commitment to the physician (beta=.14; P<.01). The impact of empowerment on compliance was partially mediated by commitment to the physician (beta=.32; 95% CI 0.22-0.44) but not by satisfaction. Conclusions This study highlights the importance of peer-to-peer OHCs for two main reasons. The primary reason is that patient empowerment gained through peer-to-peer OHCs both directly and indirectly enhances patient compliance with the proposed treatment. The underlying mechanisms of these effects were shown. Second, commitment to the physician was found to play a more critical role than satisfaction with the physician in determining patient-physician relationship quality. Overall, our findings support the assumption that health care stakeholders should encourage the use of peer-to-peer OHCs to favor patient empowerment and patient commitment to the physician to increase patient compliance with the proposed treatment.
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Affiliation(s)
| | | | - Myriam Ertz
- Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
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21
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Dempsey A, Butt M, Kirby JS. Prevalence and Impact of Dietary Avoidance among Individuals with Hidradenitis Suppurativa. Dermatology 2019; 236:289-295. [PMID: 31678977 DOI: 10.1159/000503063] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/29/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND People with hidradenitis suppurativa (HS) are interested in dietary alterations to manage the condition. However, there are few data on the prevalence of this or the impact on HS activity. The objective of this study was to investigate the prevalence and impact of dietary alterations made by people with HS. METHODS A cross-sectional survey was sent to people with HS through multiple sources. Participants reported food alterations in the prior 6 months. -Results: Overall, 242 complete surveys were included in this analysis; the mean age was 35.8 years, and most (87.5%) were women. The majority (75.8%, n = 182) altered at least one food from their diet. Within this group, 154 (84.6%) made changes to multiple food groups. The top 5 food groups that were altered were gluten (48.8%), dairy (44.2%), refined sugars (40.0%), tomatoes (36.7%), and alcohol (37.1%). Smoking was eliminated in 27.5% of participants. Some participants (30.9%) reported the change made the HS "much better." CONCLUSIONS Dietary alteration to manage HS was common among participants in this study. Some people reported improvement in HS activity, but some noted worsening. Additional research is needed to evaluate the efficacy of dietary alteration to manage HS and to better understand the underlying pathomechanisms.
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Affiliation(s)
- Alison Dempsey
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Melissa Butt
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Joslyn S Kirby
- Department of Dermatology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA,
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