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Maramba ID, Jones R, Austin D, Edwards K, Meinert E, Chatterjee A. The Role of Health Kiosks: A Scoping Review (Preprint). JMIR Med Inform 2020; 10:e26511. [PMID: 35348457 PMCID: PMC9006133 DOI: 10.2196/26511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/05/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health kiosks are publicly accessible computing devices that provide access to services, including health information provision, clinical measurement collection, patient self–check-in, telemonitoring, and teleconsultation. Although the increase in internet access and ownership of smart personal devices could make kiosks redundant, recent reports have predicted that the market will continue to grow. Objective We seek to clarify the current and future roles of health kiosks by investigating the settings, roles, and clinical domains in which kiosks are used; whether usability evaluations of health kiosks are being reported, and if so, what methods are being used; and what the barriers and facilitators are for the deployment of kiosks. Methods We conducted a scoping review using a bibliographic search of Google Scholar, PubMed, and Web of Science databases for studies and other publications between January 2009 and June 2020. Eligible papers described the implementation as primary studies, systematic reviews, or news and feature articles. Additional reports were obtained by manual searching and querying the key informants. For each article, we abstracted settings, purposes, health domains, whether the kiosk was opportunistic or integrated with a clinical pathway, and whether the kiosk included usability testing. We then summarized the data in frequency tables. Results A total of 141 articles were included, of which 134 (95%) were primary studies, and 7 (5%) were reviews. Approximately 47% (63/134) of the primary studies described kiosks in secondary care settings. Other settings included community (32/134, 23.9%), primary care (24/134, 17.9%), and pharmacies (8/134, 6%). The most common roles of the health kiosks were providing health information (47/134, 35.1%), taking clinical measurements (28/134, 20.9%), screening (17/134, 12.7%), telehealth (11/134, 8.2%), and patient registration (8/134, 6.0%). The 5 most frequent health domains were multiple conditions (33/134, 24.6%), HIV (10/134, 7.5%), hypertension (10/134, 7.5%), pediatric injuries (7/134, 5.2%), health and well-being (6/134, 4.5%), and drug monitoring (6/134, 4.5%). Kiosks were integrated into the clinical pathway in 70.1% (94/134) of studies, opportunistic kiosks accounted for 23.9% (32/134) of studies, and in 6% (8/134) of studies, kiosks were used in both. Usability evaluations of kiosks were reported in 20.1% (27/134) of papers. Barriers (e.g., use of expensive proprietary software) and enablers (e.g., handling of on-demand consultations) of deploying health kiosks were identified. Conclusions Health kiosks still play a vital role in the health care system, including collecting clinical measurements and providing access to web-based health services and information to those with little or no digital literacy skills and others without personal internet access. We identified research gaps, such as training needs for teleconsultations and scant reporting on usability evaluation methods.
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Affiliation(s)
| | - Ray Jones
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Daniela Austin
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Katie Edwards
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Edward Meinert
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
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Letafat-nejad M, Ebrahimi P, Maleki M, Aryankhesal A. Utilization of integrated health kiosks: A systematic review. Med J Islam Repub Iran 2020; 34:114. [PMID: 33315998 PMCID: PMC7722958 DOI: 10.34171/mjiri.34.114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Indexed: 11/05/2022] Open
Abstract
Background: In some countries, integrated health kiosks are used to provide some services and information. However; it is still not officially included in many countries' health systems. The purpose of this study was to gather and summarize different aspects of using health kiosks in countries. Methods: Five English databases, including Web of Science, Cochrane Library, PubMed / Medline, Embase and Scopus, were explored from 2001 to 2018, using words related to three concepts: health, design and development, and kiosk. Different dimensions of health kiosks utilization in the world were identified and analyzed thematically. Results: Out of 918 search results, 37 articles were included in the study and analyzed. Most of them were conducted in the United States and addressed the development, implementation, design, or feasibility of utilizing integrated health kiosks. The different aspects of kiosk utilization were categorized into 6 dimensions: services provided, deployment location, user characteristics and variables of accepting kiosks, notable design and construction points, their benefits and effectiveness, and finally, the challenges of using kiosks. Conclusion: This study found that health kiosks are promising, cost-effective and multifunctional tools; if included in the formal health system of countries, they may improve health indicators in countries. However, before deploying, their challenges and concerns need to be investigated and addressed.
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Affiliation(s)
- Mozhgan Letafat-nejad
- 1Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Parvin Ebrahimi
- 1Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
,Corresponding author: Dr Parvin Ebrahimi,
| | - Mohammadreza Maleki
- 1Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aidin Aryankhesal
- 1Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Flitcroft L, Chen WS, Meyer D. The Demographic Representativeness and Health Outcomes of Digital Health Station Users: Longitudinal Study. J Med Internet Res 2020; 22:e14977. [PMID: 32589150 PMCID: PMC7381012 DOI: 10.2196/14977] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 11/20/2019] [Accepted: 12/15/2019] [Indexed: 11/30/2022] Open
Abstract
Background Digital health stations offer an affordable and accessible platform for people to monitor their health; however, there is limited information regarding the demographic profile of users and the health benefits of this technology. Objective This study aimed to assess the demographic representativeness of health station users, identify the factors associated with repeat utilization of stations, and determine if the health status of repeat users changed between baseline and final health check. Methods Data from 180,442 health station users in Australia, including 8441 repeat users, were compared with 2014-2015 Australian National Health Survey (NHS) participants on key demographic and health characteristics. Binary logistic regression analyses were used to compare demographic and health characteristics of repeat and one-time users. Baseline and final health checks of repeat users were compared using McNemar tests and Wilcoxon signed rank tests. The relationship between the number of checks and final health scores was investigated using generalized linear models. Results The demographic profile of SiSU health station users differs from that of the general population. A larger proportion of SiSU users were female (100,814/180,442, 55.87% vs 7807/15,393, 50.72%), younger (86,387/180,442, 47.88% vs 5309/15,393, 34.49% aged less than 35 years), and socioeconomically advantaged (64,388/180,442, 35.68% vs 3117/15,393, 20.25%). Compared with NHS participants, a smaller proportion of SiSU health station users were overweight or obese, were smokers, had high blood pressure (BP), or had diabetes. When data were weighted for demographic differences, only rates of high BP were found to be lower for SiSU users compared with the NHS participants (odds ratio [OR] 1.26; P<.001). Repeat users were more likely to be female (OR 1.37; P<.001), younger (OR 0.99; P<.001), and from high socioeconomic status areas—those residing in socioeconomic index for areas quintiles 4 and 5 were significantly more likely to be repeat users compared with those residing in quintile 1 (OR 1.243; P<.001 and OR 1.151; P<.001, respectively). Repeat users were more likely to have a higher BMI (OR 1.02; P<.001), high BP (OR 1.15; P<.001), and less likely to be smokers (OR 0.77; P<.001). Significant improvements in health status were observed for repeat users. Mean BMI decreased by 0.97 kg/m2 from baseline to final check (z=−14.24; P<.001), whereas the proportion of people with high BP decreased from 15.77% (1080/6848) to 12.90% (885/6860; χ21=38.2; P<.001). The proportion of smokers decreased from 11.91% (1005/8438) to 10.13% (853/8421; χ21=48.4; P<.001). Number of repeat health checks was significantly associated with smoking status (OR 0.96; P<.048) but not with higher BP (P=.14) or BMI (P=.23). Conclusions These findings provide valuable insight into the benefits of health stations for self-monitoring and partially support previous research regarding the effect of demographics and health status on self-management of health.
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Affiliation(s)
- Leah Flitcroft
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
| | - Won Sun Chen
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
| | - Denny Meyer
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
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Letafatnejad M, Maleki M, Ebrahimi P. Barriers and facilitators of deploying health kiosk in Iran: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:95. [PMID: 32509903 PMCID: PMC7271912 DOI: 10.4103/jehp.jehp_548_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/02/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION It is less than a decade in Iran that integrated health kiosks have been limitedly provided to public by private sector. Considering the significant benefits of them, this study aimed to identify the barriers and facilitators for deploying kiosks in Iran's formal health system in three phases, "design and construct, implement, and use." MATERIALS AND METHODS This was a qualitative study in Iran, and the data were collected through 20 semi-structured interviews with experts in 2019. Participants were selected by purposeful method with the most diversity in terms of background and work experience; the interview texts were coded in MAXQDA10 software and analyzed through framework analysis. Participants' viewpoint was used to verify the data and observers' review to confirm them. RESULTS The barriers for designing and constructing kiosks were identified in the form of two main themes: the overall structure of the country and the structure of the health system; the obstacles for implementing were categorized in one main theme, lack of sources; and the barriers to use were also fall into four themes related to people, policymakers, service providers, and designers of kiosks. The facilitators at construction and implementation phases included the overall structure of the country and the structure of health system. At the use stage, the facilitators related to people, health and insurance policymakers, and owners and constructers were identified. CONCLUSION It is possible to deploy health kiosks in the Iranian formal health system, although there are some time-consuming and costly barriers which can be overcome by the strengths and opportunities of the system.
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Affiliation(s)
- Mozhgan Letafatnejad
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Maleki
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Parvin Ebrahimi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Sabatello M, Blake LA, Chao A, Silverman A, Ovadia Mazzoni R, Zhang Y, Chen Y, Appelbaum PS. Including the blind community in precision medicine research: findings from a national survey and recommendations. Genet Med 2019; 21:2631-2638. [PMID: 31092907 PMCID: PMC6834864 DOI: 10.1038/s41436-019-0533-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/22/2019] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Despite ongoing efforts to increase diversity of cohorts in precision medicine research (PMR), little is known about the obstacles to inclusion of blind people and those with low vision ("the blind community") in PMR. The blind community comprises ~10% of the US adult population and its members commonly experience health disparities. Understanding barriers to inclusion of this community is necessary to facilitate their participation. METHODS An online survey was developed in disability-accessible formats. Key questions included views on PMR; willingness to participate, provide data, and engage in the study; data sharing and consent; and perceived barriers to participation. Analyses describe results for all participants. RESULTS Two hundred seventy-one blind/low-vision participants completed the survey. Participants expressed strong support for PMR, and willingness to participate in PMR, to provide lifestyle, biological and medical information, to engage with the study, and to have their data shared with other researchers. Preferences for data sharing and consent models varied. Significantly, 65% identified 3-6 barriers to participation, particularly inaccessible transportation, clinics, and facilities; inaccessible information; and attitudinal and institutional barriers. CONCLUSION Removing the identified barriers is key. Measures that could increase inclusivity of blind people and those with low vision in PMR are suggested.
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Affiliation(s)
- Maya Sabatello
- Center for Research on Ethical, Legal & Social Implications of Psychiatric, Neurologic & Behavioral Genetics, Department of Psychiatry, Columbia University, New York, NY, USA.
| | - Lou Ann Blake
- National Federation of the Blind, Baltimore, MD, USA
| | - Audrey Chao
- Columbia Law School and Columbia School of Social Work, New York, NY, USA
| | | | | | - Yuan Zhang
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Ying Chen
- New York State Psychiatric Institute, New York, NY, USA
| | - Paul S Appelbaum
- Center for Research on Ethical, Legal & Social Implications of Psychiatric, Neurologic & Behavioral Genetics, Department of Psychiatry, Columbia University, New York, NY, USA
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Abraham O, Patel M, Feathers A. Acceptability of Health Kiosks Within African American Community Settings: A Pilot Study. Health Serv Res Manag Epidemiol 2018; 5:2333392817752211. [PMID: 29383325 PMCID: PMC5784498 DOI: 10.1177/2333392817752211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Health kiosks have been increasingly adopted to provide health-care services to those with limited access. Kiosks have the potential to reach people who may have undiagnosed health conditions or those who are not under regular physician care. Thus far, there is limited research assessing the usefulness of health kiosks in the community. This study aimed to explore the acceptability, usability, usefulness, and overall satisfaction of health kiosks in African American majority community settings. METHODS Two health kiosks were placed in predominantly African American low-income areas in an urban city in Western Pennsylvania. After the kiosk interaction, participants 18 years and older were recruited to complete a survey on their overall kiosk use experience. The technology acceptance model was adapted to develop the survey. Survey responses were analyzed using descriptive statistics. Qualitative survey responses were analyzed using content analysis. RESULTS Seventy-seven percent of the 31 survey respondents were female and 37.8% were ages 60 to 69 years old. Overall, 90% of participants were satisfied with their kiosk experience and 97% found the kiosk useful for health self-management, with 94% stating that they would use the kiosk again. CONCLUSION This study showed that health kiosks are accepted among African Americans in community settings such as churches and community centers. Participants found the kiosks easy to use and an overall useful tool to help manage their health. Future studies are needed to provide a better understanding of health kiosk acceptance among minority populations and in community settings.
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Affiliation(s)
- Olufunmilola Abraham
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Megha Patel
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
| | - Alison Feathers
- Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA
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Lewis MK, Hsieh YH, Gaydos CA, Peterson SC, Rothman RE. Informed consent for opt-in HIV testing via tablet kiosk: an assessment of patient comprehension and acceptability. Int J STD AIDS 2017; 28:1292-1298. [PMID: 28345392 DOI: 10.1177/0956462417701009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although implementation of HIV testing in the emergency department has met with some success, one commonly cited challenge is the consent process. Kiosks offer one potential strategy to overcome this barrier. This pilot cross-sectional survey study examined patient comprehension of opt-in HIV testing consent and acceptability of using a kiosk to provide consent. Subjects were guided through a simulated consent process using a kiosk and then completed a survey of consent comprehension and acceptability of kiosk use. Subjects were 50.3% female, Black (74.4%), and had an education level of high school or less (61.3%). Subjects found the kiosk very easy or easy to use (83.9%) and reported they were very or mostly comfortable using the kiosk to consent to HIV testing (89.4%). Subjects understood the required aspects of consent: HIV testing was voluntary (93.0%, n = 185) and that refusal would not impact their care (98.5%, n = 196; 99.0%, n = 197). Following a simulated consent process, subjects demonstrated a high rate of comprehension about the vital components of HIV testing consent. Subjects reported they were comfortable using the kiosk, found the kiosk easy to use, and reported a positive experience using the kiosk to provide consent for HIV testing.
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Affiliation(s)
- Mitra K Lewis
- 1 Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yu-Hsiang Hsieh
- 1 Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Charlotte A Gaydos
- 1 Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Stephen C Peterson
- 1 Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Richard E Rothman
- 1 Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Chung CF, Munson SA, Thompson MJ, Baldwin LM, Kaplan J, Cline R, Green BB. Implementation of a New Kiosk Technology for Blood Pressure Management in a Family Medicine Clinic: from the WWAMI Region Practice and Research Network. J Am Board Fam Med 2016; 29:620-9. [PMID: 27613795 PMCID: PMC5065060 DOI: 10.3122/jabfm.2016.05.160096] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 06/02/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Using a self-service kiosk to measure blood pressure (BP) has the potential to increase patients' awareness of their BP control and free up medical assistant (MA) time. The objective of this study was to evaluate BP kiosk acceptability and usability, as well as its effects on the workflow of patient BP self-measurement in a primary care clinic. METHODS We used qualitative and quantitative assessments of kiosk implementation via meetings with clinic leaders, focus groups with clinic providers and staff, observations of kiosk users, and surveys of kiosk users at 2 and 8 months. RESULTS Most patients were comfortable using the kiosk (82% at 2 months, 87% at 8 months). Initial provider concerns included accuracy, but most gained confidence after comparing it with other monitors and reviewing the literature supporting its accuracy. Patients and providers saw many benefits: easier BP checks, increased patient engagement, and saved MA time for other tasks. The clinic addressed early concerns (eg, infection control, confusing instructions, perceived loss of personal touch). Most patients (86%) supported the clinic continuing to use the kiosks. CONCLUSIONS Providers, staff, and patients adapted to the use of BP kiosks, providing value by engaging patients in their own care and saving MA time. The clinic decided to keep the self-service kiosk after the pilot period.
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Affiliation(s)
- Chia-Fang Chung
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG).
| | - Sean A Munson
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG)
| | - Matthew J Thompson
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG)
| | - Laura-Mae Baldwin
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG)
| | - Jeffrey Kaplan
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG)
| | - Randall Cline
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG)
| | - Beverly B Green
- From the Department of Human Centered Design & Engineering, University of Washington, Seattle (C-FC, SAM); Department of Family Medicine, University of Washington, Seattle (MJT, L-MB); the Memorial Physicians/Yakima Valley Memorial Hospital, Yakima, WA (JK, RC); and the Group Health Research Institute, Seattle (BBG)
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