Assessing the Relationship Between Health Information Technology Use and Self-Rated Health Among Adults with Chronic Low Back Pain in the United States

OBJECTIVE

To assess the use of health information technology (HIT) among adults with chronic low back pain (CLBP) in the United States and to evaluate the relationship between HIT use and self-rated health.

METHODS

The independent variable was the use of the internet to (1) fill prescriptions, (2) communicate with a healthcare provider, (3) look up health information, and (4) schedule a medical appointment. Respondents rated their health in the last 12 months as worse, about the same, or better. A Chi-square analysis was used to assess the use of HIT among those with CLBP; a logistic regression was used to determine predictors of HIT use; and an ordinal logistic regression was used to assess the relationship between HIT and self-rated health.

RESULTS

As compared to those without CLBP, those with CLBP are more likely to use the internet to look up health information (58.9 vs. 53.8%, p-value<.001), refill prescriptions (13.9% vs. 10.5%, p-value<.001), and communicate with a healthcare provider (19.8% vs.15.3%, p-value<.001). Being employed and having a higher level of education were positive predictors of HIT use. As compared to other uses of the internet, using the internet to communicate with a healthcare provider was associated with higher odds of rating health as better compared to worse or about the same within the last 12 months.

CONCLUSION

Among adults with CLBP, a more affluent social status is associated with the use of HIT. Also, HIT is associated with a better health rating as compared to not using it at all. Further studies should assess the longitudinal relationship between HIT use and how adults with CLBP rate their health.

Validity and reliability of the Persian version of the Patient readiness to engage in health information technology (PRE-HIT) instrument

Background

The Patient readiness to engage in health information technology (PRE-HIT) is a conceptually and psychometrically validated questionnaire survey tool to measure willingness of patients with chronic conditions to use health information technology (HIT) resources.

Objectives

This study aimed to translate and validate a health information technology readiness instrument, the PRE-HIT instrument, into the Persian language.

Methods

A rigorous process was followed to translate the PRE-HIT instrument into the Persian language. The face and content validity was validated by impact score, content validity index (CVI) and content validity ratio (CVR). The instrument was used to measure readiness of 289 patients with chronic diseases to engage with digital health with a four point Likert scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was used to check the validity of structure. The convergent and discriminant validity, and internal reliability was expressed by average variance extracted (AVE), construct reliability (CR), maximum shared squared variance (MSV), average shared square variance (ASV), and Cronbach's alpha coefficient. Independent samples, t-test and one-way ANOVA were used respectively to compare the impact of sex, education and computer literacy on the performance of all PRE-HIT factors.

Results

Eight factors were extracted: health information needs, computer anxiety, computer/internet experience and expertise, preferred mode of interaction, no news is good news, relationship with doctor, cell phone expertise, and internet privacy concerns. They explained 69% of the total variance and the KMO value was 0.79; Bartlett's test of sphericity was also statistically significant (sig < 0.001). The communality of items was higher than 0.5. An acceptable model fit of the instrument was achieved (CFI = 0.943, TLI = 0.931, IFI = 0.944, GFI = 0.893, RMSEA ≤ 0.06, χ2/df = 1.625, df = 292, P-value ≤ 0.001). The Cronbach's alpha coefficient achieved a satisfactory level of 0.729. The AVE for all factors was higher than 0.50 except for PMI (0.427) and CIEE (0.463) and also the CR for all factors was higher than 0.7, therefore, the convergent validity of the instrument is adequate. The MSV and ASV values for each factor were lower than AVE values; therefore, the divergent validity was acceptable.

Conclusion

The Persian version of the PRE-HIT was empirically proved for its validity to assess the level of readiness of patients to engage with digital health.

Knowledge, Attitude, Access and Confidence in Evidence-based practice amongst French dental undergraduates: A transcultural adaptation and psychometrics analysis of French version of the KACE questionnaire

OBJECTIVE

The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated.

METHOD

Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively.

RESULTS

186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score.

CONCLUSION

This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance.

Technology readiness of medical students and the association of technology readiness with specialty interest

BACKGROUND

Technology readiness (TR) is a construct which characterizes an individual's propensity to utilize new technology. Despite increased technology use in healthcare, limited data exists on medical student TR and the relation of TR with specialty interest. This study assesses the TR of 2nd year medical students and its association with specialty interest.

METHODS

Respondents completed a survey assessing their most preferred specialty, specialty interests, and technology readiness using a 5-point Likert scale. Using Chi-square analysis, we examined the relation between demographics, TR, and specialty interest.

RESULTS

This study obtained a 45.7% (n = 53/116) response rate demonstrating that 79.2% (n = 42/53) of students were "technology ready." Male students were more likely to be technology ready (95.2%, n = 20/21, vs 68.8%, n = 22/32, p = 0.02) when compared to female students. Technology ready students were associated with being more interested in "Technology-Focused" specialties compared to students who were not technology ready (88.5%, n = 23/26 vs 70.4%, n = 19/27, p = 0.104).

CONCLUSIONS

As a cohort, most medical students were technology ready. It is inconclusive if technology ready students are more likely to be interested in technology-focused specialties due to the limited sample size of this study, although with an increased sample size, an improved understanding on technology readiness and its potential impact on student specialty interest may be obtained. Furthermore, knowledge of TR may aid in developing targeted technology-based education programs and in improving remedial approaches for students who are less comfortable with new technology.

Multilingual healthcare communication: Stumbling blocks, solutions, recommendations

OBJECTIVE

To provide guidance on multilingual and language discordant healthcare communication.

DISCUSSION

We provide a critical reflection on common stumbling blocks to securing (professional) language support, as well as on the currently available solutions to language discordance in healthcare. We discuss issues pertaining to i) the assessment of the patient and healthcare professional's language proficiency, ii) the decision making on whether to seek language support, iii) the currently available options of language support and the development of skills that ensure their effective use, iv) the inclusion of professional interpreters in the interprofessional healthcare team, and v) the transition from single- to integrated language support solutions that allow for a more comprehensive approach to multilingual healthcare communication. We present a set of recommendations for good practice.

CONCLUSION

Understanding the needs, capabilities and shortcoming of the available language- support solutions and the implications arising from them can enable decision makers to make informed decisions that ensure the quality of communication and care. The integrated use of language-support solutions at different stages of care can create the conditions for effective communication, while promoting patient and family participation in the decision making process. Evidence-based interventions that can inform the implementation of solutions are required.

A "Third Wheel" Effect in Health Decision Making Involving Artificial Entities: A Psychological Perspective

In the near future, Artificial Intelligence (AI) is expected to participate more and more in decision making processes, in contexts ranging from healthcare to politics. For example, in the healthcare context, doctors will increasingly use AI and machine learning devices to improve precision in diagnosis and to identify therapy regimens. One hot topic regards the necessity for health professionals to adapt shared decision making with patients to include the contribution of AI into clinical practice, such as acting as mediators between the patient with his or her healthcare needs and the recommendations coming from artificial entities. In this scenario, a "third wheel" effect may intervene, potentially affecting the effectiveness of shared decision making in three different ways: first, clinical decisions could be delayed or paralyzed when AI recommendations are difficult to understand or to explain to patients; second, patients' symptomatology and medical diagnosis could be misinterpreted when adapting them to AI classifications; third, there may be confusion about the roles and responsibilities of the protagonists in the healthcare process (e.g., Who really has authority?). This contribution delineates such effects and tries to identify the impact of AI technology on the healthcare process, with a focus on future medical practice.

The role of self-efficacy, flexibility, and gender in pharmacy students' health information technology readiness

INTRODUCTION

Pharmacy students' characteristics and attitudes towards health information technology (HIT) may influence their willingness to learn, adopt, and utilize technology in healthcare settings. Future pharmacists will play a key role in the successful implementation of HIT, yet their technology readiness is not well understood. The goal of this study was to understand pharmacy students' attitudes regarding HIT and identify personal characteristics and psychosocial factors that predict their readiness to use HIT in future clinical practice.

METHODS

Using an anonymous online survey, data were collected from 148 pharmacy students. Linear regression modeling was used to determine if gender, flexible thinking, and openness to using technology, and technology self-efficacy were associated with students' readiness to utilize HIT tools in future clinical practice.

RESULTS

Regression modeling successfully explained 15% of the variance in predicting students' readiness to utilize HIT tools: F(3, 144) = 8.31, p < 0.001 with an R2 of 0.148 (adj R² = 0.13). Greater information technology self-efficacy, more openness to change (in academic/work settings), and being male were associated with readiness to utilize HIT.

CONCLUSIONS

With the increased adoption of HIT in pharmacy practice, innovative approaches to HIT education are needed. Curricula that help students overcome obstacles to embracing technology may now be warranted. With enhanced training and engagement involving more than just didactic lessons, pharmacy students may not only feel confident in their ability to embrace HIT in future practice but feel professional satisfaction, increasing the likelihood for improved patient care and health system sustainability.