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von Sommoggy J, Skiba EM, Lander J, Apfelbacher C, Curbach J, Brandstetter S. Health Literacy in Pediatric Consultations on Allergy Prevention. Health Lit Res Pract 2024; 8:e47-e61. [PMID: 38599576 PMCID: PMC11006282 DOI: 10.3928/24748307-20240320-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/31/2023] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND The first 3 years of life offer an opportunity to prevent allergic diseases. Pediatricians are an important source of health information for parents. However, a certain degree of health literacy is necessary to understand, appraise, and apply preventive behavior, which can be supported by health literacy (HL) sensitive consultations and a HL friendly environment. OBJECTIVE In this study, we want to shed light on how pediatricians in outpatient care in Germany advise on early childhood allergy prevention (ECAP) and how they consider parental HL. METHODS We conducted 19 semi-standardized telephone interviews with pediatricians from North-Rhine-Westphalia and Bavaria. The interviews were audio-recorded, transcribed, pseudonymized, and subjected to content analysis. KEY RESULTS Current ECAP recommendations were well known among our sample. Despite the shift of evidence from avoidance of allergens toward early exposure, providing advice on ECAP was considered non-controversial and it was widely assumed that recommendations were easy to understand and apply for parents. However, ECAP was treated as an implicit topic resonating among others like infant nutrition and hygiene. Regarding HL, our interview partners were not aware of HL as a concept. However, they deemed it necessary to somehow assess parental information level and ability to understand provided information. Formal HL screening was not applied, but implicit strategies based on intuition and experience. Concerning effective HL-sensitive communication techniques, interviewees named the adaptation of language and visual support of explanations. More advanced techniques like Teach Back were considered too time-consuming. Medical assistants were considered important in providing an HL-sensitive environment. Time constraints and the high amount of information were considered major barriers regarding HL-sensitive ECAP counseling. CONCLUSION It seems warranted to enhance professional education and training for pediatricians in HL and HL-sensitive communication, to reach all parents with HL-sensitive ECAP counseling. [HLRP: Health Literacy Research and Practice. 2024;8(2):e47-e61.].
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Affiliation(s)
- Julia von Sommoggy
- Address correspondence to Julia von Sommoggy, Ph.D., University Children's Hospital Regensburg (KUNO), Hospital St. Hedwig of the Order of St. John, Steinmetzstr. 1–3, 93049 Regensburg;
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Lander J, Dierks ML, Apfelbacher C, Bitzer EM. Breastfeeding and the role of the commercial milk formula industry. Lancet 2023; 402:447. [PMID: 37543418 DOI: 10.1016/s0140-6736(23)01191-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/07/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover 30625, Germany.
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover 30625, Germany
| | - Christian Apfelbacher
- Institute for Social Medicine and Health Systems Research, Otto von Guericke University, Magdeburg, Germany
| | - Eva Maria Bitzer
- Department of Public Health and Health Education, University of Education Freiburg, Freiburg, Germany
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Lander J, Bitzer EM, von Sommoggy J, Pawellek M, Altawil H, John C, Apfelbacher C, Dierks ML. How do parents access, appraise, and apply health information on early childhood allergy prevention? A focus group and interview study. Front Public Health 2023; 11:1123107. [PMID: 37139377 PMCID: PMC10149846 DOI: 10.3389/fpubh.2023.1123107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/31/2023] [Indexed: 05/05/2023] Open
Abstract
Background When parents want to make health-related decisions for their child, they need to be able to handle health information from a potentially endless range of sources. Early childhood allergy prevention (ECAP) is a good example: recommendations have shifted from allergen avoidance to early introduction of allergenic foods. We investigated how parents of children under 3 years old access, appraise and apply health information about ECAP, and their respective needs and preferences. Methods We conducted 23 focus groups and 24 interviews with 114 parents of children with varied risk for allergies. The recruitment strategy and a topic guide were co-designed with the target group and professionals from public health, education, and medicine. Data were mostly collected via video calls, recorded and then transcribed verbatim. Content analysis according to Kuckartz was performed using MAXQDA and findings are presented as a descriptive overview. Results Parents most frequently referred to family members, friends, and other parents as sources of ECAP information, as well as healthcare professionals (HCPs), particularly pediatricians. Parents said that they exchanged experiences and practices with their peers, while relying on HCPs for guidance on decision-making. When searching for information online, they infrequently recalled the sources used and were rarely aware of providers of "good" health information. While parents often reported trying to identify the authors of information to appraise its reliability, they said they did not undertake more comprehensive information quality checks. The choice and presentation of ECAP information was frequently criticized by all parent groups; in particular, parents of at-risk children or with a manifested allergy were often dissatisfied with HCP consultations, and hence did not straightforwardly apply advice. Though many trusted their HCPs, parents often reported taking preventive measures based on their own intuition. Conclusion One suggestion to react upon the many criticisms expressed by parents regarding who and how provides ECAP information is to integrate central ECAP recommendations into regular child care counseling by HCPs-provided that feasible ways for doing so are identified. This would assist disease prevention, as parents without specific concerns are often unaware of the ECAP dimension of issues such as nutrition.
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Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Eva Maria Bitzer
- Department of Public Health and Health Education, University of Education Freiburg, Freiburg, Germany
| | - Julia von Sommoggy
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Maja Pawellek
- University Children's Hospital Regensburg (KUNO), University of Regensburg, Regensburg, Germany
| | - Hala Altawil
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Cosima John
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Christian Apfelbacher
- Institute for Social Medicine and Health Systems Research, Otto von Guericke University, Magdeburg, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
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Altawil H, Klawunn R, Dierks M, Lander J. Parental COVID-19-related health information practises, sources, evaluations and needs: A qualitative interview study. Health Expect 2023; 26:555-565. [PMID: 36482880 PMCID: PMC9854324 DOI: 10.1111/hex.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/02/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Parents of infants and young children may have specific health information needs and preferences, as they are responsible for their children's health. COVID-19 posed many challenges for families, not least in terms of the constantly updated disease-prevention guidelines. However, little is known about parents' experiences with this unprecedented situation, that is, how and where they seek, use and evaluate COVID-19 (child)-specific health information. We aimed to find out more about this to provide insights to health (information) providers when communicating pandemic information to parents. METHODS We conducted semistructured telephone interviews (August to October 2020) with a purposively selected sample of 20 German-speaking and 10 Arabic-speaking parents of children up to 4 years old. Recruitment occurred through multiple channels, including childcare institutions and social media. Qualitative content analysis of the interview transcripts illustrates the main differences between the two groups. RESULTS By the time the interviews were conducted (mid-2020), some parents reported to seek information less actively or not at all, compared to the beginning of COVID-19. German speakers frequently used Google to obtain information, whereas Arabic speakers mentioned social media (particularly Facebook) as a central source. However, medical providers were the most trusted source for child health. Though determining the credibility of online information was difficult for some parents, others, mostly German speakers (middle-high education), were aware of some author-related criteria. When deciding on information use, parents often rely on their own judgement and gut instinct. Besides the necessity to disseminate information via multiple outlets to reach all parents, Arabic speakers desired audio-visual and translation tools to facilitate understanding. DISCUSSION AND PUBLIC CONCLUSION Apart from education, language and knowledge of the health system and of the attributes of credible information may determine its quality and consequent decisions. There seems to be a considerable need to foster knowledge about reliable information sources, a greater understanding of the range of quality criteria and specific support for nonnative speakers, not least to better inform parents' decision-making. PATIENT AND PUBLIC CONTRIBUTION A parent panel (n = 7) contributed to gathering ideas regarding recruitment, discussing initial results and the choice of topics and questions for a second interview phase.
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Affiliation(s)
- Hala Altawil
- Deparment for Patient Orientation and Health Education, Institute for Epidemiology, Social Medicine and Health System ResearchHannover Medical School (MHH)HannoverGermany
| | - Ronny Klawunn
- Deparment for Patient Orientation and Health Education, Institute for Epidemiology, Social Medicine and Health System ResearchHannover Medical School (MHH)HannoverGermany
| | - Marie‐Luise Dierks
- Deparment for Patient Orientation and Health Education, Institute for Epidemiology, Social Medicine and Health System ResearchHannover Medical School (MHH)HannoverGermany
| | - Jonas Lander
- Deparment for Patient Orientation and Health Education, Institute for Epidemiology, Social Medicine and Health System ResearchHannover Medical School (MHH)HannoverGermany
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Lander J, Heiberger A, Von Sommoggy J, Schulz AA, Dresch C, Altawil H, Schmitt G, Wirtz MA. Intentional and actional components of engaged participation in public health research studies: qualitative synthesis of a recruitment and retention process into the theory-informed INTACT-RS framework. BMC Med Res Methodol 2023; 23:17. [PMID: 36647023 PMCID: PMC9841138 DOI: 10.1186/s12874-023-01838-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Ensuring motivated and successful study participation is a key challenge in the design and conduct of health research studies. Previously, recruitment barriers and facilitators have been identified mainly from experience, and rarely based on theoretical approaches. We developed a framework of intentional and actional components of engaged participation in public health research studies (INTACT-RS), informed by psychological behavioral models. We aimed a) to identify precise indicators for each framework component and b) to better understand which components and decision processes are essential for study participants. METHODS Within a multicenter research network, we applied various approaches to recruit parents of newborns, pediatricians, and midwives. All recruitment processes were documented from the perspective of both participants and researchers. We used different qualitative and quantitative data material, which we applied in a multistage process according to the basic principles of qualitative content analysis. RESULTS INTACT-RS encompasses pre-intentional, intentional and actional phases with a total of n = 15 components covering all aspects of an individual's involvement with a research study. During intention formation, an understanding of efforts and benefits, why participation is valuable beyond contributing to research, and how others perceive the study, were particularly important to (potential) participants. Subsequently (intentional phase), participants consider how and when participation is compatible with their own resources, ability and availability, and hence seek for close communication with, and flexibility and support from the research team. During and after (initial) participation (actional phase), participants' assessment of whether expectations and interests have been met impact crucial further steps, especially the willingness to continue and to recommend participation to others. A strong topic-wise and or supportive participation interest as well as active, continuous exchange with the researchers appeared to be central determinants of study completion and data validity. CONCLUSIONS A theoretical framework is now available to plan and conduct recruitment of different target groups, which accounts for essential motivational and volitional decision-making processes. Based on empirically specified constructs, possible barriers can be addressed even before the initial recruitment process. Therefore, recommendations for scientific practice have been formulated.
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Affiliation(s)
- Jonas Lander
- grid.10423.340000 0000 9529 9877Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Andrea Heiberger
- grid.461778.b0000 0000 9752 9146Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Freiburg, Germany
| | - Julia Von Sommoggy
- grid.7727.50000 0001 2190 5763Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Anja Alexandra Schulz
- grid.461778.b0000 0000 9752 9146Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Freiburg, Germany
| | - Carolin Dresch
- grid.461778.b0000 0000 9752 9146Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Freiburg, Germany
| | - Hala Altawil
- grid.10423.340000 0000 9529 9877Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Gwendolyn Schmitt
- grid.461778.b0000 0000 9752 9146Public Health & Health Education, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Freiburg, Germany
| | - Markus Antonius Wirtz
- grid.461778.b0000 0000 9752 9146Research Methods in Health Sciences, Faculty for Mathematics, Natural Sciences and Technology, University of Education Freiburg, Freiburg, Germany
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Lander J, Dierks ML, Hawkins M. Correction: Lander et al. Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices. Int. J. Environ. Res. Public Health 2022, 19, 7315. Int J Environ Res Public Health 2023; 20:1510. [PMID: 36674411 PMCID: PMC9859569 DOI: 10.3390/ijerph20021510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 06/17/2023]
Abstract
The authors would like to make corrections to a recently published paper [...].
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Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, 30625 Hannover, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, 30625 Hannover, Germany
| | - Melanie Hawkins
- Centre for Global Health and Equity, Faculty of Health, Arts and Design, Department of Health and Biostatistics, Swinburne University of Technology, Melbourne, VIC 3122, Australia
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Lander J, Curbach J, von Sommoggy J, Bitzer EM, Dierks ML. Correction: Awareness, Information-Seeking Behavior, and Information Preferences About Early Childhood Allergy Prevention Among Different Parent Groups: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e42011. [PMID: 36084310 PMCID: PMC9508666 DOI: 10.2196/42011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Eva Maria Bitzer
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
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Heiberger A, Schulz AA, von Sommoggy J, Dresch C, Altawil H, Schmitt G, Lander J. „Model of engaged participation in research studies“
– theoriegeleitete Planung und Umsetzung von Rekrutierungsprozessen in
der Public Health Forschung im Rahmen des DFG-Forschungsverbunds HELICAP (FOR
2959). Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Heiberger
- Pädagogische Hochschule Freiburg, Institut für
Alltagskultur, Bewegung und Gesundheit, Fachrichtung Forschungsmethoden in den
Gesundheitswissenschaften, Freiburg im Breisgau, Deutschland
| | - AA Schulz
- Pädagogische Hochschule Freiburg, Institut für
Alltagskultur, Bewegung und Gesundheit, Fachrichtung Forschungsmethoden in den
Gesundheitswissenschaften, Freiburg im Breisgau, Deutschland
| | - J von Sommoggy
- Universität Regensburg, Medizinische Soziologie, Institut
für Epidemiologie und Präventivmedizin, Regensburg,
Deutschland
| | - C Dresch
- Pädagogische Hochschule Freiburg, Institut für
Alltagskultur, Bewegung und Gesundheit, Fachrichtung Forschungsmethoden in den
Gesundheitswissenschaften, Freiburg im Breisgau, Deutschland
| | - H Altawil
- Medizinische Hochschule Hannover, Institut für Epidemiologie,
Sozialmedizin und Gesundheitssystemforschung, Hannover,
Deutschland
| | - G Schmitt
- Pädagogische Hochschule Freiburg, Institut für
Alltagskultur, Bewegung und Gesundheit, Fachrichtung Forschungsmethoden in den
Gesundheitswissenschaften, Freiburg im Breisgau, Deutschland
| | - J Lander
- Medizinische Hochschule Hannover, Institut für Epidemiologie,
Sozialmedizin und Gesundheitssystemforschung, Hannover,
Deutschland
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Altawil H, Dorr F, Dresch C, Grepmeier EM, Hasenpusch C, Heiberger A, Lander J, Matterne U, Pawellek M, Pöhnl L, Schmitt G, Schulz AA, Sieferle K, von Sommoggy J. REKRUTIERUNG VON STUDIENTEILNEHMENDEN IN DER SOZIALMEDIZINISCHEN UND
MEDIZINSOZIOLOGISCHEN FORSCHUNGSPRAXIS – ERWARTUNGEN, PRAXISERFAHRUNGEN
UND OPTIONEN FÜR THEORIEGELEITETE VORGEHENSWEISEN. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- H Altawil
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - F Dorr
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
| | - C Dresch
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
| | - E-M Grepmeier
- Otto-von-Guericke- Universität Magdeburg, Magdeburg,
Deutschland
| | - C Hasenpusch
- Otto-von-Guericke- Universität Magdeburg, Magdeburg,
Deutschland
| | - A Heiberger
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
| | - J Lander
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - U Matterne
- Otto-von-Guericke- Universität Magdeburg, Magdeburg,
Deutschland
| | - M Pawellek
- Universität Regensburg, Regensburg, Deutschland
| | - L Pöhnl
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
| | - G Schmitt
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
| | - AA Schulz
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
| | - K Sieferle
- Pädagogische Hochule Freiburg, Freiburg,
Deutschland
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Altawil H, Dierks ML, John C, Lander J. „Hebamme finde ich auch gut und ich glaube im Rahmen von den
U-Untersuchungen, könnte ich es mir gut vorstellen“ –
Elterliches Informationsverhalten zum Thema frühkindliche
Allergieprävention. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Klawunn R, Lander J, Seidel G, Melin S, Dierks ML. Soziale Gesundheit und Gesundheitskompetenz in Forschung und
Ausbildung aus einer interdisziplinären Perspektive –
Erfahrungen aus einem multizentrischen Promotionsprogramm zur
Gesundheitskompetenz von Menschen mit chronischen Erkrankungen. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- R Klawunn
- Medizinische Hochschule Hannover, Institut für Epidemiologie,
Sozialmedizin und Gesundheitssystemforschung, Hannover,
Deutschland
| | - J Lander
- Medizinische Hochschule Hannover, Institut für Epidemiologie,
Sozialmedizin und Gesundheitssystemforschung, Hannover,
Deutschland
| | - G Seidel
- Medizinische Hochschule Hannover, Institut für Epidemiologie,
Sozialmedizin und Gesundheitssystemforschung, Hannover,
Deutschland
| | - S Melin
- Robert Bosch Stiftung, Bereich Gesundheit, Stuttgart,
Deutschland
| | - M-L Dierks
- Medizinische Hochschule Hannover, Institut für Epidemiologie,
Sozialmedizin und Gesundheitssystemforschung, Hannover,
Deutschland
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Lander J, Dierks ML, Hawkins M. Health Literacy Development among People with Chronic Diseases: Advancing the State of the Art and Learning from International Practices. Int J Environ Res Public Health 2022; 19:ijerph19127315. [PMID: 35742562 PMCID: PMC9223502 DOI: 10.3390/ijerph19127315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/04/2023]
Abstract
Chronic diseases account for a considerable part of the strain on health care systems [...].
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Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, 30625 Hannover, Germany;
- Correspondence:
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, 30625 Hannover, Germany;
| | - Melanie Hawkins
- Centre for Global Health and Equity, Faculty of Health, Arts and Design, Department of Health and Biostatistics, Swinburne University of Technology, Melbourne, VIC 3122, Australia;
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Curbach J, Lander J, Dierks ML, Grepmeier EM, von Sommoggy J. How do health professionals translate evidence on early childhood allergy prevention into health literacy-responsive practice? A protocol for a mixed-method study on the views of German health professionals. BMJ Open 2021; 11:e047733. [PMID: 34785543 PMCID: PMC8596052 DOI: 10.1136/bmjopen-2020-047733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 10/13/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Paediatricians, general practitioners (GPs) and midwives in primary care are important sources of information for parents on early childhood allergy prevention (ECAP). Research has shown that preventive counselling by health professionals can be effective in improving patients' health literacy (HL) and health behaviour. Providing effective advice relies on two factors. First, health professionals need be up-to-date with research evidence on ECAP, to consider popular misconceptions and fears and to translate this knowledge into clear recommendations for parents (knowledge translation). Second, they need to know and apply counselling techniques and create a practice setting which accommodates parental HL needs (health literacy-responsive care). The objective of this study is to explore and assess how German health professionals take up and translate ECAP evidence into appropriate recommendations for parents, how they consider HL in counselling and practice organisation and what barriers and enablers they find in their performance of HL-responsive ECAP. METHODS AND ANALYSIS The study has a sequential mixed-method design, in two phases. In the first phase, qualitative semi-structured expert interviews will be conducted with health professionals (paediatricians, GPs and midwives) at primary care level and professional policy level. Data collection is ongoing until January 2022. In the second phase, based on the qualitative results, a standardised questionnaire will be developed, and pilot-tested in a wider population of German health professionals. The findings of both phases will be integrated. ETHICS AND DISSEMINATION The study has received ethical approval from the Ethics Committee of the University of Regensburg (18-1205-101). The results will be published in international peer-reviewed open access journals and via presentations at scientific conferences. The results will also be shared with German health professionals, decision-makers and potential funders of interventions.
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Affiliation(s)
- Janina Curbach
- Department of Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg Faculty of Medicine, Regensburg, Germany
- Faculty of Businesss Studies, Ostbayerische Technische Hochschule (OTH) Regensburg, Regensburg, Germany
| | - Jonas Lander
- Department of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Marie Luise Dierks
- Department of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Eva-Maria Grepmeier
- Department of Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg Faculty of Medicine, Regensburg, Germany
| | - Julia von Sommoggy
- Department of Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg Faculty of Medicine, Regensburg, Germany
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Dierks ML, von Sommoggy J, Lander J, Loss J, Curbach J. Provider Perspectives and User Needs (Der Beitrag ist ein Teil des geplanten Workshops „Health literacy in early childhood allergy prevention: parental competencies and public health context in a shifting evidence landscape (HELICAP)”). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1731990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Altawil H, Dierks ML, Lander J. Arabic, in my mother language, so that I understand”– Ergebnisse einer qualitativ-explorativen Interviewstudie mit Eltern in der COVID-19-Pandemie. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H Altawil
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung
| | - M-L Dierks
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung
| | - J Lander
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung
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Matterne U, Egger N, Tempes J, Tischer C, Lander J, Dierks ML, Bitzer EM, Apfelbacher C. Health literacy in the general population in the context of epidemic or pandemic coronavirus outbreak situations: Rapid scoping review. Patient Educ Couns 2021; 104:223-234. [PMID: 33109429 PMCID: PMC7547635 DOI: 10.1016/j.pec.2020.10.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/14/2020] [Accepted: 10/07/2020] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The aim of this rapid scoping review, for which only studies from the general population were considered, was to describe the extent of existing research on HL in the context of previous coronavirus outbreaks (SARS-CoV-1, MERS-CoV and SARS-CoV-2). METHODS We searched major databases and included publications of quantitative and qualitative studies in English and German on any type of research on the functional, critical and communicative domains of HL conducted in the context of the three outbreaks in the general population. We extracted and tabulated relevant data and narratively reported where and when the study was conducted, the design and method used, and how HL was measured. RESULTS 72 studies were included. Three investigated HL or explicitly referred to the concept of HL, 14 were guided by health behaviour theory. We did not find any study designed to develop or psychometrically evaluate pandemic/epidemic HL instruments, or relate pandemic/epidemic or general HL to a pandemic/epidemic outcome, or any controlled intervention study. Type of assessment of the domains of HL varied widely. CONCLUSION Theory-driven observational studies and interventions, examining whether pandemic-related HL can be improved are needed. PRACTICE IMPLICATIONS The development and validation of instruments that measure pandemic-related HL is desirable.
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Affiliation(s)
- Uwe Matterne
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany.
| | - Nina Egger
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Jana Tempes
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Christina Tischer
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany
| | - Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Eva-Maria Bitzer
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Christian Apfelbacher
- Institute of Social Medicine and Health Systems Research, Medical Faculty, Otto Von Guericke University, Magdeburg, Germany; Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore
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Lander J, Curbach J, von Sommoggy J, Bitzer EM, Dierks ML. Awareness, Information-Seeking Behavior, and Information Preferences About Early Childhood Allergy Prevention Among Different Parent Groups: Protocol for a Mixed Methods Study. JMIR Res Protoc 2021; 10:e25474. [PMID: 33470948 PMCID: PMC7857939 DOI: 10.2196/25474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 01/22/2023] Open
Abstract
Background In early childhood allergy prevention (ECAP), parents act on behalf of their children. Parental health literacy and the availability of high-quality information, both online and offline, are crucial for effective ECAP. Recent research highlights three main points. First, parents need sufficient health literacy to discriminate between high-quality and low-quality information. Second, ECAP information behaviors may vary between phases of childhood development and according to individual circumstances. Third, to strengthen user-centeredness of available services, a better overview of parents’ information practices and needs and how they handle uncertainties is required. Objective This study aims to explore why, how, and when parents search for and apply ECAP-specific health information and which individual (eg, understanding of advice) and organizational challenges (eg, information services, information complexity, and changing recommendations) they perceive and how they handle them. This study also aims to assess the needs and preferences that parents express for future information formats and contents. The findings should inform the practical design of ECAP information as well as formats and channels specific to different parent groups. Methods The above-named issues will be explored with parents in four German cities as one element in our efforts to cover the spectrum of perspectives. Based on a mixed methods design, including qualitative and quantitative assessments, the first year serves to prepare focus groups, a piloted focus group guide, a short standardized survey adapted from the European Health Literacy Project, recruitment channels, and the recruitment of participants. After conducting 20 focus groups in the second year, data will be analyzed via a constant comparison method in the third year. Based on this, practice implications on channels (ie, Where?), formats (ie, How?), and contents (ie, What?) of ECAP-specific information will be derived and discussed with parents and associated project partners before its dissemination to relevant ECAP actors (eg, childcare institutions and pediatricians). Results The study began with preselection of recruitment channels, drafting of recruitment and study information for potential participants, and agreement on a first full version of the guideline. Then, a detailed contact list was compiled of health professionals, administrative and social institutions, and relevant social media channels (N=386) to be approached for assistance in contacting parents. The recruitment was postponed due to COVID-19 and will start in January 2021. Conclusions ECAP is a relevant example for assessing how users (ie, parents) handle not only health information but the various and continuous changes, uncertainties, and controversies attached to it. So far, it is unclear how parents implement the respective scientific recommendations and expert advice, which is why this study aims to inform those who communicate with parents about ECAP information. International Registered Report Identifier (IRRID) PRR1-10.2196/25474
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Affiliation(s)
| | | | | | - Eva Maria Bitzer
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
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18
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Valenzano MC, Rybakovsky E, Chen V, Leroy K, Lander J, Richardson E, Yalamanchili S, McShane S, Mathew A, Mayilvaganan B, Connor L, Urbas R, Huntington W, Corcoran A, Trembeth S, McDonnell E, Wong P, Newman G, Mercogliano G, Zitin M, Etemad B, Thornton J, Daum G, Raines J, Kossenkov A, Fong LY, Mullin JM. Zinc Gluconate Induces Potentially Cancer Chemopreventive Activity in Barrett's Esophagus: A Phase 1 Pilot Study. Dig Dis Sci 2021; 66:1195-1211. [PMID: 32415564 PMCID: PMC7677901 DOI: 10.1007/s10620-020-06319-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/02/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Chemopreventive effects of zinc for esophageal cancer have been well documented in animal models. This prospective study explores if a similar, potentially chemopreventive action can be seen in Barrett's esophagus (BE) in humans. AIMS To determine if molecular evidence can be obtained potentially indicating zinc's chemopreventive action in Barrett's metaplasia. METHODS Patients with a prior BE diagnosis were placed on oral zinc gluconate (14 days of 26.4 mg zinc BID) or a sodium gluconate placebo, prior to their surveillance endoscopy procedure. Biopsies of Barrett's mucosa were then obtained for miRNA and mRNA microarrays, or protein analyses. RESULTS Zinc-induced mRNA changes were observed for a large number of transcripts. These included downregulation of transcripts encoding proinflammatory proteins (IL32, IL1β, IL15, IL7R, IL2R, IL15R, IL3R), upregulation of anti-inflammatory mediators (IL1RA), downregulation of transcripts mediating epithelial-to-mesenchymal transition (EMT) (LIF, MYB, LYN, MTA1, SRC, SNAIL1, and TWIST1), and upregulation of transcripts that oppose EMT (BMP7, MTSS1, TRIB3, GRHL1). miRNA arrays showed significant upregulation of seven miRs with tumor suppressor activity (-125b-5P, -132-3P, -548z, -551a, -504, -518, and -34a-5P). Of proteins analyzed by Western blot, increased expression of the pro-apoptotic protein, BAX, and the tight junctional protein, CLAUDIN-7, along with decreased expression of BCL-2 and VEGF-R2 were noteworthy. CONCLUSIONS When these mRNA, miRNA, and protein molecular data are considered collectively, a cancer chemopreventive action by zinc in Barrett's metaplasia may be possible for this precancerous esophageal tissue. These results and the extensive prior animal model studies argue for a future prospective clinical trial for this safe, easily-administered, and inexpensive micronutrient, that could determine if a chemopreventive action truly exists.
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Affiliation(s)
- M C Valenzano
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA
| | - E Rybakovsky
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA
| | - V Chen
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - K Leroy
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - J Lander
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - E Richardson
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - S Yalamanchili
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - S McShane
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - A Mathew
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - B Mayilvaganan
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - L Connor
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - R Urbas
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - W Huntington
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - A Corcoran
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - S Trembeth
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - E McDonnell
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - P Wong
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - G Newman
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - G Mercogliano
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - M Zitin
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - B Etemad
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - J Thornton
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - G Daum
- The Department of Pathology, Lankenau Medical Center, Wynnewood, USA
| | - J Raines
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA
| | | | - L Y Fong
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - J M Mullin
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA.
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA.
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
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Lander J, Haack M, Dierks ML. [Patient and public involvement in health-related research: How is the selection of participants reported?]. Z Evid Fortbild Qual Gesundhwes 2020; 156-157:89-99. [PMID: 33055014 DOI: 10.1016/j.zefq.2020.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES In recent years, the reporting on patient and public involvement (PPI) in health-related research has gained significantly in importance. However, little attention is being paid to the selection of target groups or participating citizens and patients. Individual contributions already point out that the selection is often described in a complex but ambiguous way; for example, individual groups are often not sufficiently differentiated from each other. The aim of our study is to provide an overview of the main topics, questions and challenges that are specific to the selection of participants in PPI by means of an explorative sample of different PPI documents (studies with PPI, studies on PPI, PPI guidelines, PPI websites, PPI journals). Based on this overview, we will make recommendations to help authors of studies and other relevant stakeholders in the planning, implementation and reporting of participant selection. METHODS First, the explorative sample of the above-mentioned PPI documents was identified by conducting a systematic database and online search. A total of 46 documents were taken into account, including 11 studies with PPI, 12 studies on PPI, 12 guidelines, 6 websites and 5 journals. Relevant text passages were extracted from each of them and evaluated using deductively and inductively developed topic-specific categories. RESULTS Overall, the selected PPI documents significantly vary a) in the use of terms, b) in the detailing of the individual aspects of participant selection, and c) in the description of the planning and implementation of participant selection. For the latter, there is usually a lack of systematic, comprehensive explanations, e. g., on how to weigh up a relevant number of participants, on objectives and methods in the selection process and on how to prepare participants. DISCUSSION The various documents about and contributions to the topic of PPI should, in future, report more transparently and systematically on the selection of participants, especially to create practical added value for authors of studies. This includes, in particular, the description of the selection (studies with PPI), a complete overview of all relevant steps of the selection process (PPI guidelines), recommendations on how to deal with representativeness (studies on PPI), notes on reporting PPI (journals) as well as overviews of individual steps of the implementation process (PPI websites).
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Affiliation(s)
- Jonas Lander
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland.
| | - Marius Haack
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland; Landesvereinigung für Gesundheit und Akademie für Sozialmedizin Niedersachsen e.V., Hannover, Deutschland
| | - Marie-Luise Dierks
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland
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Lander J, Drixler K, Dierks ML, Bitzer EM. Evidence-based reporting, methods and content of allergy-specific digital training programs. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The World Allergy Organization frames allergies as a “major global public health issue”, due to the consistently high prevalence of, e.g., allergic rhinitis (up to 30%). Digital training programs (DTPs) may help fostering self-management and provide allergy-specific information, given, for instance, their good accessibility. We aimed to assess an exploratory sample of allergy-specific, interactive and feedback-oriented DTPs towards the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information.
Methods
We searched for DTPs via scientific databases and online sources and developed a checklist from established scientific guidelines for digital health information. The checklist contained 44 items covering 11 domains related to content (e.g. evidence-base), structure (e.g. trainer qualification) and impact (e.g. user perspective).
Results
15 DTPs covered an average of 37% of the items (score 33/88). Items relating to intervention (58%), content (49%), and data safety (60%) were frequently considered, as opposed to user safety (10%), qualification of staff (10%), effectiveness (16%), and user perspective (45%). In 13 of 15 DTPs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% scored on use of scientific research, 53% on regular information update, and 33% on provision of references.
Conclusions
Allergy-specific DTPs conform only partly to established criteria for evidence-based (digital) health information and education. The named methodological and content-wise shortcomings pose considerable obstacles for users. While there have been related, general criticisms earlier, this study provides empirical evidence via the example of allergy-specific DTPs.
Key messages
For DTPs to add value, service providers and health information experts need to cooperate much closer to reduce the 'reporting vs. requirements' gap. Cooperation is also needed to agree essential methodological and content-wise features of DTPs and similar services.
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Affiliation(s)
- J Lander
- Institute for Epidemiology, Hannover Medical School, Hannover, Germany
| | - K Drixler
- Public Health Education, Freiburg University of Education, Freiburg, Germany
| | - M L Dierks
- Institute for Epidemiology, Hannover Medical School, Hannover, Germany
| | - E M Bitzer
- Public Health Education, Freiburg University of Education, Freiburg, Germany
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Lander J, Dierks ML. Patient and Public Involvement in health research: evidence on the practice of participant selection. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Research on Patient and Public Involvement (PPI) largely focusses on its aims and methods. Aspects regarding who participates in PPI are largely overlooked, though they may impact considerably on the planning, process and outcomes: who exactly are 'patients and public' in PPI? How are participants selected and why? Are and should participants be representative? Our objective was to explore respective practices and perceptions to inform future PPI.
Methods
We conducted a systematic database search to select published PPI in medical and health research. Authors of included publications (n = 315) were addressed via an electronic survey, closed and open responses were assessed using descriptive statistics and thematic content evaluation.
Results
Respondents (40%) reported to have recruited a broad spectrum of participants, often including more than one specific group (56%), e.g. publics with and without topic-wise experience. There were only little differences with respect to selecting participants for different involvement aims and using different recruiting methods. Representativeness was often seen as a crucial recruiting objective (71%), while many considered achieving it (very) difficult (69%). They identified significant respective challenges and desired more guidance on various aspects of planning and conducting PPI (56%).
Conclusions
Recruiting PPI participants and handling representativeness are controversial and are associated with various obstacles. While few prior studies addressed single related aspects using debates and theory, our results add a more comprehensive and empirical perspective, particularly regarding the (real) relevance of representativeness.
Key messages
Study authors need to be more systematic and reasonable in selecting PPI participants and in deciding about the need for representativeness. PPI-guidelines should concretize the most relevant steps for planning and conducting participant selection, so that the practice of PPI can be regarded sound and meaningful.
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Affiliation(s)
- J Lander
- Institute for Epidemiology, Hannover Medical School, Hannover, Germany
| | - M L Dierks
- Institute for Epidemiology, Hannover Medical School, Hannover, Germany
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Lander J, Dierks ML. 'Who is (Really) the Focus of Engagement?' - Evidence From Engagement Research. Am J Bioeth 2020; 20:69-71. [PMID: 32364471 DOI: 10.1080/15265161.2020.1745933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Jonas Lander
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research
| | - Marie-Luise Dierks
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health Systems Research
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Lander J, Drixler K, Dierks ML, Bitzer EM. How Do Publicly Available Allergy-Specific Web-Based Training Programs Conform to the Established Criteria for the Reporting, Methods, and Content of Evidence-Based (Digital) Health Information and Education: Thematic Content Evaluation. Interact J Med Res 2019; 8:e12225. [PMID: 31651401 PMCID: PMC6914270 DOI: 10.2196/12225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 06/01/2019] [Accepted: 08/02/2019] [Indexed: 01/17/2023] Open
Abstract
Background Allergic diseases, such as allergic asthma, rhinitis, and atopic eczema, are widespread, and they are a considerable burden on the health care system. For patients and health care professionals, Web-based training programs may be helpful to foster self-management and provide allergy-specific information, given, for instance, their good accessibility. Objective This study aimed to assess an exploratory sample of publicly available allergy-specific Web-based training programs—that is, interactive, feedback-oriented Web-based training platforms promoting health behavior change and improvement of personal skills—with regard to (1) general characteristics, aims, and target groups and (2) the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Methods Web-based training programs were identified via an initial Google search and a search of English and German language websites of medical and public health services, such as the European Centre for Allergy Research Foundation (German), Asthma UK, and Anaphylaxis Canada. We developed a checklist from (1) established guidelines for Web-based health information (eg, the Journal of the American Medical Association benchmarks, DISCERN criteria, and Health On the Net code) and (2) a database search of related studies. The checklist contained 44 items covering 11 domains in 3 areas: (1) content (completeness, transparency, and evidence), (2) structure (data safety and qualification of trainers and authors), and (3) impact (effectiveness, user perspective, and integration into health care). We rated the Web-based training programs as completely, partly, or not satisfying each checklist item and calculated overall and domain-specific scores for each Web-based training program using SPSS 23.0 (SPSS Inc). Results The 15 identified Web-based training programs covered an average of 37% of the items (score 33 out of 88). A total of 7 Web-based training programs covered more than 40% (35/88; maximum: 49%; 43/88). A total of 5 covered 30% (26/88) to 40% (35/88) of all rated items and the rest covered fewer (n=3; lowest score 24%; 21/88). Items relating to intervention (58%; 10/18), content (49%; 9/18), and data safety (60%; 1/2) were more often considered, as opposed to user safety (10%; 0.4/4), qualification of staff (10%; 0.8/8), effectiveness (16%; 0.4/2), and user perspective (45%; 5/12). In addition, in 13 of 15 Web-based training programs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% of all Web-based training programs (7/15) scored on use of scientific research, 53% on regular information update (8/15), and 33% on provision of references (5/15). None of 15 provided details on the quality of references or the strength of evidence. Conclusions English and German language allergy-specific Web-based training programs, addressing lay audiences and health care professionals, conform only partly to established criteria for the reporting, methods, and content of evidence-based (digital) health information and education. Particularly, well-conducted studies on their effectiveness are missing.
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Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Karin Drixler
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Eva Maria Bitzer
- Department of Public Health and Health Education, Freiburg University of Education, Freiburg, Germany
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Drixler K, Luntz E, Wiedemann R, Lander J, Schäfer I, Schmitt J, Dierks ML, Bitzer EM. [What motivates patients with atopic diseases to search the internet-a focus group study on expectations and demands]. Hautarzt 2019; 69:832-838. [PMID: 30105503 DOI: 10.1007/s00105-018-4241-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND People affected by allergies with mild-to-moderate symptoms are often not treated adequately, despite the availability of prevention and self-therapy measures. Given their good and quick accessibility when seeking information, evidence- and web-based services that are user-friendly may strengthen a more independent way of handling an allergy and may also increase health literacy. In order for such services to be found and read, developers and providers need to know about information needs, demands and users' behavior. OBJECTIVES On which occasions does the target group search for allergy-specific information? Which preferences and demands do affected persons have regarding a web-based service? MATERIALS AND METHODS Three individual interviews and four focus groups with 37 participants (19-81 years; hay fever, n = 30; asthma, n = 17; eczema, n = 15) were conducted in four German cities. These were recorded and transcribed verbatim. A multiprofessional team developed a system for coding the texts (two independent encoders, MAXQDA analysis software). RESULTS Those who are affected usually seek information only in case of a concrete need for action. Impulses are, among others, symptoms, suggestions from the social environment, the beginning of the allergy season or an allergy-related contact with the health system. A web-based service should primarily include information about treatment options, provide individualized support for everyday life action strategies, and promote adequate self-management skills. DISCUSSION In order to promote self-management skills, a web-based service should focus on allergy symptoms, treatment options and day-to-day help.
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Affiliation(s)
- K Drixler
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Kunzenweg 21, 79117, Freiburg, Deutschland
| | - E Luntz
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät, Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
| | - R Wiedemann
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Kunzenweg 21, 79117, Freiburg, Deutschland
| | - J Lander
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - I Schäfer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Medizinische Fakultät, Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
| | - M-L Dierks
- Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - E M Bitzer
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Kunzenweg 21, 79117, Freiburg, Deutschland.
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Lander J, Langhof H, Dierks ML. Involving patients and the public in medical and health care research studies: An exploratory survey on participant recruiting and representativeness from the perspective of study authors. PLoS One 2019; 14:e0204187. [PMID: 30615619 PMCID: PMC6322864 DOI: 10.1371/journal.pone.0204187] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/21/2018] [Indexed: 11/18/2022] Open
Abstract
Research on patient and public involvement so far concentrates on defining involvement, describing its methods, and analyzing involvement practices in various individual research disciplines. There is little empirical data on the process of and aims for selecting (lay) PPI participants, and to what extend they can and should be representative of the population at large. To explore practices and perceptions on these issues and on future PPI conduct more generally, we sent an electronic survey to authors who published involvement activities as part of their studies in medical and social science journals. We identified such authors with a systematic search of five databases and applied descriptive statistics for analysis. Of those who returned the survey (n = 127 of 315; 40%), most had previously conducted involvement activities (73%). 45% reported more than one type of involvement, e.g. consultation and deliberation and participation (14%) and to have recruited more than one type of participant for their PPI activity (56%), e.g. ‘lay publics’ and ‘expert publics’ (33% of 71). Representativeness was often seen as a crucial objective when selecting PPI participants, while less than half found it very easy (9%) or rather easy (34%) to select participants. Many respondents considered achieving good representativeness difficult (52%) or very difficult (17%). They identified significant respective challenges and desired more guidance on various aspects of planning and conducting PPI (56%). 55% thought that the concept of “involvement” should be changed or improved. We conclude that recruiting lay people for PPI activities and deciding about and handling representativeness are controversial in current PPI practice, given the manifold challenges mentioned by the survey respondents. Our findings may inform further research particularly regarding–the potentially many cases of–unpublished PPI.
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Affiliation(s)
- Jonas Lander
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Holger Langhof
- Charité - University Medicine Berlin, QUEST - Center for Transforming Biomedical Research, Berlin Institute of Health, Berlin, Germany
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
| | - Marie-Luise Dierks
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
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Drixler K, Wiedemann R, Luntz E, Lander J, Dierks ML, Bitzer EM. Allergiespezifische Gesundheitsinformationen im Internet – was motiviert Betroffene zur Suche und welche Anforderungen stellen sie an eine internetbasierte Intervention? Ergebnisse einer Fokusgruppen-Studie. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- K Drixler
- Pädagogische Hochschule Freiburg, Public Health & Health Education, Freiburg, Deutschland
| | - R Wiedemann
- Pädagogische Hochschule Freiburg, Public Health & Health Education, Freiburg, Deutschland
| | - E Luntz
- Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Zentrum für evidenzbasierte Gesundheitsversorgung (ZEGV), Dresden, Deutschland
| | - J Lander
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland
| | - ML Dierks
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland
| | - EM Bitzer
- Pädagogische Hochschule Freiburg, Public Health & Health Education, Freiburg, Deutschland
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Lander J, Drixler K, Dierks ML, Bitzer EM. Inwiefern berücksichtigen allergiespezifische Online Coaches Qualitätsstandards für die Entwicklung und Vermittlung von internetbasierten Gesundheitsinformationen? Ergebnisse einer kriteriengeleiteten Auswertung. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J Lander
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - K Drixler
- Pädagogische Hochschule Freiburg, Freiburg, Deutschland
| | - ML Dierks
- Medizinische Hochschule Hannover, Hannover, Deutschland
| | - EM Bitzer
- Pädagogische Hochschule Freiburg, Freiburg, Deutschland
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Lander J, Dierks ML. Entwicklung einer Autorenbefragung zur Überprüfung konzeptioneller und praktischer Herausforderungen in Bürger- und Patientenbeteiligung. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J Lander
- Medizinische Hochschule Hannover, Hannover
| | - ML Dierks
- Medizinische Hochschule Hannover, Hannover
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Langhof H, Lander J, Strech D. Input analysis for two public consultations on the EU Clinical Trials Regulation. Health Res Policy Syst 2016; 14:69. [PMID: 27639695 PMCID: PMC5027082 DOI: 10.1186/s12961-016-0141-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 08/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background The European Union’s (EU) Clinical Trials Directive was replaced by an EU-Regulation as of 2016. The policy revision process was subject to a formal impact assessment exercised by the European Commission (EC) from 2008 to 2014. Following the EU principles of Good Governance, deliberation with stakeholders was an integral part of this impact assessment and the policy formulation process. Hence, two public consultations (PCs) were held by the EC in 2009 and 2011, respectively. Various stakeholders contributed and submitted their written input to the EC. Though often cited in the further revision process, the input gathered in the PC was not communicated with full transparency and it is unclear how and to what extent the input has been processed and used in the policy formulation. The objective of this study was an analysis of submissions to both PCs in order to systematically present what topics have been discussed and which possible policy options have been raised by the stakeholders. Methods All written submissions publicly available were downloaded from the EC’s homepage and assessed for stakeholder characteristics. Thematic text analysis was applied to assess the full text of a random sample of 33% of these submissions. Results A total of 198 different stakeholders from the EU and the United States of America contributed to one or both of the two PCs. In total, 44 various themes have been addressed that could be clustered under 24 main themes, including the articulation of problems as well as possible policy solutions to face these problems. Conclusion The two PCs on the Clinical Trials Directive were highly appreciated by the various stakeholders and their input allowed an in-depth view on their particular interests. This input provided a rich source of information for all stakeholders in the field of clinical trials as well as to the EC’s impact assessment. Although the EC obviously gathered a large quantity of expert knowledge on practical implications of trials legislation by consulting stakeholders, it remained unclear how this input was used in the development of the new regulation. For the sake of transparency, it is recommended that in future PCs the EC uses better standardized methods for a more transparent analysis and presentation of results. Electronic supplementary material The online version of this article (doi:10.1186/s12961-016-0141-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Holger Langhof
- Institute for History, Ethics and Philosophy of Medicine, CELLS - Centre for Ethics and Law in the Life Sciences, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | - Jonas Lander
- Institute for History, Ethics and Philosophy of Medicine, CELLS - Centre for Ethics and Law in the Life Sciences, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany.,Present Address: Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School (MHH), Hannover, Germany
| | - Daniel Strech
- Institute for History, Ethics and Philosophy of Medicine, CELLS - Centre for Ethics and Law in the Life Sciences, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30625, Hannover, Germany
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Lander J, Hainz T, Hirschberg I, Bossert S, Strech D. Do Public Involvement Activities in Biomedical Research and Innovation Recruit Representatively? A Systematic Qualitative Review. Public Health Genomics 2016; 19:193-202. [PMID: 27027649 DOI: 10.1159/000444478] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 02/05/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Public involvement activities (PIAs) may contribute to the governance of ethically challenging biomedical research and innovation by informing, consulting with and engaging the public in developments and decision-making processes. For PIAs to capture a population's preferences (e.g. on issues in whole genome sequencing, biobanks or genome editing), a central methodological requirement is to involve a sufficiently representative subgroup of the general public. While the existing literature focusses on theoretical and normative aspects of 'representation', this study assesses empirically how such considerations are implemented in practice. It evaluates how PIA reports describe representation objectives, the recruitment process and levels of representation achieved. METHODS PIA reports were included from a systematic literature search if they directly reported a PIA conducted in a relevant discipline such as genomics, biobanks, biotechnology or others. PIA reports were analyzed with thematic text analysis. The text analysis was guided by an assessment matrix based on PIA-specific guidelines and frameworks. RESULTS We included 46 relevant reports, most focusing on issues in genomics. 27 reports (59%) explicitly described representation objectives, though mostly without adjusting eligibility criteria and recruiting methods to the specific objective. 11 reports (24%) explicitly reported to have achieved the intended representation; the rest either reported failure or were silent on this issue. CONCLUSION Representation of study samples in PIAs in biomedical research and innovation is currently not reported systematically. Improved reporting on representation would not only improve the validity and value of PIAs, but could also contribute to PIA results being used more often in relevant policy and decision-making processes.
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Affiliation(s)
- Jonas Lander
- Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, Hannover, Germany
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Lander J, Hainz T, Hirschberg I, Strech D. Current practice of public involvement activities in biomedical research and innovation: a systematic qualitative review. PLoS One 2014; 9:e113274. [PMID: 25469705 PMCID: PMC4254603 DOI: 10.1371/journal.pone.0113274] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 10/21/2014] [Indexed: 12/21/2022] Open
Abstract
Background A recent report from the British Nuffield Council on Bioethics associated ‘emerging biotechnologies’ with a threefold challenge: 1) uncertainty about outcomes, 2) diverse public views on the values and implications attached to biotechnologies and 3) the possibility of creating radical changes regarding societal relations and practices. To address these challenges, leading international institutions stress the need for public involvement activities (PIAs). The objective of this study was to assess the state of PIA reports in the field of biomedical research. Methods PIA reports were identified via a systematic literature search. Thematic text analysis was employed for data extraction. Results After filtering, 35 public consultation and 11 public participation studies were included in this review. Analysis and synthesis of all 46 PIA studies resulted in 6 distinguishable PIA objectives and 37 corresponding PIA methods. Reports of outcome translation and PIA evaluation were found in 9 and 10 studies respectively (20% and 22%). The paper presents qualitative details. Discussion The state of PIAs on biomedical research and innovation is characterized by a broad range of methods and awkward variation in the wording of objectives. Better comparability of PIAs might improve the translation of PIA findings into further policy development. PIA-specific reporting guidelines would help in this regard. The modest level of translation efforts is another pointer to the “deliberation to policy gap”. The results of this review could inform the design of new PIAs and future efforts to improve PIA comparability and outcome translation.
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Affiliation(s)
- Jonas Lander
- Institute for History, Ethics and Philosophy of Medicine, CELLS-Centre for Ethics and Law in the Life Science, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - Tobias Hainz
- Institute for History, Ethics and Philosophy of Medicine, CELLS-Centre for Ethics and Law in the Life Science, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - Irene Hirschberg
- Institute for History, Ethics and Philosophy of Medicine, CELLS-Centre for Ethics and Law in the Life Science, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
| | - Daniel Strech
- Institute for History, Ethics and Philosophy of Medicine, CELLS-Centre for Ethics and Law in the Life Science, Hannover Medical School, Carl-Neuberg-Street 1, 30625 Hannover, Germany
- * E-mail:
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Lander J, Van Hoyweghen I. How political cultures affect governance efforts to protect "posted genes": insights from Germany. Am J Bioeth 2014; 14:50-53. [PMID: 25325813 DOI: 10.1080/15265161.2014.957421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual’s experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.
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Affiliation(s)
- AL Dewar
- School of Nursing, University of British Columbia, Vancouver, British Columbia
| | - K Gregg
- School of Nursing, University of British Columbia, Vancouver, British Columbia
| | - MI White
- Dept of Family Practice, University of British Columbia, Vancouver, British Columbia
- Harvard Medical School and Brigham Women’s Hospital, Boston, Massachusetts
| | - J Lander
- Faculty of Nursing, University of Alberta, Edmonton, Alberta
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Dewar AL, Gregg K, White MI, Lander J. Navigating the health care system: perceptions of patients with chronic pain. Chronic Dis Can 2009; 29:162-168. [PMID: 19804680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A new framework is needed for patients with chronic pain and their primary care physicians that acknowledges the individual's experiences and provides evidence-informed education and better linkages to community-based resources. This study describes the experience of 19 chronic-pain sufferers who seek relief via the health care system. Their experiences were recorded through in-depth semistructured interviews and analyzed through qualitative methods. The participants reported early optimism, then disillusionment, and finally acceptance of living with chronic pain. Both individuals with chronic pain and their health care professionals need evidence-informed resources and information on best practices to assist them to manage pain. Empathetic communication between health care professionals and individuals with chronic pain is crucial because insensitive communication negatively affects the individual, reduces treatment compliance and increases health care utilization.
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Affiliation(s)
- A L Dewar
- School of Nursing, University of British Columbia, Vancouver, British Columbia.
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Toth C, Lander J. 464 NEUROPATHIC PAIN IS COMMON, DISABLING, AND GREATLY IMPAIRS QUALITY OF LIFE AND EARNING POTENTIAL IN CANADIANS: A POPULATION-BASED SURVEY. Eur J Pain 2007. [DOI: 10.1016/j.ejpain.2007.03.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Keelan JA, Sato TA, Marvin KW, Lander J, Gilmour RS, Mitchell MD. 15-Deoxy-Delta(12,14)-prostaglandin J(2), a ligand for peroxisome proliferator-activated receptor-gamma, induces apoptosis in JEG3 choriocarcinoma cells. Biochem Biophys Res Commun 1999; 262:579-85. [PMID: 10471366 DOI: 10.1006/bbrc.1999.1257] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Apoptosis has been described in placental (trophoblast) tissues during both normal and abnormal pregnancies. We have studied the effects of the cyclopentenone prostaglandins (PGs) on trophoblast cell death using JEG3 choriocarcinoma cells. PGJ(2), Delta(12)PGJ(2), and 15-deoxy-Delta(12,14)-PGJ(2) (15dPGJ(2)) (10 microM) significantly reduced mitochondrial activity (MTT assay) over 16 h by 17.4 +/- 4.7%, 28 +/- 9.3%, and 62.5 +/- 2.8%, respectively (mean +/- sem), while PGA(2) and PGD(2) had no effect. The synthetic PPAR-gamma ligand ciglitizone (12.5 microM) had a potency similar to 15dPGJ(2) (69 +/- 3% reduction). Morphological examination of cultures treated with PGJ(2) and its derivatives revealed the presence of numerous cells with dense, pyknotic nuclei, a hallmark of apoptosis. FACS analysis revealed an abundance (approximately 40%) of apoptotic cells after 16-h treatment with 15dPGJ(2) (10 microM). The caspase inhibitor ZVAD-fmk (5 microM) significantly diminished the apoptotic effects of Delta(12)PGJ(2) and 15dPGJ(2). JEG3 cells expressed PPAR-gamma mRNA by Northern analysis. These novel findings imply a role for PPAR-gamma ligands in various processes associated with pregnancy and parturition.
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Affiliation(s)
- J A Keelan
- Faculty of Medicine and Health Science, University of Auckland School of Medicine, Auckland, New Zealand.
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Lander J, Warnock F. Supporting the parents of children in day surgery. Can Nurse 1999; 95:29-33. [PMID: 10222886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Certainly, day surgery helps reduce health care costs, but what are the effects on the families of children undergoing surgical procedures and same-day discharge? Our research was aimed at identifying the family outcomes of day surgery, and making recommendations for change as appropriate.
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Affiliation(s)
- J Lander
- Faculty of Nursing, University of Alberta
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Abstract
Anxiety is an important component of children's pain and is routinely assessed in pain research. Two forms of the State-Trait Anxiety Inventory have been used frequently by researchers investigating children's pain and state anxiety (form C-1 and Y-1). We were unable to find psychometric information about this tool when used with a population of hospitalized children. Therefore, we undertook to assess reliability and validity, and identify problem items using data from 881 hospitalized children (aged 5-18 years) whom we had tested. Considering results of all analyses together, we concluded that the tools lack validity and reliability, and contain many problem items that are in need of revision.
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Lander J, Brady-Fryer B, Metcalfe J, Nazarali S, Muttitt S. Comparison of Ring Block, Dorsal Penile Nerve Block, and Topical Anesthesia for Neonatal Circumcision. A Randomized Controlled Trial. J Urol 1998. [DOI: 10.1016/s0022-5347(01)63145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- J. Lander
- Faculties of Medicine and Nursing, University of Alberta and Divisions of Research Administration and Pharmacy, University of Alberta Hospitals, Edmonton, Alberta, Canada
| | - B. Brady-Fryer
- Faculties of Medicine and Nursing, University of Alberta and Divisions of Research Administration and Pharmacy, University of Alberta Hospitals, Edmonton, Alberta, Canada
| | - J.B. Metcalfe
- Faculties of Medicine and Nursing, University of Alberta and Divisions of Research Administration and Pharmacy, University of Alberta Hospitals, Edmonton, Alberta, Canada
| | - S. Nazarali
- Faculties of Medicine and Nursing, University of Alberta and Divisions of Research Administration and Pharmacy, University of Alberta Hospitals, Edmonton, Alberta, Canada
| | - S. Muttitt
- Faculties of Medicine and Nursing, University of Alberta and Divisions of Research Administration and Pharmacy, University of Alberta Hospitals, Edmonton, Alberta, Canada
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Affiliation(s)
- T M Birse
- University of Alberta Hospitals, Edmonton
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Warnock FF, Lander J. The painful (and costly) facts about children's tonsillectomy day surgery. AARN News Lett 1998; 54:17. [PMID: 10594990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Lander J. Giving children our best efforts. Clin Nurs Res 1998; 7:99-102. [PMID: 9633334 DOI: 10.1177/105477389800700201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lander J, Brady-Fryer B, Metcalfe JB, Nazarali S, Muttitt S. Comparison of ring block, dorsal penile nerve block, and topical anesthesia for neonatal circumcision: a randomized controlled trial. JAMA 1997; 278:2157-62. [PMID: 9417009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Beliefs about the safety and effectiveness of current anesthetics have resulted in many newborns being circumcised without the benefit of anesthesia. OBJECTIVE To compare ring block, dorsal penile nerve block, a topical eutectic mixture of local anesthetics (EMLA), and topical placebo when used for neonatal circumcision. The placebo represented current practice, with no anesthetic for neonatal circumcision. DESIGN A randomized controlled trial. SETTING Antenatal units in 2 tertiary care hospitals in Edmonton, Alberta. PARTICIPANTS A consecutive sample of 52 healthy, full-term, male newborns, aged 1 to 3 days. INTERVENTIONS Physiological and behavioral monitoring occurred in a series of trials: baseline, drug application, preparation, circumcision, and postcircumcision. Surgical procedures defined the following 4 stages of the circumcision: cleansing, separation, clamp on, and clamp off. Methemoglobin level was assessed 6 hours after surgery. MAIN OUTCOME MEASURES Heart rate, cry, and methemoglobin level. RESULTS Newborns in the untreated placebo group exhibited homogeneous responses that consisted of sustained elevation of heart rate and high-pitched cry throughout the circumcision and following. Two newborns in the placebo group became ill following circumcision (choking and apnea). The 3 treatment groups all had significantly less crying and lower heart rates during and following circumcision compared with the untreated group. The ring block was equally effective through all stages of the circumcision, whereas the dorsal penile nerve block and EMLA were not effective during foreskin separation and incision. Methemoglobin levels were highest in the EMLA group, although no newborn required treatment. CONCLUSIONS The most effective anesthetic is the ring block; EMLA is the least effective. It is our recommendation that an anesthetic should be administered to newborns prior to undergoing circumcision.
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Affiliation(s)
- J Lander
- Faculty of Medicine, University of Alberta, Edmonton, Canada.
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Abstract
Children's strategies for coping with the pain and distress of venipuncture were examined in this descriptive study. Eighty-five children (aged 5-13 years) were interviewed prior to and following blood collection. Prior to the procedure, children reported pain expectations and coping strategies that might be used. Self-reports of the pain experienced and coping strategies used were obtained immediately after the procedure. Twenty-seven different strategies were identified from the children's responses. These strategies were subsequently grouped into 11 coping categories: Active Involvement in Procedure, Behavior-Regulating Cognitions, Cognitive Reappraisal, Direct Efforts to Maintain Control, Diversionary Thinking, Emotion-Regulating Cognitions, Information Seeking, Reality-Oriented Working Through, Reliance on Health-Care Interventions, Support Seeking, and Avoidance and Catastrophizing. Direct Efforts to Maintain Control was the most frequently used category. Age and gender differences were observed in both number and type of strategies reported by the children. Further research is needed to examine the observed relationship between the type of coping strategies generated and the children's pain experience.
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Affiliation(s)
- M J Hodgins
- Faculty of Nursing, University of Alberta, Edmonton, Canada
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Abstract
To assess a strategy to improve 288 nurses' clinical decisions about management of pain saliency of information and cue about the information were manipulated. Scores indicated that the combination of vivid information and a cue to use the information led to the best decisions.
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Affiliation(s)
- J Lander
- Faculty of Nursing, University of Alberta, Edmonton, Canada
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Abstract
Although EMLA is known to be an effective topical anesthetic, its rate of success is unknown. Indeed, researchers have suggested that EMLA may fail with young and apprehensive children. Therefore, the objectives of this study were to assess EMLA's rate of success as well as factors which predict success. A double-blind, placebo-controlled design was utilized. The sample included 258 children and adolescents aged 5-18 years who were having venipuncture or intravenous (i.v.) cannulation. After having their anxiety assessed, subjects were randomly assigned to have EMLA or placebo applied over the procedure site for 90 min. The visual analogue scale was used to assess pain caused by removal of the semi-permeable dressing and by the procedure. Other information that was collected included: duration of drug application, interval between drug removal and procedure, skin changes at bandage and drug sites and rated difficulty of the procedure. EMLA was successful 84% of the time for venipuncture and 51% of the time for i.v. cannulation. Factors which predicted success of EMLA included type of procedure, duration of drug application and anxiety. EMLA was less successful for i.v. cannulation compared to venipuncture even with duration of drug application controlled. Those who had a poor outcome were more anxious than those with a good outcome. Age of child was not a factor. Strategies for improving efficient use of EMLA were recommended.
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Affiliation(s)
- J Lander
- Clinical Sciences, University of Alberta, Edmonton, Alberta T6G 2G3 Canada
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48
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Affiliation(s)
- J Lander
- University of Alberta, Edmonton, Canada
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Abstract
Nurses routinely make complex clinical decisions under conditions of uncertainty. They collect large, unwieldy data sets in the process of making these clinical decisions. To assist nurses in collecting and organizing data and in making complex clinical decisions, some nursing scholars recommend decision support systems. One such support system, a decision tree leads the nurse from general to specific assessments and ultimately to a decision choice or outcome. In this study, a decision tree was examined for its utility in promoting accuracy in decision making for management of chronic wounds among home care nurses. Home care nurses who used the decision tree made better decisions about staging and product choices for chronic wounds. More research is necessary to discover whether decision trees for the management of chronic wounds translate into improved client outcomes.
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Abstract
The purpose of this study was to assess older adults to determine (a) the course of postoperative pain, (b) influences of pain and analgesics on mental status, and (c) relationships among age, mental status and pain. Sixty adults, aged 50-80 yr, who had total hip replacement surgery were included in this study. All subjects had met a preoperative criterion for mental status. Data collection took place over 5 days following surgery. Pain intensity and distress were assessed three times a day for 5 days. Recalled night pain intensity, pain distress, and sleep disturbance from pain were assessed daily in the early morning prior to assessment of mental status. Although no within day or day-to-day pain patterns were observed, the greatest decreases in pain occurred during the first 2 days. Night pain also improved after the third day. One-third of subjects recorded one or more episodes where mental status declined below criterion after surgery. Multivariate analysis indicated that pain, not analgesic intake, predicted mental status decline. Age was not related to pain or mental status. In general, pain was poorly managed in this group of subjects. The results suggest an explanation for acute confusion in older patients after surgery and recommend improved pain management.
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