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Rabb N, Geana M, Sloman S. Communities of Knowledge in Trouble. Perspect Psychol Sci 2024; 19:432-443. [PMID: 37565464 DOI: 10.1177/17456916231187997] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
The community-of-knowledge framework explains the extraordinary success of the human species, despite individual members' demonstrably shallow understanding of many topics, by appealing to outsourcing. People follow the cues of members of their community because understanding of phenomena is generally distributed across the group. Typically, communities do possess the relevant knowledge, but it is possible in principle for communities to send cues despite lacking knowledge-a weakness in the system's design. COVID-19 in the United States offered a natural experiment in collective-knowledge development because a novel phenomenon arrived at a moment of intense division in political partisanship. We review evidence from the pandemic showing that the thought leaders of the two partisan groups sent radically different messages about COVID, which were, in turn, reinforced by close community members (family, friends, etc.). We show that although actual understanding of the individual plays a role in a key COVID-mitigation behavior (vaccination), it plays a smaller role than perceived understanding of thought leaders and beliefs about COVID-related behaviors of close community members. We discuss implications for theory and practice when all communities are in the same epistemic circumstance-relying on the testimony of others.
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Affiliation(s)
| | - Mugur Geana
- William Allen White School of Journalism and Mass Communications, University of Kansas
| | - Steven Sloman
- Cognitive, Linguistic, and Psychological Sciences, Brown University
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Eysenbach G, Geana M, Overton K, Benton M, Lu L, Khan F, Rohleder M, Ahluwalia J, Resnicow K, Zhu Y. Use of a Smartphone App Versus Motivational Interviewing to Increase Walking Distance and Weight Loss in Overweight/Obese Adults With Peripheral Artery Disease: Pilot Randomized Trial. JMIR Form Res 2022; 6:e30295. [PMID: 35113020 PMCID: PMC8855281 DOI: 10.2196/30295] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/17/2021] [Revised: 10/01/2021] [Accepted: 11/27/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Walking therapy improves functional outcomes in patients with peripheral artery disease (PAD). Less is known about the additive benefit of a dietary intervention. OBJECTIVE Our objectives were to develop a smartphone app and, as a pilot, explore its potential efficacy as compared to motivational interviewing (MI) to increase walking distance and promote weight loss in overweight/obese adults with PAD. METHODS We conducted a 3-month, 2-arm randomized pilot study at the University of Kansas. Inclusion criteria were BMI >27 kg/m2 and symptomatic PAD, defined by an ankle-brachial index <0.9. Patients were randomized into 2 groups: MI, delivered through in-person and telephone counseling, and app, a mobile smartphone app. Both interventions encouraged walking for exercise and healthy dietary habits (increasing fruits and vegetables and whole grains while reducing fat and sugary drinks). We assessed medical history at baseline. At baseline and 3 months, participants completed an assessment of 6-minute walking distance, weight, quality of life, exercise behaviors, and dietary habits. The primary outcome was 3-month change in walking distance. Secondary outcomes were changes in weight, quality of life, exercise behaviors, and dietary habits. We used a Wilcoxon rank-sum test to analyze the primary and secondary outcomes at 3 months within the MI and app groups and to compare the changes between the groups with adjustment for baseline. RESULTS We randomized 29 participants with a mean age of 66.03 (SD 8.12) years; 25 participants completed the trial. At baseline, mean walking distance among completers was 260.40 (SD 94.32) meters and 326.15 (SD 69.28) meters for MI and app participants, respectively. At 3 months, the mean walking distance was 298.67 (SD 101.20) meters and 331.19 (SD 58.63) meters for MI and app participants, respectively (group difference P=.03, adjusting for baseline). Increase in walking distance at 3 months was 40.5 meters (95% CI 6.77 to 61.34; P=.02) in MI group. At baseline, mean body weight was 253.10 (SD 59.45) lbs and 225.13 (SD 58.93) lbs for MI and app participants, respectively. At 3 months, mean body weight was 242.14 (SD 58.54) lbs and 223.44 (SD 59.54) lbs for MI and app, respectively (group difference P=.006, adjusting for baseline). Pre-post study decrease in weight was 10.1 lbs (95% CI -17.9 to -3.0) and 2.3 lbs (95% CI -3.4 to -0.7) in MI and app group, respectively. Comparing baseline to 3 months, there were no statistically significant differences in quality of life, exercise behaviors, or dietary habits. CONCLUSIONS Our study demonstrates that MI can promote walking and weight loss in overweight/obese adults with PAD. The smartphone app showed a small weight loss but no statistically significant increase in walking distance. As this was a pilot study, future large-scale studies are needed to replicate the efficacy of MI to promote weight loss in overweight or obese adults with PAD. TRIAL REGISTRATION ClinicalTrials.gov NCT03694652; https://clinicaltrials.gov/ct2/show/NCT03694652.
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Affiliation(s)
| | - Mugur Geana
- School of Journalism and Mass Communications, University of Kansas, Lawrence, KS, United States
| | | | - Mary Benton
- University of Kansas School of Medicine, Wichita, KS, United States
| | - Liuqiang Lu
- University of Kansas School of Medicine, Wichita, KS, United States
| | - Faarina Khan
- University of Kansas School of Medicine, Wichita, KS, United States
| | - Mason Rohleder
- University of Kansas School of Medicine, Wichita, KS, United States
| | | | - Ken Resnicow
- University of Michigan, Ann Arbor, MI, United States
| | - Yiliang Zhu
- University of New Mexico, School of Medicine, Albuquerque, NM, United States
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Geana M. Kansans in the Middle of the Pandemic: Risk Perception, Knowledge, Compliance with Preventive Measures, and Primary Sources of Information about COVID-19. Kans J Med 2020. [DOI: 10.17161/kjm.v13i.13821] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction. As we conduct this study, the world is in the grasp of a deadly pandemic. In less than six months since its first diagnosis in Wuhan, China, the COVID-19 infectious disease due to the novel coronavirus has infected over 5,000,000 people and claimed over 350,000 lives. In the United States, most of the cases are in large urban settings along the coasts, but the disease is slowly progressing through the mainland. Kansas, with its particular location in the midwest United States, has seen a relatively small number of cases, but these are increasing. The Kansas government took radical measures to prevent the spread of the disease. According to the Health Beliefs Model, an individual’s perception of risk will dictate engagement with preventive behaviors. Knowledge about the disease and preventive measures drive the risk assessment. Knowledge is dependant on the sources of information used. This study explored these metrics in a sample of Kansans living in the times of the COVID-19 pandemic.
Methods. A combination of snowball samples and random distribution through social media was used to recruit participants to an online survey. The risk and knowledge instrument was developed and validated by WHO Europe. Data collection lasted 96 hours.
Results. The attitudes and behaviors of Kansans concerning COVID-19 were consistent with its location in an area of the country with a relatively lower incidence of the disease. Participants had good knowledge about the disease and preventive measures and were willing to comply with recommendations from local authorities.
Conclusion. Localized information sources that cater to the community are often primary, while social media is not a valuable source for information pertinent to COVID-19.
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Ellis S, Geana M, Griebling T, McWilliams C, Gills J, Stratton K, Mackay C, Shifter A, Zganjar A, Thrasher B. Development, acceptability, appropriateness and appeal of a cancer clinical trials implementation intervention for rural- and minority-serving urology practices. Trials 2019; 20:578. [PMID: 31590694 PMCID: PMC6781342 DOI: 10.1186/s13063-019-3658-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 02/18/2019] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background Few community urologists offer cancer patients the opportunity to participate in cancer clinical trials, despite national guidelines that recommend it, depriving an estimated 260,000 urological cancer patients of guideline-concordant care each year. Existing strategies to increase urologists’ offer of clinical trials are designed for resource-rich environments and are not feasible for many community urologists. We sought to design an implementation intervention for dissemination in under-resourced community urology practices and to compare its acceptability, appropriateness and adoption appeal among trial-naïve and trial-experienced urologists. Methods We used a design-for-dissemination approach, informed by the Theoretical Domains Framework and Behavior Change Wheel, to match determinants of the clinical trial offer to theoretically informed implementation strategies. We described the implementation intervention in evaluation workshops offered at urology professional society meetings. We surveyed participants to assess the implementation intervention’s acceptability and appropriateness using validated instruments. We also measured adoption appeal, intention to adopt and previous trial offer. Results Our design process resulted in a multi-modal implementation intervention, comprised of multiple implementation strategies designed to address six domains from the Theoretical Domains Framework. Evaluation workshops delivered at four meetings, convened five separate professional societies. Sixty-one percent of those offered an opportunity to participate in the implementation intervention indicated intention to adopt. Average implementation intervention acceptability and appropriateness ratings were 4.4 and 4.4 (out of 5), respectively. Acceptability scores were statistically significantly higher among those offering trials compared to those not (p = 0.03). Appropriateness scores did not differ between those offering trials and those not (p = 0.24). After urologists ranked their top three innovation attributes, 43% of urologists included practice reputation in their top three reasons for offering clinical trials; 30% listed practice differentiation among their top three reasons. No statistically significant differences were found between those who offered trials and those who did not among any of the innovation attributes. Conclusions LEARN|INFORM|RECRUIT is a promising implementation intervention to address low accrual to clinical trials, poised for implementation and effectiveness testing. The implementation intervention is appealing to its target audience and may have equal uptake among trial-naïve and trial-experienced practices. Electronic supplementary material The online version of this article (10.1186/s13063-019-3658-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shellie Ellis
- Department of Population Health, University of Kansas School of Medicine, 3901 Rainbow Blvd., MS 3044, Kansas City, KS, 66160, USA.
| | - Mugur Geana
- School of Journalism and Mass Communications, University of Kansas, Lawrence, KS, USA
| | - Tomas Griebling
- Department of Urology and The Landon Center on Aging, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Charles McWilliams
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jessie Gills
- Department of Urology, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Kelly Stratton
- Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christine Mackay
- Department of Population Health, University of Kansas School of Medicine, 3901 Rainbow Blvd., MS 3044, Kansas City, KS, 66160, USA
| | - Ariel Shifter
- Department of Population Health, University of Kansas School of Medicine, 3901 Rainbow Blvd., MS 3044, Kansas City, KS, 66160, USA
| | - Andrew Zganjar
- Department of Urology, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Brantley Thrasher
- Department of Urology, University of Kansas School of Medicine, Kansas City, KS, USA
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Ellis SD, Geana M, Mackay CB, Moon DJ, Gills J, Zganjar A, Brekke G, Thrasher JB, Griebling TL. Science in the Heartland: Exploring determinants of offering cancer clinical trials in rural-serving community urology practices. Urol Oncol 2019; 37:529.e9-529.e18. [PMID: 30935846 PMCID: PMC6661185 DOI: 10.1016/j.urolonc.2019.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 10/19/2018] [Revised: 01/24/2019] [Accepted: 03/10/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Engaging community urologists in referring patients to clinical trials could increase the reach of cancer trials and, ultimately, alleviate cancer disparities. We sought to identify determinants of referring patients to clinical trials among urology practices serving rural communities. METHODS We conducted semistructured qualitative interviews based on the Theoretical Domains Framework at nonmetropolitan urology practices located in communities offering urological cancer trials. Participants were asked to consider barriers and strategies that might support engaging their patients in discussions about urological cancer clinical trials and referring them appropriately. Recorded interviews were transcribed and coded using template analysis. RESULTS Most participants were not aware of available trials and had no experience with trial referral. Overall, participants held positive attitudes toward clinical trials and recognized their potential roles in accrual, but limited local resources reduced opportunities for offering trials. Most participants expressed a need for increased human, financial, and other resources to support this role. Many participants requested information and training to increase their knowledge of clinical trials and confidence in offering them to patients. Participants highlighted the need to build efficient pathways to identify available trials, match eligible patients, and facilitate communication and collaboration with cancer centers for patient follow-up and continuity of care. CONCLUSIONS With adequate logistical and informational support, community urology practices could play an important role in clinical trial accrual, advancing cancer research and increasing treatment options for rural cancer patients. Future studies should explore the effectiveness of strategies to optimize urology practices' role in clinical trial accrual.
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Affiliation(s)
- Shellie D Ellis
- Department of Health Policy & Management, University of Kansas School of Medicine, Kansas City, KS; University of Kansas Cancer Center, Kansas City, KS.
| | - Mugur Geana
- School of Journalism and Mass Communications, University of Kansas, Lawrence, KS; University of Kansas Cancer Center, Kansas City, KS
| | - Christine B Mackay
- Department of Health Policy & Management, University of Kansas School of Medicine, Kansas City, KS; University of Kansas Cancer Center, Kansas City, KS
| | - Deborah J Moon
- Department of Health Policy & Management, University of Kansas School of Medicine, Kansas City, KS
| | - Jessie Gills
- Department of Urology, Louisiana State University, New Orleans, LA
| | - Andrew Zganjar
- Department of Urology, University of Kansas School of Medicine, Kansas City, KS
| | - Gayle Brekke
- Department of Health Policy & Management, University of Kansas School of Medicine, Kansas City, KS
| | - J Brantley Thrasher
- Department of Urology, University of Kansas School of Medicine, Kansas City, KS
| | - Tomas L Griebling
- Department of Urology, University of Kansas School of Medicine, Kansas City, KS; The Landon Center on Aging, Kansas University Medical Center, Kansas City, KS
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Lumpkins CY, Mabachi N, Lee J, Pacheco C, Greiner KA, Geana M. A Prescription for Internet Access: Appealing to Middle-Aged and Older Racial and Ethnic Minorities Through Social Network Sites to Combat Colorectal Cancer. Health Commun 2017; 32:916-920. [PMID: 27435103 DOI: 10.1080/10410236.2016.1195679] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The popularity and usage of social media networks or SNS (social networking sites) among American Internet users age 50 and over doubled between 2009 and 2010 and has steadily climbed. Part of this increased access may be the result of older adults who are living with a chronic disease and are reaching out for online support. Colorectal cancer (CRC) risk is among those concerns, particularly among middle-age and older minority populations where disparities exist. This exploratory study investigates information seeking behavior related to cancer factors (e.g. testing for colon cancer, cancer fatalism) and current social media usage among racial and ethnic minority groups (African American and Latinos) and Whites age 50 and older. The secondary data from the 2012 Health Information National Trends Survey (HINTS) was analyzed to compare these populations. Results show that African Americans and Latinos were only slightly more likely to use social network sites to seek out cancer information compared to Whites. However, Whites were more likely to use the Internet to seek health information compared to African Americans and Latinos. In this sample, Whites were also more likely to be informed by a physician about CRC testing (p <.01). Whites were also more fatalistic about CRC (p<.001) and more likely to have self-reported receiving a positive diagnosis (p <.001). Implications of this study suggest that use of both traditional health information sources (physician) and the Internet (social media networks, Internet sites) have increased among older Americans and can serve as critical channels for cancer information and education.
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Affiliation(s)
- Crystal Y Lumpkins
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Natabhona Mabachi
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Jaehoon Lee
- b Institute for Measurement, Methodology, Analysis and Policy , Texas Tech University
| | | | - K Allen Greiner
- a Department of Family Medicine Research Division , University of Kansas Medical Center
| | - Mugur Geana
- d William Allen White School of Journalism and Mass Communications , University of Kansas
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Geana M, Erba J, Krebill H, Doolittle G, Madhusudhana S, Qasem A, Malomo N, Sharp D. Searching for cures: Inner-city and rural patients' awareness and perceptions of cancer clinical trials. Contemp Clin Trials Commun 2017; 5:72-79. [PMID: 29740623 PMCID: PMC5936702 DOI: 10.1016/j.conctc.2016.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 11/22/2016] [Accepted: 12/12/2016] [Indexed: 11/25/2022] Open
Abstract
Fewer than 5% of cancer patients participate in clinical trials, making it challenging to test new therapies or interventions for cancer. Even within that small number, patients living in inner-city and rural areas are underrepresented in clinical trials. This study explores cancer patients' awareness and perceptions of cancer clinical trials, as well as their perceptions of patient-provider interactions related to discussing cancer clinical trials in order to improve accrual in cancer clinical trials. Interviews with 66 former and current in inner-city and rural cancer patients revealed a lack of awareness and understanding about clinical trials, as well as misconceptions about what clinical trials entail. Findings also revealed that commercials and television shows play a prominent role in forming inner-city and rural patients' attitudes and/or misconceptions about clinical trials. However, rural patients were more likely to hold unfavorable views about clinical trials than inner-city patients. Patient-provider discussions emerged as being crucial for increasing awareness of clinical trials among patients and recruiting them to trials. Findings from this study will inform communication strategies to enhance recruitment to cancer clinical trials by increasing awareness and countering misconceptions about clinical trials.
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Affiliation(s)
- Mugur Geana
- William Allen White School of Journalism and Mass Communications, The University of Kansas, 1435 Jayhawk Blvd., Lawrence, KS 66045, USA
| | - Joseph Erba
- William Allen White School of Journalism and Mass Communications, The University of Kansas, 1435 Jayhawk Blvd., Lawrence, KS 66045, USA
| | - Hope Krebill
- Midwest Cancer Alliance, 4350 Shawnee Mission Parkway, Fairway, KS 66205, USA
| | - Gary Doolittle
- School of Medicine, The University of Kansas Cancer Center, 3901 Rainbow Blvd., Kansas City, KS 66160, USA
| | - Sheshadri Madhusudhana
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
| | - Abdulraheem Qasem
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
| | - Nikki Malomo
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
| | - Denise Sharp
- Richard and Annette Bloch Cancer Center, Truman Medical Centers, 2301 Holmes., Kansas City, MO 64108, USA
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Greiner KA, Daley CM, Epp A, James A, Yeh HW, Geana M, Born W, Engelman KK, Shellhorn J, Hester CM, LeMaster J, Buckles DC, Ellerbeck EF. Implementation intentions and colorectal screening: a randomized trial in safety-net clinics. Am J Prev Med 2014; 47:703-14. [PMID: 25455115 PMCID: PMC4311575 DOI: 10.1016/j.amepre.2014.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 07/08/2014] [Accepted: 08/05/2014] [Indexed: 02/06/2023]
Abstract
CONTEXT Low-income and racial/ethnic minority populations experience disproportionate colorectal cancer (CRC) burden and poorer survival. Novel behavioral strategies are needed to improve screening rates in these groups. BACKGROUND The study aimed to test a theoretically based "implementation intentions" intervention for improving CRC screening among unscreened adults in urban safety-net clinics. DESIGN Randomized controlled trial. SETTING/PARTICIPANTS Adults (N=470) aged ≥50 years, due for CRC screening, from urban safety-net clinics were recruited. INTERVENTION The intervention (conducted in 2009-2011) was delivered via touchscreen computers that tailored informational messages to decisional stage and screening barriers. The computer then randomized participants to generic health information on diet and exercise (Comparison group) or "implementation intentions" questions and planning (Experimental group) specific to the CRC screening test chosen (fecal immunochemical test or colonoscopy). MAIN OUTCOME MEASURES The primary study outcome was completion of CRC screening at 26 weeks based on test reports (analysis conducted in 2012-2013). RESULTS The study population had a mean age of 57 years and was 42% non-Hispanic African American, 28% non-Hispanic white, and 27% Hispanic. Those receiving the implementation intentions-based intervention had higher odds (AOR=1.83, 95% CI=1.23, 2.73) of completing CRC screening than the Comparison group. Those with higher self-efficacy for screening (AOR=1.57, 95% CI=1.03, 2.39), history of asthma (AOR=2.20, 95% CI=1.26, 3.84), no history of diabetes (AOR=1.86, 95% CI=1.21, 2.86), and reporting they had never heard that "cutting on cancer" makes it spread (AOR=1.78, 95% CI=1.16, 2.72) were more likely to complete CRC screening. CONCLUSIONS The results of this study suggest that programs incorporating an implementation intentions approach can contribute to successful completion of CRC screening even among very low-income and diverse primary care populations. Future initiatives to reduce CRC incidence and mortality disparities may be able to employ implementation intentions in large-scale efforts to encourage screening and prevention behaviors.
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Affiliation(s)
- K Allen Greiner
- Department of Family Medicine; University of Kansas Cancer Center.
| | - Christine M Daley
- Department of Family Medicine; Center for American Indian Community Health; Department of Preventive Medicine; University of Kansas Cancer Center
| | | | - Aimee James
- Siteman Cancer Center, Washington University, St. Louis, Missouri
| | - Hung-Wen Yeh
- Department of Biostatistics; University of Kansas Cancer Center
| | - Mugur Geana
- Department of Family Medicine; University of Kansas Cancer Center; Center of Excellence for Health Communications to Underserved Populations, William Allen White School of Journalism and Mass Communications
| | | | | | - Jeremy Shellhorn
- School of Architecture Design and Planning, University of Kansas, Kansas City, Kansas
| | | | | | - Daniel C Buckles
- Department of Internal Medicine, University of Kansas Medical Center
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Young R, Willis E, Cameron G, Geana M. "Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults. Health Informatics J 2013; 20:127-35. [PMID: 24056750 DOI: 10.1177/1460458213486906] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.
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