Telephone-Based Training Intervention for Using Digital Communication Technologies for Social Housing Residents During the COVID-19 Pandemic: Mixed Methods Feasibility and Acceptability Evaluation

BACKGROUND

In an era in which digital communication technologies play a pivotal role in everyday life, social housing residents remain highly susceptible to digital exclusion.

OBJECTIVE

This study aims to evaluate the feasibility and acceptability of a telephone-based training intervention designed to empower people to confidently use digital communication technologies (ie, video calls and web-based messaging).

METHODS

Conducted in collaboration with a UK social housing association, the intervention was facilitated by a unitary authority's Digital Inclusion Team during the COVID-19 pandemic. A mixed methods approach was used, encompassing quantitative and qualitative data collection on demand, reach, implementation, and potential outcomes. Demographic and qualitative data on the reasons for undertaking or not undertaking the training were collected via telephone interviews during the recruitment process. Digital competency and well-being data were collected via a self-reported survey before and after the intervention.

RESULTS

Among the 4485 residents who were offered training, 67 (1.49%) expressed interest, of whom 12 (18%) of the 67 completed the training. The findings indicate a demand for basic digital training among social housing residents. The key findings revolve around the substantial dropout rate among those who were interested in undertaking the training. Barriers were strongly influenced by socioeconomic and health circumstances, reflecting the sociodigital inequalities commonly found in this group. For the training participants, the intervention was acceptable and achieved its goals, demonstrating the potential of tailored, persistent training efforts in overcoming barriers. There were no changes in self-reported well-being or digital competency outcomes (but this was limited by the small sample size).

CONCLUSIONS

Sociodigital inequalities impact the reach, implementation, and acceptability of telephone-based digital training for social housing residents. Barriers to reaching and training digitally excluded groups can be overcome through the use of trusted intermediaries, personalized recruitment approaches, the minimization of administrative barriers, and tailored and agile training programs. Recognizing the resource-intensive nature of such initiatives, this study calls for enhanced recognition of intermediary efforts in national digital inclusion policies.

A Miniaturized Tri-Band Implantable Antenna for ISM/WMTS/Lower UWB/Wi-Fi Frequencies

This study aims to design a compact antenna structure suitable for implantable devices, with a broad frequency range covering various bands such as the Industrial Scientific and Medical band (868-868.6 MHz, 902-928 MHz, 5.725-5.875 GHz), the Wireless Medical Telemetry Service (WMTS) band, a subset of the unlicensed 3.5-4.5 GHz ultra-wideband (UWB) that is free of interference, and various Wi-Fi spectra (3.6 GHz, 4.9 GHz, 5 GHz, 5.9 GHz, 6 GHz). The antenna supports both low and high frequencies for efficient data transfer and is compatible with various communication technologies. The antenna features an asynchronous-meandered radiator, a parasitic patch, and an open-ended square ring-shaped ground plane. The antenna is deployed deep inside the muscle layer of a rectangular phantom below the skin and fat layer at a depth of 7 mm for numerical simulation. Furthermore, the antenna is deployed in a cylindrical phantom and bent to check the suitability for different organs. A prototype of the antenna is created, and its reflection coefficient and radiation patterns are measured in fresh pork tissue. The proposed antenna is considered a suitable candidate for implantable technology compared to other designs reported in the literature. It can be observed that the proposed antenna in this study has the smallest volume (75 mm3) and widest bandwidth (181.8% for 0.86 GHz, 9.58% for 1.43 GHz, and 285.7% for the UWB subset and Wi-Fi). It also has the highest gain (-26 dBi for ISM, -14 dBi for WMTS, and -14.2 dBi for UWB subset and Wi-Fi) compared to other antennas in the literature. In addition, the SAR values for the proposed antenna are well below the safety limits prescribed by IEEE Std C95.1-1999, with SAR values of 0.409 W/Kg for 0.8 GHz, 0.534 W/Kg for 1.43 GHz, 0.529 W/Kg for 3.5 GHz, and 0.665 W/Kg for 5.5 GHz when the applied input power is 10 mW. Overall, the proposed antenna in this study demonstrates superior performance compared to existing tri-band implantable antennas in terms of size, bandwidth, gain, and SAR values.

Health Emergencies, Falls, and Use of Communication Technologies by Older People with Functional and Social Frailty: Ageing in Place in Deprived Areas of Italy

Frail older people ageing alone in place need help to perform daily living activities, especially when functional limitations are increasing and formal/informal supports are lacking. This context represents a risk of experiencing health emergencies, in particular falls. It is thus important to understand how seniors manage these potential difficulties and who helps them. The present study aimed to explore these dimensions in Italy, where 120 qualitative interviews were carried out in 2019 within the "Inclusive ageing in place" (IN-AGE) research project, involving frail older people living alone at home. A content analysis was conducted. Results showed that seniors need to manage health emergencies regarding heart and breathing problems but mainly episodes of falls are reported, with consequent fractures and fear of falling again. In several cases, the use of a mobile phone was crucial in order to seek for help, and the first to intervene were children, in addition to some neighbors. Some seniors also referred their ability to call independently the General Practitioner (GP) or the emergency room, in order to not disturb family members. These findings highlight new useful insights for policy makers, regarding health emergencies prevention and management measures to put in place, especially concerning falls, and the support provided by communication technologies.

E-Cardiac Care: A Comprehensive Systematic Literature Review

The Internet of Things (IoT) is a complete ecosystem encompassing various communication technologies, sensors, hardware, and software. IoT cutting-edge technologies and Artificial Intelligence (AI) have enhanced the traditional healthcare system considerably. The conventional healthcare system faces many challenges, including avoidable long wait times, high costs, a conventional method of payment, unnecessary long travel to medical centers, and mandatory periodic doctor visits. A Smart healthcare system, Internet of Things (IoT), and AI are arguably the best-suited tailor-made solutions for all the flaws related to traditional healthcare systems. The primary goal of this study is to determine the impact of IoT, AI, various communication technologies, sensor networks, and disease detection/diagnosis in Cardiac healthcare through a systematic analysis of scholarly articles. Hence, a total of 104 fundamental studies are analyzed for the research questions purposefully defined for this systematic study. The review results show that deep learning emerges as a promising technology along with the combination of IoT in the domain of E-Cardiac care with enhanced accuracy and real-time clinical monitoring. This study also pins down the key benefits and significant challenges for E-Cardiology in the domains of IoT and AI. It further identifies the gaps and future research directions related to E-Cardiology, monitoring various Cardiac parameters, and diagnosis patterns.

Communication Technologies for Interoperable Smart Microgrids in Urban Energy Community: A Broad Review of the State of the Art, Challenges, and Research Perspectives

In modern urban energy communities, diverse natured loads (homes, schools, hospitals, malls, etc.) are situated in the same locality and have self-electricity generation/management facilities. The power systems of these individual buildings are called smart microgrids. Usually, their self-electricity generation is based on renewable energy sources, which are uncertain due to their environmental dependency. So, the consistency of self-energy generation throughout the day is not guaranteed; thus, the dependency on the central utility grid is continued. To solve this, researchers have recently started working on interoperable smart microgrids (ISMs) for urban communities. Here, a central monitoring and control station captures the energy generation/demand information of each microgrid and analyzes the availability/requirement, thereby executing the energy transactions among these ISMs. Such local energy exchanges among the ISMs reduce the issues with uncertain renewable energy and the dependency on the utility grid. To establish such useful ISMs, a well-established communication mechanism has to be adopted. In this view, this paper first reviews various state-of-the-art developments related to smart grids and then provides extensive insights into communication standards and technologies, issues/challenges, and future research perspectives for ISM implementation. Finally, a discussion is presented on advanced wireless technology, called LoRa (Long Range), and a modern architecture using the LoRa technology to establish a communication network for ISMs is proposed.

Helping Children to Participate in Human Papillomavirus-Related Discussions: Mixed Methods Study of Multimedia Messages

BACKGROUND

Human papillomavirus (HPV) can cause several types of cancers and genital warts. A vaccine is available to prevent HPV infections, and several efforts have been made to increase HPV education and, eventually, vaccination. Although previous studies have focused on the development of messages to educate children about HPV and the existence of the HPV vaccine, limited research is available on how to help children better communicate with their parents and health care professionals about the HPV vaccination. In addition, limited research is available on the target audience of this study (Italian children).

OBJECTIVE

This manuscript describes a study assessing the feasibility of using an evidence-based animated video and a web-based game to help children (aged 11-12 years) participate in discussions about their health-in particular when such conversations center around the HPV vaccination-and improve several HPV-related outcomes. The study also compares the effects of these 2 educational multimedia materials on children's knowledge and perceptions of HPV prevention.

METHODS

A mixed methods approach consisting of focus group discussions and an experiment with children (N=35) was used to understand children's experiences with, and perceptions of, the animated video and the game and to measure possible improvements resulting from their interaction with these materials.

RESULTS

Both the animated video and a web-based game increased children's knowledge and positive perceptions about HPV and HPV vaccination. Any single message was not more effective than the others. The children discussed aspects of the features and characters they liked and those that need improvements.

CONCLUSIONS

This study shows that both materials were effective for improving children's education about the HPV vaccine and for helping them to feel more comfortable and willing to communicate with their parents and health care professionals about their health. Several elements emerged that will allow further improvements in the design and development of the messages used in this study as well as the creation of future campaigns.

Notification of STI test results by text messaging: Why do patients refuse? Cross-sectional study in a Parisian sexual health centre

Text messaging has been used to notify patients of results after sexually transmitted infection (STI) testing. This study aimed to characterise the population who refused notification of results by short message services (SMS) and to explore their reasons for refusing. From January to August 2018, 1180 patients coming for STI testing in a Parisian sexual health centre were offered SMS notification of their results, completed a self-administered questionnaire and were included in the study. Factors associated with refusal of SMS notification were explored using logistic regression models. Reasons for refusal were analysed following a qualitative content analysis methodology. In the study population, 7.3% [95% CI 5.8-8.8] of patients refused SMS notification. In the multivariate logistic regression model, male gender and older age were associated with refusal, as were non-French nationality, having forgone health care for economic reasons and being unemployed. Qualitative analysis showed that preferring face-to-face medical contact (32%) and anxiety about the test result (29%) were the main reasons given by patients for refusal. Socially disadvantaged patients may have more limited access to technology and be less at ease using it in a health context. Preference for face-to-face medical contact may reflect the need for human support in vulnerable populations.

The role of communication technology across the life course: A field guide to social support in East York

This paper builds on a body of work over the decades that examines how East Yorkers give and receive support. We go beyond the earlier work taking into consideration communication technologies and how they play a role in the ways people exchange social support across the life course. We draw on 101 in-depth interviews conducted in 2013-2014 to shed light on the support networks of a sample of East York residents and discern the role of communication technologies in the exchange of different types of social support across age groups. Our findings show that not much has changed since the 1960s in terms of the social ties that our sample of East Yorkers have, and the types of support mobilized via social networks: companionship, small and large services, emotional aid, and financial support. What has changed is how communication technologies interweave in complex ways with different types of social ties (partners, siblings, friends, etc.) to mobilize social support. We found that communication technologies helped siblings and extended kin to increase the frequency of interaction and help exchange support at a distance. Communication technologies helped solidify friendship ties by providing a continuous flow of interaction. We draw implications for theories of social support and for social policy associated with interventions aimed at helping vulnerable groups cope in hard times such as the COVID-19 pandemic.

Accessing needed sexual health services during the COVID-19 pandemic in British Columbia, Canada: a survey of sexual health service clients

Objectives

We assessed COVID-19 pandemic impacts on accessing needed sexual health services, and acceptability of alternative service delivery models, among sexual health service clients in British Columbia (BC), Canada.

Methods

We administered an online survey on 21 July–4 August 2020 to clients using a provincial STI clinic or internet-based testing service, GetCheckedOnline, in the year prior to March 2020. We used logistic regression to identify factors associated with having unmet sexual health needs (ie, not accessing needed services) during March–July 2020 and the likelihood of using various alternative service models, if available.

Results

Of 1198 survey respondents, 706 (59%) reported needing any sexual health service since March 2020; of these 706, 365 (52%) did not access needed services and 458 (66%) had avoided or delayed accessing services. GetCheckedOnline users (univariate OR (uOR)=0.62; 95% CI 0.43 to 0.88) or clients with more urgent needs (eg, treatment for new STI, uOR 0.40 (95% CI 0.21 to 0.7)) had lower odds of unmet sexual health needs. The most common factors reported for avoiding or delaying access were public messaging against seeking non-urgent healthcare (234/662, 35%), concern about getting COVID-19 while at (214/662, 32%) or travelling to (147/662, 22%) a clinic or lab and closure of usual place of accessing services (178/662, 27%). All factors were positively associated with having unmet sexual health needs, with public messaging showing the strongest effect (adjusted OR=4.27 (95% CI 2.88 to 6.42)). Likelihood of using alternative sexual health service models was high overall, with the most appealing options being home self-collection kits (634/706, 90%), receiving test kits or antibiotics at home (592/700, 85%) and express testing (565/706, 80%).

Conclusions

Of BC sexual health service clients needing services during March–July 2020, many had unmet needs. Offering alternative service delivery methods may help to improve access during and beyond the COVID-19 pandemic.

A cohort study comparing rate of repeat testing for sexually transmitted and blood-borne infections between clients of an internet-based testing programme and of sexually transmitted infection clinics in Vancouver, Canada

Objectives

Internet-based sexually transmitted and blood-borne infection (STBBI) testing services reduce testing barriers through bypassing face-to-face clinical encounters, potentially enabling clients at ongoing sexual risk to test more frequently. To our knowledge, this hypothesis has not been previously tested. We compared the frequency of repeat testing between Vancouver-based clients of GetCheckedOnline (GCO)—an internet-based STBBI testing service in British Columbia, Canada—and clients of three sexually transmitted infection (STI) clinics in Vancouver for 29 months after GCO launched.

Methods

An administrative data cohort (n=19 497) was assembled using GCO, clinical and laboratory databases. We included all individuals who tested for HIV, gonorrhoea/chlamydia, syphilis or hepatitis C at three STI clinics or using GCO, between September 2014 and February 2017. The rate of repeat testing (>30 days after first episode) was compared between clients who used GCO at least once and those who tested only in STI clinics. Poisson regression was used to generate relative rate (RR) for repeat testing, with adjustment for age, gender/sexual orientation, risk factors (eg, history of STI diagnosis) and rate of testing before GCO launched.

Results

1093 GCO clients were identified, of whom 434 (40%) had repeat test episodes; 8200/18 404 (45%) of clinic clients tested more than once. During the 29-month analysis period, GCO clients repeat tested 1.87 times per person-year, whereas clinic clients repeat tested 1.53 times per person-year, resulting in a crude RR of 1.22 (95% CI: 1.14 to 1.31). Adjustment for covariates increased the RR to 1.26 (95% CI: 1.15 to 1.37).

Conclusions

In this cohort, individuals using internet-based STBBI testing had a rate of repeat testing 22% greater than clinic-based clients. This effect was increased after adjusting for characteristics associated with higher test frequency. The online interface of GCO may facilitate more frequent testing and may therefore contribute to earlier STBBI diagnosis.

What are the barriers and challenges faced by adolescents when searching for sexual health information on the internet? Implications for policy and practice from a qualitative study

OBJECTIVES

As sexual health information is increasingly presented digitally, and adolescents are increasingly seeking sexual health information on the internet, it is important to explore the challenges presented by this developing source of information provision. This study examined the key barriers and challenges faced by young people when accessing and using sexual health information online.

METHODS

A novel qualitative approach was used which combined paired interviews with real-time online activities. A purposive sample of 49 young people aged between 16 and 19 years and diverse in terms of gender, sexuality, religion and socio-demographic background were recruited from areas across Scotland. Data analysis comprised framework analysis of conversational data (including pair interactions), descriptive analysis of observational data, and data integration.

RESULTS

This study highlighted practical and socio-cultural barriers to engagement with online sexual health content. Key practical barriers included difficulty filtering overabundant content; limited awareness of specific, relevant, trusted online sources; difficulties in finding locally relevant information about services; and difficulties in navigating large organisations' websites. Key socio-cultural barriers included fear of being observed; wariness about engaging with visual and auditory content; concern about unintentionally accessing sexually explicit content; and reticence to access sexual health information on social networking platforms or through smartphone applications. These practical and socio-cultural barriers restricted access to information and influenced searching practices.

CONCLUSION

This study provides insights into some of the key barriers faced by young people in accessing and engaging with sexual health information and support online. Reducing such challenges is essential. We highlight the need for sexual health information providers and intervention developers to produce online information that is accurate and accessible; to increase awareness of and promote reliable, accessible sources; and to be sensitive to young people's concerns about 'being seen' accessing sexual health information regarding audio-visual content and platform choice.

[Communication technologies, time pressure and the right to disconnect]

Essential tools in the constant race against time endured by companies, communication technologies also bring with them a new time pressure, emergency situations and information overload which can lead to new types of disorders, stress and sometimes burnout. One of the ways to escape these negative consequences is to implement sustainable practices within the telecommunications environment, in particular through the creation of a time buffer zone and the opportunity to partially disconnect.

Telemonitoring in asthma control: a randomized controlled trial

OBJECTIVE

Telemonitoring seems to be a useful tool for patients' management. The aim of our project was to test the applicability and potential effects of a 12-month telemonitoring of patients with asthma supported by information and communication technologies.

METHODS

We included 100 patients with asthma followed in the outpatient pulmonary clinic in a randomized controlled clinical trial. The patients' data were collected by study questionnaires and lung function tests at the inclusion and at the end of interventional period. In the interventional group, asthma control test (ACT) and peak expiratory flow measurements (PEF) were stimulated to be regularly reported by Short Message Service (SMS). As a response to reported values, the patients automatically received a preformed text or a call from a study nurse in case of detected predefined critical values.

RESULTS

The compliance of reporting PEF and ACT values was higher than 80% in 96% of patients. Although we did not detect significant differences in ACT score improvement between the two study groups, we found more prominent improvement of ACT score in the subgroup of patients with two or more exacerbations prior to inclusion in the interventional group, compared to the control group. 40 (78%) patients in the interventional group listed at least one positive effect of telemonitoring on management of asthma.

CONCLUSIONS

The developed program for home monitoring of patients with asthma was applicable and offered the patients support in managing their disease. Further studies with more selected patients are needed to confirm its usefulness in improving asthma control.

Acceptability and effectiveness of using mobile applications to promote HIV and other STI testing among men who have sex with men in Barcelona, Spain

OBJECTIVE

To evaluate the acceptability and effectiveness of a pilot intervention programme using gay geosocial mobile applications (apps) to offer rapid HIV and other STI tests to men who have sex with men (MSM) in Barcelona between December 2015 and March 2016.

METHODOLOGY

We offered rapid HIV, syphilis and hepatitis C testing by sending private messages on apps for sexual and social encounters. Acceptance was defined as the proportion of users who favourably responded to the message and effectiveness was defined as the proportion of users who attended our facilities among those who were interested in attending. To identify variables associated with the response to the messages, multivariate logistic regression was used. Adjusted OR (OR_a) and 95% CIs were calculated. We collected information on sociodemographics, sexual behaviours and app usage from the contacted user profiles and from users who attended our facilities. A descriptive analysis was carried out.

RESULTS

2656 individual messages were sent. Overall, a 38.4% response rate was obtained, 83.0% of them found it acceptable to receive the unsolicited message, and 73.2% effectiveness was obtained. Responders had higher odds of being 45 years or older (OR_a=1.48; 95% CI 1.06 to 2.08), being connected at the moment the message was sent or during the previous hour (OR_a=1.92; 95% CI 1.38 to 2.68), having a profile photo not exposing bare chest or abdomen (OR_a=1.44; 95% CI 1.07 to 1.92) and using the Grindr app (OR_a=1.39; 95% CI 1.12 to 1.73). Of those who were tested and took the survey (n=77), 45.5% had not taken an HIV test in over a year, 24.7% had had a previous STI diagnosis, 51.4% had reported anal sex without condom and 52% had consumed alcohol or drugs for sex.

CONCLUSIONS

The response rate, acceptance and effectiveness observed in this study indicate that this strategy could be a useful tool for promoting STI testing among high-risk MSM population.

Using the eSexual Health Clinic to access chlamydia treatment and care via the internet: a qualitative interview study

Objective

We developed the eSexual Health Clinic (eSHC), an innovative, complex clinical and public health intervention, embedded within a specialist sexual health service. Patients with genital chlamydia access their results online and are offered medical management via an automated online clinical consultation, leading to antibiotic collection from community pharmacy. A telephone helpline, staffed by Sexual Health Advisers, is available to support patients and direct them to conventional services if appropriate. We sought to understand how patients used this ehealth intervention.

Methods

Within exploratory studies of the eSHC (2014–2015), we conducted in-depth interviews with a purposive sample of 36 patients diagnosed with chlamydia, who had chosen to use the eSHC (age 18–35, 20 female, 16 male). Thematic analysis was conducted.

Results

Participants described choosing to use this ehealth intervention to obtain treatment rapidly, conveniently and privately, within busy lifestyles that hindered clinic access. They described completing the online consultation promptly, discreetly and with ease. The information provided online was considered comprehensive, reassuring and helpful, but some overlooked it in their haste to obtain treatment. Participants generally described being able to collect treatment from pharmacies discreetly and promptly, but for some, poor awareness of the eSHC by pharmacy staff undermined their ability to do this. Those unsuitable for remote management, who were directed to clinic, described frustration and concern about health implications and clinic attendance. However, the helpline was a highly valued source of information, assistance and support.

Conclusion

The eSHC is a promising adjunct to traditional care. Its users have high expectations for convenience, speed and privacy, which may be compromised when transitioning from online to face-to-face elements of the eSHC. Managing expectations and improving implementation of the pharmacy process, could improve their experiences. Positive views on the helpline provide further support for embedding this ehealth intervention within a specialist clinical service.

An Exploratory Investigation of Communication Technologies to Alleviate Communicative Difficulties and Depression in Older Adults

OBJECTIVE

To explore associations between older adults' communicative difficulties, depressive symptoms, and e-mail and telephone use with adult children.

METHOD

We examined these associations using data from 1,634 participants (age M = 71.16, SD = 0.89; 54% female) in the 2011 wave of the Wisconsin Longitudinal Study.

RESULTS

Better vision and worse speech were associated with more frequent e-mail contact with the selected child. Worse hearing was associated with more depressive symptoms for participants with low e-mail use but not for those with average or high e-mail use. Telephone use was not associated with communicative difficulties or depressive symptoms.

DISCUSSION

This study provides preliminary evidence that older adults might use communication technologies such as e-mail in their close relationships to compensate for communicative difficulties. The text-based format of e-mail might also help older adults mitigate hearing impairments and associated depressive symptoms.

Implications of online learning for nurse managers

Online learning for nurses is growing in popularity, with programmes ranging from mandatory update training to part-time master's degrees. E-learning, as it is known, offers flexibility in access to learning, study time and learning styles. In busy clinical areas, where guidance is provided on minimum nurse staffing levels, e-learning provides solutions for managers who wish to encourage professional development while maintaining adequate nursing cover. Caution must be taken, however, when choosing e-learning programmes, as quality and efficacy differ across the range. This article highlights the properties of good e-learning pedagogy to prepare nurse managers for successful assessment of these programmes.

Patient-Clinician Communication: The Roadmap for HCI

Effective communication between patients and their clinicians during clinical encounters has a positive impact on health outcomes. Technology has the potential to help transform this synchronous interaction, but researchers are still at early stages of developing interventions to assess and improve patient-clinician communication. In this workshop, we envision opening up a dialogue among researchers and clinicians who wish to discuss directions for future research in this domain. In particular, the workshop will focus on exploring how technologies available today, as well as projected for the future, can support the communication needs of clinicians and patients.