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Kim J, Cai ZR, Chen ML, Onyeka S, Ko JM, Linos E. Telehealth Utilization and Associations in the United States During the Third Year of the COVID-19 Pandemic: Population-Based Survey Study in 2022. JMIR Public Health Surveill 2024; 10:e51279. [PMID: 38669075 DOI: 10.2196/51279] [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] [Received: 07/26/2023] [Revised: 12/28/2023] [Accepted: 03/05/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic rapidly changed the landscape of clinical practice in the United States; telehealth became an essential mode of health care delivery, yet many components of telehealth use remain unknown years after the disease's emergence. OBJECTIVE We aim to comprehensively assess telehealth use and its associated factors in the United States. METHODS This cross-sectional study used a nationally representative survey (Health Information National Trends Survey) administered to US adults (≥18 years) from March 2022 through November 2022. To assess telehealth adoption, perceptions of telehealth, satisfaction with telehealth, and the telehealth care purpose, we conducted weighted descriptive analyses. To identify the subpopulations with low adoption of telehealth, we developed a weighted multivariable logistic regression model. RESULTS Among a total of 6252 survey participants, 39.3% (2517/6252) reported telehealth use in the past 12 months (video: 1110/6252, 17.8%; audio: 876/6252, 11.6%). The most prominent reason for not using telehealth was due to telehealth providers failing to offer this option (2200/3529, 63%). The most common reason for respondents not using offered telehealth services was a preference for in-person care (527/578, 84.4%). Primary motivations to use telehealth were providers' recommendations (1716/2517, 72.7%) and convenience (1516/2517, 65.6%), mainly for acute minor illness (600/2397, 29.7%) and chronic condition management (583/2397, 21.4%), yet care purposes differed by age, race/ethnicity, and income. The satisfaction rate was predominately high, with no technical problems (1829/2517, 80.5%), comparable care quality to that of in-person care (1779/2517, 75%), and no privacy concerns (1958/2517, 83.7%). Younger individuals (odd ratios [ORs] 1.48-2.23; 18-64 years vs ≥75 years), women (OR 1.33, 95% CI 1.09-1.61), Hispanic individuals (OR 1.37, 95% CI 1.05-1.80; vs non-Hispanic White), those with more education (OR 1.72, 95% CI 1.03-2.87; at least a college graduate vs less than high school), unemployed individuals (OR 1.25, 95% CI 1.02-1.54), insured individuals (OR 1.83, 95% CI 1.25-2.69), or those with poor general health status (OR 1.66, 95% CI 1.30-2.13) had higher odds of using telehealth. CONCLUSIONS To our best knowledge, this is among the first studies to examine patient factors around telehealth use, including motivations to use, perceptions of, satisfaction with, and care purpose of telehealth, as well as sociodemographic factors associated with telehealth adoption using a nationally representative survey. The wide array of descriptive findings and identified associations will help providers and health systems understand the factors that drive patients toward or away from telehealth visits as the technology becomes more routinely available across the United States, providing future directions for telehealth use and telehealth research.
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Affiliation(s)
- Jiyeong Kim
- Stanford Center for Digital Health, School of Medicine, Stanford University, Stanford, CA, United States
| | - Zhuo Ran Cai
- Stanford Center for Digital Health, School of Medicine, Stanford University, Stanford, CA, United States
| | - Michael L Chen
- Stanford Center for Digital Health, School of Medicine, Stanford University, Stanford, CA, United States
| | - Sonia Onyeka
- Stanford Center for Digital Health, School of Medicine, Stanford University, Stanford, CA, United States
| | - Justin M Ko
- Stanford Center for Digital Health, School of Medicine, Stanford University, Stanford, CA, United States
| | - Eleni Linos
- Stanford Center for Digital Health, School of Medicine, Stanford University, Stanford, CA, United States
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Barnawi NA, Al-Otaibi H, Alkhudairy AI, Alajlan MA, Alajlan RA, Alay SM, Alqahtani SM, Bushnak IA, Abolfotouh MA. Awareness, Knowledge, Attitude, and Skills (AKAS) of Telemedicine and Its Use by Primary Healthcare Providers. Int J Gen Med 2024; 17:1047-1058. [PMID: 38532847 PMCID: PMC10964027 DOI: 10.2147/ijgm.s452641] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
Background This study aimed to determine the rate of telemedicine (TM) use and the levels of awareness, knowledge, attitude, and skills of TM among primary healthcare (PHC) providers. Methods In a cross-sectional study, 104 PHC providers were subjected to a validated AKAS scale via Survey Monkey. The tool consists of 4 parameters that users can respond to using a 4-point Likert scale to assess their awareness (12 statements), knowledge (11 statements), attitude (11 statements), and skills (13 statements) on TM. Total and percentage mean scores (PMS) were calculated for each parameter. Participants were categorized in each parameter into three categories: low (≤ 49% score), average (50-70% score), and high (≥ 71% score) levels. The association of AKAS levels with personal characteristics and TM use was investigated. The significance was set at p<0.05. Results One-half of participants (51%) reported current use of TM, and two-thirds (63.5%) reported a high level of AKAS, with a PMS of 72.9±14.7, 95% CI: 70.1-75.7. There were significant associations between the following: years of experience and levels of knowledge (Χ2LT = 6.77, p= 0.009) and skills (Χ2LT = 4.85, p = 0.028), respectively; and total household income and levels of skills (Χ2LT = 6.91, p= 0.009). The rate of TM use was significantly associated with awareness levels (Χ2LT = 6.14, p = 0.013). Lack of training ranked as the first barrier (45.5%), followed by connection problems and tools' unavailability (35.1% each). The participants recommended providing TM training (41.1%) and stabilization of connection and networking signals (30.1%). Conclusion Despite their high level of TM awareness, the rate of TM use by PHC providers is less than satisfactory. Establishing standardized TM training and supporting the network signals are recommended. A large-scale study on the impact of TM integration with PHC services is necessary.
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Affiliation(s)
- Najla A Barnawi
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- College of Nursing, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Hazza Al-Otaibi
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz I Alkhudairy
- College of Medicine, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Mohammed A Alajlan
- College of Medicine, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Renad A Alajlan
- College of Medicine, Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Saeed M Alay
- College of Pharmacy, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | | | - Ibraheem A Bushnak
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mostafa A Abolfotouh
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Dryden EM, Anwar C, Conti J, Boudreau JH, Kennedy MA, Hung WW, Nearing KA, Pimentel CB, Moo L. The Development and Use of a New Visual Tool (REVISIT) to Support Participant Recall: Web-Based Interview Study Among Older Adults. JMIR Form Res 2024; 8:e52096. [PMID: 38300691 PMCID: PMC10870211 DOI: 10.2196/52096] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Qualitative health services research often relies on semistructured or in-depth interviews to develop a deeper understanding of patient experiences, motivations, and perspectives. The quality of data gathered is contingent upon a patient's recall capacity; yet, studies have shown that recall of medical information is low. Threats to generating rich and detailed interview data may be more prevalent when interviewing older adults. OBJECTIVE We developed and studied the feasibility of using a tool, Remembering Healthcare Encounters Visually and Interactively (REVISIT), which has been created to aid the recall of a specific telemedicine encounter to provide health services research teams with a visual tool, to improve qualitative interviews with older adults. METHODS The REVISIT visual appointment summary was developed to facilitate web-based interviews with our participants as part of an evaluation of a geriatric telemedicine program. Our primary aims were to aid participant recall, maintain focus on the index visit, and establish a shared understanding of the visit between participants and interviewers. The authors' experiences and observations developing REVISIT and using it during videoconference interviews (N=16) were systematically documented and synthesized. We discuss these experiences with REVISIT and suggest considerations for broader implementation and future research to expand upon this preliminary work. RESULTS REVISIT enhanced the interview process by providing a focus and catalyst for discussion and supporting rapport-building with participants. REVISIT appeared to support older patients' and caregivers' recollection of a clinical visit, helping them to share additional details about their experience. REVISIT was difficult to read for some participants, however, and could not be used for phone interviews. CONCLUSIONS REVISIT is a promising tool to enhance the quality of data collected during interviews with older, rural adults and caregivers about a health care encounter. This novel tool may aid recall of health care experiences for those groups for whom it may be more challenging to collect accurate, rich qualitative data (eg, those with cognitive impairment or complex medical care), allowing health services research to include more diverse patient experiences.
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Affiliation(s)
- Eileen M Dryden
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
| | - Chitra Anwar
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
| | - Jennifer Conti
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
| | - Jacqueline H Boudreau
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
| | - Meaghan A Kennedy
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
- Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, United States
| | - William W Hung
- Bronx Geriatric Research, Education, and Clinical Center, James J. Peters VA Medical Center, Veterans Health Administration, Bronx, NY, United States
- Icahn School of Medicine, New York, NY, United States
| | - Kathryn A Nearing
- Eastern Colorado Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Veterans Health Administration, Aurora, CO, United States
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Camilla B Pimentel
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Lauren Moo
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
- New England Geriatric Research, Education, and Clinical Center, VA Bedford Healthcare System, Veterans Health Administration, Bedford, MA, United States
- Harvard Medical School, Boston, MA, United States
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Muacevic A, Adler JR, Abbas RA, Alshareef A, Nassar N, Alharbi A. Physicians' Attitude and Perception Towards Social Media Medical Consultation. Cureus 2023; 15:e33671. [PMID: 36793810 PMCID: PMC9922936 DOI: 10.7759/cureus.33671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 01/13/2023] Open
Abstract
AIM Social media plays a major role in modern healthcare. However, little is known about physicians' experience as related to medical consultation through social media, such as Twitter. This study aims to characterize physicians' attitudes and perceptions toward medical consultations through social media and estimate the use of social media for medical consultation purposes. MATERIALS AND METHODS The study was conducted through the distribution of electronic questionnaires to physicians from different specialities. A total of 242 healthcare providers responded to the questionnaire. RESULTS Our results demonstrated that 79% of the healthcare providers received consultations through social media at least "sometimes" and that 56% of them agreed that it is appropriate to have personal social media platforms that can be accessible by patients. They also agreed (87%) that it is appropriate to interact with patients on social media; however, most of them do not find social media platforms appropriate for diagnosis or treatment. CONCLUSION Physicians think positively of social media consults, but do not consider it a proper method to manage medical conditions.
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Day S, Smith J, Perera S, Jones S, Kinsella R. Beyond the binary: sexual health outcomes of transgender and non-binary service users of an online sexual health service. Int J STD AIDS 2021; 32:896-902. [PMID: 34106795 DOI: 10.1177/0956462420982830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sexual health data on transgender and non-binary (TNB) people in the United Kingdom are limited. TNB individuals experience significant socioeconomic and stigma-related disadvantages. Sexual health morbidity and unmet need is likely to be significant. We compared the sexual health outcomes of TNB and cisgender users of London's online sexual health service. Of 119329 users that registered with the e-service between 30.4.19 and 31.12.19, 504 (0.42%) identified as TNB: 302 TNB users requested 463 kits. 78.4% (363/463) of kits were returned. 99.4% of dispatched kits included throat and rectal swabs for gonorrhoea and chlamydia testing. STI/HIV test positivity was: 5.5% syphilis, 4.8% chlamydia, 3.4% gonorrhoea and 0.7% HIV positive. HIV prevalence amongst TNB individuals was: 4.3%. 19.9% of TNB individuals engaged in chemsex, group sex, or fisting and were more likely to engage in sex work. 97.7% gave the service 4/5 or 5/5 star rating. We observed high positivity rates of HIV/STIs amongst TNB individuals and significant levels of high-risk sexual activity. Service users rated the service highly. Given TNB often have complex healthcare needs, some of which cannot be met entirely online, physical clinics must work collaboratively with e-services to support and protect this marginalised population.
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Affiliation(s)
- Sara Day
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Joanna Smith
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Sean Perera
- Brighton and Sussex University Hospitals NHS Trust, UK
| | - Sophie Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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Day S, Khan K, Kelly AM, Jones S, Kinsella R. Characteristics of newly diagnosed HIV-positive service users using a pan-London e-sexually transmitted infection screening service. Int J STD AIDS 2021; 32:1036-1042. [PMID: 33978539 DOI: 10.1177/09564624211014729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Maximising opportunities and removing barriers to HIV testing can help reduce the undiagnosed HIV population. Digital STI/HIV screening services have increased in availability and can improve access and testing coverage. We identified the characteristics of individuals who tested HIV positive using a regional, integrated, self-sampling STI service. The e-notes of service users with reactive HIV screening results were reviewed. Between 8 January 2018 and 31 December 2019, 0.097% (144/148,257) users received a reactive HIV result, 30/144 (20.8%) of whom had previously diagnosed HIV infection. All of the remaining 114 users were notified of their screening result, an estimated 109/114 (95.6%) received confirmatory testing (CT) at a sexual health clinic (SHC) and the confirmatory outcome was documented in 102/114 (89.5%) of cases: 34/114 (29.8%)were HIV positive, 68/114 (59.6%) HIV were negative and the result was unknown in 12/114 (10.5%). All new diagnoses transitioned to HIV outpatient care. These individuals were median age 28 years; 94.1% (32/34) male; 88.2% (30/34) men who have sex with men and 11.8% (4/34) heterosexual; 58.8% (20/34) of white/'white other' ethnicity and 42.2% of Black, Asian and minority ethnic group; 50%(17/34) had a concurrent STI; 9% and 21% had never tested for HIV or attended a SHC before. n HIV test reactivity rate of 0.1%(95% CI) was observed. Confirmed new HIV diagnoses comprised 0.023% of all HIV tests performed. All individuals where CT confirmed a new HIV diagnosis transitioned to HIV specialist care.
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Affiliation(s)
- Sara Day
- 9762Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Kaywaan Khan
- 9762Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Adrian M Kelly
- Lead Commissioner Sexual Health e-Service, The City of London Corporation, Guildhall, London, UK
| | - Sophie Jones
- 9762Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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Bloniecki V, Hagman G, Ryden M, Kivipelto M. Digital Screening for Cognitive Impairment - A Proof of Concept Study. J Prev Alzheimers Dis 2021; 8:127-134. [PMID: 33569558 DOI: 10.14283/jpad.2021.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Due to an ageing demographic and rapid increase of cognitive impairment and dementia, combined with potential disease-modifying drugs and other interventions in the pipeline, there is a need for the development of accurate, accessible and efficient cognitive screening instruments, focused on early-stage detection of neurodegenerative disorders. OBJECTIVE In this proof of concept report, we examine the validity of a newly developed digital cognitive test, the Geras Solutions Cognitive Test (GCST) and compare its accuracy against the Montreal Cognitive Assessment (MoCA). METHODS 106 patients, referred to the memory clinic, Karolinska University Hospital, due to memory complaints were included. All patients were assessed for presence of neurodegenerative disorder in accordance with standard investigative procedures. 66% were diagnosed with subjective cognitive impairment (SCI), 25% with mild cognitive impairment (MCI) and 9% fulfilled criteria for dementia. All patients were administered both MoCA and GSCT. Descriptive statistics and specificity, sensitivity and ROC curves were established for both test. RESULTS Mean score differed significantly between all diagnostic subgroups for both GSCT and MoCA (p<0.05). GSCT total test time differed significantly between all diagnostic subgroups (p<0.05). Overall, MoCA showed a sensitivity of 0.88 and specificity of 0.54 at a cut-off of <=26 while GSCT displayed 0.91 and 0.55 in sensitivity and specificity respectively at a cut-off of <=45. CONCLUSION This report suggests that GSCT is a viable cognitive screening instrument for both MCI and dementia.
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Affiliation(s)
- V Bloniecki
- Victor Bloniecki, Karolinska Institute, Karolinska Uinversity Hospital, Eugeniavägen 3, SE-17176, Stockholm, Sweden. Tel.: +46 70-726 82 20;
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Day S, Kinsella R, Jones S, Tittle V, Suchak T, Forbes K. Safeguarding outcomes of 16 and 17-year-old service users of Sexual Health London (SHL.uk), a pan-London online sexual health service. Int J STD AIDS 2020; 31:1373-1379. [PMID: 33103583 DOI: 10.1177/0956462420933462] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Guidance around how to safeguard young people using online sexual health services (e-SHSs) is limited. Sexual Health London (SHL.uk) is an e-SHS, integrated with London's sexual health clinics (SHCs), offering users aged 16 years and above sexually transmitted infection (STI) testing. For a safeguarding risk assessment, under 18s must complete a safeguarding e-triage, and any concern raised results in a 'call back' (CB) by the SHL.uk team. The safeguarding outcomes of CBs between 8 January 2018 and 18 September 2018 were reviewed; 261/454 (57.5%) users never triggered a CB on their e-triage (non-CB group) and 193/454 (42.5%) users triggered one or more CB(s) (CB group). Safeguarding concerns disclosed predominantly related to drug/alcohol use and partner's age imbalance. Successful telephonic risk assessment took place in 84.5% CB cases. Safeguarding outcomes comprised referrals to: SHC in 35.5%; child protection team in 8.5%; social services in 7%. STI positivity was 16.4% and 15.2% in the CB and non-CB groups, respectively. Although a high number of safeguarding triggers were disclosed, only a small proportion warranted referral for further support/intervention. Using e-triage with telephony support to screen and safeguard adolescents accessing an e-SHS was acceptable to users and enabled their clinical and safeguarding needs to be safely met. e-SHS integration within a network of SHCs further supported this model.
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Affiliation(s)
- Sara Day
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Sophie Jones
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Victoria Tittle
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Tara Suchak
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Kimberley Forbes
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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Soriano JB, Fernández E, de Astorza Á, Pérez de Llano LA, Fernández-Villar A, Carnicer-Pont D, Alcázar-Navarrete B, García A, Morales A, Lobo M, Maroto M, Ferreras E, Soriano C, Del Rio-Bermudez C, Vega-Piris L, Basagaña X, Muncunill J, Cosio BG, Lumbreras S, Catalina C, Alzaga JM, Gómez Quilón D, Valdivia CA, de Lara C, Ancochea J. Hospital Epidemics Tracker (HEpiTracker): Description and pilot study of a mobile app to track COVID-19 in hospital workers. JMIR Public Health Surveill 2020; 6:e21653. [PMID: 32845852 PMCID: PMC7511223 DOI: 10.2196/21653] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/21/2020] [Revised: 07/29/2020] [Accepted: 08/21/2020] [Indexed: 12/22/2022] Open
Abstract
Background Hospital workers have been the most frequently and severely affected professional group during the COVID-19 pandemic, and have a big impact on transmission. In this context, innovative tools are required to measure the symptoms compatible with COVID-19, the spread of infection, and testing capabilities within hospitals in real time. Objective We aimed to develop and test an effective and user-friendly tool to identify and track symptoms compatible with COVID-19 in hospital workers. Methods We developed and pilot tested Hospital Epidemics Tracker (HEpiTracker), a newly designed app to track the spread of COVID-19 among hospital workers. Hospital staff in 9 hospital centers across 5 Spanish regions (Andalusia, Balearics, Catalonia, Galicia, and Madrid) were invited to download the app on their phones and to register their daily body temperature, COVID-19–compatible symptoms, and general health score, as well as any polymerase chain reaction and serological test results. Results A total of 477 hospital staff participated in the study between April 8 and June 2, 2020. Of note, both health-related (n=329) and non–health-related (n=148) professionals participated in the study; over two-thirds of participants (68.8%) were health workers (43.4% physicians and 25.4% nurses), while the proportion of non–health-related workers by center ranged from 40% to 85%. Most participants were female (n=323, 67.5%), with a mean age of 45.4 years (SD 10.6). Regarding smoking habits, 13.0% and 34.2% of participants were current or former smokers, respectively. The daily reporting of symptoms was highly variable across participating hospitals; although we observed a decline in adherence after an initial participation peak in some hospitals, other sites were characterized by low participation rates throughout the study period. Conclusions HEpiTracker is an already available tool to monitor COVID-19 and other infectious diseases in hospital workers. This tool has already been tested in real conditions. HEpiTracker is available in Spanish, Portuguese, and English. It has the potential to become a customized asset to be used in future COVID-19 pandemic waves and other environments. Trial Registration ClinicalTrials.gov NCT04326400; https://clinicaltrials.gov/ct2/show/NCT04326400
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Affiliation(s)
- Joan B Soriano
- Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Esteve Fernández
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia-ICO, Hospitalet de Llobregat, Barcelona, Spain.,Grupo de Control y Prevención del Cáncer, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.,Departamento de Ciencias Clínicas, Facultad de Medicina, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | - Dolors Carnicer-Pont
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Unidad de Control del Tabaco, Centro Colaborador de la OMS para el Control del Tabaco, Institut Català d'Oncologia-ICO, Hospitalet de Llobregat, Barcelona, Spain.,Grupo de Control y Prevención del Cáncer, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain.,Departamento de Ciencias Clínicas, Facultad de Medicina, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Bernardino Alcázar-Navarrete
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Servicio de Neumología, Hospital de Alta Resolución de Loja, Loja, Spain
| | | | | | - María Lobo
- Fundación Teófilo Hernando, Madrid, Spain
| | | | | | - Cecilia Soriano
- CIMNE - International Center for Numerical Methods in Engineering, Barcelona, Spain
| | | | - Lorena Vega-Piris
- Unidad de Metodología, IIS del Hospital Universitario La Princesa, Madrid, Spain
| | | | | | - Borja G Cosio
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,IdISBa, Palma, Spain.,Servicio de Neumología, Hospital Universitari Son Espases, Palma, Spain
| | - Sara Lumbreras
- Institute for Research in Technology, Universidad Pontificia Comillas, Madrid, Spain
| | | | | | | | | | | | - Julio Ancochea
- Hospital Universitario La Princesa, Universidad Autónoma de Madrid, Madrid, Spain.,Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Mamadnabiev I, Imfeld S, Gürke L, Aschwanden M, Isaak A. A telemedicine communication exchange network in Gorno-Badakhshan Autonomic Oblast in collaboration with Swiss Surgical Teams. J Telemed Telecare 2020; 28:488-493. [PMID: 32830613 DOI: 10.1177/1357633x20948989] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The purpose of this article is to report on the implementation of a telemedicine network serving as a second opinion pool for a surgeon in a remote area of a developing country. METHODS This study involved an international collaboration between two members of Swiss Surgical Teams at a tertiary referral hospital and a surgeon in a remote area in Gorno-Badakhshan Autonomic Oblast, Tajikistan, which established a second opinion pool discussing diagnostics and therapeutic options via a messenger application. A retrospective analysis of response times was performed using a series of 50 challenging cases. RESULTS The median time to receive a first telemedical response from any of the two contacts was 24 min (interquartile range 6-73). Urgent and emergent pathologies accounted for 57% of cases. The suggested treatment was carried out in 90% (n = 44) of cases. CONCLUSIONS Timely and convenient telemedicine support to provide diagnostic and therapeutic reassurance and improve treatment quality for patients presenting to a general and vascular surgeon in the large and remote region of Gorno-Badakhshan Autonomic Oblast can be installed via a messenger application.
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Affiliation(s)
| | | | - Lorenz Gürke
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Switzerland.,Vascular and Endovascular Surgery, University Hospital Basel, Switzerland
| | | | - Andrej Isaak
- Vascular and Endovascular Surgery, Cantonal Hospital Aarau, Switzerland.,Vascular and Endovascular Surgery, University Hospital Basel, Switzerland
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Khoza-Shangase K, Moroe N. South African hearing conservation programmes in the context of tele-audiology: A scoping review. S Afr J Commun Disord 2020; 67:e1-e10. [PMID: 32129657 PMCID: PMC7136824 DOI: 10.4102/sajcd.v67i2.670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/13/2019] [Accepted: 01/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The limited involvement of audiologists in occupational noise-induced hearing loss (ONIHL) management through hearing conservation programmes (HCPs) is a global issue. In low- and middle-income (LAMI) countries such as South Africa, this is also exacerbated by demand versus capacity challenges. Tele-audiology is an option requiring serious deliberation by the audiology community within HCPs in LAMI contexts. OBJECTIVES This scoping review explores if tele-audiology has a potential value in HCPs and reviews what has been documented in the literature on the use of tele-audiology in HCPs. METHOD A scoping review was conducted using the Arksey and O'Malley's framework. A search was conducted in five electronic bibliographic databases including Science Direct, PubMed, Scopus Medline, ProQuest and Google Scholar and the grey literature to identify publications presenting considerations around tele-audiology in the implementation of HCPs. RESULTS Findings revealed significant dearth of evidence specific to the use or application of tele-audiology in ONIHL and/or HCPs both within the African context and internationally, despite the purported potential benefit of this service delivery model, particularly in resource-constrained contexts such as LAMI countries. Of the publications deemed potentially relevant to this scoping review, none were found that specifically investigated or addressed the use of tele-audiology in ONIHL or HCPs as their main objective. Nuanced analysis of publications revealed that in the last decade, indication for potential growth in the use of tele-audiology within occupational audiology is indicated. CONCLUSION Because of the significant demand versus capacity challenges in LAMI countries, and because of the need for scaling up audiology professionals' management of HCPs, careful consideration of teleaudiology as a platform to deliver services in these contexts is required.
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Affiliation(s)
- Katijah Khoza-Shangase
- Department of Audiology, Faculty of Humanities, University of the Witwatersrand, Johannesburg.
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Prout Parks E, Moore RH, Li Z, Bishop-Gilyard CT, Garrett AR, Hill DL, Bruton YP, Sarwer DB. Assessing the Feasibility of a Social Media to Promote Weight Management Engagement in Adolescents with Severe Obesity: Pilot Study. JMIR Res Protoc 2018; 7:e52. [PMID: 29555623 PMCID: PMC5881040 DOI: 10.2196/resprot.8229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 06/21/2017] [Revised: 09/28/2017] [Accepted: 12/07/2017] [Indexed: 11/13/2022] Open
Abstract
Background Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. Objective The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ≥ 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. Methods In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or “posts” 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. Results All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 ±3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at the conclusion of the intervention (M=.589, P=.28). Increased social media comments correlated with weight change (r=–.633, P=.04). Conclusions This pilot trial demonstrated that the use of social media as an adjunct to medical weight management was feasible and acceptable to adolescents with severe obesity. Based upon these preliminary findings, social media may be an effective way to mitigate attrition from obesity treatment programs, and improve health outcomes in this high-risk population.
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Affiliation(s)
- Elizabeth Prout Parks
- Division of Gastreoenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Reneé H Moore
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States.,Biostatistics Collaboration Core, Emory University, Atlanta, GA, United States
| | - Ziyi Li
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, United States
| | | | - Andrew R Garrett
- Division of Gastreoenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States.,College of Science and Technology, Temple University, Philadelphia, PA, United States
| | - Douglas L Hill
- Pediatrics Advanced Care Team, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Yasmeen P Bruton
- Division of Gastreoenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - David B Sarwer
- College of Public Health, Temple University, Philadelphia, PA, United States
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Murphy R, Clissold E, Keynejad RC. Problem-based, peer-to-peer global mental health e-learning between the UK and Somaliland: a pilot study. Evid Based Ment Health 2017; 20:142-146. [PMID: 29056610 PMCID: PMC10516401 DOI: 10.1136/eb-2017-102766] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 06/22/2017] [Revised: 08/23/2017] [Accepted: 09/06/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND WHO's mental health gap action programme intervention guide (mhGAP-IG) is an evidence-based tool aimed at front-line health workers in low-income and middle-income countries (LMICs). Its potential to improve global mental health education, especially through digital technologies, has been little studied. Problem-based learning (PBL) is usually conducted face-to-face, but its remote application could facilitate cross-cultural education. OBJECTIVE To evaluate PBL, applied to peer-to-peer global mental health e-learning (Aqoon), using mhGAP-IG. METHODS Twelve pairs of UK and Somaliland medical students completed the full programme. Participants self-directedly met online, via the low-bandwidth Medicine Africa website, for PBL-style tutorials focused on modules of the mhGAP-IG, V.2.0. Preparticipation and postparticipation surveys used mixed methods to evaluate Aqoon, including the Attitudes Toward Psychiatry (ATP-30) instrument. FINDINGS Median ATP-30 scores for Somaliland (82.0 vs 95.0, p=0.003) and UK students (82.0 vs 95.0, p=0.011) improved significantly following Aqoon. Qualitative feedback showed that participants valued peer connectivity and learning about cultural and psychosocial differences in their partner's country. Somaliland students were motivated by clinical learning and UK students by global health education. Feedback on the PBL structure was positive. CONCLUSIONS Digital PBL represents an innovative method to extend the benefits of mhGAP-IG beyond front-line clinical staff, to healthcare students in LMICs. CLINICAL IMPLICATIONS Educational resource limitations in LMICs may be overcome using digital platforms and PBL. Replication with non-medical healthcare students is the next step for this model to explore Aqoon's relevance to pressing global mental health workforce challenges.
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Affiliation(s)
- Roberta Murphy
- South London and Maudsley NHS Foundation Trust, London, UK
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