Public Health Dashboards in Overdose Prevention: The Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action

As the field of public health rises to the demands of real-time surveillance and rapid data-sharing needs in a postpandemic world, it is time to examine our approaches to the dissemination and accessibility of such data. Distinct challenges exist when working to develop a shared public health language and narratives based on data. It requires that we assess our understanding of public health data literacy, revisit our approach to communication and engagement, and continuously evaluate our impact and relevance. Key stakeholders and cocreators are critical to this process and include people with lived experience, community organizations, governmental partners, and research institutions. In this viewpoint paper, we offer an instructive approach to the tools we used, assessed, and adapted across 3 unique overdose data dashboard projects in Rhode Island, United States. We are calling this model the "Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action." This approach reflects the iterative lessons learned about the improvement of data dashboards through collaboration and strong partnerships across community members, state agencies, and an academic research team. We will highlight key tools and approaches that are accessible and engaging and allow developers and stakeholders to self-assess their goals for their data dashboards and evaluate engagement with these tools by their desired audiences and users.

Community engagement in the development of health-related data visualizations: a scoping review

OBJECTIVE

This scoping review aims to address a gap in the literature on community engagement in developing data visualizations intended to improve population health. The review objectives are to: (1) synthesize literature on the types of community engagement activities conducted by researchers working with community partners and (2) characterize instances of "creative data literacy" within data visualizations developed in community-researcher partnerships.

METHODS

Using the 2018 PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, the review focuses on peer-reviewed journal articles from 2010 to 2022 in PubMed, Web of Science, and Google Scholar. A community engagement tool was applied to the studies by independent reviewers to classify levels of community engagement, social determinants, and vulnerable populations.

RESULTS

Twenty-seven articles were included in the scoping review. Twelve articles worked with vulnerable populations. Four articles attempted to alleviate barriers to representation in their respective studies, with addressing language barriers being the most prevalent approach. Thirteen articles considered social determinants of health. Sixteen studies engaged in iterative approaches with intended users when developing the visualization or tool.

DISCUSSION

Only a few significant examples of creative data literacy are incorporated in the studies. We recommend a specific focus on engaging intended users at every step of the development process, addressing language and cultural differences, and empowering intended users as data storytellers.

CONCLUSIONS

There is room for deeper and more meaningful community involvement in the development of health-related data visualizations geared towards them.

Data literacy in genome research

With an ever increasing amount of research data available, it becomes constantly more important to possess data literacy skills to benefit from this valuable resource. An integrative course was developed to teach students the fundamentals of data literacy through an engaging genome sequencing project. Each cohort of students performed planning of the experiment, DNA extraction, nanopore sequencing, genome sequence assembly, prediction of genes in the assembled sequence, and assignment of functional annotation terms to predicted genes. Students learned how to communicate science through writing a protocol in the form of a scientific paper, providing comments during a peer-review process, and presenting their findings as part of an international symposium. Many students enjoyed the opportunity to own a project and to work towards a meaningful objective.

Lessons Learned From a Systematic, Hospital-Wide Implementation of the ABCDEF Bundle: A Survey Evaluation

Objective

We recently reported the first part of a study testing the impact of data literacy training on "assessing pain, spontaneous awakening and breathing trials, choice of analgesia and sedation, delirium monitoring/management, early exercise/mobility, and family and patient empowerment" [ABCDEF [A-F]) compliance. The purpose of the current study, part 2, was to evaluate the effectiveness of the implementation approach by surveying clinical staff to examine staff knowledge, skill, motivation, and organizational resources.

DESIGN

The Clark and Estes Gap Analysis framework was used to study knowledge, motivation, and organization (KMO) influences. Assumed influences identified in the literature were used to design the A-F bundle implementation strategies. The influences were validated against a survey distributed to the ICU interprofessional team.

SETTING

Single-center study was conducted in eight adult ICUs in a quaternary academic medical center.

SUBJECTS

Interprofessional ICU clinical team.

INTERVENTIONS

A quantitative survey was sent to 386 participants to evaluate the implementation design postimplementation. An exploratory factor analysis was performed to understand the relationship between the KMO influences and the questions posed to validate the influence. Descriptive statistics were used to identify strengths needed to sustain performance and weaknesses that required improvement to increase A-F bundle adherence.

MEASUREMENT AND RESULTS

The survey received an 83% response rate. The exploratory factor analysis confirmed that 38 of 42 questions had a strong relationship to the KMO influences, validating the survey's utility in evaluating the effectiveness of implementation design. A total of 12 KMO influences were identified, 8 were categorized as a strength and 4 as a weakness of the implementation.

CONCLUSIONS

Our study used an evidence-based gap analysis framework to demonstrate key implementation approaches needed to increase A-F bundle compliance. The following drivers were recommended as essential methods required for successful protocol implementation: data literacy training and performance monitoring, organizational support, value proposition, multidisciplinary collaboration, and interprofessional teamwork activities. We believe the learning generated in this two-part study is applicable to implementation design beyond the A-F bundle.

Teaching Health Literacy and Digital Literacy Together at University Level: The FLOURISH Module

Many universities have wellness programs to promote overall health and well-being. Using students' own personal data as part of improving their own wellness would seem to be a natural fit given that most university students are already data and information literate. In this work, we aim to show how the interplay between health literacy and data literacy can be used and taught together. The method we use is the development and delivery of the FLOURISH module, an accredited, online-only but extra-curricular course that delivers practical tips in the areas that impact students' everyday wellness including sleep, nutrition, work habits, procrastination, relationships with others, physical activity, positive psychology, critical thinking, and more. For most of these topics, students gather personal data related to the topic and submit an analysis of their data for assessment thus demonstrating how students can use their personal data for their benefit. More than 350 students have taken the module and an analysis of the use of online resources, as well as feedback on the module experience, are presented. The contributions of this article are to further endorse the need for health literacy and digital literacy for students, and we demonstrate that these can be taught together making each literacy more appealing to the digital natives of Generation Z who make up the majority of students. The implications for public health research and practice are that two student literacies, health and digital, are not independent and for our students, they should be taught together.

Scaffolding STEM Literacy Assignments To Build Greater Competence in Microbiology Courses

Different approaches can be used to impart science, technology, engineering, and math (STEM) literacy among undergraduates and thus can be modified to support various scientific concepts and course objectives. In comparable microbiology-related courses, scaffolded assignments to improve STEM literacy through data, information, and communication analysis skills were developed using the ASM Curriculum Guidelines and the Microbiology Course Inventory (MCI) to structure the course and assignments. Examples of such assignments included a meta-analysis using literature and bioinformatics, as well as a public data presentation and an epidemiological model based on current events. To evaluate the effectiveness of such approaches, assignment components were aligned to determine whether the activities reinforced the MCI concepts. Comparison of pre- and postcourse data indicated relative strengths (and weaknesses) addressed by scaffolded STEM literacy pedagogy. These efforts also contribute to a department-wide initiative to enhance career readiness and implementation of course assessments. Future goals are to broaden the integration of assignment components to other microbiology-related courses and have longitudinal assessment.

Implementation of a digital health module for undergraduate medical students: A comparative study on knowledge and attitudes

BACKGROUND

Digital competencies are more and more required in everyday work, and training future healthcare professionals in digital health is highly important.

OBJECTIVE

Aim of this study was to assess medical students' gain of knowledge by participation in a teaching module "Digital Health", and to evaluate their attitudes towards digital health and its role in medical education.

METHODS

Students of the module were asked to complete a questionnaire and a multiple-choice-test before and after completing the classes. Students of the same educational level in different modules served as reference group.

RESULTS

34 students took part (n= 17 "Digital Health group"; n= 17 "reference group"). There was no significant difference in pre-existing knowledge between the groups. After having completed the module, participants reached significantly higher scores, compared to their preexisting knowledge (p< 0.05) and the reference group (p< 0.05). Most students found that digital medicine is not sufficiently represented in undergraduate medical education, but will influence everyday work of physicians in the next five years.

CONCLUSIONS

Students showed a high awareness for the impact of digital health on physicians' work. The results suggest that the format can sufficiently transfer knowledge about digital health. Teaching of digital knowledge and competencies should be firmly implemented into medical education to form digitally competent future doctors.

Working with Data in Adult English Classrooms: Lessons Learned about Communicative Justice during the COVID-19 Pandemic

Throughout COVID-19, health officials have relied on data visualizations to communicate urgent messages about the spread of the virus and preventative measures. Relatively few efforts have employed participatory engagement with communities who have experienced a disproportionate burden of COVID-19 illness to shape these communications. Sociologist W.E.B. Du Bois viewed data visualization as an approach to changing the way people think about themselves. This paper describes a community-engaged approach to data literacy skill-building with bilingual Latina learners in an adult English program in Northern California, Bay Area. The curriculum combines data visualization activities with language instruction and preventive health themes. Early work on COVID-19 in 2020-21 emphasized improving health knowledge and message interpretation but later shifted to a critical data literacy perspective, focusing on myth-busting, improving risk messaging in their own social networks, and supporting learners to see the power of their own experiences in data story-telling processes. This pedagogical approach, guided by Charles Brigg's idea of communicative justice priorities, locates adult learners' data visualization work as part of a broader effort to be included in the perspectives that shape knowledge production in today's healthcare system. This approach can be used to examine disparities in information access in linguistically minoritized communities and guide future education interventions.

Data Literacy in Medical Education - An Expedition into the World of Medical Data

With the advancing digitization in medicine, digital medical data is playing an increasingly important role in health care and research, which is why data literacy must already be taught in medical education. To this end, a 28-hour online elective for medical students - following a constructivist approach - has been implemented. It teaches learners different aspects of data literacy for a critical collection and use of sensitive medical data. The assessment of the learners' reflections on the course topics shows, on the one hand, the importance of data literacy from learners' perspective and, on the other hand, the importance of taking an overarching and coherent view of medical data. In further curricular courses, such as medical ethics, and statistics, special themes are to be deepened in an application-oriented manner.

Data practices during COVID: Everyday sensemaking in a high-stakes information ecology

How do people reason with data to make sense of the world? What implications might everyday practices hold for data literacy education? We leverage the unique context of the COVID-19 pandemic to shed light on these questions. COVID-19 has engendered a complex, multimodal ecology of information resources, with which people engage in high-stakes sensemaking and decision-making. We take a relational approach to data literacy, examining how people navigate and interpret data through interactions with tools and other people. Using think-aloud protocols, a diverse group of people described their COVID-19 information-seeking practices while working with COVID-19 information resources they use routinely. Although participants differed in their disciplinary background and proficiency with data, they each consulted data frequently and used it to make sense of life in the pandemic. Three modes of interacting with data were examined: scanning, looking closer and puzzling through. In each of these modes, we examined the balance of agency between people and their tools; how participants experienced and managed emotions as part of exploring data; and how issues of trust mediated their sensemaking. Our findings provide implications for cultivating more agentic publics, using a relational lens to inform data literacy education.

Practitioner notes

What is already known about this topic Many people, even those with higher education, struggle with interpreting quantitative data representations.Social and emotional factors influence cognition and learning.People are often overwhelmed by the abundance of available information online.There is a need for data literacy approaches that are humanistic and relational. What this paper adds Everyday data practices can be variable and adaptable, and include engaging with data at different levels: scanning, looking closer, and puzzling through. Each of these modes involves different data practices.People, independently of their quantitative interpretation skills and disciplinary backgrounds, may engage differently with data (eg, avoiding versus delving deeper) based on their emotional responses, level of trust or interpersonal relationships that are evoked by the data.These everyday data practices have implications for people's sense of their own agency with data and involve emotional and trust-based relationships that shape their interpretations of data. These relational aspects of data literacy suggest productive directions for data literacy education. Implications for practice and/or policy Data literacy can be taught as a process that is inherently relational, for example, by discussing the ways in which learners are personally connected to different data, what emotions these connections evoke, and how that affects the ways in which they attend to, trust and interpret the data.Data literacy education can cultivate a wider range of data practices at a variety of depths of interaction, rather than prioritizing only in-depth inquiry.It may be helpful to include complex experiences with data sources that require learners to go beyond a binary "trustworthy/untrustworthy" distinction, so that learners can become more strategic, nuanced and intentional in forming a variety of trust relationships with different sources.Discussing how learners' everyday data practices interact with different data representations and tools can help them become more critically aware of the possible purposes, values, and risks associated with their everyday data practices.

Technocratic Decision-Making in Times of Crisis? The Use of Data for Scientific Policy Advice in Germany’s COVID-19 Management

COVID-19 has demonstrated the importance of data for scientific policy advice. Mechanisms by which data is generated, shared, and ultimately lead to policy responses are crucial for enhancing transparency and legitimacy of decisions. At the same time, the volume, complexity and volatility of data are growing. Against this background, mechanisms, actors, and problems of data-driven scientific policy advice are analysed. The study reveals role conflicts, ambiguities, and tensions in the interaction between scientific advisors and policy-makers. The assumption of a technocratic model, promoted by well-established structures and functioning processes of data-driven government, cannot be confirmed. Reality largely corresponds to the pragmatic model, in parts also the decisionist model, albeit with dysfunctional characteristics.

Adaptations to a Secondary School-Based Citizen Science Project to Engage Students in Monitoring Well Water for Arsenic during the COVID-19 Pandemic

Secondary schools in Maine and New Hampshire have been involved in a citizen science program called "All About Arsenic" aimed at addressing arsenic contamination of well water, one of the most pressing public health issues in both states. Nearly half of the population of Maine and New Hampshire derive their drinking water from private wells which often have arsenic levels above the EPA limit of 10 ppb. Arsenic exposure can cause cancer, adverse cardiovascular effects, and other health problems. Addressing this issue in schools provides context and motivation for students to engage in scientific inquiry and acquire data literacy skills. This project involves students collecting well water samples for arsenic analysis, entering their data into an online citizen science data portal, Anecdata, and using Tuva online software tools to visualize and interpret their data. Students present their data at public meetings to inform community members of their findings with the goal of moving "data to action". The COVID-19 pandemic presented multiple challenges for teachers engaging their students in this citizen science project. We adapted our program and implemented a series of interventions aimed at supporting teachers in their continued efforts to engage their students the "All About Arsenic" project.

Integrating Service Learning into a Neuropsychopharmacology Course

Incorporating service learning (SL) experiences into undergraduate courses can be a meaningful way to engage students and connect course content to the real world. Neuropsychopharmacology courses are often popular amongst undergraduate students, but it can be a challenge to find ways to connect the theoretical issues discussed in the classroom to the real world, and convey the complexities of research on substance use. This article describes a partnership between a 300-level "Drugs & Behavior" laboratory course and a local not-for-profit anti-drug coalition focused on drug education and prevention. A series of semester-long service-learning projects were developed that met instructional objectives and coalition goals. Briefly, students applied critical thinking and analytical skills to survey data on substance use, collected from local 6-12^th grade students, that would inform coalition programming. By the end of the semester, students had produced scientific reports of the data, developed informational summaries for community distribution, and wrote a mock grant proposal incorporating proposed improvements to the study. During the semester, students reflected on the SL experience and took surveys on SL outcomes. Findings suggested that this SL opportunity helped students make connections between course content and the real world, enhanced skills or awareness in ways that added value to the course, challenged them to understand a problem and generate solutions, and expanded their thinking regarding their ability to help tackle substance use-related issues in the community. Suggestions for implementation and refinement of this experience are offered.

Mediatisation and datafication in the global COVID-19 pandemic: on the urgency of data literacy

In the COVID-19 pandemic, societal discourses and social interaction are subject to rapid mediatisation and digitalisation, which accelerate datafication. This indicates urgency for increasing data literacy: individual abilities in understanding and critically assessing datafication and its social implications. Immediate challenges concern misconceptions about the crisis, data misuses, widening (social) divides and (new) data biases. Citizens need to be on guard in respect to the crisis’ impact on the next stages of the digital transformation.

Teamwork, communication and exchange despite Covid-19 - experiences from a digital elective in human medicine studies as part of the HiGHmed project

Introduction: In order to promote training and further education on topics related to the digitization of medicine, the HiGHmeducation consortium is developing online learning modules. These modules could also be offered across locations. For students of human medicine, an elective for the acquisition of data literacy has been implemented. Originally designed as a blended learning offer, the elective was then carried out completely online due to the Covid-19 pandemic. Despite the lack of classroom teaching, the aim was to achieve intensive cooperation between the students. Project description: In the elective, the students worked on a total of 14 learning tasks, so-called e-tivities, which stimulate collaborative work and thus promote the examination of the learning content. These asynchronous learning activities were supplemented by video conferences, in which the students also took on the role of presenters. The teachers accompanied this learning process as e-moderators. Results: In April/May 2020, the elective course was carried out with 12 students entirely online. Despite a workload that was experienced as high, the elective was rated very well by the students. Discussion: The didactic concept of the elective enabled an active engagement with the learning material and the social interaction between the learners. With the digital learning offers, the learners were able to gain new experiences which are also of professional relevance. Conclusion: The didactic concept of the elective can be transferred to other courses. Future studies must show which long-term learning effects can be generated by digital teaching based on teamwork, communication and exchange.

Data and Information Literacy: A Fundamental Nursing Competency

Nurses in the 21st-century are expected to be data and information literate and proficient in data management. Nurses graduating from baccalaureate programs must be able to use computers and information systems and apply data and evidence to inform practice. Those competencies are also essential for the entire nursing workforce. That puts the onus on school nurses, school nurse supervisors, school districts, and state affiliates to take responsibility for comprehensive data and information literacy professional development. Fortunately, the National Association of School Nurses (NASN) has anticipated the needs of the membership. NASN included data and information capacity building as a part of The National School Health Data Set: Every Student Counts!, a national standardized data set and data collection initiative.

Developing a Data Dashboard Framework for Population Health Surveillance: Widening Access to Clinical Trial Findings

BACKGROUND

Population surveillance sites generate many datasets relevant to disease surveillance. However, there is a risk that these data are underutilized because of the volumes of data gathered and the lack of means to quickly disseminate analysis. Data visualization offers a means to quickly disseminate, understand, and interpret datasets, facilitating evidence-driven decision making through increased access to information.

OBJECTIVES

This paper describes the development and evaluation of a framework for data dashboard design, to visualize datasets produced at a demographic health surveillance site. The aim of this research was to produce a comprehensive, reusable, and scalable dashboard design framework to fit the unique requirements of the context.

METHODS

The framework was developed and implemented at a demographic surveillance platform at the Africa Health Research Institute, in KwaZulu-Natal, South Africa. This context represents an exemplar implementation for the use of data dashboards within a population health-monitoring setting. Before the full launch, an evaluation study was undertaken to assess the effectiveness of the dashboard framework as a data communication and decision-making tool. The evaluation included a quantitative task evaluation to assess usability and a qualitative questionnaire exploring the attitudes to the use of dashboards.

RESULTS

The evaluation participants were drawn from a diverse group of users working at the site (n=20), comprising of community members, nurses, scientific and operational staff. Evaluation demonstrated high usability for the dashboard across user groups, with scientific and operational staff having minimal issues in completing tasks. There were notable differences in the efficiency of task completion among user groups, indicating varying familiarity with data visualization. The majority of users felt that the dashboards provided a clear understanding of the datasets presented and had a positive attitude to their increased use.

CONCLUSIONS

Overall, this exploratory study indicates the viability of the data dashboard framework in communicating data trends within population surveillance setting. The usability differences among the user groups discovered during the evaluation demonstrate the need for the user-led design of dashboards in this context, addressing heterogeneous computer and visualization literacy present among the diverse potential users present in such settings. The questionnaire highlighted the enthusiasm for increased access to datasets from all stakeholders highlighting the potential of dashboards in this context.