Photovoice as a research, advocacy, and harmonization tool for refugee and local youth in Turkey

Abstract Background Turkey has millions of refugee and local youth, who share common youth health problems. As part of the REACH Project, this study aimed to assess youth's access to health information, health care, and healthy environments, in addition to their perspectives on using digital health technologies. Methods We used photovoice, a community based participatory research approach, and worked with 4 mixed (refugee and local) youth groups between the ages of 15 to 24 in Istanbul. Each youth group met with the research team and a professional photographer before data collection. Young people then took photos of barriers and facilitators regarding their access to health information, health care, and digital health technologies, in addition to their health problems. This was followed by focus group-like discussions, where young people discussed the photos and their meanings for them. Content analysis was used for data analysis and findings were shared with stakeholders via photo exhibits, panels, and policy briefs for advocacy purposes. The study was funded by TaiwanICDF and Columbia University. Results Findings showed that youth had a wide range of physical, social and mental health problems coupled with problems in accessing health information and youth-friendly services. Problems with social determinants of health were more prominent for refugees. Although youth often used the internet to access information, their experiences with digital health technologies were very limited. Conclusions Our study findings indicated that despite legal rights to access health care for all youth, refugee youth faced more barriers in accessing information and services. On the other hand, refugee and local youth showed similarities regarding common youth health problems and access to youth-friendly services. The photovoice approach enabled active participation and created a shared environment for refugee and local youth to discuss their mutual problems and understand each other. Key messages Photography is a communication tool that acts as a bridge between participants, researchers, and decision makers. Photovoice, as a participatory approach, creates a learning environment for both participants and researchers.

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Co-designing mHealth technologies with youth: REACH Initiative in Turkey and Lebanon

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1035 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

O Karadag Caman ◽

S Karabey ◽

I Sumbuloglu ◽

N Yazbik-Dumit ◽

Y Ben Amor

Keyword(s):

Health Care ◽

Health Promotion ◽

Health Literacy ◽

Young People ◽

Health Information ◽

Health Care Access ◽

Youth Health ◽

Host Countries ◽

Care Access ◽

Youth Friendly

Abstract Issue Many young people face barriers in accessing youth-friendly health information and health care. Differing cultural norms, languages, laws, and stigma pose additional challenges for young refugees in host countries. There is a need to implement more innovative, youth-friendly and widely used solutions to address the health education and health care needs of young people. Description of the practice REACH (REfugees Act and Communicate for Health) is a regional initiative, which aims to bridge the gap in health literacy and health care access among refugee and local youth via digital technologies in Turkey and Lebanon. Using community based participatory action research (CBPAR) approach, REACH aims to assess the impact of information and communication technologies on accessing health information and services among youth in countries that host large refugee populations. The initiative is supported by TaiwanICDF, Blue Chip Foundation and Columbia University. Results With a strong youth-adult partnership, the initiative includes stakeholders’ meetings, a mixed-methods study (survey and photovoice study with youth, qualitative interviews with service providers and policy makers), photo exhibitions, panels, and production of policy reports and scientific publications. Based on local needs in each country, REACH works with refugee and local youth, software developers, academia, local health authorities, UN organizations and NGOs to develop a multilingual mHealth application to increase health literacy and improve health care access among young refugee and host communities, and aims to assess its effectiveness to contribute to the limited evidence base on using health technologies for youth health promotion in forced migration settings. Lessons Using CBPAR and co-design approaches and engaging both refugee and local youth in the process of assessing needs and developing mHealth technologies can help to mitigate risks and increase the success rate of interventions. Key messages Community involvement and empowerment as well as harmonization between refugee and host communities increases the success of health interventions and builds a shared environment in host countries. mHealth solutions can be used for youth health promotion in a cost-effective way, and help in reaching vulnerable or stigmatized youth that struggle with health information and health care access.

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Digital Health and Inequalities in Access to Health Services in Bangladesh: Mixed Methods Study

JMIR mhealth and uhealth ◽

10.2196/16473 ◽

2020 ◽

Vol 8 (7) ◽

pp. e16473

Author(s):

Tanvir Ahmed ◽

Syed Jafar Raza Rizvi ◽

Sabrina Rasheed ◽

Mohammad Iqbal ◽

Abbas Bhuiya ◽

...

Keyword(s):

Health Care ◽

Health System ◽

Health Information ◽

Mobile Phones ◽

Access To Health Care ◽

Digital Health ◽

Electronic Devices ◽

Technical Skill ◽

Integrating Technology ◽

Access To Health

Background Globally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper aims to examine the implications of digital health on access to health care in Bangladesh, considering who uses electronic devices to access health information and services and why. Objective This study aims to understand how access to health care and related information through electronic means (digital health) is affected by sociodemographic determinants (ie, age, gender, education, socioeconomic status, and personal and household ownership of mobile phones) in a semiurban community in Bangladesh. Methods A cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February 2017 and March 2017) were conducted to understand (1) who owns electronic devices; (2) who, among the owners, uses these to access health information and services and why; (3) the awareness of electronic sources of health information; and (4) the role of intermediaries (family members or peers who helped to look for health information using electronic devices). Results A total of 90.3% (771/854) of households (471/854, 55.2% of respondents) owned electronic devices, mostly mobile phones. Among these, 7.2% (34/471) used them to access health information or services. Middle-aged (35-54 years), female, less (or not) educated, and poorer people used these devices the least (α=.05, α is the level of significance). The lack of awareness, discomfort, differences with regular care-seeking habits, lack of understanding and skills, and proximity to a health facility were the main reasons for not using devices to access digital health. Conclusions Although influenced by sociodemographic traits, access to digital health is not merely related to device ownership and technical skill. Rather, it is a combination of general health literacy, phone ownership, material resources, and technical skill as well as social recognition of health needs and inequity. This study’s findings should serve as a basis for better integrating technology within the health system and ensuring equitable access to health care.

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Exploring digital health care: eHealth, mHealth, and librarian opportunities

Journal of the Medical Library Association JMLA ◽

10.5195/jmla.2021.1180 ◽

2021 ◽

Vol 109 (3) ◽

Author(s):

Janet Chan

Keyword(s):

Health Care ◽

Health Literacy ◽

Health Information ◽

Digital Health ◽

The United States ◽

Security And Privacy ◽

Care Providers ◽

Vast Number ◽

Health Technologies ◽

Technology Advances

Technology advances in eHealth and mHealth are changing the way that health care consumers and providers communicate, receive and deliver care, and access health information. As electronic health records and smartphones have become ubiquitous in the United States, opportunities and applications for the integration of eHealth and mHealth have increased. In addition to technology advances, the changing health care model is simultaneously adapting to and driving initiatives in digital health care. With these digital initiatives have come challenges, including data overload, security and privacy concerns, deficits in technological and health literacy skills, and sorting through the vast number of choices of digital applications. Navigating this changing landscape can be overwhelming and time consuming for both health care providers and consumers. Librarians are uniquely positioned to assist providers and consumers to break down barriers within the digital health care landscape through data management initiatives, technology and health literacy instruction, and finding and evaluating health information and digital health technologies.

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The perception of youth health centres’ friendliness: does it differ between immigrant and Swedish-Scandinavian youths?

European Journal of Public Health ◽

10.1093/eurpub/ckaa077 ◽

2020 ◽

Vol 30 (4) ◽

pp. 780-785

Author(s):

Mazen Baroudi ◽

Miguel San Sebastian ◽

Anna-Karin Hurtig ◽

Isabel Goicolea

Keyword(s):

Health Care ◽

Parental Support ◽

Access To Health Care ◽

Quality Service ◽

Youth Health ◽

Point Scale ◽

Psychosocial Services ◽

Access To Health ◽

Health Centres ◽

Youth Friendly

Abstract Background Ensuring a good quality service and equal access according to need for all young people is a key objective of the Swedish health system. The aim of this study was to explore youths’ perception of youth health centres’ (YHCs’) friendliness and to assess the differences in perception between immigrant and Swedish-Scandinavian youths. Methods All YHCs in the four northern counties in Sweden were invited (22 centres), and 20 agreed to participate. Overall, 1089 youths aged 16–25 years answered the youth-friendly health services-Sweden questionnaire between September 2016 and February 2017. Thirteen sub-domains of friendliness were identified and their scores were calculated. Multilevel analysis was used to examine the differences in perception between immigrant and Swedish-Scandinavian youths. Results Our sample consisted of 971 Swedish-Scandinavian youths (89.2%) and 118 immigrants (10.8%). Generally, both groups perceived the services to be very friendly. All 13 sub-domains were rated more than three in a four-point scale except for fear of exposure and parental support of psychosocial services. However, immigrant youths perceived YHCs less friendly than their counterparts, particularly regarding the domains of equity, respect, quality and parental support. Conclusions Our study suggests that even though youths perceived YHCs as highly friendly, there is a space for improvement regarding access to health care. Our findings highlight the importance of an open and culturally sensitive attitude of the staff and the need to engage parents and community as a key to improve immigrant youths’ accessibility to health care.

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Digital Health and Inequalities in Access to Health Services in Bangladesh: Mixed Methods Study (Preprint)

10.2196/preprints.16473 ◽

2019 ◽

Author(s):

Tanvir Ahmed ◽

Syed Jafar Raza Rizvi ◽

Sabrina Rasheed ◽

Mohammad Iqbal ◽

Abbas Bhuiya ◽

...

Keyword(s):

Health Care ◽

Health System ◽

Health Information ◽

Mobile Phones ◽

Access To Health Care ◽

Digital Health ◽

Electronic Devices ◽

Technical Skill ◽

Integrating Technology ◽

Access To Health

BACKGROUND Globally, the rapid growth of technology and its use as a development solution has generated much interest in digital health. In line with global trends, Bangladesh is also integrating technology into its health system to address disparities. Strong political endorsement and uptake of digital platforms by the government has influenced the rapid proliferation of such initiatives in the country. This paper aims to examine the implications of digital health on access to health care in Bangladesh, considering who uses electronic devices to access health information and services and why. OBJECTIVE This study aims to understand how access to health care and related information through electronic means (digital health) is affected by sociodemographic determinants (ie, age, gender, education, socioeconomic status, and personal and household ownership of mobile phones) in a semiurban community in Bangladesh. METHODS A cross-sectional survey of 854 households (between October 2013 and February 2014) and 20 focus group discussions (between February 2017 and March 2017) were conducted to understand (1) who owns electronic devices; (2) who, among the owners, uses these to access health information and services and why; (3) the awareness of electronic sources of health information; and (4) the role of intermediaries (family members or peers who helped to look for health information using electronic devices). RESULTS A total of 90.3% (771/854) of households (471/854, 55.2% of respondents) owned electronic devices, mostly mobile phones. Among these, 7.2% (34/471) used them to access health information or services. Middle-aged (35-54 years), female, less (or not) educated, and poorer people used these devices the least (α=.05, α is the level of significance). The lack of awareness, discomfort, differences with regular care-seeking habits, lack of understanding and skills, and proximity to a health facility were the main reasons for not using devices to access digital health. CONCLUSIONS Although influenced by sociodemographic traits, access to digital health is not merely related to device ownership and technical skill. Rather, it is a combination of general health literacy, phone ownership, material resources, and technical skill as well as social recognition of health needs and inequity. This study’s findings should serve as a basis for better integrating technology within the health system and ensuring equitable access to health care.

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31.C. Workshop: Development and implementation of action plans on health literacy

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1396 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Public Health ◽

Health Care ◽

Health Literacy ◽

Health Information ◽

Digital Health ◽

Action Plan ◽

Knowledge Society ◽

Implementation Strategies ◽

Social Consequences ◽

Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

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Health and Gender Comparisons in the Long-Haul Trucking Industry

AAOHN Journal ◽

10.1177/216507990905701003 ◽

2009 ◽

Vol 57 (10) ◽

pp. 405-413 ◽

Cited By ~ 1

Author(s):

Diane M. Layne ◽

Bonnie Rogers ◽

Susan A. Randolph

Keyword(s):

Health Care ◽

Health Information ◽

Health Care Access ◽

Health Problems ◽

Health Care Information ◽

Male And Female ◽

The Road ◽

On The Road ◽

Trade Magazines ◽

And Gender

This descriptive pilot study was conducted to determine whether health conditions and health care access differ between male and female long-haul truck drivers. Data indicated that 54% of men and 66% of women had a health care provider, but 21% of men and 35% of women had no health insurance. Male and female drivers both reported common health problems (e.g., back pain, sinus problems, hypertension, headaches, and arthritis). While working, drivers of each gender often waited until returning home to seek treatment for health problems. Approximately half of the drivers expressed dissatisfaction with health care while “on the road.” Occupational and environmental health nurses could address the health needs of drivers by conducting examinations and distributing wellness information at truck stop clinics and from mobile health vans, posting health information within truck stop driver lounges, creating interactive websites with real-time health care information, attending trucker trade shows to conduct health screenings, or providing health information through occupational or trade magazines and newsletters.

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Digital Health

10.1093/oso/9780197503133.001.0001 ◽

2021 ◽

Author(s):

Eric D. Perakslis ◽

Martin Stanley ◽

Erin Brodwin

Keyword(s):

Health Care ◽

Side Effects ◽

Care Delivery ◽

Digital Health ◽

Detailed Examination ◽

Medical Diagnostics ◽

Medical Interventions ◽

Health Technologies ◽

Solid Models ◽

Medical Side

Digital health has been touted as a true transformation of health care, but all medical interventions have associated risks that must be understood and quantified. The Internet has brought many advancements, which quickly jumped from our computers into our pockets via powerful and completely connected mobile devices that are now being envisioned as devices for medical diagnostics and care delivery. As health care struggles with cost, inequity, value, and rapid virtualization, solid models of benefit-risk determination, new regulatory approaches for biomedical products, and clear risk-based conversations with all stakeholders are essential. Detailed examination of emerging digital health technologies has revealed 10 categories of digital side effects or “toxicities” that must be understood, prevented when possible, and managed when not. These toxicities include cyberthreat, loss of privacy, cyberchondria and cyber addiction, threats to physical security, charlatanism, overdiagnosis and overtreatment, medical/user error, and the plague of medical misinformation. For digital health to realize its promise, these toxicities must be understood, measured, warned against, and managed as concurrent side effects, in the same fashion as any other medical side effect.

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Personal Health Records Status-Quo and Future Perspectives

Ubiquitous Health and Medical Informatics ◽

10.4018/978-1-61520-777-0.ch003 ◽

2010 ◽

pp. 43-63

Author(s):

Simon Y. Liu,

Keyword(s):

Health Care ◽

Health Information ◽

Personal Health Record ◽

Full Range ◽

Personal Health Records ◽

Controlled Vocabulary ◽

Care Process ◽

Personal Health ◽

Health Records ◽

Access To Health

Consumers, industry, and government have recently focused attention on the potential of personal health records to empower patients in the health care process, improve patient-provider relationships, facilitate patient access to health information, and improve the quality of health care. A Personal Health Record (PHR) is a private and secure digital record that is created, managed, and owned by an individual, and contains the owner’s relevant health information. The benefits of PHRs have not yet been widely realized due to several significant challenges in their adoption, including the need for privacy, security, and interoperability, and the lack of accepted standards. Although many players in the healthcare arena are beginning to offer partial solutions, none have adequately addressed the full range of challenges. The adoption of PHRs can be significantly accelerated by the development of Open Source software that enables an individual to collect, create, organize, and manage his or her own private and secure PHR, using a standardized format and controlled vocabulary.

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