scholarly journals Perceived Value of Using a Digital Tool to Screen for Elder Mistreatment in the Emergency Department

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 195-195
Author(s):  
Fuad Abujarad ◽  
Thomas Gill ◽  
Michael Pantalon ◽  
Karen Jubanyik ◽  
James Dziura ◽  
...  
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Focus Groups ◽  
Digital Health ◽  
Perceived Value ◽  
Digital Tool ◽  
Elder Mistreatment ◽  
Self Disclosure ◽  
Major Barrier ◽  
Electronic Screening

Abstract A major barrier to reducing Elder Mistreatment (EM) is an inability to accurately identify victims. We conducted a qualitative study to evaluate stakeholders’ perceived value and likelihood of adopting a tablet-based digital health tool to facilitate screening and prompt self-disclosure of EM in emergency departments (ED). The interactive tool utilizes virtual coaching, interactive multimedia libraries (graphics, animations, etc.), electronic screening, and brief motivational interviewing designed to enhance identifying EM among older adults. We conducted 3 focus groups with stakeholders, including 24 adults 60+ years, 2 social workers, 2 caregivers, and 2 ED clinicians. Two focus groups included only older adults, while one included representatives of all stakeholders. The main findings include: using a female voice for the tool narrator, larger font size, more multimedia, and headphones for privacy; and making a person available during screening if assistance is needed. Stakeholders indicated that it is difficult for victims to ask for help and any type of mistreatment screening would be helpful. On a 7-point Likert scale ranging from “1=Very Comfortable” to “ 7=Very Uncomfortable”, older adults scored 2.8 on average for whether they would feel comfortable using a tablet to screen for EM. Some said digital screening would maintain privacy and anonymity. Stakeholders highlighted the need to explain community resources available to older adults once EM is disclosed, especially resources offering help to the caregiver. In summary, this qualitative study supported using tablet-based screening for EM and highlighted the need to target stigma related to EM disclosure and fear of retaliation.

scholarly journals Digital Health Tool to Assist Older Adults in Self-Disclosing Elder Mistreatment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 755-756
Author(s):  
Fuad Abujarad ◽  
Esther Choo ◽  
Michael Pantalon ◽  
Karen Jubanyik ◽  
James Dziura ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Global Health ◽  
Motivational Interviewing ◽  
Digital Health ◽  
Elder Mistreatment ◽  
Traditional Methods ◽  
Self Disclosure ◽  
Healthcare Settings ◽  
Global Health Issue

Abstract Elder Mistreatment (EM) is a global health issue that continues to be under detected and inadequately addressed in healthcare settings. In this symposium, we will describe how we built and currently use the VOICES digital health tool to screen for EM. The tool is designed exclusively with older adults in mind and runs on iPads to be used in the emergency department. VOICES screens, educates, uses motivational interviewing to facilitate self-disclosure of EM, and refers patients for in-person screening. The tool includes multimedia components such as videos, audio and animations designed to educate and enhance screening for EM. Patients who screen positive are then guided through an automated Brief Negotiated Interview (BNI) that uses motivational interviewing to help them self-identify and self-disclose. Our tool will help identify cases of EM that otherwise may go undetected and overcomes major challenges associated with traditional methods of screening.

Perceived Facilitators and Barriers to Implementation of a Decision Support Tool for Adolescent Depression and Suicidality Screening: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Ana Radovic ◽  
Nathan Anderson ◽  
Megan Hamm ◽  
Brandie George-Milford ◽  
Carrie Fascetti ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Decision Support Tool ◽  
Depression Screening ◽  
Self Disclosure ◽  
Support Tool ◽  
Adolescent Parent ◽  
Barriers To Implementation

BACKGROUND Screening Wizard (SW) is a technology-based decision support tool aimed at guiding primary care providers (PCPs) to respond to depression and suicidality screens in adolescents. Separate screens assess adolescents’ and parents’ reports on mental health symptoms, treatment preferences, and potential treatment barriers. A detailed summary is provided to PCPs, also identifying adolescent-parent discrepancies. The goal of SW is to enhance decision making to increase utilization of evidence-based treatments. OBJECTIVE We describe a multi-stakeholder qualitative study with adolescents, parents, and providers to understand potential barriers to implementation of SW. METHODS We interviewed 11 parents and 11 adolescents, and conducted 2 focus groups with 17 healthcare providers (PCPs, nurses, therapists, staff) across 2 pediatric practices. Participants described previous experiences with screening for depression and were shown a mock-up of SW and asked for feedback. Interviews and focus groups were transcribed verbatim, and codebooks inductively developed based on content. Transcripts were double-coded, and disagreements adjudicated to full agreement. Completed coding was used to produce thematic analyses of interviews and focus groups. RESULTS We identified five main themes across the interviews and focus groups: (1) parents, adolescents, and pediatric PCPs agree that depression screening should occur in pediatric primary care; (2) there is concern that accurate self-disclosure does not always occur during depression screening; (3) Screening Wizard is viewed as a tool that could facilitate depression screening, and which might encourage more honesty in screening responses; (4) parents, adolescents and providers do not want Screening Wizard to replace mental health discussions with providers; and (5) providers want to maintain autonomy in treatment decisions. CONCLUSIONS We identified that providers, parents, and adolescents all have concerns with current screening practices, mainly regarding inaccurate self-disclosure. They recognized value in SW as a computerized tool that may elicit more honest responses and identify adolescent-parent discrepancies. Surprisingly, providers did not want the SW report to include treatment recommendations, and all groups did not want the SW report to replace conversations with the PCP about depression. While SW was originally developed as a treatment decision algorithm, this qualitative study has led us to remove this component, and instead focus on aspects identified as most useful by all groups. We hope that this initial qualitative work will improve future implementation of SW.

A Qualitative Study of Sleep and Daily Routines From Focus Groups With Chinese and Bangladeshi American Older Adults Living in New York City

2021 ◽  
Vol 47 (12) ◽  
pp. 35-41
Author(s):  
Rebecca Robbins ◽  
Stella K. Chong ◽  
Allison Tzu-Han Chou ◽  
Jiayi Yang ◽  
Alice Li Juan Liang ◽  
...  
Keyword(s):  
Older Adults ◽  
New York ◽  
New York City ◽  
Qualitative Study ◽  
Focus Groups ◽  
York City ◽  
Daily Routines

scholarly journals A Digital Coach Promoting Healthy Aging among Older Adults in Transition to Retirement: Results from a Qualitative Study in Italy

2020 ◽  
Vol 12 (18) ◽  
pp. 7400
Author(s):  
Sara Santini ◽  
Flavia Galassi ◽  
Johannes Kropf ◽  
Vera Stara
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Psychological Health ◽  
Older Workers ◽  
Healthy Aging ◽  
Digital Health ◽  
Health Coaching ◽  
Health Determinants ◽  
Health Coach ◽  
Transition To Retirement

Global aging and increasing multimorbidity are questioning the sustainability of healthcare systems. Healthy aging is at the top of the world political agenda, as a possible means for hindering the collapse of care systems. In the aging process, the transition to retirement can lead to an improvement or a deterioration of physical and psychological health. Digital health coaching technology can support older adults at this stage, but what must be the role of such a solution in promoting healthy aging and shaping sustainable care? This qualitative study, carried out in Italy in 2019, involved 15 older workers, retirees, and colleagues. Based on a user-centered design approach, this study aims at gathering older adults’ feelings on a digital health coaching technology for exploring this solution’s potential in promoting healthy aging. Findings highlighted that the digital health coach may help older adults improve several health determinants, e.g., physical activity, cognitive capabilities, and social life, but it can also entail the risk of stigma and break people’s privacy. The latter can be guaranteed by technology customization and codesign. Further research on the digital health coach benefits to boost healthy aging is needed to understand its potential for shaping future sustainable healthcare.

scholarly journals Formative Examination of a Multi-Focus Educational Exergame Designed for Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 978-978
Author(s):  
Laurie Ruggiero ◽  
Elizabeth Orsega-Smith ◽  
Roghayeh Barmaki
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Focus Groups ◽  
Healthy Aging ◽  
Digital Health ◽  
Sound Quality ◽  
Hand Tracking ◽  
Senior Center ◽  
Aging Theory ◽  
Survey Results

Abstract Exergames and digital health games have shown promising outcomes in older adults. Most games have had one focus (e.g., physical activity, cognitive functioning). We developed a demonstration version of a multi-focus educational exergame (i.e., healthy eating, physical activity, cognition) that builds on healthy aging theory. Community-engaged and mixed methods (e.g., surveys, focus groups) research approaches were used to examine preliminary game acceptability and usability. The game was demonstrated with 20 senior center members (95% female; 48% African American; 52% White; average age 64 years) and participants were able to play the game. The post-gameplay survey results support acceptability/usability of the game. For example, 87% of participants “agreed” or “strongly agreed” that they felt comfortable playing; the game instructions were clear; the text was readable; and gameplay was enjoyable. The majority also “agreed”/“strongly agreed” that the audio was appealing/helpful in playing the game (86%); sound quality was appropriate (78%); hand tracking was precise (57%), feedback on correct/incorrect responses was motivating (73%); they felt excited to get the correct answers (80%); they would play the game again (87%); and they would recommend it to a friend/family member (80%). When asked how often they would play it, the responses were: 33% five or more times/week; 27% three-four times/week; 20% one-two times/week; and 20% never. Observations and focus groups further clarified acceptability and identified areas for improvement (e.g., game instructions). Preliminary results support acceptability of this multi-component educational exergame with older adults and suggest the potential for future tailoring of this game.

Irrelevant Gadgets or a Source of Worry

2021 ◽  
Vol 14 (3) ◽  
pp. 1-28
Author(s):  
Dimitri Vargemidis ◽  
Kathrin Gerling ◽  
Vero Vanden Abeele ◽  
Luc Geurts ◽  
Katta Spiel
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Individual Differences ◽  
Qualitative Study ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Older Persons ◽  
Late Life ◽  
Activity Trackers ◽  
Wearable Activity Trackers

Wearable activity trackers are routinely applied in physical activity (PA) interventions in late life, but there is little research that focuses on older adults' perspectives on the technology. We conducted a qualitative study with 24 older persons to explore their perspective on wearables and PA. First, we discussed their relationship with PA and wearable trackers during focus groups. Next, nine participants crafted prototypes for wearables during co-design sessions. Through Thematic Analysis, we identified two main themes: (1) PA is personal in terms of preferred activities and reasons for PA, and (2) wearables are an emotional technology, causing negative emotions when resembling medical trackers or pressurizing to perform. We followed upon these results through a survey with 41 participants, which further highlighted individual differences in the perception of wearables. We conclude with questions to guide the design of wearables and reflect on their role to support PA in late life.

scholarly journals Earning the Trust of African American Communities to Increase Representation in Dementia Research

2020 ◽  
Vol 30 (Suppl) ◽  
pp. 719-734
Author(s):  
Elena Portacolone ◽  
Nynikka R. Palmer ◽  
Peter Lichtenberg ◽  
Catherine M. Waters ◽  
Carl V. Hill ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Focus Groups ◽  
Community Advisory Board ◽  
New Paradigm ◽  
Major Barrier ◽  
Black African ◽  
Dementia Research ◽  
African American Communities ◽  
African American Older Adults

Black/African American populations are un­derrepresented as participants in dementia research. A major barrier to participation of African American older adults in dementia research is a tendency to distrust research institutions owing to both historical and contemporary racism. Building on the Ford framework, the objective of our study was to examine factors that influence participa­tion in dementia research among African American older adults and caregivers, with an emphasis on understanding factors related to trust. Data were collected during January 2019 and March 2020 from 10 focus groups with African American older adults (n=91), 5 focus groups with caregiv­ers (n=44), and interviews with adminis­trators of community-based organizations (n=11), and meetings with our Community Advisory Board. Inductive/deductive con­tent analysis was used to identify themes. The results identified an overall tension be­tween distrust of researchers and a compel­ling desire to engage in dementia research. This overarching theme was supported by six themes that provided insights about the multiple layers of distrust, as well as expectations about the appropriate conduct of researchers and academic institutions. Strong commitment to the community was identified as a priority. The findings suggest that a paradigm shift is needed to increase the representation of African Americans in dementia research. In this new paradigm, earning the trust of African American com­munities becomes a systemic endeavor, with academic, state, and national institutions deeply committed to earning the trust of African American communities and guiding researchers in this endeavor. The findings also generated actionable recommendations to help improve representation of African American older adults in dementia research.Ethn Dis. 2020;30(Suppl 2):719-734; doi:10.18865/ed.30.S2.719

scholarly journals Earning the Trust of African American Communities to Increase Representation in Dementia Research

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 878-878
Author(s):  
Elena Portacolone ◽  
Nynikka Palmer ◽  
Peter Lichtenberg ◽  
Catherine Waters ◽  
Carl Hill ◽  
...  
Keyword(s):  
Older Adults ◽  
African American ◽  
Focus Groups ◽  
Community Advisory Board ◽  
New Paradigm ◽  
Major Barrier ◽  
Black African ◽  
Dementia Research ◽  
African American Communities ◽  
African American Older Adults

Abstract Black/African American populations are underrepresented as participants in dementia research. A major barrier to participation of African American older adults in dementia research is a tendency to distrust research institutions owing to a legacy of racism. Building on the Ford framework, the objective of our study was to examine factors that influence participation in dementia research among African American older adults and caregivers, with an emphasis on understanding factors related to trust. Data were collected from 10 focus groups with African American older adults (n=91), 5 focus groups with caregivers (n=44), and interviews with administrators of community-based organizations (n=11), and meetings with our Community Advisory Board. Inductive/deductive content analysis was used to identify themes. The results identified an overall tension between distrust of researchers and a compelling desire to engage in dementia research. This overarching theme was supported by six themes that provided insights about the multiple layers of distrust, as well as expectations about the appropriate conduct of researchers and academic institutions. Strong commitment to the community was identified as a priority. The findings suggest that a paradigm shift is needed to increase the representation of African Americans in dementia research. In this new paradigm, earning the trust of African American communities becomes a systemic endeavor, with academic, state and national institutions deeply committed to earning the trust of African American communities and guiding researchers in this endeavor. The findings also generated actionable recommendations to help improve representation of African American older adults in dementia research.

59. General medicine residents' perception of the mini-CEXs

2007 ◽  
Vol 30 (4) ◽  
pp. 61
Author(s):  
S. Malhotra ◽  
R. Hatala ◽  
C.-A. Courneya
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Focus Group ◽  
Qualitative Study ◽  
Focus Groups ◽  
General Medicine ◽  
Clinical History ◽  
Phenomenological Approach ◽  
Medical Teacher ◽  
The Impact

The mini-CEX is a 30 minute observed clinical encounter. It can be done in the outpatient, inpatient or emergency room setting. It strives to look at several parameters including a clinical history, physical, professionalism and overall clinical competence. Trainees are rated using a 9-point scoring system: 1-3 unsatisfactory, 4-6 satisfactory and 7-9 superior. Eight months after the introduction of the mini-CEX to the core University of British Columbia Internal Medicine Residents, a one hour semi-structured focus group for residents in each of the three years took place. The focus groups were conducted by an independent moderator, audio-recorded and transcribed. Using a phenomenological approach the comments made by the focus groups participants were read independently by three authors, organized into major themes. In doing so, several intriguing common patterns were revealed on how General Medicine Residents perceive their experience in completing a mini-CEX. The themes include Education, Assessment and Preparation for the Royal College of Physicians and Surgeons Internal Medicine exam. Resident learners perceived that the mini-CEX process provided insight into their clinical strengths and weaknesses. Focus group participants favored that the mini-CEX experience will benefit them in preparation, and successful completion of their licensing exam. Daelmans HE, Overmeer RM, van der Hem-Stockroos HH, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. In-training assessment: qualitative study of effects on supervision and feedback in an undergraduate clinical rotation. Medical Education 2006; 40(1):51-8. De Lima AA, Henquin R, Thierer J, Paulin J, Lamari S, Belcastro F, Van der Vleuten CPM. A qualitative study of the impact on learning of the mini clinical evaluation exercise in postgraduate training. Medical Teacher January 2005; 27(1):46-52. DiCicco-Bloom B, Crabtree BF. The Qualitative Research Interview. Medical Education 2006; 40:314-32.

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