scholarly journals Cocreation of a digital patient health hub to enhance education and person-centred integrated care post hip fracture: a mixed-methods study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033128 ◽  
Author(s):  
Lalit Yadav ◽  
Tiffany K Gill ◽  
Anita Taylor ◽  
Unyime Jasper ◽  
Jen De Young ◽  
...  

IntroductionOlder people with hip fractures often require long-term care and a crucial aspect is the provision of quality health information to patients and their carers to support continuity of care. If patients are well informed about their health condition and caring needs, particularly posthospital discharge into the community setting, this may support recovery and improve quality of life. As internet and mobile access reach every household, it is possible to deliver a new model of service using a digital education platform as a personal health hub where both patients and their providers of care can establish a more efficient information integration and exchange process. This protocol details proposed research, which aims to develop a ‘model of care’ by using a digital health solution that will allow delivery of high quality and patient-centred information, integrated into the existing process delivered within the community setting.Methods and analysisThis phase of the study uses a pragmatic mixed-methods design and a participatory approach through engagement of patients, their carers and healthcare providers from multiple disciplines to inform the development of a digital health platform. Quantitative methods will explore health literacy and e-health literacy among older people with hip fractures admitted to the two public tertiary care hospitals in Adelaide, South Australia. Qualitative methods will provide an understanding of aspects of content and context required for the digital health platform to be developed in order to deliver quality health information. The study will use appropriate theoretical frameworks and constructs to guide the design, analysis and overall conduct of the research study. The scope of the study intends to ultimately empower patients and their carers to improve self-management and to better use coordinated services at the community level. This could prevent further falls including associated injuries or new fractures; reduce new hospital admissions and improve confidence and engagement by limiting the psychologically restrictive ‘fear of falls’.Ethics and disseminationThe study has been approved by the Human Research Ethics Committee of the Central Adelaide Local Health Network, South Australia (SA) Health, Government of South Australia and the University of Adelaide Human Research Ethics Committee. Findings from the study will be published in suitable peer-reviewed journals and disseminated through workshops or conferences.

2021 ◽  
Author(s):  
Lalit Yadav ◽  
Tiffany K Gill ◽  
Anita Taylor ◽  
Jen DeYoung ◽  
Mellick J Chehade

UNSTRUCTURED Introduction Majority of older people with hip fractures once admitted to acute hospital care are unable to return to their pre-fracture level of independence and a significant number are either newly admitted or return to residential aged care. Patient education involves family members and/or residential aged care staff as networked units, crucial for empowerment through improving health literacy. Advancement of digital technology has led to evolving solutions around optimising health care including self-management of chronic disease conditions and telerehabilitation. The aim of this study is to understand perspectives of older patients with hip fractures, their family members and residential aged carers, to inform the development of a digitally enabled model of care using a personalised digital health hub (pDHH). Methods A mixed methods study was conducted at a public tertiary care hospital in South Australia involving patients aged 50 years and above along with their family members and residential aged carers. Quantitative data, including basic demographic characteristics, access to computers and Internet were analysed using descriptive statistics. Spearman’s Rank Order Correlation was used to examine correlations between the perceived role of a pDHH in improving health and likelihood of subsequent usage. Whereas qualitative data included series of open-ended questions and findings were interpreted using constructs of capability, opportunity and motivation to help understand the factors influencing the likelihood of potential pDHH use Results Overall, 100 people were recruited in the study, representing 55 patients, 13 family members and 32 residential aged carers. The mean age of patients was 76.4 years (SD-8.4, age range 54-88) and females represented 60% of patients. Although a moderate negative correlation existed with increasing age and likelihood of pDHH usage (ρ= -0.50, p<0.001) the perceived role of the DHH in improving health had a strong positive correlation with the likelihood of pDHH usage by self (ρ=0.71, p<0.001) and by society, including friends and family members (ρ=0.75, p<0.001). Of particular note, almost all the patients (98%) believed they had a family member or friend /carer who would be able to help them to use a digital health platform. Whereas our qualitative findings suggest emphasising on complex interplay of capability, opportunity and motivation as crucial factors while designing a pDHH enabled model of care for hip fractures at a local context level. Conclusion Findings from this study contributed to understand the dynamics around capabilities, motivation and opportunities of patients, family members and formal carers as a “patient networked unit”. Future research recommendation must involve co-creation guided by iterative processes through improving understanding of factors influencing development and successful integration of complex digital healthcare interventions in real-world scenarios.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  

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.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Dratva ◽  
S Juvalta ◽  
M Gemperle ◽  
D Händler-Schuster ◽  
M Scheermesser ◽  
...  

Abstract Background Digital transformation in health and health systems is a chance and a challenge for health professionals irrespective of their field. To maximize the benefit for patients high digital health literacy is required. A requirement not represented in health professions’ curricula in Switzerland. Little is known on the digital health competencies of students, on their utilization and views of digital media in the context of health, thus a cross-sectional survey was performed at a School of Health Professsions in Switzerland. Methods All BSc. students (N = 1200; nursing, midwifery, occupational health, physiotherapy and health promotion) received an online questionnaire covering utilization of various information resources, views on digital health & media and the German eHealth Literacy Scale (eHEALS, score 0 - 40). Descriptive and group analyses were performed, further adjusted analyses will be run. Results 453 students responded (female N = 368, male N = 26). Participation was 38% and highest in 1st students. Personal health information resources used most were: internet 82%, familiy&friends 70%, health professionals 66%, textbooks 40%. A majority rated digital media as important (66%) or rather important (30%) for their future professional activities. The overall eHeals-score was 28.6 (sd 4.93); critical evaluation and confidence in applying information scored lowest. Preliminary group analyses show significant increase by study year (1st 28.0, 2nd 28.9, 3rd 29.7, p = 0.01), while scores by gender or health profession were non-significantly different. Conclusions Almost all students in health professions use digital media for their own health information needs and consider digital media as highly relevant for their future career. Critical evaluation skills need to be strenghtend. Digital Health Literacy is only slightly higher in 3rd year students. Longitudinal data are needed to differentiate cohort from learning effects. Key messages Digital media are increasingly important in health systems, a view shared by future health professionals. Data indicate only a small increase of digital health literacy across three years of study. Curricula should include digital health competencies to ensure a highly digitally skilled health work force.


2020 ◽  
Author(s):  
Peggy Liu ◽  
Ling-Ling Yeh ◽  
Jiun-Yi Wang ◽  
Shao-Ti Lee

BACKGROUND The increasing amount of health information available on the internet makes it more important than ever to ensure that people can judge the accuracy of this information to prevent them from harm. It may be possible for platforms to set up protective mechanisms depending on the level of digital health literacy and thereby to decrease the possibility of harm by the misuse of health information. OBJECTIVE This study aimed to create an instrument for digital health literacy assessment (DHLA) based on the eHealth Literacy Scale (eHEALS) to categorize participants by level of risk of misinterpreting health information into high-, medium-, and low-risk groups. METHODS This study developed a DHLA and constructed an online health information bank with correct and incorrect answers. Receiver operating characteristic curve analysis was used to detect the cutoff value of DHLA, using 5 items randomly selected from the online health information bank, to classify users as being at low, medium, or high risk of misjudging health information. This provided information about the relationship between risk group for digital health literacy and accurate judgement of online health information. The study participants were Taiwanese residents aged 20 years and older. Snowball sampling was used, and internet questionnaires were anonymously completed by the participants. The reliability and validity of DHLA were examined. Logistic regression was used to analyze factors associated with risk groups from the DHLA. RESULTS This study collected 1588 valid questionnaires. The online health information bank included 310 items of health information, which were classified as easy (147 items), moderate (122 items), or difficult (41 items) based on the difficulty of judging their accuracy. The internal consistency of DHLA was satisfactory (α=.87), and factor analysis of construct validity found three factors, accounting for 76.6% of the variance. The receiver operating characteristic curve analysis found 106 people at high risk, 1368 at medium risk, and 114 at low risk of misinterpreting health information. Of the original grouped cases, 89.6% were correctly classified after discriminate analysis. Logistic regression analysis showed that participants with a high risk of misjudging health information had a lower education level, lower income, and poorer health. They also rarely or never browsed the internet. These differences were statistically significant. CONCLUSIONS The DHLA score could distinguish those at low, medium, and high risk of misjudging health information on the internet. Health information platforms on the internet could consider incorporating DHLA to set up a mechanism to protect users from misusing health information and avoid harming their health.


2021 ◽  
Vol 109 (3) ◽  
Author(s):  
Janet Chan

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.


Dementia ◽  
2021 ◽  
pp. 147130122110496
Author(s):  
Michelle Kimzey ◽  
Carol J. Howe ◽  
Chelsea Martin ◽  
Jim McLarty ◽  
Ramona Baucham

Background Persons living with dementia and their caregivers need health information to understand and manage daily life. Previous studies focused on the associations of health literacy and cognitive impairment with less exploring if and how individuals develop health literacy during the course of the disease. Purpose This descriptive qualitative study aimed to explore the development of health literacy competencies among persons living with dementia and their caregivers. Methods Directed content analysis of six focus groups conducted in the community setting (15 persons living with dementia and 28 caregivers) was completed, using predetermined categories from the Integrated Model of Health Literacy: access, understand, appraise, and apply health information. Findings Participants described developing health literacy competencies over time, moving from a dependence on health care providers to becoming their own experts. Although health care providers were involved in the diagnosis and medication management, most participants admitted that they provided very little information on how to manage their daily life with dementia and often failed to inform them of community resources. Conclusion Participants seemed to find dementia resources on their own for both education and support, often stumbling upon them by accident. Health care providers should promote the health literacy competencies of their patients and caregivers by more intentionally providing dementia health and community resource information.


2017 ◽  
Vol 21 (2) ◽  
pp. 111-124 ◽  
Author(s):  
Amy Armstrong-Heimsoth ◽  
Melissa L. Johnson ◽  
Aubrey McCulley ◽  
Marisa Basinger ◽  
Kelly Maki ◽  
...  

2020 ◽  
Vol 4 (1) ◽  
pp. 57-67
Author(s):  
Rut Rismanta Silalahi ◽  
Puri Bestari Mardani ◽  
Maria Febiana Christanti

Internet allows people to access various types of information, including health information. The problem is not all of the health information that circulating through Internet come from reliable sources. This community service intended to enhance the digital literacy on health information for the housewives in Flamboyan integrated healthcare center, Bekasi. Digital health literacy known as e-health literacy is the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. These abilities are important especially for housewives since scientific research shows that there is a significant correlation between the levels of mother’s literacy and the health of family. Through this community service, the housewives in Flamboyan integrated healthcare center were trained to detect hoax through a simple fact-checking process. We found out that none of the participants know how to verify the health information that they get through social media or messaging application. They were only suspicious about the information that they get if the information contains title, content, or image that does not make sense. This community service has successfully shared the effective and simple way for housewives to do fact-checking process of health information with their own smartphones.


10.2196/19767 ◽  
2020 ◽  
Vol 22 (12) ◽  
pp. e19767
Author(s):  
Peggy Liu ◽  
Ling-Ling Yeh ◽  
Jiun-Yi Wang ◽  
Shao-Ti Lee

Background The increasing amount of health information available on the internet makes it more important than ever to ensure that people can judge the accuracy of this information to prevent them from harm. It may be possible for platforms to set up protective mechanisms depending on the level of digital health literacy and thereby to decrease the possibility of harm by the misuse of health information. Objective This study aimed to create an instrument for digital health literacy assessment (DHLA) based on the eHealth Literacy Scale (eHEALS) to categorize participants by level of risk of misinterpreting health information into high-, medium-, and low-risk groups. Methods This study developed a DHLA and constructed an online health information bank with correct and incorrect answers. Receiver operating characteristic curve analysis was used to detect the cutoff value of DHLA, using 5 items randomly selected from the online health information bank, to classify users as being at low, medium, or high risk of misjudging health information. This provided information about the relationship between risk group for digital health literacy and accurate judgement of online health information. The study participants were Taiwanese residents aged 20 years and older. Snowball sampling was used, and internet questionnaires were anonymously completed by the participants. The reliability and validity of DHLA were examined. Logistic regression was used to analyze factors associated with risk groups from the DHLA. Results This study collected 1588 valid questionnaires. The online health information bank included 310 items of health information, which were classified as easy (147 items), moderate (122 items), or difficult (41 items) based on the difficulty of judging their accuracy. The internal consistency of DHLA was satisfactory (α=.87), and factor analysis of construct validity found three factors, accounting for 76.6% of the variance. The receiver operating characteristic curve analysis found 106 people at high risk, 1368 at medium risk, and 114 at low risk of misinterpreting health information. Of the original grouped cases, 89.6% were correctly classified after discriminate analysis. Logistic regression analysis showed that participants with a high risk of misjudging health information had a lower education level, lower income, and poorer health. They also rarely or never browsed the internet. These differences were statistically significant. Conclusions The DHLA score could distinguish those at low, medium, and high risk of misjudging health information on the internet. Health information platforms on the internet could consider incorporating DHLA to set up a mechanism to protect users from misusing health information and avoid harming their health.


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