scholarly journals The formation of patient trust and its transference to online health services: the case of a Dutch online patient portal for rehabilitation care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lex van Velsen ◽  
Ina Flierman ◽  
Monique Tabak
Keyword(s):  
Health Services ◽  
Structural Equation ◽  
Assessment Tool ◽  
Measurement Model ◽  
Care Team ◽  
Care Organization ◽  
Patient Portal ◽  
Patient Trust ◽  
Related Factors ◽  
Ehealth Service

Abstract Background Trust is widely recognized as a crucial factor in successful physician–patient communication and patient engagement in treatment. However, with the rise of eHealth technologies, such as online patient portals, the role of trust and the factors that influence it need to be reconsidered. In this study, we aim to identify the factors that contribute to trust in an eHealth service and we aim to identify the consequences of trust in an eHealth service in terms of use. Methods The Patient Trust Assessment Tool was provided to new outpatients of a rehabilitation center in the Netherlands, that were expected to use the center’s online patient portal. Via this tool, we assessed five trust-related factors. This data was supplemented by questions about demographics (age, gender, rehabilitation treatment) and data about use (number of sessions, total time spent in sessions), derived from data logs. Data was analyzed via Partial Least Squares Structural Equation Modelling. Results In total, 93 patients participated in the study. Out of these participants, 61 used the portal at least once. The measurement model was considered good. Trust in the organization was found to affect trust in the care team (β = .63), trust in the care team affected trust in the treatment (β = .60). Both, trust in the care team and trust in the treatment influenced trust in the technology (β = .42 and .30, respectively). Trust in the technology affected the holistic concept trust in the service (β = .78). This holistic trust in the service finally, did not affect use. Conclusions This study shows that the formation of this trust is not unidimensional, but consists of different, separate factors (trust in the care organization, trust in the care team and trust in the treatment). Trust transfer does take place from offline to online health services. However, trust in the service does not directly affect the use of the eHealth technology.

scholarly journals Validating a model & self-assessment tool to measure organizational health literacy in hospitals

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J Pelikan ◽  
P Nowak
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Services ◽  
Assessment Tool ◽  
Health Care Organization ◽  
Organizational Health ◽  
Care Organization ◽  
Self Assessment ◽  
Health Promoting

Abstract Background The European Health Literacy Survey (HLS-EU) demonstrated that in many European countries a considerable proportion of the population has limited health literacy (HL), that there is a social gradient for HL and that HL is associated with use of health services. Furthermore research mostly from the US also showed that HL of patients has detrimental effects not only on use but also on outcomes of health care. Therefore in the US the concept of the Health Literate Health Care Organization (HLHCO) has been developed by IOM to make health services more sensitive to the needs of patients with limited HL. Methods Based on the IOM concept, a more comprehensive model of a Health Literate Health Care Organization fulfilling criteria of WHÓs health promoting setting approach has been developed. A set of standards and indicators according to quality management criteria (ISQUA) to measure the organizational HL of a hospital has been constructed, tested and validated in 9 different kinds of hospitals by a team in Vienna. This model and measurement tool has been translated to English and other languages and been used and validated also in other countries (Belgium, Italy, Taiwan). By an international working group of the international Health Promoting Hospitals and Health Services network an international version of the model and tool has been developed and will be tested in different countries. Results The model and self-assessment tool has been demonstrated to be acceptable, feasibly, valid and useful to start self-assessment and improvement of organizational HL in different types of hospitals and health care systems. Conclusions Organizational HL of health services matters for use and quality of health care of patients. Measuring organizational HL of hospitals by a validated instrument can support development of a more health literate health care organization and by that improve quality of care and tackle the health gap. Key messages Health literacy matter for health care and can be measured and improved on a personal and on an organizations or systems level to improve quality of care and tackle the health gap. A model and self-assessment instrument to measure organizational health literacy of hospitals has been developed and validated to support hospitals to improve their organizational health literacy.

scholarly journals Multilevel Pathways of Colorectal Cancer Screening Among Low-Income Vietnamese Americans: A Structural Equation Modeling Analysis

2021 ◽  
Vol 28 ◽  
pp. 107327482110110
Author(s):  
Grace X. Ma ◽  
Lin Zhu ◽  
Timmy R. Lin ◽  
Yin Tan ◽  
Phuong Do
Keyword(s):  
Health Beliefs ◽  
Low Income ◽  
Self Efficacy ◽  
Limited English Proficiency ◽  
Structural Equation ◽  
Vietnamese Americans ◽  
Equation Modeling ◽  
Community Based ◽  
Related Factors ◽  
Crc Screening

Background: Colorectal cancer (CRC) disproportionately affects Vietnamese Americans, especially those with low income and were born outside of the United States. CRC screening tests are crucial for prevention and early detection. Despite the availability of noninvasive, simple-to-conduct tests, CRC screening rates in Asian Americans, particularly Vietnamese Americans, remain suboptimal. The purpose of this study was to evaluate the interplay of multilevel factors – individual, interpersonal, and community – on CRC screening behaviors among low-income Vietnamese Americans with limited English proficiency. Methods: This study is based on the Sociocultural Health Behavior Model, a research-based model that incorporates 6 factors associated with decision-making and health-seeking behaviors that result in health care utilization. Using a community-based participatory research approach, we recruited 801 Vietnamese Americans from community-based organizations. We administered a survey to collect information on sociodemographic characteristics, health-related factors, and CRC screening-related factors. We used structural equation modeling (SEM) to identify direct and indirect predictors of lifetime CRC screening. Results: Bivariate analysis revealed that a greater number of respondents who never screened for CRC reported limited English proficiency, fewer years of US residency, and lower self-efficacy related to CRC screening. The SEM model identified self-efficacy (coefficient = 0.092, P < .01) as the only direct predictor of lifetime CRC screening. Educational attainment (coefficient = 0.13, P < .01) and health beliefs (coefficient = 0.040, P < .001) had a modest significant positive relationship with self-efficacy. Health beliefs (coefficient = 0.13, P < .001) and educational attainment (coefficient = 0.16, P < .01) had significant positive relationships with CRC knowledge. Conclusions: To increase CRC screening uptake in medically underserved Vietnamese American populations, public health interventions should aim to increase community members’ confidence in their abilities to screen for CRC and to navigate associated processes, including screening preparation, discussions with doctors, and emotional complications.

scholarly journals Validity and Internal Consistency of the Preschool-FLAT, a New Tool for the Assessment of Food Literacy in Young Children from the Training-To-Health Project

2020 ◽  
Vol 17 (8) ◽  
pp. 2759
Author(s):  
Garden Tabacchi ◽  
Giuseppe Battaglia ◽  
Giuseppe Messina ◽  
Antonio Paoli ◽  
Antonio Palma ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Content Validity ◽  
Structural Equation ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Intervention Group ◽  
Equation Modeling ◽  
Control Group ◽  
Food Literacy ◽  
Health Project

Background: The importance of assessing “food literacy” since youth has been highlighted and, to this purpose, valid and consistent instruments are needed. This study aimed to assess the validity and internal consistency of the preschool-FLAT (Food Literacy Assessment Tool). Methods. 505 children from 21 kindergartens, recruited within the Training-to-Health Project in Palermo (Italy), underwent oral sessions and activities on food-related aspects. Their knowledge/skills were recorded in the preschool-FLAT. The following scale measures were assessed: Content validity; internal consistency (Chronbach’s alpha coefficients); construct validity (Structural Equation Modeling—SEM); discriminant validity (intervention subgroup of 100 children vs. control group of 27 children). Results. Acceptable content validity of a 16-items scale and overall adequate internal consistency were revealed: Content validity index (CVI) 0.94, content validity ratio (CVR) 0.88, Chronbach’s alpha 0.76. The SEM revealed a 4-factor model fitting the data well (comparative fit index 0.939, root mean square error of approximation 0.033). Discriminant validity was good (intervention group scoring higher than control, p < 0.001, unpaired Student’s t-test). Conclusion. The preschool-FLAT revealed good psychometric properties, adequate validity and internal consistency. This is the only instrument in the literature specifically targeted to 3–6 years old children that could be effectively used to assess food literacy.

scholarly journals Performance-Influencing Factors and Improvement Paths of Third-Party Governance Service Regarding Environmental Pollution—An Empirical Study of the SEM Based on Shanghai Data

2021 ◽  
Vol 13 (4) ◽  
pp. 2354
Author(s):  
Liping Cao ◽  
Fenqi Zhou ◽  
Yuan Zhu
Keyword(s):  
Environmental Pollution ◽  
Influencing Factors ◽  
Structural Equation ◽  
Process Management ◽  
Empirical Test ◽  
Measurement Model ◽  
Third Party ◽  
Force Model ◽  
Governance Mechanism ◽  
Performance Influencing Factors

By employing ecological economics involving performance-influencing factors and third-party governance services that have the aim of reducing environmental pollution, a theoretical framework which includes object, subject, process that measures the performance of such services is analyzed on the basis of the idea of sustainability science (2.0). The research hypotheses regarding the relationships among service performance, multi-stakeholder subjects’ satisfaction, and the effect of process management are put forward; then, a three-dimensional performance measurement model, which includes performance, stakeholders, and the process of providing third-party governance services for addressing environmental pollution, is constructed based on the pressure–state–response (PSR) driving force model. At the same time, based on empirical data of the Shanghai municipality, the structural equation model (SEM) is used to empirically test the nine proposed research hypotheses. The empirical test results show that, except for the research hypotheses in regard to regulating variables and controlling variables, all of the research hypotheses passed the test. It means the direct performance, single subjective satisfaction, process management effects are performance-influencing factors. However, the stakeholders’ cooperation satisfaction partially influences the performance of third-party governance services regarding environmental pollution. Finally, through theoretical and empirical research, this paper proposes countermeasures and suggestions for improving the performance of third-party governance services regarding environmental pollution in Shanghai focusing on two aspects: one is the market governance mechanism innovation, and the other is regulations and standards innovation.

scholarly journals Social Support and Health Services Use in People Aged over 65 Years Migrating within China: A Cross-Sectional Study

2020 ◽  
Vol 17 (13) ◽  
pp. 4651 ◽  
Author(s):  
Chengxu Long ◽  
Ruoxi Wang ◽  
Da Feng ◽  
Lu Ji ◽  
Zhanchun Feng ◽  
...  
Keyword(s):  
Social Support ◽  
Health Services ◽  
Structural Equation ◽  
Mediating Effect ◽  
Dynamic Monitoring ◽  
Equation Modeling ◽  
Chinese Elderly ◽  
Registration System ◽  
Elderly Migrants ◽  
Use Of Health Services

Background: Due to the household registration system, Chinese elderly migrants have insufficient access to health services and social support. Thus, this study examined the use of health services, the access to social support, and the interaction among the elderly migrating within China. Methods: Data were obtained from the China Migrant Dynamic Monitoring Survey in 2015, adopting probability proportionate to size as the sampling strategy. Structural equation modeling and mediating effect tests were employed to explore the associations. Results: Approximately 45.9% of elderly migrants did not seek health services when needed. The use of outpatient and inpatient services was more common than free essential public health services. The use of health services was negatively associated with migrating duration and migrating for offspring, while it was positively associated with outer social support. The mediating effects of outer social support were discovered on the relationships between the use of health services and independent variables such as migrating duration and migrating for offspring, respectively. Conclusion: Elderly migrants with a longer migrating duration or migrated for offspring seem to obtain less outer social support, resulting in a decreased use of health services. Outer social support was suggested as a key effort to improve the equalization of health services in Chinese elderly migrants.

Privacy helplessness on social media: its constituents, antecedents and consequences

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hichang Cho
Keyword(s):  
Theoretical Model ◽  
Structural Equation ◽  
Factor Model ◽  
Measurement Model ◽  
Equation Modeling ◽  
Confirmatory Factor Analyses ◽  
Content Type ◽  
Internet Users ◽  
The Usa ◽  
Antecedents And Consequences

PurposeMany internet users exhibit signs of privacy helplessness and entirely give up online privacy management. However, we know little about what privacy helplessness is, when users are likely to experience it and its implications for privacy behavior. The objectives of this study were twofold: (a) the conceptual explication of privacy helplessness as a novel construct in privacy research and (b) the development of a theoretical model that specifies the antecedents and consequences of privacy helplessness.Design/methodology/approachA research model of privacy helplessness that contains three subcomponents of privacy helplessness, five antecedents and one outcome was developed. The model was empirically examined based on survey data collected from 589 Facebook users in the USA.FindingsThe results of exploratory and confirmatory factor analyses showed that privacy helplessness is adequately assessed by a three-factor model with affective, cognitive and motivational components. The results of structural equation modeling indicated that these three aspects of privacy helplessness are uniquely predicted by five theoretical factors: (a) prior experience of privacy risks, (b) personal mastery, (c) perceived costs of adaptive privacy actions, (d) perceived rewards of privacy inactions and (e) perceived vulnerability. Furthermore, it was found that helplessness as motivational deficits (and cognitive helplessness via this) impedes adaptive privacy actions, while cognitive helplessness promotes adaptive privacy actions when they do not result in motivational deficits.Originality/valueThis study pioneers investigation in understanding key constituents, attributes and processes underlying privacy helplessness. First, the present study developed the first theory-derived, successively validated measurement model of privacy helplessness. Second, this research proposed a theoretical model of privacy helplessness, specifying antecedents and consequences of privacy helplessness.

scholarly journals Structural Equation Modeling: Theory and Applications in Forest Management

2012 ◽  
Vol 2012 ◽  
pp. 1-16 ◽  
Author(s):  
Tzeng Yih Lam ◽  
Douglas A. Maguire
Keyword(s):  
Structural Equation Modeling ◽  
Forest Management ◽  
Measurement Errors ◽  
Structural Equation ◽  
Light Attenuation ◽  
Measurement Model ◽  
Ecosystem Dynamics ◽  
Path Model ◽  
Management Tool ◽  
Equation Modeling

Forest ecosystem dynamics are driven by a complex array of simultaneous cause-and-effect relationships. Understanding this complex web requires specialized analytical techniques such as Structural Equation Modeling (SEM). The SEM framework and implementation steps are outlined in this study, and we then demonstrate the technique by application to overstory-understory relationships in mature Douglas-fir forests in the northwestern USA. A SEM model was formulated with (1) a path model representing the effects of successively higher layers of vegetation on late-seral herbs through processes such as light attenuation and (2) a measurement model accounting for measurement errors. The fitted SEM model suggested a direct negative effect of light attenuation on late-seral herbs cover but a direct positive effect of northern aspect. Moreover, many processes have indirect effects mediated through midstory vegetation. SEM is recommended as a forest management tool for designing silvicultural treatments and systems for attaining complex arrays of management objectives.

scholarly journals Development of a System Measurement Model of the Brazilian Hospital Accreditation System

2018 ◽  
Vol 15 (11) ◽  
pp. 2520 ◽  
Author(s):  
João Corrêa ◽  
João Turrioni ◽  
Carlos Mello ◽  
Ana Santos ◽  
Carlos da Silva ◽  
...  
Keyword(s):  
Structural Equation Modeling ◽  
Structural Equation ◽  
Structural Model ◽  
Measurement Model ◽  
Equation Modeling ◽  
Scientific Software ◽  
Health Organizations ◽  
Hospital Accreditation ◽  
Management Quality ◽  
Culture Process

The purpose of this study is to develop and validate a measurement model that evaluates the Brazilian hospital accreditation methodology (ONA), based on a multivariate model using structural equation modeling (SEM). The information used to develop the model was obtained from a questionnaire sent to all organizations accredited by the ONA methodology. A model was built based on the data obtained and tested through a structural equation modeling (SEM) technique using the LISREL® software (Scientific Software International, Inc., Skokie, IL, USA). Four different tests were performed: Initial, calibrated, simulated, and cross-validation models. By analyzing and validating the proposed measurement model, it can be verified that the selected factors satisfy the required criteria for the development of a structural model. The results show that leadership action is one of the most important factors in the process of health services accredited by ONA. Although, leadership, staff management, quality management, organizational culture, process orientation, and safety are strongly linked to the development of health organizations, and directly influence the accreditation process.

EFFECTS OF INTERPERSONAL TRUST AMONG USERS OF ONLINE HEALTH COMMUNITIES ON PATIENT TRUST IN AND SATISFACTION WITH THEIR PHYSICIAN

2018 ◽  
Vol 34 (1) ◽  
pp. 56-62 ◽  
Author(s):  
Anne-Françoise Audrain-Pontevia ◽  
Loick Menvielle
Keyword(s):  
Patient Satisfaction ◽  
Structural Equation ◽  
Medical Information ◽  
Interpersonal Trust ◽  
Positive Influence ◽  
Equation Modeling ◽  
Patient Trust ◽  
Online Health Communities ◽  
Health Communities ◽  
The Impact

Objectives:Online Health Communities (OHCs) are increasingly being used by patients in the Web 2.0 era. Today's patients have instant access to a great deal of medical information and contacts. Despite the considerable development of OHCs, little is known regarding the impact on the patient–physician relationship. This research aims at filling this gap and examines how interpersonal trust on peer-to-peer OHCs influences two key relational variables, namely patient trust in the physician and patient satisfaction with the physician. It also investigates their influences on the patient's attitude toward the physician.Methods:Drawing on both the relational and medical literatures, we propose a research model that brings out the relationships between interpersonal trust in OHCs, and patients’ trust, satisfaction and attitude toward the physician. We then conduct a quantitative survey of 512 OHC users in France, using structural equation modeling to test our hypotheses.Results:Our findings indicate that interpersonal trust in OHCs exerts a positive influence on both patients’ trust in and satisfaction with their physician. It also highlights that these two relational variables have a positive influence on patient attitude toward the physician. Our findings also indicate that patient trust influences patient satisfaction with the physician.Conclusions:This research highlights the importance of OHCs, which can be seen as valuable instruments for enhancing patient–physician relationships. It shows that healthcare managers should seek to enhance interpersonal trust among OHC users, because this trust has a positive influence on patient satisfaction with, trust in and attitude toward the physician.

scholarly journals Patient satisfaction with mental health services based on Andersen’s Behavioral Model

2017 ◽  
Vol 63 (2) ◽  
pp. 103-114 ◽  
Author(s):  
Marilyn Fortin ◽  
Jean-Marie Bamvita ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Patient Satisfaction ◽  
Mental Health Services ◽  
Health Services ◽  
Continuity Of Care ◽  
Multiple Linear Regression Model ◽  
Behavioral Model ◽  
Related Factors ◽  
Negatively Associated ◽  
Andersen’S Behavioral Model

Objective: The purpose of this article was to assess the satisfaction of adult patients who received mental health services (MHS) in healthcare networks staffed by multidisciplinary professionals and offering a range of MHS, and to identify variables associated with patient satisfaction. Methods: This cross-sectional study included 325 patients with mental disorders (MDs) among 4 Quebec health service networks. Data were collected using 9 standardized instruments and participant medical records. A 3-factor conceptual framework (predisposing, enabling, and needs-related factors) based on Andersen’s Behavioral Model was used, integrating sociodemographic, clinical, needs-related, service utilization, social support, and quality-of-life (QOL) variables. An adjusted multiple linear regression model was performed. Results: The global mean score for patient satisfaction was 4.11 (minimum: 2.0; maximum: 5.0). Among the enabling factors, continuity of care, having a case manager, and help received from services were positively associated with patient satisfaction, whereas being hospitalized was negatively associated. Among the needs-related factors, the number of needs was negatively associated with satisfaction. Conclusions: Findings demonstrated higher levels of satisfaction among patients who received good continuity of care and well-managed, frequent services in relation to their needs. Dissatisfaction was higher for patients with serious unmet needs or those hospitalized, which underlines the importance of taking these particular variables into account in the interest of improving MHS delivery and patient recovery.

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