scholarly journals Placing equity at the heart of eHealth implementation: A qualitative pilot study

2021 ◽  
Author(s):  
Milena Heinsch ◽  
Campbell Tickner ◽  
Frances Kay-Lambkin
Keyword(s):  
Social Justice ◽  
Pilot Study ◽  
Health Services ◽  
Home Environment ◽  
Health Professionals ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Cultural Barriers ◽  
Key Dimensions ◽  
Diverse Groups

Abstract Background: There is a growing urgency to tackle issues of equity and justice in the implementation of eHealth technologies. Methods: Qualitative interviews were conducted with 19 multidisciplinary health professionals to explore the implementation and uptake of eHealth technologies in practice. Results were analysed using Nancy Fraser’s social justice framework to identify key dimensions and patterns of distribution, recognition, and participation in the implementation of digital health services.Results: Health professionals reported that eHealth offered their clients a greater sense of safety, convenience, and flexibility, allowing them to determine the nature and pace of their healthcare, and giving them more control over their treatment and recovery. However, they also expressed concerns about the use of eHealth with clients whose home environment is unsafe. Application of Fraser’s social justice framework revealed that eHealth technologies may not always provide a secure clinical space in which the voices of vulnerable clients can be recognised and heard. It also highlighted critical systemic and cultural barriers that hinder the representation of clients’ voices in the decision to use eHealth technologies and perpetuate inequalities in the distribution of eHealth servies.Conclusions: To facilitate broad participation, eHealth tools need to be adaptable to the needs and circumstances of diverse groups. Future implementation science efforts must also be directed at identifying and addressing the underlying structures that hinder equitable recognition, representation, and distribution in the implementation of eHealth resources.

scholarly journals Placing equity at the heart of eHealth implementation: A qualitative pilot study

2021 ◽  
Author(s):  
Milena Heinsch ◽  
Campbell Tickner ◽  
Frances Kay-Lambkin
Keyword(s):  
Social Justice ◽  
Pilot Study ◽  
Home Environment ◽  
Health Professionals ◽  
Digital Health ◽  
Qualitative Interviews ◽  
Cultural Barriers ◽  
Ehealth Services ◽  
Key Dimensions ◽  
Diverse Groups

Abstract Background There is a growing urgency to tackle issues of equity and justice in the implementation of eHealth technologies. Methods Qualitative interviews were conducted with 19 multidisciplinary health professionals to explore the implementation and uptake of eHealth technologies in practice. Results were analysed using Nancy Fraser’s social justice framework to identify key dimensions and patterns of distribution, recognition, and participation in the implementation of digital health services. Results Health professionals reported that eHealth offered their clients a greater sense of safety, convenience, and flexibility, allowing them to determine the nature and pace of their healthcare, and giving them more control over their treatment and recovery. However, they also expressed concerns about the use of eHealth with clients whose home environment is unsafe. Application of Fraser’s social justice framework revealed that eHealth technologies may not always provide a secure clinical space in which the voices of vulnerable clients can be recognised and heard. It also highlighted critical systemic and cultural barriers that hinder the representation of clients’ voices in the decision to use eHealth technologies and perpetuate inequalities in the distribution of eHealth services. Conclusions To facilitate broad participation, eHealth tools need to be adaptable to the needs and circumstances of diverse groups. Future implementation science efforts must also be directed at identifying and addressing the underlying structures that hinder equitable recognition, representation, and distribution in the implementation of eHealth resources.

scholarly journals Workshop: Bridging the Gap in Digital Public Health in Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Health Professionals ◽  
Digital Health ◽  
Good Practice ◽  
Point Of View ◽  
Public Health Services ◽  
New Paradigm ◽  
The Public ◽  
Challenges And Opportunities

Abstract Europe is facing several health challenges and public health plays an important role in it. However, to address the increasing demand for public health services, public health institutions need to tackle digitalization in a proper and evidence-based way. Digital health comprises both an organizational and a technological component. While the technological one has been widely addressed, the organizational one got little attention so far. This is due to a lack of knowledge regarding the understanding of the new role of organizations that provide digital health services. Public health is a field deeply dependent on data and with an important opportunity to leverage information technology. Digital health could, within 10 years establish a new paradigm in public health. The public health professionals need urgently to tackle digital health to bridge the gap with others areas of healthcare. Moreover, since public health is a multi-disciplinary activity we want to take the opportunity to debate digital public health with European experts from different fields of knowledge. Three presentations from the point of view of People, Technology and Services. Digital health should be addressed as an evidenced-based approach towards both improving health professionals performance and quality of life of patients. This workshop aims at: To create the momentum towards the proper use of digital technologies in public health by discussing the main challenges and opportunities for European Public Health.To establish a forum to discuss digital public health solutions based on evidence to better improve the adoption of these tools in the public health profession;To have a serious discussion after 3 presentations that will clarify the main challenges and opportunities;After de presentations, a debate will be guide to help identify the main challenges for digital public health in Europe; Key messages Public Health Digitalization is essential to address health inequalities in Europe. The workshop identifies what are the main priorities for a sustainable EU public Health digitalization. Mutual learning, knowledge and good practice exchange in using digital technology can be organised in various ways – we show practical current examples on how it has been done.

scholarly journals Free access to nicotine substitutes and e-cigarette for tobacco cessation: STOP a pilot intervention

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Héron ◽  
M Melchior ◽  
F El-Khoury
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Health Professionals ◽  
Social Inequalities ◽  
Qualitative Interviews ◽  
Smoking Cessation Intervention ◽  
Free Access ◽  
Cessation Intervention ◽  
Paris Area ◽  
Economic Position

Abstract Background Smoking rates in France are high, and present a substantial socio-economic gradient. Smokers with low socio-economic position (SEP) may be more dependent on nicotine, and have more financial difficulties to buy nicotine substitutes. Tailored approaches are therefore needed. Methods STOP (Sevrage Tabagique à l’aide d’Outils dédiés selon la Préférence) is an ongoing pilot study, examining the acceptability of a smoking cessation intervention. Smokers with low SEP are recruited in six healthcare centres in Greater Paris area by health professionals and are offered substitute(s) of their choice for 4 weeks. Participants can choose between different types of nicotine substitutes (NS; patches, inhalers, etc.) and/or an e-cigarette delivered free of charge. The acceptability of this approach is examined in patients and doctors, using a mixed-method approach. Results So far, 30 smokers have been included in our study, 20% chose e-cigarettes, 36% chose NS, 36% chose both, and 2 participants (8%) chose neither. More than half of participants quit smoking (66%) at one week after inclusion, with 11 reporting tobacco abstinence out of 16 participants followed for 4 weeks. The average number of cigarettes smoked decreased from 15(sd = 10) at inclusion to 8.5 (sd = 5) among those who didn’t quit at four week. In qualitative interviews, one of the facilitators highlighted by health professionals was the perceived “met need” of smokers with low SEP when given free quitting aids without upfront-payment. One of the reported obstacles is the difficulty in scheduling consecutive follow-up meetings in short time. Discussion It is feasible to implement a smoking cessation programme aimed at smokers with low SEP, and embedded in the healthcare system. If proven effective, this intervention could contribute to decreasing social inequalities with regard to tobacco use. Recruitment in a randomised controlled multicentre trial based on this pilot study will start at the end of 2019. Key messages It is feasible to put in place a smoking cessation intervention among socially-disadvantaged in healthcare centres. Free access to nicotine substitutes and e-cigarettes could be a promising smoking cessation intervention among smokers with low socio-economic position.

HOW STUDENTS DEFINE THEIR SUCCESS: A RESEARCH STUDY

2020 ◽  
Author(s):  
Max Ullrich ◽  
David S. Strong
Keyword(s):  
Pilot Study ◽  
Engineering Students ◽  
Research Study ◽  
Survey Instrument ◽  
Undergraduate Engineering ◽  
Diversity And Inclusion ◽  
Full Study ◽  
Definition Of Success ◽  
Definition Of ◽  
Diverse Groups

How undergraduate engineering students define their success and plan for their future differs notably amongst students. With a push for greater diversity and inclusion in engineering schools, it is valuable to also better understand the differences in these areas among different students to allow institutions to better serve the needs of these diverse groups.  The purpose of this research study is to explore students’ definition of success both in the present and projecting forward 5 to 10 years, as well as to understand to what level students reflect on, and plan for, the future. The proposed survey instrument for the pilot stage of this research includes 56 closed-ended questions and 3 open-ended questions. Evidence for the validity of the research instrument is established through a mixed-method pilot study. This paper will discuss the survey instrument, the pilot study, and outline plans for the full study.

scholarly journals Implementing a digital health model of care in Australian youth mental health services: protocol for impact evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Piper ◽  
Tracey A. Davenport ◽  
Haley LaMonica ◽  
Antonia Ottavio ◽  
Frank Iorfino ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Impact Evaluation ◽  
Digital Health ◽  
Youth Mental Health ◽  
Model Of Care ◽  
Health Service Provision ◽  
Industrial Grade ◽  
The Impact

Abstract Background The World Economic Forum has recently highlighted substantial problems in mental health service provision and called for the rapid deployment of smarter, digitally-enhanced health services as a means to facilitate effective care coordination and address issues of demand. In mental health, the biggest enabler of digital solutions is the implementation of an effective model of care that is facilitated by integrated health information technologies (HITs); the latter ensuring the solution is easily accessible, scalable and sustainable. The University of Sydney’s Brain and Mind Centre (BMC) has developed an innovative digital health solution – delivered through the Youth Mental Health and Technology Program – which incorporates two components: 1) a highly personalised and measurement-based (data-driven) model of youth mental health care; and 2) an industrial grade HIT registered on the Australian Register of Therapeutic Goods. This paper describes a research protocol to evaluate the impact of implementing the BMC’s digital health solution into youth mental health services (i.e. headspace - a highly accessible, youth-friendly integrated service that responds to the mental health, physical health, alcohol or other substance use, and vocational concerns of young people aged 12 to 25 years) within urban and regional areas of Australia. Methods The digital health solution will be implemented into participating headspace centres using a naturalistic research design. Quantitative and qualitative data will be collected from headspace health professionals, service managers and administrators, as well as from lead agency and local Primary Health Network (PHN) staff, via service audits, Implementation Officer logs, online surveys, and semi-structured interviews, at baseline and then three-monthly intervals over the course of 12 months. Discussion At the time of publication, six headspace centres had been recruited to this study and had commenced implementation and impact evaluation. The first results are expected to be submitted for publication in 2021. This study will focus on the impact of implementing a digital health solution at both a service and staff level, and will evaluate digital readiness of service and staff adoption; quality, usability and acceptability of the solution by staff; staff self-reported clinical competency; overall impact on headspace centres as well as their lead agencies and local PHNs; and social return on investment.

scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

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