Development and Early Feasibility of Chatbots for Educating Patients With Lung Cancer and Their Caregivers in Japan: Mixed Methods Study

Background Chatbots are artificial intelligence–driven programs that interact with people. The applications of this technology include the collection and delivery of information, generation of and responding to inquiries, collection of end user feedback, and the delivery of personalized health and medical information to patients through cellphone- and web-based platforms. However, no chatbots have been developed for patients with lung cancer and their caregivers. Objective This study aimed to develop and evaluate the early feasibility of a chatbot designed to improve the knowledge of symptom management among patients with lung cancer in Japan and their caregivers. Methods We conducted a sequential mixed methods study that included a web-based anonymized questionnaire survey administered to physicians and paramedics from June to July 2019 (phase 1). Two physicians conducted a content analysis of the questionnaire to curate frequently asked questions (FAQs; phase 2). Based on these FAQs, we developed and integrated a chatbot into a social network service (phase 3). The physicians and paramedics involved in phase I then tested this chatbot (α test; phase 4). Thereafter, patients with lung cancer and their caregivers tested this chatbot (β test; phase 5). Results We obtained 246 questions from 15 health care providers in phase 1. We curated 91 FAQs and their corresponding responses in phase 2. In total, 11 patients and 1 caregiver participated in the β test in phase 5. The participants were asked 60 questions, 8 (13%) of which did not match the appropriate categories. After the β test, 7 (64%) participants responded to the postexperimental questionnaire. The mean satisfaction score was 2.7 (SD 0.5) points out of 5. Conclusions Medical staff providing care to patients with lung cancer can use the categories specified in this chatbot to educate patients on how they can manage their symptoms. Further studies are required to improve chatbots in terms of interaction with patients.

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Health Care Providers’ Knowledge of HPV Vaccination, Barriers, and Strategies in a State With Low HPV Vaccine Receipt: Mixed-Methods Study

JMIR Cancer ◽

10.2196/cancer.7345 ◽

2017 ◽

Vol 3 (2) ◽

pp. e12 ◽

Cited By ~ 9

Author(s):

Echo L Warner ◽

Qian Ding ◽

Lisa Pappas ◽

Julia Bodson ◽

Brynn Fowler ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Mixed Methods Study ◽

Care Providers ◽

Vaccination Barriers

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Use and Effects of Patient Access to Medical Records in General Practice Through a Personal Health Record in the Netherlands: Protocol for a Mixed-Methods Study

JMIR Research Protocols ◽

10.2196/10193 ◽

2018 ◽

Vol 7 (9) ◽

pp. e10193 ◽

Cited By ~ 1

Author(s):

Maria MT Vreugdenhil ◽

Rudolf B Kool ◽

Kees van Boven ◽

Willem JJ Assendelft ◽

Jan AM Kremer

Keyword(s):

Health Care ◽

General Practice ◽

Health Care Providers ◽

Personal Health Record ◽

Mixed Methods Study ◽

Personal Health ◽

Care Providers ◽

Group Discussions ◽

Web Based ◽

Staff Level

Background In the Dutch health care system, general practitioners hold a central position. They store information from all health care providers who are involved with their patients in their electronic health records. Web-based access to the summary record in general practice through a personal health record (PHR) may increase patients’ insight into their medical conditions and help them to be involved in their care. Objective We describe the protocol that we will use to investigate the utilization of patients’ digital access to the summary of their medical records in general practice through a PHR and its effects on the involvement of patients in their care. Methods We will conduct a multilevel mixed-methods study in which the PHR and Web-based access to the summary record will be offered for 6 months to a random sample of 500 polypharmacy patients, 500 parents of children aged <4 years, and 500 adults who do not belong to the former two groups. At the patient level, a controlled before-after study will be conducted using surveys, and concurrently, qualitative data will be collected from focus group discussions, think-aloud observations, and semistructured interviews. At the general practice staff (GP staff) level, focus group discussions will be conducted at baseline and Q-methodology inquiries at the end of the study period. The primary outcomes at the patient level are barriers and facilitators for using the PHR and summary records and changes in taking an active role in decision making and care management and medication adherence. Outcomes at the GP staff level are attitudes before and opinions after the implementation of the intervention. Patient characteristics and changes in outcomes related to patient involvement during the study period will be compared between the users and nonusers of the intervention using chi-square tests and t tests. A thematic content analysis of the qualitative data will be performed, and the results will be used to interpret quantitative findings. Results Enrollment was completed in May 2017 and the possibility to view GP records through the PHR was implemented in December 2017. Data analysis is currently underway and the first results are expected to be submitted for publication in autumn 2019. Conclusions We expect that the findings of this study will be useful to health care providers and health care organizations that consider introducing the use of PHR and Web-based access to records and to those who have recently started using these. Trial Registration Netherlands Trial Registry NTR6395; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6395 (Archived by WebCite at http://www.webcitation.org/71nc8jzwM) Registered Report Identifier RR1-10.2196/10193

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In pursuit of a cure: The plural therapeutic landscape of onchocerciasis-associated epilepsy in Cameroon – A mixed methods study

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009206 ◽

2021 ◽

Vol 15 (2) ◽

pp. e0009206

Author(s):

Maya Ronse ◽

Julia Irani ◽

Charlotte Gryseels ◽

Tom Smekens ◽

Serge Ekukole ◽

...

Keyword(s):

Mixed Methods ◽

Health Care Providers ◽

Economic Status ◽

Health Service Delivery ◽

Mixed Methods Study ◽

Faith Healing ◽

Care Providers ◽

Therapeutic Landscape ◽

Populations At Risk ◽

Important Health

Background A high prevalence of epilepsy has been observed in several onchocerciasis-endemic villages in the Sanaga River basin, Cameroon. Recent studies suggest that ivermectin, a drug that is distributed annually with the aim of eliminating onchocerciasis, may have a protective effect against acquiring onchocerciasis-associated epilepsy (OAE). This study, therefore, provides an in-depth understanding of both the complex therapeutic landscape for epilepsy as well as the experiences related to the ‘community-directed treatment with ivermectin’ (CDTI) campaign in order to identify a more trenchant path forward in the fight against epilepsy. Methodology/Principal findings Based on a mixed methods study combining a qualitative strand with a quantitative survey, we found that epilepsy was perceived to have had an epidemic emergence in the past and was still considered an important health issue in the study area. Socio-economic status, availability and accessibility of drugs and practitioners, as well as perceived aetiology shaped therapeutic itineraries for epilepsy, which included frequenting (in)formal biomedical health care providers, indigenous and/or faith healing practitioners. Ivermectin uptake for onchocerciasis was generally well known and well regarded. The CDTI faced structural and logistical bottlenecks undermining equal access and optimal adherence to the drug. Conclusions/Significance Uninterrupted, sustainable and comprehensive health-service delivery is essential to help alleviate the epilepsy burden on afflicted households. Addressing structural challenges of CDTI and communicating the potential link with epilepsy to local populations at risk could optimize the uptake of this potentially significant tool in OAE prevention.

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Codeveloping a multibehavioural mobile phone app to enhance social and emotional well-being and reduce health risks among Aboriginal and Torres Strait Islander women during preconception and pregnancy: a three-phased mixed-methods study

BMJ Open ◽

10.1136/bmjopen-2021-052545 ◽

2021 ◽

Vol 11 (11) ◽

pp. e052545

Author(s):

Michelle Kennedy ◽

Ratika Kumar ◽

Nicole M Ryan ◽

Jessica Bennett ◽

Gina La Hera Fuentes ◽

...

Keyword(s):

Mixed Methods ◽

Mobile Phone ◽

Phase 1 ◽

Qualitative Interviews ◽

Mixed Methods Study ◽

Phase 2 ◽

Community Members ◽

Phase 3 ◽

Aboriginal Community ◽

Aboriginal Women

ObjectiveDescribe the development and pretest of a prototype multibehavioural change app MAMA-EMPOWER.DesignMixed-methods study reporting three phases: (1) contextual enquiry included stakeholder engagement and qualitative interviews with Aboriginal women, (2) value specification included user-workshop with an Aboriginal researcher, community members and experts, (3) codesign with Aboriginal researchers and community members, followed by a pretest of the app with Aboriginal women, and feedback from qualitative interviews and the user-Mobile Application Rating Scale (U-MARS) survey tool.SettingsAboriginal women and communities in urban and regional New South Wales, Australia.ParticipantsPhase 1: interviews, 8 Aboriginal women. Phase 2: workshop, 6 Aboriginal women. Phase 3: app trial, 16 Aboriginal women. U-MARS, 5 Aboriginal women.ResultsPhase 1 interviews revealed three themes: current app use, desired app characteristics and implementation. Phase 2 workshop provided guidance for the user experience. Phase 3 app trial assessed all content areas. The highest ratings were for information (mean score of 3.80 out of 5, SD=0.77) and aesthetics (mean score of 3.87 with SD of 0.74), while functionality, engagement and subjective quality had lower scores. Qualitative interviews revealed the acceptability of the app, however, functionality was problematic.ConclusionsDeveloping a mobile phone app, particularly in an Aboriginal community setting, requires extensive consultation, negotiation and design work. Using a strong theoretical foundation of behavioural change technique’s coupled with the consultative approach has added rigour to this process. Using phone apps to implement behavioural interventions in Aboriginal community settings remains a new area for investigation. In the next iteration of the app, we aim to find better ways to personalise the content to women’s needs, then ensure full functionality before conducting a larger trial. We predict the process of development will be of interest to other health researchers and practitioners.

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P.024 Educational needs in migraine care: results from a mixed-methods study among Canadian primary care providers and specialists

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.126 ◽

2018 ◽

Vol 45 (s2) ◽

pp. S22-S22

Author(s):

S Peloquin ◽

E Leroux ◽

G Shapero ◽

S Labbe ◽

S Murray ◽

...

Keyword(s):

Mixed Methods ◽

General Practitioners ◽

Online Survey ◽

Medical Training ◽

Phase 1 ◽

Primary Care Providers ◽

Educational Needs ◽

Phase 2 ◽

Care Providers ◽

Structured Interviews

Background: Migraines are sub-optimally treated, affect millions of Canadians, and are underrepresented in medical training. A study was conducted to identify the needs of Canadian Healthcare Providers (HCPs) for migraine education, with the aim to inform the development of learning activities. Methods: This ethics-approved study was deployed in two consecutive phases using a mixed-methods approach. Phase 1 (qualitative) explored the causes of challenges to migraine care via a literature review, input from an expert working group, and semi-structured interviews with multiple stakeholders. Phase 2 (quantitative) validated these causes using an online survey. Results: The study included 103 participants (28 in phase 1; 75 in phase 2): general practitioners=37; neurologists=24; nurses=14; pharmacists=20; administrators, policy influencers and payers=8. Four areas of sub-optimal knowledge were identified: (1) Canadian guidelines, (2) diagnostic criteria, (3) preventive treatment, and (4) non-pharmacological therapies. Attitudinal issues related to the management of migraine patients were also identified. Detailed data including the frequencies of knowledge gaps among general practitioners and general neurologists will be presented along with qualitative findings. Conclusions: Educational activities for general practitioners and general neurologists who treat patients with migraines should be designed to address the four educational needs described in this study.

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Violence Against Health Care Providers: A Mixed-Methods Study from Karachi, Pakistan

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2017.12.047 ◽

2018 ◽

Vol 54 (4) ◽

pp. 558-566.e2 ◽

Cited By ~ 6

Author(s):

Lubna Ansari Baig ◽

Shiraz Shaikh ◽

Maciej Polkowski ◽

Syeda Kausar Ali ◽

Seemin Jamali ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Health Care Providers ◽

Mixed Methods Study ◽

Care Providers

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Medical Students’ Experiences and Outcomes Using a Virtual Human Simulation to Improve Communication Skills: Mixed Methods Study (Preprint)

10.2196/preprints.15459 ◽

2019 ◽

Author(s):

Timothy C Guetterman ◽

Rae Sakakibara ◽

Srikar Baireddy ◽

Frederick W Kron ◽

Mark W Scerbo ◽

...

Keyword(s):

Health Care ◽

Mixed Methods ◽

Medical Students ◽

Communication Skills ◽

Health Care Providers ◽

Mixed Methods Study ◽

Virtual Human ◽

Care Providers ◽

Empathic Communication ◽

Nonverbal Skills

BACKGROUND Attending to the wide range of communication behaviors that convey empathy is an important but often underemphasized concept to reduce errors in care, improve patient satisfaction, and improve cancer patient outcomes. A virtual human (VH)–based simulation, MPathic-VR, was developed to train health care providers in empathic communication with patients and in interprofessional settings and evaluated through a randomized controlled trial. OBJECTIVE This mixed methods study aimed to investigate the differential effects of a VH-based simulation developed to train health care providers in empathic patient-provider and interprofessional communication. METHODS We employed a mixed methods intervention design, involving a comparison of 2 quantitative measures—MPathic-VR–calculated scores and the objective structured clinical exam (OSCE) scores—with qualitative reflections by medical students about their experiences. This paper is a secondary, focused analysis of intervention arm data from the larger trial. Students at 3 medical schools in the United States (n=206) received simulation to improve empathic communication skills. We conducted analysis of variance, thematic text analysis, and merging mixed methods analysis. RESULTS OSCE scores were significantly improved for learners in the intervention group (mean 0.806, SD 0.201) compared with the control group (mean 0.752, SD 0.198; <italic>F</italic><sub>1,414</sub>=6.09; <italic>P</italic>=.01). Qualitative analysis revealed 3 major positive themes for the MPathic-VR group learners: gaining useful communication skills, learning awareness of nonverbal skills in addition to verbal skills, and feeling motivated to learn more about communication. Finally, the results of the mixed methods analysis indicated that most of the variation between high, middle, and lower performers was noted about nonverbal behaviors. Medium and high OSCE scorers most often commented on the importance of nonverbal communication. Themes of motivation to learn about communication were only present in middle and high scorers. CONCLUSIONS VHs are a promising strategy for improving empathic communication in health care. Higher performers seemed most engaged to learn, particularly nonverbal skills.

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