scholarly journals Feasibility, Acceptability, and Adoption of Digital Fingerprinting During Contact Investigation for Tuberculosis in Kampala, Uganda: A Parallel-Convergent Mixed-Methods Analysis (Preprint)

2018 ◽  
Author(s):  
Elizabeth B White ◽  
Amanda J Meyer ◽  
Joseph M Ggita ◽  
Diana Babirye ◽  
David Mark ◽  
...  

BACKGROUND In resource-constrained settings, challenges with unique patient identification may limit continuity of care, monitoring and evaluation, and data integrity. Biometrics offers an appealing but understudied potential solution. OBJECTIVE The objective of this mixed-methods study was to understand the feasibility, acceptability, and adoption of digital fingerprinting for patient identification in a study of household tuberculosis contact investigation in Kampala, Uganda. METHODS Digital fingerprinting was performed using multispectral fingerprint scanners. We tested associations between demographic, clinical, and temporal characteristics and failure to capture a digital fingerprint. We used generalized estimating equations and a robust covariance estimator to account for clustering. In addition, we evaluated the clustering of outcomes by household and community health workers (CHWs) by calculating intraclass correlation coefficients (ICCs). To understand the determinants of intended and actual use of fingerprinting technology, we conducted 15 in-depth interviews with CHWs and applied a widely used conceptual framework, the Technology Acceptance Model 2 (TAM2). RESULTS Digital fingerprints were captured for 75.5% (694/919) of participants, with extensive clustering by household (ICC=.99) arising from software (108/179, 60.3%) and hardware (65/179, 36.3%) failures. Clinical and demographic characteristics were not markedly associated with fingerprint capture. CHWs successfully fingerprinted all contacts in 70.1% (213/304) of households, with modest clustering of outcomes by CHWs (ICC=.18). The proportion of households in which all members were successfully fingerprinted declined over time (ρ=.30, P<.001). In interviews, CHWs reported that fingerprinting failures lowered their perceptions of the quality of the technology, threatened their social image as competent health workers, and made the technology more difficult to use. CONCLUSIONS We found that digital fingerprinting was feasible and acceptable for individual identification, but problems implementing the hardware and software lead to a high failure rate. Although CHWs found fingerprinting to be acceptable in principle, their intention to use the technology was tempered by perceptions that it was inconsistent and of questionable value. TAM2 provided a valuable framework for understanding the motivations behind CHWs’ intentions to use the technology. We emphasize the need for routine process evaluation of biometrics and other digital technologies in resource-constrained settings to assess implementation effectiveness and guide improvement of delivery.


2018 ◽  
Author(s):  
Elizabeth B White ◽  
Amanda J Meyer ◽  
Joseph M Ggita ◽  
Diana Babirye ◽  
David Mark ◽  
...  

Background: In resource-constrained settings, challenges with unique patient identification may limit continuity of care, monitoring and evaluation, and data integrity. Biometrics offer an appealing but understudied potential solution. Methods: We conducted a mixed-methods study to understand feasibility, acceptability, and adoption of digital fingerprinting for patient identification in a study of household TB contact investigation in Kampala, Uganda. We tested associations between demographic, clinical, and temporal characteristics and failure to capture a digital fingerprint. We used generalized estimating equations and a robust covariance estimator to account for clustering. We evaluated clustering of outcomes by household and community health worker by calculating intra-class correlation coefficients. To understand determinants of intended and actual use of fingerprinting technology, we conducted fifteen in-depth interviews with community health workers and applied a widely used conceptual framework, the Technology Acceptance Model 2. Results: Digital fingerprints were captured in 74% of participants, with extensive clustering by household (ICC = 0.99) arising from hardware (36%) and software (60%) failures. Clinical and demographic characteristics were not significantly associated with fingerprint capture. Community health workers successfully fingerprinted all contacts in 70% of households, with modest clustering of outcomes by CHW (ICC = 0.18). Fingerprinting success at the household level declined over time (Spearman’s rho = 0.30, P < 0.001). In interviews, CHWs reported that fingerprinting non-capture events lowered their own perception of the quality of the technology, threatened their social image, and made the technology more difficult to use. Conclusions: We found digital fingerprinting to be feasible and acceptable for indvidual identification, but problems implementing the hardware and software led to a high failure rate. Although CHWs found fingerprinting to be acceptable in principle, their intention to use the technology was tempered by perceptions that it was inconsistent and of questionable value. We emphasize the need for routine process evaluation of biometrics and other digital technologies during implementation in resource-constrained settings.



2018 ◽  
Author(s):  
Elizabeth B White ◽  
Amanda J Meyer ◽  
Joseph M Ggita ◽  
Diana Babirye ◽  
David Mark ◽  
...  

Background: In resource-constrained settings, challenges with unique patient identification may limit continuity of care, monitoring and evaluation, and data integrity. Biometrics offer an appealing but understudied potential solution. Methods: We conducted a mixed-methods study to understand feasibility, acceptability, and adoption of digital fingerprinting for patient identification in a study of household TB contact investigation in Kampala, Uganda. We tested associations between demographic, clinical, and temporal characteristics and failure to capture a digital fingerprint. We used generalized estimating equations and a robust covariance estimator to account for clustering. We evaluated clustering of outcomes by household and community health worker by calculating intra-class correlation coefficients. To understand determinants of intended and actual use of fingerprinting technology, we conducted fifteen in-depth interviews with community health workers and applied a widely used conceptual framework, the Technology Acceptance Model 2. Results: Digital fingerprints were captured in 74% of participants, with extensive clustering by household (ICC = 0.99) arising from hardware (36%) and software (60%) failures. Clinical and demographic characteristics were not significantly associated with fingerprint capture. Community health workers successfully fingerprinted all contacts in 70% of households, with modest clustering of outcomes by CHW (ICC = 0.18). Fingerprinting success at the household level declined over time (Spearman’s rho = 0.30, P < 0.001). In interviews, CHWs reported that fingerprinting non-capture events lowered their own perception of the quality of the technology, threatened their social image, and made the technology more difficult to use. Conclusions: We found digital fingerprinting to be feasible and acceptable for indvidual identification, but problems implementing the hardware and software led to a high failure rate. Although CHWs found fingerprinting to be acceptable in principle, their intention to use the technology was tempered by perceptions that it was inconsistent and of questionable value. We emphasize the need for routine process evaluation of biometrics and other digital technologies during implementation in resource-constrained settings.



10.2196/11541 ◽  
2018 ◽  
Vol 20 (11) ◽  
pp. e11541 ◽  
Author(s):  
Elizabeth B White ◽  
Amanda J Meyer ◽  
Joseph M Ggita ◽  
Diana Babirye ◽  
David Mark ◽  
...  


2018 ◽  
Author(s):  
Sandra Barteit ◽  
Albrecht Jahn ◽  
Annel Bowa ◽  
Sigrid Lüders ◽  
Gregory Malunga ◽  
...  

BACKGROUND Zambia faces a severe shortage of health workers, particularly in rural areas. To tackle this shortage, the Medical Licentiate program was initiated at Chainama College of Health Sciences in the capital, Lusaka, in 2002. The objective of the program was to alleviate the shortage of human resources in curative care. On-the-job training is conducted in decentralized teaching hospitals throughout Zambia. However, the program faces significant challenges such as shortages of senior medical instructors and learning materials. OBJECTIVE Our aim was to address these challenges by introducing a self-directed, e-learning platform with an offline tablet as part of a collaborative blended-learning intervention to supplement local teaching and training. METHODS The pilot phase of the e-learning platform was evaluated using a mixed-methods approach with a convergent parallel design. Various methods were employed to test the data’s adequacy and potential for generating valid results. Methods included questionnaires according to the technology acceptance model and information system success model by DeLone and McLean, semistructured interviews, learner diaries, pretesting, the collection of usage data, exam results, demographics, and informal feedback. Outcome measures included usage, adoption, efficiency, acceptance, user-friendliness, and gained knowledge and skills. RESULTS In total, 52 students and 17 medical instructors participated in the pilot evaluation. The questionnaire results showed a high acceptance of the technology (>80%) and high agreement (>75%) with the e-learning platform. Semistructured interview results showed an overall appreciation of the e-learning intervention, but the need for more e-learning materials. Respondents identified a need for multimedia materials that transfer skills such as medical procedure visualization and interactive exercises to practice procedural knowledge. The learning diaries identified the lack of specific learning materials and potential shortcomings of existing learning materials. However, students were satisfied with the current e-learning content. The majority of students used the e-learning platform offline on their tablets; online e-learning was underutilized. CONCLUSIONS The pilot phase of the tablet-based e-learning platform to support the self-directed learning intervention was well received and appreciated by students and medical instructors of Chainama College of Health Sciences. E-learning for knowledge acquisition appears to be adequate and feasible for this low-resource educational environment. Our evaluation results guide the further development of the full implementation of the e-learning platform in this educational setting. E-learning materials should reflect curriculum requirements, and additional multimedia and interactive content is needed, as well as improved integration and active participation from medical instructors in the e-learning processes.



2020 ◽  
Author(s):  
Kristin Natal Riang Gea

AbstrakKeselamatan pasien merupakan dasar dari pelayanan kesehatan yang baik. Pengetahuan tenaga kesehatan dalam sasaran keselamatan pasien terdiri dari ketepatan identifikasi pasien, peningkatan komunikasi yang efektif, peningkatan keamanan obat yang perlu diwaspadai, kepastian tepat lokasi, prosedur, dan tepat pasien operasi, pengurangan risiko infeksi, pengurangan risiko pasien jatuh. Tujuan penelitian untuk mengetahui hubungan antara pengetahuan dengan penerapan keselamatan pasien pada petugas kesehatan di Puskesmas Kedaung Wetan Kota Tangerang. Metode Penelitian menggunakan deskriptif korelasi menggunakan pendekatan cross sectional. Populasi sebanyak 50 responden. Teknik pengambilan sampel menggunakan total sampling. Instrumen yang digunakan berupa lembar kuesioner. Teknik analisa diatas menggunakan analisa Univariat dan Bivariat. Hasil Penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien pada Petugas Kesehatan, dengan hasil, p value sebesar 0,013 &lt; 0,05 maka dapat disimpulkan bahwa ada Hubungan Pengetahuan dengan Penerapa Keselamatan Pasien pada Petugas Kesehatan. Kesimpulan penelitian ada Hubungan Pengetahuan dengan Penerapan Keselamatan Pasien.. AbstrackPatient safety is the basis of good health services. Knowledge of health personnel in patient safety targets consists of accurate patient identification, increased effective communication, increased safety of the drug that needs to be watched, certainty in the right location, procedure, and precise patient surgery, reduction in risk of infection, reduction in risk of falling patients. The purpose of this study was to determine the relationship between knowledge and the application of patient safety to health workers in the Kedaung Wetan Health Center, Tangerang City. The research method uses descriptive correlation using cross sectional approach. The population is 50 respondents. The sampling technique uses total sampling. The instrument used was a questionnaire sheet. The analysis technique above uses Univariate and Bivariate analysis. The results of the study there is a Relationship of Knowledge with the Implementation of Patient Safety in Health Officers, with the result, p value of 0.013 &lt;0.05, it can be concluded that there is a Relationship between Knowledge and Patient Safety Implementation in Health Officers. The conclusion of the study is the Relationship between Knowledge and the Implementation of Patient Safety.Keywords Knowledge, Patient safety, Health workers



BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042579
Author(s):  
Leonardo W Heyerdahl ◽  
Muriel Vray ◽  
Vincent Leger ◽  
Lénaig Le Fouler ◽  
Julien Antouly ◽  
...  

IntroductionVoluntary organisations provide essential support to vulnerable populations and front-line health responders to the COVID-19 pandemic. The French Red Cross (FRC) is prominent among organisations offering health and support services in the current crisis. Comprised primarily of lay volunteers and some trained health workers, FRC volunteers in the Paris (France) region have faced challenges in adapting to pandemic conditions, working with sick and vulnerable populations, managing limited resources and coping with high demand for their services. Existing studies of volunteers focus on individual, social and organisational determinants of motivation, but attend less to contextual ones. Public health incertitude about the COVID-19 pandemic is an important feature of this pandemic. Whether and how uncertainty interacts with volunteer understandings and experiences of their work and organisational relations to contribute to Red Cross worker motivation is the focus of this investigation.Methods and analysisThis mixed-methods study will investigate volunteer motivation using ethnographic methods and social network listening. Semi-structured interviews and observations will illuminate FRC volunteer work relations, experiences and concerns during the pandemic. A questionnaire targeting a sample of Paris region volunteers will allow quantification of motivation. These findings will iteratively shape and be influenced by a social media (Twitter) analysis of biomedical and public health uncertainties and debates around COVID-19. These tweets provide insight into a French lay public’s interpretations of these debates. We evaluate whether and how socio-political conditions and discourses concerning COVID-19 interact with volunteer experiences, working conditions and organisational relations to influence volunteer motivation. Data collection began on 15 June 2020 and will continue until 15 April 2021.Ethics and disseminationThe protocol has received ethical approval from the Institut Pasteur Institutional Review Board (no 2020-03). We will disseminate findings through peer-reviewed articles, conference presentations and recommendations to the FRC.



2021 ◽  
Vol 45 (4) ◽  
Author(s):  
Stefanie Jauk ◽  
Diether Kramer ◽  
Alexander Avian ◽  
Andrea Berghold ◽  
Werner Leodolter ◽  
...  

AbstractEarly identification of patients with life-threatening risks such as delirium is crucial in order to initiate preventive actions as quickly as possible. Despite intense research on machine learning for the prediction of clinical outcomes, the acceptance of the integration of such complex models in clinical routine remains unclear. The aim of this study was to evaluate user acceptance of an already implemented machine learning-based application predicting the risk of delirium for in-patients. We applied a mixed methods design to collect opinions and concerns from health care professionals including physicians and nurses who regularly used the application. The evaluation was framed by the Technology Acceptance Model assessing perceived ease of use, perceived usefulness, actual system use and output quality of the application. Questionnaire results from 47 nurses and physicians as well as qualitative results of four expert group meetings rated the overall usefulness of the delirium prediction positively. For healthcare professionals, the visualization and presented information was understandable, the application was easy to use and the additional information for delirium management was appreciated. The application did not increase their workload, but the actual system use was still low during the pilot study. Our study provides insights into the user acceptance of a machine learning-based application supporting delirium management in hospitals. In order to improve quality and safety in healthcare, computerized decision support should predict actionable events and be highly accepted by users.



KWALON ◽  
2020 ◽  
Vol 25 (3) ◽  
Author(s):  
Julie Vanderlinden ◽  
Sabine Lambers ◽  
Reninka De Koker ◽  
Liza Musch

Mixed methods to measure movement and sleep in the elderly Movement and sleep are both crucial for the elderly in terms of healthy ageing. Staying physically active as people age is positively associated with better sleep and health outcomes. But despite the growing attention to healthy ageing, the elderly don’t always keep up with the applicable guidelines in terms of movement. Furthermore, health workers don’t always know how to measure movement and sleep in elderly in order to advise and help them to better adhere to guidelines. Literature lacks a summary of accessible objective and subjective ways to measure movement and sleep in the elderly. This study combines both objective and subjective measuring methods and elaborates on the practical aspects of their use. This paper highlights the advantages of mixed methods when measuring movement and sleep in elderly people and aims to inform health workers who want to evaluate their patients’ movement and sleep in order to guide them towards a healthier lifestyle.



2021 ◽  
Author(s):  
Yen-Chang Chen ◽  
Yen-Yuan Chen

UNSTRUCTURED While health care and public health workers are working on measures to mitigate the COVID-19 pandemic, there is an unprecedentedly large number of people spending much more time indoors, and relying heavily on the Internet as their lifeline. What has been overlooked is the influence of the increasing online activities on public health issues. In this article, we pointed out how a large-scale online activity called cyber manhunt may threaten to offset the efficacy of contact tracing investigation, a public health intervention considered highly effective in limiting further transmission in the early stage of a highly contagious disease outbreak such as the COVID-19 pandemic. In the first section, we presented a case to show how personal information obtained from contact investigation and disclosed in part on the media provoked a vehement cyber manhunt. We then discussed the possible reasons why netizens collaborate to reveal anonymized personal information about contact investigation, and specify, from the perspective of public health and public health ethics, four problems of cyber manhunt, including the lack of legitimate public health goals, the concerns about privacy breach, the impact of misinformation, and social inequality. Based on our analysis, we concluded that more moral weight may be given to protecting one's confidentiality, especially in an era with the rapid advance of digital and information technologies.



2020 ◽  
Author(s):  
Titilayo Tatiana Agbadje ◽  
Samira Abbasgholizadeh Rahimi ◽  
Mélissa Côté ◽  
Andrée-Anne Tremblay ◽  
Mariama Penda Diallo ◽  
...  

Abstract Background To help pregnant women and their partners make informed value-congruent decisions about Down syndrome prenatal screening, our team developed two successive versions of a decision aid (DAv2017 and DAv2014). We aimed to assess pregnant women and their partners’ perceptions of the usefulness of the two DAs for preparing for decision making, their relative acceptability and their most desirable features. Methods This is a mixed methods pilot study. We recruited participants of study (women and their partners) when consulting for prenatal care in three clinical sites in Quebec City. To be eligible, women had to: (a) be at least 18 years old; (b) be more than 16 weeks pregnant; or having given birth in the previous year and (c) be able to speak and write in French or English. Both women and partners were invited to give their informed consent. We collected quantitative data on the usefulness of the DAs for preparing for decision making and their relative acceptability. We developed an interview grid based on the Technology Acceptance Model and Acceptability questionnaire to explore their perceptions of the most desirable features. We performed descriptive statistics and deductive analysis. Results Overall, 23 couples and 16 individual women participated in the study. The majority of participants were between 25 and 34 years old (79% of women and 59% of partners) and highly educated (66.7% of women and 54% of partners had a university-level education). DAv2017 scored higher for usefulness for preparing for decision making (86.2 ± 13 out of 100 for DAv2017 and 77.7 ± 14 for DAv2014). For most dimensions, DAv2017 was more acceptable than DAv2014 (e.g. the amount of information was found “just right” by 80% of participants for DAv2017 against 56% for DAv2014). However, participants preferred the presentation and the values clarification exercise of DAv2014. In their opinion, neither DA presented information in a completely balanced manner. They suggested adding more information about raising Down syndrome children, replacing frequencies with percentages, different values clarification methods, and a section for the partner. Conclusions A new user-centered version of the prenatal screening DA will integrate participants’ suggestions to reflect end users’ priorities.



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