scholarly journals Feasibility and Acceptability of Using Smartphone Apps in Diabetes Self-Management in an Underserved Population: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Jenny Luo ◽  
Shelley White-Means
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Mobile Health ◽  
Low Income ◽  
Underserved Populations ◽  
Low Cost ◽  
Self Management ◽  
Care Providers ◽  
Health Apps ◽  
Patients With Diabetes

BACKGROUND The successful management of diabetes is a chronic endeavor. It involves a whole host of factors ranging from a consistent patient-provider relationship to regular physical activity. Not all patients with diabetes, however, have access to the resources needed for effective disease management. Health disparities contribute to a higher frequency of diabetes development in poor and minority populations. Moreover, health care disparities limit the care these patient populations receive. Because underserved populations have little to no access to traditional means of health care, providers must explore other avenues to reach this patient group. Mobile health (mHealth) has grown significantly in the last decade. With the fast-paced adoption of cell phones across all socioeconomic groups, mobile health presents the opportunity to offer patients a low-cost way to receive health information, to communicate with providers, and to self-manage chronic conditions. It has been well established that low-income, minority populations experience several barriers to receiving basic health care including uninsurance, limited transportation, and high out-of-pocket costs. The provision of health care via mobile devices may have the potential to address such health disparities. Little is known about the effectiveness of using mobile health and smartphone applications (apps) in underserved populations to help with diabetes management. Knowledge of these patients’ interest in using mobile apps to augment their home self-management may have use in future implementations. OBJECTIVE The objective of this study is to examine the perception of and willingness to use diabetes mobile health apps on smartphones in patients with limited access to primary care providers. METHODS This study used purposive sampling to select patients for personal interviews. The study was conducted at a general hospital located in a part of town with predominate minority and low-income residency, as well as the highest diabetes prevalence rates. Semi-structured interviews were conducted according to McNamara’s interview staging. A total of 15 interviews were collected and coded by the researcher according to the interpretative phenomenological analysis framework. An independent committee reviewed all interview transcripts and coding to verify trustworthiness of collection and analysis. RESULTS The data produced 7 clusters related to smartphone app use and mHealth, each highlighting a component of the patient experience, which supported 3 overarching themes. The themes are as follows: despite limited knowledge about health apps and varying phone use patterns, patients were all willing to try at least one diabetes-related app; apps functions should be individualized to meet each patient’s needs for maximum benefit; and barriers to app use were varied but commonly included knowledge and technological challenges and security issues. CONCLUSIONS Personal interviews of this underserved patient population demonstrated an interest in and willingness to try mobile health apps, despite limited knowledge about the technology. Responses indicate that tailoring app choices to individual needs, instead of choosing a multi-functional one-size-fits-all app, would provide the most benefit for at-home diabetes self-management. Smartphone apps may serve as a viable low-cost resource for patients with diabetes who have limited access to traditional health care providers.

scholarly journals A Patient-Centered Mobile Phone App (iHeartU) With a Virtual Human Assistant for Self-Management of Heart Failure: Protocol for a Usability Assessment Study (Preprint)

2019 ◽  
Author(s):  
Lingling Zhang ◽  
Sabarish V Babu ◽  
Meenu Jindal ◽  
Joel E Williams ◽  
Ronald W Gimbel
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Virtual Human ◽  
Self Management ◽  
Care Providers ◽  
Patient Centered ◽  
Usability Assessment ◽  
User Centric

BACKGROUND Heart failure (HF) causes significant economic and humanistic burden for patients and their families, especially those with a low income, partly due to high hospital readmission rates. Optimal self-care is considered an important nonpharmacological aspect of HF management that can improve health outcomes. Emerging evidence suggests that self-management assisted by smartphone apps may reduce rehospitalization rates and improve the quality of life of patients. We developed a virtual human–assisted, patient-centered mobile health app (iHeartU) for patients with HF to enhance their engagement in self-management and improve their communication with health care providers and family caregivers. iHeartU may help patients with HF in self-management to reduce the technical knowledge and usability barrier while maintaining a low cost and natural, effective social interaction with the user. OBJECTIVE With a standardized systematic usability assessment, this study had two objectives: (1) to determine the obstacles to effective and efficient use of iHeartU in patients with HF and (2) to evaluate of HF patients’ adoption, satisfaction, and engagement with regard to the of iHeartU app. METHODS The basic methodology to develop iHeartU systems consists of a user-centric design, development, and mixed methods formative evaluation. The iterative design and evaluation are based on the guidelines of the American College of Cardiology Foundation and American Heart Association for the management of heart failure and the validated “Information, Motivation, and Behavioral skills” behavior change model. Our hypothesis is that this method of a user-centric design will generate a more usable, useful, and easy-to-use mobile health system for patients, caregivers, and practitioners. RESULTS The prototype of iHeartU has been developed. It is currently undergoing usability testing. As of September 2018, the first round of usability testing data have been collected. The final data collection and analysis are expected to be completed by the end of 2019. CONCLUSIONS The main contribution of this project is the development of a patient-centered self-management system, which may support HF patients’ self-care at home and aid in the communication between patients and their health care providers in a more effective and efficient way. Widely available mobile phones serve as care coordination and “no-cost” continuum of care. For low-income patients with HF, a mobile self-management tool will expand their accessibility to care and reduce the cost incurred due to emergency visits or readmissions. The user-centered design will improve the level of engagement of patients and ultimately lead to better health outcomes. Developing and testing a novel mobile system for patients with HF that incorporates chronic disease management is critical for advancing research and clinical practice of care for them. This research fills in the gap in user-centric design and lays the groundwork for a large-scale population study in the next phase. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13502

scholarly journals Social Needs Screening and Referral Program at a Large US Public Hospital System, 2017

2020 ◽  
Vol 110 (S2) ◽  
pp. S211-S214
Author(s):  
Carolyn Berry ◽  
Margaret Paul ◽  
Rachel Massar ◽  
Roopa Kalyanaraman Marcello ◽  
Marian Krauskopf
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Underserved Populations ◽  
Qualitative Evaluation ◽  
The United States ◽  
Social Needs ◽  
Public Health Care ◽  
Care Providers ◽  
Hospital System

Many health care providers and systems are developing and implementing processes to screen patients for social determinants of health and to refer patients to appropriate nonclinical and community-based resources. The largest public health care system in the United States, New York City Health + Hospitals, piloted such a program in 2017. A qualitative evaluation yielded insights into the implementation and feasibility of such screening and referral programs in health care systems serving low-income, minority, immigrant, and underserved populations.

scholarly journals Reducing the Health Risks of Diabetes

2009 ◽  
Vol 35 (3) ◽  
pp. 484-492 ◽  
Author(s):  
Geoffrey C. Williams ◽  
Heather Patrick ◽  
Christopher P. Niemiec ◽  
L. Keoki Williams ◽  
George Divine ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Medication Adherence ◽  
Health Care Providers ◽  
Medication Use ◽  
Perceived Competence ◽  
Self Management ◽  
Care Providers ◽  
Patients With Diabetes

Purpose The purpose of this study is to apply the self-determination theory (SDT) model of health behavior to predict medication adherence, quality of life, and physiological outcomes among patients with diabetes. Methods Patients with diabetes (N = 2973) receiving care from an integrated health care delivery system in 2003 and 2004 were identified from automated databases and invited to participate in this study. In 2005, patients responded to a mixed telephone-and-mail survey assessing perceived autonomy support from health care providers, autonomous self-regulation for medication use, perceived competence for diabetes self-management, medication adherence, and quality of life. In 2006, pharmacy claims data were used to indicate medication adherence, and patients' non—high-density lipoprotein (HDL) cholesterol, A1C, and glucose levels were assessed. Results The SDT model of health behavior provided adequate fit to the data. As hypothesized, perceived autonomy support from health care providers related positively to autonomous self-regulation for medication use, which in turn related positively to perceived competence for diabetes self-management. Perceived competence then related positively to quality of life and medication adherence, and the latter construct related negatively to non-HDL cholesterol, A1C, and glucose levels. Conclusions Health care providers' support for patients' autonomy and competence around medication use and diabetes self-management related positively to medication adherence, quality of life, and physiological outcomes among patients with diabetes.

scholarly journals Feasibility and Acceptability of Using Mobile Health Apps in Underserved Patients with Diabetes

2021 ◽  
Author(s):  
◽  
Jieyu Luo ◽  
Keyword(s):  
Health Care ◽  
Mobile Health ◽  
Diabetes Management ◽  
Low Cost ◽  
Self Management ◽  
Smartphone Apps ◽  
Health Apps ◽  
Underserved Patients ◽  
Mobile Health Apps ◽  
At Home

Introduction. Diabetes mellitus is a condition with a growing morbidity and mortality burden. An estimated 30 million adults currently live with diabetes, with each individual spending over $9500 annually on medical care. The successful management of diabetes is a lifelong endeavor. This involves balancing a variety of factors including diet, medications, and glucose monitoring. It has been well established that successful control of diabetes depends largely upon patients’ daily lifestyle habits and activities. Not all patients, however, have the resources necessary for effective diabetes management. Health disparities lead to a higher rate of diabetes development in minority and poor populations. Since underserved patients have limited access to traditional healthcare avenues, providers should explore other means, like mobile health (mHealth), to help such patients. The rapid adoption of smartphones within the last decade has allowed an opportunity for patients to use mHealth and smartphone applications (apps) as a low-cost way to get health information and services. mHealth has the potential to address such disparities in access to health care. Little is known about the effectiveness of using apps to help underserved patients with their diabetes management. Assessing these patients’ current self-management practices and their interest in using smartphone apps for their diabetes management is the first step in determining how mHealth may benefit this patient population. Purpose. The purpose of this study was to assess how underserved patients with limited access to primary care physicians handled their diabetes on their own at home, to determine what challenges they faced with their self-management, and to examine their willingness to use diabetes mHealth apps on their smartphones to assist with their diabetes management. Methods. This study employed purposive sampling to select patients for individual interviews. Participant selection occurred at a Memphis hospital located in an area of town with predominately low-income and minority residents, as well as a high prevalence of diabetes. Semi-structured interviews were conducted on-site at the hospital based on McNamara’s interview staging. In all, 15 interviews were recorded, transcribed, and coded according to the interpretative phenomenological analysis framework. Results. The data produced 5 topic clusters related to at-home diabetes management, which supported 2 overarching themes, and 7 clusters related to mHealth smartphone app use, which supported 3 overarching themes. The themes related to self-management are as follows: 1. Patients are aware that successful diabetes control requires active engagement on their part but voiced struggles related to balancing limited income and a healthy diet, how to manage fluctuating glucose readings throughout the day, and affording medications; and 2. Lacking a traditional relationship with a primary care doctor, these underserved patients turn to friends and family, written materials, and the internet as health care resources. The themes related to smartphone mHealth are as follows: 1. Despite limited knowledge about health apps and varying phone use patterns, patients were all willing to try at least one diabetes-related app; 2. App functions should be individualized to meet each patient’s needs for maximum benefit; and 3. Barriers to app use were varied but commonly included knowledge and technological challenges and security issues. Conclusion. Interviews from this vulnerable population demonstrated that individuals understood the importance of their own active involvement in controlling their diabetes. Yet, because of limited economic and health care resources, these patients struggle with the implementation of effective lifestyle choices in their daily routine. Furthermore, interviewees expressed interest in trying mobile health apps for diabetes management, despite minimal knowledge about the technology. Responses showed that selecting apps tailored to each individual’s needs, instead of offering one blanket multifunctional app, would provide patients with the greatest benefit. Smartphone apps may be a low-cost health resource that patients without regular access to physicians can use for their at-home diabetes management.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

scholarly journals Gestational diabetes mellitus: a qualitative study of lived experiences of South Asian immigrant women and perspectives of their health care providers in Melbourne, Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mridula Bandyopadhyay
Keyword(s):  
Health Care ◽  
Gestational Diabetes ◽  
South Asian ◽  
Health Care Providers ◽  
Lived Experiences ◽  
Lifestyle Modification ◽  
Self Management ◽  
Asian Women ◽  
Care Providers ◽  
South Asian Women

Abstract Background South Asian women are at a high risk of developing gestational diabetes mellitus than other women in Australia. Gestational diabetes affects up to 14–19% of all pregnancies among South Asian, South East Asian, and Arabic populations placing women at risk of adverse pregnancy outcomes. Although, gestational diabetes resolves after childbirth, women with gestational diabetes are up to seven times more likely to develop type 2 diabetes within five to ten years of the index pregnancy. Increasingly, South Asian women are being diagnosed with gestational diabetes in Australia. Therefore, we aimed to gain a better understanding of the lived experiences of South Asian women and their experiences of self-management and their health care providers’ perspectives of treatment strategies. Methods Using an ethnographic qualitative research methodology, semi-structured one-on-one, face-to-face interviews were conducted with 21 health care providers involved in gestational diabetes management and treatment from the three largest tertiary level maternity hospitals in Melbourne, Victoria, Australia. In-depth interviews were conducted with 23 South Asian women post diagnosis between 24–28 weeks gestation in pregnancy. Results Health care providers had challenges in providing care to South Asian women. The main challenge was to get women to self-manage their blood glucose levels with lifestyle modification. Whilst, women felt self-management information provided were inadequate and inappropriate to their needs. Women felt ‘losing control over their pregnancy’, because of being preoccupied with diet and exercise to control their blood glucose level. Conclusions The gestational diabetes clinical practice at the study hospitals were unable to meet consumer expectations. Health care providers need to be familiar of diverse patient cultures, rather than applying the current ‘one size fits all’ approach that failed to engage and meet the needs of immigrant and ethnic women. Future enabling strategies should aim to co-design and develop low Glycaemic Index diet plans of staple South Asian foods and lifestyle modification messages.

Immigrant Communities and COVID-19: Strengthening the Public Health Response

2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Immigrant Communities ◽  
Care Providers ◽  
Public Health Response ◽  
The Public ◽  
Public Health Infrastructure ◽  
Health Infrastructure

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )

scholarly journals Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Research Question ◽  
Chronic Musculoskeletal Pain ◽  
Self Management ◽  
Care Providers ◽  
The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

scholarly journals A Study Protocol for Increasing Access to Smoking Cessation Treatments for Low-Income Minority Smokers

2021 ◽  
Vol 9 ◽  
Author(s):  
Alicia K. Matthews ◽  
Karriem S. Watson ◽  
Cherdsak Duang ◽  
Alana Steffen ◽  
Robert Winn
Keyword(s):  
Health Care ◽  
Smoking Cessation ◽  
Health Care Providers ◽  
Low Income ◽  
Access To Health Care ◽  
Social Determinant ◽  
Evidence Based ◽  
Patient Portal ◽  
Care Providers ◽  
Access To Health

Background: Smoking rates among low-income patients are double those of the general population. Access to health care is an essential social determinant of health. Federally qualified health care centers (FQHC) are government-supported and community-based centers to increase access to health care for non-insured and underinsured patients. However, barriers to implementation impact adherence and sustainability of evidence-based smoking cessation within FQHC settings. To address this implementation barrier, our multi-disciplinary team proposes Mi QUIT CARE (Mile Square QUITCommunity-Access-Referral-Expansion) to establish the acceptability, feasibility, and capacity of an FQHC system to deliver an evidence-based and multi-level intervention to increase patient engagement with a state tobacco quitline.Methods: A mixed-method approach, rooted in an implementation science framework of RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance), will be used in this hybrid effectiveness-implementation design. We aim to evaluate the efficacy of a novel delivery system (patient portal) for increasing access to smoking cessation treatment. In preparation for a future randomized clinical trial of Mi QUIT CARE, we will conduct the following developmental research: (1) Examine the burden of tobacco among patient populations served by our partner FQHC, (2) Evaluate among FQHC patients and health care providers, knowledge, attitudes, barriers, and facilitators related to smoking cessation and our intervention components, (3) Evaluate the use of tailored communication strategies and patient navigation to increase patient portal uptake among patients, and (4) To test the acceptability, feasibility, and capacity of the partner FQHC to deliver Mi QUIT CARE.Discussion: This study provides a model for developing and implementing smoking and other health promotion interventions for low-income patients delivered via patient health portals. If successful, the intervention has important implications for addressing a critical social determinant of cancer and other tobacco-related morbidities.Trial Registration: U.S. National Institutes of Health Clinical Trials, NCT04827420, https://clinicaltrials.gov/ct2/show/NCT04827420.

scholarly journals MALAYSIAN DIABETES PATIENTS’ PERCEPTIONS, ATTITUDES AND PRACTICES IN RELATION TO SELF-CARE AND ENCOUNTERS WITH PRIMARY HEALTH CARE PROVIDERS

2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Attitudes And Practices ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Primary Healthcare Clinics ◽  
Diabetes Patients

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.

Sign in / Sign up

Export Citation Format

Share Document