scholarly journals Website Rankings for Digital Health Centers in the USA: Applying Usability Testing for Public Engagement. (Preprint)

2020 ◽  
Author(s):  
Joshua David Calvano ◽  
Edwin Lauritz Fundingsland Jr ◽  
Deborah Lai ◽  
Sara Silacci ◽  
Ali S Raja ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Health Center ◽  
Standard Error ◽  
Computer Literacy ◽  
Digital Health ◽  
Usability Testing ◽  
Health Centers ◽  
Average Score ◽  
Content Quality ◽  
Web Presence

BACKGROUND As the public increasingly looks to the internet for resources and information regarding health and medicine, it is important that healthcare organizations provide adequate web resources. Usability refers to the ease of user experience on a website. In this study, we focus on usability analyses for digital health center websites. Our objectives were to develop adapt pre-existing usability scoring systems for United States digital health center websites, then apply this system to a sample for the purposes of testing this system and deriving insights from the results on potential areas of improvement for this sample. OBJECTIVE The primary aims of the study were to: 1) Adapt a pre-existing usability scoring methodology to digital health centers; 2) apply and test this adapted usability scoring methodology on a sample set of digital health center website and; 3) derive recommendations from these results on potential areas of improvements for our sample of digital health center websites. METHODS All website usability testing took place from 1 March 2020 to 15 March 2020. We adapted a methodology and scoring system developed from previous literature and applied it to digital health center websites. Our sample included 67 digital health centers affiliated with U.S. universities or hospitals systems. Usability was split into four broad categories: Accessibility (ability of those with low levels of computer literacy to access and navigate hospital’s Web presence), Marketing (ability to be found through search engines, examining the relevance of descriptions to the links provided), Content Quality (grammar, frequency of info updates, material relevancy, and readability), and Technology (download speed, quality of the programming code, and website infrastructure). Using these usability tools, we scored each website in each of the four categories. The composite of key factors in each of the four categories contributed to an overall “General Usability” score for each website. An overall score was then calculated by applying a weighted percentage across all factors and used for the final ranking system. RESULTS The category with the overall highest average score was Content Quality, with a 6.3. Content Quality also had the highest standard deviation at +/- 2.18, with a standard error of 0.27. The lowest performing category was Technology, with an average of 0.9. Technology also had the smallest standard deviation at +/- 0.07, with a standard error of 0.01. CONCLUSIONS Data suggests that Content Quality on average was the highest scored variable amongst digital health center websites. Because content is crucial to the knowledge of digital health it is justified that digital health centers invest more in creating quality content. The overall lowest scored variable was Technology. Potential reasons for this finding are related to designated funding for servers, a lack of regulatory framework around social media presence and liability, or infrequent website audits. An easy way to improve this variable is by increasing speed. Accessibility is another area in which these organizations have potential for improvement. In the effort to improve the dissemination of reliable information, this is arguably the most important variable for digital health centers to address. Our recommendation is that these organizations perform periodic audits of their web presence utilizing these tools.

scholarly journals Applying Website Rankings to Digital Health Centers in the United States to Assess Public Engagement: Website Usability Study

10.2196/20721 ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e20721
Author(s):  
Joshua David Calvano ◽  
Edwin Lauritz Fundingsland Jr ◽  
Deborah Lai ◽  
Sara Silacci ◽  
Ali S Raja ◽  
...  
Keyword(s):  
Health Center ◽  
Health Knowledge ◽  
Digital Health ◽  
The United States ◽  
Health Centers ◽  
Average Score ◽  
Content Quality ◽  
Website Usability ◽  
Regulatory Frameworks ◽  
Hospital Systems

Background As the public increasingly uses the internet to search for resources and information regarding health and medicine, it is important that health care organizations provide adequate web resources. Website usability refers to the ease of user experience on a website. In this study, we conducted usability analyses on digital health center websites. Objective The primary aims of this study were to (1) replicate a preexisting usability scoring methodology for digital health centers; (2) apply and test this replicated usability scoring methodology on a sample set of digital health center websites; and (3) derive recommendations from the results on potential areas of improvements for our sample of digital health center websites. Methods Website usability testing was conducted from March 1, 2020, to March 15, 2020. We replicated a methodology and scoring system from previous literature and applied them to digital health center websites. Our sample included 67 digital health centers that were affiliated with US universities or hospital systems. Usability was split into the following four broad categories: accessibility, marketing, content quality, and technology. Usability tools were used to score websites in each of the four categories. The composite of the key factors of each category was used to generate a general usability and overall usability score for each website. Results The category with the highest average score (6.3) was content quality. The content quality score also had the highest SD (2.18) and an SE of 0.27. The lowest performing category was technology, which had an average score of 0.9. The technology score also had the smallest SD (0.07) and an SE of 0.01. Conclusions Our data suggest that content quality, on average, was the highest scoring variable among digital health center websites. As content is crucial to digital health knowledge, it is justified that digital health centers invest more resources into creating quality content. The overall lowest scoring variable was technology. Potential reasons for this finding include designated funding for servers, a lack of regulatory frameworks for social media presence and liability, and infrequent website audits. An easy approach for improving this variable is increasing website speed. Accessibility is another area that organizations can potentially improve. We recommend that these organizations perform periodic audits of their web presence with usability tools.

scholarly journals Pengaruh Edukasi Gizi Terhadap Feeding Practice Pada Ibu Dengan Balita Stunting Di Puskesmas Simpang Agung Kecamatan Seputih Agungkabupaten Lampung Tengah

2021 ◽  
Vol 3 (1) ◽  
pp. 126-135
Author(s):  
Linawati Novikasari ◽  
Livia Eka Fitriana
Keyword(s):  
Public Health ◽  
Standard Deviation ◽  
Health Center ◽  
Nutrition Education ◽  
Standard Error ◽  
Statistical Tests ◽  
P Value ◽  
Feeding Practice ◽  
Nutritional Education ◽  
Public Health Center

ABSTRACT :   THE EFFECT OF NUTRITIONAL EDUCATION ON FEEDING PRACTICE IN MOTHER WITH STUNTING CHILDREN AT PUSKESMAS SIMPANG AGUNG KECAMATAN SEPUTIHAGUNG KABUPATEN LAMPUNGMIDDLE OF 2020 Background : Nutrition is one of the factors that determine the success of achieving optimal growth and development during toddlerhood. The golden period of growth requires proper nutritional support. Good nutrition will speed up recovery and reduce the intensity (emergency) of infectious diseases in toddlers.Purpose : Of this study was to determine the effect of nutrition education on feeding practice in mothers with stunted children at the Simpang Agung Public Health Center, Seputih Agung District, Central Lampung Regency, 2020.Method : The type of research used in this research is quantitative with the design in this study using a Quasi Experiment using the One Group Pretest Postest approach. The population in this study were all mothers who had children under five with a total of 30 mothers with a total sample of 30 mothers. In this study the sampling technique used was the total population, this is because the available population <100 respondentsResult : Based on statistical tests, it is known that the p-value is 0,000 or p-value <0.05, which means the effect of nutritional education on feeding practice in mothers with stunting children at the Simpang Agung Public Health Center, Seputih Agung District, Central Lampung Regency in 2020.Conclusion : It is known that at Simpang Agung Public Health Center, Seputih Agung District, Central Lampung Regency in 2020, the average Feeding Practice before being given nutrition education was 27.13 with a standard deviation of 8.978 and a standard error of 1.639, while after being given nutrition education the average Feeding Practice was 40.83 with a standard deviation of 10.923 and a standard error of 1.994. It is known that based on the average results before and after, the difference is 13,700. Keywords            : Nutrition Education & Feeding Practice  Pendahuluan : Gizi merupakan salah satu faktor yang menentukan keberhasilan untuk mencapai tumbuh kembang optimal pada masa balita. Periode emas pertumbuhan memerlukan dukungan gizi yang tepat. Gizi yang baik akan mempercepat pemulihan dan mengurangi intensitas (kegawatan) penyakit infeksi pada balita.Tujuan : Dalam penelitian ini adalah diketahui Pengaruh Edukasi Gizi Terhadap Feeding Practice pada Ibu dengan Balita Stunting Di Puskesmas Simpang Agung Kecamatan Seputih Agung Kabupaten Lampung Tengah Tahun 2020Metode : Jenis penelitian yang digunakan dalam penelitian ini adalah kuantitatif dengan rancangan dalam penelitian ini menggunakan Quasi Eksperimen dengan menggunakan pendekatan One Group Pretes Postest. Populasi dalam penelitian ini adalah seluruh ibu yang mempunyai balita  Stunting  yang berjumlah 30 ibu dengan jumlah sampel berjumlah 30 ibu. Dalam penelitian ini teknik sampling yang digunakan adalah total populasi, hal ini dikarenakan populasi yang tersedia < 100 respondenHasil : Berdasarkan uji statistic, diketahui p-value 0,000 atau p-value < 0,05, yang artinya Pengaruh Edukasi Gizi Terhadap Feeding Practice pada Ibu dengan Balita Stunting Di Puskesmas Simpang Agung Kecamatan Seputih Agung Kabupaten Lampung Tengah Tahun 2020Kesimpulan : Diketahui bahwa Di Puskesmas Simpang Agung Kecamatan Seputih Agung Kabupaten Lampung Tengah Tahun 2020, rata-rata Feeding Practice sebelum diberikan edukasi gizi adalah 27,13 dengan standar deviasi 8,978 dan standar eror 1,639, sedangkan sesudah diberikan edukasi gizi rata rata Feeding Practice adalah 40,83 dengan standar deviasi 10,923 dan standar error 1,994. Diketahui berdasarkan hasil rata-rata sebelum dan sesudah, nilai selisihnya adalah 13,700. Kata Kunci               : Edukasi Gizi & Feeding Practice

Website Usability Analysis of United States Academic Medical Centers (Preprint)

2021 ◽  
Author(s):  
Jonathan Gale ◽  
Kameron Black ◽  
Joshua David Calvano ◽  
Edwin Lauritz Fundingsland Jr ◽  
Deborah Lai ◽  
...  
Keyword(s):  
United States ◽  
Standard Deviation ◽  
Standard Error ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical Centers ◽  
Content Quality ◽  
Website Usability ◽  
Medical Centers ◽  
Academic Medical

BACKGROUND Many healthcare organizations are now tasked with providing web-based health resources and information. Usability refers to the ease of user experience on a website. Our objective was to adapt pre-existing usability scoring systems for United States academic medical center websites, then apply this system to a sample for the purposes of testing this system and deriving insights from the results on potential areas of improvement. OBJECTIVE The primary aims of the study were to: 1) Adapt a pre-existing usability scoring methodology to academic medical centers; 2) apply and test this adapted usability scoring methodology on a sample set of academic medical center website and; 3) derive recommendations from these results on potential areas of improvements for our sample of academic medical centers websites. METHODS All website usability testing took place from 1 June 2020 to 15 December 2020. We replicated a methodology developed in previous literature and applied it to academic medical centers. Our sample included 73 U.S. academic medical centers. Usability was split into four broad categories: Accessibility (ability of those with low levels of computer literacy to access and navigate hospital’s Web presence), Marketing (ability to be found through search engines, examining the relevance of descriptions to the links provided), Content Quality (grammar, frequency of info updates, material relevancy, and readability), and Technology (download speed, quality of the programming code, and website infrastructure). Using these tools, we scored each website in each category. The composite of key factors in each category contributed to an overall “General Usability” score for each website. An overall score was then calculated by applying a weighted percentage across all factors and used for the final Overall Usability ranking. RESULTS The category with the highest average score was Technology, with a 0.82 (standard deviation of 0.068, standard error of 0.008). The lowest-performing category was Content Quality, with an average of 0.22 (standard deviation of 0.069, standard error of 0.008). CONCLUSIONS Our data suggests that Technology, on average, was the highest scored variable amongst academic medical center websites. Because website functionality is essential to a user’s experience, it is justified that academic medical centers invest in optimal website performance. The overall lowest scored variable was Content Quality. A potential reason for this may be that academic medical center websites are usually larger in size, making it difficult to monitor the increased quantity of content. An easy way to improve this variable is to conduct more frequent website audits to assess readability, grammar, and relevancy. Marketing is another area in which these organizations have potential for improvement. Our recommendation is that organizations utilize search engine optimization techniques to improve their online visibility and discoverability.

scholarly journals ANALYSIS OF TRAINING METHOD OF TAEKWONDO ATHLETES WITH REACTION BALL

2022 ◽  
Vol 28 (1) ◽  
pp. 14-16
Author(s):  
Wei Zong
Keyword(s):  
Standard Deviation ◽  
Reaction Time ◽  
Standard Error ◽  
Average Score ◽  
Training Methods ◽  
Research Subjects ◽  
Level Of Evidence ◽  
Camera System ◽  
The Moment ◽  
Reaction Speed

ABSTRACT Introduction: Brief introduction: Taekwondo is a sport that integrates explosive power and reaction speed. The reaction speed of the athletes has a direct bearing on the result of the competition. Objective: To improve the reaction time effect of athletes. Methods: Forty-one Taekwondo team athletes were selected as the research subjects. Then, the training methods were introduced, and special technology using an emg tester and a synchronous camera system was implemented to analyze the earliest emg signals and the moment of the hit, the time from signal emergence to the emg reaction for reaction time, and from signal emergence to hit for the total time. Results: The average score of the 41 athletes before the test was 0.282673,with standard deviation of 0.0377349 and standard error of 0.0058932. The average score, standard deviation, and standard error of the 41 athletes after small training were 0.28217, 0.037744 and 0.005895. Conclusions: From the test results of the three training modes, the small training mode had a significant impact on the reaction time of Taekwondo athletes, while the medium and large training modes did not have significant effects. The results show that a small amount of training is best and plays a significant role in improving the reaction of an athlete. Level of evidence II; Therapeutic studies - investigation of treatment results.

scholarly journals PENGARUH PEMBERIAN SEDUHAN DAUN KELOR TERHADAP KUANTITAS AIR SUSU IBU (ASI) PADA IBU MENYUSUI BAYI 0-6 BULAN DI WILAYAH KERJA PUSKESMAS SUMUR BATU KOTA BANDAR LAMPUNG

2020 ◽  
Vol 2 (3) ◽  
pp. 549-558
Author(s):  
Eka Trismiyana ◽  
Mei Kurnia Pitaloka
Keyword(s):  
Standard Deviation ◽  
Breast Milk ◽  
Health Center ◽  
Exclusive Breastfeeding ◽  
Standard Error ◽  
Community Health Center ◽  
P Value ◽  
Work Area ◽  
Quasi Experimental ◽  
Average Quantity

THE EFFECT OF GIVING KELOR LEAVES TOWARDS MILK (ASI) WATER QUANTITY IN 0-6 MONTHS OF BABY BREAST MILK IN WORKING AREAS OF HEALTH CENTER OF BATU BANDAR LAMPUNG CITY IN 2019 Introduction: Bandar Lampung City Health Office data shows that there are 3 Puskesmas with the lowest ASI coverage, namely Sumur Batu Health Center, with a total of 6 months exclusive breastfeeding coverage 142, as many as 102 infants (28.17%) did not receive exclusive breastfeeding at 6 months of age, and 40 ASI received exclusive breastfeeding, Way Kandis Health Center, with a total of 6 months exclusive breastfeeding coverage in 919, 621 infants (32.93%) did not receive exclusive breastfeeding aged 6 months, and 298 ASIs received exclusive breastfeeding, Kemiling Health Center, with total breastfeeding coverage exclusive 6 months 98, 62 babies (36.73%) did not get exclusive breastfeeding at the age of 6 months, and 36 ASIs received exclusive breastfeeding (Data from Bandar Lampung City Health Office, 2018). Objective: To determine the effect of administration of Moringa leaves on the quantity of breast milk in breastfeeding mothers of infants 0-6 months in the Work Area of Sumur Batu Health Center, Bandar Lampung City in 2019.Method: This type of research is quantitative. The design of the Quasi Experimental method is one group pretest-posttest one group pretest-posttest approach. Population and sample of 30 people. Data analysis uses univariate and bivariate with t-test.Results: The average quantity of breast milk in breastfeeding mothers of infants 0-6 months before being given moringa leaf steeping in the Sumur Batu Health Center Working Area, with a mean of 72.50 standard deviation 25.317 standard error 4.622, after being given steeping leaves of moringa mean 97.17 standard deviation of 17.601 standard error 3.214. P-value 0,000 (<0.05) t-test test results.Conclusion: means that there is an effect of steeping Moringa leaves on the quantity of breast milk in breastfeeding mothers of infants 0-6 months in the Sumur Batu Community Health Center Working Area in Bandar Lampung City in 2019. Suggestions for respondents are expected to be used as input for clients in order to know how to increase the smoothness of breast milk during breastfeeding. Keywords: Moringa Leaf Steeping, Breast Milk, Breastfeeding Mother  INTISARI: PENGARUH PEMBERIAN SEDUHAN DAUN KELOR TERHADAP KUANTITAS AIR SUSU IBU (ASI) PADA IBU MENYUSUI BAYI 0-6 BULAN DI WILAYAH KERJA PUSKESMAS SUMUR BATU KOTA BANDAR LAMPUNG TAHUN 2019 Pendahuluan: Data Dinas Kesehatan Kota Bandar Lampung menunjukan  bahwa terdapat 3 Puskesmas dengan cakupan pemberian ASI terendah yaitu, Puskesmas Sumur Batu, dengan total keseluruhan cakupan ASI eksklusif 6 bulan 142, sebanyak 102 bayi (28.17%) tidak mendapat ASI eksklusif usia 6 bulan, dan 40 ASI mendapat ASI eksklusif, Puskesmas Way Kandis, dengan total keseluruhan cakupan ASI eksklusif 6 bulan 919, sebanyak 621 bayi (32.93%) tidak mendapat ASI eksklusif usia 6 bulan, dan 298 ASI mendapat ASI eksklusif, Puskesmas Kemiling, dengan total keseluruhan cakupan ASI eksklusif 6 bulan 98, sebanyak 62 bayi (36.73%) tidak mendapat ASI eksklusif usia 6 bulan, dan 36 ASI mendapat ASI eksklusif (Data Dinkes Kota Bandar Lampung, 2018).Tujuan: Untuk mengetahui pengaruh pemberian seduhan daun kelor terhadap kuantitas air susu ibu (ASI) pada ibu menyusui bayi 0-6 bulan di Wilayah Kerja Puskesmas Sumur Batu Kota Bandar Lampung tahun 2019.Metode: Jenis penelitian ini adalah Kuantitatif. Desain penelitian metode Quasi Eksperimental pendekatan one group pretes-postes one group pretes-postes. Populasi dan sampel 30 orang. Analisa data mengguanakan univariat dan bivariate dengan t-tes.Hasil : Rata-rata kuantitas air susu ibu (ASI) pada ibu menyusui bayi 0-6 bulan sebelum diberi seduhan daun kelor di Wilayah Kerja Puskesmas Sumur Batu, dengan mean 72,50 standar deviasi 25,317  standar eror 4,622, setelah diberi seduhan daun kelor mean 97,17 standar deviasi 17,601  standar eror 3,214. Hasil uji t-tes p-value 0.000 (<0.05).Kesimpulan : artinya terdapat pengaruh pemberian seduhan daun kelor terhadap kuantitas air susu ibu (ASI) pada ibu menyusui bayi 0-6 bulan di Wilayah Kerja Puskesmas Sumur Batu Kota Bandar Lampung Tahun 2019. Saran bagi responden diharapkan hasil penelitian ini dapat digunakan sebagai masukan bagi klien agar dapat mengetahui bagaimana cara menambah kelancaran ASI pada masa menyusui. Kata Kunci             : Seduhan Daun Kelor, ASI, Ibu Menyusui 

FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN KEKURANGAN ENERGI KRONIS PADA IBU HAMIL

2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Negative Impact ◽  
Univariate Analysis ◽  
Good Condition ◽  
Health Centers ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Energy Deficiency ◽  
Chronic Energy Deficiency

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>

HUBUNGAN ANTARA UMUR BALITA DAN PENGETAHUAN IBU DENGAN KEJADIAN PNEUMONIA PADA BALITA DI PUSKESMAS CAMBAI TAHUN 2016

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri
Keyword(s):  
Health Center ◽  
Sampling Technique ◽  
Health Centers ◽  
Survey Method ◽  
Maternal Knowledge ◽  
Chi Square ◽  
Cross Sectional ◽  
Significance Level ◽  
Care Workers ◽  
Important Health

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.

scholarly journals Supporting deprescribing in hospitalised patients: formative usability testing of a computerised decision support tool

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa T. Baysari ◽  
Mai H. Duong ◽  
Patrick Hooper ◽  
Michaela Stockey-Bridge ◽  
Selvana Awad ◽  
...  
Keyword(s):  
Decision Support ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Adverse Drug Events ◽  
Digital Health ◽  
Usability Testing ◽  
Routine Care ◽  
Assessment Tools ◽  
Support Tool ◽  
Hospitalised Patients

Abstract Background Despite growing evidence that deprescribing can improve clinical outcomes, quality of life and reduce the likelihood of adverse drug events, the practice is not widespread, particularly in hospital settings. Clinical risk assessment tools, like the Drug Burden Index (DBI), can help prioritise patients for medication review and prioritise medications to deprescribe, but are not integrated within routine care. The aim of this study was to conduct formative usability testing of a computerised decision support (CDS) tool, based on DBI, to identify modifications required to the tool prior to trialling in practice. Methods Our CDS tool comprised a DBI MPage in the electronic medical record (clinical workspace) that facilitated review of a patient’s DBI and medication list, access to deprescribing resources, and the ability to deprescribe. Two rounds of scenario-based formative usability testing with think-aloud protocol were used. Seventeen end-users participated in the testing, including junior and senior doctors, and pharmacists. Results Participants expressed positive views about the DBI CDS tool but testing revealed a number of clear areas for improvement. These primarily related to terminology used (i.e. what is a DBI and how is it calculated?), and consistency of functionality and display. A key finding was that users wanted the CDS tool to look and function in a similar way to other decision support tools in the electronic medical record. Modifications were made to the CDS tool in response to user feedback. Conclusion Usability testing proved extremely useful for identifying components of our CDS tool that were confusing, difficult to locate or to understand. We recommend usability testing be adopted prior to implementation of any digital health intervention. We hope our revised CDS tool equips clinicians with the knowledge and confidence to consider discontinuation of inappropriate medications in routine care of hospitalised patients. In the next phase of our project, we plan to pilot test the tool in practice to evaluate its uptake and effectiveness in supporting deprescribing in routine hospital care.

scholarly journals Development and validation of the Readiness to Train Assessment Tool (RTAT)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ianita Zlateva ◽  
Amanda Schiessl ◽  
Nashwa Khalid ◽  
Kerry Bamrick ◽  
Margaret Flinter
Keyword(s):  
United States ◽  
Factor Analysis ◽  
Conceptual Framework ◽  
Health Center ◽  
Assessment Tool ◽  
Training Programs ◽  
Health Professions ◽  
Internal Consistency Reliability ◽  
The United States ◽  
Health Centers

Abstract Background In recent years, health centers in the United States have embraced the opportunity to train the next generation of health professionals. The uniqueness of the health centers as teaching settings emphasizes the need to determine if health professions training programs align with health center priorities and the nature of any adjustments that would be needed to successfully implement a training program. We sought to address this need by developing and validating a new survey that measures organizational readiness constructs important for the implementation of health professions training programs at health centers where the primary role of the organizations and individuals is healthcare delivery. Methods The study incorporated several methodological steps for developing and validating a measure for assessing health center readiness to engage with health professions programs. A conceptual framework was developed based on literature review and later validated by 20 experts in two focus groups. A survey-item pool was generated and mapped to the conceptual framework and further refined and validated by 13 experts in three modified Delphi rounds. The survey items were pilot-tested with 212 health center employees. The final survey structure was derived through exploratory factor analysis. The internal consistency reliability of the scale and subscales was evaluated using Chronbach’s alpha. Results The exploratory factor analysis revealed a 41-item, 7-subscale solution for the survey structure, with 72% of total variance explained. Cronbach’s alphas (.79–.97) indicated high internal consistency reliability. The survey measures: readiness to engage, evidence strength and quality of the health professions training program, relative advantage of the program, financial resources, additional resources, implementation team, and implementation plan. Conclusions The final survey, the Readiness to Train Assessment Tool (RTAT), is theoretically-based, valid and reliable. It provides an opportunity to evaluate health centers’ readiness to implement health professions programs. When followed with appropriate change strategies, the readiness evaluations could make the implementation of health professions training programs, and their spread across the United States, more efficient and cost-effective. While developed specifically for health centers, the survey may be useful to other healthcare organizations willing to assess their readiness to implement education and training programs.

scholarly journals Exploring country-wide equitable government health care facility access in Uganda

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nicholas Dowhaniuk
Keyword(s):  
Health Care ◽  
Random Forest ◽  
Health Center ◽  
Travel Time ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Walking Distance ◽  
Laboratory System ◽  
Government Health ◽  
Sub Saharan

Abstract Background Rural access to health care remains a challenge in Sub-Saharan Africa due to urban bias, social determinants of health, and transportation-related barriers. Health systems in Sub-Saharan Africa often lack equity, leaving disproportionately less health center access for the poorest residents with the highest health care needs. Lack of health care equity in Sub-Saharan Africa has become of increasing concern as countries enter a period of simultaneous high infectious and non-communicable disease burdens, the second of which requires a robust primary care network due to a long continuum of care. Bicycle ownership has been proposed and promoted as one tool to reduce travel-related barriers to health-services among the poor. Methods An accessibility analysis was conducted to identify the proportion of Ugandans within one-hour travel time to government health centers using walking, bicycling, and driving scenarios. Statistically significant clusters of high and low travel time to health centers were calculated using spatial statistics. Random Forest analysis was used to explore the relationship between poverty, population density, health center access in minutes, and time saved in travel to health centers using a bicycle instead of walking. Linear Mixed-Effects Models were then used to validate the performance of the random forest models. Results The percentage of Ugandans within a one-hour walking distance of the nearest health center II is 71.73%, increasing to 90.57% through bicycles. Bicycles increased one-hour access to the nearest health center III from 53.05 to 80.57%, increasing access to the tiered integrated national laboratory system by 27.52 percentage points. Significant clusters of low health center access were associated with areas of high poverty and urbanicity. A strong direct relationship between travel time to health center and poverty exists at all health center levels. Strong disparities between urban and rural populations exist, with rural poor residents facing disproportionately long travel time to health center compared to wealthier urban residents. Conclusions The results of this study highlight how the most vulnerable Ugandans, who are the least likely to afford transportation, experience the highest prohibitive travel distances to health centers. Bicycles appear to be a “pro-poor” tool to increase health access equity.

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