Chatbots to Support People with Dementia and Their Caregivers: A Systematic Review of Functions and Quality (Preprint)

BACKGROUND Over the past decade, there has been an increase in the use of information technologies to educate and support persons with dementia and their family caregivers. At the same time, chatbot technologies have become increasingly popular for use by the public and have been identified as having benefits for healthcare delivery. However, little remains known about how chatbot technologies may benefit persons with dementia and their caregivers. OBJECTIVE Our aim was to identify the types of currently available chatbots that are designed for use by persons with dementia and their caregivers and to assess their quality of features and content. METHODS Chatbots were identified through a systematic search of Google Play, the IOS store, Alexa skills, and the web. An evidence-based assessment tool was used to evaluate the features and content of the identified apps. The assessment was conducted through inter-rater agreement among four separate reviewers. RESULTS Of the 505 initial chatbots identified, six were included in the review. The chatbots assessed varied significantly in content and scope. While chatbots were generally found to be easy to use, there were noted limitations to their performance and programmed content for dialogue. CONCLUSIONS While chatbot technologies have become well-established and commonly used by the public, their development for persons with dementia and their caregivers is in its infancy. Given the successful use of chatbots for other healthcare settings and applications, there are opportunities for integrating this technology into dementia care. However, more evidence-based chatbots that have undergone end-user evaluation are needed to evaluate their potential for adequately educating and supporting these populations.

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Comprehensively addressing postpartum maternal health: a content and image review of commercially available mobile health apps

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03785-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Laura Tucker ◽

Alan Cuevas Villagomez ◽

Tamar Krishnamurti

Keyword(s):

Maternal Health ◽

Health Information ◽

Mobile Health ◽

Rating Scale ◽

The United States ◽

People Of Color ◽

Evidence Based ◽

Or Education ◽

Google Play

Abstract Background The United States is currently facing a maternal morbidity and mortality crisis, with the highest rates of any resource-rich nation. In efforts to address this, new guidelines for postpartum care suggest that mobile health (mHealth) apps can help provide complementary clinical support for new mothers during the postpartum period. However, to date no study has evaluated the quality of existing mHealth tools targeted to this time period in terms of sufficiency of maternal health information, inclusivity of people of color, and app usability. Methods Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards were used to review the peripartum apps from the Apple and Google Play stores in either the Health/Fitness, Medical, or Education categories. Apps were evaluated for extent and quality of maternal health information and inclusivity of people of color using an a priori coding scheme. App usability was evaluated using the Mobile Application Rating Scale (MARS) score. Results Of the 301 apps from the Apple and Google Play stores, 25 met criteria for final evaluation. Of the 30 maternal health topics coded for, the median number addressed by apps was 19.5 (65%). Peripartum behaviors were more frequently addressed than peripartum outpatient care topics and peripartum acute health risks. The coverage of maternal health information and inclusivity of people of color in app imagery both correlated positively with the MARS usability score of the app. Only 8 apps (32%) portrayed greater than 24% images of people of color- the percent of non-white Americans according to 2019 census estimates. There was no correlation between MARS usability score and number of app users, as estimated by number of ratings for the app available on the app store. In addition, apps with evidence-based maternal health information had greater MARS engagement, information, and aesthetics scores. However, presence of evidence-based information did not correlate with greater numbers of app users. Conclusions Current commercially available peripartum apps range widely in quality. Overall current app offerings generally do not provide adequate maternal health information and are not optimally accessible to the target users in terms of inclusivity of women of color or app usability. Apps delivering evidence-based information and more usable design are more likely to meet these standards but are not more likely to be downloaded by users.

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Evidence based medicine? Access to information & medicines regulation in New Zealand

10.26686/wgtn.17006779.v1 ◽

2021 ◽

Author(s):

◽

Amy Hill

Keyword(s):

New Zealand ◽

Regulatory Regime ◽

Pharmaceutical Companies ◽

Evidence Based ◽

Access To Information ◽

The Public ◽

The World ◽

Medicines Regulation ◽

Based Medicine

<p>This paper explores one very important issue in the regulatory regime for medicines in New Zealand and around the world- the deficit of information about medicines available to doctors, patients and independent researchers. Much of the information about safety, efficacy and quality of drugs is held and controlled by pharmaceutical companies and regulators. The public is entitled to this information in full.</p>

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Quality assessment of nutrition coverage in the media: a 6-week survey of five popular UK newspapers

BMJ Open ◽

10.1136/bmjopen-2016-014633 ◽

2017 ◽

Vol 7 (12) ◽

pp. e014633 ◽

Cited By ~ 12

Author(s):

Alice R Kininmonth ◽

Nafeesa Jamil ◽

Nasser Almatrouk ◽

Charlotte E L Evans

Keyword(s):

Health Outcome ◽

Quality Assessment ◽

Assessment Tool ◽

Poor Quality ◽

Quality Score ◽

Food Type ◽

The Public ◽

Day Of The Week ◽

Article Quality

ObjectivesTo investigate the quality of nutrition articles in popular national daily newspapers in the UK and to identify important predictors of article quality.SettingNewspapers are a primary source of nutrition information for the public.DesignNewspaper articles were collected on 6 days of the week (excluding Sunday) for 6 weeks in summer 2014. Predictors included food type and health outcome, size of article, whether the journalist was named and day of the week.Outcome measuresA validated quality assessment tool was used to assess each article, with a minimum possible score of −12 and a maximum score of 17. Newspapers were checked in duplicate for relevant articles. The association of each predictor on article quality score was analysed adjusting for remaining predictors. A logistic regression model was implemented with quality score as the binary outcome, categorised as poor (score less than zero) or satisfactory (score of zero or more).ResultsOver 6 weeks, 141 nutrition articles were included across the five newspapers. The median quality score was 2 (IQR −2–6), and 44 (31%) articles were poor quality. There was no substantial variation in quality of reporting between newspapers once other factors such as anonymous publishing, health outcome, aspect of diet covered and day of the week were taken into account. Particularly low-quality scores were obtained for anonymously published articles with no named journalist, articles that focused on obesity and articles that reported on high fat and processed foods.ConclusionsThe general public are regularly exposed to poor quality information in newspapers about what to eat to promote health, particularly articles reporting on obesity. Journalists, researchers, university press officers and scientific journals need to work together more closely to ensure clear, consistent nutrition messages are communicated to the public in an engaging way.

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Measuring quality of life of people with predementia and dementia and their caregivers: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2017-019082 ◽

2018 ◽

Vol 8 (3) ◽

pp. e019082 ◽

Cited By ~ 7

Author(s):

Filipa Landeiro ◽

Katie Walsh ◽

Isaac Ghinai ◽

Seher Mughal ◽

Elsbeth Nye ◽

...

Keyword(s):

Quality Of Life ◽

Literature Review ◽

Systematic Literature Review ◽

Assessment Tool ◽

Public Health Practice ◽

Data Access ◽

Cochrane Central Register ◽

Full Spectrum ◽

People With Dementia

IntroductionDementia is the fastest growing major cause of disability globally and may have a profound impact on the health-related quality of life (HRQoL) of both the patient with dementia and those who care for them. This review aims to systematically identify and synthesise the measurements of HRQoL for people with, and their caregivers across the full spectrum of, dementia from its preceding stage of predementia to end of life.Methods and analysisA systematic literature review was conducted in Medical Literature Analysis and Retrieval System Online , ExcerptaMedicadataBASE, Cochrane Database of Systematic Reviews , Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effect, National Health Service Economic Evaluation Database and PsycINFO between January 1990 and the end of April 2017. Two reviewers will independently assess each study for inclusion and disagreements will be resolved by a third reviewer. Data will be extracted using a predefined data extraction form following best practice. Study quality will be assessed with the Effective Public Health Practice Project quality assessment tool. HRQoL measurements will be presented separately for people with dementia and caregivers by instrument used and, when possible, HRQoL will be reported by disease type and stage of the disease. Descriptive statistics of the results will be provided. A narrative synthesis of studies will also be provided discussing differences in HRQoL measurements by instrument used to estimate it, type of dementia and disease severity.Ethics and disseminationThis systematic literature review is exempt from ethics approval because the work is carried out on published documents. The findings of the review will be disseminated in a related peer-reviewed journal and presented at conferences. They will also contribute to the work developed in the Real World Outcomes across the Alzheimer’s disease spectrum for better care: multimodal data access platform (ROADMAP).Trial registration numberCRD42017071416.

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Impact of Health Information Technologies on the Quality of Healthcare Deliveries

International Journal of Applied Research on Public Health Management ◽

10.4018/ijarphm.2021010103 ◽

2021 ◽

Vol 6 (1) ◽

pp. 30-44

Author(s):

Patricia Whitley ◽

Hossain Shahriar ◽

Sweta Sneha

Keyword(s):

Patient Care ◽

Health Information ◽

Medical Errors ◽

Information Technologies ◽

Healthcare Delivery ◽

Well Being ◽

Quality Of Healthcare ◽

Quality Healthcare ◽

The Impact

Through a literary review of recent research, this paper examines the mixed impact of health information technology (HIT) on patient care, medical errors, and the quality of healthcare delivery in selected hospital settings such as emergency departments. Specific technologies examined include the electronic health record (EHR), medical devices, artificial intelligence, and robotics. The paper identifies that some healthcare technologies are increasingly valuable in reducing medical errors, improving healthcare quality, and in producing better patient-centered outcomes. It also determines that technologies have complicated the delivery of quality patient care, increased the incidences of clinician burnout, and made receiving quality healthcare in America's hospital systems possibly less sure. The paper concludes with some suggestions for improving HIT's implementations and confirms the need for further evaluation of the impact of HIT in increasing patient safety and clinician well-being.

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Validation evidence of the paediatric Objective Structured Assessment of Debriefing (OSAD) tool

BMJ Simulation and Technology Enhanced Learning ◽

10.1136/bmjstel-2015-000017 ◽

2016 ◽

Vol 2 (3) ◽

pp. 61-67 ◽

Cited By ~ 4

Author(s):

Jane Runnacles ◽

Libby Thomas ◽

James Korndorffer ◽

Sonal Arora ◽

Nick Sevdalis

Keyword(s):

Assessment Tool ◽

Learning Experience ◽

Pearson Correlation ◽

Phase 1 ◽

Evidence Based ◽

Validity Evidence ◽

Multiple Sources ◽

Simulation Based ◽

Expert Input

IntroductionDebriefing is essential to maximise the simulation-based learning experience, but until recently, there was little guidance on an effective paediatric debriefing. A debriefing assessment tool, Objective Structured Assessment of Debriefing (OSAD), has been developed to measure the quality of feedback in paediatric simulation debriefings. This study gathers and evaluates the validity evidence of OSAD with reference to the contemporary hypothesis-driven approach to validity.MethodsExpert input on the paediatric OSAD tool from 10 paediatric simulation facilitators provided validity evidence based on content and feasibility (phase 1). Evidence for internal structure validity was sought by examining reliability of scores from video ratings of 35 postsimulation debriefings; and evidence for validity based on relationship to other variables was sought by comparing results with trainee ratings of the same debriefings (phase 2).ResultsSimulation experts’ scores were significantly positive regarding the content of OSAD and its instructions. OSAD's feasibility was demonstrated with positive comments regarding clarity and application. Inter-rater reliability was demonstrated with intraclass correlations above 0.45 for 6 of the 7 dimensions of OSAD. The internal consistency of OSAD (Cronbach α) was 0.78. Pearson correlation of trainee total score with OSAD total score was 0.82 (p<0.001) demonstrating validity evidence based on relationships to other variables.ConclusionThe paediatric OSAD tool provides a structured approach to debriefing, which is evidence-based, has multiple sources of validity evidence and is relevant to end-users. OSAD may be used to improve the quality of debriefing after paediatric simulations.

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Change and improvement 50 years in the making: a scoping review of the use of soft systems methodology in healthcare

BMC Health Services Research ◽

10.1186/s12913-020-05929-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Hanna Augustsson ◽

Kate Churruca ◽

Jeffrey Braithwaite

Keyword(s):

Scoping Review ◽

Assessment Tool ◽

Soft Systems Methodology ◽

Local Context ◽

Problem Situation ◽

Systems Methodology ◽

Soft Systems ◽

Problem Situations ◽

Healthcare Settings

Abstract Introduction Improving the quality of healthcare has proven to be a challenging task despite longstanding efforts. Approaches to improvements that consider the strong influence of local context as well as stakeholders’ differing views on the situation are warranted. Soft systems methodology (SSM) includes contextual and multi-perspectival features. However, the way SSM has been applied and the outcomes of using SSM to stimulate productive change in healthcare have not been sufficiently investigated. Aim This scoping review aimed to examine and map the use and outcomes of SSM in healthcare settings. Method The review was based on Arksey and O’Malley’s framework. We searched six academic databases to January 2019 for peer-reviewed journal articles in English. We also reviewed reference lists of included citations. Articles were included if they were empirical studies focused on the application of SSM in a healthcare setting. Two reviewers conducted the abstract review and one reviewer conducted the full-text review and extracted data on study characteristics, ways of applying SSM and the outcomes of SSM initiatives. Study quality was assessed using Hawker’s Quality Assessment Tool. Result A total of 49 studies were included in the final review. SSM had been used in a range of healthcare settings and for a variety of problem situations. The results revealed an inconsistent use of SSM including departing from Checkland’s original vision, applying different tools and involving stakeholders idiosyncratically. The quality of included studies varied and reporting of how SSM had been applied was sometimes inadequate. SSM had most often been used to understand a problem situation and to suggest potential improvements to the situation but to a lesser extent to implement and evaluate these improvements. Conclusion SSM is flexible and applicable to a range of problem situations in healthcare settings. However, better reporting of how SSM has been applied as well as evaluation of different types of outcomes, including implementation and intervention outcomes, is needed in order to appreciate more fully the utility and contribution of SSM in healthcare.

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NEW APPROACHES TO THE METHODOLOGICAL FOUNDATIONS OF LABOR RATIONING IN THE PUBLIC SECTOR

social & labor researches ◽

10.34022/2658-3712-2021-45-4-28-40 ◽

2021 ◽

Vol 45 (4) ◽

pp. 28-40

Author(s):

I.B. Omel’chenko ◽

◽

V.K. Koshkina ◽

K.Yu. Chudinov ◽

◽

...

Keyword(s):

Public Sector ◽

Information Technologies ◽

Communication Technologies ◽

Electronic System ◽

Remote Work ◽

Work Intensity ◽

The Public ◽

Provision Of Services ◽

The Impact

Digital technologies are being actively introduced into our life and economy that it is often impossible to track all innovations and the resulting effect of their appearance; the population quickly adapts and gets used to them. Similar trends are observed in the public sector. Visitors to clinics, museums, Multifunctional Public Services Centers, and other institutions easily use an electronic system that puts a queue to a specialist, use various services and gadgets. Due to digitalization, remote work is gaining more popularity, especially among young people, pensioners and women. The remote work market plays a very important role in the modern economy. As an extremely complex distribution mechanism, it ensures the connection of workers to remote workplaces. Thus, it affects both productivity and growth rates, as well as many other parameters of the economy as a whole. Digitalization is becoming such an important factor in increasing labor productivity and improving the quality of life that the changes taking place in the market are considered as the onset of a new stage of economic development. Currently, the development of digitalization is primarily associated with the introduction of digital communication technologies, the platform for which is the Internet and mobile devices. Information technologies are being integrated into all spheres of economic activity. In this regard, the nature of labor, as well as labor functions are undergoing dramatic changes, the proportion of work performed remotely or using specialized software is increasing. In this regard, the work intensity (provision of services) requires attention, which directly depends on the updating of the methodology of labor rationing. Within the framework of this article, the methodological foundations of labor rationing in the public sector are analyzed, considering the impact of digitalization and automation processes on labor rationing.

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Mobile Apps for Speech-Language Therapy in Adults With Communication Disorders: Review of Content and Quality

JMIR mhealth and uhealth ◽

10.2196/18858 ◽

2020 ◽

Vol 8 (10) ◽

pp. e18858

Author(s):

Atiyeh Vaezipour ◽

Jessica Campbell ◽

Deborah Theodoros ◽

Trevor Russell

Keyword(s):

Rating Scale ◽

Mobile Apps ◽

Communication Disorders ◽

Mobile App ◽

Evidence Based ◽

Language Therapy ◽

Eligibility Criteria ◽

App Store ◽

Google Play

Background Worldwide, more than 75% of people with acquired brain injury (ABI) experience communication disorders. Communication disorders are impairments in the ability to communicate effectively, that is, sending, receiving, processing, and comprehending verbal and nonverbal concepts and symbols. Such disorders may have enduring impacts on employment, social participation, and quality of life. Technology-enabled interventions such as mobile apps have the potential to increase the reach of speech-language therapy to treat communication disorders. However, ensuring that apps are evidence-based and of high quality is critical for facilitating safe and effective treatment for adults with communication disorders. Objective The aim of this review is to identify mobile apps that are currently widely available to adults with communication disorders for speech-language therapy and to assess their content and quality using the validated Mobile App Rating Scale (MARS). Methods Google Play Store, Apple App Store, and webpages were searched to identify mobile apps for speech-language therapy. Apps were included in the review if they were designed for the treatment of adult communication disorders after ABI, were in English, and were either free or for purchase. Certified speech-language pathologists used the MARS to assess the quality of the apps. Results From a total of 2680 apps identified from Google Play Store, Apple App Store, and web searches, 2.61% (70/2680) apps met the eligibility criteria for inclusion. Overall, 61% (43/70) were available for download on the iPhone Operating System (iOS) platform, 20% (14/70) on the Android platform, and 19% (13/70) on both iOS and Android platforms. A content analysis of the apps revealed 43 apps for language, 17 apps for speech, 8 apps for cognitive communication, 6 apps for voice, and 5 apps for oromotor function or numeracy. The overall MARS mean score was 3.7 out of 5, SD 0.6, ranging between 2.1 and 4.5, with functionality being the highest-scored subscale (4.3, SD 0.6), followed by aesthetics (3.8, SD 0.8), information (3.4, SD 0.6), and engagement (3.3, SD 0.6). The top 5 apps were Naming Therapy (4.6/5), Speech Flipbook Standard (4.6/5), Number Therapy (4.5/5), Answering Therapy, and Constant Therapy (4.4/5). Conclusions To our knowledge, this is the first study to systematically identify and evaluate a broad range of mobile apps for speech-language therapy for adults with communication disorders after sustaining ABI. We found a lack of interactive and engaging elements in the apps, a critical factor in sustaining self-managed speech-language therapy. More evidence-based apps with a focus on human factors, user experience, and a patient-led design approach are required to enhance effectiveness and long-term use.

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Interprofessional Evidence-Based Practice Education: Impact on Organizational Culture in Healthcare Settings

Multicolors: The International Journal of Educational Research and Theory ◽

10.33496/003 ◽

2019 ◽

pp. 12-23

Keyword(s):

Health Care ◽

Interprofessional Education ◽

Evidence Based Practice ◽

High Reliability ◽

Clinical Care ◽

Evidence Based ◽

Culture Of Safety ◽

Healthcare Settings ◽

Safety Research

A key strategy for improving the quality of health care is through the widespread implementation of evidence-based practice (EBP). Most importantly, EBP helps organizations achieve high reliability and a culture of safety. Research shows that EBP reduces morbidity, mortality, medical errors, and geographic variation in health care. This paper describes an interprofessional education intervention to transform clinical care and institutionalize EBP in one medical facility. Through the adoption of an intensive EBP training platform and the rapid implementation of EBP solutions to address traditional challenges, the organization is effectively accelerating its efforts to move from a health care system to a highly reliable system of health.

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