Chinese Americans’ use of patient portal systems: a scoping review (Preprint)

2021 ◽  
Author(s):  
Katharine Lawrence ◽  
Stella Chong ◽  
Holly Krelle ◽  
Timothy Roberts ◽  
Lorna Thorpe ◽  
...  

BACKGROUND Patient portals are increasingly deployed in healthcare systems as communication and information-sharing tools for patients and providers. While portals show promise in addressing healthcare access, quality, and outcomes, research on portal access and use patterns among diverse populations is limited, including among Chinese Americans. OBJECTIVE This study aimed to summarize existing evidence on the access and use patterns, barriers, and facilitators of patient portals among Chinese Americans, and to identify gaps and areas for future research. METHODS The authors conducted a scoping review using the PRISMA Protocol for Scoping Reviews of articles published in major databases (MEDLINE, Embase, PsycINFO) on the topic of patient portals and Chinese Americans. Authors independently reviewed the papers during initial screening and full-text review. The studies were analyzed and coded for study method type, sample population, and main outcomes of interest. RESULTS In total 17 articles were selected for inclusion in the review. The included articles varied in study aims, methodology, data collection, sample population, and geographic areas of study. The majority of studies were cross-sectional in nature. Major findings and themes identified from the articles include: variable patterns of patient portal access and use among Chinese Americans compared to other racial/ethnic groups; limited evidence on the specific barriers and facilitators of access and use for this group; a reliance on quantitative proxy measures (e.g. log-ins, click-throughs) to assess portal access and use; and a pattern of aggregating Chinese American-related data into a larger Asian or Asian American designation. CONCLUSIONS There is limited research dedicated to understanding the use patterns, experiences, and needs of Chinese Americans who access and utilize patient portal systems. Most research is cross-sectional, focusing on disparities in use and access, and have tended to aggregate the Chinese American experience into that of Asian Americans. Future research should focus specifically on Chinese Americans and prioritize more detailed evaluations of their relationship to patient portal technology to understand specific use patterns, preferences, and needs. A broader understanding of the diversity of health technology users can help ensure applicable and equitable design, development, and implementation of these tools. CLINICALTRIAL N/a

2021 ◽  
Author(s):  
M. Pilar Ingle ◽  
Cristina Valdovinos ◽  
Kelsey L. Ford ◽  
Shou Zhou ◽  
Sheana Bull ◽  
...  

BACKGROUND Although patient portals are widely used for health promotion, little is known about use of palliative care and end-of-life (PCEOL) portal tools available for patients and caregivers. OBJECTIVE To identify and assess user perspectives of PCEOL portal tools available to patients and caregivers described and evaluated in the literature. METHODS A scoping review of the academic literature directed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR). We searched three databases. Sources were included if they reported the development or testing of a feature, resource, tool, or intervention, focused on at least one PCEOL domain defined by the National Coalition for Hospice and Palliative Care, targeted adults with serious illness and/or caregivers, and were offered via patient portal tethered to an electronic medical record. Authors independently screened titles and abstracts (N=796) for eligibility. Full texts (N=84) sources were reviewed. Descriptions of the portal tool name, content, targeted population, and reported user acceptability for each tool were abstracted from included sources (N=19). RESULTS Nineteen articles describing 12 tools were included, addressing the following PCEOL domains: ethical/legal (N=5), physical (N=5), and psychological/psychiatric (N=2). No tools for bereavement or hospice were identified. Studies reported high acceptability of tools among users; however, few sources commented on usability among older adults. CONCLUSIONS PCEOL patient portal tools are understudied. As medical care increasingly moves towards virtual platforms, future research should investigate the usability and acceptability of PCEOL patient portals resources and evaluate their impact on health outcomes.


Author(s):  
Anna Lee ◽  
Kathleen Knafl ◽  
Marcia Van Riper

The purpose of this scoping review was to identify the family and child quality of life variables that have been studied in relation to one another in children with Down syndrome, the frequency with which different relationships have been studied, and the extent to which family variables were the focus of the research aims. A literature search was conducted to find studies published between January 2007 and June 2018. The initial search yielded 2314 studies; of these, 43 were selected for a final review. Researchers most often addressed family resources and family problem-solving and coping concerning child personal development and physical well-being. Little attention to child emotional well-being was observed, with none considering family appraisal of child emotional well-being. The relationship between family variables and child QoL rarely was the primary focus of the study. Methodologically, most reviewed studies used cross-sectional designs, were conducted in North America and based on maternal report. From future research considering the issues found in this review, healthcare providers can obtain an in-depth understanding of relationships between children and family variables.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1955.2-1955
Author(s):  
K. O Donoghue ◽  
L. Larkin

Background:Physical activity is an important aspect in the management of JIA (1). However physical activity levels are low in this population (2). Limited research has been conducted to identify definitive barriers and facilitators to physical activity in children and adolescents who have JIA.Objectives:The objective of this scoping review was to identify the common barriers and facilitators to physical activity in JIA.Methods:Original studies, either quantitative or qualitative, including participants with a diagnosis of JIA, who were under 18 years of age were included. Two independent reviewers carried out a search of the literature and full text reviews of papers to determine eligibility for inclusion. The Critical Skills Appraisal Programme (CASP), Appraisal tool for Cross-Sectional Studies (AXIS) and Downs and Black critical appraisal tools were used to assess the quality of the included research articles.Results:Eighteen studies were included in the review. The included studies were of a variety of low, moderate and high quality. The synthesis of the data identified pain to be the most common barrier and the modification of physical activities to the need of the individual to be the most common facilitator to physical activity in JIA.Conclusion:Identifying the most common barriers and facilitators to physical activity allows clinicians to apply better management strategies when treating an individual with JIA. Our findings demonstrate the need for further research in this area to assist increasing physical activity participation for children and adolescents who have JIA.References:[1]Kuntze, G., Nesbitt, C., Whittaker, J.L., Nettel-Aguirre, A., Toomey, C., Esau, S., Doyle-Baker, P.K., Shank, J., Brooks, J., Benseler, S., Emery, C.A. (2018) ‘Exercise Therapy in Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis’,Archives of Physical Medicine and Rehabilitation, 99(1), 178-193[2]Bos, G.J.F.J., Lelieveld, O.T.H.M., Armbrust, W., Sauer, P.J.J., Geertzen, J.H.B., Dijkstra, P.U. (2016) ‘Physical activity in children with Juvenile Idiopathic Arthritis compared to controls’, Pediatric Rheumatology, 14(1), 42.Disclosure of Interests:None declared


2020 ◽  
Author(s):  
Kea Turner ◽  
Alecia Clary ◽  
Young-Rock Hong ◽  
Amir Alishahi Tabriz ◽  
Christopher M Shea

BACKGROUND Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. OBJECTIVE This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. METHODS Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. RESULTS The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; <i>P</i>=.01). Older age (OR 1.01, 95% CI 1.00-1.02; <i>P</i>&lt;.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; <i>P</i>&lt;.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; <i>P</i>=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; <i>P</i>&lt;.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; <i>P</i>&lt;.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; <i>P</i>&lt;.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; <i>P</i>&lt;.001) had significantly higher odds of indicating that they were uncomfortable with a computer. CONCLUSIONS The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.


Author(s):  
Joana Ribeiro ◽  
Cláudia Dias ◽  
Valter Cardoso Barbosa Filho ◽  
José Cruz ◽  
António Fonseca

Abstract This article presents a scoping review of the published literature on mental imagery in the context of volleyball. Four online databases and one peer-reviewed journals were searched, based on the inclusion criteria. Publication information, procedures and research methods, sample characteristics, sport type and type of mental imagery were analyzed. The selection process found 52 studies, and results showed that from 1987 to 2018 the mental images, along with other psychological skills, have gained popularity in volleyball settings. The examined studies used cross-sectional and experimental approaches, and the analysis was assessed by quantitative data and/ or mental imagery training programs (with relaxation and scripts), mainly focusing on the isolated analysis of the mental imagery construct, and evaluating its use. The studies included both male and female participants, but only 11% were volleyball players. Additionally, the focus was on adolescents and young adult athletes, mostly from high school/ university or international/ elite levels. However, just two studies examined athletes under the age of 16. Considering the present study’s results, limitations, and its implications for practice (e. g. to provide the coach certification programs with specific mental imagery contents), future research directions were highlighted, such as improve mental imagery training programs for children and youth volleyball players.


2019 ◽  
Vol 59 (6) ◽  
pp. e802-e815 ◽  
Author(s):  
Ifah Arbel ◽  
Kathleen S Bingham ◽  
Deirdre R Dawson

Abstract Background and Objectives Sex and gender differences among dementia spousal caregivers have been investigated, but never systematically reviewed or synthesized. A synthesis of findings can help facilitate specificity in practice and in health policy development. As a first step towards such a synthesis, this scoping review reports the available evidence, identifies research gaps, and suggests possible directions for future research. Research Design and Methods A scoping review methodology was used to identify articles, and to chart and analyze data. Systematic searches for published, empirical studies, with an explicit goal or hypothesis related to sex or gender differences were conducted in seven databases. Results Sixty-one studies met inclusion criteria. Most (n = 45) were quantitative, cross-sectional studies. Caregivers included in the studies were generally 61–70 years old, Caucasian, middle-class, and highly educated. The most extensively investigated differences are: depression, burden, objective physical health, and informal supports. Discussion and Implications This scoping review is the first to summarize and critique the research on sex and gender differences that are specific to dementia spousal caregivers. The review can be used by researchers to make decisions regarding future systematic reviews and primary studies. To further strengthen the evidence base, future studies may benefit from including more caregivers of ethnic minorities, using more qualitative, longitudinal, or experimental designs, and focusing on variables needed to inform caregiving models and theories. Overall, this scoping review contributes to furthering gender-sensitive practices and policies that are better tailored to the specific needs of this population.


2020 ◽  
Vol 11 ◽  
Author(s):  
Joseph Baker ◽  
Stuart Wilson ◽  
Kathryn Johnston ◽  
Nima Dehghansai ◽  
Aaron Koenigsberg ◽  
...  

Several recent systematic and targeted reviews have highlighted limitations in our understanding of talent in sport. However, a comprehensive profile of where the scientific research has focused would help identify gaps in current knowledge. Our goal in this scoping review was (a) to better understand what others have done in the field of research (e.g., what groups have been examined using what research designs and in what areas), (b) to summarize the constituent areas of research in a meaningful way, (c) to help identify gaps in the research, and (d) to encourage future research to address these gaps. Peer-reviewed articles written in English that met several inclusion criteria were analyzed. A total of 1,899 articles were identified, and the descriptive findings revealed a relatively narrow focus of research on talent in sport. Specifically, the majority of examined articles focused on (a) males only, (b) the sport of soccer, (c) perceptual cognitive variables, (d) developing athletes, (e) adult samples, and (f) cross-sectional designs. For better or worse, the concept of talent remains a central element of how coaches, practitioners, and scientists think about athlete development. Findings from this scoping review highlight the continued need to explore issues related to talent identification, selection, and development in more diverse samples (e.g., female athletes and younger ages) and contexts (e.g., from Africa, Asia, and South America). There is also a clear necessity to focus on under-researched areas using alternative methodologies.


2021 ◽  
Author(s):  
Maria Sääskilahti ◽  
Anna Ojanen ◽  
Riitta Ahonen ◽  
Johanna Timonen

BACKGROUND Patient engagement is a worldwide trend in health care. Patient portals have the potential to increase patients’ knowledge about their health and care and therefore enhance patient engagement. Portal users’ experiences are needed to determine if these portals work appropriately and if there are barriers to achieving the aims that were set before their implementation. OBJECTIVE The aim of this study is to analyze pharmacy customers’ experiences of the Finnish nationwide patient portal My Kanta in terms of benefits, problems, and potential improvements. METHODS A questionnaire survey was conducted among pharmacy customers in the spring of 2019. The questionnaires (N=2866) were distributed from 18 community pharmacies across mainland Finland to customers aged ≥18 years who were purchasing prescription medicines for themselves or their children aged &lt;18 years. Using open-ended questions, customers were asked about their experiences of the benefits and problems of My Kanta and what improvements could be made. Their responses were encoded and categorized using inductive content analysis, stored in SPSS Statistics for Windows, and analyzed using frequencies. RESULTS Of the 2866 questionnaires, a total of 994 (34.68%) questionnaires were included in the analysis. Most respondents were My Kanta users (820/994, 82.5%); of these 820 users, 667 (81.3%) reported at least one benefit, 311 (37.9%) reported at least one problem, and 327 (39.9%) reported at least one potential improvement when using My Kanta. The most commonly mentioned benefits were opportunities to view health data (290/667, 43.5%) and prescriptions (247/667, 37%) and to renew prescriptions (220/667, 33%). The most extensively reported problems with My Kanta were that the portal lacks health data (71/311, 22.8%), navigating the service and searching for information is difficult (68/311, 21.9%), and the delay before health data are incorporated into the service (41/311, 13.2%). The most frequently suggested potential improvements were that My Kanta needs more comprehensive health data (89/327, 27.2%); the service should be easier to navigate and information easier to access (71/327, 21.7%); the service should have more functions (51/327, 15.6%); and health data should be entered into the portal more promptly (47/327, 14.4%). CONCLUSIONS Pharmacy customers reported more benefits than problems or potential improvements regarding the use of My Kanta. The service is useful for viewing health data and prescriptions and for renewing prescriptions. However, portal users would like to see more data and functions available in the portal and data searches to be made easier. These improvements could make the data and functions provided by the portal easier to view and use and hence promote patient engagement.


2021 ◽  
Author(s):  
Julie A. Wright ◽  
Julie E Volkman ◽  
Suzanne G Leveille ◽  
Daniel J. Amante

BACKGROUND Self-management of health is becoming increasingly more influenced by Health IT as online patient portals become more common. Patient portals allow patients direct access to their health information and opportunities to engage with their healthcare team. Data suggest that e-Health literacy is an important skill for using portals. Emerging adults (EA; ages 18-29), while generally healthy, are regular users of the healthcare system. A good understanding about their use of online patient portals and how their e-Health literacy skills impact their use is lacking. OBJECTIVE To describe patient portal use and explore the predictors of portal use among a diverse sample of EAs. METHODS A convenience sample, cross-sectional survey study was conducted at two universities. Demographics, healthcare visits, e-Health literacy, patient engagement and use of patient portal features (administrative and clinical) were asked. Logistic regression models were used to examine factors associated with portal use. RESULTS Of the 340 EAs (76% female, 65% white, 47% low income), 54% reported having patient portal access. Of those reporting access, 77% used at least 1 portal feature and 23% reported using none. Significant predictors were patient engagement (OR 1.08, 95% CI 1.04-1.13, p=.001;) and total encounters (OR 1.23, 95% CI 1.05-1.44, p=.009;) but not e-Health literacy. Hispanic and Asian EAs were more likely to be frequent users of clinical portal features than white EAs (Hispanic, OR 2.97, 95%CI 1.03-8.52 p=.043; and Asian, OR 4.28, 95%CI 1.08-16.89, p=.038). CONCLUSIONS Surprisingly, e-Health literacy did not predict use of patient portals in this diverse sample of EAs. Moreover, there may be ethnic differences that are important for healthcare systems to consider. Interventions to promote patient portal use, an essential self-management skill, should include strategies to increase patient engagement with patient portals in EA populations. CLINICALTRIAL N/A


2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e19-e21
Author(s):  
Dan Devoe ◽  
Thomas Lange ◽  
Pauline MacPherson ◽  
Dillon Traber ◽  
Rosemary Perry ◽  
...  

Abstract Primary Subject area Mental Health Background The transition from high school to postsecondary is a critical milestone for independence and empowerment. This life stage frequently coincides with the emergence of most mental health conditions (MHCs). Without adequate support to assist with the transition to postsecondary education, the mental health of arriving students with existing MHCs is likely to decline or remain unmet. Declining mental health is strongly associated with students withdrawing from both secondary and postsecondary education. However, a scoping review of interventions aiming to support youth with MHCs transition to postsecondary has not been conducted. Objectives The objectives of this scoping review were to identify: (1) researched interventions that support youth with MHCs during the transition to postsecondary; (2) best practices used to support this transition; (3) methods of evaluating these interventions and any limitations; and (4) gaps where future research is warranted. Design/Methods A database search of MEDLINE, PsycINFO, Embase, SocINDEX, ERIC, CINHAL, and Education Research Complete was undertaken. Two reviewers independently screened studies and extracted the data. Thematic analysis and risk-of-bias assessment were conducted on included studies. Results Nine studies were included in this review, describing eight unique interventions (Figure 1). Sixty-two percent of interventions were nonspecific in the MHCs that they were targeting in postsecondary students. These interventions were designed to support students upon arrival to postsecondary. Peer mentorship, student engagement, and interagency collaboration were found to be beneficial approaches to supporting youth transitioning into postsecondary (Table 1). The overall quality and level of evidence in these studies was low. Three knowledge gaps were found: evidence was not generalizable to the diversity of MHCs, intervention studies were mostly cross-sectional in nature and lacked follow-up data, and sustaining intervention funding remained a challenge for postsecondary institutions. Conclusion The volume of research identified was limited but indicated overall that offering support during the transition to postsecondary was beneficial for students with MHCs. Further evidence is needed that is generalizable across the mental health spectrum, and that assesses intervention outcomes in relation to intervention costs.


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