Message Frame-Tailoring in Digital Health Communication: Intervention Redesign and Usability Testing (Preprint)

BACKGROUND Message frame-tailoring based on the need for autonomy is a promising strategy to improve the effectiveness of digital health communication interventions. An example of a digital health communication intervention is PAS, an online content-tailored smoking cessation program. PAS was effective in improving cessation success, but its effect sizes were small and disappeared after six months. OBJECTIVE We aim to improve the effectiveness of PAS further by incorporating message frame-tailoring, providing smokers with autonomy-supportive or controlling message frames – depending on their individual need for autonomy. METHODS Various methods were used to redesign the PAS program to include message frame-tailoring with optimal usability: usability testing, think-aloud methodology, heuristic evaluations, and an online experiment. RESULTS The most autonomy-supportive and controlling message frames were identified, the cut-off point for the need for autonomy to distinguish between people with a high and low need for autonomy was determined, and the usability was optimized. CONCLUSIONS This resulted in a redesigned digital health communication intervention that included message frame-tailoring and had optimal usability. A detailed description of the redesigning process of the PAS program is provided.

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Identifying the Most Autonomy-Supportive Message Frame in Digital Health Communication: A 2x2 Between-Subjects Experiment

Journal of Medical Internet Research ◽

10.2196/14074 ◽

2019 ◽

Vol 21 (10) ◽

pp. e14074 ◽

Cited By ~ 3

Author(s):

Eline Suzanne Smit ◽

Chamoetal Zeidler ◽

Ken Resnicow ◽

Hein de Vries

Keyword(s):

Health Communication ◽

Autonomy Support ◽

Vegetable Intake ◽

Digital Health ◽

Significant Positive Effect ◽

Message Frame ◽

Overall Evaluation ◽

Perceived Relevance ◽

Perceived Autonomy Support ◽

Positive Effect

Background The effectiveness of digital health communication may be increased by enhancing autonomy supportiveness. Objective This study aimed to identify the most autonomy-supportive message frame within an intervention for increasing vegetable intake by testing the effect of the following 2 strategies: (1) using autonomy-supportive language and (2) providing choice. Methods A Web-based 2 (autonomy-supportive vs controlling language)×2 (choice vs no choice) experiment was conducted among 526 participants, recruited via a research panel. The main outcome measures were perceived autonomy support (measured using the Virtual Care Climate Questionnaire, answered with scores 1 to 5), perceived relevance (measured with one question, answered with scores 1 to 5), and overall evaluation of the intervention (measured with 1 open-ended question, answered with scores 1 to 10). Results Choice had a significant positive effect on the overall evaluation of the intervention (b=.12; P=.003), whereas for participants with a high need for autonomy, there was a significant positive effect on perceived relevance (b=.13; P=.02). The positive effect of choice on perceived autonomy support approached significance (b=.07; P=.07). No significant effects on any of the three outcomes were observed for language. Conclusions Results suggest that provision of choice rather than the use of autonomy-supportive language can be an easy-to-implement strategy to increase the effectiveness of digital forms of health communication, especially for people with a high need for autonomy.

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Public disaster mental/behavioral health communication: Intervention across disaster phases

Journal of Emergency Management ◽

10.5055/jem.2012.0106 ◽

2012 ◽

Vol 10 (4) ◽

pp. 283 ◽

Cited By ~ 15

Author(s):

J. Brian Houston, PhD

Keyword(s):

Public Health ◽

Health Communication ◽

Behavioral Health ◽

Behavioral Outcomes ◽

Communication Intervention ◽

Review Of The Literature ◽

Public Health Response ◽

Disaster Communication ◽

Health Response ◽

Communication Interventions

Background: Disasters have been found to significantly impact mental and behavioral health.1 A public health response to disaster seeks to ameliorate this impact by identifying mental/behavioral health effects resulting from an event and by promoting healthy disaster-related outcomes. Disaster communication interventions are effective tools that disaster managers can use to achieve these outcomes.Objectives: Based on a review of the literature, the objectives of this article are to describe disaster communication intervention activities and corresponding outcomes and to place those activities in a multiphase disaster communication framework.Results: The Disaster Communication Intervention Framework (DCIF) is proposed. Outcomes targeted by DCIF include improving individual and community preparedness and resilience; decreasing disaster-related distress; promoting wellness, coping, recovery, and resilience; helping a community make sense of what happened during and after a disaster; and rebuilding the community. Strategies for achieving these outcomes are described.Conclusions: DCIF provides a multiphase framework of public disaster mental/behavioral health communication intervention that can be used by disaster managers to improve mental and behavioral outcomes following a disaster.

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The power of choice. Identifying the most autonomy-supportive message frame in digital health communication (Preprint)

10.2196/preprints.14074 ◽

2019 ◽

Author(s):

Eline Suzanne Smit ◽

Chamoetal Zeidler ◽

Kenneth Resnicow ◽

Hein de Vries

Keyword(s):

Health Communication ◽

Autonomy Support ◽

Vegetable Intake ◽

Digital Health ◽

Positive Effects ◽

Message Frame ◽

Overall Evaluation ◽

Perceived Relevance ◽

Power Of Choice ◽

Perceived Autonomy Support

BACKGROUND Effectiveness of digital health communication may be increased by enhancing autonomy-supportiveness. OBJECTIVE Aim of this study was to identify the most autonomy-supportive message frame within an intervention aimed at vegetable intake, by testing the effect of two strategies, i.e. 1) using autonomy-supportive language and 2) providing choice. METHODS An online 2 (autonomy-supportive vs. controlling language) x 2 (choice vs. no choice) experiment was conducted among 526 participants, recruited via a research panel. Main outcome measures were perceived autonomy-support (VCCQ; 1-5), perceived relevance (1 item; 1-5) and overall evaluation of the intervention (1 item; 1-10). RESULTS Choice had a positive effect on the overall evaluation of the intervention (b = .12, p = .003) and for participants with a high need for autonomy also on perceived relevance (b = .13, p = .017). A trend was observed of choice having positive effects on perceived autonomy-support (b = .07, p = .065). No significant effects on any of the three outcomes were observed for language. CONCLUSIONS Results suggest that provision of choice rather than use of autonomy-supportive language can be an easy-to-implement strategy to increase the effectiveness of online computer-tailored health communication, especially for people with a high need for autonomy.

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

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01484-z ◽

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.

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Processes of knowing in the translation of a health communication intervention for dialysis patients awaiting kidney transplantation

Patient Education and Counseling ◽

10.1016/j.pec.2020.09.009 ◽

2020 ◽

Author(s):

Marit Helen Andersen ◽

Kristin Hjorthaug Urstad ◽

Marie Hamilton Larsen ◽

Eivind Engebretsen ◽

John Ødemark ◽

...

Keyword(s):

Kidney Transplantation ◽

Health Communication ◽

Communication Intervention ◽

Dialysis Patients

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Effectiveness of Digital Health Interventions on Unintentional Injury, Violence, and Suicide: Meta-Analysis

Trauma Violence & Abuse ◽

10.1177/1524838020967346 ◽

2020 ◽

pp. 152483802096734

Author(s):

Mengtong Chen ◽

Ko Ling Chan

Keyword(s):

Interpersonal Violence ◽

Care Delivery ◽

Digital Health ◽

Meta Analysis ◽

Random Effect ◽

Unintentional Injury ◽

Health Interventions ◽

Effect Sizes ◽

Future Research ◽

Face To Face

Digital technologies are increasingly used in health-care delivery and are being introduced into work to prevent unintentional injury, violence, and suicide to reduce mortality. To understand the potential of digital health interventions (DHIs) to prevent and reduce these problems, we conduct a meta-analysis and provide an overview of their effectiveness and characteristics related to the effects. We searched electronic databases and reference lists of relevant reviews to identify randomized controlled trials (RCTs) published in or before March 2020 evaluating DHIs on injury, violence, or suicide reduction. Based on the 34 RCT studies included in the meta-analysis, the overall random effect size was 0.21, and the effect sizes for reducing suicidal ideation, interpersonal violence, and unintentional injury were 0.17, 0.24, and 0.31, respectively, which can be regarded as comparable to the effect sizes of traditional face-to-face interventions. However, there was considerable heterogeneity between the studies. In conclusion, DHIs have great potential to reduce unintentional injury, violence, and suicide. Future research should explore DHIs’ successful components to facilitate future implementation and wider access.

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Randomized trial of a health communication intervention for parents of children with asthma

Journal of Asthma ◽

10.3109/02770903.2014.930881 ◽

2014 ◽

Vol 51 (9) ◽

pp. 989-995 ◽

Cited By ~ 6

Author(s):

Ivor B. Horn ◽

Stephanie J. Mitchell ◽

Catherine W. Gillespie ◽

Kristin M. Burke ◽

Leandra Godoy ◽

...

Keyword(s):

Health Communication ◽

Randomized Trial ◽

Communication Intervention ◽

Children With Asthma

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Twenty Years of Communication Intervention Research With Individuals Who Have Severe Intellectual and Developmental Disabilities

American Journal on Intellectual and Developmental Disabilities ◽

10.1352/1944-7558-115-5.364 ◽

2010 ◽

Vol 115 (5) ◽

pp. 364-380 ◽

Cited By ~ 77

Author(s):

Martha E. Snell ◽

Nancy Brady ◽

Lee McLean ◽

Billy T. Ogletree ◽

Ellin Siegel ◽

...

Keyword(s):

Developmental Disabilities ◽

Literature Review ◽

Treatment Fidelity ◽

Intervention Research ◽

Communication Intervention ◽

Future Research ◽

Intellectual And Developmental Disabilities ◽

Communication Performance ◽

Current State ◽

Communication Interventions

Abstract This literature review was conducted to evaluate the current state of evidence supporting communication interventions for individuals with severe intellectual and developmental disabilities. We reviewed 116 articles published between 1987 and 2007 in refereed journals meeting three criteria: (a) described a communication intervention, (b) involved one or more participants with severe intellectual and developmental disabilities, and (c) addressed one or more areas of communication performance. Many researchers failed to report treatment fidelity or to assess basic aspects of intervention effects, including generalization, maintenance, and social validity. The evidence reviewed indicates that 96% of the studies reported positive changes in some aspects of communication. These findings support the provision of communication intervention to persons with severe intellectual and developmental disabilities. Gaps in the research were reported as were recommendations for future research.

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Investigating Health Communication Interventions on Three Major Illnesses in Nigeria

South Asian Journal of Social Studies and Economics ◽

10.9734/sajsse/2018/v1i325798 ◽

2018 ◽

pp. 1-9

Author(s):

Chinwe Catherine Okpoko ◽

Elias Chikee Aniwada

Keyword(s):

Health Communication ◽

Public Awareness ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Treatment Change ◽

Cross Sectional ◽

Intervention Measures ◽

The Status ◽

Communication Interventions ◽

Hiv Aids

Background: Communication methods are used to create and increase public awareness of a disease; its causes and treatment; change a person’s or group’s attitudes about a disease; advocate for policy changes in favor of prevention and control, and create social norms that favor healthful living. Objectives: This study sought to examine the health communication interventions so far used on HIV/AIDS, malaria and TB in Nigeria, find out what has been achieved in the process and suggest how the status quocan be improved. Methods: A total of 390 respondents comprising healthcare providers, patients and the general public in the selected states; Enugu (Southeast), Kaduna (Northwest) and Oyo (Southwest) states in Nigeria were sampled using questionnaire. It was a Cross-sectional study. Results: Health communication interventions on HIV/AIDS are majorly received through radio (34.7%), friends (30.1%) and television (18.85%). For malaria, television and radio predominate (31.9%) and (26.7%) respectively, then newspaper (13.1%). However, TB was chiefly through health facilities (30.1%) then television (20.1%) and newspaper, (12.9%). Major types of intervention messages on the illnesses include HIV/AIDS Preventive (76.6%), Malaria Drug use (37.3%) and Tuberculosis control (38.8%). Lack of knowledge of available media was the major factor identified as hindering communication interventions for the 3 diseases. (HIV/AIDS 29.8%, Malaria 32.6% and TB 35.7%). Conclusion: There is a need for attitudinal change by all to ensure that the level of awareness is matched with action and subsequently influence the adoption of intervention measures to improve management of these diseases.

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