scholarly journals “In a Way We Took the Hospital Home”—A Descriptive Mixed-Methods Study of Parents’ Usage and Experiences of eHealth for Self-Management after Hospital Discharge Due to Pediatric Surgery or Preterm Birth

Author(s):  
Rose-Marie Lindkvist ◽  
Annica Sjöström-Strand ◽  
Kajsa Landgren ◽  
Björn A. Johnsson ◽  
Pernilla Stenström ◽  
...  

The costly and complex needs for children with long-term illness are challenging. Safe eHealth communication is warranted to facilitate health improvement and care services. This mixed-methods study aimed to describe parents’ usage and experiences of communicating with professionals during hospital-to-home-transition after their child’s preterm birth or surgery for colorectal malformations, using an eHealth device, specifically designed for communication and support via nurses at the hospital. The eHealth devices included the possibility for daily reports, video calls, text messaging, and sending images. Interviews with 25 parents were analyzed with qualitative content analysis. Usage data from eHealth devices were compiled from database entries and analyzed statistically. Parents using the eHealth device expressed reduced worry and stress during the initial period at home through effective and safe communication. Benefits described included keeping track of their child’s progress and having easy access to support whenever needed. This was corroborated by usage data indicating that contact was made throughout the day, and more among families living far away from hospital. The eHealth device potentially replaced phone calls and prevented unnecessary visits. The eHealth technique can aid safe self-treatment within child- and family-centered care in neonatal and pediatric surgery treatment. Future research may consider organization perspectives and health economics.

2019 ◽  
Author(s):  
Jeffrey C Greene ◽  
Jolie N Haun ◽  
Dustin D French ◽  
Susan L Chambers ◽  
Robert H Roswell

BACKGROUND The association between health literacy and health care costs, particularly for hospitalizations and emergency room services, has been previously observed. Health information interventions aimed at addressing the negative impacts of inadequate health literacy are needed. The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is a Web-based system designed to improve health and lower costs by aligning patient-doctor incentives. OBJECTIVE In this mixed methods study of a Web-based patient-doctor aligned-incentive, information therapy program conducted in an 1800-member employee health plan, we aimed to (1) determine the program’s quantitative impact on hospitalization and emergency room utilization and costs, and (2) assess survey responses about the program’s perceived value. METHODS We used a mixed methods, single within-group, pre-post, descriptive study design. We analyzed quantitative data using pre-post mean utilization and cost differences and summarized the data using descriptive statistics. We used open-ended electronic survey items to collect descriptive data and analyzed them using thematic content analysis. RESULTS Hospitalizations and emergency room visits per 1000 decreased 32% (26.5/82.4) and 14% (31.3/219.9), respectively, after we implemented the program in 2015-2017, relative to 2013-2014. Correspondingly, the plan’s annual per capita expenditures declined US $675 (95% CI US $470-865), or 10.8% ($675/$6260), after program implementation in 2015-2017 (US $5585 in 2013-2014 dollars), relative to the baseline years of 2013-2014 (US $6260; <italic>P</italic>&lt;.05). Qualitative findings suggested that respondents valued the program, benefiting from its educational and motivational aspects to better self-manage their health. CONCLUSIONS Analyses suggested that the reported reductions in hospitalizations, emergency room visits, and costs were associated with the program. Qualitative findings indicated that targeted users perceived value in participating in the MAIT Program. Further research with controls is needed to confirm these outcomes and more completely understand the health improvement and cost-containment capabilities of this Web-based health information, patient-doctor, aligned-incentive program.


2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 155-155
Author(s):  
Echo L. Warner ◽  
Brynn Fowler ◽  
Samantha Pannier ◽  
Douglas Beaty Fair ◽  
Holly Perlman ◽  
...  

155 Background: We describe patient navigator preferences for adolescent and young adult (AYA) cancer patients by geographical distance from cancer treatment centers. Methods: In this mixed methods study, N = 39 participants were recruited primarily from oncology clinics in Utah. Participants were diagnosed between ages 15-39 and had completed ≥ 1 month of treatment. Participants were interviewed and surveyed on preferences for patient navigation. Thematic content analysis revealed navigation preferences based on participants’ travel distance from their treatment center, classified as < 20 miles (local) and ≥ 20 miles (distance). Qualitative data was quantized and the proportion of codes in each theme was compared by travel distance using two-tailed z-scores. Results: Mean travel distance to cancer treatment center was 53.5 miles (SD = 77.4); 53.8% of participants were local ( < 20 miles) and 46.2% were distance ( ≥ 20 miles). There were no differences by age or ethnicity. Local patients were less likely to endorse that travel distance was a challenge for their oncology appointments than distance patients (25.0% vs. 75.0%, p = 0.01). Local patients reported a higher proportion of codes (62.5%) related to believing a patient navigator would be helpful to them compared to distance patients (37.5%, p = 0.01). Connecting with a patient navigator at the time of first diagnosis was endorsed by more local patients than distance (66.7% vs. 33.3%, p = 0.01). Local patients reported a greater need for navigation support regarding finances (local 69.6% vs. distance 30.4%, p = < 0.001) and social support (local 87.5% vs. distance 12.5%, p = 0.03). Most participants, regardless of travel distance, desired navigation primarily via telephone (audio and text messaging). Conclusions: While AYAs with cancer living further from their treatment location were more likely to report that travel was a barrier, local AYAs reported more needs related to patient navigation than remote patients. Patient navigators may need to consider different support services for distanced patients including strategies to address geographic barriers to care.


2020 ◽  
Author(s):  
Sofie Compernolle ◽  
Greet Cardon ◽  
Hidde P van der Ploeg ◽  
Femke Van Nassau ◽  
Ilse De Bourdeaudhuij ◽  
...  

BACKGROUND Although healthy aging can be stimulated by the reduction of sedentary behavior, few interventions are available for older adults. Previous studies suggest that self-monitoring might be a promising behavior change technique to reduce older adults’ sedentary behavior. However, little is known about older adults’ experiences with a self-monitoring–based intervention aimed at the reduction of sedentary behavior. OBJECTIVE The aim of this study is to evaluate engagement, acceptability, usability, and preliminary efficacy of a self-monitoring–based mHealth intervention developed to reduce older adults’ sedentary behavior. METHODS A mixed methods study was performed among 28 community-dwelling older adults living in Flanders, Belgium. The 3-week intervention consisted of general sedentary behavior information as well as visual and tactile feedback on participants’ sedentary behavior. Semistructured interviews were conducted to explore engagement with, and acceptability and usability of, the intervention. Sitting time was measured using the thigh-worn activPAL (PAL Technologies) accelerometer before and after the intervention. System usage data of the app were recorded. Quantitative data were analyzed using descriptive statistics and paired-samples <i>t</i> tests; qualitative data were thematically analyzed and presented using pen profiles. RESULTS Participants mainly reported positive feelings regarding the intervention, referring to it as motivating, surprising, and interesting. They commonly reported that the intervention changed their thinking (ie, they became more aware of their sedentary behavior) but not their actual behavior. There were mixed opinions on the kind of feedback (ie, tactile vs visual) that they preferred. The intervention was considered easy to use, and the design was described as clear. Some problems were noticed regarding attaching and wearing the self-monitoring device. System usage data showed that the median frequency of consulting the app widely differed among participants, ranging from 0 to 20 times a day. No significant reductions were found in objectively measured sitting time. CONCLUSIONS Although the intervention was well perceived by the majority of older adults, no reductions in sitting time were found. Possible explanations for the lack of reductions might be the short intervention duration or the fact that only bringing the habitual sedentary behavior into conscious awareness might not be sufficient to achieve behavior change. CLINICALTRIAL ClinicalTrials.gov NCT04003324; https://tinyurl.com/y2p4g8hx


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christina R. Welter ◽  
Elizabeth Jarpe-Ratner ◽  
Steven Seweryn ◽  
Tessa Bonney ◽  
Pooja Verma ◽  
...  

10.2196/14772 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14772 ◽  
Author(s):  
Jeffrey C Greene ◽  
Jolie N Haun ◽  
Dustin D French ◽  
Susan L Chambers ◽  
Robert H Roswell

Background The association between health literacy and health care costs, particularly for hospitalizations and emergency room services, has been previously observed. Health information interventions aimed at addressing the negative impacts of inadequate health literacy are needed. The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is a Web-based system designed to improve health and lower costs by aligning patient-doctor incentives. Objective In this mixed methods study of a Web-based patient-doctor aligned-incentive, information therapy program conducted in an 1800-member employee health plan, we aimed to (1) determine the program’s quantitative impact on hospitalization and emergency room utilization and costs, and (2) assess survey responses about the program’s perceived value. Methods We used a mixed methods, single within-group, pre-post, descriptive study design. We analyzed quantitative data using pre-post mean utilization and cost differences and summarized the data using descriptive statistics. We used open-ended electronic survey items to collect descriptive data and analyzed them using thematic content analysis. Results Hospitalizations and emergency room visits per 1000 decreased 32% (26.5/82.4) and 14% (31.3/219.9), respectively, after we implemented the program in 2015-2017, relative to 2013-2014. Correspondingly, the plan’s annual per capita expenditures declined US $675 (95% CI US $470-865), or 10.8% ($675/$6260), after program implementation in 2015-2017 (US $5585 in 2013-2014 dollars), relative to the baseline years of 2013-2014 (US $6260; P<.05). Qualitative findings suggested that respondents valued the program, benefiting from its educational and motivational aspects to better self-manage their health. Conclusions Analyses suggested that the reported reductions in hospitalizations, emergency room visits, and costs were associated with the program. Qualitative findings indicated that targeted users perceived value in participating in the MAIT Program. Further research with controls is needed to confirm these outcomes and more completely understand the health improvement and cost-containment capabilities of this Web-based health information, patient-doctor, aligned-incentive program.


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