scholarly journals Commitment Devices for Health

2021 ◽  
pp. 35-54
Author(s):  
Manu M. Savani
Keyword(s):  
Digital Health ◽  
Research Priorities ◽  
Health Behaviours ◽  
Empirical Literature ◽  
Unintended Effects ◽  
Moral Licensing ◽  
Preventative Health ◽  
Theoretical Predictions ◽  
Unexpected Findings ◽  
Commitment Devices

This chapter examines how and why commitment devices have been used for weight management and frames research priorities going forward. A theoretical framework drawing on Thaler and Shefrin motivates the use of commitment devices to change health behaviours. An original taxonomy separates commitment devices into three distinct types. A review of the empirical literature, with a focus on unexpected findings that defy theoretical predictions, indicates that commitment devices (1) can have positive effects on health behaviours, but (2) can also have unintended effects, which warrants further research attention to under-theorised issues of ‘commitment overload' and ‘moral licensing', and empirical testing of online commitment strategies. The COVID-19 pandemic emphasises the need for innovative but evidence-based digital health interventions. The chapter closes with suggestions for policymakers considering commitment devices for preventative health behaviours.

scholarly journals ‘We are very individual’: anticipated effects on stroke survivors of using their person-generated health data

2020 ◽  
Vol 27 (3) ◽  
pp. e100149
Author(s):  
Gerardo Luis Dimaguila ◽  
Frances Batchelor ◽  
Mark Merolli ◽  
Kathleen Gray
Keyword(s):  
Health Services ◽  
Information Technologies ◽  
Digital Health ◽  
Healthcare Providers ◽  
Health Behaviours ◽  
Stroke Care ◽  
Health Data ◽  
Care Process ◽  
Stroke Survivors ◽  
Patient Reported

BackgroundPerson-generated health data (PGHD) are produced by people when they use health information technologies. People who use PGHD may experience changes in their health and care process, such as engagement with their own healthcare, and their sense of social support and connectedness. Research into evaluating those reported effects has not kept up; thus, a method for measuring PGHD outcomes was previously designed and applied to the exemplar case of Kinect-based stroke rehabilitation systems. A key step of the method ensures that the patient’s voice is included. Allowing stroke survivors to participate in the development and evaluation of health services and treatment can inform healthcare providers on decisions about stroke care, and thereby improve health outcomes.ObjectiveThis paper presents the perspectives of stroke survivors and clinicians on the anticipated effects of stroke survivors’ use of PGHD from a poststroke simulated rehabilitation technology.MethodsThis study gathered the perspectives of stroke survivors and clinicians through three focus groups and three interviews, recruited for convenience. Participants were also asked questions intended to encourage them to comment on the initial items of the patient-reported outcome measure-PGHD. Deductive thematic analysis was performed.ResultsThis paper has further demonstrated that outcomes of using PGHD can be measured. For instance, stroke survivors described that using PGHD could result in positive, negative and nil effects on their health behaviours. Survivors and clinicians had varying perspectives in three of the six themes presented, and emphasise the importance of allowing stroke survivors to participate in the evaluation of digital health services.

Progress and Perspectives in the Study of Political Selection

2018 ◽  
Vol 10 (1) ◽  
pp. 541-575 ◽  
Author(s):  
Ernesto Dal Bó ◽  
Frederico Finan
Keyword(s):  
Supply And Demand ◽  
Comparative Statics ◽  
Empirical Literature ◽  
Future Research ◽  
Political Class ◽  
The Past ◽  
Political Selection ◽  
Theoretical Predictions ◽  
Shed Light

We provide a model of self-selection by candidates in a probabilistic voting environment to shed light on the forces shaping the quality of politicians from both the supply and demand sides of politics. The model highlights the idea that the patterns of selection and the comparative statics of politician quality depend critically on how the costs of running for office vary for candidates with different qualities. The model offers predictions on how the quality of the political class will vary with key parameters pertaining to both the supply and demand for candidates. We use the model to frame a review of the empirical literature on political selection that has emerged over the past two decades. We contrast areas where significant progress has been made with others where important theoretical predictions remain untested or existing evidence does not allow a consensus, highlighting areas for future research.

Self-Care in Relation to Informal and Formal Care

1990 ◽  
Vol 10 (1) ◽  
pp. 41-59 ◽  
Author(s):  
Margaret J. Penning ◽  
Neena L. Chappell
Keyword(s):  
Health Status ◽  
Random Sample ◽  
Informal Care ◽  
Chronic Conditions ◽  
Functional Disability ◽  
Health Behaviours ◽  
Formal Care ◽  
Perceived Health Status ◽  
Elderly Individuals ◽  
Preventative Health

ABSTRACTThis paper examines the prevalence, inter-relationships and correlates of various forms of self, informal and formal care. Analyses of data drawn from a random sample of 743 non-institutionalised elderly individuals living in Winnipeg, Manitoba reveal similarities as well as differences among the three types of care. Self- and formal care are somewhat similar, being positively related and having similar correlates. Nevertheless, substitutability as a consequence of medical scepticism is also evident. Both are unrelated to informal care. It is poor health in the form of functional disability and the availability of support through the marital relationship which are the strongest correlates of informal care. In contrast, health (chronic conditions and perceived health status) as well as beliefs in the efficacy of both preventative health behaviours and medical services are among the strongest correlates of self- and formal care.

scholarly journals What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review

2022 ◽  
Vol 9 ◽  
Author(s):  
Rodolfo Castro ◽  
Marcelo Ribeiro-Alves ◽  
Cátia Oliveira ◽  
Carmen Phang Romero ◽  
Hugo Perazzo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Digital Health ◽  
Research Priorities ◽  
Lifestyle Changes ◽  
Cochrane Library ◽  
Delivery Methods ◽  
Intermediate Outcomes ◽  
Scoping Reviews ◽  
Meta Analyses

Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods.Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change.Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites.Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention—but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.

scholarly journals Impact of the COVID-19 Pandemic on Cancer Researchers in 2020: A Qualitative Study of Events to Inform Mitigation Strategies

2021 ◽  
Vol 9 ◽  
Author(s):  
Louis Fox ◽  
Katharina Beyer ◽  
Elke Rammant ◽  
Esme Morcom ◽  
Mieke Van Hemelrijck ◽  
...  
Keyword(s):  
Cancer Research ◽  
English Language ◽  
Qualitative Content Analysis ◽  
Digital Health ◽  
Research Priorities ◽  
Economic Effects ◽  
Mitigation Strategies ◽  
Future Research ◽  
Research Strategies ◽  
Research Activity

Introduction: The COVID-19 pandemic has had an unprecedented impact on global health systems and economies. With ongoing and future challenges posed to the field due to the pandemic, re-examining research priorities has emerged as a concern. As part of a wider project aiming to examine research priorities, here we aimed to qualitatively examine the documented impacts of the COVID-19 pandemic on cancer researchers.Materials and Methods: We conducted a literature review with the aim of identifying non-peer-reviewed journalistic sources and institutional blog posts which qualitatively documented the effects of the COVID-19 pandemic on cancer researchers. We searched on 12th January 2021 using the LexisNexis database and Google, using terms and filters to identify English-language media reports and blogs, containing references to both COVID-19 and cancer research. The targeted search returned 751 results, of which 215 articles met the inclusion criteria. These 215 articles were subjected to a conventional qualitative content analysis, to document the impacts of the pandemic on the field of cancer research.Results: Our analysis yielded a high plurality of qualitatively documented impacts, from which seven categories of direct impacts emerged: (1) COVID measures halting cancer research activity entirely; (2) COVID measures limiting cancer research activity; (3) forced adaptation of research protocols; (4) impacts on cancer diagnosis, cases, and services; (5) availability of resources for cancer research; (6) disruption to the private sector; and (7) disruption to supply chains. Three categories of consequences from these impacts also emerged: (1) potential changes to future research practice; (2) delays to the progression of the field; and (3) potential new areas of research interest.Discussion: The COVID-19 pandemic had extensive practical and economic effects on the field of cancer research in 2020 that were highly plural in nature. Appraisal of cancer research strategies in a post-COVID world should acknowledge the potential for substantial limitations (such as on financial resources, limited access to patients for research, decreased patient access to cancer care, staffing issues, administrative delays, or supply chain issues), exacerbated cancer disparities, advances in digital health, and new areas of research related to the intersection of cancer and COVID-19.

scholarly journals Offline Digital Education for Postregistration Health Professions: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration (Preprint)

2018 ◽  
Author(s):  
Pawel Posadzki ◽  
Malgorzata M Bala ◽  
Bhone Myint Kyaw ◽  
Monika Semwal ◽  
Ushashree Divakar ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Digital Health ◽  
Meta Analysis ◽  
Health Professions ◽  
Computer Assisted ◽  
Unintended Effects ◽  
Digital Education ◽  
Mental Health Therapists ◽  
Traditional Training

BACKGROUND The shortage and disproportionate distribution of health care workers worldwide is further aggravated by the inadequacy of training programs, difficulties in implementing conventional curricula, deficiencies in learning infrastructure, or a lack of essential equipment. Offline digital education has the potential to improve the quality of health professions education. OBJECTIVE The primary objective of this systematic review was to evaluate the effectiveness of offline digital education compared with various controls in improving learners’ knowledge, skills, attitudes, satisfaction, and patient-related outcomes. The secondary objectives were (1) to assess the cost-effectiveness of the interventions and (2) to assess adverse effects of the interventions on patients and learners. METHODS We searched 7 electronic databases and 2 trial registries for randomized controlled trials published between January 1990 and August 2017. We used Cochrane systematic review methods. RESULTS A total of 27 trials involving 4618 individuals were included in this systematic review. Meta-analyses found that compared with no intervention, offline digital education (CD-ROM) may increase knowledge in nurses (standardized mean difference [SMD]=1.88; 95% CI 1.14 to 2.62; participants=300; studies=3; I2=80%; low certainty evidence). A meta-analysis of 2 studies found that compared with no intervention, the effects of offline digital education (computer-assisted training [CAT]) on nurses and physical therapists’ knowledge were uncertain (SMD 0.55; 95% CI –0.39 to 1.50; participants=64; I2=71%; very low certainty evidence). A meta-analysis of 2 studies found that compared with traditional learning, a PowerPoint presentation may improve the knowledge of patient care personnel and pharmacists (SMD 0.76; 95% CI 0.29 to 1.23; participants=167; I2=54%; low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, the effects of computer-assisted training on skills in community (mental health) therapists, nurses, and pharmacists were uncertain (SMD 0.45; 95% CI –0.35 to 1.25; participants=229; I2=88%; very low certainty evidence). A meta-analysis of 4 studies found that compared with traditional training, offline digital education may have little effect or no difference on satisfaction scores in nurses and mental health therapists (SMD –0.07; 95% CI –0.42 to 0.28, participants=232; I2=41%; low certainty evidence). A total of 2 studies found that offline digital education may have little or no effect on patient-centered outcomes when compared with blended learning. For skills and attitudes, the results were mixed and inconclusive. None of the studies reported adverse or unintended effects of the interventions. Only 1 study reported costs of interventions. The risk of bias was predominantly unclear and the certainty of the evidence ranged from low to very low. CONCLUSIONS There is some evidence to support the effectiveness of offline digital education in improving learners’ knowledge and insufficient quality and quantity evidence for the other outcomes. Future high-quality studies are needed to increase generalizability and inform use of this modality of education.

Assessment of the Readability of Online Patient Education Material from Major Canadian Pediatric Associations (Preprint)

2021 ◽  
Author(s):  
Alice Man ◽  
Courtney van Ballegooie
Keyword(s):  
Patient Education ◽  
Medical Information ◽  
Health Behaviours ◽  
Reading Level ◽  
Pediatric Society ◽  
Word Analysis ◽  
Education Material ◽  
Preventative Health ◽  
Grade Reading Level ◽  
Online Patient Education

BACKGROUND Online patient education materials (PEMs) are frequently written above the recommended reading level in North America. Poor PEM readability limits the accessibility of medical information to individuals with average to lower literacy levels. Pediatric hospital and association websites have not only been shown to be a preferred source of information among caregivers but have also become a necessity in the COVID-19 pandemic. The readability of Canadian pediatric association websites has not yet been assessed quantitatively. OBJECTIVE To assess the readability of online Canadian pediatric association PEMs to determine if the content of the material is written at a reading level that the majority of Canadians can understand. METHODS PEMs were extracted from ten Canadian pediatric associations and evaluated for their reading level using ten validated readability scales. Associations underwent a difficult word analysis and cross association comparisons were assessed. RESULTS Online PEMs were identified from three pediatric association websites, where the grade reading level was found to be 8.8 +/- 1.8 for the Caring for Kids website, 9.5 +/- 2.2 for the Pediatric Endocrine Group website and 13.1 +/- 2.1 for the Atlantic Pediatric Society website. The difficulty word analysis identified that 19.9% of words were unfamiliar overall. CONCLUSIONS The online PEMs were found to be written above the recommended seventh grade reading level for Canadians. Consideration should be made to create PEMs at an appropriate grade reading level for both patients and their caregivers to encourage health literacy and ultimately promote preventative health behaviours and child health outcomes.

scholarly journals The competitor release effect applied to carnivore species: how red foxes can increase in numbers when persecuted

2013 ◽  
Vol 36 (1) ◽  
pp. 37-46
Author(s):  
J. Lozano ◽  
◽  
J. G. Casanovas ◽  
E. Virgós ◽  
J. M. Zorrilla ◽  
...  
Keyword(s):  
Wildlife Management ◽  
Red Fox ◽  
Intrinsic Rate ◽  
Management Tool ◽  
Unintended Effects ◽  
Predator Control ◽  
Red Foxes ◽  
Control Programs ◽  
Carnivore Species ◽  
Theoretical Predictions

The objective of our study was to numerically simulate the population dynamics of a hypothetical community of three species of small to medium–sized carnivores subjected to non–selective control within the context of the competitor release effect (CRE). We applied the CRE to three carnivore species, linking interspecific competition with predator control efforts. We predicted the population response of European badger, the red fox and the pine marten to this wildlife management tool by means of numerical simulations. The theoretical responses differed depending on the intrinsic rate of growth (r), although modulated by the competition coefficients. The red fox, showing the highest r value, can increase its populations despite predator control efforts if control intensity is moderate. Populations of the other two species, however, decreased with control efforts, even reaching extinction. Three additional theoretical predictions were obtained. The conclusions from the simulations were: 1) predator control can play a role in altering the carnivore communities; 2) red fox numbers can increase due to control; and 3) predator control programs should evaluate the potential of unintended effects on ecosystems.

scholarly journals Digital Presence of a Research Center as a Research Dissemination Platform: Reach and Resources

10.2196/11686 ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. e11686 ◽  
Author(s):  
Sarah E Lord ◽  
Katherine M Seavey ◽  
Sonia D Oren ◽  
Alan J Budney ◽  
Lisa A Marsch
Keyword(s):  
Health Care ◽  
Behavioral Health ◽  
Digital Health ◽  
Empirical Literature ◽  
Evidence Based ◽  
Web Based ◽  
Research Dissemination ◽  
Digital Platforms ◽  
Web Presence ◽  
Industry Standards

Background Web-based platforms can be powerful tools for research dissemination. By leveraging the advantages of mass media and interpersonal channels of communication, Web-based dissemination platforms may improve awareness about, and subsequent adoption of, evidence-based practices (EBPs). Digital dissemination strategies can augment traditional dissemination models, improving stakeholder access to digestible and actionable information and promoting translation of EBPs. Objective This study aimed to describe the reach and content of the Web presence of a National Institute on Drug Abuse Center of Excellence and how it is used to disseminate research related to digital behavioral health approaches. Methods The Center for Technology and Behavioral Health (CTBH) has a website and regularly updated Facebook and Twitter accounts. The website features include summaries of digital behavioral health approaches and related empirical literature, a blog feed focused on the state of the science and technology concerning digital health care approaches, and a newsletter about Center activities. We extracted website usage metrics from Google Analytics and follower counts from social media accounts for the period from March 1, 2013, to July 17, 2018. Results Since the implementation of analytic tracking, 70,331 users have initiated 96,995 sessions on the CTBH website. The website includes summaries of 86 digital therapeutic programs, encompassing 447 empirical articles. There are 1160 posts in the CTBH blog feed, including 180 summaries of scholarly articles. The Twitter and Facebook accounts have 577 and 1500 followers, respectively. The newsletter has reached a growing subscriber network and has a high open rate relative to industry standards. Conclusions The CTBH Web presence serves as a model for how to leverage accessible and easily updatable digital platforms as research dissemination channels. Digital dissemination tools can augment traditional dissemination strategies to promote awareness about evidence-based digital therapeutic approaches for behavioral health and health care more broadly.

scholarly journals A Patient-Centered Framework for Measuring the Economic Value of the Clinical Benefits of Digital Health Apps: Theoretical Modeling

10.2196/18812 ◽  
2020 ◽  
Vol 7 (10) ◽  
pp. e18812
Author(s):  
Adam Powell ◽  
John Torous
Keyword(s):  
Digital Health ◽  
Economic Value ◽  
Research Priorities ◽  
Health Impact ◽  
The United States ◽  
Quality Adjusted Life Year ◽  
Patient Centered ◽  
Health Apps ◽  
Clinical Benefits ◽  
Country Specific

Background As digital health tools such as smartphone apps evolve and enter clinical use, questions regarding their value must be addressed. Although there are scarce generalizable data on the value of health apps given their nascency and diverse use cases, it is possible to estimate the economic value of the clinical improvement they bring to patients using a quality-adjusted life-year (QALY)-based approach and generalized values from existing literature. Objective This paper aims to provide a patient-centered framework for assessing the economic value of the clinical benefits delivered by digital health apps. Methods We proposed a model based upon 5 levers: country-specific monetary value of a QALY, QALYs lost due to the condition, engagement rate of app users, average effect size of the app’s health impact, and duration of the app’s impact before remission. Results Using 2 digital health apps from the United States and United Kingdom as examples, we explored how this model could generate country-specific estimates of the economic value of the clinical benefits of health apps. Conclusions This new framework can help drive research priorities for digital health by elucidating the factors that influence the economic value.

Sign in / Sign up

Export Citation Format

Share Document