scholarly journals Implementation of a Web-Based Tool With Text Message Prompts to Improve End-of-Shift Assessments for Emergency Medicine Residents

2020 ◽  
Vol 12 (6) ◽  
pp. 753-758
Author(s):  
Adam Tobias ◽  
Robert Sobehart ◽  
Ankur A. Doshi ◽  
Brian Suffoletto

ABSTRACT Background End-of-shift assessments (ESA) can provide representative data on medical trainee performance but do not occur routinely and are not documented systematically. Objective To evaluate the implementation of a web-based tool with text message prompts to assist mobile ESA (mESA) in an emergency medicine (EM) residency program. Methods mESA used timed text messages to prompt faculty/trainees to expect in-person qualitative ESA in a milestone content area and for the faculty to record descriptive performance data through a web-based platform. We assessed implementation between January 2018 and November 2019 using the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance). Results Reach: 96 faculty and 79 trainees participated in the mESA program. Effectiveness: From surveys, approximately 72% of faculty and 58% of trainees reported increases in providing and receiving ESA feedback after program implementation. From ESA submissions, trainees reported receiving in-person feedback on 90% of shifts. Residency leadership confirmed perceived utility of the mESA program. Adoption: mESA prompts were sent on 7792 unique shifts across 4 EDs, all days of week, and different times of day. Faculty electronically submitted ESA feedback on 45% of shifts. Implementation quality: No technological errors occurred. Maintenance: Completion of in-person ESA feedback and electronic submission of feedback by faculty was stable over time. Conclusions We found mixed evidence in support of using a web-based tool with text message prompts for mESA for EM trainees.

Sexual Health ◽  
2013 ◽  
Vol 10 (4) ◽  
pp. 377 ◽  
Author(s):  
Sarah Huffam ◽  
Christopher K. Fairley ◽  
Mark Chung ◽  
Jun Kit Sze ◽  
Jade Bilardi ◽  
...  

Let Them Know (www.letthemknow.org.au) is an Australian internet based service designed to support individuals diagnosed with an STI to notify sexual partners using anonymous or personal text messages. A review of user activity and acceptability of the website was performed. Between 17 March 2010 and 31 March 2011, of 13 024 website visits, 4863 (37%) visits resulted in a text message being sent. From 3 December 2010, of 1383 consecutive users, 963 (70%) indicated they were more likely to contact a partner because of the website. A short period of misuse was identified and controlled, and additional measures to monitor for and prevent misuse were subsequently implemented. Web-based notification systems such as the Let Them Know website can help to facilitate partner notification for individuals who may be reluctant to do this in person.


Crisis ◽  
2010 ◽  
Vol 31 (2) ◽  
pp. 109-112 ◽  
Author(s):  
Hui Chen ◽  
Brian L. Mishara ◽  
Xiao Xian Liu

Background: In China, where follow-up with hospitalized attempters is generally lacking, there is a great need for inexpensive and effective means of maintaining contact and decreasing recidivism. Aims: Our objective was to test whether mobile telephone message contacts after discharge would be feasible and acceptable to suicide attempters in China. Methods: Fifteen participants were recruited from suicide attempters seen in the Emergency Department in Wuhan, China, to participate in a pilot study to receive mobile telephone messages after discharge. All participants have access to a mobile telephone, and there is no charge for the user to receive text messages. Results: Most participants (12) considered the text message contacts an acceptable and useful form of help and would like to continue to receive them for a longer period of time. Conclusions: This suggests that, as a low-cost and quick method of intervention in areas where more intensive follow-up is not practical or available, telephone messages contacts are accessible, feasible, and acceptable to suicide attempters. We hope that this will inspire future research on regular and long-term message interventions to prevent recidivism in suicide attempters.


2019 ◽  
Author(s):  
Megan Partch ◽  
Cass Dykeman

Mental health treatment providers seek high-impact and low-cost means of engaging clients in care. As such, text messaging is becoming more frequently utilized as a means of communication between provider and client. Research demonstrates that text message interventions increase treatment session attendance, decrease symptomology, and improve overall functioning. However, research is lacking related to the linguistic make up of provider communications. Text messages were collected from previously published articles related to the treatment of mental health disorders. A corpus of 39 mental health treatment text message interventions was composed totaling 286 words. Using Linguistic Inquiry and Word Count (LIWC) software, messages were analyzed for prevalence of terminology thought to enhance client engagement. Clout, demonstrating the writer’s confidence and expertise, and positive Emotional Tone were found to be at a high level within the corpus. Results demonstrated statistical significance for five linguistic variables. When compared with national blog norms derived from Twitter, Clout, Emotional Tone, and use of Biological terminology were found to be at higher rates than expected. Authenticity and Informal terminology were found at significantly lesser rates.


2020 ◽  
Author(s):  
Stephanie Craig Rushing ◽  
Allyson Kelley ◽  
Sheana Bull ◽  
David Stephens ◽  
Julia Wrobel ◽  
...  

BACKGROUND Culturally-relevant interventions are needed to help American Indian and Alaska Native (AI/AN) teens and young adults navigate common risky situations involving family and friends, including drug and alcohol misuse, dating violence, and suicidality. We R Native – a multimedia health resource for Native teens and young adults – designed an intervention for Native youth, delivered via text message, that includes role model videos, mental wellness strategies, and links to culturally-relevant resources (hotlines, chat-lines, websites, etc.) and social support. OBJECTIVE This study aims to test the efficacy of BRAVE to improve participant’s physical, mental, and spiritual health, their use of mental wellness strategies, their help-seeking skills, and associated factors, including cultural resilience, identity, and cultural pride. METHODS The randomized controlled trial was carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,334 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,044 to participate. AI/AN teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and cultural resilience; or 8 weeks of STEM text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine (STEM); and then received the other set of messages. Primary and secondary outcomes were tested using linear mixed-effect models and linear regressions. RESULTS A total of 833 AI/AN teens and young adults were included in the analysis. Individuals in the BRAVE and STEM arms showed significant positive trends over the course of the study for all primary outcomes except cultural identity and help seeking behavior. Mean scores were significantly different for health (P<.001), resilience (P<.001), negative coping (P=.027), positive coping (P<.001), self-efficacy (P=.021), and self-esteem (P<.001). Changes in help-seeking self-efficacy were significant for those exhibiting risky behavior at baseline to exit (P=.01). Those who reported positive coping scores at baseline also reported better health on average, but no difference in risky drug and alcohol use (P<.001). The number of participants that used text messages to help themselves increased from 69% at 3-months (427/618) to 75% at 8-months (381/501) (P<.001). Similarly, the number of participants that used text messages to help a friend or family member increased from 22% at 3-months (138/616) to 55% at 8-months (272/498). CONCLUSIONS This is the first nationwide randomized controlled trial for AI/AN teens and young adults to test the efficacy of an mHealth intervention on mental wellness. The findings suggest that culturally-relevant multimedia, mHealth interventions can improve help-seeking behavior. Lessons learned from this study may help other AI/AN-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN change-makers.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1479.1-1479
Author(s):  
R. te Kampe ◽  
A. Boonen ◽  
T. Jansen ◽  
J. M. Elling ◽  
M. Flendrie ◽  
...  

Background:Adherence to prescribed urate-lowering therapy (ULT) among gout patients is considered to be among the poorest of all chronic conditions. eHealth programs can be a possible opportunity to foster ULT adherence.Objectives:This study describes the development and usability evaluation of a web-based tool to support ULT adherence among gout patients, specifically designed for a complement to usual care.Methods:The Integrated Change (I-Change) model was used as theoretical basis for the development. The model combines various socio-cognitive theories and differentiates between three phases: a pre-motivational, a motivational, and a post-motivational phase. In practices, the I-Change gout tool contains three sessions, following the three phases of the I-Change model. Patients receive tailored feedback based on their answers in the form of animated videos and text messages after each session, and are prompted to set specific goals and action plans for their ULT adherence. The content and development of the I-Change gout tool was determined along an iterative process within a steering group of clinicians and researchers, supported by patient interviews and gout specific literature related to key aspects of medication adherence behavior. A cross-sectional mixed methods design was used to test usability of the support tool consisting of a think aloud method and a usability questionnaire.Results:The steering group decided on the content of the three sessions of the I-Change gout tool. Depending on the intention to change ULT adherence behavior patients were navigated through the I-Change gout tool, patients with a low intention go through all 3 sessions and patients with a high intention go through the pre- and post-motivational session (figure 1). In total, the I-Change gout tool contains three sessions with 80 questions, 66 tailored textual feedback messages, and 40 tailored animated videos.Figure 1.Flowchart of the computer-tailored I-Change gout tool for urate-lowering therapy adherence.Twenty gout patients and seven healthcare professionals participated in the usability tests. The program end score rating for the gout tool was on average 8.4±0.9 (range 6-10) for patients and 7.7±1.0 (range 6-9) for healthcare professionals. Furthermore, participants reported a high intention to use and/or recommend the program in the future. Yet, participants identified some issues for further improvement of the systems user-friendliness by addressing barriers (e.g. more explicitly navigation) and weaknesses (e.g. technical and health literacy). The I-Change gout tool was updated according suggestions of improvements of the participants.Conclusion:This study provides initial support for the usability by patients and healthcare professionals of a ULT adherence I-Change gout tool. Further studies need to be conducted to assess its efficacy and (cost-) effectiveness in daily practice.Disclosure of Interests:None declared


2021 ◽  
Vol 12 (02) ◽  
pp. 293-300
Author(s):  
Kevin S. Naceanceno ◽  
Stacey L. House ◽  
Phillip V. Asaro

Abstract Background Clinical trials performed in our emergency department at Barnes-Jewish Hospital utilize a centralized infrastructure for alerting, screening, and enrollment with rule-based alerts sent to clinical research coordinators. Previously, all alerts were delivered as text messages via dedicated cellular phones. As the number of ongoing clinical trials increased, the volume of alerts grew to an unmanageable level. Therefore, we have changed our primary notification delivery method to study-specific, shared-task worklists integrated with our pre-existing web-based screening documentation system. Objective To evaluate the effects on screening and recruitment workflow of replacing text-message delivery of clinical trial alerts with study-specific shared-task worklists in a high-volume academic emergency department supporting multiple concurrent clinical trials. Methods We analyzed retrospective data on alerting, screening, and enrollment for 10 active clinical trials pre- and postimplementation of shared-task worklists. Results Notifications signaling the presence of potentially eligible subjects for clinical trials were more likely to result in a screen (p < 0.001) with the implementation of shared-task worklists compared with notifications delivered as text messages for 8/10 clinical trials. The change in workflow did not alter the likelihood of a notification resulting in an enrollment (p = 0.473). The Director of Research reported a substantial reduction in the amount of time spent redirecting clinical research coordinator screening activities. Conclusion Shared-task worklists, with the functionalities we have described, offer a viable alternative to delivery of clinical trial alerts via text message directly to clinical research coordinators recruiting for multiple concurrent clinical trials in a high-volume academic emergency department.


Infection ◽  
2021 ◽  
Author(s):  
Knut Erik Emberland ◽  
K.-A. Wensaas ◽  
S. Litleskare ◽  
A. Iversen ◽  
K. Hanevik ◽  
...  

Abstract Purpose Outbreaks of Campylobacter infection are common, but studies exploring the clinical features of acute illness in the outbreak setting are scarce in existing literature. The main purpose of the present study was to investigate the clinical features of self-reported acute illness in gastroenteritis cases during a large waterborne Campylobacter outbreak in Askøy municipality, Norway, in 2019. Methods A web-based self-administered questionnaire, and invitation to participate was sent by the municipality of Askøy as text message to mobile phones using the municipality’s warning system to the inhabitants during the ongoing outbreak. Results Out of 3624 participants, 749 (20.7%) were defined as cases, of which 177 (23.6%) reported severe gastroenteritis. The most common symptoms were loose stools (90.7%), abdominal pain (89.3%) and diarrhea (88.9%), whereas 63.8% reported fever, 50.2% joint pain and 14.2% bloody stools. Tiredness, a symptom non-specific to gastroenteritis, was the overall most common symptom (91.2%). Conclusion About one in four of the cases reported symptoms consistent with severe gastroenteritis. We found more joint pain and less bloody stools than reported in published studies of laboratory confirmed campylobacteriosis cases. Tiredness was common in the current study, although rarely described in previous literature of acute illness in the outbreak setting.


2021 ◽  
Vol 7 ◽  
pp. 205520762110149
Author(s):  
Sarah A Stotz ◽  
Jung Sun Lee ◽  
Jennifer Jo Thompson

Objective The purpose of this paper is to describe a participant-driven, online text message-based social support network that emerged from an eLearning nutrition education and supplemental produce intervention. Methods Adults (n = 20) who utilized a safety-net clinic for their healthcare participated in a 12-week smartphone-based nutrition education eLearning program using loaned smartphones. Participants also received a box of fresh produce weekly. Participants received weekly text message reminders to collect their produce, and from this researcher-initiated reminder text, a supportive, participant-led, all-group text message thread commenced. Researchers collected all 471 text messages in this all-group thread and included them in the qualitative content analysis of pre and post intervention focus groups. Results The original design of the eLearning nutrition education program was to asynchronously engage learners with nutrition education resources. However, participants themselves initiated a robust group text message support system through which they shared encouragement, recipes, grocery shopping tips, and images of food they prepared with the produce box amongst themselves for the duration of the 12-week intervention. Conclusion The novel nature by which these participants voluntarily engaged in this peer-to-peer nutrition education-focused text message conversation exemplifies participants becoming agents in their own learning experience and will be used to enhance future eLearning nutrition education experiences developed by our team.


Author(s):  
Joy Waughtal ◽  
Phat Luong ◽  
Lisa Sandy ◽  
Catia Chavez ◽  
P Michael Ho ◽  
...  

Abstract Almost 50% of patients with cardiovascular diseases face challenges in taking medications and increased morbidity and mortality. Text messaging may impact medication refill behavior and can be delivered at scale to patients by texting mobile phones. To obtain feedback from persons with chronic conditions on the design of interactive text messages and determine language of message for making messages that can motivate patients to refill medications on time. We purposively sampled 35 English and Spanish speaking patients with at least one chronic condition from three large healthcare delivery systems to participate in N-of-1 video-based synchronous interviews. Research assistants shared ideas for theory-informed text messages with content intended to persuade patients to refill their medication. We transcribed recorded interviews and conducted a content analysis to identify strategies to employ generating a dynamic interactive text message library intended to increase medication refill. Those interviewed were of diverse age and race/ethnicity and typical of persons with multiple chronic conditions. Several participants emphasized that personally tailored and positively framed messages would be more persuasive than generic and/or negative messages. Some patients appreciated humor and messages that could evoke a sense of social support from their providers and rejected the use of emojis. Messages to remind patients to refill medications may facilitate improvements in adherence, which in turn can improve chronic care. Designing messages that are persuasive and can prompt action is feasible and should be considered given the ease with which such messages can be delivered automatically at scale.


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