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Couple-Focused Smartphone Intervention to Reduce Problem Drinking: Pilot Randomized Control Trial. 以夫妻为重点的智能手机干预,减少问题饮酒:试点随机对照试验。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-01 DOI: 10.2196/58622
David H Gustafson, David H Gustafson, Marie-Louise Mares, Darcie C Johnston, Olivia J Vjorn, John J Curtin, Elizabeth E Epstein, Genie L Bailey
<p><strong>Background: </strong>Alcohol use disorder is among the most pervasive substance use disorders in the United States, with a lifetime prevalence of 30%. Recommended treatment options include evidence-based behavioral interventions; smartphone-based interventions confer a number of benefits such as portability, continuous access, and stigma avoidance; and research suggests that interventions involving couples may outperform those for patients only. In this context, a behavioral intervention delivered to couples through smartphones may serve as an effective adjunct to alcohol use disorder treatment.</p><p><strong>Objective: </strong>This pilot study aimed to (1) evaluate the feasibility of comparing a patient-only (Addiction version of the Comprehensive Health Enhancement Support System; A-CHESS) versus a couple-focused (Partner version of the Comprehensive Health Enhancement Support System; Partner-CHESS) eHealth app for alcohol misuse delivered by smartphone, (2) assess perceptions about and use of the 2 apps, and (3) examine initial indications of differences in primary clinical outcomes between patient groups using the 2 apps. Broadly, these aims serve to assess the feasibility of the study protocol for a larger randomized controlled trial.</p><p><strong>Methods: </strong>A total of 33 romantic couples were randomized to 6 months of A-CHESS app use (active treatment control) or Partner-CHESS app use (experimental). Couples comprised a patient with current alcohol use disorder (25/33, 76% male) and a romantic partner (26/33, 79% female). Patients and partners in both arms completed outcome measure surveys at 0, 2, 4, and 6 months. Primary outcomes were patients' percentage of days with heavy drinking and percentage of days with any drinking, measured by timeline follow back. Secondary outcomes included app use and perceptions, and multiple psychosocial variables.</p><p><strong>Results: </strong>At 6 months, 78% (14/18) of Partner-CHESS patients and 73% (11/15) of A-CHESS patients were still using the intervention. The apps were rated helpful on a 5-point scale (1=not at all helpful, 5=extremely helpful) by 89% (29/33) of both Partner-CHESS patients (mean 3.7, SD 1) and partners (mean 3.6, SD 0.9) and by 87% (13/15) of A-CHESS patients (mean 3.1, SD 0.9). At 6 months, Partner-CHESS patients had a nonsignificantly lower percentage of days with heavy drinking compared with A-CHESS patients (β=-17.4, 95% CI -36.1 to 1.4; P=.07; Hedges g=-0.53), while the percentage of drinking days was relatively equal between patient groups (β=-2.1, 95% CI -24.8 to 20.7; P=.85; Hedges g=-0.12).</p><p><strong>Conclusions: </strong>Initial results support the feasibility of evaluating patient-only and couple-focused, smartphone-based interventions for alcohol misuse. Results suggest that both interventions are perceived as helpful and indicate maintained engagement of most participants for 6 months. A future, fully powered trial is warranted to evaluate the
背景:酒精使用障碍是美国最普遍的药物使用障碍之一,终生患病率为 30%。推荐的治疗方案包括循证行为干预;基于智能手机的干预具有便携性、连续访问性和避免污名化等诸多优点;研究表明,涉及夫妇的干预可能优于仅针对患者的干预。在这种情况下,通过智能手机向夫妇提供行为干预可能会成为酒精使用障碍治疗的有效辅助手段:本试验性研究旨在:(1)评估通过智能手机提供的治疗酒精滥用的患者专用电子健康应用程序(上瘾版全面增强健康支持系统;A-CHESS)与夫妻专用电子健康应用程序(伴侣版全面增强健康支持系统;Partner-CHESS)进行比较的可行性;(2)评估对这两款应用程序的看法和使用情况;以及(3)检查使用这两款应用程序的患者群体之间主要临床结果差异的初步迹象。从广义上讲,这些目的都是为了评估研究方案的可行性,以便进行更大规模的随机对照试验:共有 33 对恋爱情侣被随机安排使用 A-CHESS 应用程序(积极治疗对照组)或 Partner-CHESS 应用程序(实验组)6 个月。情侣中包括一名酒精使用障碍患者(25/33,76%为男性)和一名恋爱伴侣(26/33,79%为女性)。两组患者和伴侣分别在 0、2、4 和 6 个月时完成结果测量调查。主要结果是患者大量饮酒天数的百分比和任何饮酒天数的百分比,通过时间线跟踪进行测量。次要结果包括应用程序的使用和感知,以及多种社会心理变量:6个月后,78%(14/18)的 "伴侣-健康支持 "患者和 73%(11/15)的 "A-健康支持 "患者仍在使用干预措施。89%(29/33)的 "伴侣-CHESS "患者(平均 3.7,标度 1)和伴侣(平均 3.6,标度 0.9)以及 87%(13/15)的 "A-CHESS "患者(平均 3.1,标度 0.9)对应用程序的帮助程度进行了 5 级评分(1=完全没有帮助,5=非常有帮助)。6个月时,与A-CHESS患者相比,Partner-CHESS患者大量饮酒天数的百分比明显降低(β=-17.4,95% CI -36.1至1.4;P=.07;Hedges g=-0.53),而各组患者饮酒天数的百分比相对相同(β=-2.1,95% CI -24.8至20.7;P=.85;Hedges g=-0.12):初步结果表明,对仅针对患者和以夫妇为中心、基于智能手机的酒精滥用干预进行评估是可行的。结果表明,这两种干预方法都被认为是有帮助的,而且大多数参与者都能在 6 个月内保持参与。有必要在未来进行一次全面的试验,以评估这两种干预措施的相对有效性:试验注册:ClinicalTrials.gov NCT04059549;https://clinicaltrials.gov/ct2/show/NCT04059549。
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引用次数: 0
Understanding Users' Engagement in a Provider-Created Mobile App for Training to Advance Hepatitis C Care: Knowledge Assessment Survey Study. 了解用户在提供商创建的移动应用程序中的参与情况,以促进丙型肝炎护理培训:知识评估调查研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-01 DOI: 10.2196/52729
Maximilian Wegener, Katarzyna Sims, Ralph Brooks, Lisa Nichols, Robert Sideleau, Sharen McKay, Merceditas Villanueva
<p><strong>Background: </strong>The World Health Organization and the Centers for Disease Control and Prevention have set ambitious hepatitis C virus (HCV) elimination targets for 2030. Current estimates show that the United States is not on pace to meet elimination targets due to multiple patient, clinic, institutional, and societal level barriers that contribute to HCV testing and treatment gaps. Among these barriers are unawareness of testing and treatment needs, misinformation concerning adverse treatment reactions, need for substance use sobriety, and treatment efficacy. Strategies to improve viral hepatitis education are needed.</p><p><strong>Objective: </strong>We aim to provide a high-quality HCV educational app for patients and health care workers, particularly nonprescriber staff. The app was vetted by health care providers and designed to guide users through the HCV testing and treatment stages in a self-exploratory way to promote engagement and knowledge retention. The app is comprised of five learning modules: (1) Testing for Hep C (hepatitis C), (2) Tests for Hep C Positive Patients, (3) Treatments Available to You, (4) What to Expect During Treatment, and (5) What to Expect After Treatment.</p><p><strong>Methods: </strong>An HCV knowledge assessment survey was administered to providers and patients at the Yale School of Medicine and 11 Connecticut HIV clinics as part of a grant-funded activity. The survey findings and pilot testing feedback guided the app's design and content development. Data on app usage from November 2019 to November 2022 were analyzed, focusing on user demographics, engagement metrics, and module usage patterns.</p><p><strong>Results: </strong>There were 561 app users; 216 (38.5%) accessed the training modules of which 151 (69.9%) used the app for up to 60 minutes. Of them, 65 (30.1%) users used it for >60 minutes with a median time spent of 5 (IQR 2-8) minutes; the median time between initial accession and last use was 39 (IQR 18-60) days. Users accessed one or more modules and followed a nonsequential pattern of use: module 1: 163 (75.4%) users; module 4: 82 (38%); module 5: 67 (31%); module 3: 49 (22.7%); module 2: 41 (19%).</p><p><strong>Conclusions: </strong>This app, created in an academic setting, is one of a few available in English and Spanish that provides content-vetted HCV education for patients and health care supportive staff. It offers the convenience of on-demand education, allowing users to access crucial information about HCV management and treatment in a self-directed fashion that acknowledges and promotes variable preferences in learning approaches. While app uptake was relatively limited, we propose that future efforts should focus on combined promotion efforts with marketing strategies experts aligned with academic experts. Incorporating ongoing user feedback and integrating personalized reminders and quizzes, will further enhance engagement, supporting the broader public health HCV elimin
背景:世界卫生组织和美国疾病控制与预防中心制定了雄心勃勃的 2030 年消除丙型肝炎病毒(HCV)的目标。目前的估计显示,由于患者、诊所、机构和社会层面的多重障碍导致丙型肝炎病毒检测和治疗缺口,美国无法如期实现消除丙型肝炎病毒的目标。这些障碍包括对检测和治疗需求的不了解、有关治疗不良反应的错误信息、对药物使用的清醒需求以及治疗效果。我们需要改进病毒性肝炎教育的策略:我们旨在为患者和医护人员(尤其是非处方人员)提供一款高质量的丙型肝炎病毒教育应用程序。该应用程序由医护人员审核,旨在以自我探索的方式引导用户完成 HCV 检测和治疗阶段的学习,以提高参与度和知识保留率。该应用程序由五个学习模块组成:(1) 丙型肝炎检测;(2) 丙型肝炎阳性患者的检测;(3) 可用的治疗方法;(4) 治疗期间的注意事项;(5) 治疗后的注意事项:作为资助活动的一部分,耶鲁大学医学院和康涅狄格州 11 家艾滋病诊所的医疗服务提供者和患者接受了丙肝病毒知识评估调查。调查结果和试点测试反馈为应用程序的设计和内容开发提供了指导。对 2019 年 11 月至 2022 年 11 月的应用程序使用数据进行了分析,重点关注用户人口统计、参与度指标和模块使用模式:共有 561 名应用程序用户;216 人(38.5%)访问了培训模块,其中 151 人(69.9%)使用应用程序长达 60 分钟。其中,65 名用户(30.1%)使用时间超过 60 分钟,使用时间中位数为 5 分钟(IQR 2-8 分钟);从首次使用到最后一次使用的时间中位数为 39 天(IQR 18-60 天)。用户访问了一个或多个模块,使用模式无先后之分:模块 1:163(75.4%)人;模块 4:82(38%)人;模块 5:67(31%)人;模块 3:49(22.7%)人;模块 2:41(19%)人:这款在学术环境中开发的应用程序是为数不多的为患者和医疗保健辅助人员提供经过内容审核的丙型肝炎病毒教育的英语和西班牙语应用程序之一。它为按需教育提供了便利,使用户能够以自主的方式获取有关 HCV 管理和治疗的重要信息,这种方式承认并促进了学习方法的不同偏好。虽然应用程序的使用率相对有限,但我们建议未来的工作重点应放在结合营销策略专家与学术专家的推广工作上。纳入持续的用户反馈并整合个性化提醒和测验,将进一步提高参与度,从而支持更广泛的公共卫生消除丙型肝炎病毒的目标。
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引用次数: 0
Web-Based Intervention (SunnysideFlex) to Promote Resilience to Posttraumatic Stress Disorder Symptoms During Pregnancy: Development and Pilot Study. 基于网络的干预措施(SunnysideFlex),促进孕期创伤后应激障碍症状的恢复能力:开发与试点研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-11-01 DOI: 10.2196/53744
Katherine C Paltell, Jennifer Duffecy, Pauline M Maki, Shiva Edalatian Zakeri, Anka A Vujanovic, Erin C Berenz

Background: Approximately 4% to 8% of pregnant individuals meet the criteria for current posttraumatic stress disorder (PTSD), a known risk factor for a multitude of adverse maternal and child health outcomes. However, PTSD is rarely detected or treated in obstetric settings. Moreover, available prenatal PTSD treatments require in-person services that are often inaccessible due to barriers to care. Thus, web-based interventions offer great potential in extending PTSD treatment to high-risk pregnant individuals by providing affordable, accessible care. However, there are currently no web-based interventions designed specifically for the treatment of PTSD symptoms during pregnancy.

Objective: This study aims to develop and pilot a 6-week, web-based, cognitive behavioral therapy intervention for PTSD, SunnysideFlex, in a sample of 10 pregnant women with current probable PTSD. Consistent with established guidelines for developing and testing novel interventions, the focus of this pilot study was to evaluate the initial feasibility and acceptability of the SunnysideFlex intervention and preintervention to postintervention changes in PTSD and depression symptoms. This approach will allow for early refinement and optimization of the SunnysideFlex intervention to increase the odds of success in a larger-scale clinical trial.

Methods: The SunnysideFlex intervention adapted an existing web-based platform for postpartum depression, Sunnyside for Moms, to include revised, trauma-focused content. A total of 10 pregnant women in weeks 16 to 28 of their pregnancy who reported lifetime interpersonal trauma exposure (ie, sexual or physical assault) and with current probable PTSD (scores ≥33 per the PTSD checklist for DSM-5) were enrolled in the SunnysideFlex intervention. Assessments took place at baseline and 6 weeks (postintervention).

Results: All participants were retained through the postintervention assessment period. Engagement was high; participants on average accessed 90% of their lessons, logged on to the platform at least weekly, and reported a generally positive user experience. Moreover, 80% (8/10) of participants demonstrated clinically meaningful reductions in PTSD symptoms from baseline to postintervention, and 50% (5/10) of participants no longer screened positive for probable PTSD at postintervention. Most (6/10, 60%) of the participants maintained subclinical depression symptoms from baseline to postintervention.

Conclusions: Findings from this small pilot study indicate that SunnysideFlex may be a feasible and acceptable mechanism for delivering PTSD intervention to high-risk, trauma-exposed pregnant women who might otherwise not have opportunities for services. Larger-scale trials of the intervention are necessary to better understand the impact of SunnysideFlex on PTSD symptoms during pregnancy and the postpartum period.

背景:约有 4% 至 8% 的孕妇符合当前创伤后应激障碍(PTSD)的标准,这是导致多种不良母婴健康后果的已知风险因素。然而,创伤后应激障碍很少在产科环境中被发现或治疗。此外,现有的产前创伤后应激障碍治疗需要亲临现场的服务,而由于护理方面的障碍,这些服务往往无法获得。因此,基于网络的干预措施提供了巨大的潜力,通过提供可负担、可获得的护理,将创伤后应激障碍治疗扩展到高风险孕妇。然而,目前还没有专门用于治疗孕期创伤后应激障碍症状的网络干预措施:本研究旨在开发一种为期 6 周、基于网络的创伤后应激障碍认知行为疗法干预方法 SunnysideFlex,并在 10 名目前可能患有创伤后应激障碍的孕妇中进行试点。根据开发和测试新型干预措施的既定准则,本试验研究的重点是评估 SunnysideFlex 干预措施的初步可行性和可接受性,以及干预前与干预后创伤后应激障碍和抑郁症状的变化。这种方法将有助于及早完善和优化 SunnysideFlex 干预,以提高在更大规模临床试验中的成功几率:SunnysideFlex 干预疗法对现有的产后抑郁网络平台 "Sunnyside for Moms "进行了调整,增加了以创伤为重点的修订内容。共有 10 名怀孕第 16 至 28 周的孕妇参加了 SunnysideFlex 干预项目,这些孕妇报告称一生中都遭受过人际创伤(即性侵犯或身体侵犯),并且目前可能患有创伤后应激障碍(根据 DSM-5 的创伤后应激障碍检查表,得分≥33)。评估在基线和 6 周(干预后)进行:结果:所有参与者都在干预后评估期间继续参与。参与度很高;参与者平均访问了 90% 的课程,至少每周登录一次平台,并表示用户体验普遍良好。此外,从基线到干预后,80%(8/10)的参与者的创伤后应激障碍症状得到了有临床意义的缓解,50%(5/10)的参与者在干预后不再出现创伤后应激障碍阳性反应。大多数参与者(6/10,60%)从基线到干预后都保持了亚临床抑郁症状:这项小型试点研究的结果表明,向阳疗法可能是一种可行且可接受的机制,可为高风险、受创伤的孕妇提供创伤后应激障碍干预,否则她们可能没有机会获得服务。为了更好地了解 SunnysideFlex 对孕期和产后创伤后应激障碍症状的影响,有必要对该干预措施进行更大规模的试验。
{"title":"Web-Based Intervention (SunnysideFlex) to Promote Resilience to Posttraumatic Stress Disorder Symptoms During Pregnancy: Development and Pilot Study.","authors":"Katherine C Paltell, Jennifer Duffecy, Pauline M Maki, Shiva Edalatian Zakeri, Anka A Vujanovic, Erin C Berenz","doi":"10.2196/53744","DOIUrl":"10.2196/53744","url":null,"abstract":"<p><strong>Background: </strong>Approximately 4% to 8% of pregnant individuals meet the criteria for current posttraumatic stress disorder (PTSD), a known risk factor for a multitude of adverse maternal and child health outcomes. However, PTSD is rarely detected or treated in obstetric settings. Moreover, available prenatal PTSD treatments require in-person services that are often inaccessible due to barriers to care. Thus, web-based interventions offer great potential in extending PTSD treatment to high-risk pregnant individuals by providing affordable, accessible care. However, there are currently no web-based interventions designed specifically for the treatment of PTSD symptoms during pregnancy.</p><p><strong>Objective: </strong>This study aims to develop and pilot a 6-week, web-based, cognitive behavioral therapy intervention for PTSD, SunnysideFlex, in a sample of 10 pregnant women with current probable PTSD. Consistent with established guidelines for developing and testing novel interventions, the focus of this pilot study was to evaluate the initial feasibility and acceptability of the SunnysideFlex intervention and preintervention to postintervention changes in PTSD and depression symptoms. This approach will allow for early refinement and optimization of the SunnysideFlex intervention to increase the odds of success in a larger-scale clinical trial.</p><p><strong>Methods: </strong>The SunnysideFlex intervention adapted an existing web-based platform for postpartum depression, Sunnyside for Moms, to include revised, trauma-focused content. A total of 10 pregnant women in weeks 16 to 28 of their pregnancy who reported lifetime interpersonal trauma exposure (ie, sexual or physical assault) and with current probable PTSD (scores ≥33 per the PTSD checklist for DSM-5) were enrolled in the SunnysideFlex intervention. Assessments took place at baseline and 6 weeks (postintervention).</p><p><strong>Results: </strong>All participants were retained through the postintervention assessment period. Engagement was high; participants on average accessed 90% of their lessons, logged on to the platform at least weekly, and reported a generally positive user experience. Moreover, 80% (8/10) of participants demonstrated clinically meaningful reductions in PTSD symptoms from baseline to postintervention, and 50% (5/10) of participants no longer screened positive for probable PTSD at postintervention. Most (6/10, 60%) of the participants maintained subclinical depression symptoms from baseline to postintervention.</p><p><strong>Conclusions: </strong>Findings from this small pilot study indicate that SunnysideFlex may be a feasible and acceptable mechanism for delivering PTSD intervention to high-risk, trauma-exposed pregnant women who might otherwise not have opportunities for services. Larger-scale trials of the intervention are necessary to better understand the impact of SunnysideFlex on PTSD symptoms during pregnancy and the postpartum period.</p>","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Digital Youth and Family Engagement Program for Adolescents Who Receive Outpatient Mental Health Services: Qualitative Evaluation. 针对接受门诊心理健康服务的青少年的数字化青少年和家庭参与计划:定性评估。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-31 DOI: 10.2196/60317
Ana Ramirez, Justin Kramer, Katrina Hazim, Jason Roberge
<p><strong>Background: </strong>Incidents of depression, anxiety, and suicidal ideation among adolescents have increased in recent years. Mental health interventions tailored to adolescents and families need to consider mechanisms for increasing enrollment and sustaining program engagement. A telephone-based, health coach intervention for adolescents and families was implemented at a Southeastern US health system with the goals of improving psychiatric appointment attendance, medication adherence, reduction in emergency department visits, and assisting with crisis management ("Youth and Family Engagement" [YFE] program).</p><p><strong>Objective: </strong>This study aims to explore patients' and parents' perceptions of a mental health program and the factors that impact enrollment and sustained engagement.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with adolescent patients (n=9, 56%), parents (n=11, 92%), and clinicians who placed patient referrals (n=6, 100%). Interviews were in English (participants: 19/26, 73%) or Spanish (parents: 7/11, 64%), depending upon participants' preference. Interviews explored perceptions of the YFE program, experiences working with health coaches, suggestions for program changes, and program goals. The data were analyzed using inductive coding methodologies, with thematic analysis used to organize emergent themes. Two qualitatively trained researchers, one bilingual in English and Spanish, facilitated all data collection and collaboratively performed data analysis.</p><p><strong>Results: </strong>The YFE program's structure was often mentioned as promoting engagement, with telephone appointments and health coaches' ability to accommodate inflexible work or school schedules alleviating participation barriers. Skills learned from health coaches were frequently referenced, with adolescents generally citing internal processes, such as positive thinking and mindfulness. Parents discussed behaviors relative to their children, such as improvements with discipline, setting boundaries, and improved parent-child communication. Many participants discussed the importance of health coaches assisting families in navigating social systems, such as accessing resources (eg, housing) and navigating school processes (eg, individualized educational plans), with clinicians suggesting an increased emphasis on adolescents' nutrition and engagement in primary care. Spanish-speaking parents highlighted numerous advantages of working with bilingual health coaches, emphasizing both enhanced communication and cultural understanding. They specifically noted the coaches' ability to grasp their lived experiences and challenges as immigrants in the United States, which significantly enriched their participation in the program.</p><p><strong>Conclusions: </strong>Prioritizing convenient engagement for adolescents and families may be important for sustained program participation, as inflexible schedules and competing pri
背景:近年来,青少年抑郁症、焦虑症和自杀倾向的发病率有所上升。针对青少年和家庭的心理健康干预措施需要考虑增加注册人数和维持项目参与度的机制。美国东南部一家医疗系统针对青少年和家庭实施了一项基于电话的健康指导干预措施,目的是提高精神科预约就诊率、服药依从性、减少急诊就诊率,并协助危机管理("青少年和家庭参与"[YFE] 计划):本研究旨在探讨患者和家长对心理健康项目的看法,以及影响注册和持续参与的因素:研究人员对青少年患者(9 人,占 56%)、家长(11 人,占 92%)以及转介患者的临床医生(6 人,占 100%)进行了结构化访谈。根据参与者的偏好,访谈以英语(参与者:19/26,73%)或西班牙语(家长:7/11,64%)进行。访谈内容包括对 YFE 计划的看法、与健康顾问合作的经历、对计划改革的建议以及计划目标。采用归纳编码方法对数据进行分析,并使用主题分析法对出现的主题进行整理。两名接受过定性培训的研究人员(其中一人精通英语和西班牙语)协助了所有的数据收集工作,并共同进行了数据分析:人们经常提到 YFE 项目的结构促进了参与度,电话预约和健康指导员能够满足工作或学习时间安排不灵活的情况,从而减轻了参与障碍。从健康指导员那里学到的技能也经常被提及,青少年普遍提到了内部过程,如积极思考和正念。家长们则讨论了与子女有关的行为,如改善纪律、设定界限以及改善亲子沟通等。许多参与者讨论了健康指导员协助家庭驾驭社会系统的重要性,如获取资源(如住房)和驾驭学校程序(如个性化教育计划),临床医生建议更加重视青少年的营养和参与初级保健。讲西班牙语的家长强调了与双语健康指导员合作的诸多优势,强调了加强沟通和文化理解的重要性。他们特别指出,教练能够理解他们作为美国移民的生活经历和面临的挑战,这极大地丰富了他们对项目的参与:结论:优先考虑方便青少年和家庭的参与对于持续参与项目可能很重要,因为不灵活的时间安排和相互竞争的优先事项对传统的预约造成了障碍。未来的计划应仔细考虑健康指导员与参与者之间的关系,特别是文化能力、用母语提供服务以及协助家庭进行综合护理,因为这些可能对持续参与至关重要。
{"title":"Digital Youth and Family Engagement Program for Adolescents Who Receive Outpatient Mental Health Services: Qualitative Evaluation.","authors":"Ana Ramirez, Justin Kramer, Katrina Hazim, Jason Roberge","doi":"10.2196/60317","DOIUrl":"10.2196/60317","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Incidents of depression, anxiety, and suicidal ideation among adolescents have increased in recent years. Mental health interventions tailored to adolescents and families need to consider mechanisms for increasing enrollment and sustaining program engagement. A telephone-based, health coach intervention for adolescents and families was implemented at a Southeastern US health system with the goals of improving psychiatric appointment attendance, medication adherence, reduction in emergency department visits, and assisting with crisis management (\"Youth and Family Engagement\" [YFE] program).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to explore patients' and parents' perceptions of a mental health program and the factors that impact enrollment and sustained engagement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Semistructured interviews were conducted with adolescent patients (n=9, 56%), parents (n=11, 92%), and clinicians who placed patient referrals (n=6, 100%). Interviews were in English (participants: 19/26, 73%) or Spanish (parents: 7/11, 64%), depending upon participants' preference. Interviews explored perceptions of the YFE program, experiences working with health coaches, suggestions for program changes, and program goals. The data were analyzed using inductive coding methodologies, with thematic analysis used to organize emergent themes. Two qualitatively trained researchers, one bilingual in English and Spanish, facilitated all data collection and collaboratively performed data analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The YFE program's structure was often mentioned as promoting engagement, with telephone appointments and health coaches' ability to accommodate inflexible work or school schedules alleviating participation barriers. Skills learned from health coaches were frequently referenced, with adolescents generally citing internal processes, such as positive thinking and mindfulness. Parents discussed behaviors relative to their children, such as improvements with discipline, setting boundaries, and improved parent-child communication. Many participants discussed the importance of health coaches assisting families in navigating social systems, such as accessing resources (eg, housing) and navigating school processes (eg, individualized educational plans), with clinicians suggesting an increased emphasis on adolescents' nutrition and engagement in primary care. Spanish-speaking parents highlighted numerous advantages of working with bilingual health coaches, emphasizing both enhanced communication and cultural understanding. They specifically noted the coaches' ability to grasp their lived experiences and challenges as immigrants in the United States, which significantly enriched their participation in the program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Prioritizing convenient engagement for adolescents and families may be important for sustained program participation, as inflexible schedules and competing pri","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-Reported Patient and Provider Satisfaction With Neurology Telemedicine Visits After Rapid Telemedicine Implementation in an Urban Academic Center: Cross-Sectional Survey. 在城市学术中心快速实施远程医疗后,患者和医疗服务提供者对神经科远程医疗就诊的自述满意度:横断面调查。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-30 DOI: 10.2196/53491
Noah Robertson, Maryam J Syed, Bowen Song, Arshdeep Kaur, Janaki G Patel, Rohit Marawar, Maysaa Basha, Deepti Zutshi
<p><strong>Background: </strong>Many clinics and health systems implemented telemedicine appointment services out of necessity due to the COVID-19 pandemic.</p><p><strong>Objective: </strong>Our objective was to evaluate patient and general provider satisfaction with neurology telemedicine implementation at an urban academic medical center.</p><p><strong>Methods: </strong>Patients who had completed 1 or more teleneurology visits from April 1 to December 31, 2020, were asked to complete a survey regarding their demographic information and satisfaction with teleneurology visits. Providers of all specialties within the same hospital system were given a different survey to gather their experiences of providing telemedicine care.</p><p><strong>Results: </strong>Of the estimated 1500 patients who had completed a teleneurology visit within the given timeframe, 117 (7.8%) consented to complete the survey. Of these 117 respondents, most appointments were regarding epilepsy (n=59, 50.4%), followed by multiple sclerosis (n=33, 28.2%) and neuroimmunology (n=7, 6%). Overall, 74.4% (n=87) of patients rated their experience as 8 out of 10 or higher, with 10 being the highest satisfaction. Furthermore, 75.2% (n=88) of patients reported missing an appointment in the previous year due to transportation issues and thought telemedicine was more convenient instead. A significant relationship between racial or ethnic group and comfort sharing private information was found (P<.001), with 52% (26/50) of Black patients reporting that an office visit is better, compared to 25% (14/52) of non-Black patients. The provider survey gathered 40 responses, with 75% (n=30) of providers agreeing that virtual visits are a valuable tool for patient care and 80% (n=32) reporting few to no technical issues. The majority of provider respondents were physicians on faculty or staff (n=21, 52%), followed by residents or fellows (n=15, 38%) and nurse practitioners or physician assistants (n=4, 10%). Of the specialties represented, 15 (38%) of the providers were in neurology.</p><p><strong>Conclusions: </strong>Our study found adequate satisfaction among patients and providers regarding telemedicine implementation and its utility for patient care in a diverse urban population. Additionally, while access to technology and technology literacy are barriers to telemedical care, a substantial majority of patients who responded to the survey had access to devices (101/117, 86.3%) and were able to connect with few to no technological difficulties (84/117, 71.8%). One area identified by patients in need of improvement was comfortability in communicating via telemedicine with their providers. Furthermore, while providers agreed that telemedicine is a useful tool for patient care, it limits their ability to perform physical exams. More research and quality studies are needed to further appreciate and support the expansion of telemedical care into underserved and rural populations, especially in the a
背景:由于 COVID-19 大流行,许多诊所和医疗系统不得不实施远程医疗预约服务:由于 COVID-19 大流行,许多诊所和医疗系统不得不实施远程医疗预约服务:我们的目的是评估患者和一般医疗服务提供者对城市学术医疗中心神经科远程医疗实施情况的满意度:我们要求在 2020 年 4 月 1 日至 12 月 31 日期间完成 1 次或 1 次以上远程神经病学就诊的患者完成一份调查,内容涉及他们的人口统计学信息以及对远程神经病学就诊的满意度。同一医院系统内所有专科的医疗人员都接受了不同的调查,以收集他们提供远程医疗服务的经验:在规定时间内完成远程神经科就诊的约 1500 名患者中,有 117 人(7.8%)同意完成调查。在这 117 名受访者中,大多数预约都与癫痫有关(59 人,占 50.4%),其次是多发性硬化症(33 人,占 28.2%)和神经免疫学(7 人,占 6%)。总体而言,74.4%(87 人)的患者将就医体验评为 8 分或以上(满分 10 分),其中 10 分的满意度最高。此外,75.2%(人数=88)的患者表示去年因交通问题错过了一次预约,并认为远程医疗反而更方便。研究发现,种族或民族群体与是否乐于分享私人信息之间存在重要关系(结论:我们的研究发现,患者和医生对远程医疗的满意度都很高:我们的研究发现,在一个多元化的城市人口中,患者和医疗服务提供者对远程医疗的实施及其对患者护理的实用性表示满意。此外,虽然获得技术和技术知识是远程医疗的障碍,但绝大多数回复调查的患者都能获得设备(101/117,86.3%),并且在连接时几乎没有遇到任何技术困难(84/117,71.8%)。患者认为需要改进的一个方面是通过远程医疗与医疗服务提供者沟通时的舒适度。此外,虽然医疗服务提供者同意远程医疗是病人护理的有用工具,但它限制了他们进行身体检查的能力。需要进行更多的研究和质量调查,以进一步了解和支持将远程医疗扩展到服务不足的人群和农村地区,尤其是神经病学亚专科护理领域。
{"title":"Self-Reported Patient and Provider Satisfaction With Neurology Telemedicine Visits After Rapid Telemedicine Implementation in an Urban Academic Center: Cross-Sectional Survey.","authors":"Noah Robertson, Maryam J Syed, Bowen Song, Arshdeep Kaur, Janaki G Patel, Rohit Marawar, Maysaa Basha, Deepti Zutshi","doi":"10.2196/53491","DOIUrl":"https://doi.org/10.2196/53491","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Many clinics and health systems implemented telemedicine appointment services out of necessity due to the COVID-19 pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Our objective was to evaluate patient and general provider satisfaction with neurology telemedicine implementation at an urban academic medical center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients who had completed 1 or more teleneurology visits from April 1 to December 31, 2020, were asked to complete a survey regarding their demographic information and satisfaction with teleneurology visits. Providers of all specialties within the same hospital system were given a different survey to gather their experiences of providing telemedicine care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the estimated 1500 patients who had completed a teleneurology visit within the given timeframe, 117 (7.8%) consented to complete the survey. Of these 117 respondents, most appointments were regarding epilepsy (n=59, 50.4%), followed by multiple sclerosis (n=33, 28.2%) and neuroimmunology (n=7, 6%). Overall, 74.4% (n=87) of patients rated their experience as 8 out of 10 or higher, with 10 being the highest satisfaction. Furthermore, 75.2% (n=88) of patients reported missing an appointment in the previous year due to transportation issues and thought telemedicine was more convenient instead. A significant relationship between racial or ethnic group and comfort sharing private information was found (P&lt;.001), with 52% (26/50) of Black patients reporting that an office visit is better, compared to 25% (14/52) of non-Black patients. The provider survey gathered 40 responses, with 75% (n=30) of providers agreeing that virtual visits are a valuable tool for patient care and 80% (n=32) reporting few to no technical issues. The majority of provider respondents were physicians on faculty or staff (n=21, 52%), followed by residents or fellows (n=15, 38%) and nurse practitioners or physician assistants (n=4, 10%). Of the specialties represented, 15 (38%) of the providers were in neurology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study found adequate satisfaction among patients and providers regarding telemedicine implementation and its utility for patient care in a diverse urban population. Additionally, while access to technology and technology literacy are barriers to telemedical care, a substantial majority of patients who responded to the survey had access to devices (101/117, 86.3%) and were able to connect with few to no technological difficulties (84/117, 71.8%). One area identified by patients in need of improvement was comfortability in communicating via telemedicine with their providers. Furthermore, while providers agreed that telemedicine is a useful tool for patient care, it limits their ability to perform physical exams. More research and quality studies are needed to further appreciate and support the expansion of telemedical care into underserved and rural populations, especially in the a","PeriodicalId":14841,"journal":{"name":"JMIR Formative Research","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An Online Tailored COVID-19 Vaccination Decision Aid for Dutch Citizens: Development, Dissemination, and Use. 为荷兰公民量身定制的在线 COVID-19 疫苗接种决策辅助工具:开发、传播和使用。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-30 DOI: 10.2196/56390
Katharina Preuhs, Daphne Bussink-Voorend, Hilde M van Keulen, Ilona Wildeman, Jeannine Hautvast, Marlies Hulscher, Pepijn van Empelen

Background: Since December 2019, COVID-19 led to a pandemic causing many hospitalizations and deaths. Vaccinations were developed and introduced to control viral transmission. In the Dutch context, the decision to accept vaccination is not mandatory. An informed decision is based on sufficient and reliable information, in line with one's attitudes and values, and with consideration of pros and cons. To support people in informed decision-making, we developed an online COVID-19 vaccination decision aid (DA).

Objective: This article aims to describe the development, dissemination, and use of the DA.

Methods: Building on a previously developed DA, the COVID-19 vaccination DA was developed in 3 phases following a user-centered design approach: (1) definition phase, (2) concept testing, and (3) prototype testing. End users, individuals with low literacy, and experts (with relevant expertise on medical, behavioral, and low literacy aspects) were involved in the iterative development, design, and testing, with their feedback forming the basis for adaptations to the DA.

Results: The DA was developed within 14 weeks. The DA consists of 3 modules, namely, Provide Information, Support Decision-Making, and Facilitate Actions Following a Decision. These modules are translated into various information tiles and diverse functionalities such as a knowledge test, a value clarification tool using a decisional balance, and a communication tool. The DA was disseminated for use in May 2021. Users varied greatly regarding age, gender, and location in the Netherlands.

Conclusions: This paper elaborates on the development of the COVID-19 vaccination DA in a brief period and its dissemination for use among Dutch adults in the Netherlands. The evaluation of use showed that we were able to reach a large proportion and variety of people throughout the Netherlands.

背景:自 2019 年 12 月以来,COVID-19 引发了一场大流行,造成许多人住院和死亡。为控制病毒传播,荷兰开发并引入了疫苗接种。在荷兰,接受疫苗接种的决定不是强制性的。知情的决定是基于充分和可靠的信息,符合个人的态度和价值观,并考虑到利弊。为了帮助人们做出知情决定,我们开发了一个在线 COVID-19 疫苗接种辅助决策工具(DA):本文旨在介绍DA的开发、传播和使用情况:方法:COVID-19 疫苗接种辅助工具是在之前开发的辅助工具基础上,按照以用户为中心的设计方法分三个阶段开发的:(1)定义阶段;(2)概念测试;(3)原型测试。最终用户、识字率低的个人和专家(具有医学、行为学和识字率低方面的相关专业知识)参与了迭代开发、设计和测试,他们的反馈意见构成了对DA进行调整的基础:DA 在 14 周内开发完成。DA 由 3 个模块组成,即提供信息、支持决策和促进决策后的行动。这些模块被转化为各种信息瓦片和多种功能,如知识测试、使用决策平衡的价值澄清工具和交流工具。2021 年 5 月,DA 开始推广使用。用户的年龄、性别和在荷兰的地点差异很大:本文阐述了 COVID-19 疫苗接种评估工具在短时间内的开发过程,以及在荷兰成年人中的推广使用情况。对使用情况的评估表明,我们能够在荷兰全国范围内接触到大量不同人群。
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引用次数: 0
Perceptions Toward Using Artificial Intelligence and Technology for Asthma Attack Risk Prediction: Qualitative Exploration of Māori Views. 对使用人工智能和技术预测哮喘发作风险的看法:毛利人观点的定性探索。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-30 DOI: 10.2196/59811
Widana Kankanamge Darsha Jayamini, Farhaan Mirza, Marie-Claire Bidois-Putt, M Asif Naeem, Amy Hai Yan Chan

Background: Asthma is a significant global health issue, impacting over 500,000 individuals in New Zealand and disproportionately affecting Māori communities in New Zealand, who experience worse asthma symptoms and attacks. Digital technologies, including artificial intelligence (AI) and machine learning (ML) models, are increasingly popular for asthma risk prediction. However, these AI models may underrepresent minority ethnic groups and introduce bias, potentially exacerbating disparities.

Objective: This study aimed to explore the views and perceptions that Māori have toward using AI and ML technologies for asthma self-management, identify key considerations for developing asthma attack risk prediction models, and ensure Māori are represented in ML models without worsening existing health inequities.

Methods: Semistructured interviews were conducted with 20 Māori participants with asthma, 3 male and 17 female, aged 18-76 years. All the interviews were conducted one-on-one, except for 1 interview, which was conducted with 2 participants. Altogether, 10 web-based interviews were conducted, while the rest were kanohi ki te kanohi (face-to-face). A thematic analysis was conducted to identify the themes. Further, sentiment analysis was carried out to identify the sentiments using a pretrained Bidirectional Encoder Representations from Transformers model.

Results: We identified four key themes: (1) concerns about AI use, (2) interest in using technology to support asthma, (3) desired characteristics of AI-based systems, and (4) experience with asthma management and opportunities for technology to improve care. AI was relatively unfamiliar to many participants, and some of them expressed concerns about whether AI technology could be trusted, kanohi ki te kanohi interaction, and inadequate knowledge of AI and technology. These concerns are exacerbated by the Māori experience of colonization. Most of the participants were interested in using technology to support their asthma management, and we gained insights into user preferences regarding computer-based health care applications. Participants discussed their experiences, highlighting problems with health care quality and limited access to resources. They also mentioned the factors that trigger their asthma control level.

Conclusions: The exploration revealed that there is a need for greater information about AI and technology for Māori communities and a need to address trust issues relating to the use of technology. Expectations in relation to computer-based applications for health purposes were expressed. The research outcomes will inform future investigations on AI and technology to enhance the health of people with asthma, in particular those designed for Indigenous populations in New Zealand.

背景:哮喘是一个重大的全球性健康问题,影响着新西兰50多万人,对新西兰毛利社区的影响尤为严重,他们的哮喘症状和发作更为严重。包括人工智能(AI)和机器学习(ML)模型在内的数字技术在哮喘风险预测方面越来越受欢迎。然而,这些人工智能模型可能对少数民族群体的代表性不足,并引入偏见,从而可能加剧差异:本研究旨在探讨毛利人对使用人工智能和ML技术进行哮喘自我管理的观点和看法,确定开发哮喘发作风险预测模型的关键考虑因素,并确保ML模型中毛利人的代表性不会加剧现有的健康不平等:对 20 名患有哮喘的毛利人进行了半结构式访谈,其中男性 3 人,女性 17 人,年龄在 18-76 岁之间。除了一次访谈是与两名参与者一起进行外,其他所有访谈都是一对一进行的。总共进行了 10 次网络访谈,其余的都是 kanohi ki te kanohi(面对面)访谈。我们进行了主题分析,以确定主题。此外,我们还进行了情感分析,使用预先训练好的转换器双向编码器表征模型来识别情感:我们确定了四个关键主题:(1) 对使用人工智能的担忧;(2) 使用技术为哮喘提供支持的兴趣;(3) 基于人工智能的系统的理想特性;(4) 哮喘管理经验和技术改善护理的机会。人工智能对许多参与者来说相对陌生,其中一些人对人工智能技术是否值得信赖、kanohi ki te kanohi 互动以及对人工智能和技术了解不足表示担忧。毛利人的殖民经历加剧了这些担忧。大多数参与者都有兴趣使用技术来支持他们的哮喘管理,我们也因此深入了解了用户对基于计算机的医疗保健应用程序的偏好。参与者讨论了他们的经历,强调了医疗质量和资源有限的问题。他们还提到了影响哮喘控制水平的因素:调查显示,毛利社区需要更多关于人工智能和技术的信息,并需要解决与技术使用相关的信任问题。人们表达了对基于计算机的健康应用的期望。研究成果将为今后有关人工智能和技术的调查提供信息,以提高哮喘患者的健康水平,特别是为新西兰土著居民设计的人工智能和技术。
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引用次数: 0
Ensuring Accuracy and Equity in Vaccination Information From ChatGPT and CDC: Mixed-Methods Cross-Language Evaluation. 确保来自 ChatGPT 和 CDC 的疫苗接种信息的准确性和公平性:混合方法跨语言评估。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-30 DOI: 10.2196/60939
Saubhagya Joshi, Eunbin Ha, Andee Amaya, Melissa Mendoza, Yonaira Rivera, Vivek K Singh
<p><strong>Background: </strong>In the digital age, large language models (LLMs) like ChatGPT have emerged as important sources of health care information. Their interactive capabilities offer promise for enhancing health access, particularly for groups facing traditional barriers such as insurance and language constraints. Despite their growing public health use, with millions of medical queries processed weekly, the quality of LLM-provided information remains inconsistent. Previous studies have predominantly assessed ChatGPT's English responses, overlooking the needs of non-English speakers in the United States. This study addresses this gap by evaluating the quality and linguistic parity of vaccination information from ChatGPT and the Centers for Disease Control and Prevention (CDC), emphasizing health equity.</p><p><strong>Objective: </strong>This study aims to assess the quality and language equity of vaccination information provided by ChatGPT and the CDC in English and Spanish. It highlights the critical need for cross-language evaluation to ensure equitable health information access for all linguistic groups.</p><p><strong>Methods: </strong>We conducted a comparative analysis of ChatGPT's and CDC's responses to frequently asked vaccination-related questions in both languages. The evaluation encompassed quantitative and qualitative assessments of accuracy, readability, and understandability. Accuracy was gauged by the perceived level of misinformation; readability, by the Flesch-Kincaid grade level and readability score; and understandability, by items from the National Institutes of Health's Patient Education Materials Assessment Tool (PEMAT) instrument.</p><p><strong>Results: </strong>The study found that both ChatGPT and CDC provided mostly accurate and understandable (eg, scores over 95 out of 100) responses. However, Flesch-Kincaid grade levels often exceeded the American Medical Association's recommended levels, particularly in English (eg, average grade level in English for ChatGPT=12.84, Spanish=7.93, recommended=6). CDC responses outperformed ChatGPT in readability across both languages. Notably, some Spanish responses appeared to be direct translations from English, leading to unnatural phrasing. The findings underscore the potential and challenges of using ChatGPT for health care access.</p><p><strong>Conclusions: </strong>ChatGPT holds potential as a health information resource but requires improvements in readability and linguistic equity to be truly effective for diverse populations. Crucially, the default user experience with ChatGPT, typically encountered by those without advanced language and prompting skills, can significantly shape health perceptions. This is vital from a public health standpoint, as the majority of users will interact with LLMs in their most accessible form. Ensuring that default responses are accurate, understandable, and equitable is imperative for fostering informed health decisions across diverse co
背景:在数字时代,像 ChatGPT 这样的大型语言模型(LLMs)已成为医疗保健信息的重要来源。它们的交互能力为提高医疗服务的可及性带来了希望,特别是对于面临保险和语言限制等传统障碍的群体。尽管其在公共卫生领域的应用日益广泛,每周处理的医疗查询达数百万次,但 LLM 所提供信息的质量仍然参差不齐。以往的研究主要评估 ChatGPT 的英语回复,忽略了美国非英语使用者的需求。本研究通过评估 ChatGPT 和美国疾病控制与预防中心 (CDC) 提供的疫苗接种信息的质量和语言平等性来弥补这一不足,同时强调健康公平:本研究旨在评估 ChatGPT 和 CDC 用英语和西班牙语提供的疫苗接种信息的质量和语言平等性。本研究旨在评估 ChatGPT 和 CDC 用英语和西班牙语提供的疫苗接种信息的质量和语言公平性,强调跨语言评估的关键需求,以确保所有语言群体都能公平地获取健康信息:我们用两种语言对 ChatGPT 和疾病预防控制中心对疫苗接种相关常见问题的回答进行了比较分析。评估包括对准确性、可读性和可理解性的定量和定性评估。准确性通过错误信息的感知程度来衡量;可读性通过弗莱什-金凯德等级和可读性评分来衡量;可理解性通过美国国立卫生研究院的患者教育材料评估工具 (PEMAT) 工具中的项目来衡量:研究发现,ChatGPT 和 CDC 提供的回答大多准确易懂(例如,满分 95 分以上)。但是,Flesch-Kincaid 等级往往超过美国医学会的建议等级,尤其是英语(例如,ChatGPT 的英语平均等级=12.84,西班牙语=7.93,建议等级=6)。在两种语言的可读性方面,疾病防治中心的回复都优于 ChatGPT。值得注意的是,一些西班牙语回复似乎是从英语直接翻译过来的,导致措辞不自然。这些发现强调了将 ChatGPT 用于医疗保健访问的潜力和挑战:结论:ChatGPT 具有作为健康信息资源的潜力,但需要在可读性和语言公平性方面加以改进,才能对不同人群真正有效。最重要的是,ChatGPT 的默认用户体验(通常是那些没有高级语言和提示技能的用户)会极大地影响人们的健康观念。从公共卫生的角度来看,这一点至关重要,因为大多数用户将以最容易理解的形式与 LLM 互动。确保默认回复的准确性、可理解性和公平性对于促进不同社区做出明智的健康决定至关重要。
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引用次数: 0
Person-Centered Web-Based Mobile Health System (Symptoms) for Reporting Symptoms in COVID-19 Vaccinated Individuals: Observational Study of System, Users, and Symptoms. 以人为本的网络移动医疗系统(症状)用于报告 COVID-19 疫苗接种者的症状:对系统、用户和症状的观察研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-30 DOI: 10.2196/57514
Emelie Gustafson Hedov, Fredrik Nyberg, Stefan Gustafsson, Huiqi Li, Magnus Gisslén, Johan Sundström
<p><strong>Background: </strong>The full spectrum of side effects from COVID-19 vaccinations and infections, including milder symptoms or health effects that do not lead to health care visits, remains unknown. Person-centered self-reporting of symptoms may offer a solution. Monitoring patient-reported outcomes over time will vary in importance for different patients. Individuals have unique needs and preferences, in terms of both communication methods and how the collected information is used to support care.</p><p><strong>Objective: </strong>This study aims to describe how Symptoms, a system for person-centered self-reporting of symptoms and health-related quality of life, was utilized in investigating COVID-19 vaccine side effects. We illustrate this by presenting data from the Symptoms system in newly vaccinated individuals from the RECOVAC (Register-based large-scale national population study to monitor COVID-19 vaccination effectiveness and safety) study.</p><p><strong>Methods: </strong>During the COVID-19 pandemic, newly vaccinated individuals were identified as the ideal population to query for milder symptoms related to COVID-19 vaccinations and infections. To this end, we used posters in observation areas at 150 vaccination sites across the Västra Götaland region of Sweden, inviting newly vaccinated individuals to use a novel digital system, Symptoms. In the Symptoms system, users can track their symptoms, functioning, and quality of life as often as they wish, using evidence-based patient-reported outcome measures and short numeric rating scales. These scales cover a prespecified list of symptoms based on common COVID-19 symptoms and previously reported vaccine side effects. Participants could also use numeric rating scales for self-defined symptoms if their symptom was not included on the prespecified list.</p><p><strong>Results: </strong>A total of 731 people created user accounts and consented to share data for research between July 21, 2021, and September 27, 2022. The majority of users were female (444/731, 60.7%), with a median age of 38 (IQR 30-47) years. Most participants (498/702, 70.9%) did not report any of the comorbidities included in the questionnaire. Of the 731 participants, 563 (77.0%) reported experiencing 1 or more symptoms. The most common symptom was pain at the injection site (486/563, 86.3%), followed by fatigue (181/563, 32.1%) and headache (169/563, 30.0%). In total, 143 unique symptoms were reported. Of these, 29 were from the prespecified list, while the remaining 114 (79.7%) were self-defined entries in the symptom field. This suggests that the flexibility of the self-directed system-allowing individuals to decide which symptoms they consider worth tracking-may be an important feature.</p><p><strong>Conclusions: </strong>Self-reported symptoms in the Symptoms system appeared to align with previously observed post-COVID-19 vaccination symptoms. The system was relatively easy to use and successfully captured br
背景:COVID-19 疫苗接种和感染所产生的各种副作用(包括较轻的症状或不会导致就医的健康影响)仍不为人所知。以人为本的症状自我报告可能是一种解决方案。随着时间的推移,监测患者报告的结果对不同患者的重要性会有所不同。在沟通方式和如何使用收集到的信息支持护理方面,个人都有独特的需求和偏好:本研究旨在描述在调查 COVID-19 疫苗副作用时,如何利用 "症状 "这一以人为中心的症状和健康相关生活质量自我报告系统。我们通过展示 RECOVAC(基于登记的大规模全国人口研究,用于监测 COVID-19 疫苗接种的有效性和安全性)研究中新接种者的症状系统数据来说明这一点:方法:在 COVID-19 大流行期间,新接种者被确定为理想的人群,可查询与 COVID-19 疫苗接种和感染相关的较轻症状。为此,我们在瑞典Västra Götaland地区150个疫苗接种点的观察区张贴海报,邀请新接种者使用新型数字系统 "症状"。在 "症状 "系统中,用户可以使用循证患者报告结果测量方法和简短的数字评分量表,根据自己的意愿随时跟踪自己的症状、功能和生活质量。这些量表涵盖了根据 COVID-19 常见症状和之前报告的疫苗副作用预先指定的一系列症状。如果参与者的症状不在预设清单中,他们也可以使用数字评分量表对自我定义的症状进行评分:结果:在 2021 年 7 月 21 日至 2022 年 9 月 27 日期间,共有 731 人创建了用户账户并同意分享研究数据。大多数用户为女性(444/731,60.7%),中位年龄为 38(IQR 30-47)岁。大多数参与者(498/702,70.9%)未报告问卷中包含的任何合并症。在 731 名参与者中,有 563 人(77.0%)报告出现过一种或多种症状。最常见的症状是注射部位疼痛(486/563,86.3%),其次是疲劳(181/563,32.1%)和头痛(169/563,30.0%)。总共报告了 143 个独特的症状。其中 29 项来自预设清单,其余 114 项(79.7%)是在症状栏中自行定义的条目。这表明,自主系统的灵活性--允许个人决定哪些症状值得追踪--可能是一个重要特点:结论:"症状 "系统中的自我报告症状似乎与之前观察到的 COVID-19 疫苗接种后症状一致。该系统相对易于使用,并能成功获取广泛的纵向数据。该系统以人为本、自主设计,这对于全面了解用户的症状似乎至关重要。
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引用次数: 0
Interest in the Use of Herbal Supplements to Close the Treatment Gap for Hazardous Alcohol Use Among Men Who Have Sex With Men: Secondary Analysis of a Cross-Sectional Study. 对使用草药补充剂缩小男性同性性行为者中有害酒精使用治疗差距的兴趣:一项横断面研究的二次分析。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-10-29 DOI: 10.2196/60370
Christopher Hernandez, Christopher Rowe, Janet Ikeda, Justine Arenander, Glenn-Milo Santos

Background: Hazardous alcohol consumption is highly prevalent for men who have sex with men (MSM). The 4 treatments currently approved by the Food and Drug Administration for alcohol use are reaching an alarmingly low percentage of people who would benefit from a reduction in their alcohol use. There is increasing interest in alternative methods of treatment, such as herbal supplements, to address hazardous drinking. However, research on the acceptability of alternative pharmacotherapies among MSM remains limited.

Objective: We examined the prevalence and correlates of expressing interest in using herbal supplements for alcohol treatment among MSM with hazardous alcohol consumption.

Methods: We conducted a secondary data analysis from a cross-sectional study of MSM who use alcohol, conducted from March 2015 to July 2017 in San Francisco, California, to assess the overall prevalence of interest in using herbal supplements to help reduce alcohol consumption. Associations between expressing interest in herbal supplements and demographic, social, and clinical characteristics were examined using bivariate and multivariable logistic regression models.

Results: One-third (66/200, 33%) of the participants expressed interest in an herbal supplement for reducing alcohol consumption. In the multivariable analyses, weekly binge drinking (adjusted odds ratio [aOR] 2.85, 95% CI 1.17-6.93), interest in abstaining from alcohol use (aOR 5.04, 95% CI 1.46-17.40), higher severity of alcohol dependence score (aOR 1.22, 95% CI 1.04-1.41), and interest in naltrexone (aOR 3.22, 95% CI 2.12-4.91) were independently associated with higher odds of being interested in using an herbal supplement to reduce alcohol consumption, adjusting for age, race or ethnicity, and education.

Conclusions: We found that MSM who have hazardous drinking habits, more severe alcohol dependence, and interest in pharmacotherapy were more likely to express interest in using an herbal supplement for reducing alcohol consumption. To our knowledge, this is the first study that has evaluated correlates of interest in herbal supplements for alcohol use among MSM. As researchers implement novel alcohol treatment studies, they should focus on recruitment efforts among MSM with a motivation to reduce their alcohol use patterns.

背景:在男男性行为者(MSM)中,酗酒危害很大。目前,美国食品和药物管理局批准了 4 种针对酗酒的治疗方法,但这些治疗方法在因减少酗酒而受益的人群中所占比例却低得惊人。人们对草药补充剂等替代治疗方法越来越感兴趣,以解决危险饮酒问题。然而,有关 MSM 对替代药物疗法接受程度的研究仍然有限:我们研究了有酗酒危险的 MSM 对使用草药补充剂治疗酒精表示兴趣的普遍性和相关性:我们对 2015 年 3 月至 2017 年 7 月在加利福尼亚州旧金山进行的一项针对饮酒 MSM 的横断面研究进行了二次数据分析,以评估使用草药补充剂帮助减少酒精消费的总体兴趣流行率。使用二元和多变量逻辑回归模型研究了对草药补充剂表示兴趣与人口统计学、社会和临床特征之间的关联:结果:三分之一的参与者(66/200,33%)表示对草药补充剂有兴趣,以减少饮酒量。在多变量分析中,每周酗酒(调整后的几率比 [aOR] 2.85,95% CI 1.17-6.93)、对戒酒感兴趣(aOR 5.04,95% CI 1.46-17.40)、酒精依赖评分严重程度较高(aOR 1.22,95% CI 1.04-1.41)、对盐酸饮料感兴趣。41)和对纳曲酮的兴趣(aOR 3.22,95% CI 2.12-4.91)与有兴趣使用草药补充剂来减少酒精消费的更高几率独立相关,并对年龄、种族或民族以及教育程度进行了调整:我们发现,有危险饮酒习惯、更严重酒精依赖和对药物治疗感兴趣的 MSM 更有可能表示有兴趣使用草药补充剂来减少饮酒量。据我们所知,这是第一项对 MSM 使用草药补充剂解酒的兴趣相关性进行评估的研究。研究人员在开展新型酒精治疗研究时,应重点关注有减少饮酒动机的 MSM 的招募工作。
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