Patient Education and Counseling最新文献

英文中文

Are AI chatbots concordant with evidence-based cancer screening recommendations?

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-21 DOI: 10.1016/j.pec.2025.108677

Brooke Nickel , Julie Ayre , M Luke Marinovich , David P. Smith , Karen Chiam , Christoph I. Lee , Timothy J. Wilt , Melody Taba , Kirsten McCaffery , Nehmat Houssami

Objective

This study aimed to assess whether information from AI chatbots on benefits and harms of breast and prostate cancer screening were concordant with evidence-based cancer screening recommendations.

Methods

Seven unique prompts (four breast cancer; three prostate cancer) were presented to ChatGPT in March 2024. A total of 60 criteria (30 breast; 30 prostate) were used to assess the concordance of information. Concordance was scored between 0 and 2 against the United States Preventive Services Task Force (USPSTF) breast and prostate cancer screening recommendations independently by international cancer screening experts.

Results

43 of 60 (71.7 %) criteria were completely concordant, 3 (5 %) were moderately concordant and 14 (23.3 %) were not concordant or not present, with most of the non-concordant criteria (9 of 14, 64.3 %) being from prompts for the oldest age groups. ChatGPT hallucinations (i.e., completely made up, non-sensical or irrelevant information) were found in 9 of 60 criteria (15 %).

Conclusions

ChatGPT provided information mostly concordant with USPSTF breast and prostate cancer screening recommendations, however, important gaps exist. These findings provide insights into the role of AI to communicate cancer screening benefits and harms and hold increased relevance for periods of guideline change.

Practice implications

AI generated information on cancer screening should be taken in conjunction with official screening recommendations and/or information from clinicians.

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引用次数: 0

Websites parents' access for information regarding their child's chronic lower limb pain: A qualitative study

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-21 DOI: 10.1016/j.pec.2025.108670

Luke M. Davies , Jeremy Lai , Louise Tofts , Daphne Nguyen , Sacha McCulloch , Cylie M. Williams , Verity Pacey

Objective

To explore the parent experience of finding information on websites to support their child with chronic lower limb pain and explore the quality of information available on those websites.

Methods

Parents of children with chronic lower limb pain conducted real-time searching of websites followed by semi-structured interviews via Zoom. Interviews were recorded, transcribed verbatim, and analysed thematically using an inductive approach. Websites were evaluated by two reviewers across seven domains using the Health Information Website Evaluation Tool.

Results

Fourteen parents of children impacted by chronic lower limb pain searched and viewed 34 websites. Four themes were identified: (i) aesthetics matter; (ii) trust builds trust; (iii) something is better than nothing, but it’s never enough; (iv) improving accessibility. Nine websites (26 %) were considered ‘good’ quality and 25 (74 %) were considered ‘moderate’ quality. The Readability domain achieved maximum scores across 88 % of websites, and the Accuracy domain, reflecting referencing and evidence search processes, scored the most minimum scores on 74 % of websites.

Conclusion

Parents accessing online resources for their child's chronic lower limb pain seek accessible and in-depth information. While parents find easy to understand quality websites, there is a need for more paediatric-specific resources that reflect current evidence.

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引用次数: 0

Stage-based analysis of an adaptive worksite intervention trial for diabetes prevention

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-20 DOI: 10.1016/j.pec.2025.108671

Carla K. Miller , Danielle King , Kentaro Fujita , Jennifer Cheavens

Objective

Stage-based models of change posit stage specific factors to promote motivation and intention formation for those not ready to change and volitional action strategies for others. The impact of two interventions on energy restriction and weight change among adults with prediabetes (n = 190) was examined by baseline stage.

Methods

Stage classification included: Pre-intenders had no intention to change; Intenders set an intention but were not acting; and Actors reported eating a low-fat diet at baseline. Intervention impact on intention formation, planning, self-efficacy, energy intake, and weight change was evaluated. Structural equation modeling identified mechanisms of change.

Results

At baseline, Pre-intenders (28.3 %) and Actors (41.7 %) significantly differed in action self-efficacy, planning, and energy intake. Post-intervention, 91.7 % of the sample remained Actors or progressed in stage placement; intention to consume a low-fat diet increased for Pre-intenders. An increase in action self-efficacy strengthened intention formation for Intenders/Actors. Model fit for post-intentional factors was unsatisfactory, but dietary planning may promote energy restriction.

Conclusions

The lifestyle interventions promoted stage progression. Whether post-intentional mechanisms of change differ for Pre-intenders compared to Intenders/Actors requires further research.

Practice implications

Classifying participants by intention and tailoring interventions to stage may promote greater intention formation and reduction in energy intake.

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引用次数: 0

Do people prefer AI-generated patient educational materials over traditional ones?

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-20 DOI: 10.1016/j.pec.2025.108672

Kathia E. Nitsch, Srinivas J. Ivatury

Objective

This study aimed to assess people’s preference between traditional and Artificial Intelligence (AI)-generated colon cancer staging Patient Education Materials (PEMs).

Methods

We assessed preference among patients and companions being seen for a non-cancer diagnosis at the UT Health Austin Colon and Rectal Surgery Clinic. Participants were blinded to the study concept of AI and generation method of PEMs (Traditional: National Cancer Institute and the American Cancer Society; AI-generated: ChatGPT and Google Bard). Participants completed an anonymous demographic survey and ranked their PEM preference for randomized, de-identified materials. We hypothesized that there would be no difference in preference between the AI-generated and traditional PEMs. This study is IRB approved (STUDY00005203).

Results

35 participants were recruited, ages 27–79 years (mean 46; SD 14 years) and 57 % female. 54 % were four-year college graduates. Among the participants, 51 % ranked the traditional PEMs as most preferred, while 49 % ranked the AI-generated PEMs as most preferred (p = NS).

Conclusion

People do not have a dominant preference for AI-generated or traditional PEMs.

Practice implications

Further investigation on the use of AI for PEM generation is warranted. AI may be capable of generating PEMs that incorporate the strengths of traditional PEMs while also reducing the required resources for PEM generation.

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引用次数: 0

The effect of conflicting versus consistent messaging on older women’s support for breast cancer screening cessation

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-20 DOI: 10.1016/j.pec.2025.108675

Nancy L. Schoenborn , Sarah E. Gollust , Craig E. Pollack , Mara A. Schonberg , Cynthia M. Boyd , Qian-Li Xue , Rebekah H. Nagler

Objective

Breast cancer over-screening is common in older women. Messaging about breast cancer screening cessation may reduce over-screening but the broader informational environment often emphasizes screening continuation. We aimed to examine the effect of receiving consistent messages about breast cancer screening cessation versus conflicting messages (i.e., receiving messages about screening cessation and screening continuation from different sources).

Methods

In a two-wave survey experiment with 3809 women 65 + years from a U.S. population-based online panel, we randomized participants to a) no messages, b) consistent messages promoting screening cessation, or c) conflicting messages – a message promoting screening continuation followed by a message promoting screening cessation.

Results

The conflicting message group had significantly lower support for screening cessation in a hypothetical older woman (mean 3.87 [SD 2.00] on 7-point scale, 95 % CI 3.76–3.97) compared with the consistent message group (mean 4.17 [SD 1.99], 95 % CI 4.08–4.28), but was still significantly higher than the control group (mean 2.68 [SD 1.87], 95 % CI 2.54–2.82, p’s < 0.001). Message effects on self-screening intentions were similar. Participants reported low rates of confusion, distrust or ambivalence.

Conclusions

Messaging about screening cessation can significantly increase older women’s support for screening cessation, with low rates of negative reactions, even if there are competing messages on continued screening.

Practice implications

Messaging about screening cessation can be incorporated into clinical discussions or used in conjunction with other interventions aimed at reducing over-screening.

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引用次数: 0

Hierarchies of knowledge in responses to messages of newbies in online health support groups

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-18 DOI: 10.1016/j.pec.2025.108661

Carolina Figueras Bates , Barbara De Cock

Objectives

To determine how hierarchies of knowledge are established in two online health forums: one for recovery from eating disorders and the other for diabetes.

Methods

28 threads, with a total of 55,462 words were collected from the eating disorders (ED) forum. From the diabetes (D) forum, 18 threads were extracted, with a total of 51,397 words.

We performed a quantitative and a qualitative analysis of the structures and mechanisms to convey experiential knowledge and to deliver advice.

Results

The frequency of strategies such as providing facts about the illness, sharing personal stories and using medical terminology was higher in the diabetes forum than in the eating disorder forum. In the category of providing advice, ED and D responders behaved as experts and formulated advice in an authoritative way by resorting to imperatives and deontics of obligation.

Conclusion

In both fora, epistemic and emotional experiences are presented. The goal in each site is the creation of shared understanding among their members. Experiential knowledge is highly personal, and it is never depicted as antagonistic to medical expertise.

Practice Implications

Experiential knowledge is complex and rich and can complement medical expertise in the treatment of long-term and/or chronic health conditions.

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引用次数: 0

The electronic health record as an interactional and epistemic resource: Insights from pediatric well-child visits

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-18 DOI: 10.1016/j.pec.2025.108664

Federica Ranzani

Objective

Electronic health records (EHRs) have increasingly become integral to contemporary medical consultations, including pediatric care. This study aims at exploring the interactional use of the EHR during naturally occurring pediatric well-child visits, focusing specifically on how pediatricians and parents manage knowledge concerning infants’ growth inscribed in the EHR.

Methods

Conversation analysis is used to analyze 23 video-recorded Italian well-child visits involving two pediatricians and twenty-two families with children aged 0–18 months.

Results

The analysis focuses on the delicate activity of assessing infants’ growth, a widespread parental concern. It illustrates how a no-problem assessment is collaboratively achieved through the interactional mobilization of the EHR. While parents draw upon their experiential knowledge to assess their child’s “normality” (or not), pediatricians resort to expert knowledge inscribed in the EHR (e.g., growth percentiles and growth charts), thereby making the EHR a locally and institutionally relevant agent in the interaction.

Conclusion

A hierarchy of types and sources of knowledge is presupposed and ratified by both parents and pediatricians in these visits. Expert information inscribed in the EHR is collaboratively built as the most authoritative voice to the detriment of parent-reported experiential knowledge.

Practice implications

While acknowledging potential risks, leveraging the EHR can be a valuable interactional and epistemic resource for healthcare professionals working in pediatric care to a) soothe parental concerns regarding infants’ development, and b) offer evidential support for their evaluations, thereby displaying professional accountability.

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引用次数: 0

From experts’ perspective, factors affecting the effectiveness of online educational programs in promoting the health literacy of MS patients: A grounded theory approach

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-17 DOI: 10.1016/j.pec.2025.108673

Seyed Kian Haji seyed javadi , Aisan Nouri

Background

Online educational programs have emerged as a promising tool for promoting health literacy (HL) among multiple sclerosis (MS) patients. However, identifying influencing factors is crucial for maximizing their effectiveness.

Aim

This study aimed to explain the factors affecting the effectiveness of online educational programs in promoting HL among MS patients in Iran.

Methods

A qualitative methodology based on Grounded Theory (GT) was employed and participants were recruited using snowball sampling. A total of 17 experts, including patient educators and HL experts, were interviewed until theoretical saturation was achieved. Participants were selected from patient rehabilitation centers in Tehran and members of the Iran MS Society.

Results

Analysis of the interview data revealed six contextual factors. These factors included socioeconomic status, healthcare infrastructure, technological accessibility and literacy, cultural and linguistic diversity, support networks and caregiver involvement, and health policy and regulatory environment.

Conclusions

Addressing socioeconomic disparities, improving technological access and literacy and fostering cultural sensitivity are essential steps to enhance the effectiveness and accessibility of these programs. Moreover, collaboration with caregivers and policymakers is crucial for creating an enabling environment that supports the successful integration of online health education initiatives into MS care.

Practice implications

Findings from this study can enhance the efficacy and productivity of online programs aimed at boosting HL among patients with specific conditions like MS

{"title":"From experts’ perspective, factors affecting the effectiveness of online educational programs in promoting the health literacy of MS patients: A grounded theory approach","authors":"Seyed Kian Haji seyed javadi , Aisan Nouri","doi":"10.1016/j.pec.2025.108673","DOIUrl":"10.1016/j.pec.2025.108673","url":null,"abstract":"<div><h3>Background</h3><div>Online educational programs have emerged as a promising tool for promoting health literacy (HL) among multiple sclerosis (MS) patients. However, identifying influencing factors is crucial for maximizing their effectiveness.</div></div><div><h3>Aim</h3><div>This study aimed to explain the factors affecting the effectiveness of online educational programs in promoting HL among MS patients in Iran.</div></div><div><h3>Methods</h3><div>A qualitative methodology based on Grounded Theory (GT) was employed and participants were recruited using snowball sampling. A total of 17 experts, including patient educators and HL experts, were interviewed until theoretical saturation was achieved. Participants were selected from patient rehabilitation centers in Tehran and members of the Iran MS Society.</div></div><div><h3>Results</h3><div>Analysis of the interview data revealed six contextual factors. These factors included socioeconomic status, healthcare infrastructure, technological accessibility and literacy, cultural and linguistic diversity, support networks and caregiver involvement, and health policy and regulatory environment.</div></div><div><h3>Conclusions</h3><div>Addressing socioeconomic disparities, improving technological access and literacy and fostering cultural sensitivity are essential steps to enhance the effectiveness and accessibility of these programs. Moreover, collaboration with caregivers and policymakers is crucial for creating an enabling environment that supports the successful integration of online health education initiatives into MS care.</div></div><div><h3>Practice implications</h3><div>Findings from this study can enhance the efficacy and productivity of online programs aimed at boosting HL among patients with specific conditions like MS</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108673"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient and family engagement in culturally-tailored diabetes self-management education in a Hispanic community

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-17 DOI: 10.1016/j.pec.2025.108669

Denise J. Deverts , Margaret F. Zupa , Edith C. Kieffer , Stephanie Gonzalez , Claudia Guajardo , Felix Valbuena , Gretchen A. Piatt , Jonathan G. Yabes , Christina Lalama , Michele Heisler , Ann-Marie Rosland

Objectives

Diabetes self-management education (DSME) is effective in improving outcomes among adults with diabetes (AWD); but engagement in DSME has been lower among Hispanic AWD. We examined factors predicting engagement of Hispanic AWD in culturally tailored DSME that included a family/friend ‘support person’.

Methods

222 predominantly Hispanic AWD enrolled in DSME with a support person (SP), half of the AWD-SP pairs participated in pair-focused (‘FAM-ACT’) DSME and the others in patient-focused DSME. Enrollment survey and health record-based participant characteristics were compared to program attendance data.

Results

On average, AWD completed 3.8 of 6 and SPs 2.6 of 6 sessions. Engaged AWD (attended ≥4/6 DSME sessions) were more likely to live apart from their SP, have HbA1c ≥ 9 % (11.8 mmol/L), and currently prioritize diabetes among other competing demands. Engaged AWD in FAM-ACT were more likely to have SPs who also met engagement criteria (attended ≥3 DSME sessions), and SPs with pre-diabetes and high ‘patient activation’.

Conclusions

Hispanic AWD who co-attended with family supporters, had higher glycemic levels, and ability to prioritize diabetes management were more engaged in culturally-tailored DSME.

Practice implications

Engaging family supporters and focusing on those with current health and personal motivation may increase Hispanic adult engagement in DSME.

{"title":"Patient and family engagement in culturally-tailored diabetes self-management education in a Hispanic community","authors":"Denise J. Deverts , Margaret F. Zupa , Edith C. Kieffer , Stephanie Gonzalez , Claudia Guajardo , Felix Valbuena , Gretchen A. Piatt , Jonathan G. Yabes , Christina Lalama , Michele Heisler , Ann-Marie Rosland","doi":"10.1016/j.pec.2025.108669","DOIUrl":"10.1016/j.pec.2025.108669","url":null,"abstract":"<div><h3>Objectives</h3><div>Diabetes self-management education (DSME) is effective in improving outcomes among adults with diabetes (AWD); but engagement in DSME has been lower among Hispanic AWD. We examined factors predicting engagement of Hispanic AWD in culturally tailored DSME that included a family/friend ‘support person’.</div></div><div><h3>Methods</h3><div>222 predominantly Hispanic AWD enrolled in DSME with a support person (SP), half of the AWD-SP pairs participated in pair-focused (‘FAM-ACT’) DSME and the others in patient-focused DSME. Enrollment survey and health record-based participant characteristics were compared to program attendance data.</div></div><div><h3>Results</h3><div>On average, AWD completed 3.8 of 6 and SPs 2.6 of 6 sessions. Engaged AWD (attended ≥4/6 DSME sessions) were more likely to live apart from their SP, have HbA1c ≥ 9 % (11.8 mmol/L), and currently prioritize diabetes among other competing demands. Engaged AWD in FAM-ACT were more likely to have SPs who also met engagement criteria (attended ≥3 DSME sessions), and SPs with pre-diabetes and high ‘patient activation’.</div></div><div><h3>Conclusions</h3><div>Hispanic AWD who co-attended with family supporters, had higher glycemic levels, and ability to prioritize diabetes management were more engaged in culturally-tailored DSME.</div></div><div><h3>Practice implications</h3><div>Engaging family supporters and focusing on those with current health and personal motivation may increase Hispanic adult engagement in DSME.</div></div>","PeriodicalId":49714,"journal":{"name":"Patient Education and Counseling","volume":"134 ","pages":"Article 108669"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploring epistemic management of healthcare interactions in the digital era

IF 2.9 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Patient Education and Counseling

Pub Date : 2025-01-17 DOI: 10.1016/j.pec.2025.108660

Ramona Bongelli , Ilaria Riccioni

引用次数: 0

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