K4Health
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This Digital Health Resource Library houses three legacy collections previously maintained by the Knowledge for Health (K4Health) Project. K4Health’s work was made possible by the support of the American People through the United States Agency for International Development (USAID) . K4Health was supported from 2008-2019 by USAID's Office of Population and Reproductive Health, Bureau for Global Health, under cooperative agreements with the Johns Hopkins University. K4Health was implemented by the Johns Hopkins Center for Communication Programs (CCP) in collaboration with FHI 360, Management Sciences for Health (MSH), and IntraHealth International. The K4Health Project ended in September 2019.
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Browsing K4Health by Subject "Addressing individual beliefs and practices"
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- ItemThe acceptability of e-technology to monitor and assess patient symptoms following palliative radiotherapy for lung cancer.(2011-10-11) Cox, Anna; Illsley, Marianne; Knibb, Wendy; Lucas, Caroline; O'Driscoll, Michael; Potter, Claire; Flowerday, Adrian; Faithfull, SaraE technology is increasingly used in oncology to obtain self reported symptom assessment information from patients although its potential to provide a clinical monitoring tool in palliative care is relatively unexplored in the UK This study aimed to evaluate the support provided to lung cancer patients post palliative radiotherapy using a computerized assessment tool and to determine the clinical acceptability of the tool in a palliative care setting However of the 17 clinicians identified as managing patients who met the initial eligibility criteria for the study only one clinician gave approval for their patient to be contacted regarding participation therefore the benefits of this novel technology could not be assessed Thirteen key clinicians from the centres involved in the study were subsequently interviewed They acknowledged potential benefits of incorporating computerized patient assessment from both a patient and practice perspective but emphasized the importance of clinical intuition over standardized assessment Although clinicians were positive about palliative care patients participating in research they felt that this population of patients were normally too old with too rapidly deteriorating a condition to participate in a study using e technology In order to encourage acceptance of e technology within palliative care emphasis is needed on actively promoting the contribution of technologies with the potential to improve patient outcomes and the patient experience
- ItemAcceptability of smartphone application-based HIV prevention among young men who have sex with men.(2014-01-29) Holloway, Ian W; Rice, Eric; Gibbs, Jeremy; Winetrobe, Hailey; Dunlap, Shannon; Rhoades, HarmonyYoung men who have sex with men YMSM are increasingly using mobile smartphone applications apps such as Grindr to meet sex partners A probability sample of 195 Grindr using YMSM in Southern California were administered an anonymous online survey to assess patterns of and motivations for Grindr use in order to inform development and tailoring of smartphone based HIV prevention for YMSM The number one reason for using Grindr 29 was to meet hook ups Among those participants who used both Grindr and online dating sites a statistically significantly greater percentage used online dating sites for hook ups 42 compared to Grindr 30 Seventy percent of YMSM expressed a willingness to participate in a smartphone app based HIV prevention program Development and testing of smartphone apps for HIV prevention delivery has the potential to engage YMSM in HIV prevention programming which can be tailored based on use patterns and motivations for use
- ItemAcceptance of information and communication technologies for healthcare delivery: a SingHealth Polyclinics study.(2009-06-30) Luo, Nan; Koh, Woon-Puay; Ng, Wai-Yee; Yau, Joachim Wen-Kien; Lim, Lian-Kiat; Sim, Samuel Syn-Pin; Tay, Ee-GuanOBJECTIVE This study aimed to determine the prevalence of short message system SMS and internet usage in patients visiting the SingHealth Polyclinics and to measure patients acceptance of using these technologies in healthcare delivery MATERIALS AND METHODS A representative sample of patients visiting the 9 SingHealth Polyclinics were interviewed in person by trained medical students Collected information included demographic characteristics access to and usage of mobile phone SMS and internet as well as acceptance and concerns on using these technologies in primary healthcare delivery RESULTS Among 705 patients surveyed mean age 54 6 years female 50 6 response rate 92 407 57 7 were SMS users and 158 22 4 were internet users Two hundred and eighty four of 412 SMS and or internet users 40 3 of the entire sample were comfortable with the use of these technologies in healthcare delivery Malay or Indian ethnicity better education and visiting the clinic for acute symptoms or screening were factors positively associated with willingness to use such technologies The main concerns associated with the use of SMS and internet in healthcare delivery were preference for in person consultation with a doctor 23 5 reduced patient doctor interaction 23 0 and increased healthcare cost 20 8 CONCLUSION The present prevalence of SMS and internet usage among patients visiting the SingHealth Polyclinics and their concerns towards use of these technologies in healthcare delivery do not support current widespread implementation of services entailing SMS and internet in the study sites
- ItemAfrican American adolescents and new media: associations with HIV/STI risk behavior and psychosocial variables.(2011-07-13) Whiteley, Laura B; Brown, Larry K; Swenson, Rebecca R; Romer, Daniel; DiClemente, Ralph J P; Salazar, Laura E; Vanable, Peter A; Carey, Michael P; Valois, Robert FOBJECTIVES Cell phones and online media are used frequently but we know little about their use among African American adolescents This study examines the frequency of such use and its relationship to psychosocial variables and STI HIV risk behavior SETTING PARTICIPANTS 1 518 African American aged 13 18 years from 2 Northeast US cities Providence RI Syracuse NY and 2 Southeast US cities Columbia SC Macon GA were assessed from 2008 2009 DESIGN Participants were assessed on frequency of cell phone and Internet use psychological constructs ie depression life satisfaction impulsivity and HIV STI risk behaviors ie history of intercourse sexual sensation seeking attitudes peer sexual risks norms with reliable scales and measures using an audio computer assisted self interview RESULTS Over 90 of African American adolescents used cell phones every day or most days and 60 used social networking sites every day or most days 96 used Myspace Greater frequency of cell phone use was associated with sexual sensation seeking P 000 riskier peer sexual norms P 000 and impulsivity P 016 Greater frequency of Internet use was associated with a history of oral vaginal anal sex OR 1 03 CI 1 0 1 05 and sexual sensation seeking P 000 CONCLUSION These findings suggest that riskier youth are online and using cell phones frequently The Internet and cell phones may be useful platforms for targeted health promotion and prevention efforts with AA adolescents
- ItemAligning health information technologies with effective service delivery models to improve chronic disease care.(2014-08-06) Bauer, Amy M; Thielke, Stephen M; Katon, Wayne; Unützer, Jürgen; Areán, PatriciaOBJECTIVE Healthcare reforms in the United States including the Affordable Care and HITECH Acts and the NCQA criteria for the Patient Centered Medical Home have promoted health information technology HIT and the integration of general medical and mental health services These developments which aim to improve chronic disease care have largely occurred in parallel with little attention to the need for coordination In this article the fundamental connections between HIT and improvements in chronic disease management are explored We use the evidence based collaborative care model as an example with attention to health literacy improvement for supporting patient engagement in care METHOD A review of the literature was conducted to identify how HIT and collaborative care an evidence based model of chronic disease care support each other RESULTS Five key principles of effective collaborative care are outlined care is patient centered evidence based measurement based population based and accountable The potential role of HIT in implementing each principle is discussed Key features of the mobile health paradigm are described including how they can extend evidence based treatment beyond traditional clinical settings CONCLUSION HIT and particularly mobile health can enhance collaborative care interventions and thus improve the health of individuals and populations when deployed in integrated delivery systems
- ItemAnalyzing recommender systems for health promotion using a multidisciplinary taxonomy: A scoping review(2018-05-14) Hors-Fraile, S; Rivera-Romero, O; Schneider, F; Fernandez-Luque, L; Luna-Perejon, F; Civit- Balcells, A; de Vries, HUnderdiv Underspan style font size 10 5755px Recommender systems are information retrieval systems that provide users with relevant items e g through messages Despite their extensive use in the e commerce and leisure domains their application in healthcare is still in its infancy These systems may be used to create tailored health interventions thus reducing the cost of healthcare and fostering a healthier lifestyle in the population Under span Under div Underdiv Andnbsp Under div Underdiv Underspan style font size 10 5755px ObjectiveUnder span Under div Underdiv Underspan style font size 10 5755px This paper identifies categorizes and analyzes the existing knowledge in terms of the literature published over the past 10 years on the use of health recommender systems for patient interventions The aim of this study is to understand the scientific evidence generated about health recommender systems to identify any gaps in this field to achieve the United Nations Sustainable Development Goal 3 SDG3 namely Ensure healthy lives and promote well being for all at all ages and to suggest possible reasons for these gaps as well as to propose some solutions Under span Under div
- ItemApps of steel: are exercise apps providing consumers with realistic expectations?: a content analysis of exercise apps for presence of behavior change theory.(2013-04-03) Cowan, Logan T; Van Wagenen, Sarah A; Brown, Brittany A; Hedin, Riley J; Seino-Stephan, Yukiko; Hall, P Cougar; West, Joshua HOBJECTIVE To quantify the presence of health behavior theory constructs in iPhone apps targeting physical activity METHODS This study used a content analysis of 127 apps from Apple s App Store Health And Fitness category Coders downloaded the apps and then used an established theory based instrument to rate each app s inclusion of theoretical constructs from prominent behavior change theories Five common items were used to measure 20 theoretical constructs for a total of 100 items A theory score was calculated for each app Multiple regression analysis was used to identify factors associated with higher theory scores RESULTS Apps were generally observed to be lacking in theoretical content Theory scores ranged from 1 to 28 on a 100 point scale The health belief model was the most prevalent theory accounting for 32 of all constructs Regression analyses indicated that higher priced apps and apps that addressed a broader activity spectrum were associated with higher total theory scores CONCLUSION It is not unexpected that apps contained only minimal theoretical content given that app developers come from a variety of backgrounds and many are not trained in the application of health behavior theory The relationship between price and theory score corroborates research indicating that higher quality apps are more expensive There is an opportunity for health and behavior change experts to partner with app developers to incorporate behavior change theories into the development of apps These future collaborations between health behavior change experts and app developers could foster apps superior in both theory and programming possibly resulting in better health outcomes
- ItemAre MSM willing to SMS for HIV prevention?(2013-12-27) Khosropour, Christine M; Lake, Jason G; Sullivan, Patrick SText messaging is a potential HIV prevention tool for men who have sex with men MSM specifically young MSM and MSM of color To determine the willingness of MSM to receive text messages as part of an HIV prevention intervention we administered an online survey to MSM recruited from MySpace com which included questions about mobile phone ownership and willingness to participate in a future text message based HIV research study Of participants 85 n 5 378 reported owning a mobile phone and 49 n 2 483 of mobile phone owners reported being willing to receive text messages in a future HIV research study Black and Hispanic men were more willing than White non Hispanic men to receive text messages Men with a college degree were less willing to receive texts than men with a high school level of education and men 22 years old were less likely to be willing to receive texts than those younger than 22 years of age The authors findings demonstrate that willingness to receive text messages as part of an HIV research study is moderate and mirrors patterns of text message use in age and race Variations in willingness should be taken into account when designing and implementing future interventions
- ItemAre smokers with HIV using information and communication technology? Implications for behavioral interventions.(2012-02-08) Chander, Geetanjali; Stanton, Cassandra; Hutton, Heidi E; Abrams, David B; Pearson, Jennifer; Knowlton, Amy; Latkin, Carl; Holtgrave, David; Moore, Richard D; Niaura, RaymondSmoking is highly prevalent among persons living with HIV AIDS PLWHA and associated with adverse outcomes including malignancy and cardiovascular disease Information and communication technology ICT may be effective in disseminating cessation interventions among PLWHA This study examines the prevalence of ICT use among 492 PLWHA attending an urban clinic and characteristics associated with ICT use Participants completed a survey of demographics smoking status and ICT use Factors associated with ICT use were examined with logistic regression Overall 63 of participants smoked with 73 of smokers owning their own cell phone Use of other modalities was lower with 48 of smokers reporting any internet use 39 text messaging and 31 using email Higher education was associated with the use of all modalities Cell phone interventions may have the broadest reach among PLWHA though with almost half using the internet this may also be a low cost means of delivering cessation interventions
- ItemAttitudes of heart failure patients and health care providers towards mobile phone-based remote monitoring.(2010-11-30) Seto, Emily; Leonard, Kevin J; Masino, Caterina; Cafazzo, Joseph A; Barnsley, Jan; Ross, Heather JBACKGROUND Mobile phone based remote patient monitoring systems have been proposed for heart failure management because they are relatively inexpensive and enable patients to be monitored anywhere However little is known about whether patients and their health care providers are willing and able to use this technology OBJECTIVE The objective of our study was to assess the attitudes of heart failure patients and their health care providers from a heart function clinic in a large urban teaching hospital toward the use of mobile phone based remote monitoring METHODS A questionnaire regarding attitudes toward home monitoring and technology was administered to 100 heart failure patients 94 100 returned a completed questionnaire Semi structured interviews were also conducted with 20 heart failure patients and 16 clinicians to determine the perceived benefits and barriers to using mobile phone based remote monitoring as well as their willingness and ability to use the technology RESULTS The survey results indicated that the patients were very comfortable using mobile phones mean rating 4 5 SD 0 6 on a five point Likert scale even more so than with using computers mean 4 1 SD 1 1 The difference in comfort level between mobile phones and computers was statistically significant PUnder 001 Patients were also confident in using mobile phones to view health information mean 4 4 SD 0 9 Patients and clinicians were willing to use the system as long as several conditions were met including providing a system that was easy to use with clear tangible benefits maintaining good patient provider communication and not increasing clinical workload Clinicians cited several barriers to implementation of such a system including lack of remuneration for telephone interactions with patients and medicolegal implications CONCLUSIONS Patients and clinicians want to use mobile phone based remote monitoring and believe that they would be able to use the technology However they have several reservations such as potential increased clinical workload medicolegal issues and difficulty of use for some patients due to lack of visual acuity or manual dexterity
- ItemBrdsNBz: a text-messaging forum for improving the sexual health of adolescents in North Carolina.(2010-12-09) Phillips, Kay R
- ItemCell phone text messaging may boost smoking quit rates.(2011-09-14) Snider, Janice
- ItemCell phone usage among adolescents in Uganda: acceptability for relaying health information.(2011-09-08) Mitchell, Kimberly J; Bull, Sheana; Kiwanuka, Julius; Ybarra, Michele LThe increase in cell phone use has manifested a growing interest in using this technology for health promotion The portability and always on features of the cell phone along with increasing capability for the devices to carry and transfer data suggest that they will reach more people than computers and the Internet in coming years Self reported quantitative survey data from 1503 secondary school students in Mbarara Uganda collected in 2008 2009 suggest that 27 currently have cell phones and about half 51 of all students and 61 of those who owned a cell phone believe that they would access a text messaging based HIV prevention program if it were available Other forms of program delivery modality e g Internet religious organizations schools were preferred to text messaging however We are in need of effective HIV prevention programs that can reach large audiences at low cost and are culturally relevant for the East African context Researchers are encouraged to consider translation of effective HIV prevention programs for cell phone delivery in Africa
- ItemCommunication technologies and maternal interest in health-promotion information about postpartum weight and parenting practices.(2012-07-27) Walker, Lorraine O; Im, Eun-Ok; Vaughan, Misha WOBJECTIVE To describe postpartum women s access perceived skill confidence and use of Internet and mobile technologies their views about receiving health information about postpartum weight and parenting and whether these factors varied by race ethnicity or income level DESIGN Health survey of a stratified random sample SETTING County in central Texas PARTICIPANTS One hundred forty five 145 White Anglo African American or Hispanic women of higher and lower income RESULTS Overall 122 84 1 of respondents had access to a computer with an Internet connection at home and made daily use of the following the Internet 77 6 e mail 75 4 cell phone 97 1 and text messaging 66 7 Significant racial ethnic and income differences occurred in home Internet access frequency of Internet and e mail use and perceived confidence or skill favoring White Anglo women over ethnic minority women and those of higher over lower income Overall 35 9 of women expressed a lot of interest in an Internet based weight loss program 38 9 in a weight loss program sent by mail 44 8 in an Internet based parenting advice and 38 6 in parenting advice sent by mail Women of higher and lower income differed significantly in their interest in three of the four types of health promotion information and methods of delivery CONCLUSION Generally women with lower income were more likely to express high interest in receiving health information related to parenting by mail than those of higher incomes whereas women of higher incomes were more likely to express high interest in receiving weight loss and parenting information through the Internet
- ItemComparison of the middle-aged and older users' adoption of mobile health services in China.(2014-01-20) Deng, Zhaohua; Mo, Xiuting; Liu, ShanOBJECTIVE Given the increasing number of older people China has become an aging society A mobile health service is a type of health informatics that provides personalized healthcare advice to those who require it especially the older people and the middle aged However few studies consider the adoption of mobile health services with regard to older and middle aged users This paper explored a research model based on the value attitude behavior model theory of planned behavior and four aging characteristic constructs to investigate how older and middle aged citizens adopted mobile health services METHOD The hypothesized model was empirically tested using data collected from a survey of 424 residents older than 40 years in China Structural equation modeling was used to estimate the significance of the path coefficients RESULTS The findings revealed that 1 perceived value attitude perceived behavior control and resistance to change can be used to predict intention to use mobile health services for the middle aged group 2 perceived value attitude perceived behavior control technology anxiety and self actualization need positively affected the behavior intention of older users and 3 subjective norm and perceived physical condition showed no significant effects on the behavior intention to use mobile health services for the two groups The theoretical and practical implications and contributions of this study are then discussed
- ItemDeaf client with bipolar illness: a case report.(2007-11-20) Gupta, Maneesh; Caddy, JennyThis case report highlights the diagnostic and assessment difficulties faced by mental health professionals when dealing with a Deaf client
- ItemDevelopment and feasibility of a text messaging and interactive voice response intervention for low-income, diverse adults with type 2 diabetes mellitus.(2013-06-13) Osborn, Chandra Y; Mulvaney, Shelagh ALow income racial ethnic minorities are often nonadherent to diabetes medications have uncontrolled glycemia and have high rates of diabetes related morbidity Cell phones provide a viable modality to support medication adherence but few cell phone based interventions have been designed for low income persons a population with more feature phone penetration than smartphone penetration In an effort to reach the broadest range of patients we leveraged the voice and text messaging capabilities shared by all cell phones to design the MEssaging for Diabetes intervention We specifically advanced and adapted an existing tailored text messaging system to include interactive voice response functionality and support the medication adherence barriers of low income diverse adults with type 2 diabetes mellitus We report on the design process and feasibility testing results i e technical use patterns and subjective user experiences from patients from the target population who used the intervention in one of three user centered design iterations The types of challenges encountered in design were related to providing text message content with valued information and support that engages patients The design process also highlighted the value of obtaining mixed methods data to provide insight into legitimate versus illegitimate missing data patterns of use and subjective user experiences The iterative testing process and results outlined here provide a potential template for other teams seeking to design technology based self care support solutions for comparable patient populations
- ItemDevelopment and functionality of a handheld computer program to improve fruit and vegetable intake among low-income youth.(2013-03-13) Nollen, Nicole L; Hutcheson, Tresza; Carlson, Susan; Rapoff, Michael; Goggin, Kathy; Mayfield, Carlene; Ellerbeck, EdwardMobile technologies hold promise for improving diet and physical activity but little attention is given to creating programs that adolescents like and will use This study developed a personal digital assistant PDA program to promote increased intake of fruits and vegetables FV in predominately low income ethnic minority girls This study used a three phase community engaged process including i engagement of a Student Advisory Board SAB to determine comfort with PDAs ii early testing of Prototype I and rapid re design by the SAB and iii feasibility testing of Prototype II in a new sample of girls Phase 1 results showed that girls were comfortable with the PDA Testing of Prototype I in Phase 2 showed that acceptability was mixed with girls responding to 47 3 of the prompts Girls wanted more reminders accountability in monitoring FV help in meeting daily goals and free music downloads based on program use The PDA was reprogrammed and testing of Prototype II in Phase 3 demonstrated marked improvement in use 78 3 increases in FV intake 1 8 2 6 daily servings and good overall satisfaction Findings suggest that mobile technology designed with the early input of youth is a promising way to improve adolescent health behaviors
- ItemDevelopment and pretesting multimedia HIV-prevention text messages for mobile cell phone delivery.(2011-08-26) Cornelius, Judith B; Cato, Michael; Lawrence, Janet St; Boyer, Cherrie B; Lightfoot, Marguerita
- ItemDevelopment of smartphone applications for nutrition and physical activity behavior change.(2013-04-24) Hebden, Lana; Cook, Amelia; van der Ploeg, Hidde P; Allman-Farinelli, MargaretBACKGROUND Young adults aged 18 to 35 are a population group at high risk for weight gain yet we know little about how to intervene in this group Easy access to treatment and support with self monitoring of their behaviors may be important Smartphones are gaining in popularity with this population group and software applications apps used on these mobile devices are a novel technology that can be used to deliver brief health behavior change interventions directly to individuals en masse with potentially favorable cost utility However existing apps for modifying nutrition or physical activity behaviors may not always reflect best practice guidelines for weight management OBJECTIVE This paper describes the process of developing four apps aimed at modifying key lifestyle behaviors associated with weight gain during young adulthood including physical activity and consumption of take out foods fast food fruit and vegetables and sugar sweetened drinks METHODS The development process involved 1 deciding on the behavior change strategies relevant guidelines graphic design and potential data collection 2 selecting the platform Web based versus native 3 creating the design which required decisions about the user interface architecture of the relational database and programming code and 4 testing the prototype versions with the target audience young adults aged 18 to 35 RESULTS The four apps took 18 months to develop involving the fields of marketing nutrition and dietetics physical activity and information technology Ten subjects provided qualitative feedback about using the apps The slow running speed of the apps due to a reliance on an active Internet connection was the primary issue identified by this group as well as the requirement to log in to the apps CONCLUSIONS Smartphone apps may be an innovative medium for delivering individual health behavior change intervention en masse but researchers must give consideration to the target population available technologies existing commercial apps and the possibility that their use will be irregular and short lived