Dr Google and the consumer: A qualitative study exploring the navigational needs and online health information-seeking behaviors of consumers with chronic health conditions

Background: The abundance of health information available online provides consumers with greater access to information pertinent to the management of health conditions. This is particularly important given an increasing drive for consumer-focused health care models globally, especially in the management of chronic health conditions, and in recognition of challenges faced by lay consumers with finding, understanding, and acting on health information sourced online. There is a paucity of literature exploring the navigational needs of consumers with regards to accessing online health information. Further, existing interventions appear to be didactic in nature, and it is unclear whether such interventions appeal to consumers’ needs. Objective: Our goal was to explore the navigational needs of consumers with chronic health conditions in finding online health information within the broader context of consumers’ online health information-seeking behaviors. Potential barriers to online navigation were also identified. Methods: Semistructured interviews were conducted with adult consumers who reported using the Internet for health information and had at least one chronic health condition. Participants were recruited from nine metropolitan community pharmacies within Western Australia, as well as through various media channels. Interviews were audio-recorded, transcribed verbatim, and then imported into QSR NVivo 10. Two established approaches to thematic analysis were adopted. First, a data-driven approach was used to minimize potential bias in analysis and improve construct and criterion validity. A theory-driven approach was subsequently used to confirm themes identified by the former approach and to ensure identified themes were relevant to the objectives. Two levels of analysis were conducted for both data-driven and theory-driven approaches: manifest-level analysis, whereby face-value themes were identified, and latent-level analysis, whereby underlying concepts were identified. Results: We conducted 17 interviews, with data saturation achieved by the 14th interview. While we identified a broad range of online health information-seeking behaviors, most related to information discussed during consumer-health professional consultations such as looking for information about medication side effects. The barriers we identified included intrinsic barriers, such as limited eHealth literacy, and extrinsic barriers, such as the inconsistency of information between different online sources. The navigational needs of our participants were extrinsic in nature and included health professionals directing consumers to appropriate online resources and better filtering of online health information. Our participants’ online health information-seeking behaviors, reported barriers, and navigational needs were underpinned by the themes of trust, patient activation, and relevance. Conclusions: This study suggests that existing interventions aimed to assist consumers with navigating online health information may not be what consumers want or perceive they need. eHealth literacy and patient activation appear to be prevalent concepts in the context of consumers’ online health information-seeking behaviors. Furthermore, the role for health professionals in guiding consumers to quality online health information is highlighted

Design Principals of Social Navigation

8th Delos Workshop on "User Interfaces for Digital Libraries" (on 21 October it will be held in conjuction with the 4th ERCIM Workshop on "User Interfaces for All"), SICS, Kista, Sweden, 21-23 October 1998PERSON

Pennsylvania: Base Line Report - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.Although the ACA will no doubt have real financial consequences for insurers, hospitals, and health care providers, at this early stage in implementation, it is difficult to calculate precise gains and losses. For example, the Hospital Association of Pennsylvania supported the ACA, believing, in part, that reform was necessary to reduce current levels of uncompensated care and to reduce reliance on emergency care for patients who put off treatment for as long as possible to avoid out-of-pocket costs. The association agreed to significant cuts in Medicare and Medicaid to support the bill's passage. However, because cost savings from universal coverage have not yet been realized, hospitals reported cutting staff in April 2014 to offset the loss of Medicaid and Medicare funding. Safety net hospitals, which are required to serve all populations, seem especially affected, as many of their patients who fall into the Medicaid coverage gap are still showing up in emergency rooms without insurance

A Practical Environment to Apply Model-Driven Web Engineering

The application of a model-driven paradigm in the development of Web Systems has yielded very good research results. Several research groups are defining metamodels, transformations, and tools which offer a suitable environment, known as model-driven Web engineering (MDWE). However, there are very few practical experiences in real Web system developments using real development teams. This chapter presents a practical environment of MDWE based on the use of NDT (navigational development techniques) and Java Web systems, and it provides a practical evaluation of its application within a real project: specialized Diraya.Ministerio de Educación y Ciencia TIN2007-67843-C06-03Ministerio de Educación y Ciencia TIN2007-30391-

Implicit Measures of Lostness and Success in Web Navigation

In two studies, we investigated the ability of a variety of structural and temporal measures computed from a web navigation path to predict lostness and task success. The user’s task was to find requested target information on specified websites. The web navigation measures were based on counts of visits to web pages and other statistical properties of the web usage graph (such as compactness, stratum, and similarity to the optimal path). Subjective lostness was best predicted by similarity to the optimal path and time on task. The best overall predictor of success on individual tasks was similarity to the optimal path, but other predictors were sometimes superior depending on the particular web navigation task. These measures can be used to diagnose user navigational problems and to help identify problems in website design

A Practical Example for Model-Driven Web Requirements

The number of approaches for Web environments has grown very fast in the last years: HDM, OOHDM, and WSDM were among the first, and now a large number can be found in the literature. With the definition of MDA (Model- Driven Architecture) and the acceptance of MDE (Model-Driven Engineering) techniques in this environment, some groups are working in the use of metamodels and transformations to make their approaches more powerful. UWE (UMLBased Web Engineering) or OOWS (Object-Oriented Web Solutions) are only some examples. However, there are few real experiences with Web Engineering in the enterprise environment, and very few real applications of metamodels and MDE techniques. In this chapter the practical experience of a Web Engineering approach, NDT, in a big project developed in Andalusia is presented. Besides, it shows the usability of metamodels in real environments

Maryland: Round 1 - State Level Field Network Study of the Implementation of the Affordable Care Act

This report is part of a series of 21 state and regional studies examining the rollout of the ACA. The national network -- with 36 states and 61 researchers -- is led by the Rockefeller Institute of Government, the public policy research arm of the State University of New York, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania.There is clear alignment among most groups and institutions on the state's adoption and implementation of the ACA. Because of its all-payer rate system, competition between private plans and exchange plans is muted. Some conservative elements in the Democratic-heavy legislature oppose rate-setting and the state's generous Medicaid expansions as well as its affirmation of the ACA. But with strong Democratic majorities in both houses, together with Democrats in the governor's and lieutenant governor's offices and professionals with policy and political expertise, the state's progressive reformers are clear winners. The state's inclusive and generous eligibility decisions will afford coverage to a broad portion of the state's uninsured populations. Advocates for these groups also win. In the case of Maryland, the "stars were aligned" to formulate an aggressive and expansive approach to the law. Minority opposition simply could not mount effective challenges to these forces

An athletic approach to studying perception-action integration: Does sport-specific training, and the impact of injury, influence how individuals visually guide navigation?

The objective of this thesis was to investigate perception-action integration capabilities of individuals during a choice navigation task. This task assessed navigation strategies in open space while individuals avoided colliding with two vertical obstacles that created a body-scaled, horizontal gap, at three varying obstacle distances from the starting location (3m, 5m, 7m). The two studies completed in this thesis employed the same paradigm to assess the hypothesized group differences. Gaze behaviours and kinematics of navigation strategies were compared between: 1) athletes specifically trained in navigating in open space versus non-athletes; and 2) athletes with post-concussion syndrome (PCS) versus non-concussed, specifically trained athletes. Specifically trained athletes have been identified as demonstrating more successful perception-action integration in discrete motor tasks related to their sport (Mann et al., 2007; Vickers, 2007). However, whether these abilities translate to the continuous motor task of obstacle avoidance in open space was unknown. The purpose of Study 1 was to identify the influence of sport-specific training on navigating in open space (i.e. navigational strategies of large field sport athletes) compared to age-matched, non-athletes. It was hypothesized that specifically-trained athletes would demonstrate fewer, longer fixations, suggesting a more successful perception-action integration strategy (as defined by Mann et al., 2007), and would employ more sport-specific navigation strategies than non-athletes by maintaining their straight trajectory toward the goal (Fajen & Warren, 2003). Athletes were found to make fewer, longer fixations than non-athletes. However, no differences were observed between navigation strategies of the two groups, nor were any kinematic measures found to differ between groups. It can be concluded that athletes and non-athletes differentially obtain visual information to perform the same actions, suggesting that athletes and non-athletes differentially perform perception-action integration when navigating in open space. Future studies are required to identify sport-specific nuances of navigation (moving obstacles, running) to better identify athletic-related navigation strategies. Although athletic training can enhance perception-action integration strategies, sport-related injuries can hinder this process. Following a concussion, individuals experience deficits of perception-action integration that persist well beyond 30 days of recovery, post-concussion (Baker and Cinelli, 2014; Slobounov et al., 2006). These perception-action integration deficits may also exist in individual with postconcussion syndrome (PCS). The purpose of the Study 2 was to identify whether perception-action integration deficits persist with the persistent physical symptoms of concussion characteristic of PCS. The current study revealed that athletes with PCS did not differ from non-concussed athletes on any measure of visual fixation strategy, nor were they found to differ on any kinematic measure assessed. These findings suggest that in the context of the current paradigm, athletes with PCS have no perception-action integration deficit. In that, athletes with PCS may have adapted perception-action integration strategies to navigate with equal efficiency as a specifically-trained group of athletes or that the paradigm was not sensitive enough to identify these differences. Such findings suggest that more research is required to assess what, if any, perception-action integration deficits persist with persisting physical symptoms of PCS to better benefit rehabilitative procedures and outcomes for these individuals. Together, these studies add to what was previously known about perception-action integration, as it relates to navigation. Both studies assessed perception-action integration in unique populations that add to understanding of behavioural dynamics in the sport setting. Study 1 builds on a line of research assessing affordance theory and behavioural dynamics in sport (Fajen, Riley, & Turvey, 2008). The findings of this study suggest that although navigation strategies did not differ between specifically trained athletes and non-athletes, visual search strategies employed in task did. Such findings add to the understanding that sport-specific training influences perception-action integration, through our understanding of how athletes obtain visual information to perform actions. This thesis did not identify perception-action integration deficits in athletes with PCS. These findings suggest that the individuals in the present study likely adapted to their injury as they demonstrated equal ability in gaze and navigation strategies to specifically-trained athletes. As such, further research is required to assess the cognitive, motor, and sensory-motor deficits that may persist with the persisting physical symptoms of PCS. As individuals with PCS do not demonstrate similar visuomotor integration deficits as individuals with acute concussions (Baker & Cinelli, 2014), such individuals must be assessed and researched as a separate population