Smoking cessation problem-based learning: Virtual experience

Background and Objectives: Problem-based learning (PBL) is a student-centered teaching and learning methodology where students collaboratively address specific issues. Tobacco use is a major health issue globally. Health professions and students need to have knowledge and skills to facilitate smoking cessation. The objective of this study is to assess feasibility of PBL during a virtual attachment involving institutions from Malaysia and the USA. Methods: A 4-week smoking cessation virtual attachment was conducted for three third-year University of Pittsburgh, USA pharmacy students. Malaysian smoking cessation experts designed and facilitated a PBL smoking cessation module. It was split into two 2-hour sessions with 3 triggers; Trigger 1: ‘Chief Presentation’, Trigger 2: ‘History & Motivational Interview’, and Trigger 3: ‘Brief 5A’s Intervention’. Students received Trigger 1 a day earlier and discussed amongst themselves. In session 1, Triggers 1-3 were given sequentially and discussed after completing all tasks from each trigger. In session 2 one-week later, facilitators gave formative assessment and students provided reflection regarding the PBL session. Upon completing the four-week virtual attachment, students provided feedback and facilitators graded the students. Result and Discussion: A comprehensive and interactive PBL session was successfully conducted virtually. Based on the clinical practice guidelines of both countries, there were differences in terms of availability and use of cessation medications, but the general principles of smoking cessation consultation and interventions were similar. Students were able to discuss the case openly, putting forth ideas and questions in both sessions. All students provided positive feedbacks regarding the PBL. Conclusions: With the extensive development of online platforms connecting the world over, student virtual attachment and mobility programmes can be easily conducted with minimal cost. A suitable module embedding PBL can be designed and conducted to best suit the online platform and the intended students

Addressing data accuracy and information integrity in mHealth using ML

The aim of the study was finding a way in which Machine Learning can be applied in mHealth Solutions to detect inaccurate data that can potentially harm patients. The result was an algorithm that classified accurate and inaccurate data

Smoking cessation problem-based learning: Virtual experience

Background and Objectives: Problem-based learning (PBL) is a student-centered teaching and learning methodology where students collaboratively address specific issues. Tobacco use is a major health issue globally. Health professions and students need to have knowledge and skills to facilitate smoking cessation. The objective of this study is to assess feasibility of PBL during a virtual attachment involving institutions from Malaysia and the USA. Methods: A 4-week smoking cessation virtual attachment was conducted for three third-year University of Pittsburgh, USA pharmacy students. Malaysian smoking cessation experts designed and facilitated a PBL smoking cessation module. It was split into two 2-hour sessions with 3 triggers; Trigger 1: ‘Chief Presentation’, Trigger 2: ‘History & Motivational Interview’, and Trigger 3: ‘Brief 5A’s Intervention’. Students received Trigger 1 a day earlier and discussed amongst themselves. In session 1, Triggers 1-3 were given sequentially and discussed after completing all tasks from each trigger. In session 2 one-week later, facilitators gave formative assessment and students provided reflection regarding the PBL session. Upon completing the four-week virtual attachment, students provided feedback and facilitators graded the students. Result and Discussion: A comprehensive and interactive PBL session was successfully conducted virtually. Based on the clinical practice guidelines of both countries, there were differences in terms of availability and use of cessation medications, but the general principles of smoking cessation consultation and interventions were similar. Students were able to discuss the case openly, putting forth ideas and questions in both sessions. All students provided positive feedbacks regarding the PBL. Conclusions: With the extensive development of online platforms connecting the world over, student virtual attachment and mobility programmes can be easily conducted with minimal cost. A suitable module embedding PBL can be designed and conducted to best suit the online platform and the intended students

Exploring perspectives of people with type-1 diabetes on goalsetting strategies within self-management education and care

Background. Collaborative goal-setting strategies are widely recommended for diabetes self-management support within healthcare systems. Creating self-management plans that fit with peoples’ own goals and priorities has been linked with better diabetic control. Consequently, goal-setting has become a core component of many diabetes selfmanagement programmes such as the ‘Dose Adjustment for Normal Eating (DAFNE) programme’. Within DAFNE, people with Type-1 Diabetes (T1D) develop their own goals along with action-plans to stimulate goal-achievement. While widely implemented, limited research has explored how goal-setting strategies are experienced by people with diabetes.Therefore, this study aims to explore the perspectives of people with T1D on theimplementation and value of goal-setting strategies within DAFNE and follow-up diabetes care. Furthermore, views on barriers and facilitators to goal-attainment are explored.Methods. Semi-structured interviews were conducted with 20 people with T1D who attended a DAFNE-programme. Following a longitudinal qualitative research design, interviews took place 1 week, and 6-8 months after completion of DAFNE. A recurrent cross-sectional approach is applied in which themes will be identified at each time-point using thematic analyses.Expected results. Preliminary identified themes surround the difference in value that participants place on goal-setting strategies, and the lack of support for goal-achievement within diabetes care.Current stage. Data collection complete; data-analysis ongoing.Discussion. Goal-setting strategies are increasingly included in guidelines for diabetes support and have become essential parts of many primary care improvement schemes. Therefore, exploring the perspectives of people with T1D on the value and implementation of goal-setting strategies is vital for their optimal application

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Health technology assessment for digital health technologies

Health technology assessment (HTA) frameworks used for making public funding decisions on digital health technologies (DHTs) have not been informed by large stakeholder preference studies and rarely cover all nine domains of the widely used EUnetHTA “Core Model”. Our aim was to develop a literature-informed and stakeholder-prioritised checklist of DHT-specific considerations for DHTs that manage chronic disease that extends an internationally established HTA framework. We conducted two systematic reviews to identify: (i) DHT evaluation frameworks and (ii) primary research on DHTs published until 20 March 2020. Stakeholder prioritisation of issues was performed using a best-worst preference study among a broad cross-section of patients, carers, health professionals, and the general population in Australia, Canada, New Zealand, and the UK. Systematic review issues were prioritised and adapted for use as a practical checklist. DHT evaluation content was recommended by 44 identified frameworks for 28 of the 145 issues in the Core Model and for 22 new DHT-specific issues. A coverage assessment of 112 clinical studies of remote treatment and self-management DHTs for patients with cardiovascular disease or diabetes revealed that less than half covered DHT-specific content in all but one domain, or traditional HTA content in clinical effectiveness and ethical analysis. The preference survey of 1,251 stakeholders identified broad agreement on the 12 most important DHT attributes, six of which were related to safety. The most important attribute was “helps health professionals respond quickly when changes in patient care are needed”, which is not a focus of existing DHT HTA frameworks. Using the thesis-developed checklist in conjunction with the Core Model can enable users to perform a DHT-specific and comprehensive HTA on DHTs that manage chronic disease and can assist primary researchers to collect appropriate data to inform this HTA

Digital Health to Improve Australians Experience of Care: The case of melanoma post-treatment care

Improving access to care is not enough if it is not effectively delivered. Poor quality healthcare services have proven to slow progress to achieve better health outcomes and substantially increase the societal and economic burden of diseases. It is essential to provide healthcare services that constantly meet client-specific needs, which vary widely per individual, and to consider factors such as sociodemographic, psychological, health conditions. The emergence of digital technologies has played a critical role in the advancement of the healthcare sector. However, there remains critical knowledge-gaps demonstrating best practices to support digital health adoption and integration. The current research aimed to address this gap by making a case for providing a user-informed digital health model to improve Australians’ experience of melanoma post-treatment care. It captured information about the experience of care from a melanoma patient’s perspective and attitude toward digital health interventions. The data were collected through an online questionnaire developed based on clinical recommendations from melanoma guidelines and the literature. 95 patients were investigated, as well as their attitude toward digital health. Overall, 30% expressed difficulties accessing care due to geographical barriers, cost and time pressure. A majority presented signs of distress and desire for more educational and psychosocial support. The data also identified significant associations between access and psychological distress. Overall, participants reported positive attitudes toward the use of digital health, particularly if it can improve their quality of life. The findings showed that adapted uses of digital health could increase self-management and healthy behaviour; reduce psychological distress and social isolation; enable timely access to healthcare providers and communication, and support collaboration between clinicians. However, the study also reported a substantial lack of knowledge and awareness about technologies made available to melanoma patients. Recommendations on where to start and how we could encourage digital health uptake to provide high-quality, effective and adequate care are proposed. The thesis concludes on a call to action for healthcare stakeholders to ‘upgrade’ the existing melanoma healthcare system

Sit Less, Move More: A National Study of Physical-Activity Behavior and Cancer

Background: Physical activity is associated with lower risks of cancer, the second leading cause of death among Americans. Yet, sedentary behavior is the prevailing lifestyle for about 80% of American adults. Additionally, cancer survivors remain significantly inactive, even though physical activity has been shown to decrease risk of cancer and cancer recurrence, improve tolerance of cancer therapy, and reduce mortality. This research explores the relative impact of personal agency, social support, and key demographic variables on physical-activity behavior for a national sample of adults as well as how these relationships differ for cancer survivors and their counterparts. Methods: Using the theoretical frameworks of Social Cognitive Theory and Intersectionality, this investigation employed hierarchical regression modeling utilizing the 2020 Health Information National Trends Survey (HINTS) 5, Cycle 4 dataset. Additionally, analyses were conducted separately for cancer survivors and those who never had cancer to assess for differences in the relationships between the independent variables and physical activity-behavior. Results: Several variables within the domains of personal agency (wearing activity trackers, confidence in care, feeling strong), social support (YouTube, health insurance), and demographics (sex, race, marital status, education, feeling comfortable with income) significantly impacted physical-activity behavior in the general population. However, when the sample was split between cancer survivors and those who never had cancer, the analyses revealed several intersectional differences demonstrating that confidence in care, being female, and household size were the variables that influenced physical activity behavior for cancer survivors. Conclusions: The findings from this study suggest that various personal agency, social support, and demographic variables predict physical-activity behavior. In addition, the intersectional findings suggest the need for tailored assessments and interventions for cancer survivors. Keywords: physical activity, sedentary behavior, cancer, Intersectionalit