85 research outputs found

    Designing prenatal m-Health interventions through transmigrants reflection on their pregnancy ecology

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    This dissertation presents the findings from three participatory focus group and co-design sessions with Caribbean transmigrant women in the United States. Informed by their focus group discussions regarding their pregnancy experiences in the United States, the participants produced design ideas that reflected on physical, emotional, informational and social gap themes. The purpose of this study was to understand the challenges affecting the women’s prenatal wellbeing practices, and to conceive a set of recommendations and opportunities for mHealth technology design to assist with prenatal preventative care and management. The study uses the theoretical concept of pregnancy ecology to identify gaps in prenatal health management, and understand participants’ reflection on these gaps through design. Then, the study identifies opportunities for mHealth and HCI research to consider designing tailored interventions to the realities of the expecting immigrant mother, including the role of transnational social support, and embracing the role of entertainment in mental health during pregnancy

    ADAPT: Approach to Develop context-Aware solutions for Personalised asthma managemenT

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    People with asthma have heterogeneous triggers and symptoms, which they need to be aware of in order to implement the strategies to manage their condition. Context-aware reasoning has the potential to provide the personalisation that is required to address the heterogeneity of asthma by helping people to define the information that is relevant considering the characteristics of their condition and delivering services based on this information. This research work proposes the Approach to Develop context-Aware solutions for Personalised asthma managemenT (ADAPT), whose aim is to facilitate the creation of solutions allowing the required customisation to address the heterogeneity of asthma. ADAPT is the result of the constant interaction with people affected by asthma throughout the research project, which was possible to achieve thanks to the collaboration formed with the Centre for Applied Research of Asthma UK. ADAPT context dimensions facilitate the development of preventive and reactive features that can be configured depending on the characteristics of the person with asthma. The approach also provides support to people not knowing their triggers through case-based reasoning and includes virtual assistant as a complementing technology supporting asthma management. ADAPT is validated by people with asthma, carers and experts in respiratory conditions, who evaluated a mobile application that was built based on the approach

    Creating digital materials for Antimicrobial Resistance One Health awareness and behaviour change for Rhodes University peer educators

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    Antimicrobial resistance (AMR) is an urgent, global health problem that stems from the inappropriate use of and poor adherence to antibiotics that treat diseases in human beings. It is further exacerbated by the proliferation of antibiotics into the food chain, particularly from the overuse and misuse of antibiotics in agricultural, meat, and dairy production. The recently developed World Health Organisation (WHO) One Health (OH) approach encompasses and acknowledges the various interconnected pathways that drive AMR between the human, animal, and environmental spheres. Until recently, AMR health challenges have been viewed primarily through a biomedical lens, but this study draws on the more holistic perspective that the One Health approach offers. AMR from food sources (AMR-OH) is an underrepresented topic of research. Creating digital health communication for low-literate end-users on this topic using the One Health approach is an emerging field of research. AMR-OH has not been extensively covered in health communication campaigns and requires developing context-specific digital educational materials, such as the ones this study presents. This study draws on Social Behaviour Change Communication (SBCC) theory elements to create a suggested approach to disseminate AMR-OH information. This intervention was aimed at low-health-literate end-users to accomplish two objectives. First, create awareness and improve knowledge about AMR-OH via a video. Second, offer feasible, easily implementable behaviour change actions in the form of an infographic comprising four food safety steps (Clean, Separate, Cook, and Chill). The study was conducted in three phases. First, recruit participants and conduct a literature review to identify the effective SBCC elements of health communication intervention design. Second, conduct a needs assessment to gauge the volunteering participants’ familiarity with digital media and their current health literacy on AMR-OH. Third, conceptualise and design the two AMR-OH digital educational materials (a video and accompanying infographic). The materials were first evaluated by the researcher using the Clear Communication Index (CCI) test, and then shared with the participants via WhatsApp to be evaluated by them, using two end-user tests: the Patient Education Material Assessment Tool (PEMAT) and the Suitability Assessment of Materials (SAM) test. These two tests assessed the materials’ readability, understandability, and actionability. A post-evaluation, semi-structured interview (SSI) was then conducted with the participants. Deductive thematic analysis was conducted on the SSI data and analysed using the five design benchmarks as themes: Ease of Use of Technology, Clarity of Content, Appropriate Format, Target Audience Resonance (Appropriate for target audience), and Clear calls to Action (Actionable). The rapid onset of COVID-19 restrictions forced the project to scale down and shift entirely online. The study could be conducted due to the active and enthusiastic virtual participation of two Rhodes University Peer Educators (PEs) whose contribution was vital to developing and evaluating the materials. The needs assessment showed that the PEs were comfortable using WhatsApp, had reliable internet connection when on campus, and used this social media platform for professional and personal communication. This assessment also showed that they had prior knowledge of AMR but only from the human health perspective. The video and infographic scored high on the Clear Communication Index, 93.3% and 94.4%, respectively. The PEs’ evaluation of the materials was also high on the PEMAT and SAM assessments: video narration (100%, 80% respectively), video (100%, 99% respectively), and infographic (86%, 90% respectively). This study produced an easy-to-use, accessible and appropriate online repository of AMR-OH information in a novel format with actionable steps. The post-evaluation SSI revealed that the materials and the channel of delivery were welcomed. The PEs expressed their confidence in receiving, using, and sharing this novel presentation of evidence and solutions-based information about AMR-OH. They further highlighted that this is the first time they have received and evaluated context-specific digital multimedia about AMR-OH and that this information equipped them to adopt the food safety behaviours – namely, the four food safety steps. This study demonstrates that the theory-informed creation of engaging digital media for AMR-OH is feasible and viable. Furthermore, it affirms that engaging digital media for AMR-OH can be created to enhance the knowledge of end-users about this health issue. The scaled-down approach created a blueprint to implement a more extensive intervention in the future, informed by this intervention’s methods and tools. Lastly, this blueprint for a particular conceptualisation of an AMR-OH digital media intervention provides effective and empowering tools with which the PEs can disseminate this information to the university's support staff.Thesis (MA) -- Faculty of Humanities, School of Journalism and Media Studies, 202

    Front-Line Physicians' Satisfaction with Information Systems in Hospitals

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    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

    Development of a theory and evidence-based, user-centred family healthy eating app

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    The proliferation of health promotion apps along with smartphone's array of features supporting health behaviour change, offers a new and innovative approach to childhood weight management. However, research on the content of current industry led apps reveals they lack a basis in behaviour change theory and evidence. Equally important remains the issue of how to maximise users' engagement with mHealth. Therefore the thesis aimed to address these gaps and design and develop an evidence and theory based, user-centred healthy eating app targeting parents for childhood weight management. The Behaviour Change Wheel framework (BCW), a theoretically-based approach for health behaviour change intervention development, along with a user-centred design philosophy and collaboration with industry, guided the development process. This involved a review of the evidence and conducting a series of nine focus groups (Study one and two), a usability workshop and a 'Think Aloud' study (study three) (N=70) comprised of Change4Life advisors, parents with overweight and healthy weight children aged 5-11 years, university students and staff and consultation with experts to inform the app development. Thematic analysis of focus groups helped to extract information related to relevant theoretical (using the Capability, Opportunity, Motivation, Behaviour Model (COM-B) and Theoretical Domains Framework (TDF)), user-centred and technological components to underpin the design and development of the app. Inputs from parents, case workers and experts working in the area of childhood weight management helped to identify the main target behaviour: to support parents' provision of age appropriate food portion sizes. To achieve this target behaviour, the behavioural analysis revealed the need for eliciting change in parents' Capability, Motivation and Opportunity and twelve associated TDF domains. Therefore, the thesis provides a more comprehensive analysis of the problem compared to previous theoretical accounts, demonstrating that parents' internal processes such as their emotional responses, habits and beliefs, along with social influences such as partners and grandparents and the environmental influences relating to aspects such as schools, the media, and household objects, all interact and impact on their portion behaviours. Theoretical domains were subsequently mapped to five intervention functions and twenty-three behaviour change techniques (BCTs) to bring about change in this target behaviour. BCTs were then translated into engaging app features drawing on parental preferences for healthy eating app features including ease of use, minimal data input, visual aids of food and gamification. Overall parents viewed the prototype app positively. The 'Think Aloud' study highlighted key areas to improve usability in such as navigability. Application of the BCW to the issue of childhood weight management yielded a novel conceptualisation of potential approaches to supporting parents' portion behaviours in the home environment. This thesis is also the first to fully explicate the systematic approach applied in developing a family-oriented mHealth app grounded in the BCW framework and evidence, and balanced with users' preferences to help maximise its potential engagement with the target population. Challenges and adaptations relating to the implementation of the BCW are discussed and suggestions for future research in mHealth development and childhood weight management are provided, along with the implications for public health practice

    An exploration of the potential contribution of a medication management app in heart failure outpatients’ care: the experiences of staff and older patients

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    Background: Managing the care of older adults with Heart Failure (HF) largely centres on symptom and medication management. Medication management in patients with HF is challenging due to frequent medication adjustments in response to changes in their symptomatology and polypharmacy. Some patients with HF typically take on average 10-25 tablets daily. Given the complexity of HF self-management, assisting older adults in managing their own care at home is critical to the success of HF management. Aim: To explore the role of a medication management app in supporting the care of older adults attending a HF outpatients ‘clinic and the impact of this new intervention on staff working practices. Methods: Mixed methods sequential design to test the feasibility of a medication app with HF patients. Observations of clinical practice were conducted followed by semi-structured interviews with healthcare professionals (HCPs) and patients pre- and post-intervention. Interviews were transcribed and analysed using thematic analysis, the Normalisation Process Theory (NPT) framework was used to capture challenges and facilitators to technology use in phase three. A systematic search of apps was also conducted to identify commercially available apps with a medication functionality, followed by an evaluation of apps using a validated tool. The optimal app was selected and implemented in a three-month intervention with patients attending the HF clinic. A case study strategy was used to present the experiences and opinions of HCPs and patients using the app. Findings: Patients normalised the use of the app and found it easy to use after training for medication self-management at home. HCPs found the use of the app to empower patients and to assist them in maintaining an up-to-date medication list and concluded that the use of the app was beneficial to both HCPs and patients. However, several challenges need to be overcome before implementing and scaling up this intervention. Some of the barriers to technology uptake identified in this study were: HCPs attitudes towards older people using technology, lack of managerial support and the need for training and ongoing technical support for older adults Conclusion: The use of the NPT framework captured individual and organisational barriers and facilitators to the normalisation of the use of the medication app with HF older patients. These barriers need to be overcome to enable the implementation and scaling up of this intervention. The findings of this feasibility study are encouraging and warrant further investigation to test the effectiveness of a medication app with HF older adults at a larger scale in future studies

    Self-management outcome measures for children with inflammatory bowel disease

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    Paediatric Inflammatory Bowel Disease (IBD) can significantly affect a child’s physical and psychological well-being, and the incidence is increasing globally. An emerging focus of paediatric IBD care that has the potential to improve disease outcomes is that of self-management, whereby children are encouraged to develop skills and attributes to enable them to manage their own disease and treatment. Self-management comprises a number of intertwined elements; knowledge, adherence, self-regulation, and communication. In order to provide targeted support in these areas’ children should be frequently assessed to highlight gaps or misconceptions that may affect their disease outcomes. Few self-management outcome measures are available for this population group. The aim of this research was to undertake a series of projects to develop and validate assessment and reporting tools that address components of self-management in order to provide targeted education and support for children with IBD. This research also contributed to the design of a mobile health app that is aimed at encouraging children with IBD to self-manage their disease. Section one explains the detailed, iterative development process of a mobile health app aimed at encouraging self-management for children with IBD: IBD-Tracker. Section two presents the development process of a knowledge assessment tool for children with IBD: IBD-KID2. A series of studies were performed to assess the validity, reliability, feasibility, and generalisability of IBD-KID2, as well as testing IBD knowledge levels in different population groups. Section three details the development of a symptom self-report tool for children with IBD that uses a series of text and pictorial Likert scales that enables children to report their IBD symptoms: IBDnow. A study performed in two tertiary paediatric IBD centres showed that children from the age of three years can use IBDnow to produce symptom reports with a good level of agreement to reports from their gastroenterologist when using standard validated clinical tools. Section four contains a systematic literature review undertaken to identify self-management skills assessment tools specific to the target population, none of which were appropriate for use with younger children with IBD. Using the available evidence, a novel self-management skills assessment tool was developed: IBD-STAR. A content validity evaluation by a series of experts appraised the relevance, appropriateness, and likely effectiveness for the target population. A study then compared the children’s skills assessment using IBD-STAR with an assessment undertaken by their parents, and gastroenterologist. This showed that children’s reported skills using IBD-STAR correlated well with their gastroenterologist’s assessment, but their skills were underestimated by their parents. Section five assessed whether the content of the mHealth app IBD-Tracker, when delivered in an alternative format (booklet) was effective and acceptable regardless of the mode of delivery. The results highlighted a positive trend towards improving self-management outcomes, but the response rates and feedback suggest that interventions aimed at children should prioritise engagement in addition to ensuring a strong evidence base for the content. Children with IBD should have multi-disciplinary support as they develop self-management skills. This series of studies has provided a number of outcome measures to address the various components of self-management for children with IBD that will highlight where targeted interventions, such as a mobile health app, may be effective
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