Adult patients’ experiences of using electronic personal health records for self-management of chronic non-communicable disease: a qualitative systematic review

Objective: The objective of the systematic review was to identify and synthesise the best available evidence on adult patients’ experiences of using electronic personal health records (e-PHRs) for chronic non-communicable disease self-management. Introduction: Self-management is a key component of chronic non-communicable disease management. One of the strategies to support self-management in patients with chronic non-communicable disease is the use of e-PHRs. Electronic personal health records offer patients the opportunity to actively engage with their own health management, promote continuity of care and collaboration through disease tracking, and provide patients and providers with an ongoing connection. For e-PHRs to be adopted and their benefits for chronic non-communicable disease management maximised, they should align with patients’ values and preferences. Methods: The systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of qualitative evidence, with meta-aggregation as the method of synthesis. The review included qualitative studies that explored the experiences of adult patients (aged 18 years and over) with a chronic non-communicable disease who had used e-PHRs for the self-management of their condition. Published studies were retrieved following searches conducted in CINAHL, PubMed, PsycINFO, Embase and Scopus. Grey literature was also considered. Critical appraisal and data extraction were conducted using the appropriate JBI tools. Studies were included, regardless of their methodological quality. Extracted data were aggregated and analysed to produce a set of synthesised findings that were used to develop evidence-informed recommendations for the use of e-PHRs in chronic non-communicable disease self-management. Results: Fifteen studies that considered adult patients’ (n= 412) experiences of using e-PHRs for chronic non-communicable disease self-management were included in the review. A total of 113 findings were extracted and aggregated into 17 categories from which four synthesised findings were developed: 1) Electronic personal health records can strengthen patient-practitioner relationships and support personcentred care when both patients and practitioners engage in productive and transparent communication built on mutual trust; 2) The versatility of e-PHR functions can support self-management of various chronic diseases; 3) Adoption of e-PHRs is dependent on individual patient characteristics, and may be compromised if patients’ expectations remain unmet, there were unintended consequences that hinder use, and patients believe e-PHRs are unnecessary for their care needs; and 4) Tailoring e-PHRs to the design preferences, training and education needs of patients with chronic disease through developer-user collaboration may facilitate optimal use of e-PHR. Conclusions: Electronic personal health records are an emerging technology that have the potential to empower patients and facilitate shared decision-making with their health practitioners. The findings of this review suggest that to facilitate adoption of e-PHRs, patients should be proactive in raising and discussing their concerns with healthcare practitioner (HCPs). Additionally, HCPs should learn appropriate ways of communicating with their patients in order to build trust, maintain transparency, and offer reassurance for effective patient and provider encounters. Awareness of the various functions of e- PHRs that are the most useful for the management of a specific chronic disease will assist patients and their providers in making informed decisions regarding which functions best fit their needs and requirements. Adoption of e-PHR may be optimised when the patient’s individual characteristics or concerns around their specific chronic disease needs are understood. The findings of this review also suggest that patients require tailored training and education programs which are focused on the technical and non-technical aspects of e-PHR use in chronic disease management. Creating avenues where health information technology developers can engage with patients and obtain their input in relation to the design or modification of e-PHRs can yield useful information that can increase e-PHR adoption. Further studies exploring the experiences of e-PHR use for other prevalent chronic conditions such as obesity, asthma and kidney disease may provide valuable contributions for the enhanced use of e-PHR for selfmanagement. Future studies should also aim to adhere to well established and robust qualitative methodologies, which is a significant issue identified in the current review. Furthermore, to assist future qualitative evidence synthesis and strengthen findings for subsequent systematic reviews, future research should focus on advancing efforts to create a standardised e-PHR taxonomy.Thesis (MClinSc.) -- University of Adelaide, The Joanna Briggs Institute, 202

Wearables at work:preferences from an employee’s perspective

This exploratory study aims to obtain a first impression of the wishes and needs of employees on the use of wearables at work for health promotion. 76 employ-ees with a mean age of 40 years old (SD ±11.7) filled in a survey after trying out a wearable. Most employees see the potential of using wearable devices for workplace health promotion. However, according to employees, some negative aspects should be overcome before wearables can effectively contribute to health promotion. The most mentioned negative aspects were poor visualization and un-pleasantness of wearing. Specifically for the workplace, employees were con-cerned about the privacy of data collection

Influence Factors for Customer Acceptance of Data-Driven Contracts in Insurance Ecosystems

Datafication offers several benefits to the insurance sector, but the success of data-driven insurance depends very much on customer acceptance. Thus, this study examines factors that influence customer acceptance of data-driven car and health insurance. These two types of data-driven insurance are based on fitness and driving data, both of which require access to sensor and geo-localization data. The results of an online study with 217 participants using advertisements for data-driven insurances showed that highlighting monetary incentives leads to a higher acceptance than highlighting health or safety incentives. Data-driven insurances allow for individualized tariffs, and accordingly, it is more likely that people who rate their driving skills above-average will take out a datadriven car insurance. Privacy concerns are another important influence factor. The findings demonstrate that customer acceptance of data-driven insurance can be influenced to some extent by framing decision-relevant information material

#Physical Activity: Influencing Parent Behavior Change Through Social Media

Background: Parents play a major role in supporting physical activity in and around the home, creating a home environment that encourages physical activity as well as participation in activity with their children and supporting children\u27s physically active lifestyles are important areas of concern for health promotion. Despite support for family-based interventions, there is still little evidence to demonstrate the most effective ways of targeting families with physical activity interventions. Social media has been one area of promise for connecting with parent participants in physical activity interventions. Sites like Facebook have an existing high prevalence of parent users and offer media-rich tools in a socially connected digital environment that are suited for connecting with parents. The purpose of this study was to determine if the use of a social media physical activity intervention could enhance physical activity behavior change in parents. Additionally, this study sought to discover if the level of parent engagement in the social media group influenced their behavior change-related outcomes, within the same intervention.;Methods: Parent participants in this study were randomized at the school level as part of a larger physical activity intervention consisting of three different experimental conditions (Control, School, Family). Participants in the family intervention received a nineteen-week strategic messaging campaign delivered through a Facebook group in addition to existing family intervention components. Strategic messaging consisted of core messaging related to parent education as well as dedicated behavior change messaging targeting parents specific to their existing stage of change. Parent completed pre/post survey instruments to evaluate family health behaviors ((Family Health Climate (FHC), Stage of Change (SOC), Parent Support for Physical Activity (PSPA) and Physical Activity (PA) levels) and attitudes in an existing family-based physical activity intervention. Additional data were collected on interaction in the Facebook group to determine parents engagement level with Facebook content.;Results: A total of 84 parents were included in the analysis control n = 42 and family n = 42. A repeated measures MANOVA was used to determine if there were significant differences between groups by time. Overall Pillai\u27s trace was statistically significant for time*group F (8, 75) = 2.866, p = .008, partial eta2 = .234. Follow-up univariate ANOVA\u27s were performed to determine which of the study variables across time points had significant mean differences, Family health climate p \u3c .02, parent support p \u3c .004, self-efficacy p \u3c .034 all had significant mean differences between times and groups. No other study variables were significantly different. Pairwise comparisons showed significant mean improvements for family intervention participants in Family health climate (m = 4.972, p \u3c .017) and parent support (m = 7.69, p \u3c .005).;Conclusion: Results indicate that strategic messaging campaigns delivered through Facebook have the potential to influence parent support for physical activity, parent self-efficacy as well as the family home climate. These factors relate to the overall physical activity behaviors in families and can contribute to lifestyle behavior change when coupled with evidence-based physical activity interventions. Strategic messaging campaigns delivered through social media outlets can be considered effective communication channels for family physical activity interventions