Acceptability of medical digital libraries

Evidenced-based medicine has increased the importance of quick accessibility to reputable, upto-date information. Web-accessible digital libraries (DLs) on the wards can address the demand for such information. The use and acceptability of these resources has, however, been lower than expected due to a poor understanding of the context of use. To appreciate the social and organizational impacts of ward-accessible DLs for clinicians, results of a study within a large London-based hospital are presented. In-depth interviews and focus groups with 73 clinicians (from pre-registration nurses to surgeons) were conducted, and the data analysed using the grounded theory method. It was found that clinical social structures interact with inadequate training provision (for senior clinicians), technical support and DL usability to produce a knowledge gap between junior and senior staff, resulting in information – and technology – hoarding behaviours. Findings also detail the perceived effectiveness of traditional and digital libraries and the impact of clinician status on information control and access. One important conclusion is that increased DL usability and adequate support and training for senior clinicians would increase perceptions of DLs as support for, rather than replacement of, their clinical expertise. © 2002, The Continuum Publishing Group Ltd. All rights reserved

Using digital media to improve dementia care in India: A pilot randomised control trial

Background: India is undergoing a demographic transition characterised by population ageing and is witnessing a high dementia rate. Although, around 4.4 million people live with dementia in India, dementia awareness is poor and current resources addressing dementia care are basic and often incomplete, duplicated, and/or conflicting. To address this gap, the current study aims to use digital media, which has had a massive technological uptake in India, to improve dementia care in India. / Objective: To describe the design of an intervention study that examines the feasibility and acceptability of a digital media resource (Moving Pictures India) to improve dementia care in India. / Methods: The study employs a mixed methods design and is divided into four phases: (i) video interviews with Indian carers and health professionals; (ii) co-production of resources; (iii) pilot randomised controlled trial (RCT); and (iv) dissemination and analytics. The pilot RCT will follow an experimental parallel group design with two arms aiming to assess impact, feasibility and acceptability of the developed resources. The primary outcome measures for the pilot RCT will be feasibility and acceptability. Secondary outcome measures for the pilot RCT will be carer burden, carer mood and carer quality of life. / Results: This study was funded by the Alzheimer’s Association US in July 2021. In 2023, we will enroll 60 dementia carers (40 carers for the intervention arm and 20 for the control) for the pilot RCT. The study has been approved by the National Institute of Mental Health and Neurosciences (NIMHANS) Ethics Committee (NIMHANS/26th IEC (BEH.SC.DIV.)/2020-21 dated 11.11.2020), Health Ministry's Screening Committee, India (HMSC; proposal ID 2020-10137), the Curtin University Human Research Ethics Committee (HREC; Approval number: HRE2020-0735), and the NARI Research Governance Office (Site specific approval dated 17.03.2021). / Conclusions: This study protocol is designed to deliver unique, co-produced, evidence-based resources to support carers of persons with dementia in India and other countries aiming to utilize digital media for dementia care. Analytics and qualitative feedback post-piloting will be used, if the intervention is found feasible and acceptable, to develop an implementation trial to evaluate the effectiveness of the potential low-risk high-benefit intervention in practice. Clinical Trial: The trial was registered with the Clinical Trials Registry-India (Trial Registration No. CTRI/2021/01/030403). Registered on Jan 12, 2021

The unseen and unacceptable face of digital libraries

The social and organisational aspects of digital libraries (DLs) are often overlooked, but this paper reviews how they can affect users' awareness and acceptance of DLs. An analysis of research conducted within two contrasting domains (clinical and academic) is presented which highlights issues of user interactions, work practices and organisational social structures. The combined study comprises an analysis of 98 in-depth interviews and focus groups with lecturers, librarians and hospital clinicians. The importance of current and past roles of the library, and how users interacted with it, are revealed. Web-based DLs, while alleviating most library resource and interaction problems, require a change in librarians' and DL designers' roles and interaction patterns if they are to be implemented acceptably and effectively. Without this role change, users will at best be unaware of these digital resources and at worst feel threatened by them. The findings of this paper highlight the importance of DL design and implementation of the social context and supporting user communication (i.e., collaboration and consultation) in information searching and usage activities. © Springer-Verlag 2004

Evaluating empowerment and control of HE e-learning in a secure environment

With the increased spread of HE distance learning into a wide variety of contexts it is important for us to understand the factors involved in its successful deployment for students. E-learning has a great potential to support effective and empowering HE distance learning (Wilson, 2007; Adams, 2005; Hughes, 2005). However, within two secure environments, prisons and health service, the factors involved are complex. This paper reviews HE e-learning technology perceptions within these two contrasting contexts from 225 students' and stakeholders' perspectives. Previous research has detailed literature limitations on obtaining students' perspectives of e-learning (Conole et al, 2006). These limitations are compounded when other stakeholder perceptions are not integrated (Sun et al, 2007; Adams et al, 2005; Millen at al, 2002). This paper developed and applied an e-learning framework for student and stakeholder perceptions. This social psychological framework, is based on previous practice based e-learning studies and is used here to synthesise two large-scale case studies. The framework focuses on three concepts learner Access (e.g. learning design, technology design, physical access), Awareness (e.g. of resources, their usage and support for e-learning tasks) and Acceptability (e.g. trust, privacy, aesthetics, engagement). Students' and stakeholders' perceptions identified high levels of students' empowerment through e-learning whilst still requiring a further pedagogical tailoring and an awareness of support. However, serious problems within these contexts have identified blocks to e-learning through stakeholders perceptions and fears of acceptability (i.e. issues of risk and trust). Ultimately, through understanding competing perceptions and needs within these complex environments we can support the effective technological development, pedagogical design and deployment of e-learning systems

Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page:Qualitative Interview Process Evaluation

Background:The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy.Objective:In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app.Methods:A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews. The interview questions were mapped on to the 7 facets of acceptability according to the Theoretical Framework of Acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Alongside these constructs, we also included a question on perceived personal relevance, which previous research has linked to acceptability and engagement. Framework and thematic analysis of data was undertaken.Results:The Drink Less app was perceived as being ethical, easy, user-friendly, and effective for the period the app was used. Participants reported particularly liking the tracking and feedback sections of the app, which they reported increased personal relevance and which resulted in positive affect when achieving their goals. They reported no opportunity cost. Factors such as negative affect when not meeting goals and boredom led to disengagement in the longer term for some participants. The NHS alcohol advice web page was rated as being easy and user-friendly with no opportunity costs. However, the information presented was not perceived as being personally relevant or effective in changing drinking behavior. Most participants reported neutral or negative affect, most participants thought the alcohol advice web page was accessible, and some participants reported ethical concerns around the availability of suggested resources. Some participants reported that it had acted as a starting point or a signpost to other resources. Participants in both groups discussed motivation to change and contextual factors such as COVID-19 lockdowns, which influenced their perceived self-efficacy regardless of their assigned intervention.Conclusions:Drink Less appears to be an acceptable digital intervention among the recruited sample. The NHS alcohol advice web page was generally considered unacceptable as a stand-alone intervention among the recruited sample, although it may signpost and help people access other resources and interventions.</p

Evaluating the Acceptability of the Drink Less App and the National Health Service Alcohol Advice Web Page:Qualitative Interview Process Evaluation

Background:The extent to which interventions are perceived as acceptable to users impacts engagement and efficacy.Objective:In this study, we evaluated the acceptability of (1) the smartphone app Drink Less (intervention) and (2) the National Health Service (NHS) alcohol advice web page (usual digital care and comparator) among adult drinkers in the United Kingdom participating in a randomized controlled trial evaluating the effectiveness of the Drink Less app.Methods:A subsample of 26 increasing- and higher-risk drinkers (Alcohol Use Disorders Identification Test score≥8) assigned to the intervention group (Drink Less; n=14, 54%; female: n=10, 71%; age: 22-72 years; White: n=9, 64%) or usual digital care group (NHS alcohol advice web page; n=12, 46%; female: n=5, 42%; age: 23-68 years: White: n=9, 75%) took part in semistructured interviews. The interview questions were mapped on to the 7 facets of acceptability according to the Theoretical Framework of Acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy. Alongside these constructs, we also included a question on perceived personal relevance, which previous research has linked to acceptability and engagement. Framework and thematic analysis of data was undertaken.Results:The Drink Less app was perceived as being ethical, easy, user-friendly, and effective for the period the app was used. Participants reported particularly liking the tracking and feedback sections of the app, which they reported increased personal relevance and which resulted in positive affect when achieving their goals. They reported no opportunity cost. Factors such as negative affect when not meeting goals and boredom led to disengagement in the longer term for some participants. The NHS alcohol advice web page was rated as being easy and user-friendly with no opportunity costs. However, the information presented was not perceived as being personally relevant or effective in changing drinking behavior. Most participants reported neutral or negative affect, most participants thought the alcohol advice web page was accessible, and some participants reported ethical concerns around the availability of suggested resources. Some participants reported that it had acted as a starting point or a signpost to other resources. Participants in both groups discussed motivation to change and contextual factors such as COVID-19 lockdowns, which influenced their perceived self-efficacy regardless of their assigned intervention.Conclusions:Drink Less appears to be an acceptable digital intervention among the recruited sample. The NHS alcohol advice web page was generally considered unacceptable as a stand-alone intervention among the recruited sample, although it may signpost and help people access other resources and interventions.</p

Acceptability of artificial intelligence (AI)-enabled chatbots, video consultations and live webchats as online platforms for sexual health advice

Objectives Sexual and reproductive health (SRH) services are undergoing a digital transformation. This study explored the acceptability of three digital services, (i) video consultations via Skype, (ii) live webchats with a health advisor and (iii) artificial intelligence (AI)-enabled chatbots, as potential platforms for SRH advice. Methods A pencil-and-paper 33-item survey was distributed in three clinics in Hampshire, UK for patients attending SRH services. Logistic regressions were performed to identify the correlates of acceptability. Results In total, 257 patients (57% women, 50% aged <25 years) completed the survey. As the first point of contact, 70% preferred face-to-face consultations, 17% telephone consultation, 10% webchats and 3% video consultations. Most would be willing to use video consultations (58%) and webchat facilities (73%) for ongoing care, but only 40% found AI chatbots acceptable. Younger age (<25 years) (OR 2.43, 95% CI 1.35 to 4.38), White ethnicity (OR 2.87, 95% CI 1.30 to 6.34), past sexually transmitted infection (STI) diagnosis (OR 2.05, 95% CI 1.07 to 3.95), self-reported STI symptoms (OR 0.58, 95% CI 0.34 to 0.97), smartphone ownership (OR 16.0, 95% CI 3.64 to 70.5) and the preference for a SRH smartphone application (OR 1.95, 95% CI 1.13 to 3.35) were associated with video consultations, webchats or chatbots acceptability. Conclusions Although video consultations and webchat services appear acceptable, there is currently little support for SRH chatbots. The findings demonstrate a preference for human interaction in SRH services. Policymakers and intervention developers need to ensure that digital transformation is not only cost-effective but also acceptable to users, easily accessible and equitable to all populations using SRH services

Development of a game-based learning tool for applied team science communication in a virtual clinical trial.

Educational tools for application of team science competencies in clinical research are needed. Our interdisciplinary group developed and evaluated acceptability of a virtual world game-based learning tool simulating a multisite clinical trial; performance hinges on effective intrateam communication. Initial implementation with clinical research trainees (n=40) indicates high satisfaction and perceived relevance to team science and research career goals. Game-based learning may play an important role in team science training

Effect of cowpea flour processing on the chemical properties and acceptability of a novel cowpea blended maize porridge

Childhood growth stunting is a pervasive problem in Malawi and is in large part due to low quality complementary foods and chronic gut inflammation. Introducing legumes such as cowpea (Vigna unguiculata) into the complementary diet has the potential to improve childhood growth by improving diet quality through improvements in macro- and micronutrients and also by reducing gut inflammation. However, cowpea is relatively underutilized in complementary feeding in Malawi due to its strong taste, long processing time, and high energy requirements for processing. Effective utilization of cowpea in complementary feeding requires processing which may affect chemical composition as well as sensory quality. The present study evaluated the effect of processing on the retention of zinc, crude fibre, and flavonoid in roasted, boiled, and dehulled cowpea flours, and assessed the acceptability of maize porridge (70%) enriched with one of the three cowpea flours (30%). Roasting, dehulling, and boiling did not have any effect on zinc content. Crude fibre content increased after processing by all methods. Processing had no effect on measurable flavonoids. Roasted, boiled, and dehulled cowpea blended maize porridges were acceptable to children with mean quantities of leftover food of less than 3g from the given 100g. Caregivers also rated the blended flours to be highly acceptable to them as well, with maize porridge blended with dehulled cowpea flour the most acceptable to both children and caregivers. These results demonstrate that cowpea flour, processed by any of these three different methods, could serve as a useful addition to maize porridge for complementary feeding of children in sub-Saharan Africa