Health information on firefighter websites: Structured analysis

© Mostin A Hu, Joy C MacDermid, Shannon Killip, Margaret Lomotan, FIREWELL. Background: Owing to the fact that firefighters have unique health risks, access to firefighter-specific internet-based health information is a potential mechanism for achieving better health and work outcomes. Objective: The objective of our study was to identify the amount and nature of health information resources available on Canadian firefighter-specific websites and the extent to which resources are consistent across websites as a surrogate indicator of diffusion of information. Methods: A search of health resources on firefighter websites (union and employer) for all Canadian provinces, major cities and a subset of smaller cities, and the International Association of Fire Fighters (IAFF) website was conducted on Google (July 2017). Content was identified and classified based on the type of resource, health focus, and location. The quantity and nature of the resources were summarized using descriptive statistics. Results: Among all (N=313) websites reviewed, 41 websites had health information with a cumulative total of 128 resources that addressed firefighter mental (59/128, 46.1%), physical (43/128, 33.6%), and work health (26/128, 20.3%). The highest density of information was found on international and national websites (13 resources per website) and the least on local websites (1 resource per 7 websites). Three provinces (Ontario, Québec, and British Columbia) hosted 81% (65/80) of the provincial, territorial and local resources. General mental health (20/59, 34%), posttraumatic stress disorder (14/59, 24%), and suicide (14/59, 24%) were the most prevalent topics within the mental health resources, whereas half (21/43, 49%) of all physical health resources were on cancer. No resources from Northern Canada were found. Musculoskeletal health was not mentioned in any of the resources identified. There was minimal cross-linking of resources across sites (only 4 resources were duplicated across sites), and there was no clear indication of how the content was vetted or evaluated for quality. Conclusions: There was wide variation in the amount and type of information available on different firefighter websites with limited diffusion of information across jurisdictions. Quality evaluation and coordination of resources should be considered to enhance firefighters’ access to quality health information to meet their specific needs. Mental health and cancer information aligned with high rates of these health problems in firefighters, whereas the lack of information on musculoskeletal health was discordant with their high rate of work injury claims for these problems

The Quality, Readability, Completeness, and Accuracy of PTSD Websites for Firefighters

Firefighters appear at an increased risk for post-traumatic stress disorder (PTSD). Because of PTSD-related stigma, firefighters may search for information online. The current study evaluated the quality, readability, and completeness of PTSD online resources, and to determine how the online treatment recommendations align with current evidence. Google.ca (Canada) searches were performed using four phrases: ‘firefighter PTSD’, ‘firefighter operational stress’, ‘PTSD symptoms’, and ‘PTSD treatment’. The 75 websites identified were assessed using quality criteria for consumer health information (DISCERN), readability and health literacy statistics, content analysis, and a comparison of treatments mentioned to the current best evidence. The average DISCERN score was 43.8 out of 75 (indicating ‘fair’ quality), with 9 ‘poor’ websites (16–30), 31 ‘fair’ websites (31–45), 26 “good” websites (46–60), and nine excellent websites (61–75). The average grade level required to understand the health-related content was 10.6. The most mentioned content was PTSD symptoms (48/75 websites) and PTSD treatments (60/75 websites). The most frequently mentioned treatments were medications (41/75 websites) and cognitive behavioural therapy (40/75 websites). Cognitive behavioural therapy is supported by strong evidence, but evidence for medications appears inconsistent in current systematic reviews. Online PTSD resources exist for firefighters, but the information is challenging to read and lacks evidence-based treatment recommendations

Measurement Properties of a 2-Dimensional Movement Analysis System: A Systematic Review and Meta-analysis

© 2020 American Congress of Rehabilitation Medicine Objectives: To critically appraise, compare, and summarize the quality of the measurement properties of the Dartfish software across various populations and motion tasks. Data Sources: Systematic electronic searches were performed in the PsychInfo, Embase, Medline@Ovid, CINAHL, and Google Scholar databases from January 1999 to January 2020. Study Selection: Prospective measurement studies published in English peer-reviewed journals that reported on at least 1 psychometric property (reliability, validity, measurement error) using Dartfish were included. An independent reviewer performed searches and identified studies. Data Extraction: We followed the COnsensus-based Standards for the selection of health Measurement INstruments 2018 guideline for abstracting and assessing data quality. Independent extraction was performed by 2 individual authors. The extracted data involved the author, year, study population, setting, sample size, and measurement properties, as well as information on camera positions, analyzed movement variables, and the corresponding strategy for addressing perspective error. Data Synthesis: In total, 23 studies were included in this review. Studies were pooled to examine inter-rater reliability estimates for different tasks: single-leg squat angle (2 studies, 115 participants; intra-class correlation coefficient [ICC], 0.94; 95% confidence interval [CI], 0.62-0.99), single-leg vertical drop jump angle (2 studies, 94 participants; ICC, 0.92; 95% CI, 0.20-0.99), and vertical drop jump angle (2 studies, 100 participants; ICC, 0.88; 95% CI, 0.83-0.92). Concurrent validity (2-dimensional Dartfish vs 3-dimensional Vicon) was established using the push and release task, single leg stance, and single leg stance with acutely induced dizziness in 45 healthy Parkinson patients. A correlation of 0.59 to 0.98 was reported. For tracking angles across various movements, a measurement error of approximately 10° retest variation was reported in 3 studies. Conclusion: Dartfish is a reliable software for assessing a variety of tasks across multiple contexts of assessments. Evidence suggests that the estimates of motion obtained with Dartfish are valid for single plane movements

Rasch analysis of the brief Michigan Hand Questionnaire in patients with thumb osteoarthritis

Background: The brief Michigan Hand Questionnaire (brief MHQ) is a 12-item self-reported measure of hand function for patients with hand disorders which has been validated using Classical Test Theory. Rasch analysis can provide more detailed psychometric information. The purpose of this Rasch analysis is to assess the psychometric properties of the brief MHQ for patients with thumb osteoarthritis, and to make recommendations for improvements to the questionnaire if needed. Methods: The Michigan Hand Questionnaire and demographic data were collected from 923 thumb osteoarthritis patients treated in specialized clinics for hand surgery and therapy in the Netherlands. Rasch analysis was performed on the 12 items of the brief MHQ using RUMM 2030 to assess the fit of the brief MHQ to the Rasch model. To determine fit, analysis of fit summary statistics, individual person fit and individual item fit were assessed. Threshold distributions were assessed to identify if any items required rescoring. The Person Separation Index was calculated to measure reliability of the questionnaire. Differential item functioning was assessed to identify item bias, and Principal Component Analysis was performed to identify unidimensionality and local dependence. Results: The brief MHQ showed misfit (χ2 = 1312.5, p < 0.0001) with 6 items having disordered thresholds and 9 items requiring rescoring. After deleting 3 of the rescored items due to significant item fit residuals, the brief MHQ had an acceptable reliability (Cronbach’s alpha = 0.79). Misfit to the model (χ2 = 49.6, p = 0.0001), multidimensionality (10.2% of t-tests were significant), and item bias from non-uniform differential item functioning for 7 items across many person variables were still found. Conclusion: Although no satisfactory solutions were found to correct the misfit to the Rasch model, it is recommended that the response options of the brief MHQ be rescored, and that items 6, 9 and 10 be removed. The lack of unidimensionality indicates that the items do not represent the singular construct of hand disability and that totalling the scores of the brief MHQ does not provide a valid measure of hand disability for people with thumb osteoarthritis. The 37-item Michigan Hand Questionnaire may provide a better assessment of hand disability for patients with thumb osteoarthritis