Evidence-based digital literacy class for low-income African-American older adults. Journal of Applied Communication Research, 47(2), 130-152.
While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.
In many correctional facilities across the United States, COVID‐19 vaccine refusal rates are as high as 50%. Most women leaving jails have low SES, health literacy, and mistrust of governmental institutions, thus exacerbating existing health disparities and making women leaving jail vulnerable. Data from 25 interviews with recently released women suggest that interventions to promote vaccines to this population will have to address health education and mitigate mistrust, misinformation, and conspiracy theories.
Background Few community urologists offer cancer patients the opportunity to participate in cancer clinical trials, despite national guidelines that recommend it, depriving an estimated 260,000 urological cancer patients of guideline-concordant care each year. Existing strategies to increase urologists’ offer of clinical trials are designed for resource-rich environments and are not feasible for many community urologists. We sought to design an implementation intervention for dissemination in under-resourced community urology practices and to compare its acceptability, appropriateness and adoption appeal among trial-naïve and trial-experienced urologists. Methods We used a design-for-dissemination approach, informed by the Theoretical Domains Framework and Behavior Change Wheel, to match determinants of the clinical trial offer to theoretically informed implementation strategies. We described the implementation intervention in evaluation workshops offered at urology professional society meetings. We surveyed participants to assess the implementation intervention’s acceptability and appropriateness using validated instruments. We also measured adoption appeal, intention to adopt and previous trial offer. Results Our design process resulted in a multi-modal implementation intervention, comprised of multiple implementation strategies designed to address six domains from the Theoretical Domains Framework. Evaluation workshops delivered at four meetings, convened five separate professional societies. Sixty-one percent of those offered an opportunity to participate in the implementation intervention indicated intention to adopt. Average implementation intervention acceptability and appropriateness ratings were 4.4 and 4.4 (out of 5), respectively. Acceptability scores were statistically significantly higher among those offering trials compared to those not (p = 0.03). Appropriateness scores did not differ between those offering trials and those not (p = 0.24). After urologists ranked their top three innovation attributes, 43% of urologists included practice reputation in their top three reasons for offering clinical trials; 30% listed practice differentiation among their top three reasons. No statistically significant differences were found between those who offered trials and those who did not among any of the innovation attributes. Conclusions LEARN|INFORM|RECRUIT is a promising implementation intervention to address low accrual to clinical trials, poised for implementation and effectiveness testing. The implementation intervention is appealing to its target audience and may have equal uptake among trial-naïve and trial-experienced practices.
Introduction. As we conduct this study, the world is in the grasp of a deadly pandemic. In less than six months since its first diagnosis in Wuhan, China, the COVID-19 infectious disease due to the novel coronavirus has infected over 5,000,000 people and claimed over 350,000 lives. In the United States, most of the cases are in large urban settings along the coasts, but the disease is slowly progressing through the mainland. Kansas, with its particular location in the midwest United States, has seen a relatively small number of cases, but these are increasing. The Kansas government took radical measures to prevent the spread of the disease. According to the Health Beliefs Model, an individual’s perception of risk will dictate engagement with preventive behaviors. Knowledge about the disease and preventive measures drive the risk assessment. Knowledge is dependant on the sources of information used. This study explored these metrics in a sample of Kansans living in the times of the COVID-19 pandemic. Methods. A combination of snowball samples and random distribution through social media was used to recruit participants to an online survey. The risk and knowledge instrument was developed and validated by WHO Europe. Data collection lasted 96 hours. Results. The attitudes and behaviors of Kansans concerning COVID-19 were consistent with its location in an area of the country with a relatively lower incidence of the disease. Participants had good knowledge about the disease and preventive measures and were willing to comply with recommendations from local authorities. Conclusion. Localized information sources that cater to the community are often primary, while social media is not a valuable source for information pertinent to COVID-19.
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