Objective
There is growing evidence that hand-held touchscreen devices (tablets) can support people with mild dementia to manage their life and engage in meaningful activities. However, as it can be difficult to find apps that match one’s personal needs, wishes and abilities, a person-centred selection tool was developed, called FindMyApps.
Method
To ensure its usability, the FindMyApps selection tool was developed using a ‘user-participatory design’ in which users (persons with dementia and informal carers), and experts (designers, developers and researchers) closely collaborated. In three short iterative rounds – so called ‘sprints’ – the users were invited to test whether the prototypes harmonised with their needs, wishes and abilities.
Results
Each sprint provided insight into potential improvements of the tool. The development team gained an understanding of issues regarding usefulness (e.g. meaningful content of (sub)categories for apps in domains of self-management and meaningful activities), as well as issues to increase the user-friendliness (e.g. intuitive design with instructive navigation support).
Conclusion
The FindMyApps selection tool was conceived as a means to make it easier for people with mild dementia to select apps meeting their needs, wishes and abilities. This provisional end version will be further tested, and, if necessary, improved in a feasibility study.
Background: The implementation of primary healthcare-based screening and advice that is effective in reducing heavy drinking can be enhanced with training.
Objectives: Undertaking secondary analysis of the five-country ODHIN study, we test: the extent to which practice, provider and patient characteristics affect the likelihood of patients being screened and advised; the extent to which such characteristics moderate the impact of training in increasing screening and advice; and the extent to which training mitigates any differences due to such characteristics found at baseline.
Methods: A cluster randomized factorial trial involving 120 practices, 746 providers and 46 546 screened patients from Catalonia, England, the Netherlands, Poland, and Sweden. Practices were randomized to receive training or not to receive training. The primary outcome measures were the proportion of adult patients screened, and the proportion of screen-positive patients advised.
Results: Nurses tended to screen more patients than doctors (OR = 3.1; 95%CI: 1.9, 4.9). Screen-positive patients were more likely to be advised by doctors than by nurses (OR = 2.3; 95%CI: 1.4, 4.1), and more liable to be advised the higher their risk status (OR = 1.9; 95%CI: 1.3, 2.7). Training increased screening and advice giving, with its impact largely unrelated to practice, provider or patient characteristics. Training diminished the differences between doctors and nurses and between patients with low or high-risk status.
Conclusions: Training primary healthcare providers diminishes the negative impacts that some practice, provider and patient characteristics have on the likelihood of patients being screened and advised.
Trial registration ClinicalTrials.gov. Trial identifier: NCT01501552
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