Will online symptom checkers improve health care in Australia?

Dunn, Adam G.

doi:10.5694/mja2.50621

Cited by 6 publications

(16 citation statements)

References 8 publications

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“…For some people, online symptom checkers could be a channel to provide tailored information, where users could be prompted for key concerns to link them to the most relevant information 21,22 , as opposed to searching for this in long 'Frequently Asked Questions' pages on government health websites. However, symptom checkers are not always reliable 23 , and may not be accessed by some groups such as culturally and linguistically diverse communities. Public health messaging could be better targeted to key motivation issues in different communities to address this.…”

Section: Discussionmentioning

confidence: 99%

Behavioural barriers to COVID-19 testing in Australia: Two national surveys to identify barriers and estimate prevalence by health literacy level

Bonner

Batcup

Ayre

et al. 2021

Preprint

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Background: COVID-19 testing and contact tracing has been crucial in Australia's prevention strategy. However, testing for COVID-19 is far from optimal, and behavioural barriers are unknown. Study 1 aimed to identify the range of barriers to testing. Study 2 aimed to estimate prevalence in a nationally relevant sample to target interventions. Methods: Study 1: National longitudinal COVID-19 survey from April-November 2020. Testing barriers were included in the June survey (n=1369). Open responses were coded using the COM-B framework (capability-opportunity-motivation). Study 2: Barriers from Study 1 were presented to a new nationally representative sample in November to estimate prevalence (n=2869). Barrier prevalence was analysed by health literacy level using Chi square tests. Results: Study 1: 49% strongly agreed to get tested for symptoms, and 69% would self-isolate. Concern about pain was the top barrier from a provided list (11%), but 32 additional barriers were identified from open responses and coded to the COM-B framework. Study 2: The most prevalent barriers were motivation issues (e.g. don't believe symptoms are COVID-19: 28%, few local cases: 18%). Capability issues were also common (e.g. not sure symptoms are bad enough: 19%, not sure whether symptoms need testing: 15%). Many barriers were more prevalent amongst people with low compared to high health literacy, including motivation (preference to self isolate: 21% vs 12%, pain: 15% vs 9%) and capability (not sure symptom needs testing: 12% vs 8%, not sure how to test:11% vs 4%). Conclusion: Even in a health system with free and widespread access to COVID-19 testing, motivation and capability barriers were prevalent issues, particularly for people with lower health literacy. This study highlights the important of diagnosing behaviour barriers to target public health interventions for COVID-19 and future pandemics.

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Section: Discussionmentioning

confidence: 99%

Behavioural barriers to COVID-19 testing in Australia: Two national surveys to identify barriers and estimate prevalence by health literacy level

Bonner

Batcup

Ayre

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…For some people, online symptom checkers could be a channel to provide tailored information, where users could be prompted for key concerns to link them to the most relevant information 23,24 , as opposed to searching for this in long FAQ pages on government health websites. However, they are not all reliable 25 , and may not be accessed by some groups such as culturally and linguistically diverse communities. To address gaps between intentions and actual behaviour, we could help people to plan in advance for the inconvenience of testing and self isolation, for example a person could have a plan worked out in advance with their manager for how they will notify work and change shifts or work from home.…”

Section: Discussionmentioning

confidence: 99%

Behavioural barriers to COVID-19 testing in Australia

Bonner

Batcup

Ayre

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The current suppression strategy for COVID-19 in Australia is dependent on people getting tested and self-isolating while they have COVID-19 symptoms. However, there is very little research on the behaviours and behavioural barriers involved in getting tested, both in Australia and worldwide, despite there being some evidence that these barriers do exist. Methods: The Sydney Health Literacy Lab (SHeLL) has been conducting a national longitudinal survey in Australia since April 2020. A list of testing barriers was included in Wave 3 in June 2020 (n=1369), along with intentions to test and self-isolate if symptomatic. Open responses were also collected. The test barriers identified were categorised using the COM-B framework. Results: Only 49% of people strongly agreed they would get tested if they had COVID-19 symptoms, but most people agreed to some extent that they would get tested (96%). The most common barriers selected from the list provided were that testing is painful (11%), not knowing how to get tested (7%), and worry about getting infected at the testing centre (5%). Many participants (10%) indicated other reasons, and open responses included many additional barriers to testing than those provided in the initial list. These covered all components of the COM-B model. Conclusion: We identified a wide range of barriers using both quantitative and qualitative methods, which need to be addressed in order to increase COVID-19 testing behaviour.

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“…It is possible that as a consequence of being one of the most widely used SAAs in Australia (Gilbert et al 2021), and its optimisation based on user feedback, the Ada app performed better than some of the other apps assessed by Hill et al (2020). In an editorial on the study of Hill et al (2020), Dunn (2020 considered that 61% exact match to optimal advice insufficient. Nevertheless, it was also acknowledged that relatively conservative advice from SAAs is appropriate (Dunn 2020).…”

Section: Relevance Of the Results To The Australian Setting And Implications For Clinicians And Policy Makersmentioning

confidence: 99%

“…In an editorial on the study of Hill et al (2020), Dunn (2020 considered that 61% exact match to optimal advice insufficient. Nevertheless, it was also acknowledged that relatively conservative advice from SAAs is appropriate (Dunn 2020). Rørtveit et al (2013) showed that GP telephone triage is often risk averse and moderate overcautiousness is appropriate for safety, commenting that 'Prehospital triage of emergency patients is necessarily an inexact process and some degree of overtriage must generally be accepted'.…”

Section: Relevance Of the Results To The Australian Setting And Implications For Clinicians And Policy Makersmentioning

confidence: 99%

Quality of condition suggestions and urgency advice provided by the Ada symptom assessment app evaluated with vignettes optimised for Australia

Gilbert

Fenech²,

Upadhyay³

et al. 2021

Aust. J. Primary Health

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When people face a health problem, they often first ask, 'Is there an app for that?'. We investigated the quality of advice provided by the Ada symptom assessment application to address the question, 'How do I know the app on my phone is safe and provides good advice?'. The app was tested with 48 independently created vignettes developed for a previous study, including 18 specifically developed for the Australian setting, using an independently developed methodology to evaluate the accuracy of condition suggestions and urgency advice. The correct condition was listed first in 65% of vignettes, and in the Top 3 results in 83% of vignettes. The urgency advice in the app exactly matched the gold standard 63% of vignettes. The app's accuracy of condition suggestion and urgency advice is higher than that of the best-performing symptom assessment app reported in a previous study (61%, 77% and 52% for conditions suggested in the Top 1, Top 3 and exactly matching urgency advice respectively). These results are relevant to the application of symptom assessment in primary and community health, where medical quality and safety should determine app choice.

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Will online symptom checkers improve health care in Australia?

Cited by 6 publications

References 8 publications

Behavioural barriers to COVID-19 testing in Australia: Two national surveys to identify barriers and estimate prevalence by health literacy level

Behavioural barriers to COVID-19 testing in Australia: Two national surveys to identify barriers and estimate prevalence by health literacy level

Behavioural barriers to COVID-19 testing in Australia

Quality of condition suggestions and urgency advice provided by the Ada symptom assessment app evaluated with vignettes optimised for Australia

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