PinCloud: Effective Personalization and Self-management of Health Data and Care Services

Background More adolescents with chronic physical illness are living into adulthood, and they require the development of proficient self-management skills to maintain optimal physical health as they transition into adult care services. It is often during this vulnerable transition period that deterioration in illness control is seen as a result of inadequate self-management skills and understanding of their chronic illness. Mobile technology has been proposed as an innovative opportunity to assist in improving the management of chronic conditions as young people transition to adult care services. Over the past 5 years, there has been a significant increase in research into the use of health-related apps. Objective This study aimed to evaluate the utility and effectiveness of mobile and Web-based health apps that support self-management and transition in young people with chronic physical health illnesses. Methods We conducted a comprehensive review of the literature in 5 bibliographic databases, using key search terms, considering only articles published from 2013, as we were extending the data from 2 previous systematic reviews. Abstracts were screened for possible inclusion by 2 reviewers. Data extraction and quality assessment tools were used for the evaluation of included studies. Results A total of 1737 records were identified from the combined electronic searches, and 854 records were removed as duplicates. A total of 68 full articles were further assessed for eligibility, and 6 articles met our review criteria: 3 pilot studies, 2 randomized controlled trials, and 1 prospective cohort study. Publication years ranged from 2015 to 2018. The apps reported were targeted at type 1 diabetes mellitus, epilepsy, asthma, beta thalassemia major, and sickle cell disease, with a combined sample size of 336. A total of 4 studies included in this review reported being effective in increasing knowledge of the targeted condition and increasing therapy adherence, including increased medication adherence. A total of 2 manuscripts only mentioned the word transition. Participant’s satisfaction was reported for all studies. Heterogeneity of the studies prevented meta-analysis. Conclusions There remain limited data on the effectiveness and use of mobile and Web-based apps, which might facilitate the transition of adolescents with chronic illnesses from pediatric to adult health care services. This systematic review provides an updated overview of available apps for adolescents with chronic illnesses. This systematic review has been unable to provide evidence for effectiveness of this approach, but it does provide insights into future study design, with reference to the development, evaluation, and efficacy of apps tailored for adolescents with chronic illnesses, including the involvement of adolescents in such designs. Trial Registration PROSPERO CRD42018104611; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=104611

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A Causal Relationship of Home Care Services on the Quality of Life among Survivors of Stroke in Thailand

Walailak Journal of Science and Technology (WJST) ◽

10.48048/wjst.2021.9049 ◽

2021 ◽

Vol 18 (5) ◽

Author(s):

Patoomthip ADUNWATANASIRI ◽

Siriorn SINDHU ◽

Napaporn WANITKUN ◽

Chukiat VIWATWONGKASEM

Keyword(s):

Quality Of Life ◽

Home Care ◽

Functional Status ◽

Home Care Services ◽

Self Management ◽

Stroke Survivors ◽

Management Support ◽

Policy Makers ◽

Care Services

Survivors of stroke suffer impairments associated with a complex need of care from healthcare services after being discharged from hospital and returning home, and these impairments affect the quality of their lives. This cross-sectional study, aimed at evaluating the pathways linking home care services, patient factors, and quality of life (QOL), was carried out by conducting interviews and questionnaires with stroke survivors at their homes. Simple random sampling was used to select the settings for data collection, and multi-stage sampling was used to select the samples. In all, 317 stroke survivors admitted to 13 hospitals in rural and urban setting were selected for participation in the study. The data obtained were analyzed by using Structural Equation Modeling (SEM). The hypothetical model demonstrated a good fit (chi-square = 15.299, df = 9, p = 0.083, GFI = 0.98, CFI = 0.98, RMSEA = 0.047). Statistically significant explanatory variables for the home care service had a direct effect on perceived self-management support, functional status, and QOL (β = 0.39, 0.12 and 0.11, respectively), while number of community supporters had a significant positive indirect effect on QOL through functional status (β = 0.13). The variables accounted for 56 % of the variance in QOL. This finding could be used by policy makers to make important policy development in home care services and help improve health outcomes. In particular, it is also recommended that policy makers push for policies that encompass self-management support and community support groups among stroke survivors in community settings.

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Impact of an arthritis self-management programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: An experimental study

Patient Education and Counseling ◽

10.1016/j.pec.2006.06.019 ◽

2007 ◽

Vol 65 (1) ◽

pp. 113-121 ◽

Cited By ~ 48

Author(s):

Y.B. Yip ◽

Janet W. Sit ◽

Karin K.Y. Fung ◽

Doris Y.S. Wong ◽

Samantha Y.C. Chong ◽

...

Keyword(s):

Health Care ◽

Experimental Study ◽

Functional Outcomes ◽

Health Care Services ◽

Management Programme ◽

Self Management ◽

Osteoarthritic Knee ◽

Care Services ◽

Use Of Health Care

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Reaching out to diabetic soles: Outreach foot care pilot project

SAGE Open Medicine ◽

10.1177/2050312118820030 ◽

2018 ◽

Vol 6 ◽

pp. 205031211882003

Author(s):

Tracey Rickards ◽

Tammy Cornish

Keyword(s):

Social Services ◽

Pilot Project ◽

Management Plan ◽

Self Management ◽

Life Questionnaire ◽

Foot Care ◽

Foot Health ◽

Care Services ◽

Patient Health ◽

Related Quality

Objectives: To assess the effectiveness of outreach foot care services as a tool for engagement with isolated vulnerable seniors. To improve foot health of diabetic seniors, thus avoiding expensive and potentially life-threatening diabetic complications. Methods: Four validated tools are used to gather data: InLow 60-second Diabetic Foot Screen©, Short Diabetes Knowledge Instrument for Older and Minority Adults, Brief Healthcare Questionnaire (Patient Health Questionnaire-9), and the Health-Related Quality of Life Questionnaire. Results: Five monthly visits to 20 participants resulted in multiple co-morbidities being identified, improvements in foot status and diabetic knowledge realized, and determinants of health addressed. Seniors needed support and resources to engage in diabetes self-management. Conclusion: The importance of regular foot care as a key element of any self-management plan for diabetes cannot be understated, nor can increasing social services spending to include coverage for foot care thereby avoiding expensive healthcare. Using foot care as a tool for engagement conferred access to vulnerable seniors who ultimately benefited from healthcare and social interactions with a provider.

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Enhancing the Self Management of Type II Diabetes in Elderly Greeks Using m- and e - Health Facilitated Integrated Care Services and Policy Implications for Greece

International Journal of Integrated Care ◽

10.5334/ijic.2901 ◽

2016 ◽

Vol 16 (6) ◽

pp. 353

Author(s):

Anastasios Rentoumis ◽

Pantelis Angelidis ◽

Loannis Fostiropoulos ◽

Anastasia Ntikoudi ◽

Georgios Landis ◽

...

Keyword(s):

Integrated Care ◽

Type Ii Diabetes ◽

The Self ◽

Policy Implications ◽

Self Management ◽

Type Ii ◽

Care Services

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Factors for Supporting Primary Care Physician Engagement With Patient Apps for Type 2 Diabetes Self-Management That Link to Primary Care: Interview Study (Preprint)

10.2196/preprints.11885 ◽

2018 ◽

Author(s):

Julie Ayre ◽

Carissa Bonner ◽

Sian Bramwell ◽

Sharon McClelland ◽

Rajini Jayaballa ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Care Physician ◽

Self Management ◽

Clinical Tool ◽

Face To Face ◽

Care Services ◽

Primary Care Services ◽

Potential Benefits

BACKGROUND The health burden of type 2 diabetes can be mitigated by engaging patients in two key aspects of diabetes care: self-management and regular contact with health professionals. There is a clear benefit to integrating these aspects of care into a single clinical tool, and as mobile phone ownership increases, apps become a more feasible platform. However, the effectiveness of online health interventions is contingent on uptake by health care providers, which is typically low. There has been little research that focuses specifically on barriers and facilitators to health care provider uptake for interventions that link self-management apps to the user’s primary care physician (PCP). OBJECTIVE This study aimed to explore PCP perspectives on proposed features for a self-management app for patients with diabetes that would link to primary care services. METHODS Researchers conducted 25 semistructured interviews. The interviewer discussed potential features that would link in with the patient’s primary care services. Interviews were audio-recorded, transcribed, and coded. Framework analysis and the Consolidated Criteria for Reporting Qualitative Research checklist were employed to ensure rigor. RESULTS Our analysis indicated that PCP attitudes toward proposed features for an app were underpinned by perceived roles of (1) diabetes self-management, (2) face-to-face care, and (3) the anticipated burden of new technologies on their practice. Theme 1 explored PCP perceptions about how an app could foster patient independence for self-management behaviors but could also increase responsibility and liability for the PCP. Theme 2 identified beliefs underpinning a commonly expressed preference for face-to-face care. PCPs perceived information was more motivating, better understood, and presented with greater empathy when delivered face to face rather than online. Theme 3 described how most PCPs anticipated an initial increase in workload while they learned to use a new clinical tool. Some PCPs accepted this burden on the basis that the change was inevitable as health care became more integrated. Others reported potential benefits were outweighed by effort to implement an app. This study also identified how app features can be positively framed, highlighting potential benefits for PCPs to maximize PCP engagement, buy-in, and uptake. For example, PCPs were more positive when they perceived that an app could facilitate communication and motivation between consultations, focus on building capacity for patient independence, and reinforce rather than replace in-person care. They were also more positive about app features that were automated, integrated with existing software, flexible for different patients, and included secondary benefits such as improved documentation. CONCLUSIONS This study provided insight into PCP perspectives on a diabetes app integrated with primary care services. This was observed as more than a technological change; PCPs were concerned about changes in workload, their role in self-management, and the nature of consultations. Our research highlighted potential facilitators and barriers to engaging PCPs in the implementation process.

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Challenging Themes in American Health Information Privacy and the Public’s Health: Historical and Modern Assessments

The Journal of Law Medicine & Ethics ◽

10.1111/j.1748-720x.2004.tb01972.x ◽

2004 ◽

Vol 32 (4) ◽

pp. 670-679 ◽

Cited By ~ 9

Author(s):

James G. Hodge ◽

Kieran G. Gostin

Keyword(s):

Health Information ◽

Health Care Services ◽

Information Privacy ◽

Health Data ◽

Policy Objective ◽

Care Services ◽

Federal Department ◽

Health Related ◽

Health Information Privacy ◽

Electronic Health

Protecting the privacy of individually-identifiable health data is a dominant health policy objective in the new millennium. Technological, economic, and health-related reasons substantiate the development of a national electronic health information infrastructure. Through this emerging infrastructure, billions of pieces of health data of varying sensitivities are exchanged annually to provide health care services and service transactions, conduct health research, and promote the public’s health. These multi-purpose, rapid exchanges of electronic health data, far removed from the typical disclosure of health information through the doctor/patient relationship of yesteryear, contribute to heightened individual concerns about identifiable health data. Responding to American fears and perceptions of actual and potential privacy abuses, policymakers have recently developed new, modern privacy protections through legislative and regulatory laws, as well as ethical and industry codes.Modern health information privacy protections are reflected in federal regulations developed by the federal Department of Health and Human Services (DHHS) pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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