Patel, Vaishali N; Dhopeshwarkar, Rina V; Edwards, Alison; Barrón, Yolanda; Sparenborg, Jeffrey; Kaushal, Rainu
In order to characterize consumer support for electronic health information exchange (HIE) and personal health records (PHRs) in a community where HIE is underway, we conducted a survey of English speaking adults who visited primary care practices participating in a regional community-wide clinical data exchange, during August, 2008. Amongst the 117 respondents, a majority supported physicians' use of HIE (83%) or expressed interest in potentially using PHRs (76%). Consumers' comfort sending personal information electronically over the Internet and their perceptions regarding the potential benefits of HIE were independently associated with their support for HIE. Consumers' prior experience using the Internet to manage their healthcare, perceptions regarding the potential benefits of PHRs and college education were independently associated with potential PHR use. Bolstering consumer support for HIE and PHRs will require addressing privacy and security concerns, demonstrating clinical benefits, and reaching out to those who are less educated and computer literate.
Cornacchia, Harold J.
Consumer health refers to the potential or actual impact upon the consumer, individually or collectively, of any substances, devices, services, or systems that are offered for the supposed purpose of protecting, preserving, or restoring physical or mental health. This book is an effort to help the consumer to choose intelligently in spending for…
Harrelson, Orvis A.; And Others
This guide to consumer health contains two parts, the first of which covers consumerism, cosmetics (aids for skin problems, dandruff, deodorants, dentifrices), food shopping, and clothes shopping. Part 2 discusses health quackery, including arthritis quackery, and mail-order "doctoring", food quackery, weight-reducing products, and how…
Introduction: The purpose of this paper is to provide a framework for building a consumer health ontology using social tags. This would assist health users when they are accessing health information and increase the number of documents relevant to their needs. Methods: In order to extract concepts from social tags, this study conducted an…
Clossey, Laurene; Rheinheimer, David
This research explores the impact of mental health agency culture on consumers' perceptions of agency support for their recovery. This study hypothesized that a constructive organizational culture must be present for consumers to perceive agency support for recovery. A sample of 12 mental health agencies in rural Pennsylvania participated in the research. Agency administrators completed an instrument called the recovery oriented service environment, which measured the number of recovery model program components offered by the agency. Consumers completed the recovery oriented services indicators, which taps into their perception of agency support for recovery. Direct service staff completed the organizational social context, which measured their agency's culture. Results showed that in this sample stronger consumer perceptions of agency support for recovery were correlated with higher ratings of agency constructive culture. The results suggest that agency culture is an important variable to target when implementing recovery model programming.
Cheng, Zhen Hadassah; Tu, Ming-Che; Yang, Lawrence Hsin
Limited research has investigated how culture impacts expressions of social support, which is crucial in developing culturally sensitive care. Using a classification based on theories of social support, we examined the social support experiences of 49 Chinese immigrant mental health consumers with psychosis, paying particular attention to frequency and sources. We found that the most common forms of social support were belonging and companionship, perceived emotional support, social control, and perceived instrumental support, while self-esteem and sense of mastery were the least common forms. Family and friends were the main sources of support. These results demonstrate the influence of Confucian values of renqing (or fulfillment of relational obligations) and guanxi (or social networks) and the negative effects of stigma in diminishing the social standing of these consumers by compromising 'personhood.' Clinical implications for increasing the cultural competency of clinicians and improving the mental health outcomes of Chinese immigrants are discussed.
This article presents an annotated bibliography of 19 titles that focus on cancer and health-care reform. These include: (1) Anderson, John W. "Stand by Her: A Breast Cancer Guide for Men." AMACOM: American Management Assn.; (2) Carstensen, Laura L. "A Long Bright Future: An Action Plan for a Lifetime of Happiness, Health, and Financial Security."…
Yanos, Philip T.; Stefancic, Ana; Tsemberis, Sam
Objective Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Methods Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Results Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Conclusions Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration. PMID:22549530
Walsh, Louisa; Hill, Sophie; Wluka, Anita E; Brooks, Peter; Buchbinder, Rachelle; Cahill, Ainslie; Dans, Leonila F; Lowe, Dianne; Taylor, Michael; Tugwell, Peter
Consumer involvement in the design and delivery of their healthcare is an integral strategy to ensure that health services and systems meet consumers' needs. This is also true for the design and delivery of Models of Care. This chapter presents the identified healthcare needs of people with musculoskeletal conditions and focuses on the current systematic review evidence for consumer involvement interventions in musculoskeletal Models of Care across the micro, meso and macro levels of healthcare. This chapter also presents three case studies of consumer involvement in different aspects of healthcare, offers a series of practice points to help translate the systematic review evidence into practice, and also provides direction to available resources, which support the implementation of consumer involvement within Models of Care.
Danovitch, Itai; Kan, David
Health care insurance plans covering treatment for substance use disorders (SUD) offer a wide range of benefits. Distinctions between health plan benefits are confusing, and consumers making selections may not adequately understand the characteristics or significance of the choices they have. The California Society of Addiction Medicine sought to help consumers make informed decisions about plan selections by providing education on the standard of care for SUD and presenting findings from an expert analysis of selected health plans. We developed an assessment framework, based on criteria endorsed by the American Society of Addiction Medicine, to rate the quality of SUD treatment benefits offered by a sample of insurance plans. We convened an expert panel of physicians to rate 16 policies of 10 insurance providers across seven categories. Data from published resources for 2014 insurance plans were extracted, categorized, and rated. The framework and ratings were summarized in a consumer-facing white paper. We found significant heterogeneity in benefits across comparable plans, as well as variation in the characterization and clarity of published services. This article presents findings and implications of the project. There is a pressing need to define requirements for SUD benefits and to hold health plans accountable for offering quality services in accordance with those benefits.
Sayers, Jan M; Cleary, Michelle; Hunt, Glenn E; Burmeister, Oliver K
Mental health is a major concern in Indigenous communities, as Indigenous people experience poorer health outcomes generally, and poorer social and emotional well-being throughout their lives, compared to non-Indigenous populations. Interviews were conducted with 20 mental health workers from a housing assistance programme for Indigenous clients with mental illness. Service and infrastructure needs identified to support clients were classified under the following overarching theme 'supports along the road to recovery'. Subthemes were: (i) It is OK to seek help; (ii) linking in to the local community; (iii) trusting the workers; and (iv) help with goal setting and having activities that support their achievement. This paper highlights the importance of targeted housing and accommodation support programmes for Indigenous people to prevent homelessness, and the essential services and infrastructure required to support Indigenous clients' mental health needs. These insights may inform service review, workforce development, and further research.
This review provides an overview of the botany and classification of seeds, summarizes recent research examining the health benefits of seeds, and discusses barriers to incorporating seeds into Western diets. Strategies to help practitioners support their patients in incorporating more seed foods in...
Inge, Katherine J., Ed.
This newsletter issue provides rehabilitation professionals with various information pieces concerning consumer leadership in supported employment of people with disabilities. First, a chart lists five questions concerning self advocacy and supported employment, and provides consumer responses to the questions. A second item describes…
Rosemblat, Graciela; Gemoets, Darren; Browne, Allen C; Tse, Tony
The U.S. National Institutes of Health, through its National Library of Medicine, developed ClinicalTrials.gov to provide the public with easy access to information on clinical trials on a wide range of conditions or diseases. Only English language information retrieval is currently supported. Given the growing number of Spanish speakers in the U.S. and their increasing use of the Web, we anticipate a significant increase in Spanish-speaking users. This study compares the effectiveness of two common cross-language information retrieval methods using machine translation, query translation versus document translation, using a subset of genuine user queries from ClinicalTrials.gov. Preliminary results conducted with the ClinicalTrials.gov search engine show that in our environment, query translation is statistically significantly better than document translation. We discuss possible reasons for this result and we conclude with suggestions for future work.
Gelkopf, Marc; Pagorek-Eshel, Shira; Trauer, Tom; Roe, David
This study examined whether mental health community service users completed outcome self-reports differently when assessments were supervised by internal vs. external staff. The examination of potential differences between the two has useful implications for mental health systems that take upon themselves the challenge of Routine Outcome Measurement (ROM), as it might impact allocation of public resources and managed care program planning. 73 consumers completed the Manchester Short Assessment of Quality of Life (MANSA), a shortened version of the Recovery Assessment Scale (RAS), and a functioning questionnaire. Questionnaires were administered, once using support provided by internal staff and once using support provided by external professional staff, with a one-month time interval and in random order. A MANOVA Repeated Measures showed no differences in outcomes of quality of life and recovery between internal and external support. Functioning scores were higher for the internal support when the internal assessments were performed first. Overall, except for the differences in functioning assessment, outcome scores were not determined by the supporting agency. This might indicate that when measuring quality of life and recovery, different supporting methods can be used to gather outcome measures and internal staff might be a good default agency to do this. Differences found in functioning assessment are discussed.
Haag, Jessie Helen
This book presents a general overview of consumer health, its products and services. Consumer health is defined as those topics dealing with a wise selection of health products and services, agencies concerned with the control of these products and services, evaluation of quackery and health misconceptions, health careers, and health insurance.…
Zeng, Qing T.; Tse, Tony
Laypersons (“consumers”) often have difficulty finding, understanding, and acting on health information due to gaps in their domain knowledge. Ideally, consumer health vocabularies (CHVs) would reflect the different ways consumers express and think about health topics, helping to bridge this vocabulary gap. However, despite the recent research on mismatches between consumer and professional language (e.g., lexical, semantic, and explanatory), there have been few systematic efforts to develop and evaluate CHVs. This paper presents the point of view that CHV development is practical and necessary for extending research on informatics-based tools to facilitate consumer health information seeking, retrieval, and understanding. In support of the view, we briefly describe a distributed, bottom-up approach for (1) exploring the relationship between common consumer health expressions and professional concepts and (2) developing an open-access, preliminary (draft) “first-generation” CHV. While recognizing the limitations of the approach (e.g., not addressing psychosocial and cultural factors), we suggest that such exploratory research and development will yield insights into the nature of consumer health expressions and assist developers in creating tools and applications to support consumer health information seeking. PMID:16221948
Chakraborty, G; Ettenson, R; Gaeth, G
The authors used choice-based conjoint analysis to model consumers' decision processes when evaluating and selecting health insurance in a multiplan environment. Results indicate that consumer choice is affected by as many as 19 attributes, some of which have received little attention in previous studies. Moreover, the importance of the attributes varies across different demographic segments, giving marketers several targeting opportunities.
CDHPs can stabilize growth in health costs, but the health plan-subscriber relationship should be more transparent. CFOs should ensure that increased cost exposure in CDHPs is paired with broad, deep disease management and employee assistance support. Hospitals should plan for the likelihood that, one way or another, consumers will be paying more of their healthcare bill.
Fridinger, F; Goodwin, G; Chng, C L
This study assessed the creditability of self-help health support groups as an adjunct to traditional medical care among a sampling of physicians (N = 120) and group members (N = 73) located in the Dallas/Ft. Worth Metropolitan area. Findings suggest a general lack of awareness of local groups among physicians, referral to only a few select groups, as well as little communication between health care professionals and their patients. Physicians in group practice, surgical specialties, and having never referred patients to support groups responded less favorably. Several benefits were reported by the group members, although for a majority their patient-physician relationship remained relatively unchanged.
Fergie, Gillian; Hunt, Kate; Hilton, Shona
Social media offer opportunities to both produce and consume content related to health experiences. However, people's social media practices are likely to be influenced by a range of individual, social and environmental factors. The aim of this qualitative study was to explore how engagement with user-generated content can support people with long-term health conditions, and what limits users' adoption of these technologies in the everyday experience of their health condition. Forty semi-structured interviews were conducted with young adults, aged between 18 and 30 years, with experience of diabetes or a common mental health disorder (CMHD). We found that the online activities of these young adults were diverse; they ranged from regular production and consumption ('prosumption') of health-related user-generated content to no engagement with such content. Our analysis suggested three main types of users: 'prosumers'; 'tacit consumers' and 'non-engagers'. A key determinant of participants' engagement with resources related to diabetes and CMHDs in the online environment was their offline experiences of support. Barriers to young adults' participation in online interaction, and sharing of content related to their health experiences, included concerns about compromising their presentation of identity and adherence to conventions about what content is most appropriate for specific social media spaces. Based on our analysis, we suggest that social media do not provide an unproblematic environment for engagement with health content and the generation of supportive networks. Rather, producing and consuming user-generated content is an activity embedded within individuals' specific health experiences and is impacted by offline contexts, as well as their daily engagement with, and expectations, of different social media platforms.
Banschback, Kaitlin; Santorelli, Gennarina D; Constantino, Michael J
Background Self-guided mental health interventions that are disseminated via the Web have the potential to circumvent barriers to treatment and improve public mental health. However, self-guided interventions often fail to attract consumers and suffer from user nonadherence. Uptake of novel interventions could be improved by consulting consumers from the beginning of the development process in order to assess their interest and their preferences. Interventions can then be tailored using this feedback to optimize appeal. Objective The aim of our study was to determine the level of public interest in a new mental health intervention that incorporates elements of self-help and peer counseling and that is disseminated via a Web-based training course; to identify predictors of interest in the program; and to identify consumer preferences for features of Web-based courses and peer support programs. Methods We surveyed consumers via Amazon’s Mechanical Turk to estimate interest in the self-help and peer support program. We assessed associations between demographic and clinical characteristics and interest in the program, and we obtained feedback on desired features of the program. Results Overall, 63.9% (378/592) of respondents said that they would try the program; interest was lower but still substantial among those who were not willing or able to access traditional mental health services. Female gender, lower income, and openness to using psychotherapy were the most consistent predictors of interest in the program. The majority of respondents, although not all, preferred romantic partners or close friends as peer counselors and would be most likely to access the program if the training course were accessed on a stand-alone website. In general, respondents valued training in active listening skills. Conclusions In light of the apparent public interest in this program, Web-disseminated self-help and peer support interventions have enormous potential to fill gaps in
Kraft, F B; Goodell, P W
Individuals who lead a "wellness-oriented" lifestyle are concerned with nutrition, fitness, stress, and their environment. They accept responsibility for their health and are excellent customers for health-related products and services. Those who lack a wellness orientation are identified as higher health risks and become candidates for health promotion program intervention. The authors report a new scale by which to measure the wellness-oriented lifestyle. Scale development procedures are detailed, followed by information from five studies that support its validity. The authors suggest ways health care marketers may use the Wellness Scale to segment and target potential customers and position their products and services.
Edgerly, Gisele; And Others
Text, illustrations and exercises are utilized in this set of six learning modules dealing with health topics of interest to the general public. The first module, "Do You Know Your Rights as a Patient?" by Gisele Edgerly, details the personal and financial rights of hospital patients. The second module, "The Consumer's Guide to…
Monkman, Helen; Kushniruk, Andre W
Derived from overlapping concepts in consumer health, a consumer health information system refers to any of the broad range of applications, tools, and educational resources developed to empower consumers with knowledge, techniques, and strategies, to manage their own health. As consumer health information systems become increasingly popular, it is important to explore the factors that impact their adoption and success. Accumulating evidence indicates a relationship between usability and consumers' eHealth Literacy skills and the demands consumer HISs place on their skills. Here, we present a new model called the Consumer Health Information System Adoption Model, which depicts both consumer eHealth literacy skills and system demands on eHealth literacy as moderators with the potential to affect the strength of relationship between usefulness and usability (predictors of usage) and adoption, value, and successful use (actual usage outcomes). Strategies for aligning these two moderating factors are described.
Gold, Marsha; Hossain, Mynti; Mangum, Amy
Rationale: Policymakers want health information technology (health IT) to support consumer engagement to help achieve national health goals. In this paper, we review the evidence to compare the rhetoric with the reality of current practice. Current Reality and Barriers: Our environmental scan shows that consumer demand exists for electronic access to personal health information, but that technical and system or political barriers still limit the value of the available information and its potential benefits. Conclusions and Policy Implications: There is a gap between current reality and the goals for consumer engagement. Actions that may help bridge this gap include: (1) resolving technical barriers to health information exchange (HIE); (2) developing more consumer-centric design and functionality; (3) reinforcing incentives that attract provider support by showing that consumer engagement is in their interest; and (4) building a stronger empirical case to convince decision makers that consumer engagement will lead to better care, improved health outcomes, and lower costs. PMID:26665120
Niedzwiecki, P; Priest, S L; Pivnicny, V C; Ruffino, B C
The consumer empowerment movement needs to provide consumers with more access and control of their healthcare records. The premise of this article is that there is a fundamental market shift towards consumer empowerment--and technology is the driving force. We contend the results will satisfy the intent of the HIPAA mandate. Two restrictions impede the market from moving toward real consumer empowerment. First, managing one's own health history record is difficult because the complete record is segmented in disparate systems that are difficult to integrate. This is because unique identifiers and consistent coding are nonexistent. Second, security and control of patient identifiable health information is still evolving. There is no consensus among providers for Internet security, as we can see by all the legislative privacy bills trying to address the issue. HIPAA is both a legislative mandate and an enabler of the next healthcare paradigm. Providers must comply with the HIPAA mandates for electronic data interchange (EDI) code sets, administrative simplification, and privacy and confidentiality protocols. By recognizing HIPAA as part of a consumer-driven movement, organizations can incorporate empowerment strategies into a planning process that creates consumer options in healthcare and leverages HIPAA compliance to benefit both providers and consumers. This article suggests methods for meeting HIPAA compliance through innovative consumer empowerment methods.
Stewart, T; May, P; Muneta, A
The findings of a health consumer survey of 309 Navajo families in three areas of the Navajo Reservation are reported. The survey shows that access to facilities and lack of safe water and sanitary supplies are continuing problems for these families. The families show consistent use of Indian Health Service providers, particularly nurses, pharmacists and physicians, as well as traditional Navajo medicine practitioners. Only incidental utilization of private medical services is reported. Extended waiting times and translation from English to Navajo are major concerns in their contacts with providers. A surprisingly high availability of third-party insurance is noted. Comparisons are made between this data base and selected national and regional surveys, and with family surveys from other groups assumed to be disadvantaged in obtaining health care. The comparisons indicate somewhat lower utilization rates and more problems in access to care for this Navajo sample. The discussion suggests that attitudes regarding free health care eventually may be a factor for Navajo people and other groups, that cultural considerations are often ignored or accepted as truisms in delivering care, and that the Navajo Reservation may serve as a unique microcosm of health care in the U.S.
Fox, Michael H
Although consumer-directed health care has become a fashionable concept in recent years, stories abound asking whether the so-called free market in health care can provide adequate access to quality health care at an affordable price. In spite of these concerns, consumer-directed health care continues as the face of legitimacy behind an industry-driven campaign to limit regulatory protections of the consumer in the market and encourage the growth of health insurance products that place spending options closer to the consumer, whether or not these options are available, affordable, or easily understood. Understanding whether this empowerment is real begins with first asking what it now means to be a health consumer. This commentary offers perspective on the dilemma faced by millions of Americans in navigating our health care system under the assumption that market-driven choices foster consumer empowerment in health care, and suggests approaches for expanding the true consumer voice.
Deering, M J; Harris, J
Consumers are increasingly interested in information that will help them manage their own health and that of their families. Managed care and other health providers see consumer health information as one tool to help improve patient satisfaction and reduce costs. There is a huge and varied supply of such information, provided through myriad sources. This article summarizes findings from a preliminary assessment of consumer health information demand and delivery supported by the U.S. Department of Health and Human Services. It highlights patterns of consumer interest and supply sources, identifies problems that confront those looking for information, and suggests a role for libraries as providers and interpreters of health information. The last publicly released general study on consumer health information was commissioned by General Mills in 1979. In the sixteen years since then, the scope of consumer health information has become huge and diverse; with increased responsibility for health, consumers have developed both broad interests and very specific needs. The Department of Health and Human Services commissioned a preliminary assessment of consumer health information demand and delivery to lay the foundation for a more comprehensive understanding of the issues. This article highlights some of the key findings that suggest a role for libraries as consumer health information providers and interpreters. PMID:8826626
Health literacy has been redefined in recent years to move beyond an individual's own communication skills to include the skills of persons working within health care organizations, including librarians. Provision of consumer health services and resources, while a long-standing practice in hospital libraries, has also been redefined. As definitions of health literacy have evolved, so too have hospital librarian services as they embrace their role within health literacy. Many hospital medical and consumer health librarians have developed programs, services, and collaborations to further health literacy awareness, education, and initiatives for consumers, health care professionals, and their parent organizations.
This module, consisting of materials for use in conducting a consumer education mini-course, deals with health care and services for consumers. Covered in the individual lessons are the following topics: understanding what is and is not covered by Medicare, assessing the need for private health insurance, purchasing private health insurance,…
Gould, Stephen J.
Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)
Consumer health-care information technology is intended to improve patients' opportunities to gather information about their own health. Ideally, this will be achieved through an improved involvement of existing data bases and an improved communication of information to patients and to care providers, if desired by patients. Additionally, further interconnection of existing and new systems and pervasive system design may be used. All consumer health-care information technology services are optional and leave patients in control of their medical data at all times. This article reflects the current status of consumer health-care information technology research and suggests further research areas that should be addressed.
Happell, Brenda; Platania-Phung, Chris
People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion.
Happell, Brenda; Roper, Cath
Mental health policy reform in Australia has led to the expectation of increased consumer participation not only in all aspects of service delivery, but also in the education and training of mental health professionals. The aim of this paper is to explore the development and introduction of a role for a consumer of mental health services within an academic institution, including achievements of the role and the principles contributing to successful implementation. The consumer academic position was successfully implemented and has proved a valuable role. The success of the role was considered to be dependent on the following factors: partnership and commitment, support, scope and autonomy. In conclusion, a consumer can play a valuable role within an academic institution. However, success will depend upon a number of important environmental factors that promote the independence of the consumer voice.
Buckeridge, David L
There is a clear and pronounced gap between the demand for and access to consumer health solutions. Existing health information systems and broader health system factors such as funding models are reasons for this gap. There are strong arguments from the perspectives of the consumer and population health for closing this gap, but the case from the perspective of the current health system is mixed. Closing the gap will require a concerted effort to reorient health information systems and funding models to support online access by consumers to health information and health services.
Snowdon, Anne; Schnarr, Karin; Alessi, Charles
The lead paper from Zelmer and Hagens details the substantive evolution occurring in health information technologies that has the potential to transform the relationship between consumers, health practitioners and health systems. In this commentary, the authors suggest that Canada is experiencing a shift in consumer behaviour toward a desire to actively manage one's health and wellness that is being facilitated through the advent of health applications on mobile and online technologies platforms. The result is that Canadians are now able to create personalized health solutions based on their individual health values and goals. However, before Canadians are able to derive a personal health benefit from these rapid changes in information technology, they require and are increasingly demanding greater real-time access to their own health information to better inform decision-making, as well as interoperability between their personal health tracking systems and those of their health practitioner team.
Goeman, Dianne; Michael, J; King, J; Luu, Huy; Emmanuel, Claire; Koch, S
Objective The aim of the Vietnamese Dementia talking-book was to address low health literacy in older people of Vietnamese background living with dementia through the provision of an online resource to help individuals, their families and carers better understand and manage this condition and provide information about available dementia services. Design This qualitative study used codesign and participatory action research to develop and refine the talking-book in consultation with expert stakeholders, a consumer advocacy group and the Vietnamese community to assess its utility and ensure cultural and linguistic appropriateness and relevance. Participants 59 members of the Vietnamese community, 11 stakeholders from community health services and ethnic agencies, consumer advocacy groups and the research team participated in the codesign and refinement of the talking-book. 22 members of the Vietnamese community appraised the final product. Setting Vietnamese community planned activity groups in the Western, Northern and Southern suburbs of Melbourne, Australia. Results Our codesign study outlines the process required to develop a Vietnamese Dementia Talking-Book resource partnering with consumers and expert stakeholders to identify consumer need, selection of the content and appropriate language level, construction of the book, measuring acceptability of the talking-book, modification based on feedback and production and dissemination. Feedback on the final version of the talking-book revealed widespread consensus that the book enhanced the knowledge of members of the Vietnamese community in regard to understanding dementia and navigation and accessing of available services. Conclusions This free internationally available online Vietnamese Dementia Talking-Book facilitates improved dementia-related health literacy in the Vietnamese community. The book also serves as a tool to facilitate the provision of care to Vietnamese people living with memory loss by assisting
Christianson, Jon B; Parente, Stephen T; Feldman, Roger
Objective To assess the experience of enrollees in a consumer-driven health plan (CDHP). Data Sources/Study Setting Survey of University of Minnesota employees regarding their 2002 health benefits. Study Design Comparison of regression-adjusted mean values for CDHP and other plan enrollees: customer service, plan paperwork, overall satisfaction, and plan switching. For CDHP enrollees only, use of plan features, willingness to recommend the plan to others, and reports of particularly negative or positive experiences. Principal Findings There were significant differences in experiences of CDHP enrollees versus enrollees in other plans with customer service and paperwork, but similar levels of satisfaction (on a 10-point scale) with health plans. Eight percent of CDHP enrollees left their plan after one year, compared to 5 percent of enrollees leaving other plans. A minority of CDHP enrollees used online plan features, but enrollees generally were satisfied with the amount and quality of the information provided by the CDHP. Almost half reported a particularly positive experience, compared to a quarter reporting a particularly negative experience. Thirty percent said they would recommend the plan to others, while an additional 57 percent said they would recommend it depending on the situation. Conclusions Much more work is needed to determine how consumer experience varies with the number and type of plan options available, the design of the CDHP, and the length of time in the CDHP. Research also is needed on the factors that affect consumer decisions to leave CDHPs. PMID:15230916
Quinn, Chris; Happell, Brenda
The management of consumer-related risk is paramount in a secure forensic mental health facility. However, the consequent risk aversion presents a major barrier to consumers forming sexual relationships in a manner that is open and accepted. Investigation of the views of nurses working in forensic mental health settings on this topic is limited, and even more so for consumers of services. This qualitative exploratory study was undertaken to elicit the views of consumers and nurses about forming sexual relationships within this long-term and secure setting. Individual in-depth interviews were conducted with 12 nurses and 10 consumers. The benefits of, and barriers to, sexual relationships was identified as a major theme, and these findings are the focus of this paper. Nurse responses included the subthemes 'supportive factors' and 'potential dangers', reflecting their qualified support. Consumer responses included the subthemes 'therapeutic', 'feeling normal', 'restrictions and barriers', and 'lack of support and secrecy'. The importance of sexual relationships was clearly articulated, as was the difficulties in forming and maintaining them within the forensic setting. More open discussion about this commonly-avoided issue and the education of nurses and other health professionals is required.
Crow, Karen, Comp.; Martin, Joan, Ed.
Consumer education course objectives, content analysis, supporting objectives, and content generalizations are presented in this teacher's guide for Consumer Education 1 and 2 for the San Diego Unified School District. Course objectives are aimed at several areas of consumer and family studies: consumer education, cultural awareness, human…
Arkansas Univ., Fayetteville, Cooperative Extension Service.
Designed to be used by health educators when teaching youths and their parents about the control of veneral disease (syphilis and gonorrhea), this booklet includes the following: (1) a two-page teaching plan consisting of objectives for both youths and adults along with notes on subject matter, methods (including titles of films and printed…
Arkansas Univ., Fayetteville, Cooperative Extension Service.
This short booklet is designed to be used by health educators when teaching women about breast cancer and its early detection and the procedure for breast self-examination. It includes the following: (1) A one-page teaching plan consisting of objectives, subject matter, methods (including titles of films and printed materials), target audience,…
Brophy, Lisa M; Roper, Catherine E; Hamilton, Bridget E; Tellez, Juan José; McSherry, Bernadette M
Objective This paper examines the perspectives of consumers and their supporters regarding the use of seclusion and restraint in mental health settings.Methods Five focus groups for consumers and five focus groups for supporters were conducted in four Australian cities and in one rural location. The 66 participants were asked about strategies to reduce or eliminate the use of seclusion and restraint in mental health settings.Results All participants supported the reduction of the use of seclusion and restraint. Barriers to reducing these practices related to the environment, the effects of drug and alcohol issues, lack of a human rights focus and poor recognition of trauma, stigma and discrimination. Strategies for reducing or eliminating seclusion and restraint included workforce development, environmental and cultural changes.Conclusions Participants clearly identified that the status quo needs to change and conveyed urgency for action. Participants suggested that the involvement of supporters and a range of consumer roles are integral to reducing the use of seclusion and restraint. The findings support the current policy emphasis of working towards the elimination of these practices.What is known about the topic? Mental health policies across many jurisdictions support the reduction and elimination of restraint and seclusion. Evidence suggests those subjected to restraint and seclusion largely experience a range of harmful consequences. No studies focus on the views of supporters of consumers regarding the reduction and elimination of seclusion and restraint, whereas the views of consumers appear in a minority of international studies.What does this paper add? The research enabled an opportunity to hear from people who have been personally affected by and/or have lived experience of these coercive practices. Participants identified local reforms that can uphold the human rights of consumers. They suggested practices to increase accountability, peer support and
Sinaiko, Anna D; Hirth, Richard A
We analyze employee health plan choices when the choice set offered by their employer includes a dominated plan. During our study period, one-third of workers were enrolled in the dominated plan. Some may have selected the plan before it was dominated and then failed to switch out of it. However, a substantial number actively chose the dominated plan when they had an unambiguously better choice. These results suggest limitations in the ability of health reform based solely on consumer choice to achieve efficient outcomes and that implementation of health reform should anticipate, monitor and account for this consumer behavior.
Deshpande, Satish P; Deshpande, Samir S
The purpose of this study was to examine factors that impact consumer satisfaction with health care. This is a secondary analysis of the Center for Studying Health System Change's 2010 Health Tracking Household Survey. Regression analysis was used to examine the impact of treatment issues, financial issues, family-related issues, sources of health care information, location, and demographics-related factors on satisfaction with health care. The study involved 12280 subjects, 56% of whom were very satisfied with their health care, whereas 66% were very satisfied with their primary care physician. Fourteen percent of the subjects had no health insurance; 34% of the subjects got their health care information from the Web. Satisfaction with primary care physician, general health status, promptness of visit to doctor, insurance type, medical cost per family, annual income, persons in family, health care information from friends, and age significantly impacted satisfaction with health care. The regression models accounted for 23% of the variance in health care satisfaction. Satisfaction with primary care physicians, health insurance, and general health status are the 3 most significant indicators of an individual's satisfaction with health care.
Blair, J E
1. Social marketing provides a theoretical basis to increase awareness of preventable health conditions and to increase participation in wellness programs. 2. The philosophy of social marketing underscores the necessity to be aware of and responsive to the consumer's perception of needs. 3. Social marketing is distinguished by its emphasis on "non-tangible" products such as ideas, attitudes, and lifestyle changes. 4. "Marketing mix" is a social marketing strategy that intertwines elements of product, price, place, and promotion to satisfy needs and wants of consumers.
Angier, J J
Consumer health information as applied to mental health includes areas such as the diagnosis, management, and treatment of mental illness, as well as self-help, emotional wellness, and the relationship between life events, stress, and disease. This paper presents issues specific to the provision of mental health information to the layperson, e.g., confidentiality, literacy, competence, the social stigma of mental illness, the state of the art in psychiatry, popular psychology, and treatment fads. The development of a community education pamphlet illustrates how one organization addressed these issues.
Ball, Marion J; Costin, Melinda Y; Lehmann, Christoph
With personal health records (PHRs) acting much like ATM cards, increasingly wired consumers can "bank on health", accessing their own personal health information and a wide array of services. Consumer-owned, the PHR is dependent upon the existence of the legal electronic medical record (EMR) and interoperability. Working PHRs are in place in Veterans Health Administration, private health care institutions, and in the commercial sector. By allowing consumers to become involved in their own care, the PHR creates new roles and relationships. New tools change the clinician's workflow and thought flow, and pose new challenges for consumers. Key components of the PHR include the EMR and regional health information organizations (RHIOs); key strategies focus on human factors in successful project management. Online resources provided by the National Library of Medicine and Health On the Net help address consumer needs for information that is reliable and understandable. The growth of self-management tools adds to the challenge and the promise of PHRs for clinicians and consumers alike.
Wolff, Jennifer L; Darer, Jonathan D; Larsen, Kevin L
Health information technology has been embraced as a strategy to facilitate patients' access to their health information and engagement in care. However, not all patients are able to access, or are capable of using, a computer or mobile device. Although family caregivers assist individuals with some of the most challenging and costly health needs, their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of engaging family caregivers through the use of consumer-oriented health information technology. We compile existing evidence to make the case that involving family caregivers in health information technology as desired by patients is technically feasible and consistent with the principles of patient-centered and family-centered care. We discuss how more explicit and purposeful engagement of family caregivers in health information technology could advance clinical quality and patient safety by increasing the transparency, accuracy, and comprehensiveness of patient health information across settings of care. Finally, we describe how clarifying and executing patients' desires to involve family members or friends through health information technology would provide family caregivers greater legitimacy, convenience, and timeliness in health system interactions, and facilitate stronger partnerships between patients, family caregivers, and health care professionals.
Consumer health informatics (CHI) is propelling important changes for medical providers and the lives of patients through information and communications technology. Independently, medical consumers seek, collect, and use health information for decision making. However, when constructing a CHI-based medical platform, high technology must be applied in a fully understandable and usable format for both health care providers and consumers. This study examines the present status of CHI and its effect on medical consumers. For the development of CHI, we discuss the need for tailored health communications and capacity building with chronic patients at the medical center. First, empowerment is a key characteristic needed for medical consumer health care management. However, promoting patient self-care management of illnesses and health is necessary to create conjugation where cooperation with medical service providers is possible. Also, establishing a health care delivery system that will support cooperation is necessary. Second, tailored health communications can uniquely construct the health information of patients, which prevents unnecessary or excessive information from leading patients to confused and inappropriate decisions. Ultimately, through the present environment of health communication, the innovation of a consumer health care information system has become the tide of the times and the positive effect of improved health can be expected.
... HUMAN SERVICES Consumer Health IT Pledge Program AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of availability for Consumer Health IT Pledge Program. SUMMARY... benefits of health information technology (health IT) in improving health and health care. As part of...
Cimino, James J; Frisse, Mark E; Halamka, John; Sweeney, Latanya; Yasnoff, William
The American College of Medical Informatics (ACMI) sponsors periodic debates during the American Medical Informatics Fall Symposium to highlight important informatics issues of broad interest. In 2012, a panel debated the following topic: "Resolved: Health Information Exchange Organizations Should Shift Their Principal Focus to Consumer-Mediated Exchange in Order to Facilitate the Rapid Development of Effective, Scalable, and Sustainable Health Information Infrastructure." Those supporting the proposition emphasized the need for consumer-controlled community repositories of electronic health records (health record banks) to address privacy, stakeholder cooperation, scalability, and sustainability. Those opposing the proposition emphasized that the current healthcare environment is so complex that development of consumer control will take time and that even then, consumers may not be able to mediate their information effectively. While privately each discussant recognizes that there are many sides to this complex issue, each followed the debater's tradition of taking an extreme position in order emphasize some of the polarizing aspects in the short time allotted them. In preparing this summary, we sought to convey the substance and spirit of the debate in printed form. Transcripts of the actual debate were edited for clarity, and appropriate supporting citations were added for the further edification of the reader.
Hunscher, Dale A
Online search for consumer health information is a public health concern. General-purpose search engines have historically returned health-related query results of dubious relevance and quality. Meanwhile, consumers have become increasingly reliant on and trusting of these engines. General-purpose search engines have attempted to make their interfaces more consumer-friendly with respect to consumer health queries and their results more relevant and trustworthy. We illustrate the characteristics of the evolving health search landscape using network visualization.
Metlen, Scott; Eveleth, Daniel; Bailey, Jeffrey J
How managers 'manage' employees influences important firm outcomes. Heskett, Sasser, and Schlesinger contend that the level of internal support for service workers will influence consumer satisfaction. This study empirically explores how skilled nursing facility (SNF) managers affect consumer satisfaction by encouraging employee effectiveness and listening to employees to determine how to improve employee effectiveness. We extend previous research by proposing management as a form of internal support and demonstrating its relationship to service process integration, as a distinct form of internal support. The results of our individual-level investigation of 630 nursing assistants from 45 SNFs provide support for our two-part hypothesis. First, active management support and process integration, as elements of internal support, do lead to increased employee satisfaction and employee effectiveness. Second, the increased employee satisfaction and effectiveness was positively related to consumer satisfaction, as evaluated by the service workers. Thus, there is a positive influence of management's internal support of nursing assistants on perceived consumer satisfaction.
Metzler, Carol W; Sanders, Matthew R; Rusby, Julie C; Crowley, Ryann N
Within a public health approach to improving parenting, the mass media offer a potentially more efficient and affordable format for directly reaching a large number of parents with evidence-based parenting information than do traditional approaches to parenting interventions that require delivery by a practitioner. Little is known, however, about factors associated with parents' interest in and willingness to watch video messages about parenting. Knowledge of consumer preferences could inform the effective design of media interventions to maximize parental engagement in the parenting messages. This study examined parents' preferred formats for receiving parenting information, as well as family sociodemographic and child behavior factors that predict parents' ratings of acceptability of a media-based parenting intervention. An ethnically diverse sample of 162 parents of children ages 3-6 years reported their preferences for various delivery formats for parenting information and provided feedback on a prototype episode of a video-format parenting program based on the Triple P Positive Parenting Program. Parents reported the strongest preference for self-administered delivery formats such as television, online programs, and written materials; the least preferred formats were home visits, therapists, and multiweek parenting groups. Parents' ratings of engagement, watchability, and realism of the prototype parenting episode were quite strong. Parents whose children exhibited clinical levels of problem behaviors rated the episode as more watchable, engaging, and realistic. Mothers also rated the episodes as more engaging and realistic than did fathers. Lower income marginally predicted higher watchability ratings. Minority status and expectations of future problems did not predict acceptability ratings. The results suggest that the episode had broad appeal across groups.
Burkell, Jacquelyn; Campbell, D. Grant
Purpose: The authors analyzed online consumer health information related to screening tests to see how well this information meets known standards for supporting the understanding of test uncertainty. Setting/Subjects: MedlinePlus documents regarding maternal serum screening (6), prostate-specific antigen testing (6), and screening mammography (6) were analyzed. Methodology: The content of the documents was analyzed. Results: This study showed that most sites conscientiously report that tests are less than 100% accurate, but few provide important details about the level of uncertainty associated with test results. In particular, few resources give information about the predictive value of screening tests and have little mention of the fact that predictive value is influenced by the a priori likelihood of having the condition. Discussion/Conclusion: These results suggest that online consumer health information does not adequately support decisions about medical screening. We suggest a potential solution to the problem: metadata harvesting coupled with optimized presentation techniques to format personalized information about screening tests. Using these techniques, the empowerment of personal choice in matters of health decisions could become the de facto standard. PMID:16059426
Hoek, Annet C; Luning, Pieternel A; Stafleu, Annette; de Graaf, Cees
The aim was to investigate socio-demographic characteristics, and attitudes to food and health of vegetarians, non-vegetarian consumers of meat substitutes, and meat consumers in The Netherlands. The sample used for this study (participants > or =18 years) was taken from the Dutch National Food Consumption Survey, 1997/1998. Vegetarians (n = 63) and consumers of meat substitutes (n = 39) had similar socio-demographic profiles: higher education levels, higher social economic status, smaller households, and more urbanised residential areas, compared to meat consumers (n = 4313). Attitudes to food were assessed by the food-related lifestyle instrument. We found that vegetarians (n = 32) had more positive attitudes towards importance of product information, speciality shops, health, novelty, ecological products, social event, and social relationships than meat consumers (n = 1638). The health consciousness scale, which was used to assess attitudes to health, supported earlier findings that vegetarians are more occupied by health. Food-related lifestyle and health attitudes of meat substitute consumers (n = 17) were predominantly in-between those from vegetarians and meat consumers. The outcome of this study suggests that in strategies to promote meat substitutes for non-vegetarian consumers, the focus should not only be on health and ecological aspects of foods.
van Trijp, Hans C M; van der Lans, Ivo A
The number of food products containing extra or reduced levels of specific ingredients (e.g. extra calcium) that bring particular health benefits (e.g. stronger bones) is still increasing. Nutrition- and health-related (NH) claims promoting these ingredient levels and their health benefit differ in terms of the (legal) strength with which the claim is brought forward and the specific wording of the claim, both of which may differ between countries. Using a large-scale cross-national internet-based survey in Italy (n=1566), Germany (n=1620), UK (n=1560) and US (n=1621), the purpose of the study described here is to investigate consumer perceptions of NH food product claims, across different countries. NH claims are systematically varied as a function of six health benefits (cardiovascular disease, stress, infections, fatigue, overweight and concentration) and five claim types (content, structure-function, product, disease-risk reduction and marketing claim). The general results indicate that consumer perceptions differ substantially by country and benefit being claimed but much less by the claim type. Implications of these findings are being discussed.
Egglestone, Corin; Morris, Anne; O'Brien, Ann
Direct-to-consumer (DTC) genetic tests can be purchased over the internet. Some companies claim to provide relative genetic risks for various diseases and thus encourage healthy behaviour. There are concerns that exposure to such information may actually discourage healthy behaviour or increase health anxiety. An online survey was conducted (n = 275). Respondents were composed of individuals who had purchased a DTC genetic test and received their results (consumers, n = 189), as well as individuals who were either awaiting test results or considering purchasing a test (potential consumers, n = 86). Consumers were asked if their health behaviour or health anxiety had changed after receiving their results. Respondents' current health behaviour and health anxiety were queried and compared. In total, 27.3 % of consumers claimed a change in health behaviour, all either positive or neutral, with no reported cessation of any existing health behaviour. A change in health anxiety was claimed by 24.6 % of consumers, 85.3 % of which were a reduction. Consumers had significantly better health behaviour scores than potential consumers (p = 0.02), with no significant difference in health anxiety. This study points towards an association between receipt of DTC genetic test results and increased adoption of healthy behaviours for a minority of consumers based on self-report, with more mixed results in relation to health anxiety.
Sapp, Lara; Cogdill, Keith
Social media technologies are transforming the way librarians are collaborating, creating, and disseminating information. This article discusses how librarians at the University of Texas Health Science Center at San Antonio created a blog to support their health information outreach activities. Launched in 2007, the Staying Well Connected blog was established with the goal of promoting access to biomedical and health information for consumers and health professionals in the South Texas region. Postings highlight relevant health news, conferences, funding opportunities, and outreach events.
Ports, Katie A.; Ayers, Antoinette; Crocker, Wayne; Hart, Alton; Mosavel, Maghboeba; Rafie, Carlin
The purpose of this study was to understand factors that may affect the usage of a consumer health center located in a public library. More specifically, the authors wanted to know what health resources are of interest to the community, what patrons' perceptions of their experience at the center are, and finally, how staff can increase utilization of the center. In general, perceptions of the center were positive. The findings support that participants appreciate efforts to provide health information in the public library setting and that utilization could be improved through marketing and outreach. PMID:25552943
Delbaere, Marjorie; Smith, Malcolm C
This research develops a framework for understanding how consumers process health-related information and interact with their caregivers. The context is direct-to-consumer (DTC) advertising by pharmaceutical companies in North America. This theoretical research presents a research framework and focuses on the presentation of information in advertisements, consumer-learning processes, consumer utilization of health care knowledge, and bias in perceived risk. The paper proposes that consumers who lack expertise with prescription drugs learn from DTC ads differently than those with expertise. Further, it is proposed that consumers also process the information in DTC ads differently depending on the perceived effectiveness of the drug being advertised, and ultimately utilize the knowledge taken from the ads in many different ways, some of which may appear irrational to health care providers. By understanding how consumers interpret and learn from DTC ads, health care organizations and providers may be able to improve health care delivery and consumer outcomes.
Wallner, Peter; Kundi, Michael; Hohenblum, Philipp; Scharf, Sigrid; Hutter, Hans-Peter
Phthalates are multifunctional chemicals used in a wide variety of consumer products. The aim of this study was to investigate whether levels of urinary phthalate metabolites in urine samples of Austrian mothers and their children were associated with consumer habits and health indicators. Within an Austrian biomonitoring survey, urine samples from 50 mother-child pairs of five communities (two-stage random stratified sampling) were analysed. The concentrations of 14 phthalate metabolites were determined, and a questionnaire was administered. Monoethyl phthalate (MEP), mono-n-butyl phthalate (MnBP), mono-isobutyl phthalate (MiBP), monobenzyl phthalate (MBzP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), mono-(5-carboxy-2-ethylpentyl) phthalate (5cx-MEPP), and 3-carboxy-mono-propyl phthalate (3cx-MPP) could be quantified in the majority of samples. Significant correlations were found between the use of hair mousse, hair dye, makeup, chewing gum, polyethylene terephthalate (PET) bottles and the diethyl phthalate (DEP) metabolite MEP. With regard to health effects, significant associations of MEP in urine with headache, repeated coughing, diarrhoea, and hormonal problems were observed. MBzP was associated with repeated coughing and MEHP was associated with itching. PMID:27428989
Cabassa, Leopoldo J.; Parcesepe, Angela; Nicasio, Andel; Baxter, Ellen; Tsemberis, Sam; Lewis-Fernández, Roberto
People with serious mental illnesses (SMI) are at increased risk for cardiovascular disease and premature mortality. We used photovoice in two supportive housing agencies to engage consumers with SMI to inform the implementation of health care interventions. Sixteen consumers participated in six weekly sessions in which they took photographs about their health and discussed the meanings of these photographs in individual interviews and group sessions. We identified several implementation themes related to consumers’ preferences. Peer-based approaches were preferred more than clinician-driven models. Participants expressed a desire to learn practical skills through hands-on activities to modify health behaviors. Consumers expressed a desire to increase their physical activity. Participants revealed in their photographs and narratives the important role that communities’ food environments play in shaping eating habits. In this article, we show how photovoice can generate valuable community knowledge to inform the translation of health care interventions in supportive housing agencies. PMID:23258117
Scholz, Brett; Gordon, Sarah; Happell, Brenda
Contemporary mental health policies call for greater involvement of mental health service consumers in all aspects and at all levels of service planning, delivery, and evaluation. The extent to which consumers are part of the decision-making function of mental health organizations varies. This systematic review synthesizes empirical and review studies published in peer-reviewed academic journals relating to consumers in leadership roles within mental health organizations. The Cochrane Library, Medline, and PsycINFO were searched for articles specifically analysing and discussing consumers' mental health service leadership. Each article was critically appraised against the inclusion criteria, with 36 articles included in the final review. The findings of the review highlight current understandings of organizational resources and structures in consumer-led organizations, determinants of leadership involvement, and how consumer leadership interacts with traditional mental health service provision. It appears that organizations might still be negotiating the balance between consumer leadership and traditional structures and systems. The majority of included studies represent research about consumer-run organizations, with consumer leadership in mainstream mental health organizations being less represented in the literature. Advocates of consumer leadership should focus more on emphasizing how such leadership itself can be a valuable resource for organizations and how this can be better articulated. This review highlights the current gaps in understandings of consumer leadership in mental health, including a need for more research exploring the benefits of consumer leadership for other consumers of services.
Keselman, Alla; Logan, Robert; Smith, Catherine Arnott; Leroy, Gondy; Zeng-Treitler, Qing
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors' recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public's health information needs, and developing informatics solutions for tailoring resources to users' needs and competencies. This article was written as a scholarly outreach and leadership project by members of the American Medical Informatics Association's Consumer Health Informatics Working Group.
Keselman, Alla; Logan, Robert; Smith, Catherine Arnott; Leroy, Gondy; Zeng-Treitler, Qing
As the emphasis on individuals' active partnership in health care grows, so does the public's need for effective, comprehensible consumer health resources. Consumer health informatics has the potential to provide frameworks and strategies for designing effective health communication tools that empower users and improve their health decisions. This article presents an overview of the consumer health informatics field, discusses promising approaches to supporting health communication, and identifies challenges plus direction for future research and development. The authors' recommendations emphasize the need for drawing upon communication and social science theories of information behavior, reaching out to consumers via a range of traditional and novel formats, gaining better understanding of the public's health information needs, and developing informatics solutions for tailoring resources to users' needs and competencies. This article was written as a scholarly outreach and leadership project by members of the American Medical Informatics Association's Consumer Health Informatics Working Group. PMID:18436895
McCann, Terence V; Clark, Eileen; Baird, John; Lu, Sai
The purpose of this study was to assess mental health clinicians' attitudes about mental health consumer participation in inpatient psychiatric units. A cross-sectional survey design was used with a non-probability sample of 47 clinicians in the psychiatric units of a large Australian hospital. The results showed that gender, length of time as a clinician, and how long the staff worked in the units influenced their attitudes about consumer involvement. Females were more likely than males to support consumer participation in management and consumer consultants. Less experienced staff showed greater support than more experienced staff for mental health consumer involvement in treatment-related matters and consumer consultants in units. New staff members were more likely to register agreement-to-uncertainty regarding consumer involvement in treatment-related issues, whereas established staff members were more likely to record uncertainty about this issue. The findings showed that although reports and policies promoted participation, some clinicians were reluctant to accept consumer and consultant involvement.
Strategies to fix America's ailing health-care system seemed to fly off the presses every month in 2007. Doctors, journalists, and policymakers clamored to have their say, as did supporters and opponents of the controversial life-extension movement. These top trends, which registered in 2006 as well, and will only balloon in this election year,…
Happell, Brenda; Bennetts, Wanda
Consumer participation in the education of health professionals is increasing, particularly in mental health nursing education and storytelling remains the most frequent approach to consumer involvement. The use of story has tended to be accepted as a legitimate educational tool with limited critique or consideration of its potential consequences presented within the academic literature. A qualitative exploratory research study was undertaken with mental health nurse academics (n = 34) and consumer educators and academics (n = 12), to investigate the perceptions and experiences of mental health nurses and consumers regarding the involvement of consumers in mental health nursing education. Data were analysed thematically. Story was a major theme to emerge from consumer participants and received some attention from nurse academics. Consumers and nurses both referred to the power of story to convey the human experience of mental illness diagnosis and service use; and the vulnerability that can result from storytelling. Consumers also described: story as expectation; preparation and support; and the politics of story. All participants supported the value of storytelling in mental health nursing education. Consumers had considered the complexities in far greater detail. The ongoing value of story as an educational technique requires further research. Equally important is considering a broader range of educational roles for mental health consumers.
Chan, Connie V; Matthews, Lisa A; Kaufman, David R
There are a range of barriers precluding patients from fully engaging in and benefiting from the spectrum of eHealth interventions developed to support patient access to health information, disease self-management efforts, and patient-provider communication. Consumers with low eHealth literacy skills often stand to gain the greatest benefit from the use of eHealth tools. eHealth skills are comprised of reading/writing/numeracy skills, health literacy, computer literacy, information literacy, media literacy, and scientific literacy . We aim to develop an approach to characterize dimensions of complexity and to reveal knowledge and skill-related barriers to eHealth engagement. We use Bloom's Taxonomy to guide development of an eHealth literacy taxonomy that categorizes and describes each type of literacy by complexity level. Illustrative examples demonstrate the utility of the taxonomy in characterizing dimensions of complexity of eHealth skills used and associated with each step in completing an eHealth task.
Tennessee Univ., Knoxville.
This health education handbook covers the following topics: (1) the consumer and health care; (2) diet and nutrition; (3) additives, supplements, and health foods; (4) prescription drugs; (5) over-the-counter drugs; (6) doctors, hospitals, and surgery; and (7) providing and paying for health care. A teacher's supplement health care unit is…
Metzler, Carol W.; Sanders, Matthew R.; Rusby, Julie C.; Crowley, Ryann N.
Within a public health approach to improving parenting, the mass media offer a potentially more efficient and affordable format for directly reaching a large number of parents with evidence-based parenting information than do traditional approaches to parenting interventions that require delivery by a practitioner. Little is known, however, about…
Hung, Man; Conrad, Jillian; Hon, Shirley D.; Cheng, Christine; Franklin, Jeremy D.; Tang, Philip
Internet usage and accessibility has grown at a staggering rate, influencing technology use for healthcare purposes. The amount of health information technology (Health IT) available through the Internet is immeasurable and growing daily. Health IT is now seen as a fundamental aspect of patient care as it stimulates patient engagement and encourages personal health management. It is increasingly important to understand consumer health IT patterns including who is using specific technologies, how technologies are accessed, factors associated with use, and perceived benefits. To fully uncover consumer patterns it is imperative to recognize common barriers and which groups they disproportionately affect. Finally, exploring future demand and predictions will expose significant opportunities for health IT. The most frequently used health information technologies by consumers are gathering information online, mobile health (mHealth) technologies, and personal health records (PHRs). Gathering health information online is the favored pathway for healthcare consumers as it is used by more consumers and more frequently than any other technology. In regard to mHealth technologies, minority Americans, compared with White Americans utilize social media, mobile Internet, and mobile applications more frequently. Consumers believe PHRs are the most beneficial health IT. PHR usage is increasing rapidly due to PHR integration with provider health systems and health insurance plans. Key issues that have to be explicitly addressed in health IT are privacy and security concerns, health literacy, unawareness, and usability. Privacy and security concerns are rated the number one reason for the slow rate of health IT adoption. PMID:24904713
Hung, Man; Conrad, Jillian; Hon, Shirley D; Cheng, Christine; Franklin, Jeremy D; Tang, Philip
Internet usage and accessibility has grown at a staggering rate, influencing technology use for healthcare purposes. The amount of health information technology (Health IT) available through the Internet is immeasurable and growing daily. Health IT is now seen as a fundamental aspect of patient care as it stimulates patient engagement and encourages personal health management. It is increasingly important to understand consumer health IT patterns including who is using specific technologies, how technologies are accessed, factors associated with use, and perceived benefits. To fully uncover consumer patterns it is imperative to recognize common barriers and which groups they disproportionately affect. Finally, exploring future demand and predictions will expose significant opportunities for health IT. The most frequently used health information technologies by consumers are gathering information online, mobile health (mHealth) technologies, and personal health records (PHRs). Gathering health information online is the favored pathway for healthcare consumers as it is used by more consumers and more frequently than any other technology. In regard to mHealth technologies, minority Americans, compared with White Americans utilize social media, mobile Internet, and mobile applications more frequently. Consumers believe PHRs are the most beneficial health IT. PHR usage is increasing rapidly due to PHR integration with provider health systems and health insurance plans. Key issues that have to be explicitly addressed in health IT are privacy and security concerns, health literacy, unawareness, and usability. Privacy and security concerns are rated the number one reason for the slow rate of health IT adoption.
Matthews, Ben; Bidargaddi, Niranjan; Jones, Gabrielle; Lawn, Sharon; Venning, Anthony; Collin, Philippa
Despite growing interest in the promise of e-mental and well-being interventions, little supporting literature exists to guide their design and the evaluation of their effectiveness. Both participatory design (PD) and design thinking (DT) have emerged as approaches that hold significant potential for supporting design in this space. Each approach is difficult to definitively circumscribe, and as such has been enacted as a process, a mind-set, specific practices/techniques, or a combination thereof. At its core, however, PD is a design research tradition that emphasizes egalitarian partnerships with end users. In contrast, DT is in the process of becoming a management concept tied to innovation with strong roots in business and education. From a health researcher viewpoint, while PD can be reduced to a number of replicable stages that involve particular methods, techniques, and outputs, projects often take vastly different forms and effective PD projects and practice have traditionally required technology-specific (eg, computer science) and domain-specific (eg, an application domain, such as patient support services) knowledge. In contrast, DT offers a practical off-the-shelf toolkit of approaches that at face value have more potential to have a quick impact and be successfully applied by novice practitioners (and those looking to include a more human-centered focus in their work). Via 2 case studies we explore the continuum of similarities and differences between PD and DT in order to provide an initial recommendation for what health researchers might reasonably expect from each in terms of process and outcome in the design of e-mental health interventions. We suggest that the sensibilities that DT shares with PD (ie, deep engagement and collaboration with end users and an inclusive and multidisciplinary practice) are precisely the aspects of DT that must be emphasized in any application to mental health provision and that any technology development process must
New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.
Designed as one of a series of modules in consumer education this booklet focuses on health problems from the consumer angle. It is designed to supplement the comprehensive health strands published by the New York State Education Department, and to be used as materials for an elective course. The module is constructed so that the student can…
Roberts, Kirk; Kilicoglu, Halil; Fiszman, Marcelo; Demner-Fushman, Dina
We present a method for automatically classifying consumer health questions. Our thirteen question types are designed to aid in the automatic retrieval of medical answers from consumer health resources. To our knowledge, this is the first machine learning-based method specifically for classifying consumer health questions. We demonstrate how previous approaches to medical question classification are insufficient to achieve high accuracy on this task. Additionally, we describe, manually annotate, and automatically classify three important question elements that improve question classification over previous techniques. Our results and analysis illustrate the difficulty of the task and the future directions that are necessary to achieve high-performing consumer health question classification. PMID:25954411
Wong, Charlene A; Polsky, Daniel E; Jones, Arthur T; Weiner, Janet; Town, Robert J; Baker, Tom
The design of the Affordable Care Act's online health insurance Marketplaces can improve how consumers make complex health plan choices. We examined the choice environment on the state-based Marketplaces and HealthCare.gov in the third open enrollment period. Compared to previous enrollment periods, we found greater adoption of some decision support tools, such as total cost estimators and integrated provider lookups. Total cost estimators differed in how they generated estimates: In some Marketplaces, consumers categorized their own utilization, while in others, consumers answered detailed questions and were assigned a utilization profile. The tools available before creating an account (in the window-shopping period) and afterward (in the real-shopping period) differed in several Marketplaces. For example, five Marketplaces provided total cost estimators to window shoppers, but only two provided them to real shoppers. Further research is needed on the impact of different choice environments and on which tools are most effective in helping consumers pick optimal plans.
Boote, Jonathan; Telford, Rosemary; Cooper, Cindy
The involvement of consumers in health research is now Department of Health policy within the UK. Despite the existence of policy directives, there is a dearth of knowledge on the effects of such involvement. This paper critically reviews the state of our knowledge on this issue, and maps out a research agenda with the aim of stimulating systematic, empirical inquiry into consumer involvement in health research. The paper discusses definitions of 'the consumer'; considers why consumer involvement is believed to be important to health research; traces the development of the policy; analyses the epistemological and methodological implications of the policy; discusses the various levels of consumer involvement in research; and outlines the objections to the policy that have been put forward by clinicians and researchers. Four questions were identified during the review as being in need of theoretical and empirical attention: (1) how can consumer involvement in health research be further conceptualised? (2) how and why does consumer involvement influence health research? (3) how can the influence of consumers in health research be measured and evaluated? and (4) what factors are associated with 'successful' consumer involvement in health research?
Masri, Maysoun Demachkie; Oetjen, Reid M; Campbell, Claudia
When Americans voted in November 2008, many had the presidential candidates' positions on health care reform in mind. Health savings accounts, which are high deductible health plans coupled with a tax-protected savings account, are 1 type of consumer-directed health plan (CDHP) that gained strong support from the Bush administration. Despite evidence of the effectiveness of CDHPs in constraining costs in other countries, the Obama health plan contains no mention of their role in future US health reform. This article seeks to provide the reader with a better understanding of how CDHPs can help to improve the use of health resources and reduce national health care expenditures by exploring the history and previous research on several types of consumer-directed plans and by providing a comparative analysis of the use of CDHPs in other countries.
Risker, D C
Public and private health data organizations are receiving increased pressure to produce consumer-level health information. In addition, the proposed health care reforms imply that health care networks will have to market their health plans. However, little attention has been given to what format the information should have and what the consumers' information needs are. This article discusses the health services marketing literature published to date on the subject, compares it to general marketing literature, and suggests some general guidelines for the effective publication and distribution of health information.
Sandefer, Ryan H; Westra, Bonnie L; Khairat, Saif S; Pieczkiewicz, David S; Speedie, Stuart M
Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access.
Sandefer, Ryan H.; Westra, Bonnie L.; Khairat, Saif S.; Pieczkiewicz, David S.; Speedie, Stuart M
Patients are increasingly using the Internet and other technologies to engage in their own healthcare, but little research has focused on the determinants of consumer eHealth behaviors related to Internet use. This study uses data from 115,089 respondents to four years of the National Health Interview Series to identify the associations between one consumer eHealth behavior (information seeking) and demographics, health measures, and Personal Health Information Management (PHIM) (messaging, scheduling, refills, and chat). Individuals who use PHIM are 7.5 times more likely to search the internet for health related information. Just as health has social determinants, the results of this study indicate there are potential social determinants of consumer eHealth behaviors including personal demographics, health status, and healthcare access. PMID:26958251
Menefee, Hannah K; Thompson, Morgan J; Guterbock, Thomas M; Williams, Ishan C
Background Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients’ health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients’ health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients’ needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. Objective Our aim was to characterize patients’ use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients’ communication needs and preferences. Methods This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study’s first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. Results Participants’ rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6
Richards, Virginia; Kettler, Mary C.; Brown, Elfrieda F.
Analysis of documents from 19 college home economics/family and consumer sciences programs demonstrated the evolution of health core curriculum from emphasis on sanitation, nutrition, and food preparation to hospital-related health care. Today's emphasis on health care costs and wellness has shifted emphasis to home health care and prevention. (SK)
The papers in the session "Food Culture and Consumer Response," show how important people's values, beliefs, aspirations and social context are to their dietary health. They also reveal several tensions that shape consumer responses to healthy food. This essay discusses the paradoxical nature of eating habits in general, and describes three paradoxes related specifically to the challenges of providing food for health in the 21st century: pleasure/health, technology/nature, innovation/nostalgia.
Scholz, Brett; Bocking, Julia; Happell, Brenda
Stigmatizing views towards consumers may be held even by those working within mental health organizations. Contemporary mental health policies require organizations to work collaboratively with consumers in producing and delivering services. Using social exchange theory, which emphasises mutual exchange to maximise benefits in partnership, the current study explores the perspectives of those working within organizations that have some level of consumer leadership. Interviews were conducted with 14 participants from a range of mental health organizations. Data were transcribed, and analyzed using thematic analytic and discursive psychological techniques. Findings suggest stigma is still prevalent even in organizations that have consumers in leadership positions, and consumers are often perceived as less able to work in mental health organizations than non-consumers. Several discourses challenged such a view - showing how consumers bring value to mental health organizations through their expertise in the mental health system, and their ability to provide safety and support to other consumers. Through a social exchange theory lens, the authors call for organizations to challenge stigma and promote the value that consumers can bring to maximize mutual benefits.
Wills, Josephine M; Storcksdieck genannt Bonsmann, Stefan; Kolka, Magdalena; Grunert, Klaus G
Health claims on food products are often used as a means to highlight scientifically proven health benefits associated with consuming those foods. But do consumers understand and trust health claims? This paper provides an overview of recent research on consumers and health claims including attitudes, understanding and purchasing behaviour. A majority of studies investigated selective product-claim combinations, with ambiguous findings apart from consumers' self-reported generic interest in health claims. There are clear indications that consumer responses differ substantially according to the nature of carrier product, the type of health claim, functional ingredient used or a combination of these components. Health claims tend to be perceived more positively when linked to a product with an overall positive health image, whereas some studies demonstrate higher perceived credibility of products with general health claims (e.g. omega-3 and brain development) compared to disease risk reduction claims (e.g. bioactive peptides to reduce risk of heart disease), others report the opposite. Inconsistent evidence also exists on the correlation between having a positive attitude towards products with health claims and purchase intentions. Familiarity with the functional ingredient and/or its claimed health effect seems to result in a more favourable evaluation. Better nutritional knowledge, however, does not automatically lead to a positive attitude towards products carrying health messages. Legislation in the European Union requires that the claim is understood by the average consumer. As most studies on consumers' understanding of health claims are based on subjective understanding, this remains an area for more investigation.
Employers are asking employees to pay more for health care through higher premium contributions, share of contribution, and out-of-pocket maximums, along with variations in deductibles, co-pays, and coinsurance based on choice of providers, networks, drugs, and other services. This issue brief examines consumer cost-sharing trends in private insurance, discusses the outlook for cost sharing in employment-based benefits, and considers public policies to support health care markets for consumers.
Axtell-Thompson, Linda M
As health care costs continue to escalate, cost control measures will likely become unavoidable and painful. One approach is to engage external forces to allocate resources--for example, through managed care or outright rationing. Another approach is to engage consumers to make their own allocation decisions, through "self-rationing," wherein they are given greater awareness, control, and hence responsibility for their health care spending. Steadily gaining popularity in this context is the concept of "consumer directed health care" (CDHC), which is envisioned to both control cost and enhance choice, by combining financial incentives with information to help consumers make more informed health care decisions and to appreciate the economic trade-offs of those decisions. While CDHC is gaining attention in the popular press, business publications, and academic journals, it is not without controversy about its relative merits and demerits. CDHC raises questions regarding the ethical limits of consumer responsibility for their choices. While the emphasis on consumer choice implies that autonomy is the ruling ethical principle in CDHC, it must be tempered by justice and beneficence. Justice must temper autonomy to protect disadvantaged populations from further widening disparities in health care access and outcomes that could arise from health care reform efforts. Beneficence must temper autonomy to protect consumers from unintended consequences of uninformed decisions. Thoughtful paternalism suggests that CDHC plans offer choices that are comprehensible to lay consumers, limited in their range of options, and carefully structured with default rules that minimize potential error costs.
Consumer attitudes about their healthcare are beginning to shift. They are taking more responsibility for their health and seeking to collaborate with their doctors. In some cases consumers will engage in self-diagnosis. Mobile health apps and devices, in combination with cloud computing, will play a major role to empower consumers. Consumer expectations for healthcare are rising by the day. mHealth has provided empowerment to patients through the power of the PSC, which I describe as personal supercomputers. The number of devices and apps are exploding onto the healthcare scene. Although some providers are not comfortable with consumer technology for self-diagnosis, the new technologies will lead to a new model for collaboration between patient and physician. PMID:28293572
Deshpande, Aparna; Menon, Ajit; Perri, Matthew; Zinkhan, George
The growth in direct-to-consumer advertising(DTCA)over the past two decades has facilitated the communication of prescription drug information directly to consumers. Data from a 1999 national survey are employed to determine the factors influencing consumers' opinions of the utility of DTC ads for health care decision making. We also analyze whether consumers use DTC ad information in health care decision making and who are the key drivers of such information utilization. The study results suggest that consumers have positive opinions of DTCA utility, varying across demographics and perceptions of certain advertisement features. Specifically, consumers value information about both risks and benefits, but the perception of risk information is more important in shaping opinions of ad utility than the perception of benefit information. Consumers still perceive, however that the quality of benefit information in DTC ads is better than that of risk information. Opinions about ad utility significantly influence whether information from DTC ads is used in health care decision making.
Gajanayake, Randike; Iannella, Renato; Sahama, Tony
In this paper, we present the results of a survey conducted to measure the attitudes of eHealth consumers towards Accountable-eHealth systems, which are designed for information privacy management. We developed a research model that identify the factors contributing to system acceptance from quantitative data of 187 completed survey responses from university students studying non-health-related courses at university (Queensland, Australia). The research model is validated using structural equation modeling and can be used to identify how specific characteristics of Accountable-eHealth systems would affect their overall acceptance by future eHealth consumers.
The present study empirically investigates the effect of consumer health information on the demand for physician visits. Using a direct information measure based on questions from the Swiss Health Survey, we estimate a Poisson hurdle model for office visits. We find that information has a negative effect on health care utilization, contradicting previous findings in the literature. We consider differences in the used information measures to be the most likely explanation for the different findings. However, our results suggest that increasing consumer health information has the potential to reduce health care expenditures.
Osceola County School District, Kissimmee, FL.
This consumer education learning activity package is one of a series of six Project SCAT (Skills for Consumer Applied Today) units. It teaches secondary level students about the importance of a balanced diet and what nutrients are most important to good health. The package includes instructions for the teacher, suggestions for activities, lists of…
Skinner, Harvey A
Electronic health tools provide little value if the intended users lack the skills to effectively engage them. With nearly half the adult population in the United States and Canada having literacy levels below what is needed to fully engage in an information-rich society, the implications for using information technology to promote health and aid in health care, or for eHealth, are considerable. Engaging with eHealth requires a skill set, or literacy, of its own. The concept of eHealth literacy is introduced and defined as the ability to seek, find, understand, and appraise health information from electronic sources and apply the knowledge gained to addressing or solving a health problem. In this paper, a model of eHealth literacy is introduced, comprised of multiple literacy types, including an outline of a set of fundamental skills consumers require to derive direct benefits from eHealth. A profile of each literacy type with examples of the problems patient-clients might present is provided along with a resource list to aid health practitioners in supporting literacy improvement with their patient-clients across each domain. Facets of the model are illustrated through a set of clinical cases to demonstrate how health practitioners can address eHealth literacy issues in clinical or public health practice. Potential future applications of the model are discussed. PMID:16867972
Guo, Haihong; Li, Jiao; Dai, Tao
This study built up a classification schema of consumer health questions which consisted of 48 quaternary categories and 35 annotation rules. Using such a schema, we manually classified 2,000 questions randomly selected from nearly 100 thousand hypertension-related messages posted by consumers on a Chinese health website to analyze the information needs of health consumers. The results showed questions in the categories of treatment, diagnosis, healthy lifestyle, management, epidemiology, and health provider choosing were 48.1%, 23.8%, 11.9%, 5.2%, 9.0%, and 1.9% respectively. The comparison of the questions asked by consumers and physicians showed that their health information needs were significantly different (P<0.0001).
Pivik, Jayne; Rode, Elisabeth; Ward, Christopher
Similar to other health policy initiatives, there is a growing movement to involve consumers in decisions affecting their treatment options. Access to treatments can be impacted by decisions made during a health technology assessment (HTA), i.e., the rigorous assessment of medical interventions such as drugs, vaccines, devices, materials, medical and surgical procedures and systems. The purpose of this paper was to empirically assess the interest and potential mechanisms for consumer involvement in HTA by identifying what health consumer organizations consider meaningful involvement, examining current practices internationally and developing a model for involvement based on identified priorities and needs. Canadian health consumer groups representing the largest disease or illness conditions reported a desire for involvement in HTA and provided feedback on mechanisms for facilitating their involvement.
Kilicoglu, Halil; Fiszman, Marcelo; Roberts, Kirk; Demner-Fushman, Dina
Orthographic and grammatical errors are a common feature of informal texts written by lay people. Health-related questions asked by consumers are a case in point. Automatic interpretation of consumer health questions is hampered by such errors. In this paper, we propose a method that combines techniques based on edit distance and frequency counts with a contextual similarity-based method for detecting and correcting orthographic errors, including misspellings, word breaks, and punctuation errors. We evaluate our method on a set of spell-corrected questions extracted from the NLM collection of consumer health questions. Our method achieves a F1 score of 0.61, compared to an informed baseline of 0.29, achieved using ESpell, a spelling correction system developed for biomedical queries. Our results show that orthographic similarity is most relevant in spelling error correction in consumer health questions and that frequency and contextual information are complementary to orthographic features. PMID:26958208
Caring for a diverse pool of patients is an ongoing challenge for health care practitioners and marketers. Communication difficulties and cultural misunderstandings still stand in the way and keep members of some minority populations from getting the health care they need. To better serve these groups, it's crucial to learn more about patients' values, needs, and expectations. Fortunately, opportunities abound for health care marketers to learn about and effectively target these still largely underserved populations.
Krohn, F B; Flynn, C
The purpose of this paper is to explore the conflicting attitudes held by physicians and health care consumers toward health care advertising in an attempt to resolve the question. The paper introduces the differing positions held by the two groups. The rationale behind physicians' attitudes is then presented that advertising can be unethical, misleading, deceptive, and lead to unnecessary price increases. They believe that word-of-mouth does and should play the major role in attracting new patients. The opposite view of consumers is then presented which contends that health care advertising leads to higher consumer awareness of services, better services, promotes competitive pricing, and lowers rather than raises health care costs. The final section of the paper compares the arguments presented and concludes that health care advertising clearly has a place in the health care industry.
Buchmueller, Thomas C
Context: For many years, leading health care reform proposals have been based on market-oriented strategies. In the 1990s, a number of reform proposals were built around the concept of “managed competition,” but more recently, “consumer-directed health care” models have received attention. Although price-conscious consumer demand plays a critical role in both the managed competition and consumer-directed health care models, the two strategies are based on different visions of the health care marketplace and the best way to use market forces to achieve greater systemwide efficiencies. Methods: This article reviews the research literature that tests the main hypotheses concerning the two policy strategies. Findings: Numerous studies provide consistent evidence that consumers’ health plan choices are sensitive to out-of-pocket premiums. The elasticity of demand appears to vary with consumers’ health risk, with younger, healthier individuals being more price sensitive. This heterogeneity increases the potential for adverse selection. Biased risk selection also is a concern when the menu of health plan options includes consumer-directed health plans. Several studies confirm that such plans tend to attract healthier enrollees. A smaller number of studies test the main hypothesis regarding consumer-directed health plans, which is that they result in lower medical spending than do more generous plans. These studies find little support for this claim. Conclusions: The experiences of employers that have adopted key elements of managed competition are generally consistent with the key hypotheses underlying that strategy. Research in this area, however, has focused on only a narrow range of questions. Because consumer-directed health care is such a recent phenomenon, research on this strategy is even more limited. Additional studies on both topics would be valuable. PMID:20021587
The year 2010 is historic because it marks the passage of a U.S. health-care reform bill as well as midterm elections that sent to Congress people looking to repeal it. Meanwhile, the public is waiting to see what it all means. It also saw the rise of personalized medicine, with genetics and electronic health records promising a more…
Young, Charlotte E; Mutch, Allyson J; Boyle, Frances M; Dean, Julie H
While chronic disease places an increasing burden on Australia's primary care system it is unrealistic to expect GPs to meet the range of support needs experienced by patients managing chronic conditions. Consumer health organisations (CHO) have the potential to augment clinical care by providing a variety of supportive services; however, they are underutilised by patients and GPs. This qualitative study investigates GPs' knowledge and perceptions of CHO and their contributions to chronic disease care. The study involved semi-structured interviews with 10 GPs. Overall, participants demonstrated clear understanding of the role of CHO in chronic disease management, but a critical finding was the way GPs' view of their own chronic care role appears to influence referral practices. GPs operating in a traditional role were less likely to refer to CHO than those who had adopted a chronic care approach. A second key finding related to GPs' views of Diabetes Australia. All GPs identified this organisation as an important referral point, providing some reassurance that CHO can be integrated into the primary care sector. Further research is needed to determine how the 'definite advantages' associated with Diabetes Australia can be used to extend GP referral and enhance the health system's integration of other CHO.
The advancement of cyberinfrastructure on the North Slope of Alaska is drastically limited by location-specific conditions, including: unique geophysical features, remoteness of location, and harsh climate. The associated cost of maintaining this unique cyberinfrastructure also becomes a limiting factor. As a result, field experiments conducted in this region have historically been at a technological disadvantage. The Arctic Glass project explored a variety of scenarios where innovative consumer-grade technology was leveraged as a lightweight, rapidly deployable, sustainable, alternatives to traditional large-scale Arctic cyberinfrastructure installations. Google Glass, cloud computing services, Internet of Things (IoT) microcontrollers, miniature LIDAR, co2 sensors designed for HVAC systems, and portable network kits are several of the components field-tested at the Toolik Field Station as part of this project. Region-specific software was also developed, including a multi featured, voice controlled Google Glass application named "Arctic Glass". Additionally, real-time sensor monitoring and remote control capability was evaluated through the deployment of a small cluster of microcontroller devices. Network robustness was analyzed as the devices delivered streams of abiotic data to a web-based dashboard monitoring service in near real time. The same data was also uploaded synchronously by the devices to Amazon Web Services. A detailed overview of solutions deployed during the 2015 field season, results from experiments utilizing consumer sensors, and potential roles consumer technology could play in support of Arctic science will be discussed.
Fox, Nick; Ward, Katie
This article explores the formation of 'health identities': embodied subjectivities that emerge out of complex psychosocial contexts of reflexive modernity, in relation to data on health and illness practices among groups of people and patients using medical technologies including weight-loss drugs and the erectile dysfunction drug sildenafil (Viagra). We examine a range of health identities, from the 'expert patient'--a person who broadly adopts a biomedical model of health and illness, to a 'resisting consumer', who fabricates a health identity around lay experiential models of health and the body. The understanding of health identities is developed within a theoretical framework drawing on previous work on body/self and the work of Deleuze and Guattari. It is concluded that the constellation of health identities reflects the diversity of relations in an industrialized, technology-driven, consumer-oriented and media-saturated society.
Vydiswaran, V G Vinod; Mei, Qiaozhu; Hanauer, David A; Zheng, Kai
Community-generated text corpora can be a valuable resource to extract consumer health vocabulary (CHV) and link them to professional terminologies and alternative variants. In this research, we propose a pattern-based text-mining approach to identify pairs of CHV and professional terms from Wikipedia, a large text corpus created and maintained by the community. A novel measure, leveraging the ratio of frequency of occurrence, was used to differentiate consumer terms from professional terms. We empirically evaluated the applicability of this approach using a large data sample consisting of MedLine abstracts and all posts from an online health forum, MedHelp. The results show that the proposed approach is able to identify synonymous pairs and label the terms as either consumer or professional term with high accuracy. We conclude that the proposed approach provides great potential to produce a high quality CHV to improve the performance of computational applications in processing consumer-generated health text.
In spring 2013, the regional directorate for youth, sports and social cohesion and the regional healthcare agency in Franche-Comté presented and signed the first regional health, sports and well-being plan.
Lester, Carolyn; Allan, Alexandra
Purpose: In response to rising prevalence of sexually transmitted infection (STI) among teenagers, this study was designed to examine teenage perceptions of sex education, access to services, and attitudes relevant to STI. Design/methodology/approach: A focus group study was conducted in three schools to discuss the sexual health needs of…
Tanner, Floyd R.; And Others
Text, illustrations, and exercises are utilized in this set of five learning modules to instruct dental patients and the general public in the fundamental principles of dental hygiene. The first module, "Identify the Responsibilities for Your Oral Health" by Floyd R. Tanner, discusses the respective roles of the dentist and the patient…
Cross, Barbara J.; And Others
Text, illustrations, and exercises are utilized in this set of seven learning modules designed to instruct diabetes patients in health care practices necessary for the control of their illness. The first module, by Barbara J. Cross, describes materials and procedures used in testing the urine for sugar and acetone. The second module, by Ruth…
Chassy, Bruce M
The major food safety risks are not eating a healthy diet, and failure to avoid foodborne illness. Over one billion people in the world suffer from food insecurity and malnutrition. Nutritionally enhanced transgenic crops such as Golden Rice are one potential strategy for reducing malnutrition in the world. Transgenic crops are subjected to a rigorous pre-market safety assessment. The safety of novel proteins and other products is established, and through compositional analysis and animal studies, the safety of any observed changes is evaluated. These studies provide evidence that the new product is as safe as, or safer than, comparable varieties. It must be asked, however, if this rigorous analysis is necessary, because unregulated crops produced by other breeding methods also undergo genetic changes and contain unintended effects. Golden Rice poses infinitesimally small, if any, risk to consumers whilst it has the potential to spare millions of lives each year. However, because it is a transgenic crop, it cannot be deployed without years of expensive pre-market safety review. Paradoxically, if Golden Rice had been produced by less precise conventional methods of breeding, it would already be in the hands of poor farmers. It is concluded that the hyper-precautionary regulatory process applied to transgenic crops works to the extreme disadvantage of the hungry and the poor.
Shaw Hughner, Renée; Schultz Kleine, Susan
Wide variations in how contemporary consumers think about health and make health care decisions often go unrecognized by health care marketers and public policy decision makers. In the current global environment, prevailing Western viewpoints on health and conventional biomedicine are being challenged by a countervailing belief system forming the basis for alternative health care practices. The ways American consumers once thought about health have changed and multiplied in this new era of competing health paradigms. Our study provides empirical evidence for this assertion in two ways. First, it demonstrates that in the current environment consumers think about health and health care in a multiplicity of very different ways, leading to the conclusion that we should not classify health care consumers as either conventional or alternative. Second, the results provide clues as to how individuals holding diverse health theories make health care decisions that impact health behaviors, treatment efficacy, and satisfaction judgments.
Mazis, Michael B.; Raymond, Mary Anne
Of sample of 180 women, 60 received information from ads, 60 from product labels, and 60 from labels with nutrition information. Beliefs about products did not differ whether health claims appeared in ads or on labels. Nutrition information influenced beliefs. Health claims challenged by the Federal Trade Commission or consumer groups were less…
Barry, Colleen L; Cullen, Mark R; Galusha, Deron; Slade, Martin D; Busch, Susan H
Consumer-directed health plans (CDHPs) hold the promise of reining in health spending by giving consumers a greater stake in health care purchasing, yet little is known about employers' experience with these products. In examining the characteristics of those selecting a CDHP offered by one large employer, we found stronger evidence of selection than has been identified in prior research. Our findings suggest that in the context of plan choice, CDHPs may offer little opportunity to greatly lower employers' cost burden, and they highlight concerns about the potential for risk segmentation and the value of conferring preferential tax treatment to CDHPs.
Retchin, Sheldon M
Consumer-centric healthcare has been extolled as the centerpiece of a new model for managing both quality and price. However, information asymmetry in consumer-directed health plans (CDHPs) is a challenge that must be addressed. For CDHPs to work as intended and to gain acceptance, consumers need information regarding the quality and price of healthcare purchases. The federal government, particularly the Agency for Healthcare Research and Quality, could function as an official resource for information on performance and comparisons among facilities and providers. Because of workforce constraints among primary care physicians, a new group of healthcare professionals called "medical decision advisors" could be trained. Academic health centers would have to play a critical role in devising an appropriate curriculum, as well as designing a certification and credentialing process. However, with appropriate curricula and training, medical decision advisors could furnish information for consumers and aid in the complicated decisions they will face under CDHPs.
Sutton, S M; Balch, G I; Lefebvre, R C
Using the consumer-oriented approach of social and commercial marketers, this article presents a process for crafting messages designed to improve people's health behaviors. The process, termed consumer-based health communications (CHC), transforms scientific recommendations into message strategies that are relevant to the consumer. The core of CHC is consumer research conducted to understand the consumer's reality, and thereby allowing six strategic questions to be answered. The immediate result of the CHC process is a strategy statement--a few pages that lay out who the target consumer is, what action should be taken, what to promise and how to make the promise credible, how and when to reach him or her, and what image to convey. The strategy statement then guides the execution of all communication efforts, be they public relations, mass media, direct marketing, media advocacy, or interpersonal influence. It identifies the most important "levers" for contact with the consumer. Everyone from creative specialists through management and program personnel can use the strategy statement as a touchstone to guide and judge the effectiveness of their efforts. The article provides a step by step illustration of the CHC process using the 5 A Day campaign as an example. PMID:8570827
Sutton, S M; Balch, G I; Lefebvre, R C
Using the consumer-oriented approach of social and commercial marketers, this article presents a process for crafting messages designed to improve people's health behaviors. The process, termed consumer-based health communications (CHC), transforms scientific recommendations into message strategies that are relevant to the consumer. The core of CHC is consumer research conducted to understand the consumer's reality, and thereby allowing six strategic questions to be answered. The immediate result of the CHC process is a strategy statement--a few pages that lay out who the target consumer is, what action should be taken, what to promise and how to make the promise credible, how and when to reach him or her, and what image to convey. The strategy statement then guides the execution of all communication efforts, be they public relations, mass media, direct marketing, media advocacy, or interpersonal influence. It identifies the most important "levers" for contact with the consumer. Everyone from creative specialists through management and program personnel can use the strategy statement as a touchstone to guide and judge the effectiveness of their efforts. The article provides a step by step illustration of the CHC process using the 5 A Day campaign as an example.
Bloche, M Gregg
Broad adoption of "consumer-directed health care" would probably widen socioeconomic disparities in care and redistribute wealth in "reverse Robin Hood" fashion, from the working poor and middle classes to the well-off. Racial and ethnic disparities in care would also probably worsen. These effects could be alleviated by adjustments to the consumer-directed paradigm. Possible fixes include more progressive tax subsidies, tiering of cost-sharing schemes to promote high-value care, and reduced cost sharing for the less well-off. These fixes, though, are unlikely to gain traction. If consumer-directed plans achieve market dominance, disparities in care by class and race will probably grow.
Reid, Paulette; Borycki, Elizabeth M
Healthcare consumers are increasingly seeking reliable forms of health information on the Internet that can be used to support health related decision-making. Frameworks that have been developed and tested in the field of health informatics have attempted to describe the effects of the Internet upon the health care consumer and physician relationship. More recently, health care organizations are responding by providing information such as hospital wait lists or strategies for self-managing disease, and this information is being provided on organizational web-sites. The authors of this paper propose that current conceptualizations of the relationship between the Internet, physicians and patients are limited from a consumer informatics perspective and may need to be extended to include healthcare organizations.
Tse, Tony; Soergel, Dagobert
Healthcare consumers often have difficulty expressing and understanding medical concepts. The goal of this study is to identify and characterize medical expressions or “terms” (linguistic forms and associated concepts) used by consumers and health mediators. In particular, these terms were characterized according to the degree to which they mapped to professional medical vocabularies. Lay participants identified approximately 100,000 term tokens from online discussion forum postings and print media articles. Of the over 81,000 extracted term tokens reviewed, more than 75% were mapped as synonyms or quasi-synonyms to the Unified Medical Language System® (UMLS®) Metathesaurus®. While 80% conceptual overlap was found between closely mapped lay (consumer and mediator) and technical (professional) medical terms, about half of these overlapping concepts contained lay forms different from technical forms. This study raises questions about the nature of consumer health vocabularies that we believe have theoretical and practical implications for bridging the medical vocabulary gap between consumers and professionals. PMID:14728258
Mancuso, Peggy J; Myneni, Sahiti
This article presents a dynamic new model of health informatics. Within the model, the focus of health informatics changes from the provider to the consumer and incorporates the dynamic relationship of technological change to health care. Bioinformatics is the scientific discipline that is translated into care through the practice of health informatics. The loci of health informatics practices are the consumer (consumer informatics), the patient (clinical informatics), and the community (public health informatics). The continuum from individual to community interacts with and contributes to health care technology, which is represented as a constantly changing progressive wave.
Hardie, Nancy A; Kyanko, Kelly; Busch, Susan; Losasso, Anthony T; Levin, Regina A
We examined health literacy and health care spending and utilization by linking responses of three health literacy questions to 2006 claims data of enrollees new to consumer-driven health plans (n = 4,130). Better health literacy on all four health literacy measures (three item responses and their sum) was associated with lower total health care spending, specifically, lower emergency department and inpatient admission spending (p < .05). Similarly, fewer inpatient admissions and emergency department visits were associated with higher adequate health literacy scores and better self-reports of the ability to read and learn about medical conditions (p-value <.05). Members with lower health literacy scores appear to use services more appropriate for advanced health conditions, although office visit rates were similar across the range of health literacy scores.
Monkman, Helen; Kushniruk, Andre
Usability and health literacy are two critical factors in the design and evaluation of consumer health information systems. However, methods for evaluating these two factors in conjunction remain limited. This study adapted a set of existing guidelines for the design of consumer health Web sites into evidence-based evaluation heuristics tailored specifically for mobile consumer health applications. In order to test the approach, a mobile consumer health application (app) was then evaluated using these heuristics. In addition to revealing ways to improve the usability of the system, this analysis identified opportunities to augment the content to make it more understandable by users with limited health literacy. This study successfully demonstrated the utility of converting existing design guidelines into heuristics for the evaluation of usability and health literacy. The heuristics generated could be applied for assessing and revising other existing consumer health information systems.
Sainfort, François; Booske, Bridget C.
Considerable efforts are underway in the public and private sectors to increase the amount of information available to consumers when making health plan choices. The objective of this study was to examine the role of information in consumer health plan decisionmaking. A computer system was developed which provides different plan descriptions with the option of accessing varying types and levels of information. The system tracked the information search processes and recorded the hypothetical plan choices of 202 subjects. Results are reported showing the relationship between information and problem perception, preference structure, choice of plan, and attitude towards the decision. PMID:10165036
Rijkers, G T; Bimmel, D; Grevers, D; den Haan, N; Hristova, Y
The purpose of this study was to evaluate the knowledge, perception and buying behaviour of probiotics. 72 participants in Middelburg, the Netherlands, filled out a detailed questionnaire regarding probiotics and their customer and consumer behaviour. It can be concluded from this study that the concept of probiotics is generally poorly understood. Health-conscious consumers seem to be the group most aware of the correct meaning of the term probiotics. Almost 50% of the participants did not believe that probiotics had any health effect. Independent organisations and/or government agencies appeared to be the preferred source of information on the functionality of probiotics.
Schneider, Carl E; Hall, Mark A
The ultimate aim of health care policy is good care at good prices. Managed care failed to achieve this goal through influencing providers, so health policy has turned to the only market-based option left: treating patients like consumers. Health insurance and tax policy now pressure patients to spend their own money when they select health plans, providers, and treatments. Expecting patients to choose what they need at the price they want, consumerists believe that market competition will constrain costs while optimizing quality. This classic form of consumerism is today's health policy watchword. This article evaluates consumerism and the regulatory mechanism of which it is essentially an example -- legally mandated disclosure of information. We do so by assessing the crucial assumptions about human nature on which consumerism and mandated disclosure depend. Consumerism operates in a variety of contexts in a variety of ways with a variety of aims. To assess so protean a thing, we ask what a patient's life would really be like in a consumerist world. The literature abounds in theories about how medical consumers should behave. We look for empirical evidence about how real people actually buy health plans, choose providers, and select treatments. We conclude that consumerism, and thus mandated disclosure generally, are unlikely to accomplish the goals imagined for them. Consumerism's prerequisites are too many and too demanding. First, consumers must have choices that include the coverage, care-takers, and care they want. Second, reliable information about those choices must be available. Third, information must be put before consumers, especially by doctors. Fourth, consumers must receive the information. Fifth, the information must be complete and comprehensible enough for consumers to use it. Sixth, consumers must understand what they are told. Seventh, consumers must be willing to analyze the information. Eighth, consumers must actually analyze the information
Misra, Rupananda; Mark, Jessica H.; Khan, Sharib; Kukafka, Rita
Consumer health informatics tools can only be effective if patients comprehend their content. Optimal design may foster better patient comprehension and health literacy, which can improve health outcomes. We developed a patient-centric decision aid, Tailored Lifestyle Conversations (TLC), to help patients comprehend behavioral risks and set behavior change priorities for reducing risk of cardiovascular disease. The TLC decision aid was developed using a design framework based on Gestalt Principles of Perception. Further iteration was informed by qualitative user feedback. Preliminary analysis showed that the TLC decision aid helped patients understand their risk and supported their decisions on health behavior change. We identified design elements that supported patient comprehension, and other elements that were not effective, to inform iterative revision. This paper describes an effective methodology for the development of consumer health informatics tools that includes grounding in design principles complemented by iterative revision based on user testing and feedback. PMID:21347027
Burger, David M
Dutch consumers can now purchase 'over-the-counter drugs' (OTCs) at three distribution channels: (a) the pharmacy; (b) the chemist; (c) other sales outlets such as supermarkets and petrol stations. However, little is known about whether consumers consider themselves and others to have adequate knowledge to purchase OTCs in relative freedom. During a recent study, members of the Healthcare Consumer Panel of the Netherlands Institute for Health Services Research completed a survey on freely available analgesics. These consumers were very confident of their personal skills in handling OTCs responsibly. However, they had less confidence in how others would deal with OTCs. Regarding the wider availability of OTCs, only 1-8% believed it would be preferable to have these drugs available in the supermarket or petrol station, depending on the type and frequency of side effects of the medication. The government would be wise in conducting this type of qualitative study before measures are taken for wider availability of medicines.
Lau, Annie Y S; Dunn, Adam; Mortimer, Nathan; Proudfoot, Judith; Andrews, Annie; Liaw, Siaw-Teng; Crimmins, Jacinta; Arguel, Amaël; Coiera, Enrico
Personally controlled health management systems (PCHMS) often consist of multiple design features. Yet, they currently lack empirical evidence on how consumers use and engage with a PCHMS. An online prospective study was designed to investigate how 709 consumers used a web-based PCHMS to manage their physical and emotional wellbeing over five months. The web-based PCHMS, Healthy.me, was developed at UNSW and incorporates an untethered personal health record, consumer care pathways, forums, polls, diaries, and messaging links with healthcare professionals. The two PCHMS features that consumers used most frequently, found most useful, and engaging were the social features, i.e. forum and poll. Compared to participants who did not use any PCHMS social feature, those who used either the poll or the forum were 12.3% more likely to visit a healthcare professional (P=0.001) during the study. Social network analysis of forums revealed a spectrum of social interaction patterns - from question-and-answer structures to community discussions. This study provides a basis for understanding how a PCHMS can be used as a socially-driven intervention to influence consumers' health behaviours.
Schewe, C D; Spotts, H E
The health-care marketplace is aging by leaps and bounds and bringing with it new and different medical needs. As costs soar and public assistance programs dwindle in impact, health-care providers will need better marketing strategies to bring treatments to patients/consumers. This article looks at the research findings of behavioral scientists and offers guidelines for effective communication with aging audiences. Health-care providers can use these findings to design more effective advertising, promotional brochures, newsletters, and a host of other communication tools targeted at an older market. Health-care managers and other professionals should find the guidelines useful in their daily interactions with patients and colleagues.
Bryant, C; Kent, E B; Lindenberger, J; Schreiher, J M; Canright, M W; Cole, S; Uccellani, V; Brown, C A; Blair, R C; Bustillo-Hernandez, M M
The key to a successful social marketing approach to health care is continually listening to consumers' feedback and being willing to change the health product or service according to their needs and preferences. This approach can increase the likelihood of consumers being satisfied with, and continuing to utilize or provide the particular health service.
Kato-Lin, Yi-Chin; Padman, Rema; Downs, Julie; Abhishek, Vibhanshu
Mobile apps have great potential to deliver promising interventions to engage consumers and change their health-related behaviors, such as healthy eating. Currently, the interventions for promoting healthy eating are either too onerous to keep consumers engaged or too restrictive to keep consumers connected with healthcare professionals. In addition, while social media allows individuals to receive information from many sources, it is unclear how peer support interacts with professional support in the context of such interventions. This study proposes and evaluates three mobile-enabled interventions to address these challenges. We examine their effects on user engagement and food choices via a 4-month randomized field experiment. Mixed models provide strong evidence of the positive effect of image-based dietitian support and negative effects of peer support, and moderate evidence of the positive effects of mobile-based visual diary, highlighting the value of mobile apps for delivering advanced interventions to engage users and facilitate behavior change.
Kato-Lin, Yi-Chin; Padman, Rema; Downs, Julie; Abhishek, Vibhanshu
Mobile apps have great potential to deliver promising interventions to engage consumers and change their health-related behaviors, such as healthy eating. Currently, the interventions for promoting healthy eating are either too onerous to keep consumers engaged or too restrictive to keep consumers connected with healthcare professionals. In addition, while social media allows individuals to receive information from many sources, it is unclear how peer support interacts with professional support in the context of such interventions. This study proposes and evaluates three mobile-enabled interventions to address these challenges. We examine their effects on user engagement and food choices via a 4-month randomized field experiment. Mixed models provide strong evidence of the positive effect of image-based dietitian support and negative effects of peer support, and moderate evidence of the positive effects of mobile-based visual diary, highlighting the value of mobile apps for delivering advanced interventions to engage users and facilitate behavior change. PMID:26958294
Pratt, Charlotte A.; Pratt, Cornelius B.
Examines the "Ladies' Home Journal" and two popular consumer magazines that target blacks to determine the proportions of food and beverage advertisements, nutrition advertisements and their promotional messages, and the health implications they reveal. Findings reveal these magazines had a significantly higher number of alcohol ads,…
The Shelter Society is a grassroots mental health consumers organization whose members sought access to the Internet and instigated a computer training program to improve their self-advocacy skills. The program fostered a sense of empowerment and prepared participants to make informed decisions. (SK)
Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.
Secondary level students learn about medical care in this learning activity package, which is one in a series. The developers believe that consumer education in the health field would ensure better patient care and help eliminate incompetent medical practices and practitioners. The learning package includes instructions for the teacher,…
Rubin, Fred H.; Black, Judith S.
Two hospitals have conducted semiannual Town Meeting for Seniors to provide community-based health education, helping seniors make informed decisions about medical care, Medigap insurance, advance directives, and proper nutrition. Town Meeting has been enthusiastically received by consumers and has led to creation of several new community…
White, Marilyn Domas
Using a thorough analytical framework, this study characterizes the questioning behavior on a consumer health-related electronic list. Analysis examines the dedication of the list to questioning; pattern of question asking within a message; type of question; length of answer anticipated; subject of question; combination of type of question and…
Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.
Personal grooming is the topic of this learning activity package, which is one part of a consumer education series for secondary students. The module attempts to make students aware of the importance of personal appearance and grooming and to emphasize the direct correlation between maintaining good health and looking good. The learning package…
Wright, C A; Bruhn, C M; Heymann, H; Bamforth, C W
Consumers' perceptions about alcohol are shaped by numerous factors. This environment includes advertisements, public service announcements, product labels, various health claims, and warnings about the dangers of alcohol consumption. This study used focus groups and questionnaires to examine consumers' perceptions of alcoholic beverages based on their nutritional value and health benefits. The overall purpose of this study was to examine beer consumers' perceptions of the health attributes and content of alcoholic beverages. Volunteers were surveyed at large commercial breweries in California, Missouri, and New Hampshire. The anonymous, written survey was presented in a self-explanatory format and was completed in 5 to 10 min. The content and style of the survey were derived from focus groups conducted in California. The data are separated by location, gender, and over or under the age of 30. Parametric data on beverage rating were analyzed using analysis of variance (ANOVA) while the nonparametric data from True/False or Yes/No questions were analyzed using chi-square. Although statistically significant variances did exist between survey location, gender, and age, general trends emerged in areas of inquiry. The findings indicate that a great opportunity exists to inform consumers about the health benefits derived from the moderate consumption of all alcoholic beverages.
Wiesner, Martin; Griebel, Lena; Becker, Kurt; Pobiruchin, Monika
Consumer Health Informatics (CHI) is a relatively new and interdisciplinary field in Medical Informatics. It focuses on consumer- rather than professional-centered services. However, the definitions and understanding of a) what is a "consumer"? or b) what is health technology in the context of CHI? and c) what factors and actors influence the usage of eHealth services? vary widely. The CHI special interest group (SIG) - associated with the German Association for Medical Informatics, Biometry and Epidemiology - conducted two workshops in 2015 to improve the common understanding on these topics. The workshop outcomes, the derived CHI-specific meta model and examples how to apply this model are presented in this paper. The model supports the definition of multi-actor contexts, as it not solely reflects the conventional patient-physician relationship but also allows for the description of second health market providers.
Brunero, S; Lamont, S; Fairbrother, G
Consumer satisfaction is today, widely accepted as a measure of the level and quality of service received by consumers. The aim of this survey-based study is to explore consumer satisfaction with quality of care, staff, environment and discharge in a south eastern Sydney adult acute inpatient mental health unit. A cross-sectional analysis is pursued in order to identify aspects of the patient stay, which form an associative relationship with an overall rating of consumer satisfaction on a 10-point scale. During the survey period, there were 182 discharges. Seventy questionnaires (38.5%) were returned from this group. The survey results highlight a number of areas of identified need, enabling the service to prioritize organizational systems around meeting these needs. Multiple regression analysis identified three items in the survey, which were independently significant associates of overall consumer satisfaction. They included being happy with the service provided by the consumer support worker, having support for services on discharge and feeling safe and secure on the ward. The model containing these three items accounted for 50% of the variation in overall satisfaction. Two primary interventions have been developed because survey administration which, it is hoped, will address issues raised in the survey. The interventions were the development of an admission and discharge pathway and a ward-based psychosocial intervention programme, which includes the involvement of consumer support workers.
Wald, J. S.
Summary Objectives Address current topics in consumer health informatics. Methods Literature review. Results Current health care delivery systems need to be more effective in the management of chronic conditions as the population turns older and experiences escalating chronic illness that threatens to consume more health care resources than countries can afford. Most health care systems are positioned poorly to accommodate this. Meanwhile, the availability of ever more powerful and cheaper information and communication technology, both for professionals and consumers, has raised the capacity to gather and process information, communicate more effectively, and monitor the quality of care processes. Conclusions Adapting health care systems to serve current and future needs requires new streams of data to enable better self-management, improve shared decision making, and provide more virtual care. Changes in reimbursement for health care services, increased adoption of relevant technologies, patient engagement, and calls for data transparency raise the importance of patient-generated health information, remote monitoring, non-visit based care, and other innovative care approaches that foster more frequent contact with patients and better management of chronic conditions. PMID:25123739
Baker, L M; Pettigrew, K E
Consumer health information studies in library and information science (LIS) are typically not grounded within a theoretical framework. This article explains the importance of theory to LIS research in general, and the specific value of using theories from other disciplines to study consumers' health information-seeking behavior. The argument is supported with two examples: Miller's psychological theory of blunting and monitoring behavior and Granovetter's sociological theory of the strength of weak ties. These theories can be applied by practitioner-researchers to investigate a variety of research problems. PMID:10550029
Baker, L M; Pettigrew, K E
Consumer health information studies in library and information science (LIS) are typically not grounded within a theoretical framework. This article explains the importance of theory to LIS research in general, and the specific value of using theories from other disciplines to study consumers' health information-seeking behavior. The argument is supported with two examples: Miller's psychological theory of blunting and monitoring behavior and Granovetter's sociological theory of the strength of weak ties. These theories can be applied by practitioner-researchers to investigate a variety of research problems.
Cohn, Wendy F; Pannone, Aaron; Schubart, Jane; Lyman, Jason; Kinzie, Mable; Broshek, Donna K; Guterbock, Thomas M; Hartman, David; Mick, David; Bolmey, Armando; Garson, Arthur T
The Consumer Health Education Institute (CHEDI) has developed a model system to improve the quality and effectiveness of patient education and health communication. Through assessment of characteristics and preferences, segmentation into groups and matching with the appropriate materials, we have demonstrated that patients and health consumers have different health information needs and preferences which show promise as a basis for selecting or designing the most appropriate materials or programs.
Annunziata, A; Pomarici, E; Vecchio, R; Mariani, A
This paper aims to contribute to the current debate on the inclusion of nutritional information and health warnings on wine labels, exploring consumers' interest and preferences. The results of a survey conducted on a sample of Italian wine consumers (N = 300) show the strong interest of respondents in the inclusion of such information on the label. Conjoint analysis reveals that consumers assign greater utility to health warnings, followed by nutritional information. Cluster analysis shows the existence of three different consumer segments. The first cluster, which included mainly female consumers (over 55) and those with high wine involvement, revealed greater awareness of the links between wine and health and better knowledge of wine nutritional properties, preferring a more detailed nutritional label, such as a panel with GDA%. By contrast, the other two clusters, consisting of individuals who generally find it more difficult to understand nutritional labels, preferred the less detailed label of a glass showing calories. The second and largest cluster comprising mainly younger men (under 44), showed the highest interest in health warnings while the third cluster - with a relatively low level of education - preferred the specification of the number of glasses not to exceed. Our results support the idea that the policy maker should consider introducing a mandatory nutritional label in the easier-to-implement and not-too-costly form of a glass with calories, rotating health warnings and the maximum number of glasses not to exceed.
Moen, Anne; Brennan, Patricia Flatley
Objective: Contemporary health care places enormous health information management demands on laypeople. Insights into their skills and habits complements current developments in consumer health innovations, including personal health records. Using a five-element human factors model of work, health information management in the household (HIMH) is characterized by the tasks completed by individuals within household organizations, using certain tools and technologies in a given physical environment. Design: We conducted a descriptive-exploratory study of the work of HIMH, involving 49 community-dwelling volunteers from a rural Midwestern community. Measurements: During in-person interviews, we collected data using semistructured questionnaires and photographs of artifacts used for HIMH. Results: The work of HIMH is largely the responsibility of a single individual, primarily engaged in the tasks of acquiring, managing, and organizing a diverse set of health information. Paper-based tools are most common, and residents develop strategies for storing information in the household environment aligned with anticipated use. Affiliative relationships, e.g., parent-child or spousal, within the household serve as the organization that gives rise to health information management practices. Synthesis of these findings led to identification of several storage strategies employed in HIMH. These strategies are labeled “just-in-time,” “just-because,” “just-in-case,” and “just-at-hand,” reflecting location of the artifacts of health information and anticipated urgency in the need to retrieve it. Conclusion: Laypeople develop and employ robust, complex strategies for managing health information in the home. Capitalizing on these strategies will complement and extend current consumer health innovations to provide functional support to people who face increasing demands to manage personal health information. PMID:16049230
Sood, Neeraj; Wagner, Zachary; Huckfeldt, Peter; Haviland, Amelia
We use health insurance claims data from 63 large employers to estimate the extent of price shopping for nine common outpatient services in consumer-directed health plans (CDHPs) compared to traditional health plans. The main measures of price-shopping include: (1) the total price paid on the claim, (2) the share of claims from low and high cost providers and (3) the savings from price shopping relative to choosing prices randomly. All analyses control for individual and zip code level demographics and plan characteristics. We also estimate differences in price shopping within CDHPs depending on expected health care costs and whether the service was bought before or after reaching the deductible. For 8 out of 9 services analyzed, prices paid by CDHP and traditional plan enrollees did not differ significantly; CDHP enrollees paid 2.3% less for office visits. Similarly, office visits was the only service where CDHP enrollment resulted in a significantly larger share of claims from low cost providers and greater savings from price shopping relative to traditional plans. There was also no evidence that, within CDHP plans, consumers with lower expected medical expenses exhibited more price-shopping or that consumers exhibited more price-shopping before reaching the deductible.
Anderson, Kevin; Emmerton, Lynne M
Objective The aim of the present study was to review the contribution of mobile health applications ('apps') to consumers' self-management of chronic health conditions, and the potential for this practice to inform health policy, procedures and guidelines.Methods A search was performed on the MEDLINE, Cochrane Library, ProQuest and Global Health (Ovid) databases using the search terms 'mobile app*', 'self-care', 'self-monitoring', 'trial', 'intervention*' and various medical conditions. The search was supplemented with manual location of emerging literature and government reports. Mapping review methods identified relevant titles and abstracts, followed by review of content to determine extant research, reports addressing the key questions, and gaps suggesting areas for future research. Available studies were organised by disease state, and presented in a narrative analysis.Results Four studies describing the results of clinical trials were identified from Canada, England, Taiwan and Australia; all but the Australian study used custom-made apps. The available studies examined the effect of apps in health monitoring, reporting positive but not robust findings. Australian public policy and government reports acknowledge and support self-management, but do not address the potential contribution of mobile interventions.Conclusions There are limited controlled trials testing the contribution of health apps to consumers' self-management. Further evidence in this field is required to inform health policy and practice relating to self-management.What is known about the topic? Australian health policy encourages self-care by health consumers to reduce expenditure in health services. A fundamental component of self-care in chronic health conditions is self-monitoring, which can be used to assess progress towards treatment goals, as well as signs and symptoms of disease exacerbation. An abundance of mobile health apps is available for self-monitoring.What does this study add
Allsop, Judith; Jones, Kathryn; Baggott, Rob
This paper argues that a health consumer movement has developed in the United Kingdom over the last decade. Drawing on two empirical studies of groups that promote and/or represent the interests of patients, users and carers, it argues that groups formed by people with personal experience of a condition are now more widespread. Feelings of pain and loss can lead to the identification of others in a similar position, and to the formation of groups and action in the political sphere. Research shows that groups share a common discourse and follow similar participative practices, and there is extensive networking. Informal and formal alliances have formed to pursue joint action and indicate a wider health consumer movement. As governments have also increased the opportunities for participation, this has the potential for patients and carers to shape services in ways more responsive to their needs.
This report summarizes an investigation conducted to forecast the amount of energy savings which could be attributed to energy efficiency standards for four consumer products as well as to determine the economic impact of such standards on consumers. The four consumer products are dishwashers, television sets, clothes washers, and humidifiers and dehumidifiers. Energy savings were forecasted for two levels of energy efficiency standards. Since the standard levels selected were greater than the energy efficiency at the minimum life cycle point, energy efficiency standards could result in increased life cycle costs for all four products. Sensitivity analyses were conducted to determine the effect that different projections of consumer purchasing behavior during a no-standards scenario would have on the forecasts of energy savings. Standards for the four products probably would not result in significant conservation of energy. The economic impact of such standards could result in higher first costs and increased life cycle costs for all four products.
Parry, David; Carter, Philip; Koziol-McLain, Jane; Feather, Jacqueline
Consumer eHealth products are often used by people in their own homes or other settings without dedicated clinical supervision, and often with minimal training and limited support--much as eCommerce and eGovernment applications are currently deployed. Internet based self-care systems have been advocated for over a decade as a way to reduce costs and allow more convenient care, and--because of the expectation that they will be used to reduced health cost--, by increasing self-care and avoiding hospitalization. However, the history of consumer eHealth interventions is mixed, with many unsuccessful implementations. Many consumer eHealth products will form part of a broader complex intervention, with many possible benefits and effects on both individuals and society. This poster describes a model of consumer eHealth assessment based on multiple methods of usability evaluation at different stages in the design and fielding of eHealth systems. We argue that different methods of usability evaluation are able to give valuable insights into the likely effects of an intervention in a way that is congruent with software development processes.
Smith, K H
Health InfoNet of Jefferson County is a new collaborative consumer health information service of the Jefferson County public libraries and the UAB Lister Hill Library of the Health Sciences. Working with the input and cooperation of local voluntary health agencies, health care professionals and other health information providers, the intent is to improve the efficiency with which consumers might access such information while avoiding duplication of effort on the part of the information providers. Various considerations in InfoNet's mission include providing service not only to established library and Internet users, but also those on the other side of the "digital divide" as well as those with low literacy skills or English as a second language. The role of health care professionals in guiding their patients to the best consumer health information resources is emphasized.
Paez, Kathryn A; Mallery, Coretta J; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E; Lucado, Jennifer L; Ganachari, Deepa
Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure.
White, Helen; Whelan, Chantal; Barnes, J Derrick; Baskerville, Bruce
Reflecting the increasing trend of consumers as providers in mental health services, the standards for Assertive Community Treatment (ACT) teams in Ontario, Canada require the hiring of at least 0.5 full-time equivalent consumer as a service provider. Through a mail-out survey, we explored how the consumer position has been integrated into these ACT teams. It was found that despite some variation in the roles and degree of integration of the consumers on these teams, consumers were generally well-incorporated team members with equal or better job satisfaction as compared to other employees.
Lau, Annie Y S; Gabarron, Elia; Fernandez-Luque, Luis; Armayones, Manuel
Recent literature has discussed the unintended consequences of clinical information technologies (IT) on patient safety, yet there has been little discussion about the safety concerns in the area of consumer health IT. This paper presents a range of safety concerns for consumers in social media, with a case study on YouTube. We conducted a scan of abstracts on 'quality criteria' related to YouTube. Five areas regarding the safety of YouTube for consumers were identified: (a) harmful health material targeted at consumers (such as inappropriate marketing of tobacco or direct-to-consumer drug advertising); (b) public display of unhealthy behaviour (such as people displaying self-injury behaviours or hurting others); (c) tainted public health messages (i.e. the rise of negative voices against public health messages); (d) psychological impact from accessing inappropriate, offensive or biased social media content; and (e) using social media to distort policy and research funding agendas. The examples presented should contribute to a better understanding about how to promote a safe consumption and production of social media for consumers, and an evidence-based approach to designing social media interventions for health. The potential harm associated with the use of unsafe social media content on the Internet is a major concern. More empirical and theoretical studies are needed to examine how social media influences consumer health decisions, behaviours and outcomes, and devise ways to deter the dissemination of harmful influences in social media.
Rollins, Brent L; Ramakrishnan, Shravanan; Perri, Matthew
Direct-to-consumer (DTC) advertising of predictive genetic tests (PGTs) has added a new dimension to health advertising. This study used an online survey based on the health belief model framework to examine and more fully understand consumers' responses and behavioral intentions in response to a PGT DTC advertisement. Overall, consumers reported moderate intentions to talk with their doctor and seek more information about PGTs after advertisement exposure, though consumers did not seem ready to take the advertised test or engage in active information search. Those who perceived greater threat from the disease, however, had significantly greater behavioral intentions and information search behavior.
Jacob, Sini; Munro, Ian; Taylor, Beverley Joan
Abstract Background Mental health recovery is a prominent topic of discussion in the global mental health settings. The concept of mental health recovery brought about a major shift in the traditional philosophical views of many mental health systems. Aim The purpose of this article is to outline the results of a qualitative study on mental health recovery, which involved mental health consumers, carers and mental health nurses from an Area Mental Health Service in Victoria, Australia. This paper is part one of the results that explored the meaning of recovery. Methods The study used van Manen's hermeneutic phenomenology to analyse the data. Findings Themes suggested that the cohort had varying views on recovery that were similar and dissimilar. The similar views were categorised under two processes involving the self, an internal process and an external process. These two processes involved reclaiming various aspects of oneself, living life, cure or absence of symptoms and contribution to community. The dissimilar views involved returning to pre-illness state and recovery was impossible. Conclusion This study highlights the need for placing importance to the person's sense of self in the recovery process.
Jacob, Sini; Munro, Ian; Taylor, Beverley Joan
Background Mental health recovery is a prominent topic of discussion in the global mental health settings. The concept of mental health recovery brought about a major shift in the traditional philosophical views of many mental health systems. Aim The purpose of this article is to outline the results of a qualitative study on mental health recovery, which involved mental health consumers, carers and mental health nurses from an Area Mental Health Service in Victoria, Australia. This paper is Part One of the results that explored the meaning of recovery. Methods The study used van Manen's hermeneutic phenomenology to analyse the data. Findings Themes suggested that the cohort had varying views on recovery that were similar and dissimilar. The similar views were categorised under two processes involving the self, an internal process and an external process. These two processes involved reclaiming various aspects of oneself, living life, cure or absence of symptoms and contribution to community. The dissimilar views involved returning to pre-illness state and recovery was impossible. Conclusion This study highlights the need for placing importance on the person's sense of self in the recovery process.
McGuerty, Amber B.; Cater, Melissa; Prinyawiwatkul, Witoon; Tuuri, Georgianna
Interventions to increase adolescents' healthful food and beverage consumption often fail to demonstrate change. An alternative is to measure a shift in willingness to consume these items as an indicator of movement toward change. A survey was developed to estimate willingness to consume a variety of foods and beverages. Twenty items were…
McCray, Alexa T.; Tse, Tony
We examined queries that led to search failures on two National Library of Medicine Web-based consumer health sites, ClincialTrials.gov and MEDLINEplus. The purpose of the study was to analyze and categorize queries resulting that led to no results with the ultimate goal of developing interventions to assist users in recovering from those failures. We first analyzed over 2,700 queries, iteratively developing a coding scheme. We subsequently applied the codes to an additional set of 2,000 queries. We found that most of the queries were in scope, relevant to the system being searched, and did not exhibit so-called consumer language. As the final step, we developed a taxonomy based on whether the search failures were due primarily to content issues, to problems in query formulation, or to limitations of the search system. The results reported here have informed the further development of our own systems, and they may be helpful to others as they seek to improve consumer access to health information. PMID:14728209
Huber, Jeffrey T.; Gillaspy, Mary L.
The consumer health information (CHI) movement is the result of various twentieth-century ideologies and is an outgrowth of the broader consumer movement. From a sociocultural and political perspective, the consumer, civil rights, and women's movements and related societal shifts helped pave the way for the consumer health movement, which laid the…
Public health practitioners interested in supporting consumers to make healthy, sustainable food choices need to understand consumer motivations to reduce food system risk. Increasingly food technologies that have enhanced access to food supply are being recognised as also impacting on the sustainability of the food system. This study explored the actions taken by Australian participants in response to their concerns about perceived food related threats to health and environment. Variance in willingness to act is analysed within the context of environmental and ecological citizenship, and a continuum describes the range of positions held. From the outset some participants self-identified as environmentally concerned and proactive, while others indicated a secondary interest in the environment. The catalyst for action for the majority was the priority of individual health and such self-interest can be a powerful motivator for change. Others related health to the environment and described efforts to minimise individual impact. Equally important for action to occur is being at a stage in life where other demands do not compete for the time and energy necessary to take citizenship actions. These results provide insight into the support that public health practitioners can offer to consumers who wish to make sustainable food choices.
Derkatch, Colleen; Spoel, Philippa
This article explores how the recent and growing promotion of local foods by public health units in Ontario, Canada, rhetorically interpellates the "good" health citizen as someone who not only takes responsibility for personal health but, through the consumption and support of "local food," also accepts and fulfills her responsibilities to care for the local economy, the community's well-being, and the natural environment. Drawing on Charland's concept of constitutive rhetoric, we analyze a selection of public health unit documents about local food to develop a textured account of the complex, multifaceted forms of health citizenship they constitute. Our analysis reveals that, despite their appeals to environmental sustainability and community well-being, these materials primarily characterize the ideal health citizen as an informed consumer who supports the interests of the neoliberal state through individualized lifestyle behaviors, consuming goods produced and distributed through private enterprise. By exhorting individuals to "buy local," public health discourse therefore frames responsible health citizenship principally in consumerist terms that constrain the range of available options for citizens to engage in meaningful action vis-à-vis their food systems.
The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.
Parent, Wendy; Kregel, John; Johnson, Angela
A Consumer Satisfaction Survey was administered to 110 persons with severe disabilities involved in a supported employment program. Results indicated most consumers liked their jobs, were happy with supported employment services, and would use them again. However, most also felt their current job was not the career they would like to have…
Wong, Yin-Ling Irene; Sands, Roberta G; Solomon, Phyllis L
In this article we describe a focus group study of the perspectives of diverse groups of mental health consumers on the concept of community. We identify the core domains that constitute the notion of community, and commonalities and differences in the perception of community along the lines of ethnicity and sexual orientation/gender identity. Seven focus groups were conducted with a total of 62 participants. Transcripts were analyzed using the grounded theory approach.Two domains-togetherness and community acceptance-emerged as common to four types of communities that were most frequently mentioned in the focus group discussion. Our findings show that identities other than those associated with mental illness and the role of service user are critical to the understanding of the psychological sense of community among persons with psychiatric disabilities. We suggest that mental health providers empower consumers to expand their "personal communities" beyond that of mental health clients using their diverse identities, and design interventions for addressing the stigma emanating from identities that are discriminated against by the wider society.
Kapsak, Wendy Reinhardt; Schmidt, David; Childs, Nancy M; Meunier, John; White, Christy
On December 18, 2002, the Food and Drug Administration (FDA) announced the Consumer Health Information for Better Nutrition Initiative. The initiative's goal is to make available more and better information about conventional foods and dietary supplements to help Americans improve their health and reduce risk of disease by making sound dietary decisions. It included a rating system to assess the "weight of the publicly available evidence." It assigns one of four ranked levels to the claim thus resulting in qualified health claims. Two phases of research were conducted by the International Food Information Council (IFIC) Foundation. Qualitative research to assess consumer understanding, vocabulary, and familiarity with claims helped with the design and orientation of the second quantitative research phase. The quantitative phase employed a Web-based survey. The claim formats included: report card graphic, report card text, embedded claim text, point-counterpoint, structure/function claim, and nutrient content claim. Respondents were asked to rate the product for perceived strength of scientific evidence provided to support the claim, and questions about the product's perceived healthfulness, quality, safety, and purchase intent. Consumers found it difficult to discriminate across four levels and showed inclination to project the scientific validity grade onto other product attributes. Consumers showed preference for simpler messages.
Scholz, Brett; Bocking, Julia; Happell, Brenda
Objectives Contemporary mental health policies call for consumers to be involved in decision-making processes within mental health organisations. Some organisations have embraced leadership roles for consumers, but research suggests consumers remain disempowered within mental health services. Drawing on a service-dominant logic, which emphasises the co-creation of value of services, the present study provides an overview of consumer leadership within mental health organisations in the Australian Capital Territory.Methods Mental health organisations subscribing to the local peak body mailing list were invited to complete a survey about consumer leadership. Survey data were summarised using descriptive statistics and interpreted through the lens of service-dominant logic.Results Ways in which organisations may create opportunities for consumers to co-create value within their mental health services included soliciting feedback, involving consumer leaders in service design, having consumer leaders involved in hiring decisions and employing consumer leaders as staff or on boards. Strategies that organisations used to develop consumer leaders included induction, workshops and training in a variety of organisational processes and skills.Conclusions The findings of the present study extend the application of a service-dominant logic framework to consumer leadership within mental health organisations through consideration of the diverse opportunities that organisations can provide for consumer co-creation of service offerings.What is known about the topic? Policy calls for consumer involvement in all levels of mental health service planning, implementation and delivery. The extent to which service organisations have included consumer leaders varies, but research suggests that this inclusion can be tokenistic or that organisations choose to work with consumers who are less likely to challenge the status quo. Service literature has explored the way consumers can co
Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery D.; Emmerton, Lynne M.
Background Health information on the Internet is ubiquitous, and its use by health consumers prevalent. Finding and understanding relevant online health information, and determining content reliability, pose real challenges for many health consumers. Purpose To identify the types of interventions that have been implemented to assist health consumers to find reliable online health information, and where possible, describe and compare the types of outcomes studied. Data Sources PubMed, PsycINFO, CINAHL Plus and Cochrane Library databases; WorldCat and Scirus ‘gray literature’ search engines; and manual review of reference lists of selected publications. Study Selection Publications were selected by firstly screening title, abstract, and then full text. Data Extraction Seven publications met the inclusion criteria, and were summarized in a data extraction form. The form incorporated the PICOS (Population Intervention Comparators Outcomes and Study Design) Model. Two eligible gray literature papers were also reported. Data Synthesis Relevant data from included studies were tabulated to enable descriptive comparison. A brief critique of each study was included in the tables. This review was unable to follow systematic review methods due to the paucity of research and humanistic interventions reported. Limitations While extensive, the gray literature search may have had limited reach in some countries. The paucity of research on this topic limits conclusions that may be drawn. Conclusions The few eligible studies predominantly adopted a didactic approach to assisting health consumers, whereby consumers were either taught how to find credible websites, or how to use the Internet. Common types of outcomes studied include knowledge and skills pertaining to Internet use and searching for reliable health information. These outcomes were predominantly self-assessed by participants. There is potential for further research to explore other avenues for assisting health
Kelley, Bruce; Attridge, Mark
Consumer-driven health plans offer employers potentially significant cost savings. Yet such potential cannot be realized without greater consumer access to price, quality and treatment information. This article describes why consumer-based strategies have taken hold and how consumer-driven plan design and financial incentives are of only limited value in controlling costs. After reviewing the importance and availability of existing health care information, the authors suggest actions employers can take to ensure consumer-driven plans reach their potential.
This project enabled novel organisational insight into the comparative utility of a portfolio of consumer health information content, by measuring patterns of attrition (abandonment) in content use. The project used as a case study the event activity log of a fully automated digital information kiosk, located in a community health facility. Direct measurements of the duration of content use were derived from the user interface activity recorded in the kiosk log, thus avoiding issues in using other approaches to collecting this type of data, such as sampling and observer bias. The distribution patterns of 1,383 durations of observed abandonments of use for twenty-eight discrete modules of health information content were visualised using Kaplan-Meir survival plots. Clear patterns of abandonment of content use were exhibited. The method of analysis is cost-effective, scalable and provides deep insight into the utility of health promotion content. The impact on the content producers, platform operators and service users is to improve organisational learning and thus increase the confidence in stakeholders that the service is continuously delivering high quality health and wellbeing benefits.
With implementation of the Patient Protection and Affordable Care Act, more Americans are gaining insurance coverage but often have high deductibles and significant out-of-pocket cost sharing. Deductibles routinely exceed $1,000 and often approach $5,000. In this essay, I share our family’s experience attempting to navigate urgent medical decisions in a high-deductible health plan. In accessing urgent care for our child’s fracture, we unknowingly encountered a 10-fold variation for what should be routine, low-cost technology (ie, plain film x-ray). Though the financial consequences for our family were minimal, for many families with high-deductible plans the financial implications are enormous. Through this experience, I learned that the principles of consumer-directed health care—that patients can and should price shop for care—are flawed in urgent and emergent situations. PMID:27184999
Nayga, R M
This study investigates the effect of socioeconomic and demographic variables, nutrition and health related factors, attitudes, and use of nutritional labels on consumers' choice for healthier food products. Seven equations are estimated representing different food types: luncheon meat, milk, cheese, ice cream, salad dressing, dessert, and meats. The results generally indicate that individuals who are less likely to choose a healthier alternative of a food product include: blacks, younger individuals, males, those with smaller households, smokers, those who take less exercise, those who are not on a special diet, those who are less aware about the linkage between diet and disease, those who put more importance on taste when food shopping, and those who less frequently use nutrition panels and labels that describe health benefits on food packages.
With implementation of the Patient Protection and Affordable Care Act, more Americans are gaining insurance coverage but often have high deductibles and significant out-of-pocket cost sharing. Deductibles routinely exceed $1,000 and often approach $5,000. In this essay, I share our family's experience attempting to navigate urgent medical decisions in a high-deductible health plan. In accessing urgent care for our child's fracture, we unknowingly encountered a 10-fold variation for what should be routine, low-cost technology (ie, plain film x-ray). Though the financial consequences for our family were minimal, for many families with high-deductible plans the financial implications are enormous. Through this experience, I learned that the principles of consumer-directed health care-that patients can and should price shop for care-are flawed in urgent and emergent situations.
Lee, Shoou-Yih D.; Arozullah, Ahsan M.; Cho, Young Ik; Crittenden, Kathleen; Vicencio, Daniel
The study examines whether social support interacts with health literacy in affecting the health status of older adults. Health literacy is assessed using the short version of the Test of Functional Health Literacy in Adults. Social support is measured with the Medical Outcome Study social support scale. Results show, unexpectedly, that rather…
Tudoran, Alina; Olsen, Svein Ottar; Dopico, Domingo C
This research explored the effect of health benefit information on individuals' stated health value, attitudes towards functional/enriched foods, expectations, perceptions, and intentions to purchase a new fibre-enriched fish product. The study used a randomized design involving an experimental group receiving fibre and health information on the product and a control group who did not receive such information. The results indicated that consumers in the experimental group scored higher on the average attitudes towards functional/enriched foods than did consumers in the control group. No significant differences were observed for other variables. Following a value-attitude-behaviour approach, the study proposed a model relating consumers' health value to their attitudes towards functional/enriched foods, attitudes towards the new functional product and intention to purchase the product, and tested how information affected the structural model. Four of the seven relationships in the structural model proved to be moderated by information. For example, the results indicated that information constrained the association between the health value and product-related health perceptions or hedonic expectations, when individuals had negative attitudes towards the functional/enriched food products. Overall, the study advances the existing literature on the effects of information on consumer behaviour by adding insights into how information simultaneously influenced the mean values and the relationships among the health value, attitudinal factors and intention.
The Environmental Control and Life Support Systems (ECLSS)/thermal systems analysis for the Space Transportation System 1 Flight (STS-1) was performed using the shuttle environmental consumables usage requirements evaluation (SECURE) computer program. This program employs a nodal technique utilizing the Fortran Environmental Analysis Routines (FEAR). The output parameters evaluated were consumable quantities, fluid temperatures, heat transfer and rejection, and cabin atmospheric pressure. Analysis of these indicated that adequate margins exist for the nonpropulsive consumables and related thermal environment.
... Consumer Health, Inc., (Pharmaceutical Product Manufacturing); Notice of Approval On January 12, 2012, the..., on behalf of Novartis Consumer Health, Inc., to manufacture pharmaceutical products under...
Lesley, Marsha L.; Oermann, Marilyn H.; Vander Wal, Jillon S.
This study examined the effectiveness of using the Internet to teach consumers about quality health care, compared consumer definitions of quality health care prior to and following completion of the Internet experience, and compared ratings of learning, satisfaction and value of the Internet instruction between consumers who completed the…
Rowell, Candace; Kuiper, Nora; Shomar, Basem
This study compared physicochemical properties, anion and carbon content and major and trace elements in desalinated and non-desalinated bottled water available in Qatar, and assessed the potential health risks associated with prolonged consumption of desalinated water. Results indicate that Qatar's population is not at elevated risk of dietary exposure to As (mean = 666 ng/L), Ba (48.0 μg/L), Be (9.27 ng/L), Cd (20.1 ng/L), Cr (874 ng/L), Pb (258 ng/L), Sb (475 ng/L) and U (533 ng/L) from consumption of both desalinated and non-desalinated bottled water types available in the country. Consumers who primarily consume desalinated water brands further minimize risk of exposure to heavy metals as levels were significantly lower than in non-desalinated bottled water. Desalinated bottled water was not a significant contributor to recommended daily intakes for Ca, Mg and F(-) for adults and children and may increase risk of deficiencies. Desalinated bottled water accounted for only 3% of the Institute of Medicine (IOM) adequate intake (AI) for Ca, 5-6% of the recommended daily allowance for Mg and 4% of the AI for F among adults. For children desalinated water contributed 2-3% of the IOM AICa, 3-10% of the RDA(Mg) and 3-9% of the AIF.
Background The increasing involvement of pharmacists in public health will require changes in the behaviour of both pharmacists and the general public. A great deal of research has shown that attitudes and beliefs are important determinants of behaviour. This review aims to examine the beliefs and attitudes of pharmacists and consumers towards pharmaceutical public health in order to inform how best to support and improve this service. Methods Five electronic databases were searched for articles published in English between 2001 and 2010. Titles and abstracts were screened by one researcher according to the inclusion criteria. Papers were included if they assessed pharmacy staff or consumer attitudes towards pharmaceutical public health. Full papers identified for inclusion were assessed by a second researcher and data were extracted by one researcher. Results From the 5628 papers identified, 63 studies in 67 papers were included. Pharmacy staff: Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Pharmacists' confidence in providing public health services was on the whole average to low. Time was consistently identified as a barrier to providing public health services. Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported by some pharmacists as barriers. A need for further training was identified in relation to a number of public health services. Consumers: Most pharmacy users had never been offered public health services by their pharmacist and did not expect to be offered. Consumers viewed pharmacists as appropriate providers of public health advice but had mixed views on the pharmacists' ability to do this. Satisfaction was found to be high in those that had experienced pharmaceutical public health Conclusions There has been little change in customer and pharmacist attitudes since reviews conducted nearly 10 years
Ng, Sandy; Russell-Bennett, Rebekah
Health care services are typically consumed out of necessity, typically to recover from illness. While the consumption of health care services can be emotional given that consumers experience fear, hope, relief, and joy, surprisingly, there is little research on the role of consumer affect in health care consumption. We propose that consumer affect is a heuristic cue that drives evaluation of health care services. Drawing from cognitive appraisal theory and affect-as-information theory, this article tests a research model (N = 492) that investigates consumer affect resulting from service performance on subsequent service outcomes.
Fragranced consumer products-such as air fresheners, cleaning supplies, and personal care products- pervade society. This study investigated the occurrence and types of adverse effects associated with exposure to fragranced products in Australia, and opportunities for prevention. Data were collected in June 2016 using an on-line survey with a representative national sample (n = 1098). Overall, 33% of Australians report health problems, such as migraine headaches and asthma attacks, when exposed to fragranced products. Of these health effects, more than half (17.1%) could be considered disabling under the Australian Disability Discrimination Act. Additionally, 7.7% of Australians have lost workdays or a job due to illness from fragranced product exposure in the workplace, 16.4% reported health problems when exposed to air fresheners or deodorizers, 15.3% from being in a room after it was cleaned with scented products, and 16.7% would enter but then leave a business as quickly as possible due to fragranced products. About twice as many respondents would prefer that workplaces, health care facilities and professionals, hotels, and airplanes were fragrance-free rather than fragranced. While 73.7% were not aware that fragranced products, even ones called green and organic, emitted hazardous air pollutants, 56.3% would not continue to use a product if they knew it did. This is the first study in Australia to assess the extent of adverse effects associated with exposure to common fragranced products. It provides compelling evidence for the importance and value of reducing fragranced product exposure in order to reduce and prevent adverse health effects and costs.
Wortans, J; Happell, B; Johnstone, H
There is a substantial body of literature pertaining to the role of the nurse practitioner. Research directed towards consumer satisfaction suggests that the care provided by nurse practitioners is perceived as at least equal to that provided by a medical practitioner. However, there is a paucity of literature examining the nurse practitioner role in the psychiatric/mental health field. An evaluation of a Nurse Practitioner demonstration model has recently been undertaken in the Crisis, Assessment and Treatment Team in Victoria, Australia. This article presents the findings of a qualitative, exploratory study. Individual interviews were conducted with consumers (n = 7) who had received care and treatment provided by the nurse practitioner candidate. Data analysis revealed two main themes: the quality of the service provided, and the unique role of the nurse. The findings supported the available literature in articulating the specific aspects of the nurse practitioner role that are favourably perceived by consumers of services. This study contributes to the limited body of knowledge in the psychiatric/mental health nursing field and specifically emphasizes the importance of the relationship between nurse practitioner and consumer in facilitating the provision of effective care and treatment.
As civilization's collective knowledge grows, we are met with the realization that human-induced physical and biological transformations influenced by exogenous psychosocial and economic factors affect virtually every ecosystem on the planet. Despite improvements in energy generation and efficiencies, demand of material goods and energy services increases with no sign of a slowing pace. Sustainable development requires a multi-prong approach that involves reshaping demand, consumer education, sustainability-oriented policy, and supply chain management that does not serve the expansionist mentality. Thus, decision support tools are needed that inform developers, consumers, and policy-makers for short-term and long-term planning. These tools should incorporate uncertainty through quantitative methods as well as qualitatively informing the nature of the model as imperfect but necessary and adequate. A case study is presented of the manufacture and deployment of utility-scale wind turbines evaluated for a proposed change in blade manufacturing. It provides the first life cycle assessment (LCA) evaluating impact of carbon nanofibers, an emerging material, proposed for integration to wind power generation systems as blade reinforcement. Few LCAs of nanoproducts are available in scientific literature due to research and development (R&D) for applications that continues to outpace R&D for environmental, health, and safety (EHS) and life cycle impacts. LCAs of emerging technologies are crucial for informing developers of potential impacts, especially where market growth is swift and dissipative. A second case study is presented that evaluates consumer choice between disposable and reusable beverage cups. While there are a few studies that attempt to make the comparison using LCA, none adequately address uncertainty, nor are they representative for the typical American consumer. By disaggregating U.S. power generation into 26 subregional grid production mixes and evaluating
Matthias, Marianne S.; Fukui, Sadaaki; Salyers, Michelle P.
Understanding consumer initiation of shared decision making (SDM) is critical to improving SDM in mental health consultations, particularly because providers do not always invite consumer participation in treatment decisions. This study examined the association between consumer initiation of nine elements of SDM as measured by the SDM scale, and measures of consumer illness self-management and the consumer-provider relationship. In 63 mental health visits, three SDM elements were associated with self-management or relationship factors: discussion of consumer goals, treatment alternatives, and pros and cons of a decision. Limitations, implications, and future directions are discussed. PMID:26427999
Matthias, Marianne S; Fukui, Sadaaki; Salyers, Michelle P
Understanding consumer initiation of shared decision making (SDM) is critical to improving SDM in mental health consultations, particularly because providers do not always invite consumer participation in treatment decisions. This study examined the association between consumer initiation of nine elements of SDM as measured by the SDM scale, and measures of consumer illness self-management and the consumer-provider relationship. In 63 mental health visits, three SDM elements were associated with self-management or relationship factors: discussion of consumer goals, treatment alternatives, and pros and cons of a decision. Limitations, implications, and future directions are discussed.
Sohn, Minji; Barrett, Hope; Talbert, Jeffery
Kentucky Department for Behavioral Health Developmental and Intellectual Disabilities conducted a survey to evaluate consumers' satisfaction with services delivered at the Community Mental Health Centers (CMHCs) in Kentucky. The survey was administered at outpatient clinics operated by fourteen CMHCs in 2010. The purpose of this study was to identify factors that predict whether clients will respond that they were "generally satisfied" with services received from CMHCs. A logistic regression model was developed using respondents' characteristics and their responses to survey questions. Survey questions were grouped into seven core domains: general satisfaction, access, quality, participation in treatment planning, outcomes, functioning, and social connectedness. In result, responses to domains of access, quality and participation in treatment planning significantly affected clients' perception of general satisfaction. Respondents who positively assessed those domains of services were more likely to answer that they were generally satisfied with services. Based on the analysis in this report, improvement in certain domains of services, especially access, quality and participation in treatment planning could increase the level of positive responses in general satisfaction.
The eradication of bovine tuberculosis and brucellosis of domestic stock in Germany through the combined efforts of veterinary medicine, the agricultural section and the state was an historic achievement. Since the two diseases are zoonoses, their successful control can also be seen as a valuable contribution to public health. Both these zoonoses are classic animal diseases presenting themselves as clinical entities complete with gross pathological lesions. In contrast, today we are confronted with pathogens causing zoonoses characterised by latent, i.e. clinically inapparent herd infections that do not result in visible tissue changes. Nevertheless, through contaminated foodstuffs, these pathogens contribute to food-borne infections leading to the outbreak of genuine zoonoses in humans. It has been estimated that there could be as many as two million cases of food-borne infections annually in Germany. Among them are salmonellosis, campylobacteriosis, yersiniosis, infections with verotoxin producing E. coli, listeriosis and toxoplasmosis. While the national animal disease legislation only foresees the control of notifiable diseases, the basis for zoonoses control is laid down in the EU Zoonosis-Directive, which is presently awaiting its transposition into national law and into practice. In order, for instance, to combat the most important Salmonella infections of humans, Integrated Quality Systems (IQS) have been formulated as a means of implementing the proven HACCP concept in animal production units and ensuring animal health from the point of view of consumer protection. The aim of all measures must be to free infected herds of pathogens, to investigate and eliminate all sources with a potential for further pathogen introductions, to maintain pathogen-free herds--with a reduced pathogen challenge in mid-term time periods--, as well as to develop diagnostics capable of identifying pathogen carriers before slaughter. For the disinfection of stock, it is important
Florida State Dept. of Education, Tallahassee. Div. of Elementary and Secondary Education.
Secondary level students learn about product safety in this consumer education learning activity package, which is one of a series. While the majority of products are safe, there remains a small percentage of consumer goods which reach the market place containing a real or potential hazard to the consumer's safety. This module is designed to make…
The Affordable Care Act calls for a new health insurance disclosure form, called the Summary of Benefits and Coverage, which uses a fixed layout and standard terms and definitions to allow consumers to compare health insurance plans and understand terms of coverage. This brief reports on findings from a Consumers Union study that examined consumers' initial reactions to the form. Testing revealed that consumers were able to use the forms to make hypothetical choices among health plans. However, the study also found deep-seated confusion and lack of confidence with respect to health plan cost-sharing. These findings have significant implications for any venue providing comparative displays of health insurance information, like the future state exchanges, and for policies that rely on the ability of consumers to make informed health insurance purchasing decisions, such as "consumer-driven health care" policies.
Healthcare technologies are evolving from a practitioner-centric model to a patient-centric model due to the increasing need for technology that directly serves healthcare consumers, including healthy people and patients. Personal health information management (PHIM) technology is one of the technologies designed to enhance an individual's ability…
The main functions of comprehensive health care are promotion, prevention, therapy, and rehabilitation, with an overall goal of health education in its many forms. The consumer has roles and responsibilities in health care which mesh with life as a participating member of society. Consumer participation in the planning and delivery of health…
The market for direct-to-consumer (DTC) health services continues to grow rapidly with former patients converting to customers for the opportunity to purchase varied diagnostic tests without the involvement of their clinician. For the first time a DTC genetic testing company is advertising health-related reports "that meet [Food and Drug Administration] standards for being clinically and scientifically valid." Ethicists and regulatory agencies alike have recognized the need for a more informed transaction in the DTC context, but how should we classify a commercial transaction for something normally protected by a duty of care? How can we assure informed agreements in an industry with terms and conditions as varied as the services performed? The doctrine of "informed consent" began as an ethical construct building on the promise of beneficence in the clinical relationship and elevating the principle of autonomy--but in the DTC context should we hold providers to legal standards of informed consent and associated medical malpractice liability, or contractual obligations where consumers would seek remedy for breach? This Article analyzes the fine balance that must be struck in an industry where companies are selling services for entertainment or non-medical purposes that possess the capacity to produce serious and disquieting medical information. It begins by reviewing current standards of consent in the clinical setting from both a legal and ethical perspective and then lays forth current standards for DTC consent using two currently controversial case studies: that of keepsake fetal ultrasound and genetic testing. DTC keepsake ultrasound and genetic testing providers attempt to de-medicalize the devices used for these procedures from their intended medical uses to non-medical uses. But while keepsake ultrasound is marketed as "intended for entertainment purposes only," it can provide medical information as an incidental finding. 23andMe currently purports to be the
Happell, Brenda; Moxham, Lorna; Platania-Phung, Chris
Consumer participation in all aspects of mental health service delivery, including the education of mental health professionals, is now a policy expectation in Australia. Whether education programs introducing nurses to mental health nursing lead to more favourable attitudes towards consumer participation is yet to be examined in pre-registration nursing programs in Australia. The current evaluation examined changes in scores for the Consumer Participation Survey for undergraduate nursing students (n = 68) in an Australian University. Data were analysed, using repeated measures t-test, to compare the pre- and post-test scores. There was a significant improvement in views on consumers participating as staff members. There were no statistically significant changes in attitudes towards consumer capacity and consumer involvement in care processes. Consumer participation in mental health care is now clearly articulated in Australian Government policy. For this to be successfully implemented a more comprehensive understanding of the ability of education to influence attitudes is required.
Cranwell, Kate; Polacsek, Meg
Abstract Medical comorbidity in people with long‐term mental illness is common and often undetected; however, these consumers frequently experience problems accessing and receiving appropriate treatment in public health‐care services. The aim of the present study was to understand the lived experience of mental health consumers with medical comorbidity and their carers transitioning through tertiary medical to primary care services. An interpretative, phenomenological analysis approach was used, and semistructured, video‐recorded, qualitative interviews were used with 12 consumers and four primary caregivers. Four main themes and related subthemes were abstracted from the data, highlighting consumer's and carers’ experience of transition through tertiary medical to primary care services: (i) accessing tertiary services is difficult and time consuming; (ii) contrasting experiences of clinician engagement and support; (iii) lack of continuity between tertiary medical and primary care services; and (iv) Mental Health Hospital Admission Reduction Programme (MH HARP) clinicians facilitating transition. Our findings have implications for organisational change, expanding the role of MH HARP clinicians (whose primary role is to provide consumers with intensive support and care coordination to prevent avoidable tertiary medical hospital use), and the employment of consumer and carer consultants in tertiary medical settings, especially emergency departments. PMID:26735771
Dean, Evan E; Dunn, Winnie; Tomchek, Scott
Consumer-directed services (CDS) are a type of support system designed to increase the quality of life and self-determination of clients, such as adults with developmental disabilities. Occupational therapists can play an important role in facilitating people's involvement in CDS supports. This paper describes CDS, evidence that supports their use, and ways that occupational therapists use their training in person-centered practice to enhance CDS supports and self-determination. A case study is used to illustrate the application.
Cochran, Gary L.; Lander, Lina; Morien, Marsha; Lomelin, Daniel E.; Brittin, Jeri; Reker, Celeste; Klepser, Donald G.
Background Consumer satisfaction is a crucial component of health information technology (HIT) utilization, as high satisfaction is expected to increase HIT utilization among providers and to allow consumers to become full participants in their own healthcare management. Objective The primary objective of this pilot study was to identify consumer perspectives on health information technologies including health information exchange (HIE), e-prescribing (e-Rx), and personal health records (PHRs). Methods Eight focus groups were conducted in seven towns and cities across Nebraska in 2013. Each group consisted of 10–12 participants. Discussions were organized topically in the following categories: HIE, e-Rx, and PHR. The qualitative analysis consisted of immersion and crystallization to develop a coding scheme that included both preconceived and emergent themes. Common themes across focus groups were identified and compiled for each discussion category. Results The study had 67 participants, of which 18 (27 percent) were male. Focus group findings revealed both perceived barriers and benefits to the adoption of HIT. Common HIT concerns expressed across focus groups included privacy and security of medical information, decreases in quality of care, inconsistent provider participation, and the potential cost of implementation. Positive expectations regarding HIT included better accuracy and completeness of information, and improved communication and coordination between healthcare providers. Improvements in patient care were expected as a result of easy physician access to consolidated information across providers as well as the speed of sharing and availability of information in an emergency. In addition, participants were optimistic about patient empowerment and convenient access to and control of personal health data. Conclusion Consumer concerns focused on privacy and security of the health information, as well as the cost of implementing the technologies and the
Both the demand for, and supply of, mental health information has increased across all sectors. Academic, public and special libraries must locate, evaluate and select materials that support consumer education, academic teaching, interdisciplinary research, and professional credentialing. Selectors must navigate disciplinary barriers to develop…
Stuttaford, Maria C
Background Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services. Objective This research is based on a survey using Mxit as a mobile phone–based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care. Methods Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes. Results Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system’s governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI. Conclusions The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform. PMID:25351980
... From the Federal Register Online via the Government Publishing Office FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 54 Universal Service Support for Low-Income Consumers; Correction AGENCY: Federal...) receiving Universal Service low-income support. That document inadvertently deleted a sentence from 47...
Göbel, G; Andreatta, S; Masser, J; Pfeiffer, K P
GIN Austria (Gesundheitsinformationsnetz Austria) offers patients and consumers reliable medical knowledge about diseases, wellness and disease management in an easy understandable way and enables them to quick and incessant access to informations about the Austrian health system and Austrian health organizations. To achieve full customer (patients, citizens) satisfaction to find relevant information we propose a concept of a vector-model oriented IR-Tool based on the controlled vocabulary of the MeSH Thesaurus (german version). By this approach users who are often not used to scientific terms and expressions are supported to build up their own query with MeSH Main Headings. In a second step broader and narrower Main Headings are added to the query vector by the system. For this calculation an adapted version of the Floyd-Warshall algorithm for directed, azyclic graphs is used. The tool is part of the GIN Search Modul, which will ease gathering health information from different heterogenous internet datasources.
Göbel, G; Masser, J; Pfeiffer, K P
GIN AUSTRIA (Gesundheitsinformationsnetz AUSTRIA) offers patients and consumers reliable medical knowledge about diseases, wellness and disease management in an easy understandable way and enables them to quick and incessant access to informations about the Austrian health system and Austrian health organizations. To achieve full customer (patients, citizens) satisfaction to find relevant information we propose a concept of a vector-model oriented IR-Tool based on the controlled vocabulary of the MeSH Thesaurus (german version). By this approach users who are often not used to scientific terms and expressions are supported to build up their own query with MeSH Main Headings. In a second step broader and narrower Main Headings are added to the query-vector by the system. The tool is part of the GIN Search Modul, which will ease gathering health information from different heterogenous internet datasources.
O'Connor, S J; Shewchuk, R M; Bowers, M R
Analysis of covariance structures (LISREL) was used to examine the influence of consumer held perceptions of service quality on consumer satisfaction and intentions to return. Results indicate that service quality is a significant predictor of consumer satisfaction which, in turn, predicts intention to return. Health care marketing implications are discussed.
Dixon, Anna; Greene, Jessica; Hibbard, Judith
Using panel data from two surveys of employees at one large employer from 2004 and 2005, this paper examines consumer-directed health plans' (CDHPs') influence on the use of health-related information and health services. We compare enrollees in a high-deductible CDHP, a lower-deductible CDHP, and a preferred provider organization (PPO). Enrollees in the lower-deductible CDHP were more likely than enrollees in the other plans to start using information. Enrollees in the high-deductible CDHP were more likely than those in the PPO to start forgoing medical care to save money.
Evangelista, Eloisa; Lee, Stuart; Gallagher, Angela; Peterson, Violeta; James, Jo; Warren, Narelle; Henderson, Kathryn; Keppich-Arnold, Sandra; Cornelius, Luke; Deveny, Elizabeth
When mental health crisis situations in the community are poorly handled, it can result in physical and emotional injuries. The purpose of this study was to ascertain the experiences and opinions of consumers about the way police and mental health services worked together, specifically via the Alfred Police and Clinical Early Response (A-PACER) model, to assist people experiencing a mental health crisis. Semi-structured in-depth interviews were conducted with 12 mental health consumers who had direct contact with the A-PACER team between June 2013 and March 2015. The study highlighted that people who encountered the A-PACER team generally valued and saw the benefit of a joint police-mental health clinician team response to a mental health crisis situation in the community. In understanding what worked well in how the A-PACER team operated, consumers perspectives can be summarized into five themes: communication and de-escalation, persistence of the A-PACER team, providing a quick response and working well under pressure, handover of information, and A-PACER helped consumers achieve a preferred outcome. All consumers acknowledged the complementary roles of the police officer and mental health clinician, and described the A-PACER team's supportive approach as critical in gaining their trust, engagement and in de-escalating the crises. Further education and training for police officers on how to respond to people with a mental illness, increased provision of follow-up support to promote rehabilitation and prevent future crises, and measures to reduce public scrutiny for the consumer when police responded, were proposed opportunities for improvement.
Crangle, Colleen E; Kart, Joyce Brothers
Despite the wealth of mental-health information available online to consumers, research has shown that the mental-health information needs of consumers are not being met. This study contributes to that research by soliciting consumer questions directly, categorizing them, analyzing their form, and assessing the extent to which they can be answered from a trusted and vetted source of online information, namely the website of the US National Institute of Mental Health (NIMH). As an alternative to surveys and analyses of online activity, this study shows how consumer questions provide new insight into what consumers do not know and how they express their information needs. The study crowdsourced 100 consumer questions through Amazon Inc.'s Mechanical Turk. Categorization of the questions shows broad agreement with earlier studies in terms of the content of consumer questions. It also suggests that consumers' grasp of mental health issues may be low compared to other health topics. The majority of the questions (74%) were simple in form, with the remainder being multi-part, multifaceted or narrative. Even simple-form questions could, however, have complex interpretations. Fifty four questions were submitted to the search box at the NIMH website. For 32 questions, no answer could be found in the top one to three documents returned. Inadequacies in the search and retrieval technology deployed at websites account for some of the failure to find answers. The nature of consumer questions in mental health also plays a role. A question that has a false presupposition is less likely to have an answer in trusted and vetted sources of information. Consumer questions are also expressed with a degree of specificity that makes the retrieval of relevant information difficult. The significance of this study is that it shows what an analysis of consumer mental-health questions can tell us about consumer information needs and it provides new insight into the difficulties facing
Mackert, Michael; Love, Brad
Direct-to-consumer (DTC) pharmaceutical advertisements have been analyzed in many ways, but richer conceptualizations of health literacy have been largely absent from this research. With approximately half of U.S. adults struggling to understand health information, it is important to consider consumers' health literacy when analyzing DTC advertisements. This project, framed by the health belief model, analyzed 82 advertisements. Advertisements provided some kinds of educational content (e.g., drugs' medical benefits) but typically failed to offer other useful information (e.g., other strategies for dealing with conditions). Issues likely to be barriers to low health literate consumers, such as nonstandard text formatting, are common.
Background How companies deal with complaints is a particularly challenging aspect in managing the quality of their service. In this study we test the direct and relative effects of service quality dimensions on consumer complaint satisfaction evaluations and trust in a company in the Dutch health insurance market. Methods A cross-sectional survey design was used. Survey data of 150 members of a Dutch insurance panel who lodged a complaint at their healthcare insurer within the past 12 months were surveyed. The data were collected using a questionnaire containing validated multi-item measures. These measures assess the service quality dimensions consisting of functional quality and technical quality and consumer complaint satisfaction evaluations consisting of complaint satisfaction and overall satisfaction with the company after complaint handling. Respondents' trust in a company after complaint handling was also measured. Using factor analysis, reliability and validity of the measures were assessed. Regression analysis was used to examine the relationships between these variables. Results Overall, results confirm the hypothesized direct and relative effects between the service quality dimensions and consumer complaint satisfaction evaluations and trust in the company. No support was found for the effect of technical quality on overall satisfaction with the company. This outcome might be driven by the context of our study; namely, consumers get in touch with a company to resolve a specific problem and therefore might focus more on complaint satisfaction and less on overall satisfaction with the company. Conclusions Overall, the model we present is valid in the context of the Dutch health insurance market. Management is able to increase consumers' complaint satisfaction, overall satisfaction with the company, and trust in the company by improving elements of functional and technical quality. Furthermore, we show that functional and technical quality do not
Lee, Kenneth; Hoti, Kreshnik; Hughes, Jeffery David
Background The abundance of health information available online provides consumers with greater access to information pertinent to the management of health conditions. This is particularly important given an increasing drive for consumer-focused health care models globally, especially in the management of chronic health conditions, and in recognition of challenges faced by lay consumers with finding, understanding, and acting on health information sourced online. There is a paucity of literature exploring the navigational needs of consumers with regards to accessing online health information. Further, existing interventions appear to be didactic in nature, and it is unclear whether such interventions appeal to consumers’ needs. Objective Our goal was to explore the navigational needs of consumers with chronic health conditions in finding online health information within the broader context of consumers’ online health information-seeking behaviors. Potential barriers to online navigation were also identified. Methods Semistructured interviews were conducted with adult consumers who reported using the Internet for health information and had at least one chronic health condition. Participants were recruited from nine metropolitan community pharmacies within Western Australia, as well as through various media channels. Interviews were audio-recorded, transcribed verbatim, and then imported into QSR NVivo 10. Two established approaches to thematic analysis were adopted. First, a data-driven approach was used to minimize potential bias in analysis and improve construct and criterion validity. A theory-driven approach was subsequently used to confirm themes identified by the former approach and to ensure identified themes were relevant to the objectives. Two levels of analysis were conducted for both data-driven and theory-driven approaches: manifest-level analysis, whereby face-value themes were identified, and latent-level analysis, whereby underlying concepts were
Rep. Cummings, Elijah E. [D-MD-7
07/09/2009 Received in the Senate and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Rep. Cummings, Elijah E. [D-MD-7
06/23/2010 Received in the Senate and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:
Happell, Brenda; Byrne, Louise; McAllister, Margaret; Lampshire, Debra; Roper, Cath; Gaskin, Cadeyrn J; Martin, Graham; Wynaden, Dianne; McKenna, Brian; Lakeman, Richard; Platania-Phung, Chris; Hamer, Helen
A systematic review of the published work on consumer involvement in the education of health professionals was undertaken using the PRISMA guidelines. Searches of the CINAHL, MEDLINE, and PsychINFO electronic databases returned 487 records, and 20 met the inclusion criteria. Further papers were obtained through scanning the reference lists of those articles included from the initial published work search (n = 9) and contacting researchers in the field (n = 1). Thirty papers (representing 28 studies) were included in this review. Findings from three studies indicate that consumer involvement in the education of mental health professionals is limited and variable across professions. Evaluations of consumer involvement in 16 courses suggest that students gain insight into consumers' perspectives of: (i) what life is like for people with mental illness; (ii) mental illness itself; (iii) the experiences of admission to, and treatment within, mental health services; and (iv) how these services could be improved. Some students and educators, however, raised numerous concerns about consumer involvement in education (e.g. whether consumers were pursuing their own agendas, whether consumers' views were representative). Evaluations of consumer involvement in education are limited in that their main focus is on the perceptions of students. The findings of this review suggest that public policy expectations regarding consumer involvement in mental health services appear to be slowly affecting the education of mental health professionals. Future research needs to focus on determining the effect of consumer involvement in education on the behaviours and attitudes of students in healthcare environments.
The University of Illinois Library of the Health Sciences at Rockford (LHS-Rockford) long has honored a commitment to serving the health information needs of the greater Rockford community. Utilization data collected over the past five years indicate that approximately 50% of reference transactions involve persons not affiliated with the university. In early 1994, LHS-Rockford submitted a proposal to the Northern Illinois Library System (NILS), a multitype system spanning twelve counties in northwestern Illinois, asking to serve as a resource library for improving medical and health information services provided by the 138 NILS member libraries. The NILS funded this pilot project as part of an effort to implement a new strategic plan, which encouraged member libraries to form networks to provide reference back-up service. LHS-Rockford acquired InfoTrac's Health Reference Center, a consumer health information database, and set up a dedicated workstation near the information and circulation desk. Referral guidelines were established and the project was promoted among NILS member libraries. Activities were documented in order to track project success in terms of referrals and outcomes. The demonstration project was very successful, and it proves public consumers seeking health information can benefit greatly from this type of cooperative arrangement. PMID:8826632
Moore, Vivianne E.
This research study used a quantitative comparative method to investigate the relationship between consumer satisfaction and communication based on the format of health record. The central problem investigated in this research study related to the format of health record used and consumer satisfaction with care provided and effect on communication…
Pifalo, V; Hollander, S; Henderson, C L; DeSalvo, P; Gill, G P
In the past two decades, consumer health libraries have proliferated in response to the changing health care environment and consumer demand. While this growth of consumer health resources and services has been extensively described in the literature, there is little documentation about the impact and value of providing consumer health information. This paper explores the issues of impact and value as examined in a retrospective study of consumers who received health information from the Delaware Academy of Medicine's Consumer Health Library during 1995. In this study, 270 adults were mailed a questionnaire that focused on whether the information influenced decisions, actions, anxiety levels, and patient-provider communication. The questionnaire also addressed the value of such library service in terms of likelihood of repeat use, recommendation to others, and willingness to pay. The results, based on a return rate of 86.7%, identified effects of library-supplied consumer health information that extend beyond the anticipated acquisition of knowledge to specific actions and effects on anxiety. The value of consumer health library information service was shown by the extremely high percentage of probable repeat use and recommendation to others, the willingness of 83.8% of the respondents to pay for such service, and the copious comments volunteered by the respondents.
Giovannelli, Justin; Curran, Emily
Issue: Policymakers have sought to improve the shopping experience on the Affordable Care Act’s marketplaces by offering decision support tools that help consumers better understand and compare their health plan options. Cost estimators are one such tool. They are designed to provide consumers a personalized estimate of the total cost--premium, minus subsidy, plus cost-sharing--of their coverage options. Cost estimators were available in most states by the start of the fourth open enrollment period. Goal: To understand the experiences of marketplaces that offer a total cost estimator and the interests and concerns of policymakers from states that are not using them. Methods: Structured interviews with marketplace officials, consumer enrollment assisters, technology vendors, and subject matter experts; analysis of the total cost estimators available on the marketplaces as of October 2016. Key findings and conclusions: Informants strongly supported marketplace adoption of a total cost estimator. Marketplaces that offer an estimator faced a range of design choices and varied significantly in their approaches to resolving them. Interviews suggested a clear need for additional consumer testing and data analysis of tool usage and for sustained outreach to enrollment assisters to encourage greater use of the estimators.
Baggott, Rob; Jones, Kathryn L
Previous studies of groups representing patients, users and carers in the UK indicate that their principal focus is on health care and treatment services. In recent years, UK government policy has emphasised prevention and health promotion as part of its wider public health agenda. This paper investigates how this might have affected health consumer and patients' organisations (HCPOs) by presenting findings from an online survey of 312 UK groups undertaken in the summer of 2010. The sample was identified using the publicly available membership lists of a number of large alliance organisations. The survey achieved a 39% response rate. The findings suggest that the main focus of lobbying and campaigning remains on health care rather than public health issues. However, a significant minority of groups stated they prioritised public health campaigning and lobbying. Possible explanations for engagement with the public health agenda include: the presence of public health on the government's agenda, the influence of other, more powerful interests in the health policy process, and growing awareness among groups of health promotion, prevention and environmental causes of illness. The paper argues that although HCPOs may be more active in the public health policy arena, more research is needed - notably with regard to their relationship with devolved governments, EU institutions and the current UK government's public health and voluntary sector agenda. The reasons why some groups engage more than others with the public health agenda also merit closer investigation. Moreover, not enough is currently known about the influence of HCPOs on the public health agenda and policies in this field.
Berlan, David; Shiffman, Jeremy
Health care providers in low-income countries often treat consumers poorly. Many providers do not consider it their responsibility to listen carefully to consumer preferences, to facilitate access to care, to offer detailed information, or to treat patients with respect. A lack of provider accountability to health consumers may have adverse effects on the quality of health care they provide, and ultimately on health outcomes. This paper synthesizes relevant research on health provision in low-, middle- and high-income countries with the aim of identifying factors that shape health provider accountability to consumers, and discerning promising interventions to enhance responsiveness. Drawing on this scholarship, we develop a framework that classifies factors into two categories: those concerning the health system and those that pertain to social influences. Among the health systems factors that may shape provider accountability are oversight mechanisms, revenue sources, and the nature of competition in the health sector-all influences that may lead providers to be accountable to entities other than consumers, such as governments and donors. Among the social factors we explore are consumer power, especially information levels, and provider beliefs surrounding accountability. Evidence on factors and interventions shaping health provider accountability is thin. For this reason, it is not possible to draw firm conclusions on what works to enhance accountability. This being said, research does suggest four mechanisms that may improve provider responsiveness: 1. Creating official community participation mechanisms in the context of health service decentralization; 2. Enhancing the quality of health information that consumers receive; 3. Establishing community groups that empower consumers to take action; 4. Including non-governmental organizations in efforts to expand access to care. This synthesis reviews evidence on these and other interventions, and points to future
Carman, Kristin L; Maurer, Maureen; Yegian, Jill Mathews; Dardess, Pamela; McGee, Jeanne; Evers, Mark; Marlo, Karen O
We undertook focus groups, interviews, and an online survey with health care consumers as part of a recent project to assist purchasers in communicating more effectively about health care evidence and quality. Most of the consumers were ages 18-64; had health insurance through a current employer; and had taken part in making decisions about health insurance coverage for themselves, their spouse, or someone else. We found many of these consumers' beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as "medical evidence" or "quality guidelines." Most believed that more care meant higher-quality, better care. The gaps in knowledge and misconceptions point to serious challenges in engaging consumers in evidence-based decision making.
Fiksdal, Alexander S; Kumbamu, Ashok; Jadhav, Ashutosh S; Cocos, Cristian; Nelsen, Laurie A; Pathak, Jyotishman
Background The Internet is a common resource that patients and consumers use to access health-related information. Multiple practical, cultural, and socioeconomic factors influence why, when, and how people utilize this tool. Improving the delivery of health-related information necessitates a thorough understanding of users’ searching-related needs, preferences, and experiences. Although a wide body of quantitative research examining search behavior exists, qualitative approaches have been under-utilized and provide unique perspectives that may prove useful in improving the delivery of health information over the Internet. Objective We conducted this study to gain a deeper understanding of online health-searching behavior in order to inform future developments of personalizing information searching and content delivery. Methods We completed three focus groups with adult residents of Olmsted County, Minnesota, which explored perceptions of online health information searching. Participants were recruited through flyers and classifieds advertisements posted throughout the community. We audio-recorded and transcribed all focus groups, and analyzed data using standard qualitative methods. Results Almost all participants reported using the Internet to gather health information. They described a common experience of searching, filtering, and comparing results in order to obtain information relevant to their intended search target. Information saturation and fatigue were cited as main reasons for terminating searching. This information was often used as a resource to enhance their interactions with health care providers. Conclusions Many participants viewed the Internet as a valuable tool for finding health information in order to support their existing health care resources. Although the Internet is a preferred source of health information, challenges persist in streamlining the search process. Content providers should continue to develop new strategies and technologies
Kart, Joyce Brothers
Despite the wealth of mental-health information available online to consumers, research has shown that the mental-health information needs of consumers are not being met. This study contributes to that research by soliciting consumer questions directly, categorizing them, analyzing their form, and assessing the extent to which they can be answered from a trusted and vetted source of online information, namely the website of the US National Institute of Mental Health (NIMH). As an alternative to surveys and analyses of online activity, this study shows how consumer questions provide new insight into what consumers do not know and how they express their information needs. The study crowdsourced 100 consumer questions through Amazon Inc.’s Mechanical Turk. Categorization of the questions shows broad agreement with earlier studies in terms of the content of consumer questions. It also suggests that consumers’ grasp of mental health issues may be low compared to other health topics. The majority of the questions (74%) were simple in form, with the remainder being multi-part, multifaceted or narrative. Even simple-form questions could, however, have complex interpretations. Fifty four questions were submitted to the search box at the NIMH website. For 32 questions, no answer could be found in the top one to three documents returned. Inadequacies in the search and retrieval technology deployed at websites account for some of the failure to find answers. The nature of consumer questions in mental health also plays a role. A question that has a false presupposition is less likely to have an answer in trusted and vetted sources of information. Consumer questions are also expressed with a degree of specificity that makes the retrieval of relevant information difficult. The significance of this study is that it shows what an analysis of consumer mental-health questions can tell us about consumer information needs and it provides new insight into the difficulties facing
LeRouge, Cynthia; Wickramasinghe, Nilmini
User-centered design (UCD) is well recognized as an effective human factor engineering strategy for designing ease of use in the total customer experience with products and information technology that has been applied specifically to health care information technology systems. We conducted a literature review to analyze the current research regarding the use of UCD methods and principles to support the development or evaluation of diabetes-related consumer health informatics technology (CHIT) initiatives. Findings indicate that (1) UCD activities have been applied across the technology development life cycle stages, (2) there are benefits to incorporating UCD to better inform CHIT development in this area, and (3) the degree of adoption of the UCD process is quite uneven across diabetes CHIT studies. In addition, few to no studies report on methods used across all phases of the life cycle with process detail. To address that void, the Appendix provides an illustrative case study example of UCD techniques across development stages. PMID:23911188
LeRouge, Cynthia; Wickramasinghe, Nilmini
User-centered design (UCD) is well recognized as an effective human factor engineering strategy for designing ease of use in the total customer experience with products and information technology that has been applied specifically to health care information technology systems. We conducted a literature review to analyze the current research regarding the use of UCD methods and principles to support the development or evaluation of diabetes-related consumer health informatics technology (CHIT) initiatives. Findings indicate that (1) UCD activities have been applied across the technology development life cycle stages, (2) there are benefits to incorporating UCD to better inform CHIT development in this area, and (3) the degree of adoption of the UCD process is quite uneven across diabetes CHIT studies. In addition, few to no studies report on methods used across all phases of the life cycle with process detail. To address that void, the Appendix provides an illustrative case study example of UCD techniques across development stages.
Chen, Liwei; Pye, Jessica; Baird, Aaron
Background Consumer use of mobile devices as health service delivery aids (mHealth) is growing, especially as smartphones become ubiquitous. However, questions remain as to how consumer traits, health perceptions, situational characteristics, and demographics may affect consumer mHealth usage intentions, assimilation, and channel preferences. Objective We examine how consumers’ personal innovativeness toward mobile services (PIMS), perceived health conditions, health care availability, health care utilization, demographics, and socioeconomic status affect their (1) mHealth usage intentions and extent of mHealth assimilation, and (2) preference for mHealth as a complement or substitute for in-person doctor visits. Methods Leveraging constructs from research in technology acceptance, technology assimilation, consumer behavior, and health informatics, we developed a cross-sectional online survey to study determinants of consumers’ mHealth usage intentions, assimilation, and channel preferences. Data were collected from 1132 nationally representative US consumers and analyzed by using moderated multivariate regressions and ANOVA. Results The results indicate that (1) 430 of 1132 consumers in our sample (37.99%) have started using mHealth, (2) a larger quantity of consumers are favorable to using mHealth as a complement to in-person doctor visits (758/1132, 66.96%) than as a substitute (532/1132, 47.00%), and (3) consumers’ PIMS and perceived health conditions have significant positive direct influences on mHealth usage intentions, assimilation, and channel preferences, and significant positive interactive influences on assimilation and channel preferences. The independent variables within the moderated regressions collectively explained 59.70% variance in mHealth usage intentions, 60.41% in mHealth assimilation, 34.29% in preference for complementary use of mHealth, and 45.30% in preference for substitutive use of mHealth. In a follow-up ANOVA examination, we
Keselman, Alla; Smith, Catherine Arnott; Divita, Guy; Kim, Hyeoneui; Browne, Allen C.; Leroy, Gondy; Zeng-Treitler, Qing
Objective This study has two objectives: first, to identify and characterize consumer health terms not found in the Unified Medical Language System (UMLS) Metathesaurus (2007 AB); second, to describe the procedure for creating new concepts in the process of building a consumer health vocabulary. How do the unmapped consumer health concepts relate to the existing UMLS concepts? What is the place of these new concepts in professional medical discourse? Design The consumer health terms were extracted from two large corpora derived in the process of Open Access Collaboratory Consumer Health Vocabulary (OAC CHV) building. Terms that could not be mapped to existing UMLS concepts via machine and manual methods prompted creation of new concepts, which were then ascribed semantic types, related to existing UMLS concepts, and coded according to specified criteria. Results This approach identified 64 unmapped concepts, 17 of which were labeled as uniquely “lay” and not feasible for inclusion in professional health terminologies. The remaining terms constituted potential candidates for inclusion in professional vocabularies, or could be constructed by post-coordinating existing UMLS terms. The relationship between new and existing concepts differed depending on the corpora from which they were extracted. Conclusion Non-mapping concepts constitute a small proportion of consumer health terms, but a proportion that is likely to affect the process of consumer health vocabulary building. We have identified a novel approach for identifying such concepts. PMID:18436906
Yi, Yong Jeong
Previous studies indicated inadequate health literacy of American adults as one of the biggest challenges for consumer health information services provided in public libraries. Little attention, however, has been paid to public users' health literacy and health information behaviors. In order to bridge the research gap, the study aims to…
Lucivero, Federica; Prainsack, Barbara
Consumer genomics and mobile health provide health-related information to individuals and offer advice for lifestyle change. These ‘technologies for healthy lifestyle’ occupy an ambiguous space between the highly regulated medical domain and the less regulated consumer market. We argue that this ambiguity challenges implicit distinctions between what is medical and what is related to personal lifestyle choices within current regulatory systems. In this article, we discuss how consumer genomics and mobile health devices give rise to new ways of creating (and making sense of) health-related knowledge. We also address some of the implications of harnessing, rather than denying, the hybridity of mobile health devices, being situated between medical devices and consumer products, between health and lifestyle. PMID:26937349
Caldwell, Joe; Heller, Tamar
Longitudinal impacts of a consumer-directed support program that provides families with an individualized budget were studied at three points in time over a 9-year period: Time 1 (1991), Time 2 (1995), and Time 3 (2000). At Time 3, families in the program were also compared with families on the waiting list. Over time, families in the program…
Patel, Sheena M.; Gunn, Janelle P.; Merlo, Caitlin L.; Tong, Xin; Cogswell, Mary E.
Purpose/Objectives: The objective of this study was to assess consumer support for policies lowering the sodium content of cafeteria foods in schools. Methods: Data were used from 9,634 adults aged >18 years who responded to questions about sodium in general and in school foods in a 2010 national mail panel survey. Prevalence of consumer…
Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J.; Demiris, George
Introduction There is a critical need for public health interventions to support the independence of older adults as the world’s population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. Methods We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. Results One thousand, six hundred and thirty nine candidate articles were identified. Thirty-one studies from the years 1998–2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). Conclusion The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of these used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults, social support and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. PMID:23639263
Bielavitz, Sarann; Wisdom, Jennifer; Pollack, David A
People with serious mental illnesses are increasingly becoming more active participants in their treatment and recovery. At times, their participation may be limited by incomplete, unclear, or insufficient information. The authors used a grounded theory approach to look at the unmet informational needs described by consumers. Participants in this study called for materials appropriate to their level of understanding, assistance with interpreting and comprehending information when necessary, and information on policies that affect the treatment they receive. Ultimately, an informed consumer is one empowered to make decisions about the course of his or her recovery and participate meaningfully in the patient-provider relationship.
Mahoney, Kevin J; Simon-Rusinowitz, Lori; Simone, Kristin; Zgoda, Karen
The Cash and Counseling Demonstration began as a 3-state social experiment to test the claims of members of the disability community that, if they had more control over their services, their lives would improve and costs would be no higher. The 2004 expansion to 12 states brings us closer to the tipping point when this option will be broadly available. The original demonstration was a controlled experiment with randomized assignment, supplemented by an ethnographic study and a process evaluation. Consumers managing flexible, individualized budgets were much more satisfied, had fewer unmet needs, and had comparable health outcomes. Access to service and supports was greatly improved. Consumer direction is increasingly accepted as a desirable option in home and community services.
Foster, Michele M; Earl, Peter E; Haines, Terry P; Mitchell, Geoffrey K
Accounting for consumer preference in health policy and delivery system design makes good economic sense since this is linked to outcomes, quality of care and cost control. Probability trade-off methods are commonly used in policy evaluation, marketing and economics. Increasingly applied to health matters, the trade-off preference model has indicated that consumers of health care discriminate between different attributes of care. However, the complexities of the health decision-making environment raise questions about the inherent assumptions concerning choice and decision-making behavior which frame this view of consumer preference. In this article, we use the example of primary care in Australia as a vehicle to examine the concept of 'consumer preference' from different perspectives within economics and discuss the significance of how we model preferences for health policy makers. In doing so, we question whether mainstream thinking, namely that consumers are capable of deliberating between rival strategies and are willing to make trade-offs, is a reliable way of thinking about preferences given the complexities of the health decision-making environment. Alternative perspectives on preference can assist health policy makers and health providers by generating more precise information about the important attributes of care that are likely to enhance consumer engagement and optimise acceptability of health care.
Lafky, Deborah Beranek; Horan, Thomas A
Personal health record (PHR) systems are a subject of intense interest in the move to improve healthcare accessibility and quality. Although a number of vendors continue to put forward PHR systems, user-centered design research has lagged, and it has not been clear what features are important to prospective PHR users. Here, we report on a user-centered design study that combines qualitative and quantitative approaches to investigate several dimensions relevant to PHR design, and to look at the effect of health status on user needs. The results indicate that health status, especially disability and chronic illness, is relevant to PHR design. Further, the results provide empirical evidence about the role of privacy and security in users' attitudes toward PHR use. The exact nature of these attitudes differs from widely held perceptions about consumer values in healthcare information management.
... the instrumentation used to perform the test, and quality control practices. There is no such requirement for consumers who purchase home tests, even the ones prescribed or recommended by their ... are important to your quality of life if you live with chronic illness. ...
Knuth, Barbara A; A Connelly, Nancy; Sheeshka, Judy; Patterson, Jacqueline
Fish consumers may incur benefits and risks from eating fish. Health advisories issued by states, tribes, and other entities typically include advice about how to limit fish consumption or change other behaviors (e.g., fish cleaning or cooking) to reduce health risks from exposure to contaminants. Eating fish, however, may provide health benefits. Risk communicators and fish consumers have suggested the importance of including risk comparison information, as well as health risk-benefit comparisons in health advisory communications. To improve understanding about how anglers fishing in waters affected by health advisories may respond to such risk-risk or risk-benefit information, we surveyed Lake Ontario (NY, USA) anglers. We interviewed by telephone 4,750 anglers, 2,593 of which had fished Lake Ontario in the past 12 months and were sent a detailed mail questionnaire (1,245 responded). We posed questions varying the magnitude of health risks and health benefits to be gained by fish consumption, and varied the population affected by these risks and benefits (anglers, children, women of childbearing age, and unborn children). Respondents were influenced by health benefit and health risk information. When risks were high, most respondents would eat less fish regardless of the benefit level. When risks were low, the magnitude of change in fish consumption was related to level of benefit. Responses differed depending on the question wording order, that is, whether "risks" were posed before "benefits." For a given risk-benefit level, respondents would give different advice to women of childbearing age versus children, with more conservative advice (eat less fish) provided to women of childbearing age. Respondents appeared to be influenced more strongly by risk-risk comparisons (e.g., risks from other foods vs. risks from fish) than by risk-benefit comparisons (e.g., risks from fish vs. benefits from fish). Risk analysts and risk communicators should improve efforts to
Maciag, Timothy; Hepting, Daryl H.; Slezak, Dominik; Hilderman, Robert J.
On the Web, many popular e-commerce sites provide consumers with decision support tools to assist them in their commerce-related decision-making. Many consumers will rank the utility of these tools quite highly. Data obtained from web usage mining analyses, which may provide knowledge about a user's online experiences, could help indicate the utility of these tools. This type of analysis could provide insight into whether provided tools are adequately assisting consumers in conducting their online shopping activities or if new or additional enhancements need consideration. Although some research in this regard has been described in previous literature, there is still much that can be done. The authors of this paper hypothesize that a measurement of consumer decision accuracy, i.e. a measurement preferences, could help indicate the utility of these tools. This paper describes a procedure developed towards this goal using elements of rough set theory. The authors evaluated the procedure using two support tools, one based on a tool developed by the US-EPA and the other developed by one of the authors called cogito. Results from the evaluation did provide interesting insights on the utility of both support tools. Although it was shown that the cogito tool obtained slightly higher decision accuracy, both tools could be improved from additional enhancements. Details of the procedure developed and results obtained from the evaluation will be provided. Opportunities for future work are also discussed.
Cummings, L E
Commercial, public foodservices are experiencing an increasing demand for menu selections consumers see as healthful. Demographic, economic and lifestyle forces are resulting in a growing proportion of individuals and families who eat away from home more frequently. Many are seeking prudent food choices not only at home, but also in foodservice operations. To them, nutrition represents one controllable lifestyle element which can influence their personal health. Weight control and preventive nutrition are the nutrition-related objectives of most consumers interested in foodservice nutrition. They look to dietary guidelines, both those which are specific to their particular health concerns, (e.g. weight control), and those intended as eating-style changes to reduce the risk of such diet-related conditions and diseases as obesity, atherosclerosis, high blood pressure, diabetes and certain forms of cancer. Focusing on these health objectives, interested foodservice operators should offer items which allow consumers to avoid certain foods and food preparation methods which add up to too much of the following: total calories; fat; refined carbohydrates; cholesterol; sodium; and certain controversial substances, (e.g., caffeine). They seek to replace some of the 'avoid' items with a variety of choices of minimally-processed plant foods, and with less-fatty animal foods. Employee education to support menuing nutrition should begin with the development of an awareness of specific target market health concerns. Employees can then be made familiar with methods to translate these dietary wants and needs into appealing, well-tuned products and service elements. The success of nutrition program elements relies heavily on this understanding by employees in their roles from recipe development to table service.
Walsh-Childers, Kim; Edwards, Heather; Grobmyer, Stephen
Women identify consumer magazines as a key source of information on many health topics, including breast cancer, which continues to rank as women's greatest personal health fear. This study examined the comprehensiveness and accuracy of breast cancer information provided in 555 articles published in 17 consumer magazines from 2002 through 2007. Accuracy of information was determined for 33 key breast cancer facts identified by an expert panel as important information for women to know. The results show that only 7 of 33 key facts were mentioned in at least 5% of the articles. These facts all dealt with breast cancer risk factors, screening, and detection; none of the key facts related to treatment or outcomes appeared in at least 5% of the articles. Other topics (not key facts) mentioned centered around controllable risk factors, support for breast cancer patients, and chemotherapy treatment. The majority of mentions of key facts were coded as fully accurate, although as much as 44% of mentions of some topics (the link between hormone replacement therapy and breast cancer) were coded as inaccurate or only partially accurate. The magazines were most likely to emphasize family history of breast cancer or genetic characteristics as risk factors for breast cancers; family history was twice as likely to be discussed as increasing age, which is in fact the most important risk factor for breast cancer other than being female. Magazine coverage may contribute to women's inaccurate perceptions of their breast cancer risk.
Lee, Nancy S
This paper examines the origins of consumerist discourse in health care from a communication perspective via a historical textual analysis of health writing in popular magazines from 1930 to 1949. The focus is on Consumers Union's Consumer Reports and the American Medical Association's lay health magazine, Hygeia. Findings from Consumer Reports show that the consumer movement of the 1930s-40s staunchly advocated for universal health insurance. Whereas consumer rights language nowadays tends towards individual choice and personal responsibility, consumerism in health care during that era articulated ideas about consumer citizenship, framing choice and responsibility in collectivist terms and health care as a social good. This paper also illuminates the limits and weaknesses of a central tenet in consumerism-freedom of choice-by analyzing stories in Hygeia about the doctor-patient relationship. A textual analysis finds that the AMA's justification in the 1930s-40s against socialized medicine, i.e., the freedom to choose a doctor, was in practice highly controlled by the medical profession. Findings show that long before the rhetoric of the "empowered consumer" became popular, some patients exercised some choice even in an era when physicians achieved total professional dominance. But these patients were few and tend to occupy the upper socioeconomic strata of US society. In reality choice was an illusion in a fee-for-service era when most American families could not afford the costs of medical care.
Xu, Weiwei; Van de Ven, Wynand P M M
The Chinese government is considering a (regulated) competitive healthcare system. Sufficient consumer information is a crucial pre-condition to benefit from such a change. We conducted a survey on the level of consumer information regarding health insurance among the insured population in Nanjing, China in 2009. The results from descriptive analysis and binary logistic regression demonstrate that the current level of consumer information about health insurance is low. The level of consumer information is positively correlated with the subscribers' motivation to obtain the information and its availability. The level of searching for health insurance information is also low; moreover, even upon searching, the chance of finding relevant information is less than 25%. We conclude that the level of consumer information is currently insufficient in China. If the Chinese government is determined to adopt market mechanisms in the healthcare sector, it should take the lead in making valid and reliable information publicly available and easily accessible.
Mills, Robert J.
This report uses data from the U.S. Census Bureau's March 2001 Current Population Survey to examine health insurance coverage. The number and percentage of people covered by employment-based health insurance rose significantly in 2000, driving the overall increase in health insurance coverage. Among the entire population age 18-64 years, workers…
MacGeorge, Erina L.; Samter, Wendy; Gillihan, Seth J.
Academic stress is associated with a variety of negative health outcomes, including depression and physical illness. The current study examined the capacity of supportive communication reported as being received from friends and family to buffer the association between academic stress and health. College students completed measures of academic…
Caron, Eduardo; Lefèvre, Fernando; Lefèvre, Ana Maria Cavalcanti
In this paper, the question of Brazil's insertion today as a country with the characteristics of modern consumer societies is discussed, focusing on the commercialization of the health sector, the segmentation of the health system and the contradictions of the rights to health care in the social context in question. Some research data on these issues broadcast in the National News Bulletins of Globo TV during the year of 2012 are presented, in which the high technology private hospital as a consumer icon, the underfunding of the public health system and the rejection of a poor and deprived Unified Health System are analyzed.
Background The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand. Objective The aim of this study is to understand the factors that drive individuals to adopt EHR portals. Methods We applied a new adoption model using, as a starting point, Ventkatesh's Unified Theory of Acceptance and Use of Technology in a consumer context (UTAUT2) by integrating a new construct specific to health care, a new moderator, and new relationships. To test the research model, we used the partial least squares (PLS) causal modelling approach. An online questionnaire was administrated. We collected 360 valid responses. Results The statistically significant drivers of behavioral intention are performance expectancy (beta=.200; t=3.619), effort expectancy (beta=.185; t=2.907), habit (beta=.388; t=7.320), and self-perception (beta=.098; t=2.285). The predictors of use behavior are habit (beta=0.206; t=2.752) and behavioral intention (beta=0.258; t=4.036). The model explained 49.7% of the variance in behavioral intention and 26.8% of the variance in use behavior. Conclusions Our research helps to understand the desired technology characteristics of EHR portals. By testing an information technology acceptance model, we are able to determine what is more valued by patients when it comes to deciding whether to adopt EHR portals or not. The inclusion of specific constructs and relationships related to the health care consumer area also had a significant impact on understanding the adoption of EHR portals. PMID:26935646
Background We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. Methods We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. Results In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. Conclusions We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply transformed the sector
Schlenker, Eleanor D.
Analysis of research on food, nutrition, and health in the Journal of Family and Consumer Sciences and Family and Consumer Sciences Research Journal 1985-2000 (n=172) identified four categories: (1) changes in dietary standards and nutrient requirements; (2) public policy and guidance on nutrition; (3) food behavior and nutrition intervention; and…
Montgomery, Ruth; Rider, Mary Ellen
Uses ecological systems theory as a foundation for integrating health care and its public policy issues into family and consumer sciences classrooms. Offers teachers alternative perspectives on consumer behavior changes and needs in heath care systems and policies. Contains 24 references. (JOW)
Fraser, Mark W.; Wu, Shiyou
This article reviews the origins, conceptual bases, psychometric properties, and limitations of consumer satisfaction measures in social welfare and behavioral health. Based on a systematic review of research reports published between 2003 and 2013, we identify 58 consumer satisfaction measures. On average, these measures have acceptable…
Sabourin, Stephane; And Others
Determined strength of relationship between social desirability, psychological distress, and consumer satisfaction with mental health treatment in 82 clients in therapy. Results indicated that both consumer satisfaction reports and psychological distress scores were contaminated by socially desirable responding. (Author/ABL)
understanding, and intellectual curiosity, this process would have been a much lonelier and more stressful experience. I feel especially indebted to my...39 3.4. Mean Values of Scales at Baseline ........................... 40 3.5. Mean Values of Scales at One Year...Support Only .............................. . ......................... .. 53 4.4. Outcome: Health Status; Scale Combining Social Support and Social
Leach, Matthew J
Background • Consumers' interest in complementary and alternative medicine (CAM) has escalated in the past few decades. Some observers argue that the changing needs and expectations of consumers are driving the surge. Although some studies support that notion, much of the research has been limited methodologically. Profiling can provide important insights into the distinct needs of CAM consumers. Objective • The study intended to profile consumers of CAM in Australia. Design • The study was a secondary analysis of 5 Australian National Health Surveys conducted between 1989 and 2008. Outcome Measures • The study measured the differences between CAM users and nonusers in terms of: (1) predisposing factors (ie, the prevailing conditions that predispose an individual to use a health service, such as age); (2) enabling factors (ie, circumstances that facilitate or hinder health service use, such as income); (3) need factors (ie, an actual or perceived need for health services, such as poor health); and (4) personal health practices (ie, behaviors that influence health status, such as alcohol consumption). Results • The 5 surveys provided data for 181 549 Australian adults and children. Predisposing factors associated with CAM use were (1) being aged >40 y, (2) being female, (3) being married, and (4) holding a postsecondary school qualification. Significant enablers of CAM use were (1) high income, (2) private health insurance, and (3) employment. As for personal health practices, CAM users had significantly higher odds of (1) being physically active, (2) being a nonsmoker, and (3) meeting national recommendations for intake of fruits and vegetables. The prevalence of chronic disease and the use of pharmaceutical agents and health services were comparatively high among CAM users. Conclusions • CAM consumers reported relatively healthier lifestyles compared with nonusers, although some data indicated that CAM users might have greater health care needs. The
Owen, Carol L.
Health planning in the United States is rapidly approaching a fork in the policy road, with one direction leading the nation toward a universal plan with strong government involvement and the other direction strengthening existing market-based reforms and preserving a commercial health insurance industry. "Consumer-driven health care," a slogan…
Pegg, S; Moxham, L
Over the last two decades in Australia, the deinstitutionalization process, which began with the intent of moving consumers of mental health services from in-patient facilities and then seeking to integrate these same individuals into the community, has served to highlight a wide range of consumer needs that have remained largely unfulfilled throughout the process. One such need has been the provision of appropriate therapeutic recreation programs for the community based consumers of the various state co-ordinated mental health services. This paper argues a case for a change in the approach which professional staff provide and lead therapeutic recreation based programs to enable participants to be empowered, rather than disempowered, through their involvement. Further, this paper contends that there is a need for health care staff, more generally, to accept the concept of such programs for the community based consumers of various mental health services as a valued one.
Osborn, Lawrence A; Stein, Catherine H
The present qualitative study examined community mental health providers' accounts of their therapeutic interactions with adults with serious mental illness in a recovery-oriented model of care. Ten long-time mental health care providers discussed their understanding of recovery principles, their use of directive practices, and factors that shape their work with consumers. Content analysis of mental health providers' accounts suggest that providers had no difficulty articulating basic principles of recovery-oriented care. Providers reported engaging in directive practices with consumers and described using traditional clinical factors such as level of functioning, degree of psychiatric symptoms, safety concerns, and legal status to assess consumers' ability for autonomous decision making. Providers generally did not express tension between their views of mental health recovery and their beliefs about utilizing directive approaches with consumers. Implications of present findings for research and practice are discussed.
current patient education programs; to determine educational methodologies used for current patient education programs; to determine resources, both...technological and personnel, used for current patient education programs; to systematically identify local consumer health education needs from input by
Yura-Petro, H; Scanelli, B R
In summary, consumers desire health care professionals with interpersonal communication skills; with ability to interpret nonverbal communication or body language beyond gross facial gestures; and with effective questioning techniques for taking family histories quickly and accurately yet uncovering some client feelings and life-style difficulties in the process. Consumers want health care professionals who know how to mobilize clients' personal healing resources through greater understanding of how the immune system functions and who know how to deliver difficult diagnoses to clients in a positive, challenging manner and involve the clients in the course of their own body's healing. They desire significantly more information and guidelines about nutrition, weight management, and the complex biochemical interactions associated with food, medication, and the combination of the two. Consumers want health care professionals with greater understanding of sleep and its effect on health and of biofeedback, hypnosis, exercise, meditation, relaxation, and support groups as disease-fighting tools. The genetic components of illness and wellness and how clients cope with some of the built-in genetic weaknesses must receive greater attention. The influence of the environment and pollutants on human health must be addressed. How to maintain health among an aging population, and utilizing norm data that is age specific, gender specific, and developmentally and socioculturally specific is essential to address. An emphasis shift is necessary towards healing and wellness. When we do all this, we still have to make it cost effective. What a challenge! How then can health care professionals be where the consumer wants them to be? How can professionals be responsive to their own human needs as well as those of the consumer? How can the faculty preparing health care professionals incorporate the dimensions outlined by futurists and by consumers by the year 2000? The answer lies in the
Kanchense, Jane Handina Murigwa
The primary health care model of public health has been implemented in many countries around the globe since the Declaration of Alma Ata in 1978, without pilot testing the primary health care model. Therefore, many public health researchers have sought methods of improving primary health care by creating evidence-based models. Many of these researchers recognize the role of behavioral models in public health. These offshoots of primary health care include the ecological, care, central human capabilities, and the SPECIES models. Holistic self-management education and support is a capacity-building philosophy that ensures active involvement of consumers of health care in the planning and implementation and evaluation of health care services. It helps consumers of health care to achieve the desired improved quality of health and life in managing and sustaining their health at the grassroots level. The care model addresses disease management ideals of the in the original primary health care model. The SPECIES model addresses those aspects of the primary health care model that include the cultural and social factors, as well as individual health education and support in the original primary health care model. The ecological model offers an improvement of the socioeconomic ideal in the original primary health care model. Improving the health of individuals will prevent illness, thereby reducing health care costs and lessening the current strain on an overburdened health care system in Zimbabwe. Holistic self-management education and support links health care delivery systems with social processes. It is a best practices model that could better serve Zimbabwean girls and women by contributing positively to the national challenges in health care, thereby meeting the Zimbabwean primary health care and safe motherhood goals. It is here recommended that holistic self-management education and support must be pilot tested before being adopted as the most appropriate model for
Bird, Victoria J.; Le Boutillier, Clair; Leamy, Mary; Larsen, John; Oades, Lindsay G.; Williams, Julie; Slade, Mike
Strengths assessments focus on the individual's talents, abilities, resources, and strengths. No systematic review of strengths assessments for use within mental health populations has been published. The aims of this study were to describe and evaluate strengths assessments for use within mental health services. A systematic review identified 12…
Harris-Kojetin, L D; McCormack, L A; Jaël, E F; Sangl, J A; Garfinkel, S A
OBJECTIVE: Social marketing techniques such as consumer testing have only recently been applied to develop effective consumer health insurance information. This article discusses lessons learned from consumer testing to create consumer plan choice materials. DATA SOURCES/STUDY SETTING: Data were collected from 268 publicly and privately insured consumers in three studies between 1994 and 1999. STUDY DESIGN: Iterative testing and revisions were conducted to design seven booklets to help Medicaid, Medicare, and employed consumers choose a health plan. DATA COLLECTION METHODS: Standardized protocols were used in 11 focus groups and 182 interviews to examine the content, comprehension, navigation, and utility of the booklets. PRINCIPAL FINDINGS: A method is suggested to help consumers narrow their plan choices by breaking down the process into smaller decisions using a set of guided worksheets. CONCLUSION: Implementing these lessons is challenging and not often done well. This article gives examples of evidence-based approaches to address cognitive barriers that designers of consumer health insurance information can adapt to their needs. Images Figure. 3 PMID:11482584
Palmisano, Donald J; Emmons, David W; Wozniak, Gregory D
Recent reports showing an increase in the number of uninsured individuals in the United States have given heightened attention to increasing health insurance coverage. The American Medical Association (AMA) has proposed a system of tax credits for the purchase of individually owned health insurance and enhancements to individual and group health insurance markets as a means of expanding coverage. Individually owned insurance would enable people to maintain coverage without disruption to existing patient-physician relationships, regardless of changes in employers or in work status. The AMA's plan would empower individuals to choose their health plan and give patients and their physicians more control over health care choices. Employers could continue to offer employment-based coverage, but employees would not be limited to the health plans offered by their employer. With a tax credit large enough to make coverage affordable and the ability to choose their own coverage, consumers would dramatically transform the individual and group health insurance markets. Health insurers would respond to the demands of individual consumers and be more cautious about increasing premiums. Insurers would also tailor benefit packages and develop new forms of coverage to better match the preferences of individuals and families. The AMA supports the development of new health insurance markets through legislative and regulatory changes to foster a wider array of high-quality, affordable plans.
Contemporary health care increasingly dictates that consumers of services should become active participants in the health care system. This has placed responsibility on administrators, managers and clinicians to include consumers in key strategic and decision making initiatives. However, this direction has not been accompanied by clear policies or guidelines. Consequently confusion about selecting consumers able to provide valuable input is identified as a barrier to active consumer involvement. The purpose of this paper is to address some concerns raised in the quest to find the "right" consumer, including: finding a consumer without an axe to grind; ensuring the consumer is representative of broader views; health professionals as consumer representatives. While these concerns are common they have not yet been extensively debated and discussed in the broader Literature. Strategies necessary to support consumers in participatory roles are also considered and the controversial subject of financial remuneration for consumers is also explored.
Health care consumers increasingly obtain health information from the Internet to inform their health care; the health care consumer, who also has the role of patient, maintains the right to access information from sources of their choosing for this purpose. However, noteworthy considerations exist including information appraisal skills, health literacy and the patient-provider relationship. Awareness and education are warranted to assist the health care consumer in achieving proficiency as they turn to the Internet for health information. PMID:23569625
van Dijk, Heleen; Fischer, Arnout R H; Honkanen, Pirjo; Frewer, Lynn J
Knowledge about differences in consumer perceptions of health risks and benefits related to fish consumption is important for the development of targeted health interventions associated with dietary choice. The purpose of this study is to identify individual differences in Russian consumers according to their perceptions of health risks and benefits associated with fish consumption. By application of a cluster analysis on perceptions of personal risks and benefits associated with the consumption of fish, four groups of Russian consumers were classified as: very positive; positive; moderately positive; and 'high risk-high benefit' about the healthiness of fish consumption. Differences in perceptions of personal risks and benefits across consumers were related to self-reported fish consumption, optimism about personal risks and benefits, and optimism about personal knowledge about risks and benefits. Implications for the development of targeted health interventions to influence perceptions of risks and benefits associated with fish consumption, and ultimately fish consumption, are discussed. It is concluded that optimism regarding perceptions and knowledge of health risks, and health benefits should be taken into account when developing interventions aimed at consumer health.
Roberts, Kirk; Boland, Mary Regina; Pruinelli, Lisiane; Dcruz, Jina; Berry, Andrew; Georgsson, Mattias; Hazen, Rebecca; Sarmiento, Raymond F; Backonja, Uba; Yu, Kun-Hsing; Jiang, Yun; Brennan, Patricia Flatley
The field of biomedical informatics experienced a productive 2015 in terms of research. In order to highlight the accomplishments of that research, elicit trends, and identify shortcomings at a macro level, a 19-person team conducted an extensive review of the literature in clinical and consumer informatics. The result of this process included a year-in-review presentation at the American Medical Informatics Association Annual Symposium and a written report (see supplemental data). Key findings are detailed in the report and summarized here. This article organizes the clinical and consumer health informatics research from 2015 under 3 themes: the electronic health record (EHR), the learning health system (LHS), and consumer engagement. Key findings include the following: (1) There are significant advances in establishing policies for EHR feature implementation, but increased interoperability is necessary for these to gain traction. (2) Decision support systems improve practice behaviors, but evidence of their impact on clinical outcomes is still lacking. (3) Progress in natural language processing (NLP) suggests that we are approaching but have not yet achieved truly interactive NLP systems. (4) Prediction models are becoming more robust but remain hampered by the lack of interoperable clinical data records. (5) Consumers can and will use mobile applications for improved engagement, yet EHR integration remains elusive.
Harada, Ken; Sugisawa, Hidehiro; Sugihara, Yoko; Yanagisawa, Shizuko; Shimmei, Masaya
This study examined the additive effects of social support and negative interactions in various relationship domains and the cross-domain buffering effects of social support on the detrimental impact of negative interactions on mental health among older adults in Japan. Data were obtained from a survey of residents of 30 municipalities in the Tokyo metropolitan area ( N = 1,592). The results indicated that family members living together may share ambivalent social ties, anchored in positive sentiments and serving as sources of support but where criticism and excessive demands may occur. We found that negative interactions had a more potent additive effect on mental health. Moreover, the interaction effects of negative interactions with family and social support from other relatives suggested reverse buffering. Our findings suggest that interventions might be more necessary to cope with the negative social exchanges of close kin relationships among the elderly Japanese.
van Kleef, Ellen; van Trijp, Hans C M; Luning, Pieternel
Two studies are reported, which aim to strengthen the scientific underpinning of strategic decisions regarding functional food development, as to (1) which health benefits to claim, (2) with which product (category), and (3) in which communication format. The first exploratory study is a secondary analysis of 10 different health claims systematically combined with 10 different food carriers to evaluate their combined suitability for functional food positioning. The results show that consumers tend to prefer functional food concepts that primarily communicate disease-related health benefits in carriers with a healthy image or health positioning history. Study 2 examines health claim format and systematically varies the way in which specific health benefits are being communicated to the consumer. Two physiologically oriented claims (heart disease and osteoporosis) and two psychologically oriented food claims (stress and lack of energy) are expressed in enhanced function format versus disease risk reduction format. Also, it includes the individual difference variable of 'regulatory focus' and the health status of the respondent to explore how these factors impact health claim evaluation. The results show that consumer evaluations primarily differ to the extent that health claims are personally relevant in addressing an experienced disease state. Framing is important, but its effect differs by health benefit. No strong effects for consumers' regulatory focus were found. Underlying mechanisms of these effects and their implications for the development of functional foods are discussed.
Martin, Laurie T; Luoto, Jill E
To date, most Affordable Care Act implementation efforts have focused on getting individuals enrolled in health insurance coverage; indeed, millions of Americans, many of whom had never been insured, have since obtained health coverage, either through the health insurance marketplaces or through expanded Medicaid eligibility, if available in their state. Yet reducing the number of uninsured is only part of the law's goal. It also aims to improve population health and lower health care costs. Less attention has been paid to confirming that the newly insured obtain appropriate health care and maintain long-term relationships with their health care providers, which are critical steps to help achieve these latter goals. This article describes lessons learned from conversations with a variety of stakeholders in the health care industry. These conversations covered the gamut of steps consumers must undergo to become fully engaged with their health care, from applying for coverage and selecting a plan to finding a provider, accessing care, and engaging in care over time. In each phase of the process, consumers must take specific actions and overcome new challenges. Stakeholder efforts to help consumers often focus on just one of these phases, at the expense of the bigger picture, and often occur in isolation, with little coordination across stakeholder groups. Thinking more strategically and holistically can help provide the "connective tissue" that can help prevent consumers from becoming disengaged and falling through the system's cracks.
Haviland, Amelia M; Marquis, M Susan; McDevitt, Roland D; Sood, Neeraj
Enrollment is increasing in consumer-directed health insurance plans, which feature high deductibles and a personal health care savings account. We project that an increase in market share of these plans--from the current level of 13 percent of employer-sponsored insurance to 50 percent--could reduce annual health care spending by about $57 billion. That decrease would be the equivalent of a 4 percent decline in total health care spending for the nonelderly. However, such growth in consumer-directed plan enrollment also has the potential to reduce the use of recommended health care services, as well as to increase premiums for traditional health insurance plans, as healthier individuals drop traditional coverage and enroll in consumer-directed plans. In this article we explore options that policy makers and employers facing these challenges should consider, including more refined plan designs and decision support systems to promote recommended services.
Lee, Soung; Brunero, Scott; Fairbrother, Greg; Cowan, Darrin
Public mental health systems have been called on to better meet the needs of consumers presenting to health services with the police, yet few studies have examined police presentations among mental health consumers in large public mental health systems. This study was designed to determine the frequency profile and characteristics of consumers of mental health services brought in by police to an emergency department (ED) in Sydney, Australia. Using data from the emergency department information system and obtaining the psychiatric assessment from the medical record, we have examined trends and characteristics in mental health presentations brought in by the police to a general ED between 2003 and 2005. The sample consisted of 542 consumers with a mental health problem brought in by the police to the ED of a 350-bed community hospital. The characteristics of this group were compared with those of all mental health related ED presentations for the same period using logistic regression. Results indicated that police presentations are likely to be young males who are unemployed, have past and present alcohol and other drugs use, present after hours, and are admitted to hospital as a result of their presentation. These consumers are likely to have a presenting problem of a psychotic disorder, less likely to have a presenting problem of depression and/or anxiety, and given a triage code of three or higher. The study results highlight the importance of the availability of 24-hour access to mental health care to ensure a quick care delivery response. Police presentations to EDs with mental health issues are an indicator of significant impact on health services, especially with the current overcrowding of EDs and the associated long waiting times. Systems need to be developed that facilitate collaboration between EDs, hospital security, police services, mental health, and ambulance services.
Musaiger, Abdulrahman O
This study aimed to investigate gender differences in the fast food intake, health attitudes, and perceptions of fast food among adult Arab consumers aged 19 to 65 years in Kuwait. A total of 499 consumers (252 males, 247 females) were selected at convenience from three shopping malls in Kuwait City. The consumers were interviewed using a specially designed questionnaire. The findings revealed that men were more frequently consumed fast food than women (p < 0.001). Men were significantly more likely to consume "double" burgers (52%) than women (29.9%) (P < 0.001). The great majority of consumers (95%) considered fast food harmful to health. However, the consumers were continued to intake fast food (92%), indicating that health information on fast food not necessarly affects their consumption. Local foods were more likely to be considered fast food if eaten as a sandwich or without a disposal container. It can be concluded that fast food perceptions are influenced by gender, media and socio-cultural factors. Nutrition education programmes should focus on nutritive values of the foods rather than on their "fast food" classification.
Free, Caroline; Phillips, Gemma; Galli, Leandro; Watson, Louise; Felix, Lambert; Edwards, Phil; Patel, Vikram; Haines, Andy
Background Mobile technologies could be a powerful media for providing individual level support to health care consumers. We conducted a systematic review to assess the effectiveness of mobile technology interventions delivered to health care consumers. Methods and Findings We searched for all controlled trials of mobile technology-based health interventions delivered to health care consumers using MEDLINE, EMBASE, PsycINFO, Global Health, Web of Science, Cochrane Library, UK NHS HTA (Jan 1990–Sept 2010). Two authors extracted data on allocation concealment, allocation sequence, blinding, completeness of follow-up, and measures of effect. We calculated effect estimates and used random effects meta-analysis. We identified 75 trials. Fifty-nine trials investigated the use of mobile technologies to improve disease management and 26 trials investigated their use to change health behaviours. Nearly all trials were conducted in high-income countries. Four trials had a low risk of bias. Two trials of disease management had low risk of bias; in one, antiretroviral (ART) adherence, use of text messages reduced high viral load (>400 copies), with a relative risk (RR) of 0.85 (95% CI 0.72–0.99), but no statistically significant benefit on mortality (RR 0.79 [95% CI 0.47–1.32]). In a second, a PDA based intervention increased scores for perceived self care agency in lung transplant patients. Two trials of health behaviour management had low risk of bias. The pooled effect of text messaging smoking cessation support on biochemically verified smoking cessation was (RR 2.16 [95% CI 1.77–2.62]). Interventions for other conditions showed suggestive benefits in some cases, but the results were not consistent. No evidence of publication bias was demonstrated on visual or statistical examination of the funnel plots for either disease management or health behaviours. To address the limitation of the older search, we also reviewed more recent literature. Conclusions Text
Grubb, Reba Douglass; And Others
Text, illustrations and exercises are utilized in these six learning modules to instruct patients in the treatment of special health care problems. The first module, "A Bladder Emptying Routine for the Incontinent Patient" by Reba Douglass Grubb, describes methods for reestablishing bladder control. The second module, "Care of the…
Sen. Rockefeller, John D., IV [D-WV
05/14/2009 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S5524-5527) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Zhang, Guo-Qiang; Wentz, Susan; Cui, Licong; Xu, Rong
Background There has been a significant increase in the popularity of Web-based question-and-answer (Q&A) services that provide health care information for consumers. Large amounts of Q&As have been archived in these online communities, which form a valuable knowledge base for consumers who seek answers to their health care concerns. However, due to consumers’ possible lack of professional knowledge, it is still very challenging for them to find Q&As that are closely relevant to their own health problems. Consumers often repeatedly ask similar questions that have already been answered previously by other users. Objective In this study, we aim to develop efficient informatics methods that can retrieve similar Web-based consumer health questions using syntactic and semantic analysis. Methods We propose the “SimQ” to achieve this objective. SimQ is an informatics framework that compares the similarity of archived health questions and retrieves answers to satisfy consumers’ information needs. Statistical syntactic parsing was used to analyze each question’s syntactic structure. Standardized Unified Medical Language System (UMLS) was employed to annotate semantic types and extract medical concepts. Finally, the similarity between sentences was calculated using both semantic and syntactic features. Results We used 2000 randomly selected consumer questions to evaluate the system’s performance. The results show that SimQ reached the highest precision of 72.2%, recall of 78.0%, and F-score of 75.0% when using compositional feature representations. Conclusions We demonstrated that SimQ complements the existing Q&A services of Netwellness, a not-for-profit community-based consumer health information service that consists of nearly 70,000 Q&As and serves over 3 million users each year. SimQ not only reduces response delay by instantly providing closely related questions and answers, but also helps consumers to improve the understanding of their health concerns
Larweh, Benjamin Teye
Background There is a growing interest concerning the potential of ICT solutions that are customized to consumers. This emerging discipline referred to as consumer health informatics (CHI) plays a major role in providing information to patients and the public, and facilitates the promotion of self-management. The concept of CHI has emerged out of the desire of most patients to shoulder responsibilities regarding their health and a growing desire of health practitioners to fully appreciate the potential of the patient. Aim To describe the role of ICT in improving the patient-provider partnership in consumer health informatics. Methods Systematic reviewing of literature, identification of reference sources and formulation of search strategies and manual search regarding the significance of developed CHI applications in healthcare delivery. Results New consumer health IT applications have been developed to be used on a variety of different platforms, including the Web, messaging systems, PDAs, and cell phones. These applications assists patients with self-management through reminders and prompts, delivery of real-time data on a patient’s health condition to patients and providers, web-based communication and personal electronic health information. Conclusion New tools are being developed for the purposes of providing information to patients and the public which has enhanced decision making in health matters and an avenue for clinicians and consumers to exchange health information for personal and public use. This calls for corroboration among healthcare organizations, governments and the ICT industry to develop new research and IT innovations which are tailored to the health needs of the consumer. PMID:25422724
Amarra, Ma Sofia V; Yee, Yeong Boon; Drewnowski, Adam
Food consumption patterns in Asia are rapidly changing. Urbanization and changing lifestyles have diminished the consumption of traditional meals based on cereals, vegetables and root crops. These changes are accompa-nied by an increasing prevalence of chronic diseases among Asian populations. ILSI Southeast Asia and CSIRO, Australia jointly organized the Symposium on Understanding and Influencing Food Behaviours for Health, focusing on the use of consumer science to improve food behaviour. The goals of the Symposium were to present an understanding of Asian consumers and their food choices, examine the use of consumer research to modify food choices towards better health, illustrate how health programs and food regulations can be utilized effectively to promote healthier choices, and identify knowledge gaps regarding the promotion of healthy food behaviour in Asian populations. There is no difference in taste perception among Asians, and Asian preference for certain tastes is determined by exposure and familiarity largely dictated by culture and its underlying values and beliefs. Cross-cultural validity of consumer science theories and tools derived from western populations need to be tested in Asia. Information on consumption levels and substitution behaviours for foods and food products, obtained using consumer research methods, can guide the development of food regulations and programs that will enable individuals to make healthier choices. Existing knowledge gaps include consumer research techniques appropriate for use in Asian settings, diet-health relationships from consumption of traditional Asian diets, and methods to address the increasing prevalence of over- and undernutrition within the same households in Asia.
Merrell, Ronald C; Merriam, Nathaniel; Doarn, Charles
Health workers are trained to work in information-rich environments. Nineteen medical students evaluated 2700 patients in four villages in Kenya where there was no power or phone. A model of information support included personal digital assistants (PDA), electronic medical records (EMR), satellite telecommunications, medical software, and solar power. The students promptly found the advantages of PDA over paper. By using software for decision support and interacting with the EMR data for medical expertise, very few live telemedicine consults were needed. The cost of this information support was only US 0.28 dollars per patient visit. We conclude information resources can be provided in remote environments at reasonable cost.
Teichert, T; Mühlbach, C
Introduction: The aim of the study was to present a picture of consumers' views on the specific market of health and health products, the second German health market. Market analysis of the product categories was carried out. Methods: A large-scale representative survey (N=1 033) determined with an innovative adaptation of the repertory grid method the consumer's perspective on the specific market. Basic questions concerning attitudes to health as well as healthy behaviors completed the telephone survey. Results: In the saturated markets, market for health is growing, especially in the context of aging societies, and this is not limited to primary medical products. In this study, product categories such as "dental care", "fruit and vegetables" or "nuts" were classified as healthy products. Conclusion: The relevance of health also in the macroeconomic context has been long underestimated. Health has still a high priority for consumers. A disclosure of individual perceptions in the health context provides a significantly more relevant product design. The identification of healthy product dimensions from the consumer's perspective sheds light on the actually desired product properties and the available potential to meet these desires.
Lustig, Daniel C.; Strauser, David R.
Access to health insurance is one of the critical aspects of securing employment for people with disabilities. This study investigated whether vocational rehabilitation consumers secured employment with an employer who offered health insurance at similar rates to workers in the general population. In general, the results show that vocational…
Flaherty, Mary Grace
To better understand health information provision in the public library setting, two cooperative library systems that serve primarily rural populations in upstate New York were studied. The central library in one of those systems established a consumer health information center (CHIC) in 1999. In the other system, the central library does not have…
Polen, Hyla H; Khanfar, Nile M; Clauson, Kevin A
The pharmaceutical industry spends billions of dollars annually on direct-to-consumer advertising (DTCA). Patient perspectives on the impact of televised DTCA on health-related behaviors and issues were assessed by means of a 68-question survey. 58.6% of respondents believed that DTCA allowed consumers to have a more active role in managing their health. However, 27.6% felt DTCA caused confusion, and an alarming 17.8% of respondents stopped taking their medication because of concerns about serious side effects mentioned in DTCA. Overall, participants believed DTCA plays a useful role in health self-management; however, a considerable percentage thought that the cost outweighs the benefits.
Hopper, J A; Busbin, J W
America is undergoing a profound age shift in its demographic make-up with people 55 and over comprising an increasing proportion of the population. Marketers may need to increase their response rate to this shift, especially in refining the application of marketing theory and practice to older age consumers. To this end, a survey of older couple buying behavior for health insurance coverage is reported here. Results clarify evaluative criteria and the viability of multiple market segmentation for health care coverage among older consumers as couples. Commentary on the efficacy of present health coverage marketing programs is provided.
Goodchild, E Y; Furman, J A; Addison, B L; Umbarger, H N
CHIPS (Consumer Health Information Program and Services/Salud y Bienestar) is a Library Services and Construction Act Title I-funded project that has as its major goal the formation of a health information network to serve the consumer, the public library client, and the hospital patient. Funded for two years, 1976-1978, this bilingual project coordinates efforts of the Los Angeles County Harbor General Hospital Regional Medical Library and the Los Angeles County Carson Regional Public Library to provide health information resources and services to the public. The target population is over two million people of diverse ethnic backgrounds. This paper discusses the project's objectives and encourages an active role for all libraries in the consumer health education movement. PMID:708959
The involvement of mental health service users in service delivery is a new and growing phenomenon. Such involvement is complex, given the history of paternalism in the mental health system, the power differential between service providers and service users, and the very differing views each group holds on multiple issues. Unless such differences are addressed, there can be no meaningful involvement. Service user involvement needs to apply to all aspects of the service delivery system, including professional training, service design, delivery, evaluation, and research. User/survivors, and their organizations, have developed a body of experience and knowledge that needs to be recognized and respected. Unless there are multiple opportunities for ongoing and open dialogue on these many difficult issues, real user involvement will not occur.
Harris-Hollingsworth, Nicole Rosella
Academic Medical Centers across the United States provide health libraries on their web portals to disseminate health promotion and disease prevention information, in order to assist patients in the management of their own care. However, there is a need to obtain consumer input, consumer satisfaction, and to conduct formal evaluations. The purpose…
Carrol, N V; Gagon, J P
Because of increasing competition, it is becoming more important that health care providers pursue consumer-based market segmentation strategies. This paper presents a methodology for identifying and describing consumer segments in health service markets, and demonstrates the use of the methodology by presenting a study of consumer segments in the ambulatory care pharmacy market.
Cox, Barbara; Thornewill, Judah
The consumer/patient perspective is often forgotten as it pertains to the electronic health record. This paper focused on engaging the patient in the adoption of EHRs. The Louisville Health Information Exchange (LouHIE) recently completed an extensive research study on this topic, using several data gathering techniques to capture the interest, benefits, concerns and payment choices of the community. This article focuses on the findings of the study and the steps LouHIE will take to ensure consumer perspectives are being heard. Specific elements of the article include explaining the consumer research study and results; discussing the patient-related benefits of an EHR, the barriers, interests and the payment choices as described by the research group; and discussing action steps needed to continue engaging the consumer/patient in the adoption process.
Papadakos, Janet; Trang, Aileen; Wiljer, David; Mis, Chiara Cipolat; Cyr, Alaina; Friedman, Audrey Jusko; Mazzocut, Mauro; Snow, Michelle; Raivich, Valeria; Catton, Pamela
Objectives: The criteria for determining whether resources are included in consumer health library collections are summarized in institutional collection development policies (CDPs). Evidence suggests that CDPs do not adequately capture all of these criteria. The aim of this study was to describe the resource review experience of librarians and compare it to what is described in CDPs. Methods: A phenomenological approach was used to explore and describe the process. Four consumer health librarians independently evaluated cancer-related consumer health resources and described their review process during a semi-structured telephone interview. Afterward, these librarians completed online questionnaires about their approaches to collection development. CDPs from participating libraries, interview transcripts, and questionnaire data were analyzed. Researchers summarized the findings, and participating librarians reviewed results for validation. Results: Librarians all utilized similar criteria, as documented in their CDPs; however, of thirteen criteria described in the study, only four were documented in CDPs. Conclusions: CDPs for consumer health libraries may be missing important criteria that are considered integral parts of the collection development process. Implications: A better understanding of the criteria and contextual factors involved in the collection development process can assist with establishing high-quality consumer health library collections. PMID:24860261
This article examined the association between household consumer durable assets and maternal health-seeking behavior. Several studies have suggested a relationship between households' socioeconomic status (SES) and health outcomes. However, SES is a multidimensional concept that encompasses variables, such as wealth, education, and income. By grouping these variables together as one construct, prior studies have not provided enough insight into possible independent associations with health outcomes. This study used data from the 2008 Ghana Demographic and Health Survey of 2,065 women aged between 15 and 49 years to examine the association between household consumer durables (a component of SES) and maternal health-seeking behavior in Ghana. Results from a set of generalized linear models indicated that household consumer durable assets were positively associated with four measures of maternal health-seeking behaviors, namely, seeking prenatal care from skilled health personnel, delivery by skilled birth attendant, place of delivery, and the number of antenatal visits. Also, households with more assets whose residents lived in urban areas were more likely to use skilled health personnel before and during delivery, and at an approved health facility, compared those who lived in rural areas. Implications for health interventions and policies that focus on the most vulnerable households are discussed.
Yan, Yu-Hua; Kung, Chih-Ming; Fang, Shih-Chieh; Chen, Yi
Background: This study analyzed differences between transparency of information disclosure and related demands from the health service consumer’s perspective. It also compared how health service providers and consumers are associated by different levels of mandatory information disclosure. Methods: We obtained our research data using a questionnaire survey (health services providers, n = 201; health service consumers, n = 384). Results: Health service consumers do not have major concerns regarding mandatory information disclosure. However, they are concerned about complaint channels and settlement results, results of patient satisfaction surveys, and disclosure of hospital financial statements (p < 0.001). We identified significant differences in health service providers’ and consumers’ awareness regarding the transparency of information disclosure (p < 0.001). Conclusions: It may not be possible for outsiders to properly interpret the information provided by hospitals. Thus, when a hospital discloses information, it is necessary for the government to consider the information’s applicability. Toward improving medical expertise and information asymmetry, the government has to reduce the burden among health service consumers in dealing with this information, and it has to use the information effectively. PMID:28075362
Zayas-Cabán, Teresa; Marquard, Jenna L.; Radhakrishnan, Kavita; Duffey, Noah; Evernden, Dana L.
For consumer health informatics (CHI) interventions to successfully aid laypeople, the interventions must fit and support their health work. This paper outlines a scenario-based human factors assessment of a disease management CHI intervention. Two student users undertook a patient use case and another user followed a nurse use case. Each user completed pre-specified tasks over a ten-day trial, recorded challenges encountered while utilizing the intervention, and logged daily time spent on each task. Results show the scenario-based user testing approach helps effectively and systematically assess potential physical, cognitive, and macroergonomic challenges for end-users, rate the severity of the challenges, and identify mediation strategies for each challenge. In particular, scenario-based user testing aids in identifying challenges that would be difficult, if not impossible, to detect in a laboratory-based usability study. With this information, CHI interventions can be re-designed and/or supplemented, making the intervention more closely fit end-users’ work. PMID:20351947
Landström, Eva; Hursti, Ulla-Kaisa Koivisto; Becker, Wulf; Magnusson, Maria
The aim of the present study was to survey attitudes to and use of functional foods and to investigate which demographic variables and attitudes to diet and health predict consumption of functional foods among Swedish consumers. A questionnaire was developed and sent to 2000 randomly selected Swedish citizens aged between 17 and 75 years. A total of 972 (48%) responded, 53% were female and 44% male. Mean age was 45 years. The results revealed that 84% of respondents were familiar with the concept of functional foods; 83% had consumed/purchased at least one of the seven functional food products presented in the questionnaire. Of those who had consumed a functional food, 25% had perceived effect of it. Positive correlations were seen between consumers perceiving a personal reward from eating functional foods, having an interest in natural products and an interest in general health. Consumption/purchase of functional foods was related to beliefs in the effects of the products, having consumed nutraceuticals or dietary supplements, having a diet-related problem personally or in the family, and a high level of education. The characteristic Swedish functional food consumer has a high level of education, is health-conscious and interested in healthy foods and believes in the health effect of functional foods. Thus, factors other than demographics better explain consumption of FF. However, the study population may represent a more health-conscious segment of the Swedish population in general. Additional studies are therefore required to elucidate the attitudes and use of FF in different consumer groups.
Moran, Galia S; Westman, Kinneret; Weissberg, Esther; Melamed, Samuel
Personal goals/plans play a central role in personal recovery and psychiatric rehabilitation of persons with mental illnesses. Yet, few studies have explored whether perceiving practitioners' assistance towards the pursuit of goals are associated with personal recovery and other favorable rehabilitation outcomes. A total of 2121 mental health consumers, of which 1222 use supported-housing services and 899 use group-home services, completed self-report questionnaires as part of a larger quality-assurance study conducted during the years 2013-2014. Eighty percent of participants living in supported-housing and 72% living in group-homes reported having personal goals/plans for the forthcoming year. Furthermore, their type of goals was different. Irrespective of the type of goal or housing service, participants who reported having goals/plans (compared with those who did not) showed higher levels of personal recovery and more favorable psychosocial outcomes. Regression analyses showed that perceiving professional staff members (but not para-professionals) as assisting in pursuing goals/plans was positively associated with personal recovery. This study empirically validates the value of having personal goals and professionals' assistance in pursuing goals/plans in regards to personal recovery. We propose that recovery-oriented services should seek to enhance goal setting and goal-pursuit, and to train practitioners in these areas.
This paper seeks to explore and understand the role of health visitor mentors undertaking a mentoring responsibility for specialist community public health nurses. During the unprecedented round of health visitor training, responsibility for the direct management of this role has been devolved from practice teachers to mentors. A qualitative approach using a purposive sample of eight participants and a semi-structured interview was the chosen method. Simple qualitative analysis was undertaken allowing data to be compared and themes identified. The overarching theme within this study was 'powerlessness'; mentors felt they had no say in adopting this role which was imposed upon them. Sub-themes included 'preparedness' relating to their perceived lack of appropriate training, and 'emotional support', which identified inadequate support from managers, while good levels of support were experienced by most mentors from their colleagues. Finally, 'compromising' related to difficulties associated with managing client care, student education and family responsibilities, achieved through prioritising and working overtime. In conclusion, the paper suggests that mentors need further support that acknowledges the pressure of the dual role, and standards for professional development of mentors need to be developed.
Al-Kandari, Yagoub Y; Crews, Douglas E
The aim of this study was to examine differences in several aspects of health between Kuwaiti men and women aged 60 years and over across three age categories (60-69, 70-79, 80+ years). The relationships between several social support variables, somatic symptoms and systolic and diastolic blood pressures were examined. A total of 1427 adult men (472) and women (955) aged 60 years and over representing all six governorates were selected. Data were collected during 2008-2009 by interview and completion of a questionnaire by participants in their own homes, after obtaining their informed consent. The Social Support Scale (SSS), Frequency of Contact Scale (FOC), Strength of Relations (SOR), Somatic Symptoms Inventory (SSI) and self-rated scales of general health were included. Systolic and diastolic blood pressures were measured. The data show that self-rated health and health in the last year differ significantly across age groups. Glycaemia differed significantly across the three age groups for the total sample. Systolic and diastolic blood pressure were higher in older respondents than younger ones, but no significant differences were observed between men and women. No significant differences in somatic symptoms were observed across the three age groups. Strength of relationship, frequency of contact, social support and children living with an elderly adult were all associated with fewer somatic symptoms, and all, except social support, were associated with lower systolic and diastolic blood pressure. Having children, the perception of social support, frequency of contact with, and strength of, relationships with kin are important modulators of somatic symptoms and blood pressure among elderly Kuwaitis.
Darst, Burcu F.; Madlensky, Lisa; Schork, Nicholas J.; Topol, Eric J.; Bloss, Cinnamon S.
Purpose To evaluate the characteristics of direct-to-consumer (DTC) genomic test consumers who spontaneously shared their test results with their health care provider. Methods Utilizing data from the Scripps Genomic Health Initiative we compared demographic, behavioral, and attitudinal characteristics of DTC genomic test consumers who shared their results with their physician or health care provider versus those who did not share. We also compared genomic risk estimates between the two groups. Results Of 2024 individuals assessed at approximately 6 months post-testing, a total of 540 individuals (26.5%) reported sharing their results with their physician or health care provider. Those who shared were older (p<.001), had a higher income (p=.01), were more likely to be married (p=.005), and more likely to identify with a religion (p=.004). As assessed prior to undergoing testing, sharers also showed higher exercise (p=.003) and lower fat intake (p=.02), and expressed fewer overall concerns about testing (p=.001) and fewer concerns related to the privacy of their genomic information (p=.03). The genomic disease risk estimates disclosed were not associated with sharing. Conclusion In a DTC genomic testing context, physicians and other health care providers may be more likely to encounter patients who are more health conscious and have fewer concerns about the privacy of their genomic information. Genomic risk itself does not appear to be a primary determinant of sharing behavior among consumers. PMID:23384116
The Tohoku-Pacific Ocean Earthquake, which occurred on March 11, 2011, caused serious damage and resulted in numerous fatalities and almost 20,000 missing persons. Furthermore, a major accident accompanied by exudation of radioactive material occurred in the Fukushima Daiichi Nuclear Power Plant. A statement regarding the victims' mental health was issued by the Japanese Society of Psychiatry and Neurology on May 21, 2011, which established the Department of Disaster Psychiatry for the provision and assurance of long-term mental care support for the victims. The Department of Disaster Psychiatry was consequently reformed in April 2012, focusing on the following objectives: to verify the validity of current mental support methods; to ensure disaster psychiatry and medical care in Japan; and to promote human resource development that can respond to future large-scale disasters. Mental health support for disaster victims is of highest priority. However, the mental health of relief personnel, who act as front liners during disasters (i. e., police officers, fire fighters, Self-Defense Forces, and health care workers), has often been neglected. Therefore, countermeasures for the problems faced by relief personnel are indispensable for a more effective reconstruction. Volunteers are also important members of the disaster relief team and they have witnessed the actual tragedy, and some have experienced burnout. Thus, they require sufficient mental health support, as do relief personnel. We thought that the mental health of disaster relief personnel is an important issue; thus, we report their mental health needs, the systematic correspondence to disaster stress, and our works for relief assistance. As first responders, relief personnel even without prior disaster education proceed to the area of disaster and may get injured. We therefore suggest that prior to the occurrence of any disaster, networking, education, and disaster awareness should be advocated among relief
Entwistle, Vikki; Calnan, Michael; Dieppe, Paul
Interest in consumer involvement in health services research started to gain momentum at around the same time that the MRC Health Services Research Collaboration (HSRC) was established. Consumer involvement was not the focus of a formal research programme within the HSRC, but HSRC members took opportunities to conduct three projects relating to consumer involvement in research agenda-setting activities. These were: (1) a comparison of the focus of published research relating to the management of osteoarthritis of the knee with clinicians' and patients' ideas about research priorities; (2) a survey that examined the consumer involvement policies of public- and voluntary-sector organizations that fund health services research in the UK; and (3) a citizens' jury that was convened to develop priorities for research relating to primary health and social care in the Bristol area. This paper reviews the findings of these projects and highlights the continued need for attention to underlying values in the development and evaluation of future efforts to involve consumers in research agenda setting.
Both the need and potential for market segmentation in the health care industry have grown substantially. Social class, a consumer behavior construct applied widely in other marketing contexts, may be useful as a basis for health care segmentation. Using a random sample of 997 households in the Pacific Northwest, the author investigates health care attitudes and behaviors across social class groups. Social class is found to be related positively and significantly to several aspects of health care, including personal health, interest, expenditures, satisfaction, and switching behavior.
Chaet, Alexis V; Morshedi, Bijan; Wells, Kristen J; Barnes, Laura E
Background As consumer health information technology (IT) becomes more thoroughly integrated into patient care, it is critical that these tools are appropriate for the diverse patient populations whom they are intended to serve. Cultural differences associated with ethnicity are one aspect of diversity that may play a role in user-technology interactions. Objective Our aim was to evaluate the current scope of consumer health IT interventions targeted to the US Spanish-speaking Latino population and to characterize these interventions in terms of technological attributes, health domains, cultural tailoring, and evaluation metrics. Methods A narrative synthesis was conducted of existing Spanish-language consumer health IT interventions indexed within health and computer science databases. Database searches were limited to English-language articles published between January 1990 and September 2015. Studies were included if they detailed an assessment of a patient-centered electronic technology intervention targeting health within the US Spanish-speaking Latino population. Included studies were required to have a majority Latino population sample. The following were extracted from articles: first author’s last name, publication year, population characteristics, journal domain, health domain, technology platform and functionality, available languages of intervention, US region, cultural tailoring, intervention delivery location, study design, and evaluation metrics. Results We included 42 studies in the review. Most of the studies were published between 2009 and 2015 and had a majority percentage of female study participants. The mean age of participants ranged from 15 to 68. Interventions most commonly focused on urban population centers and within the western region of the United States. Of articles specifying a technology domain, computer was found to be most common; however, a fairly even distribution across all technologies was noted. Cancer, diabetes, and child
Background eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information technology (IT) designs may not accommodate the needs, skills, cognitive capacities, and/or contexts of use of the intended broader population of health consumers. This may result in challenges for consumers who use the health IT systems, and could lead to limitations in adoption if the diversity of user attributes has not been adequately considered by health IT designers. Objective The objective of this paper is to propose how users’ needs and competences can be taken into account when designing new information and communications technology solutions in health care by expanding the user-task-context matrix model with the domains of a new concept of eHealth literacy. Methods This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs and requirements are under differing contexts of use. The extension of this model involved including knowledge about users’ competences within the seven domains of eHealth literacy, which had been identified based on systematic engagement with computer scientists, academics, health professionals, and patients recruited from various patient organizations and primary care. A concept map was constructed based on a structured brainstorm procedure, card sorting, and computational
Van Hooft, Gordon E.; And Others
This publication contains curriculum suggestions for teaching Environmental and Community Health - Consumer Health for grades 10, 11 and 12. Emphasis is placed on the psychological dimension of contemporary quackery and pseudo-scientific practices, and sources of health information and health counsel. In general, the grade 10 through 12 materials…
Francois Watkins, Louise K; Sanchez, Guillermo V; Albert, Alison P; Roberts, Rebecca M; Hicks, Lauri A
Appropriate antibiotic use, in particular avoidance of antibiotics for upper respiratory infections likely to be caused by viruses, is a key component of efforts to slow the increase in antibiotic-resistant infections. Studies suggest that Hispanic consumers might differ from non-Hispanic consumers in their knowledge and attitudes regarding antibiotic use (4). To better understand health care provider and consumer knowledge and attitudes that influence antibiotic use, CDC analyzed national internet survey data collected from participants living in the United States during 2012-2013. The participants represented three groups: 1) the total population of adult consumers (all ethnicities); 2) adult Hispanic consumers; and 3) health care providers. Hispanic consumers were more likely than all consumers to believe that if they have a cold, antibiotics would help them to get better more quickly (48% versus 25%), and more likely to obtain antibiotics not prescribed by a clinician, such as antibiotics left over from a previous illness (25% versus 9%), obtained from a neighborhood grocery store (23% versus 5%), or obtained from a friend or family member (17% versus 6%). Most providers surveyed (54%) reported that they believed their patients expect antibiotics during visits for a cough or cold, whereas 26% of all consumers reported this expectation. To maximize knowledge about appropriate antibiotic use among outpatients in the United States, public health initiatives should target Hispanic as well as general audiences.
Glass, C R; Arnkoff, D B
We summarize the four papers in this issue by consumers evaluating their mental health treatment, focusing on aspects of their treatment that they collectively found helpful and hindering. These factors include the context of treatment, the therapy relationship, interventions used and issues addressed, helpful experiences outside the mental health system, and hindering views of mental illness and treatment. We then present comments by two clients in outpatient therapy on the same topic. Research on clients' perceptions of their outpatient psychotherapy is discussed in reference to these six consumer perspectives, and future directions for therapists and researchers are suggested.
Judson, Richard; de Marcellus, Sally; de Knecht, Joop; Leinala, Eeva
Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect health, the nature of the effects, treatment, regulatory measures, and more. Information is structured in a variety of formats, including traditional databases, portals, prediction models, and decision making support tools. Online resources are created and housed by a variety of institutions, including libraries and government agencies. This paper focuses on three such institutions and the tools they offer to the public: the National Library of Medicine (NLM) and its Toxicology and Environmental Health Information Program, the United States Environmental Protection Agency (EPA), and the Organisation for Economic Co-operation and Development (OECD). Reference is also made to other relevant organizations. PMID:26506572
Wexler, Philip; Judson, Richard; de Marcellus, Sally; de Knecht, Joop; Leinala, Eeva
Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect health, the nature of the effects, treatment, regulatory measures, and more. Information is structured in a variety of formats, including traditional databases, portals, prediction models, and decision making support tools. Online resources are created and housed by a variety of institutions, including libraries and government agencies. This paper focuses on three such institutions and the tools they offer to the public: the National Library of Medicine (NLM) and its Toxicology and Environmental Health Information Program, the United States Environmental Protection Agency (EPA), and the Organisation for Economic Co-operation and Development (OECD). Reference is also made to other relevant organizations.
Wong, Thomas K S
New technologies from the new digital era are overcoming temporal, spatial and physical hurdles in the development and realization of individual health profiling and consumer health monitoring devices. Mature wireless and networking technologies promise more accessibility and portability of health data and records, and health monitoring. The increase in convenience and efficiency underlie the technological foundation for development of telehealth systems, which make personal health care available anytime, anywhere. On the one hand, advances in information technology are aiding in the creation of lifelong health records and hence in the tracking and understanding of the health history of individuals, which in turn will help shift the public health care delivery model toward more primary and secondary care and prevention from the current emphasis on curing. On the other, health monitoring devices are also benefiting from technological progress, and are increasingly moving toward more self-assistive, compact and appealing to consumers. However, although most of the necessary hardware and technologies are already mature and widely available, they have yet to be fully exploited for personal health care, and the general public also need to be educated and encouraged to adopt the concepts of individual health profiling and regular health monitoring into their lives. In this regard, the School of Nursing at The Hong Kong Polytechnic University has been working proactively on two fronts. First, a telehealth system has been installed in community-based venues such as clinics, hospitals and, most important, schools and youth centers in order to promote lifelong health profiling for all individuals. Second, the School of Nursing is committed to utilizing advanced technologies for developing more compact and user-friendly consumer health monitoring devices such as non-invasive meters. This is with a view to encourage individuals to take more responsibility for their own health
... COMMISSION 47 CFR Part 54 Rural Health Care Support Mechanism AGENCY: Federal Communications Commission... support on a limited, interim, fiscally responsible basis for specific Rural Health Care Pilot Program... will preserve transitioning Pilot Program participants' connectivity and the resulting health...
West, W.; Heldmann, M.; Scull, T.; Samplatsky, D.; Gentry, G. J.; Duggan, M.; Klaus, K.
Life support consumables are a significant mass driver in human spacecraft and exploration surface habitats. Utilization of local resources could further reduce resupply needs. We quantify the resupply needs of habitats on the Moon and Mars.
Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect health, the nature of the effects, treatment, regulatory measures, and more. Online resources are created and housed by a variety of institutions, including libraries and government agencies. This paper focuses on three such institutions and the tools they offer to the public: the National Library of Medicine (NLM) and its Toxicology and Environmental Health Information Program, the United States Environmental Protection Agency (EPA), and the Organisation for Economic Co-operation and Development (OECD). Reference is also made to other relevant organizations. A review of online public data sources and data resources on health effects of toxicants offered by NLM, EPA and OECD..
Evans, W Douglas; McCormack, Lauren
Social marketing uses commercial marketing strategies to change individual and organizational behavior and policies. It has been effective on a population level across a wide range of public health and health care domains. There is limited evidence of the effectiveness of social marketing in changing health care consumer behavior through its impact on patient-provider interaction or provider behavior. Social marketers need to identify translatable strategies (e.g., competition analysis, branding, and tailored messages) that can be applied to health care provider and consumer behavior. Three case studies from social marketing illustrate potential strategies to change provider and consumer behavior. Countermarketing is a rapidly growing social marketing strategy that has been effective in tobacco control and may be effective in countering pharmaceutical marketing using specific message strategies. Informed decision making is a useful strategy when there is medical uncertainty, such as in prostate cancer screening and treatment. Pharmaceutical industry marketing practices offer valuable lessons for developing competing messages to reach providers and consumers. Social marketing is an effective population-based behavior change strategy that can be applied in individual clinical settings and as a complement to reinforce messages communicated on a population level. There is a need for more research on message strategies that work in health care and population-level effectiveness studies.
Annunziata, Azzurra; Mariani, Angela; Vecchio, Riccardo
As widely acknowledged functional foods (FFs) may contribute to improve human health due to the presence of specific components useful for their protective action against several diseases. However it is essential that consumers are able to comprehend and assess the properties of FFs health claims play a central role in helping consumers to select among food alternatives, beyond providing protection against unsupported or misleading statements about foods properties. At the same time health claims are the main marketing tool that the food industry could use to differentiate FFs from other products. Clearly, massive investments in research and development are necessary to enter the FF market segment, together with the possibility to protect innovation through patents. Current paper aims to examine factors influencing consumer understanding and use of food health claims on FFs, as well as providing several indications for developers, marketers and policy makers. After a brief review of the literature the results of a quantitative survey conducted online on 650 Italian consumers are presented. Results show that consumer use and understanding of health claims on FFs depend on different variables such as socio-demographic characteristics, knowledge and confidence with nutrition information but also wording and variables related specifically to the product. Furthermore, different segments with a diverse degree of use and understanding of health claims have been identified. Therefore, to boost market growth, more efforts are needed by policy makers and marketers to provide better information on nutrition and health aspects of FF using an approach capable to ensure truthful, significant and clear information. Finally some recent patents related to the FFs market with specific regard to components and/or functionality investigated in the current paper are reviewed.
Ahmed, Munerah; Nagin, Deborah; Clark, Nancy
Lead-based paint and occupational lead hazards remain the primary exposure sources of lead in New York City (NYC) children and men, respectively. Lead poisoning has also been associated with the use of certain consumer products in NYC. The NYC Department of Health and Mental Hygiene developed the Intervention Model for Contaminated Consumer Products, a comprehensive approach to identify and reduce exposure to lead and other hazards in consumer products. The model identifies hazardous consumer products, determines their availability in NYC, enforces on these products, and provides risk communication and public education. Implementation of the model has resulted in removal of thousands of contaminated products from local businesses and continues to raise awareness of these hazardous products. PMID:24922141
Bosch, Adina C; O'Neill, Bernadette; Sigge, Gunnar O; Kerwath, Sven E; Hoffman, Louwrens C
The numerous health benefits provided by fish consumption may be compromised by the presence of toxic metals and metalloids such as lead, cadmium, arsenic and mercury, which can have harmful effects on the human body if consumed in toxic quantities. The monitoring of metal concentrations in fish meat is therefore important to ensure compliance with food safety regulations and consequent consumer protection. The toxicity of these metals may be dependent on their chemical forms, which requires metal speciation processes for direct measurement of toxic metal species or the identification of prediction models in order to determine toxic metal forms from measured total metal concentrations. This review addresses various shortcomings in current knowledge and research on the accumulation of metal contaminants in commercially consumed marine fish globally and particularly in South Africa, affecting both the fishing industry as well as fish consumers.
Schouteten, Joachim J.; De Steur, Hans; De Pelsmaeker, Sara; Lagast, Sofie; De Bourdeaudhuij, Ilse; Gellynck, Xavier
The global increase of cardiovascular diseases is linked to the shift towards unbalanced diets with increasing salt and fat intake. This has led to a growing consumers’ interest in more balanced food products, which explains the growing number of health-related claims on food products (e.g., “low in salt” or “light”). Based on a within-subjects design, consumers (n = 129) evaluated the same cheese product with different labels. Participants rated liking, saltiness and fat flavor intensity before and after consuming four labeled cheeses. Even though the cheese products were identical, inclusion of health labels influenced consumer perceptions. Cheese with a “light” label had a lower overall expected and perceived liking compared to regular cheese. Although cheese with a “salt reduced” label had a lower expected liking compared to regular cheese, no lower liking was found when consumers actually consumed the labeled cheese. All labels also influenced the perceived intensities of the attributes related to these labels, e.g., for example salt intensity for reduced salt label. While emotional profiles of the labeled cheeses differed before tasting, little differences were found when actual tasting these cheeses. In conclusion, this study shows that health-related labels might influence the perceived flavor and emotional profiles of cheese products. PMID:26690211
Verbeke, Wim; Scholderer, Joachim; Lähteenmäki, Liisa
This paper reports on consumers' reactions towards calcium-enriched fruit juice, omega-3 enriched spread and fibre-enriched cereals, each with a nutrition claim, health claim and reduction of disease risk claim. Cross-sectional data were collected in April 2006 from a sample of 341 consumers in Belgium. Consumers' reactions to the carrier product, functional ingredient and claim combinations were assessed as perceived convincingness of the claim, credibility of the product, attractiveness of the product, and intention to buy the product, while accounting for differences in product familiarity, attitudinal and demographic characteristics. Generally, health claims outperformed nutrition claims, and both of these claim types outperformed reduction of disease risk claims. Comparing consumer reactions across product concepts revealed clear preferences for fibre-enriched cereals as compared to the other two concepts. The interaction effects between claim type and product concept indicated that reduction of disease risk claims are perceived very well in omega-3 enriched spreads, particularly in terms of perceived convincingness of the claim, while not appealing to consumers in the other product concepts. Positive attitudes towards functional foods and familiarity with the concrete functional product category boosted the claim type and product ratings, whereas perceived control over own health and perceiving functional foods as a marketing scam decreased all product concept's appeal.
Verbeke, W; Viaene, J; Guiot, O
This article focuses on the impact of mass media meat-health information on consumer perception, attitude, and behavior toward fresh meat in Belgium. In a situation similar to that which occurred in most other European countries, Belgian fresh meat consumption fell considerably during 1995-1999. A multitude of messages linking meat consumption to human health risks were reported by mass media. Bovine Spongiform Encephalopathy (BSE) since 1996 and dioxin in 1999 constituted the major issues. Empirical research, conducted in April 1998, revealed the tremendous negative impact of mass media coverage of meat-health issues on consumer risk perception, health concern, and attitude and behavior toward fresh meat. Oppositely, personal communication through butchers had only a small effect on consumer decision-making in this era dominated by alarming meat-health press. Implications are threefold. First, mass media should be aware of its social responsibilities, which include spreading reliable and correct information to the society. This is especially the case as human health risks are involved. Second, the meat industry urgently needs to reorient itself toward quality, safety, and transparency. Finally, future communication dealing with similar crises situations requires cooperation across the meat chain, government, and those who are responsible for public health promotion and communication.
Wale, Janet L.; Belizán, María; Nadel, Jane; Jeffrey, Claire; Vij, Sita L.
Abstract Background The Cochrane Consumer Network is an internet‐based community of international users of health care contributing to the work of The Cochrane Collaboration, whose mission is to inform healthcare decision making through development of systematic reviews of best evidence on healthcare interventions. Objective To prioritize existing review titles listed on The Cochrane Library from a healthcare user perspective, with particular emphasis on patients, carers and health consumers. Design An online survey was developed and after piloting was made available internationally. The broad dissemination strategy targeted Consumer Network members and Cochrane Review Group editorial staff to identify champions who notified patient support groups and participated in snowballing. The first part of the survey defined criteria that could be applied to review titles and asked survey respondents to rank them. The second part asked respondents to select a health area and prioritize review titles that were of importance to them. Each health area corresponded to a Cochrane Review Group. Results and discussion Sufficient responses were obtained from 522 valid responses to prioritize review topics in 19 health areas. A total of 321 respondents completed the titles assessment. The types of prioritized interventions were determined by the health area. An important observation was the emphasis on lifestyle and non‐medication therapies in many of the included health areas. The clearest exception to this broad observation was where acute care is required such as antibiotics for acute respiratory tract and HIV‐associated infections and for cardiac conditions. For some cancers, advanced cancer interventions were prioritized. The most important criteria were for the title to convey a clear meaning and the title conveyed that the review would have an impact on health and well‐being. The least important criteria were that the topic was newsworthy or prioritized in
Elliott, Marc N; Beckett, Megan K; Kanouse, David E; Hambarsoomians, Katrin; Bernard, Shulamit
Consumer Assessment of Health Care Providers and Systems (CAHPS) is an organized effort to provide consumers with standardized, comprehensible, and usable data regarding consumers' experiences with health care. In its Medicare and other summary reports, CAHPS emphasizes the frequency of the most positive experiences. Cognitive models of survey response combined with attitude theory suggest that performance measurement might be further improved by the addition of problem-oriented reporting, which highlights the frequency of negative experiences. We propose criteria and use them to assess whether problem-oriented reporting provides valid, precise, and complementary information. Analysis of the 2000 CAHPS Medicare Fee-For-Service and 2001 CAHPS Medicare Advantage survey data shows that problem-oriented reporting (1) is viable, interpretable, and unlikely to represent noise; (2) has statistical power sufficient to capture important differences of magnitudes commonly observed; and (3) provides information that complements standard reporting.
Owen, Carol L
Health planning in the United States is rapidly approaching a fork in the policy road, with one direction leading the nation toward a universal plan with strong government involvement and the other direction strengthening existing market-based reforms and preserving a commercial health insurance industry. "Consumer-driven health care," a slogan that captures a range of market-based approaches to preserving patient choice and increasing cost savings, is most commonly implemented in the form of individual health savings accounts. These accounts are offered to employees as a means of increasing the cost sharing ofpersonal health care expenses. The author provides an overview of health insurance history and discusses some implications of abandoning earlier practices of risk pooling health care expenses across a wider community. Access and affordability issues connected with the adoption of a consumer-driven health care system in the United States are addressed. Parallels are drawn between the expansion of community-based insurance in the United States following World War II and social work's historic commitment to social justice and economic inclusion. Suggestions are made for social workers'involvement in health policy discourse and activism during this critical time ofnational reflection on universal versus market-based reforms for the U.S. health care system.
Dunfield, J F
In recent years health care delivery has placed increased emphasis on patient input. However, much of the research addressing patient satisfaction and quality of care suffers from inherent methodological difficulties, or an agenda determined by the provider, not the consumer. Of particular neglect has been the considerable, and often, preferential use of non-conventional therapy, recently shown to have an enormous presence within the U.S. health care system. This study employs a multidimensional scaling methodology as an explorative tool to examine, from the consumer's viewpoint, the issues that underlie the positive perception of the quality of health care delivery. Three principle dimensions are identified: personal-impersonal doctor patient relationship; scientific vs holistic approach; and the balance of control between doctor patient. Correlation of sociodemographic and broad based health care seeking data with respect to these dimensions furthers understanding of gender bias, and non-conventional therapy utilization. Suggestions for moderation of these attitudes are discussed.
An, Soontae; Muturi, Nancy
Older adults are increasingly the intended target of direct-to-consumer (DTC) prescription drug ads, but limited evidence exists as to how they assess the educational value of DTC ads and, more importantly, whether their assessment depends on their level of health literacy. In-person interviews of 170 older adults revealed that those with low subjective health literacy evaluated the educational value of DTC ads significantly lower than did those with high subjective health literacy. The results prompt us to pay more scholarly attention to determining how effectively DTC ads convey useful medical information, particularly to those with limited health literacy.
Remer, Robert B.
This report presents the thesis that most college health services will have to undergo critical reexamination and drastic changes before students can rightfully participate as consumers and before effective planning becomes standard operating procedure. The two basic areas where these changes will have to occur are: (1) in consideration and…
Background South Africa currently has a pluralistic health care system with separate public and private sectors. It is, however, moving towards a socialised model with the introduction of National Health Insurance. The South African legislative environment has changed recently with the promulgation of the Consumer Protection Act and proposed amendments to the National Health Act. Patients can now be viewed as consumers from a legal perspective. This has various implications for health care systems, health care providers and the doctor-patient relationship. Discussion Calling a recipient of health care a ‘consumer’ as opposed to a ‘patient’ has distinct connotations and may result in differential behaviour. Labels reflect the ideals of the context in which they are used. Various models of the doctor-patient relationship exist and different metaphors have been used to describe it. Increasingly there are third parties involved within the doctor-patient relationship making it more difficult for the doctor to play the fiduciary role. In certain parts of the world, there has been a shift from a traditional paternalistic model to a consumerist model. The ethical implications of the commodification of health care are complex. As health care becomes a ‘product’ supplied by the health care ‘provider’, there is the risk that doctors will replace professional ethics with those of the marketplace. Health care is a universal human need and cannot be considered a mere commodity. In modern medical ethics, great emphasis is placed on the principle of respect for patient autonomy. Patients are now the ultimate decision-makers. The new Consumer Protection Act in South Africa applies to consumers and patients alike. It enforces strict liability for harm caused by goods and services. Everyone in the supply chain, including the doctor, can be held jointly and severally liable. This may lead to enormous challenges in health care delivery. Summary Viewing patients as
Geeroms, Nele; Verbeke, Wim; Van Kenhove, Patrick
Based on a multidimensional perspective on the meaning of health, this study explores associations between consumers' health-related motive orientations (HRMO) and ready meal consumption behaviour. Cross-sectional data were collected from a sample of 1934 Flemish consumers through an on-line survey. The respondents rated 45 health statements referring to people's motives for pursuing health. The survey also assessed information on several aspects of ready meal consumption, i.e. consumption frequency, beliefs and attitudes toward ready meals and ready meal buying criteria. Based on a two-step cluster analysis, we identified five distinct subgroups in the sample, according to their HRMO: health is about energy (Energetic Experimenters), emotional well-being/enjoying life (Harmonious Enjoyers), social responsibility/physical well-being (Normative Carers), achievement/outward appearance (Conscious Experts) and autonomy (Rationalists). Ready meal consumption patterns differed between these segments, with Energetic Experimenters and Conscious Experts showing significantly more positive attitudes, stronger beliefs and both higher penetration and consumption frequency related to ready meals, compared to Harmonious Enjoyers, Normative Carers and Rationalists. These findings may relate to the individualistic versus altruistic health orientation perspective of the identified segments, and are valuable in the context of improving consumer-oriented product development, positioning and marketing of ready meals.
0575 N5-95-1 Occupational Safety & Health Administration (OSHA) Technical Support Committee U.S. DEPARTMENT OF THE NAVY CARDEROCK DIVISION, NAVAL...4. TITLE AND SUBTITLE The National Shipbuilding Research Program, Occupational Safety & Health Administration (OSHA) Technical Support...SPECIFICALLY DISCLAIMED. Sp-5 Safety and Health Final Report Occupational Safety & Health Administration (OSHA) Technical Support Committee Task No
... 47 Telecommunication 3 2013-10-01 2013-10-01 false Health care support mechanism. 54.602 Section... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.602 Health care support mechanism. (a) Telecommunications Program. Rural health...
... 47 Telecommunication 3 2014-10-01 2014-10-01 false Health care support mechanism. 54.602 Section... (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers Defined Terms and Eligibility § 54.602 Health care support mechanism. (a) Telecommunications Program. Rural health...
Vilekar, Saurabh A.; Hawley, Kyle; Junaedi, Christian; Walsh, Dennis; Roychoudhury, Subir; Abney. Morgan B.; Mansell, James M.
Utilizing carbon dioxide to produce water and hence oxygen is critical for sustained manned missions in space, and to support both NASA's cabin Atmosphere Revitalization System (ARS) and In-Situ Resource Utilization (ISRU) concepts. For long term missions beyond low Earth orbit, where resupply is significantly more difficult and costly, open loop ARS, like Sabatier, consume inputs such as hydrogen. The Bosch process, on the other hand, has the potential to achieve complete loop closure and is hence a preferred choice. However, current single stage Bosch reactor designs suffer from a large recycle penalty due to slow reaction rates and the inherent limitation in approaching thermodynamic equilibrium. Developmental efforts are seeking to improve upon the efficiency (hence reducing the recycle penalty) of current single stage Bosch reactors which employ traditional steel wool catalysts. Precision Combustion, Inc. (PCI), with support from NASA, has investigated the potential for utilizing catalysts supported over short-contact time Microlith substrates for the Bosch reaction to achieve faster reaction rates, higher conversions, and a reduced recycle flows. Proof-of-concept testing was accomplished for a staged Bosch process by splitting the chemistry in two separate reactors, first being the reverse water-gas-shift (RWGS) and the second being the carbon formation reactor (CFR) via hydrogenation and/or Boudouard. This paper presents the results from this feasibility study at various operating conditions. Additionally, results from two 70 hour durability tests for the RWGS reactor are discussed.
Thompson, Harmony; Chan, Huan; Logan, Florence J; Heenan, Helen F; Taylor, Lynne; Murray, Chris; Florkowski, Christopher M; Frampton, Christopher M A; Lunt, Helen
Health consumer's input into assessment of medical device safety is traditionally given either as part of study outcome (trial participants) or during post marketing surveillance. Direct consumer input into the methodological design of device assessment is less common. We discuss the difference in requirements for assessment of a measuring device from the consumer and clinician perspectives, using the example of hand held glucose meters. Around 80,000 New Zealanders with diabetes recently changed their glucose meter system, to enable ongoing access to PHARMAC subsidised meters and strips. Consumers were most interested in a direct comparison of their 'old' meter system (Accu-Chek Performa) with their 'new' meter system (CareSens brand, including the CareSens N POP), rather than comparisons against a laboratory standard. This direct comparison of meter/strip systems showed that the CareSens N POP meter read around 0.6 mmol/L higher than the Performa system. Whilst this difference is unlikely to result in major errors in clinical decision making such as major insulin dosing errors, this information is nevertheless of interest to consumers who switched meters so that they could maintain access to PHARMAC subsidised meters and strips. We recommend that when practical, the consumer perspective be incorporated into study design related to medical device assessment.
CareScience, Inc. is a public company (NASDAQ: CARE) that originated ten years ago to commercialize risk adjustment and complication predictions developed by the Wharton School of Business and the University of Pennsylvania School of Medicine. Over the past decade, the company has grown to approximately 200 clients and 150 employees. Among the "firsts" recorded by the company, CareScience was the first to offer a clinical decision support system as an Application Service Provider (ASP), the first to offer peer-to-peer clinical data sharing among health care provider organizations and practitioners (Santa Barbara Care Data Exchange), and the first to provide a care management outsourcing arrangement.
Oliffe, John L; Bottorff, Joan L; McKenzie, Michael M; Hislop, T Gregory; Gerbrandt, Julieta S; Oglov, Valerie
In this article we describe the connections between prostate cancer support groups (PCSGs) and men's health literacy and consumer orientation to health care services. The study findings are drawn from participant observations conducted at 16 PCSGs in British Columbia, Canada and 54 individual interviews that focused on men's experiences of attending group meetings. Men's communication and interactions at PCSGs provide important insights for how men talk about and conceptualize health and illness. For example, biomedical language often predominated at group meetings, and men used numbers and measures to engage with risk discourses in linking prostate cancer markers to various treatment options and morbidity and mortality rates. Many groups afforded opportunities for men to interact with health care providers as a means to better understand the language and logic of prostate cancer management. The health literacy skills fostered at PCSGs along with specific group-informed strategies could be mobilized in the men's subsequent clinical consultations. Consumer discourses and strategies to contest power relations with health care professionals underpinned many men's search for prostate cancer information and their commitment to assisting other men. Key were patients' rights, and perhaps responsibility, to compare diverse health products and services in making decisions across the entire trajectory of their prostate cancer. Overall, the study findings reveal PCSGs as having the capacity to contest as well as align with medical expertise and services facilitating men's transition from patient to informed health care consumers. The processes through which this occurs may direct the design of older men's health promotion programs.
Happell, B; Platania-Phung, C; Gray, R; Hardy, S; Lambert, T; McAllister, M; Davies, C
There is extensive international evidence that people with severe mental illness have a lower standard of physical health than the general population. This leads to higher morbidity and mortality rates. Many of the causes for this poor physical health are modifiable. Yet the physical needs of this consumer group are neglected by healthcare systems in Australia, and elsewhere. While medical specialists are clearly integral to remedying this, nurses are well placed to play a key role in focused prevention and early intervention in the physical well-being of consumers with mental health problems. This paper outlines the specifics on how mental health nurses can be sensitized, prepared and empowered to help turn this serious health issue around. In particular, mental health nurses could be trained in and then utilize a new physical health check and response system in the UK (called the Health Improvement Profile) if adapted for use within Australia. This profile will be briefly introduced, and then its value to improving health care discussed.
Happell, B; Platania-Phung, C; Scott, D
People with serious mental illness have higher rates of physical illness and are more likely to experience premature death than the general population. Nurse-led strategies to improve physical healthcare in mental healthcare services could potentially reduce these inequalities. However the extent of nurse involvement in physical healthcare (such as physical risk screening, health education and care co-ordination) in mental health settings is not known. A systematic review was conducted on nurse-led physical healthcare reported for consumers with serious mental illness (SMI) in mental health services, and their benefits. Electronic literature bases (CINAHL, Proquest, PsychINFO and Web of Science) were systematically searched, in conjunction with a manual search of literature reviews on physical healthcare in mental health services. Articles were included if they: (a) were published in the last 10 years; (b) were English language; (c) involved physical healthcare of adult consumers receiving mental healthcare services; and (d) reported nurse involvement in physical healthcare. Forty articles were included in the review. The distribution of types of care were: health education (47%), screening and/or monitoring (33.3%), care co-ordination and management (33.3%), lifestyle programme delivery (30.5%), follow-up actions to screening results (25%) and registers and data administration (5.5%). Overall, the evaluation of nurse-based physical healthcare is in early stages. Thus far, they appear to have positive implications for consumers with SMI.
Valdez, Rupa S; Holden, Richard J; Novak, Laurie L; Veinot, Tiffany C
Designing patient-centered consumer health informatics (CHI) applications requires understanding and creating alignment with patients' and their family members' health-related activities, referred to here as 'patient work'. A patient work approach to CHI draws on medical social science and human factors engineering models and simultaneously attends to patients, their family members, activities, and context. A patient work approach extends existing approaches to CHI design that are responsive to patients' biomedical realities and personal skills and behaviors. It focuses on the embeddedness of patients' health management in larger processes and contexts and prioritizes patients' perspectives on illness management. Future research is required to advance (1) theories of patient work, (2) methods for assessing patient work, and (3) techniques for translating knowledge of patient work into CHI application design. Advancing a patient work approach within CHI is integral to developing and deploying consumer-facing technologies that are integrated with patients' everyday lives.
Houston, T. K.; Chang, B. L.; Brown, S.; Kukafka, R.
BACKGROUND: Although interest in Consumer Health Informatics (CHI) has increased, a consensus definition of CHI does not yet exist. PURPOSE: To conduct a hypothesis-generating survey of AMIA members regarding definition and research agenda for CHI. METHODS: We solicited participation among AMIA members in an Internet-based survey focusing on issues related to a definition of CHI. RESULTS: One hundred thirty-five AMIA members responded. Participants indicated a broad spectrum of topics important to CHI including "self-help for disease management" and "patient access to their own medical records." CHI research was felt to rely heavily on public health methods such as epidemiology and outcomes research, a paradigm shift from traditional medical informatics. Responses indicated a perceived lack of funding and need for further research in CHI. CONCLUSIONS: A working definition should emphasize the multidisciplinary nature of CHI, include consumer input into CHI design, and focus on public health approaches to evaluation. PMID:11825193
Valdez, Rupa S; Holden, Richard J; Novak, Laurie L; Veinot, Tiffany C
Designing patient-centered consumer health informatics (CHI) applications requires understanding and creating alignment with patients’ and their family members’ health-related activities, referred to here as ‘patient work’. A patient work approach to CHI draws on medical social science and human factors engineering models and simultaneously attends to patients, their family members, activities, and context. A patient work approach extends existing approaches to CHI design that are responsive to patients’ biomedical realities and personal skills and behaviors. It focuses on the embeddedness of patients’ health management in larger processes and contexts and prioritizes patients’ perspectives on illness management. Future research is required to advance (1) theories of patient work, (2) methods for assessing patient work, and (3) techniques for translating knowledge of patient work into CHI application design. Advancing a patient work approach within CHI is integral to developing and deploying consumer-facing technologies that are integrated with patients’ everyday lives. PMID:25125685
Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J
Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole. PMID:26770802
Hibbard, J H; Harris-Kojetin, L; Mullin, P; Lubalin, J; Garfinkel, S
Most plan report cards that compare the performance of health plans have framed the decision about plan choice as an opportunity to get better-quality care. This study uses a controlled experimental design to examine the effect of reframing the health plan choice decision to one that emphasizes protecting oneself from possible risk. The findings show that framing the health plan decision using a risk message has a consistent and significant positive impact on how consumers comprehend, value, and weight comparative performance information.
Heller, Tamar; Caldwell, Joe
The impact of a consumer-directed family support program on actual out-of-home placement in one American state was evaluated over an 8-year period. Under this program, individuals with intellectual disabilities and their families control their own resources and design and direct supports through the use of cash allowances or individualized…
Padchasuwan, Natnapa; Kaewpitoon, Soraya J; Rujirakul, Ratana; Wakkuwattapong, Parichart; Norkaew, Jun; Kujapun, Jirawoot; Ponphimai, Sukanya; Chavenkun, Wasugree; Kompor, Pontip; Kaewpitoon, Natthawut
The liver fluke Opisthorchis viverrini is a serious health problem in Thailand. Infection is associated with cholangiocarcinoma (CCA), endemic among human populations in northeast and north Thailand where raw fish containing fluke metacercariae are frequently consumed. Recently, Thailand public health authorities have been organized to reduce morbidity and mortality particularly in the northeast through O. viverrini and CCA screening projects. Health modfication is one of activities included in this campaign, but systemic guidelines of modifying and developing health behavior for liver flukes and CCA prevention in communities towards health belief and social support theory are still various and unclear. Here we review the guidelines for modifying and developing health behavior among populations in rural communities to strengthen understanding regarding perceived susceptibility, severity, benefits, and barriers to liver fluke and CCA prevention. This model may be useful for public health of cancers and related organizations to further health behavior change in endemic areas.
Kozlowski, Lynn T; Sweanor, David
The United States provides an example of a country with (a) legal tobacco/nicotine products (e.g., snus, other smokeless tobacco, cigarettes) differing greatly in risks to health and (b) respected health information websites that continue to omit or provide incorrect differential risk information. Concern for the principles of individual rights, health literacy, and personal autonomy (making decisions for oneself), which are key principles of public health ethics, has been countered by utilitarian arguments for the use of misleading or limited information to protect public health overall. We argue that omitting key health relevant information for current or prospective consumers represents a kind of quarantine of health-relevant information. As with disease quarantines, the coercive effects of quarantining information on differential risks need to be justified, not merely by fears of net negative public health effects, but by convincing evidence that such measures are actually warranted, that public health overall is in imminent danger and that the danger is sufficient to override principles of individual autonomy. Omitting such health-relevant information for consumers of such products effectively blindfolds them and impairs their making informed personal choices. Moral psychological issues that treat all tobacco/nicotine products similarly may also be influencing the reluctance to inform on differential risks. In countries where tobacco/nicotine products are legally sold and also differ greatly in disease risks compared to cigarettes (e.g., smokeless tobacco and vape), science-based, comprehensible, and actionable health information (consistent with health literacy principles) on differential risks should be available and only reconsidered if it is established that this information is causing losses to population health overall.
Reavley, Nicola J; Ross, Anna M; Killackey, Eoin; Jorm, Anthony F
Background. The age at which most young people are in tertiary education is also the age of peak onset for mental illness. Because mental health problems can have adverse effects on students' academic performance and welfare, institutions require guidance how they can best provide support. However, the scientific evidence for how best to do this is relatively limited. Therefore a Delphi expert consensus study was carried out with professional and consumer experts. Methods. A systematic review of websites, books and journal articles was conducted to develop a 172 item survey containing strategies that institutions might use to support students with a mental illness. Two panels of Australian experts (74 professionals and 35 consumers) were recruited and independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. Results. The overall response rate across three rounds was 83% (80% consumers, 85% professionals). 155 strategies were endorsed as essential or important by at least 80% of panel members. The endorsed strategies provided information on policy, measures to promote support services, service provision, accessibility of support services, relationships between services, other types of support and issues associated with reasonable adjustments. They also provided guidance on the procedures the institutions should have for making staff aware of issues associated with mental illness, mental illness training, support for staff and communicating with a student with a mental illness. They also covered student rights and responsibilities, the procedures the institutions should have for making students aware of issues associated with mental illness, dealing with mental health crises, funding and research and evaluation. Conclusions. The guidelines provide guidance for tertiary institutions to assist them in supporting students with a mental illness. It is hoped that they may be used to inform policy and
Townshend, Philip L; Sellman, J Douglas
The Health and Disability Commissioner's (HDC) Code of Health and and Disability Consumers' Rights (the Code) defines in law the rights of consumers of health and disability services in New Zealand. In the first few years after the publication health educators, service providers and the HDC extensively promoted the Code. Providers of health and disability services would be expected to be knowledgeable about the areas covered by the Code if it is routinely used in the development and monitoring of treatment plans. In this study knowledge of the Code was tested in a random sample of 217 clinical staff that included medical staff, psychologists and counsellors working in Alcohol and Drug Treatment (A&D) centres in New Zealand. Any response showing awareness of a right, regardless of wording, was taken as a positive response as it was the areas covered by rights rather than their actual wording that was considered to be the important knowledge for providers. The main finding of this research was that 23% of staff surveyed were aware of none of the ten rights in the Code and only 6% were aware of more than five of the ten rights. Relating these data to results from a wider sample of treatment providers raises the possibility that A&D treatment providers are slightly more aware of the content of the Code than a general sample of health and disability service providers however overall awareness of the content of the Code by health providers is very low. These results imply that consumer rights issues are not prominent in the minds of providers perhaps indicating an ethical blind spot on their part. Ignorance of the content of the Code may indicate that the treatment community do not find it a useful working document or alternatively that clinicians are content to rely on their own good intentions to preserve the rights of their patients. Further research will be required to explain this lack of knowledge, however the current situation is that consumers cannot rely on
Monkman, Helen; Griffith, Janessa; Kushniruk, Andre W
Heuristic evaluations have proven to be valuable for identifying usability issues in systems. Commonly used sets of heuritics exist; however, they may not always be the most suitable, given the specific goal of the analysis. One such example is seeking to evaluate the demands on eHealth literacy and usability of consumer health information systems. In this study, eight essential heuristics and three optional heuristics subsumed from the evidence on eHealth/health literacy and usability were tested for their utility in assessing a mobile blood pressure tracking application (app). This evaluation revealed a variety of ways the design of the app could both benefit and impede users with limited eHealth literacy. This study demonstrated the utility of a low-cost, single evaluation approach for identifying both eHealth literacy and usability issues based on existing evidence in the literature.
discussion. The first conclusion suggests that research in child development generally, and child mental health specifically, does not incorporate the social ecology of the child is seriously flawed. There is a broad recognition within most sectors of society that the quality of civic engagement is of critical importance to community efforts to improve the health and well-being of children. This is true for all communities and families, regardless of their levels of material wealth and educational achievement. It is also well understood that poverty undermines the well-being and life chances of children. For this reason, the third conclusion requires that intensive, sustained efforts be made to eradicate poverty and reverse the current economic trend toward growing economic disparity. The implications of this knowledge for the practice of child psychiatry are not new ones. In many ways, they advocate for a re-examination of the historical roots of the field as it defined approaches to juvenile justice, school counseling, and early intellectual enrichment for economically disadvantaged preschool children. All these efforts were sensitive to children's social environment, and child psychiatrists viewed their success in taking on the challenges of changing schools, courts, and community and family environments. These challenges hardly have been overcome. The requirements of understanding and evaluating community supports for children are a fundamental component in the training and practice of child psychiatry. To quote the U.S. Surgeon General in a preamble to the recent Report on Child Mental Health: One way to ensure that our health system meets children's mental health needs is to move toward a community based health system that balances health promotion, disease prevention, early detection and universal access.
Cocosila, Mihail; Archer, Norm
Objective To develop a model of consumer perceptions of electronic personal health records (PHRs) and validate it in a comparative study between consumers who report having a chronic illness and those who report being well. Materials and methods A model of PHR use motivators and barriers was built and tested through a national survey across Canada. Data were collected from 800 individuals, 18 years or older. Half reported having a chronic illness or disability and half reported being well. Analyses were performed with structural equation modelling techniques. Results A total of 389 answers from chronically ill and 383 from well participants were collected. Perceived usefulness was the key explanation of the intention to use PHRs for both ill and well people (total effect of 0.601 and 0.565, respectively) followed by security, privacy and trust in PHRs (total effect of 0.377 and 0.479, respectively). Conversely, computer anxiety was perceived as a significant barrier (total effect of −0.327 for ill individuals and −0.212 for well individuals). Discussion The model proposed was appropriate in explaining key consumer positive and negative perceptions on electronic PHR use. We found little difference in perceptions of electronic PHRs between chronically ill and well individuals, although self-reporting their health status might have influenced the results. Conclusions To increase the adoption rate of electronic PHRs among both chronically ill and well consumers it is necessary to reinforce consumer perceptions of the usefulness of and trust in these eHealth technologies while mitigating their anxieties about computer use in general. PMID:25056975
While direct-to-consumer (DTC) prescription drug advertising has been the subject of ongoing debate, to this point the perspective of the advertising professionals engaged in creating these ads has been absent from the discussion. This study, consisting of in-depth interviews with advertising professionals (N = 22), was an initial investigation focused on these individuals. The primary purpose of this study was to explore advertising professionals' understanding of health literacy-consumers' ability to obtain, process, and act on health information; with that context in place, participants' views on the role of DTC advertising, industry regulations, and the future of the industry were also investigated. While some participants knew nothing about health literacy or had a relatively simple conceptualization (e.g., grade level of written materials), others exhibited more nuanced understanding of health literacy (e.g., the need to pair relevant images with text to enhance understanding). Participants spoke of the potential public health benefit of DTC advertising in educating consumers about health issues, but were realistic that such efforts on the part of pharmaceutical companies were driven primarily by business concerns-educational messages need to be tied directly to an advertised medication and its benefits. These professionals spoke of industry regulations as presenting additional barriers to effective communication and suggested that industry trends toward more niche products will necessitate more patient education about less well-known health issues. Directions for future research are considered, as more investigation of this understudied group is necessary to enrich the DTC prescription drug advertising debate.
Torii, Manabu; Tilak, Sameer S.; Doan, Son; Zisook, Daniel S.; Fan, Jung-wei
In an era when most of our life activities are digitized and recorded, opportunities abound to gain insights about population health. Online product reviews present a unique data source that is currently underexplored. Health-related information, although scarce, can be systematically mined in online product reviews. Leveraging natural language processing and machine learning tools, we were able to mine 1.3 million grocery product reviews for health-related information. The objectives of the study were as follows: (1) conduct quantitative and qualitative analysis on the types of health issues found in consumer product reviews; (2) develop a machine learning classifier to detect reviews that contain health-related issues; and (3) gain insights about the task characteristics and challenges for text analytics to guide future research. PMID:27375358
Wang, Tiankai; Dolezel, Diane
Personal health records (PHRs) have many benefits, including the ability to increase involvement of patients in their care, which provides better healthcare outcomes. Although issues related to usability of PHRs are a significant barrier to adoption, there is a paucity of research in this area. Thus, the researchers explored consumers' perspective on the usability of two commercially available web-based PHRs. Data from the Usefulness, Satisfaction, and Ease of Use questionnaire were collected from a sample of health information management students (N = 90). A one-way analysis of variance (ANOVA) showed that Microsoft HealthVault had higher scores in most usability categories when compared to Health Companion. Study results indicated that PHR developers should evaluate Microsoft HealthVault as a model for improving PHR usability. PMID:27134611
Gelbke, Heinz-Peter; Banton, Marcy; Faes, Eric; Leibold, Edgar; Pemberton, Mark; Duhayon, Sophie
Residual styrene present in polystyrene food packaging may migrate into food at low levels. To assure safe use, safe exposure levels are derived for consumers potentially exposed via food using No/Low Adverse Effect Levels from animal and human studies and assessment factors proposed by European organisations (EFSA, ECHA, ECETOC). Ototoxicity and developmental toxicity in rats and human ototoxicity and effects on colour discrimination have been identified as the most relevant toxicological properties for styrene health assessments. Safe exposure levels derived from animal studies with assessment factors of EFSA and ECHA were expectedly much lower than those using the ECETOC approach. Comparable safe exposure levels were obtained from human data with all sets of assessment factors while ototoxicity in rats led to major differences. The safe exposure levels finally selected based on criteria of science and health protection converged to the range of 90-120 mg/person/d. Assuming a consumption of 1 kg food/d for an adult, this translates to 90 mg styrene migration into 1 kg food as safe for consumers. This assessment supports a health based Specific Migration Limit of 90 ppm, a value somewhat higher than the current overall migration limit of 60 ppm in the European Union.
Halsted, Deborah D.; Varman, Beatriz; Sullivan, Marsha; Nguyen, Lynne
According to the 2000 United States Census, the Asian population in Houston, Texas, has increased more than 67% in the last ten years. To supplement an already active consumer health information program, the staff of the Houston Academy of Medicine-Texas Medical Center Library worked with community partners to bring health information to predominantly Asian neighborhoods. Brochures on health topics of concern to the Asian community were translated and placed in eight informational kiosks in Asian centers such as temples and an Asian grocery store. A press conference and a ribbon cutting ceremony were held to debut the kiosks and to introduce the Consumer Health Information for Asians (CHIA) program. Project goals for the future include digitizing the translated brochures, mounting them on the Houston HealthWays Website, and developing touch-screen kiosks. The CHIA group is investigating adding health resources in other Asian languages, as well as Spanish. Funding for this project has come from outside sources rather than from the regular library budget. PMID:12398246
Hartley, Jane E K
Within the contemporary culture of consumption, school-aged adolescents, though neither waged nor salaried producers, are nevertheless treated by the media and the advertisers as if they are active consumers who are engaged in the project of the self. For those adolescents who lack the financial resources to 'buy into' this culture, anxiety may ensue. In order to ease this anxiety, and to acquire social status, some - not all - may make the 'rational' 'consumer' choice to engage in risky health-related behaviour. In situ ethnographic research is needed in order to complement and inform the existing survey-based evidence on the relationship between economic status and health-related behaviour among school-aged adolescents as they deal with the pressures of consumerism.
Stanton, Robert; Reaburn, Peter; Happell, Brenda
Acute exercise performed at a self-selected intensity improves affect and may improve long-term adherence. Similarly, in people with severe depression, acute aerobic exercise performed at self-selected intensity improves affect and arousal. However, the relationship between changes in affect and arousal and perceived exercise intensity in people with mental illness has not been evaluated. Affect and arousal were assessed immediately prior to, and immediately following, a group exercise program performed at a self-selected intensity in 40 inpatient mental health consumers who received a diagnosis of anxiety or bipolar or depressive disorders. Exercise intensity was assessed immediately after exercise. Postexercise affect was significantly improved for people with bipolar and depressive disorders but not for people with anxiety disorders. For the group as a whole, results showed a significant curvilinear relationship between ratings of perceived exertion and postexercise affect. These data will inform the development and delivery of future exercise interventions for inpatient mental health consumers.
Detmer, Don; Bloomrosen, Meryl; Raymond, Brian; Tang, Paul
Background Integrated personal health records (PHRs) offer significant potential to stimulate transformational changes in health care delivery and self-care by patients. In 2006, an invitational roundtable sponsored by Kaiser Permanente Institute, the American Medical Informatics Association, and the Agency for Healthcare Research and Quality was held to identify the transformative potential of PHRs, as well as barriers to realizing this potential and a framework for action to move them closer to the health care mainstream. This paper highlights and builds on the insights shared during the roundtable. Discussion While there is a spectrum of dominant PHR models, (standalone, tethered, integrated), the authors state that only the integrated model has true transformative potential to strengthen consumers' ability to manage their own health care. Integrated PHRs improve the quality, completeness, depth, and accessibility of health information provided by patients; enable facile communication between patients and providers; provide access to health knowledge for patients; ensure portability of medical records and other personal health information; and incorporate auto-population of content. Numerous factors impede widespread adoption of integrated PHRs: obstacles in the health care system/culture; issues of consumer confidence and trust; lack of technical standards for interoperability; lack of HIT infrastructure; the digital divide; uncertain value realization/ROI; and uncertain market demand. Recent efforts have led to progress on standards for integrated PHRs, and government agencies and private companies are offering different models to consumers, but substantial obstacles remain to be addressed. Immediate steps to advance integrated PHRs should include sharing existing knowledge and expanding knowledge about them, building on existing efforts, and continuing dialogue among public and private sector stakeholders. Summary Integrated PHRs promote active, ongoing
Coulter, C H
"Consumer choice," "defined contribution health programs," "voucher systems," and "health marts" are variations on a theme: employees buying their own health care. This new approach to health care purchasing, which is designed to minimize the role of employers, is being proposed by an array of economists and by both Republican and Democratic legislators as the best way to address the nation's health care ills. Although enabling national legislation is unlikely to pass soon, the debate will nevertheless change the face of health care in America. The prospect is reminiscent of the debate over "Clinton Care" in 1993--although legislation was never passed, managed care rapidly came to dominate the U.S. health care system. As this reform takes hold, beneficiaries will make their own health plan selections but will have more responsibility and may bear more cost. Providers will have to adapt to new, customer-driven requirements for performance, accountability, and communications but will also find opportunities in a marketplace that they will have a major role in shaping. Physicians, health plans, and insurers should understand how these proposals will transform their role in health care.
Trantallidi, M; Dimitroulopoulou, C; Wolkoff, P; Kephalopoulos, S; Carrer, P
In the framework of the EU EPHECT project (Emissions, Exposure Patterns and Health Effects of Consumer Products in the EU), irritative and respiratory effects were assessed in relation to acute (30-min) and long-term (24-h) inhalation exposure to key and emerging indoor air pollutants emitted during household use of selected consumer products. A detailed Health Risk Assessment (HRA) was performed for five selected pollutants of respiratory health relevance, namely acrolein, formaldehyde, naphthalene, d-limonene and α-pinene. For each pollutant, the Critical Exposure Limit (CEL) was compared to indoor air concentrations and exposure estimates for the use of 15 selected consumer products by two population groups (housekeepers and retired people) in the four geographical regions of Europe (North, West, South, East), which were derived previously based on microenvironmental modelling. For the present HRA, health-based CELs were derived for certain compounds in case indoor air quality guidelines were not available by the World Health Organization for end-points relevant to the current study. For each pollutant, the highest indoor air concentrations in each microenvironment and exposure estimates across home microenvironments during the day were lower than the corresponding acute and long-term CELs. However, considerable contributions, especially to acute exposures, were obtained in some cases, such as formaldehyde emissions resulting from single product use of a floor cleaning agent (82% CEL), a candle (10% CEL) and an electric air freshener (17% CEL). Regarding multiple product use, the case of 30-min formaldehyde exposure reaching 34% CEL when eight product classes were used across home microenvironments, i.e. all-purpose/kitchen/floor cleaning agents, furniture/floor polish, combustible/electric air fresheners, and perfume, needs to be highlighted. Such estimated values should be evaluated with caution, as these may be attributed to the exposure scenarios
SEVENTH ANNUAL SURVEY: This Issue Brief presents findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey. This study is based on an online survey of 4,703 privately insured adults ages 21-64 to provide nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with EBRI's findings from earlier surveys. ENROLLMENT CONTINUES TO GROW: The survey finds continued growth in consumer-driven health plans: In 2011, 7 percent of the population was enrolled in a CDHP, up from 5 percent in 2010. Enrollment in HDHPs increased from 14 percent in 2010 to 16 percent in 2011. The 7 percent of the population with a CDHP represents 8.4 million adults ages 21-64 with private insurance, while the 16 percent with a HDHP represents 19.3 million people. Among the 19.3 million individuals with an HDHP, 38 percent (or 7.3 million) reported that they were eligible for a health savings ccount (HSA) but did not have such an account. Overall, 15.8 million adults ages 21-64 with private insurance, representing 13.1 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA but had not opened the account. When their children are counted, about 21 million individuals with private insurance, representing about 12 percent of the market, were either in a CDHP or an HSA-eligible plan. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether their plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about treatment options and costs; talked to their doctor about prescription drug options and costs
Barber, Andrew J; Tischler, Victoria A; Healy, Elaine
Consumer satisfaction with health care is one of the goals of health care delivery. Information on what affects satisfaction helps health care providers to deliver patient-centred care. The aim of this study was to explore the relationship between young persons' symptoms and satisfaction with Child and Adolescent Mental Health Services (CAMHS). It also examined differences in satisfaction of the parent/carer and their child. Self-report questionnaires were used to gather information from respondents. High levels of satisfaction were reported, although children and adolescents were less satisfied than parents/carers. Young people with self-reported conduct problems were least satisfied with CAMHS, as were those who rated their problems as having a significant impact on their lives. There was no relationship between carer-reported 'caseness' and carer satisfaction with services. Further exploration of the needs and expectations of young people who have behavioural difficulties is necessary so that their needs are better understood and expectations met.
Pinto, M B; Gehrt, K C
Although the presence of do-it-yourself (DIY) segments in some service-markets have long been taken for granted (e.g., home improvement and auto repair), the recent emergence of DIY segments in law, health, and other service-markets has been surprising to many observers. This paper examines the DIY segment in the health service market. The emergence of a DIY segment may be misconstrued by some service-marketers as being synonymous with lost clientele. This paper (1) explains some of the marketing implications of a DIY health services segment and (2) provides a brief profile of the DIY health services consumer. The paper concludes that the DIY segment represents new opportunity rather than lost clientele to service-marketers.
He, Zhe; Chen, Zhiwei; Oh, Sanghee; Hou, Jinghui; Bian, Jiang
The widely known vocabulary gap between health consumers and healthcare professionals hinders information seeking and health dialogue of consumers on end-user health applications. The Open Access and Collaborative Consumer Health Vocabulary (OAC CHV), which contains health-related terms used by lay consumers, has been created to bridge such a gap. Specifically, the OAC CHV facilitates consumers' health information retrieval by enabling consumer-facing health applications to translate between professional language and consumer friendly language. To keep up with the constantly evolving medical knowledge and language use, new terms need to be identified and added to the OAC CHV. User-generated content on social media, including social question and answer (social Q&A) sites, afford us an enormous opportunity in mining consumer health terms. Existing methods of identifying new consumer terms from text typically use ad-hoc lexical syntactic patterns and human review. Our study extends an existing method by extracting n-grams from a social Q&A textual corpus and representing them with a rich set of contextual and syntactic features. Using K-means clustering, our method, simiTerm, was able to identify terms that are both contextually and syntactically similar to the existing OAC CHV terms. We tested our method on social Q&A corpora on two disease domains: diabetes and cancer. Our method outperformed three baseline ranking methods. A post-hoc qualitative evaluation by human experts further validated that our method can effectively identify meaningful new consumer terms on social Q&A.
Atienza, Audie A; Zarcadoolas, Christina; Vaughon, Wendy; Hughes, Penelope; Patel, Vaishali; Chou, Wen-Ying Sylvia; Pritts, Joy
This study examined consumers' attitudes and perceptions regarding mobile health (mHealth) technology use in health care. Twenty-four focus groups with 256 participants were conducted in 5 geographically diverse locations. Participants were also diverse in age, education, race/ethnicity, gender, and rural versus urban settings. Several key themes emerged from the focus groups. Findings suggest that consumer attitudes regarding mHealth privacy/security are highly contextualized, with concerns depending on the type of information being communicated, where and when the information is being accessed, who is accessing or seeing the information, and for what reasons. Consumers frequently considered the tradeoffs between the privacy/security of using mHealth technologies and the potential benefits. Having control over mHealth privacy/security features and trust in providers were important issues for consumers. Overall, this study found significant diversity in attitudes regarding mHealth privacy/security both within and between traditional demographic groups. Thus, to address consumers' concerns regarding mHealth privacy and security, a one-size-fits-all approach may not be adequate. Health care providers and technology developers should consider tailoring mHealth technology according to how various types of information are communicated in the health care setting, as well as according to the comfort, skills, and concerns individuals may have with mHealth technology.
Costa, Marion P; Monteiro, Maria Lucia G; Frasao, Beatriz S; Silva, Vitor L M; Rodrigues, Bruna L; Chiappini, Claudete C J; Conte-Junior, Carlos A
Although the demand for goat milk products has been growing, they have lower consumer acceptability than products derived from cow milk. However, the addition of cupuassu pulp can be used to improve the formulation of these products. For this reason, the aim of this study was to investigate the influence of new goat milk yogurt manufactured with cupuassu pulp on physicochemical properties, consumers' perceptions, and overall consumer acceptance. In addition, the effect of antioxidant health information on consumer acceptance and purchase intention of cupuassu goat milk yogurts was evaluated. The results demonstrated a positive expectation regarding linking and familiarity to goat milk products and products with cupuassu pulp. The pH, total phenolic content, lightness, redness, yellowness, and apparent viscosity were potentially affected by the addition of cupuassu, with the highest concentration of cupuassu (10%) exhibiting the greatest changes in parameters. Based on principal component analysis, partial least squares regression, and just-about-right and penalty analysis, the addition of cupuassu pulp improved some sensory attributes of goat milk yogurt, such as cupuassu aroma, cupuassu flavor, yellow color, consistency, and viscosity, which positively influenced product acceptance. In addition, antioxidant health information increased the acceptance and purchase intention of cupuassu goat milk yogurts. Taking into account the parameters investigated in this study, the best scoring formulation was goat milk yogurt with 10% cupuassu pulp. Our results suggest that cupuassu pulp can be considered a potential ingredient to improve the sensory and texture properties of goat milk yogurt. Furthermore, the antioxidant health information could be a sensory strategy to increase the acceptance of cupuassu goat milk yogurts.
Pravst, Igor; Kušar, Anita
Insights into the use of health-related information on foods are important for planning studies about the effects of such information on the consumer's understanding, purchasing, and consumption of foods, and also support further food policy decisions. We tested the use of sales data for weighting consumers' exposure to health-related labeling information in the Slovenian food supply. Food labeling data were collected from 6342 pre-packed foods available in four different food stores in Slovenia. Consumers' exposure was calculated as the percentage of available food products with particular food information in the food category. In addition, 12-month sales data were used to calculate sales weighted exposure as a percentage of sold food products with certain food information in the food category. The consumer's in-store and sales-weighted exposure to nutrition claims was 37% and 45%, respectively. Exposure to health claims was much lower (13%, 11% when sales-weighted). Health claims were mainly found in the form of general non-specific claims or function claims, while children's development and reduction of disease risk claims were present on only 0.1% and 0.2% of the investigated foods, respectively. Sales data were found very useful for establishing a reliable estimation of consumers' exposure to information provided on food labels. The high penetration of health-related information on food labels indicates that careful regulation of this area is appropriate. Further studies should focus on assessing the nutritional quality of foods labeled with nutrition and health claims, and understanding the importance of such labeling techniques for consumers' food preferences and choices.
van Ommeren, M; Hanna, F; Weissbecker, I; Ventevogel, P
Armed conflicts and natural disasters impact negatively on the mental health and well-being of affected populations in the short- and long-term and affect the care of people with pre-existing mental health conditions. This paper outlines specific actions for mental health and psychosocial support by the health sector in the preparedness, response and recovery phases of emergencies. Broad recommendations for ministries of health are to: (1) embed mental health and psychosocial support in national health and emergency preparedness plans; (2) put in place national guidelines, standards and supporting tools for the provision of mental health and psychosocial support during emergencies; (3) strengthen the capacity of health professionals to identify and manage priority mental disorders during emergencies; and (4) utilize opportunities generated by the emergency response to contribute to development of sustainable mental health-care services.
Baggott, Rob; Jones, Kathryn
This article explores the policy role of health consumer and patients' organisations (HCPOs), an important subset of the UK voluntary health sector. Based on research findings from two surveys, the article examines the activities, resources and contacts of HCPOs. It also assesses their impact on health policy and reform. There is some evidence that HCPOs can influence policy and reform. However, much depends on the alliances they build with other policy actors (including other HCPOs), their resources and leadership. HCPOs seem to have more impact on the detail of policy than on the direction of travel. In addition, there are potentially adverse consequences for HCPOs that do engage with the policy process, which may partly explain why some are wary of such involvement. For example, it is possible that HCPOs can be manipulated by government and other powerful policy actors such as health professionals and the drugs industry.
Robinson, James C; Brown, Timothy T; Whaley, Christopher
Reference pricing in health insurance creates incentives for patients to select for nonemergency services providers that charge relatively low prices and still offer high quality of care. It changes the "choice architecture" by offering standard coverage if the patient chooses cost-effective providers but requires considerable consumer cost sharing if more expensive alternatives are selected. The short-term impact of reference pricing has been to shift patient volumes from hospital-based to freestanding surgical, diagnostic, imaging, and laboratory facilities. This article summarizes reference pricing's impacts to date on patient choice, provider prices, surgical complications, and employer spending and estimates its potential impacts if expanded to more services and a broader population. Reference pricing induces consumers to select lower-price alternatives for all of the forms of care studied, leading to significant reductions in prices paid and spending incurred by insurers and employers. The impact on consumer cost sharing is mixed, with some studies finding higher copayments and some lower. We conclude with a discussion of the incentives created for providers to redesign their clinical processes and for efficient providers to expand into price-sensitive markets. Over time, reference pricing may increase pressures for price competition and lead to further cost-reducing innovations in health care products and processes.
Smith, Elise; Behrmann, Jason; Martin, Carolina; Williams-Jones, Bryn
A subcategory of medical tourism, reproductive tourism has been the subject of much public and policy debate in recent years. Specific concerns include: the exploitation of individuals and communities, access to needed health care services, fair allocation of limited resources, and the quality and safety of services provided by private clinics. To date, the focus of attention has been on the thriving medical and reproductive tourism sectors in Asia and Eastern Europe; there has been much less consideration given to more recent 'players' in Latin America, notably fertility clinics in Chile, Brazil, Mexico and Argentina. In this paper, we examine the context-specific ethical and policy implications of private Argentinean fertility clinics that market reproductive services via the internet. Whether or not one agrees that reproductive services should be made available as consumer goods, the fact is that they are provided as such by private clinics around the world. We argue that basic national regulatory mechanisms are required in countries such as Argentina that are marketing fertility services to local and international publics. Specifically, regular oversight of all fertility clinics is essential to ensure that consumer information is accurate and that marketed services are safe and effective. It is in the best interests of consumers, health professionals and policy makers that the reproductive tourism industry adopts safe and responsible medical practices.
Background Many Web-based health care platforms allow patients to evaluate physicians by posting open-end textual reviews based on their experiences. These reviews are helpful resources for other patients to choose high-quality doctors, especially in countries like China where no doctor referral systems exist. Analyzing such a large amount of user-generated content to understand the voice of health consumers has attracted much attention from health care providers and health care researchers. Objective The aim of this paper is to automatically extract hidden topics from Web-based physician reviews using text-mining techniques to examine what Chinese patients have said about their doctors and whether these topics differ across various specialties. This knowledge will help health care consumers, providers, and researchers better understand this information. Methods We conducted two-fold analyses on the data collected from the “Good Doctor Online” platform, the largest online health community in China. First, we explored all reviews from 2006-2014 using descriptive statistics. Second, we applied the well-known topic extraction algorithm Latent Dirichlet Allocation to more than 500,000 textual reviews from over 75,000 Chinese doctors across four major specialty areas to understand what Chinese health consumers said online about their doctor visits. Results On the “Good Doctor Online” platform, 112,873 out of 314,624 doctors had been reviewed at least once by April 11, 2014. Among the 772,979 textual reviews, we chose to focus on four major specialty areas that received the most reviews: Internal Medicine, Surgery, Obstetrics/Gynecology and Pediatrics, and Chinese Traditional Medicine. Among the doctors who received reviews from those four medical specialties, two-thirds of them received more than two reviews and in a few extreme cases, some doctors received more than 500 reviews. Across the four major areas, the most popular topics reviewers found were the
Lingle, V A
The HEALTH PERIODICALS DATABASE, produced by the Information Access Company, is a unique online file which provides full-text access to both general interest health-related literature and key technical resources in the medical field. Available on DIALOG and CompuServe, the database is described as a useful tool for information on the health, fitness, and nutrition industries. Special features of the database are reviewed and comparisons are made with resources of similar scope.
Wilmart, Olivier; Legrève, Anne; Scippo, Marie-Louise; Reybroeck, Wim; Urbain, Bruno; de Graaf, Dirk C; Steurbaut, Walter; Delahaut, Philippe; Gustin, Pascal; Nguyen, Bach Kim; Saegerman, Claude
A scenario analysis in regard to the risk of chronic exposure of consumers to residues through the consumption of contaminated honey and beeswax was conducted. Twenty-two plant protection products and veterinary substances of which residues have already been detected in beeswax in Europe were selected. The potential chronic exposure was assessed by applying a worst-case scenario based on the addition of a "maximum" daily intake through the consumption of honey and beeswax to the theoretical maximum daily intake through other foodstuffs. For each residue, the total exposure was finally compared to the acceptable daily intake. It is concluded that the food consumption of honey and beeswax contaminated with these residues considered separately does not compromise the consumer's health, provided proposed action limits are met. In regard to residues of flumethrin in honey and in beeswax, "zero tolerance" should be applied.
Patients' rights to information in the UK are based on a mixture of statute (including legislation on access to medical records) and case law (principally revolving around the issue of informed consent). These rights are set out in the Patient's Charter, which is itself a mixture of rights based on legislation and those enforced by management practice. Failure to provide adequate information to a patient could expose a medical practitioner to action for negligence or battery. Negligent information-giving could also expose consumer health information services to damages, for which the best defence is a high standard of professional competence and adequate professional indemnity insurance. Sharing information about the risks and benefits of treatment to enable truly informed decision making and consent by the patient is a key element of an ethical relationship between care giver and consumer--the therapeutic partnership.
Winham, Donna M.
Background Bean consumption can reduce chronic disease risk and improve nutrition status. Consumer knowledge of bean health benefits could lead to increased intakes. Low-income women have poorer health and nutrition, but their level of knowledge about bean health benefits is unknown. Beans are a familiar food of reasonable cost in most settings and are cultural staples for Hispanics and other ethnicities. Study objectives were to assess awareness of bean health benefits among low-income women, and to evaluate any differences by acculturation status for Hispanic women in the Southwestern United States. Methods A convenience sample of 406 primarily Mexican-origin (70%) low-income women completed a survey on knowledge of bean health benefits and general food behaviors. Principal components analysis of responses identified two summary scale constructs representing “bean health benefits” and “food behaviors.” Acculturation level was the main independent variable in chi-square or ANOVA. Results The survey completion rate was 86% (406/471). Most women agreed or strongly agreed that beans improved nutrition (65%) and were satiating (62%). Over 50% answered ‘neutral’ to statements that beans could lower LDL cholesterol (52%), control blood glucose (56%) or reduce cancer risk (56%), indicating indifference or possible lack of knowledge about bean health benefits. There were significant differences by acculturation for beliefs that beans aid weight loss and intestinal health. Scores on the bean health benefits scale, but not the food behavior scale, also differed by acculturation. Conclusions Limited resource women have a favorable view of the nutrition value of beans, but the majority did not agree or disagreed with statements about bean health benefits. Greater efforts to educate low-income women about bean health benefits may increase consumption and improve nutrition. PMID:26820889
... Communications Commission 47 CFR Part 54 Rural Health Care Universal Service Support Mechanism; Proposed Rule #0... COMMUNICATIONS COMMISSION 47 CFR Part 54 Rural Health Care Universal Service Support Mechanism AGENCY: Federal... of health care, and addresses each of the major recommendations in the National Broadband...
Grounds, Dennis; Boehm, Al
The Human Health and Support Systems Capability Roadmap focuses on research and technology development and demonstration required to ensure the health, habitation, safety, and effectiveness of crews in and beyond low Earth orbit. It contains three distinct sub-capabilities: Human Health and Performance. Life Support and Habitats. Extra-Vehicular Activity.
Martin, E R; Lanier, D
The Library of the Health Sciences at the University of Illinois at Chicago obtained a grant from the Illinois State Library to implement a statewide demonstration project that would provide consumer health information (CHI) using InfoTrac's Health Reference Center CD-ROM database. The goals of the project were to cooperate with targeted public libraries and clinics in providing CHI at the earliest point of need; to provide access to the database via a dial-up network server and a toll-free telephone number; and to work with targeted sites on database training, core CHI reference sources, and referral procedures. This paper provides background information about the project; describes the major systems and technical issues encountered; and discusses the outcomes, impact, and envisioned enhancements. PMID:8826631
Wąsowicz, Grażyna; Styśko-Kunkowska, Małgorzata; Grunert, Klaus G
Qualitative and quantitative studies were conducted to explore the effect of front-of-pack nutrition labels on the perceived healthfulness of food products. Consumers were found to hold beliefs about colours and their fit to product categories that influence the assessment process. Consumers associate certain colours with product healthfulness. Yellow, blue, green and red were found to be evocative of health. Heather, pink and celadon suggested an artificial thus unhealthful product. The impact of labels on healthfulness assessment was observed only in the unhealthful category. The findings show the complexity of psychological processes in the perception of food healthfulness.
Cox, Carolyn C.
This paper describes lessons for teaching middle and high school students how to determine if they are influenced by the power of advertising and how to evaluate a product's health claims. To determine the influence of advertising, teachers have high school students discuss what their latest health product/service purchase was, why they bought it,…
The National Cancer Institute has targeted the reduction of cancer-related health disparities, differences in the incidence, prevalence, mortality, and burden of cancer and related adverse health conditions, as an important challenge.
Hensel, Marc J S; Silliman, Brian R
The global biodiversity crisis impairs the valuable benefits ecosystems provide humans. These nature-generated benefits are defined by a multitude of different ecosystem functions that operate simultaneously. Although several studies have simulated species loss in communities and tracked the response of single functions such as productivity or nutrient cycling, these studies have involved relatively similar taxa, and seldom are strikingly different functions examined. With the exception of highly managed ecosystems such as agricultural fields, rarely are we interested in only one function being performed well. Instead, we rely on ecosystems to deliver several different functions at the same time. Here, we experimentally investigated the extinction impacts of dominant consumers in a salt marsh. These consumers are remarkably phylogenetically diverse, spanning two kingdoms (i.e., Animalia and Fungi). Our field studies reveal that a diverse consumer assemblage significantly enhances simultaneous functioning of disparate ecosystem processes (i.e., productivity, decomposition, and infiltration). Extreme functional and phylogenetic differences among consumers underlie this relationship. Each marsh consumer affected at least one different ecosystem function, and each individual function was affected by no more than two consumers. The implications of these findings are profound: If we want ecosystems to perform many different functions well, it is not just number of species that matter. Rather, the presence of species representing markedly different ecologies and biology is also essential to maximizing multiple functions. Moreover, this work emphasizes the need to incorporate both microcomponents and macrocomponents of food webs to accurately predict biodiversity declines on integrated-ecosystem functioning.
Jadhav, Ashutosh; Andrews, Donna; Fiksdal, Alexander; Kumbamu, Ashok; McCormick, Jennifer B; Misitano, Andrew; Nelsen, Laurie; Ryu, Euijung; Sheth, Amit; Wu, Stephen
Background The number of people using the Internet and mobile/smart devices for health information seeking is increasing rapidly. Although the user experience for online health information seeking varies with the device used, for example, smart devices (SDs) like smartphones/tablets versus personal computers (PCs) like desktops/laptops, very few studies have investigated how online health information seeking behavior (OHISB) may differ by device. Objective The objective of this study is to examine differences in OHISB between PCs and SDs through a comparative analysis of large-scale health search queries submitted through Web search engines from both types of devices. Methods Using the Web analytics tool, IBM NetInsight OnDemand, and based on the type of devices used (PCs or SDs), we obtained the most frequent health search queries between June 2011 and May 2013 that were submitted on Web search engines and directed users to the Mayo Clinic’s consumer health information website. We performed analyses on “Queries with considering repetition counts (QwR)” and “Queries without considering repetition counts (QwoR)”. The dataset contains (1) 2.74 million and 3.94 million QwoR, respectively for PCs and SDs, and (2) more than 100 million QwR for both PCs and SDs. We analyzed structural properties of the queries (length of the search queries, usage of query operators and special characters in health queries), types of search queries (keyword-based, wh-questions, yes/no questions), categorization of the queries based on health categories and information mentioned in the queries (gender, age-groups, temporal references), misspellings in the health queries, and the linguistic structure of the health queries. Results Query strings used for health information searching via PCs and SDs differ by almost 50%. The most searched health categories are “Symptoms” (1 in 3 search queries), “Causes”, and “Treatments & Drugs”. The distribution of search queries for
Adherence to healthy behaviors and self-care strategies is a concern among clinicians. E-health applications, such as the internet, personal communication devices, electronic health records and web portals, and electronic games, may be a way to provide health information in a way that is reliable, c...
Fernandez-Llatas, Carlos; Traver, Vicente; Borras-Morell, Jose-Enrique; Martinez-Millana, Antonio; Karlsen, Randi
Health consumers are increasingly using the Internet to search for health information. The existence of overloaded, inaccurate, obsolete, or simply incorrect health information available on the Internet is a serious obstacle for finding relevant and good-quality data that actually helps patients. Search engines of multimedia Internet platforms are thought to help users to find relevant information according to their search. But, is the information recovered by those search engines from quality sources? Is the health information uploaded from reliable sources, such as hospitals and health organizations, easily available to patients? The availability of videos is directly related to the ranking position in YouTube search. The higher the ranking of the information is, the more accessible it is. The aim of this study is to analyze the ranking evolution of diabetes health videos on YouTube in order to discover how videos from reliable channels, such as hospitals and health organizations, are evolving in the ranking. The analysis was done by tracking the ranking of 2372 videos on a daily basis during a 30-day period using 20 diabetes-related queries. Our conclusions are that the current YouTube algorithm favors the presence of reliable videos in upper rank positions in diabetes-related searches.
Borras-Morell, Jose-Enrique; Martinez-Millana, Antonio; Karlsen, Randi
Health consumers are increasingly using the Internet to search for health information. The existence of overloaded, inaccurate, obsolete, or simply incorrect health information available on the Internet is a serious obstacle for finding relevant and good-quality data that actually helps patients. Search engines of multimedia Internet platforms are thought to help users to find relevant information according to their search. But, is the information recovered by those search engines from quality sources? Is the health information uploaded from reliable sources, such as hospitals and health organizations, easily available to patients? The availability of videos is directly related to the ranking position in YouTube search. The higher the ranking of the information is, the more accessible it is. The aim of this study is to analyze the ranking evolution of diabetes health videos on YouTube in order to discover how videos from reliable channels, such as hospitals and health organizations, are evolving in the ranking. The analysis was done by tracking the ranking of 2372 videos on a daily basis during a 30-day period using 20 diabetes-related queries. Our conclusions are that the current YouTube algorithm favors the presence of reliable videos in upper rank positions in diabetes-related searches. PMID:28243314
Kennedy, May G.; Kiken, Laura; Shipman, Jean P.
Problem: Four consumer health information centers in Richmond, Virginia, provide one-on-one assistance in accessing health information. Because they may not be fully utilized at present, an exploratory marketing study of factors affecting usage of the centers was conducted. Method: Observers counted center passers-by and tracked their paths. Also, brief intercept interviews were conducted with people who had just used a center, people nearby who could have used one but did not, and people on the street. Finally, in-depth individual interviews were conducted with key informants. Results: There was a high degree of satisfaction with the centers among users. Nonusers universally endorsed the center concept. However, most passers-by did not even glance at the centers, and intercept interviewees suggested better signage and promoting the resource centers through various media channels. Key informants added suggestions about interpersonal strategies (e.g., physician referrals) for center usage promotion but cautioned that a large increase in traffic could not be accommodated without increasing staff size or shifting from a model of individualized service. Conclusions: Triangulating findings from multiple data collection methods can provide useful guidance for efforts to promote center utilization. At minimum, steps should be taken to make the largest centers more noticeable. Because center utilization is not only associated with consumer satisfaction with hospitals, but may also foster health literacy, both hospital-based and community-based usage promotion strategies may be warranted. All such promotional strategies should be audience-tested before they are adopted. PMID:18219380
Honko, Harri; Andalibi, Vafa; Aaltonen, Timo; Parak, Jakub; Saaranen, Mika; Viik, Jari; Korhonen, Ilkka
Novel health monitoring devices and applications allow consumers easy and ubiquitous ways to monitor their health status. However, technologies from different providers lack both technical and semantic interoperability and hence the resulting health data are often deeply tied to a specific service, which is limiting its reusability and utilization in different services. We have designed a Wellness Warehouse Engine (W2E) that bridges this gap and enables seamless exchange of data between different services. W2E provides interfaces to various data sources and makes data available via unified representational state transfer application programming interface to other services. Importantly, it includes Unifier--an engine that allows transforming input data into generic units reusable by other services, and Analyzer--an engine that allows advanced analysis of input data, such as combining different data sources into new output parameters. In this paper, we describe the architecture of W2E and demonstrate its applicability by using it for unifying data from four consumer activity trackers, using a test base of 20 subjects each carrying out three different tracking sessions. Finally, we discuss challenges of building a scalable Unifier engine for the ever-enlarging number of new devices.
Mrabet, Yassine; Kilicoglu, Halil; Roberts, Kirk; Demner-Fushman, Dina
Determining the main topics in consumer health questions is a crucial step in their processing as it allows narrowing the search space to a specific semantic context. In this paper we propose a topic recognition approach based on biomedical and open-domain knowledge bases. In the first step of our method, we recognize named entities in consumer health questions using an unsupervised method that relies on a biomedical knowledge base, UMLS, and an open-domain knowledge base, DBpedia. In the next step, we cast topic recognition as a binary classification problem of deciding whether a named entity is the question topic or not. We evaluated our approach on a dataset from the National Library of Medicine (NLM), introduced in this paper, and another from the Genetic and Rare Disease Information Center (GARD). The combination of knowledge bases outperformed the results obtained by individual knowledge bases by up to 16.5% F1 and achieved state-of-the-art performance. Our results demonstrate that combining open-domain knowledge bases with biomedical knowledge bases can lead to a substantial improvement in understanding user-generated health content. PMID:28269888
Background The implementation of health technology is a national priority in the United States and widely discussed in the literature. However, literature about the use of this technology by historically underserved populations is limited. Information on culturally informed health and wellness technology and the use of these technologies to reduce health disparities facing historically underserved populations in the United States is sparse in the literature. Objective To examine ways in which technology is being used by historically underserved populations to decrease health disparities through facilitating or improving health care access and health and wellness outcomes. Methods We conducted a systematic review in four library databases (PubMed, PsycINFO, Web of Science, and Engineering Village) to investigate the use of technology by historically underserved populations. Search strings consisted of three topics (eg, technology, historically underserved populations, and health). Results A total of 424 search phrases applied in the four databases returned 16,108 papers. After review, 125 papers met the selection criteria. Within the selected papers, 30 types of technology, 19 historically underserved groups, and 23 health issues were discussed. Further, almost half of the papers (62 papers) examined the use of technology to create effective and culturally informed interventions or educational tools. Finally, 12 evaluation techniques were used to assess the technology. Conclusions While the reviewed studies show how technology can be used to positively affect the health of historically underserved populations, the technology must be tailored toward the intended population, as personally relevant and contextually situated health technology is more likely than broader technology to create behavior changes. Social media, cell phones, and videotapes are types of technology that should be used more often in the future. Further, culturally informed health information
Almasi, Elizabeth A; Stafford, Randall S; Kravitz, Richard L; Mansfield, Peter R
Background to the debate: Only two industrialized countries, the United States and New Zealand, allow direct-to-consumer advertising (DTCA) of prescription medicines, although New Zealand is planning a ban [ 1]. The challenge for these governments is ensuring that DTCA is more beneficial than harmful. Proponents of DTCA argue that it helps to inform the public about available treatments and stimulates appropriate use of drugs for high-priority illnesses (such as statin use in people with ischemic heart disease). Critics argue that the information in the adverts is often biased and misleading, and that DTCA raises prescribing costs without net evidence of health benefits. PMID:16563041
Chen, Rudan; Zhao, Xianyang; Xu, Wei; Cheng, Wenqing; Lin, Simon
Background Consumer-generated content, such as postings on social media websites, can serve as an ideal source of information for studying health care from a consumer’s perspective. However, consumer-generated content on health care topics often contains spelling errors, which, if not corrected, will be obstacles for downstream computer-based text analysis. Objective In this study, we proposed a framework with a spelling correction system designed for consumer-generated content and a novel ontology-based evaluation system which was used to efficiently assess the correction quality. Additionally, we emphasized the importance of context sensitivity in the correction process, and demonstrated why correction methods designed for electronic medical records (EMRs) failed to perform well with consumer-generated content. Methods First, we developed our spelling correction system based on Google Spell Checker. The system processed postings acquired from MedHelp, a biomedical bulletin board system (BBS), and saved misspelled words (eg, sertaline) and corresponding corrected words (eg, sertraline) into two separate sets. Second, to reduce the number of words needing manual examination in the evaluation process, we respectively matched the words in the two sets with terms in two biomedical ontologies: RxNorm and Systematized Nomenclature of Medicine -- Clinical Terms (SNOMED CT). The ratio of words which could be matched and appropriately corrected was used to evaluate the correction system’s overall performance. Third, we categorized the misspelled words according to the types of spelling errors. Finally, we calculated the ratio of abbreviations in the postings, which remarkably differed between EMRs and consumer-generated content and could largely influence the overall performance of spelling checkers. Results An uncorrected word and the corresponding corrected word was called a spelling pair, and the two words in the spelling pair were its members. In our study, there
Grants awarded by the Ontario Mental Health Foundation (OMHF) between 1986 and 1991 were analyzed for their relevance to male and female mental health topics following earlier research by Stark-Adamec in 1981. OMHF fellowships and scholarships, 1986 to 1991, National Health Research and Development Program funding, 1989 to 1990 and 1990 to 1991 funding by the Medical Research Council were also examined. Essentially, funding focused on neither gender; issues concerning gender and mental health were seldom involved in research funded by these agencies.
Nowak, Sarah A; Eibner, Christine; Adamson, David M; Saltzman, Evan
This study examines the likely effects of the Affordable Care Act (ACA) on average annual consumer health care spending and the risk of catastrophic medical costs for the United States overall and in two large states that have decided not to expand their Medicaid programs (Texas and Florida). The ACA will have varied impacts on individuals' and families' spending on health care, depending on income level and on estimated 2016 insurance status without the ACA. The authors find that average out-of-pocket spending is expected to decrease for all groups considered in the analysis, although decreases in out-of-pocket spending will be largest for those who would otherwise be uninsured. People who would otherwise be uninsured who transition to the individual market under the ACA will have higher total health care spending on average after implementation of the ACA because they will now incur the cost of health insurance premiums. The authors also find that risk of catastrophic health care spending will decrease for individuals of all income levels for the insurance transitions considered; decreases will be greatest for those at the lowest income levels. Case studies found that in Texas and Florida, Medicaid expansion would substantially reduce out-of-pocket and total health care spending for those with incomes below 100 percent of the federal poverty level, compared with a scenario in which the ACA is implemented without Medicaid expansion. Expansion would reduce the risk of high medical spending for those covered under Medicaid who would remain uninsured without expansion.
Claxton, Gary; Gabel, Jon; Gil, Isadora; Pickreign, Jeremy; Whitmore, Heidi; Finder, Benjamin; DiJulio, Bianca; Hawkins, Samantha
Based on a survey of 2,122 randomly selected public and private employers, this paper reports on the state of employer-sponsored health insurance in spring 2006, including recent changes. Premiums increased 7.7 percent from spring 2005 to spring 2006 and have risen 68 percent since 2001. About 4 percent of workers are enrolled in high-deductible health plans with savings options. The percentage of workers covered by their own employer did not statistically change from 2005 to 2006.
Fiorini, Fulvio; Ameri, Cinzia; Tarchini, Renzo; Granata, Antonio; Zuccardi Merli, Mara
The necessity for fairness and transparency during the processes of supply of consumables and capital goods within the Italian Health Service together with that of containing costs in line with budget reductions, are points outlined in the 2006 public and European Union allocation codes and related procedures. These include methods to guarantee open, limited negotiation both without or after the official announcement for competitive bidding has been made, plus mediation and framework agreement. The publicizing of announcements of bidding to potential Health Service suppliers, criteria for applicant selection and selection of personnel to comprise the panels who effectively make the choice of suppliers, are all phases that are carefully regulated at a legal level. Even small expenditures (down to 20,000) are covered by these regulations. An overview of specific responsibilities, the institution of boards of physicians and the application of sanctions ends the present review.
Bouchard, Louise; Berthelot, Jean-Marie; Casteigts, Arnaud; Chartier, Mariette; Trugeon, Alain; Warnke, Jan
Health information is indispensable for monitoring the progress that has been made in improving and maintaining population health and health system functions. In the context of health reforms aiming to bring health systems closer to populations and with the objective of consistent health services planning at the community level, access to reliable social and health data has become a major issue. The need to develop specific treatment tools and the appropriation of results by the various actors involved (decision makers, planners, researchers and consumers) are central to the presentations and exchanges in this symposium.
Shenson, Jared A.; Ingram, Ebone; Colon, Nadja; Jackson, Gretchen Purcell
Pregnancy is a time when expectant mothers may have numerous questions about their unborn children, especially when congenital anomalies are diagnosed prenatally. We sought to characterize information needs of pregnant women seen in the Vanderbilt Children’s Hospital Fetal Center. Participants recorded questions from diagnosis through delivery. Questions were categorized by two researchers using a hierarchical taxonomy describing consumer health information needs. Consensus category assignments were made, and inter-rater reliability was measured with Cohen’s Kappa. Sixteen participants reported 398 questions in 39 subcategories, of which the most common topics were prognosis (53 questions; 13.3%) and indications for intervention (31 questions; 7.8%). Inter-rater reliability of assignments showed moderate (κ=0.57) to substantial (κ=0.75) agreement for subcategories and primary categories, respectively. Pregnant women with prenatal diagnoses have diverse unmet information needs; a taxonomy of consumer health information needs may improve the ability to meet such needs through content and system design. PMID:26958254
Salter, Brian; Zhou, Yinhua; Datta, Saheli
Global health consumer demand for stem cell therapies is vibrant, but the supply of treatments from the conventional science-based model of innovation is small and unlikely to increase in the near future. At the same time, several models of medical innovation have emerged that can respond to the demand, often employing a transnational value chain to deliver the product. Much of the commentary has approached the issue from a supply side perspective, demonstrating the extent to which national and transnational regulation fails to impose what are regarded as appropriate standards on the 'illicit' supply of stem cell therapies characterized by little data and poor outcomes. By contrast, this article presents a political economic analysis with a strong demand side perspective, arguing that the problem of what is termed 'stem cell tourism' is embedded in the demand-supply relationship of the health consumer market and its engagement with different types of stem cell therapy innovation. To be meaningful, discussions of regulation must recognize that analysis or risk being sidelined by a market, which ignores their often wishful thinking.
Nicholas, David; Huntington, Paul; Williams, Peter
Examines the use, over three and a half years, of a sample of 20 touch-screen health kiosks in the United Kingdom. Identifies four patterns of use over time--declining, stable, increasing, and no trend--and discusses implications of these patterns. Thumbnail use graphs for the 20 kiosks are appended. (AEF)
Arakji, Reina Y.
The first decade of the twenty-first century has seen dramatic advances in Internet technologies. Digital social spaces have emerged as popular Internet applications that are radically changing how firms and consumers of digital content interact. In the first chapter "Research Agenda" I introduce my research and the context within which it is…
Parente, Stephen T; Feldman, Roger
Using results from peer-reviewed empirical analyses we describe the development and impact of the consumer-driven health plan market over the last 5 years. The results of these analyses show that consumers are responding to the financial incentives of these new health insurance benefits. Although the results may not always be what the consumer-driven health plan developers intended, there is clear evidence of 'consumerism', where individuals act in a way that generally increases their access to healthcare or investments, if the opportunity is present. Just as Medicare Part D enrollment demonstrated consumers could identify differences in prescription drug plans and make rational choices, so too are prospective patients able to function as consumers in the medical marketplace when give the opportunity.
Keating, David M; Rains, Stephen A
The reported study explored the implications of informal computer-mediated social support for the well-being of individuals coping with illness over the course of 3 years. A panel study was conducted in which respondents--bloggers writing about their experiences living with a health condition--reported on their perceptions of social support and well-being during 2010 and again during 2013. Among respondents who completed both questionnaires (n = 49), increases in support availability from family and friends were related to improvements in bloggers' health self-efficacy as well as improvements in bloggers' loneliness, particularly among those who also experienced increased support availability from blog readers. Increased blog reader support availability was associated with improvements in bloggers' health-related uncertainty. Among respondents who completed the initial questionnaire (N = 121), a survival analysis showed that neither support available from family and friends nor support from blog readers predicted continued health blogging over the 3-year period.
Moore, Michele Johnson; Barr, Elissa; Wilson, Kristina; Griner, Stacey
Background: Numerous studies document support for sexuality education in the schools. However, there is a dearth of research assessing support for sexual health services offered through school-based health clinics (SBHCs). The purpose of this study was to assess voter support for offering 3 sexual health services (STI/HIV testing, STI/HIV…
Sen. Boxer, Barbara [D-CA
02/27/2013 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S947) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Sen. Crapo, Mike [R-ID
06/09/2009 Referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S6385) (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:
Ghadi, V; Naiditch, M
Initially introduced by Juppé in 1996, the legislative reforms of January 2nd and March 4th 2002 legally enacted new forms of consumer representation and participation in the development of the health system. However, it appears that while this new role which was created to ensure legitimate participation has been recognised by law in theory, it has not necessarily received the same recognition and incorporation in practice at the grass roots level. As a result, it is now essential to think about practical methods of representation in order to sustain local legitimacy of consumers and patients on the ground and construct it from the bottom-up. The goal of this work was to understand how and under what conditions local legitimacy for health care system consumers, as a particular group of actors, can be effectively built, independently and irrespective of the specific question of elective democratic processes. The foundation of this work is based on material which resides in the collection of data from various local participation experiments that we or other researchers have contributed to establishing in a select group of health care settings. The results of this analysis serve to update a list of principle factors through which the legitimacy of the health care system's users is constructed. Such factors include the following: the promoting agents' expectations vis-à-vis the system's users and the a priori status which is given to them; the identification and selection methods used for choosing users, and the link to the types of users in terms of representation; the nature of the "generalisation" process for decision-making, understood as the process which transforms individuals' words and perspectives into collective ones; and the conditions for and modes of interaction between laypersons and professional experts. Finally, the paper presents the potential conflictive relationship or tension which may exist between representation and legitimacy with regard to
Agriculture and of Health in planning a national vaccination campaign to prevent rabies in dogs and assisted the Pan American Health Organization with...illnesses associated with food and by coordinating with other veterinarian assets in theater to inspect local sources of meats and water from the Haitian...communication systems, i.e. TRAC2ES. In addition, there should be a means to track the individual patient with a bar code/computer chip ( Dog Tag), which
Schnall, Rebecca; Rojas, Marlene; Bakken, Suzanne; Brown, William; Carballo-Dieguez, Alex; Carry, Monique; Gelaude, Deborah; Mosley, Jocelyn Patterson; Travers, Jasmine
Background Mobile technologies are a useful platform for the delivery of health behavior interventions. Yet little work has been done to create a rigorous and standardized process for the design of mobile health (mHealth) apps. This project sought to explore the use of the Information Systems Research (ISR) framework as guide for the design of mHealth apps. Methods Our work was guided by the ISR framework which is comprised of 3 cycles: Relevance, Rigor and Design. In the Relevance cycle, we conducted 5 focus groups with 33 targeted end-users. In the Rigor cycle, we performed a review to identify technology-based interventions for meeting the health prevention needs of our target population. In the ISR Design Cycle, we employed usability evaluation methods to iteratively develop and refine mock-ups for a mHealth app. Results Through an iterative process, we identified barriers and facilitators to the use of mHealth technology for HIV prevention for high-risk MSM, developed ‘use cases’ and identified relevant functional content and features for inclusion in a design document to guide future app development. Findings from our work support the use of the ISR framework as a guide for designing future mHealth apps. Discussion Results from this work provide detailed descriptions of the user-centered design and system development and have heuristic value for those venturing into the area of technology-based intervention work. Findings from this study support the use of the ISR framework as a guide for future mobile health (mHealth) app development. Conclusion Use of the ISR framework is a potentially useful approach for the design of a mobile app that incorporates end-users’ design preferences. PMID:26903153
Watson, Amy C.; Corrigan, Patrick W.; Angell, Beth
The use of legal coercion to compel individuals to participate in mental health treatment is expanding despite a lack of empirical support for many of its forms. Policies supporting mandated treatment are made by legislators and judges, often based on perceptions of public concern. Using data from the MacArthur Mental Health Module contained in…
Golaszewski, Thomas; Allen, Judd; Edington, Dee
A conccptual model for addressing the creation of supportive environments for worksite health promotion settings is presented. The authors also discuss the variety of organizational and cultural interventions that are necessary in creating a supportive environment for healthy behavior using a social ecology perspective. The connection to next generation strategies in worksite health promotion is proposed and summaries of the relevant literatures are cited.
Martirosyan, Alina; Schneider, Yves-Jacques
From the current state-of-the-art, it is clear that nanotechnology applications are expected to bring a range of benefits to the food sector aiming at providing better quality and conservation. In the meantime, a growing number of studies indicate that the exposure to certain engineered nanomaterials (ENMs) has a potential to lead to health complications and that there is a need for further investigations in order to unravel the biological outcomes of nanofood consumption. In the current review, we summarize the existing data on the (potential) use of ENMs in the food industry, information on the toxicity profiles of the commonly applied ENMs, such as metal (oxide) nanoparticles (NPs), address the potential food safety implications and health hazards connected with the consumption of nanofood. A number of health complications connected with the human exposure to ENMs are discussed, demonstrating that there is a real basis for the arisen concern not only connected with the gut health, but also with the potency to lead to systemic toxicity. The toxicological nature of hazard, exposure levels and risk to consumers from nanotechnology-derived food are on the earliest stage of investigation and this review also highlights the major gaps that need further research and regulation.
Martirosyan, Alina; Schneider, Yves-Jacques
From the current state-of-the-art, it is clear that nanotechnology applications are expected to bring a range of benefits to the food sector aiming at providing better quality and conservation. In the meantime, a growing number of studies indicate that the exposure to certain engineered nanomaterials (ENMs) has a potential to lead to health complications and that there is a need for further investigations in order to unravel the biological outcomes of nanofood consumption. In the current review, we summarize the existing data on the (potential) use of ENMs in the food industry, information on the toxicity profiles of the commonly applied ENMs, such as metal (oxide) nanoparticles (NPs), address the potential food safety implications and health hazards connected with the consumption of nanofood. A number of health complications connected with the human exposure to ENMs are discussed, demonstrating that there is a real basis for the arisen concern not only connected with the gut health, but also with the potency to lead to systemic toxicity. The toxicological nature of hazard, exposure levels and risk to consumers from nanotechnology-derived food are on the earliest stage of investigation and this review also highlights the major gaps that need further research and regulation. PMID:24879486
Functional foods marketed as promoting health or reducing the risk of disease open a promising avenue for consumers to pursue a healthier life. Despite the stable growth in functional foods in Taiwan, at present little is known about whether or not consumers with varying degrees of health consciousness and different healthy lifestyles will have dissimilar attitudes toward functional foods and will vary in their willingness to use them. Regression analysis of this empirical study verifies that consumers' attitudes toward functional foods do have an impact on their willingness to use such foods. Moreover, moderated regression analysis (MRA) reveals that the joint moderator of health consciousness and healthy lifestyle indeed exerts an impact on consumers' willingness to consume functional foods. Finally, one-way ANOVA tests show that there are some differences between the consumers of the "Healthy Life Attentive" group and those of the "Healthy Life Inattentive" one both in attitudes toward and in willingness to consume functional foods. The empirical results and findings from this study would be valuable for the marketers in the functional food industry to formulate marketing communication strategies and facilitate this industry's development.
Annunziata, Azzurra; Pomarici, Eugenio; Vecchio, Riccardo; Mariani, Angela
The global strategy to reduce the harmful use of alcohol launched in 2010 by the World Health Organization includes, amongst several areas of recommended actions, providing consumer information about, and labelling, alcoholic beverages to indicate alcohol-related harm. Labelling requirements worldwide for alcoholic drinks are currently quite diverse and somewhat limited compared to labelling on food products and on tobacco. In this context, the current paper contributes to the academic and political debate on the inclusion of nutritional and health information on wine labelling, providing some insights into consumer interest in, and preferences for, such information in four core wine-producing and -consuming countries: Italy, France, Spain, and the United States of America. A rating-based conjoint analysis was performed in order to ascertain consumer preferences for different formats of additional information on wine labels, and a segmentation of the sample was performed to determine the existence of homogeneous groups of consumers in relation to the degrees of usefulness attached to the nutritional and health information on wine labels. Our results highlight the interest expressed by European and United States consumers for introducing nutrition and health information on wine labels. However, the results of conjoint analysis show some significant differences among stated preferences of the information delivery modes in different countries. In addition, segmentation analysis reveal the existence of significant differences between consumer groups with respect to their interest in receiving additional information on wine labels. These differences are not only linked to the geographic origin of the consumers, or to socio-demographic variables, but are also related to wine consumption habits, attitudes towards nutritional information, and the degree of involvement with wine. This heterogeneity of consumer preferences indicates a need for a careful consideration of wine
Annunziata, Azzurra; Pomarici, Eugenio; Vecchio, Riccardo; Mariani, Angela
The global strategy to reduce the harmful use of alcohol launched in 2010 by the World Health Organization includes, amongst several areas of recommended actions, providing consumer information about, and labelling, alcoholic beverages to indicate alcohol-related harm. Labelling requirements worldwide for alcoholic drinks are currently quite diverse and somewhat limited compared to labelling on food products and on tobacco. In this context, the current paper contributes to the academic and political debate on the inclusion of nutritional and health information on wine labelling, providing some insights into consumer interest in, and preferences for, such information in four core wine-producing and -consuming countries: Italy, France, Spain, and the United States of America. A rating-based conjoint analysis was performed in order to ascertain consumer preferences for different formats of additional information on wine labels, and a segmentation of the sample was performed to determine the existence of homogeneous groups of consumers in relation to the degrees of usefulness attached to the nutritional and health information on wine labels. Our results highlight the interest expressed by European and United States consumers for introducing nutrition and health information on wine labels. However, the results of conjoint analysis show some significant differences among stated preferences of the information delivery modes in different countries. In addition, segmentation analysis reveal the existence of significant differences between consumer groups with respect to their interest in receiving additional information on wine labels. These differences are not only linked to the geographic origin of the consumers, or to socio-demographic variables, but are also related to wine consumption habits, attitudes towards nutritional information, and the degree of involvement with wine. This heterogeneity of consumer preferences indicates a need for a careful consideration of wine
The presence of pesticide residues in apples raises serious health concerns, especially when the fresh fruits are consumed by children, particularly vulnerable to the pesticide hazards. This study demonstrates the results from nine years of investigation (2005-2013) of 696 samples of Polish apples for 182 pesticides using gas and liquid chromatography and spectrophotometric techniques. Only 33.5% of the samples did not contain residues above the limit of detection. In 66.5% of the samples, 34 pesticides were detected, of which maximum residue level (MRL) was exceeded in 3%. Multiple residues were present in 35% of the samples with two to six pesticides, and one sample contained seven compounds. A study of the health risk for children, adults and the general population consuming apples with these pesticides was performed. The pesticide residue data have been combined with the consumption of apples in the 97.5 percentile and the mean diet. A deterministic model was used to assess the chronic and acute exposures that are based on the average and high concentrations of residues. Additionally, the "worst-case scenario" and "optimistic case scenario" were used to assess the chronic risk. In certain cases, the total dietary pesticide intake calculated from the residue levels observed in apples exceeds the toxicological criteria. Children were the group most exposed to the pesticides, and the greatest short-term hazard stemmed from flusilazole at 624%, dimethoate at 312%, tebuconazole at 173%, and chlorpyrifos methyl and captan with 104% Acute Reference Dose (ARfD) each. In the cumulative chronic exposure, among the 17 groups of compounds studied, organophosphate insecticides constituted 99% acceptable daily intake (ADI). The results indicate that the occurrence of pesticide residues in apples could not be considered a serious public health problem. Nevertheless, an investigation into continuous monitoring and tighter regulation of pesticide residues is recommended.
Wallace, Jessica; Pyman, Ella; Faunce, Thomas
In April 2015, North J of the Federal Court of Australia made a finding of unconscionable conduct against Advanced Medical Institute, a promoter and provider of erectile dysfunction treatment, in a case concerning unfair contract terms (Australian Competition and Consumer Commission vACN 117 372 915 Pty Ltd (in liq) (formerly Advanced Medical Institute Pty Ltd)  FCA 368). The contract required a minimum 12-month commitment, with costs exceeding treatments available from general practitioners, and made refunds available only after all possible treatment plans were exhausted which included penile injections. This column analyses that case, particularly in respect to the consumer law standards of practice under which it was litigated. Those standards refer to patients as "consumers" yet North J made extensive reference to the Good Medical Practice: A Code of Conduct for Doctors in Australia, a text which refers to "patients", as evidence of what constitutes appropriate professional conduct or practice for the health profession. This column considers whether legislative and judicial categorisation of patients (a class of people presumptively suffering, sick and vulnerable) as "consumers" undermines the formal and informal protections accorded to patients under normative systems of medical ethics such as those represented by the Code. The case, it is argued, also illuminates the contemporary tensions between the ethical, legal and human rights standards required of doctors in their treatment of patients and the commercial interests of businesses.
Butts, Marcus M.; Hurst, Carrie S.; Eby, Lillian T.
Executive Summary Two studies were conducted to develop a psychometrically sound measure of supervisor health and safety support (SHSS). We identified three dimensions of supervisor support (physical health, psychological health, safety) and used Study 1 to develop items and establish content validity. Study 2 was used to establish the dimensionality of the new measure and provide criterion-related and discriminant validity evidence of the measure using supervisor and subordinate data. The measure had incremental validity in predicting employee performance and psychological strain outcomes above and beyond general work support variables. Implications of these findings and for workplace support theory and practice are discussed. PMID:24771991
...In this document, the Federal Communications Commission reforms its universal service support program for health care, transitioning its existing Internet Access and Rural Health Care Pilot programs into a new, efficient Healthcare Connect Fund. This Fund will expand health care provider access to broadband, especially in rural areas, and encourage the creation of state and regional broadband......
... COMMISSION 47 CFR Part 54 Rural Health Care Support Mechanism AGENCY: Federal Communications Commission... services under the rural health care program. Grandfathered providers do not currently qualify as ``rural,'' but play a key role in delivering health care services to surrounding regions that do qualify...
... COMMISSION 47 CFR Part 54 Rural Health Care Support Mechanism AGENCY: Federal Communications Commission... information collection associated with the Commission's Universal Service--Rural Health Care Program, Report... August 23, 2013). OMB Expiration Date: August 31, 2016. Title: Universal Service--Rural Health...
... COMMISSION 47 CFR Part 54 Rural Health Care Support Mechanism AGENCY: Federal Communications Commission... Form. This announcement is consistent with the Universal Service--Rural Health Care Program, Report and... of the Instructions; Page 8, line 122, the Rural Health Care Program offset indicator was...
... COMMISSION 47 CFR Part 54 Rural Health Care Support Mechanism AGENCY: Federal Communications Commission...) adopts an interim rule permitting health care providers that are located in a ``rural area'' under the... rural health care program prior to July 1, 2005, to continue to be treated as if they are located...
Sahavechaphan, Naiyana; Phengsuwan, Jedsada; U-Ruekolan, Suriya; Aroonrua, Kamron; Ponhan, Jukrapong; Harnsamut, Nattapon; Vannarat, Sornthep
Heath information across geographically distributed healthcare centers has been recognized as an essential resource that drives an efficient national health-care plan. There is thus a need for the National Health Information System (NHIS) that provides the transparent and secure access to health information from different healthcare centers both on demand and in a time efficient manner. As healthiness is the ultimate goal of people and nation, we believe that the NHIS should be sustainable by taking the healthcare center and information consumer perspectives into account. Several issues in particular must be resolved altogether: (i) the diversity of health information structures among healthcare centers; (ii) the availability of health information sharing from healthcare centers; (iii) the efficient information access to various healthcare centers; and (iv) the privacy and privilege of heath information. To achieve the sustainable NHIS, this paper details our work which is divided into 3 main phases. Essentially, the first phase focuses on the application of metadata standard to enable the interoperability and usability of health information across healthcare centers. The second phase moves forward to make information sharing possible and to provide an efficient information access to a large number of healthcare centers. Finally, in the third phase, the privacy and privilege of health information is promoted with respect to access rights of information consumers.
Reise, Steven P.; Meijer, Rob R.; Ainsworth, Andrew T.; Morales, Leo S.; Hays, Ron D.
Group-level parametric and non-parametric item response theory models were applied to the Consumer Assessment of Healthcare Providers and Systems (CAHPS[R]) 2.0 core items in a sample of 35,572 Medicaid recipients nested within 131 health plans. Results indicated that CAHPS responses are dominated by within health plan variation, and only weakly…
Francis, Linda E; Colson, Paul W; Mizzi, Pamela
Involvement of mental health service consumers in the provision of mental health services is a growing model in community mental health. It is, however, a complicated issue, made ever more so by the passage of the Americans with Disabilities Act. In this ethnographic case study, we seek to explore the changes one social services agency has made to adjust to the requirements of the ADA and the impact of these changes on their consumer employees. Our results indicate potential for positive progress as a result of the ADA, but also unexpected pitfalls as organizational cultures change as well.
Welch Cline, Rebecca J; Young, Henry N
Proponents and opponents of direct-to-consumer advertising (DTCA) of prescription drugs argue that it promotes greater participation in health care by consumers with significant implications for public health and health care outcomes. This article (a). proposes a social cognitive theoretical framework to explain DTCA's effects, and (b). reports the first in a series of studies on DTCA's observational learning functions that may influence consumer behavior and the physician-patient relationship. This investigation addresses visual features of print DTCA. Results focus on the prevalence and nature of models featured in the ads and how visual cues may offer identity and relational motivators while reinforcing the value of prescription drug treatments. Further, DTCA may market disenfranchising images that increase disparity in health care information and access, despite their argued educational function.
Pavlova, Milena; Groot, Wim; van Merode, Godefridus
One approach to the problem of low patient satisfaction in Bulgaria is to identify attributes of health care services that the consumers value most and to focus on their improvement. Based on data from a household survey, this paper examines the importance that health care consumers attach to quality, access and price. The survey was conducted in 2000 among the population of the region of Varna (the third largest city in Bulgaria). The elicitation of attribute importance was based on a self-explicated method. To analyse the data, an ordered logit regression was performed. The analysis shows that clinical quality is the most valued characteristic by Bulgarian health care consumers compared with social quality, access and price. Given the poor quality of health care provision in Bulgaria, the allocation of revenues to its improvement appears to be essential in order to raise patient satisfaction and to enhance social efficiency.
Research in toxicology generates vast quantities of data which reside on the Web and are subsequently appropriated and utilized to support further research. This data includes a broad spectrum of information about chemical, biological and radiological agents which can affect hea...
Haviland, Amelia M; Eisenberg, Matthew D; Mehrotra, Ateev; Huckfeldt, Peter J; Sood, Neeraj
"Consumer-Directed" Health Plans (CDHPs), those with high deductibles and personal medical accounts, are intended to reduce health care spending through greater patient cost exposure. Prior research agrees that in the first year, CDHPs reduce spending. There is little research and in it results are mixed regarding the impact of CDHPs over the longer term. We add to this literature with an intent-to-treat, difference-in-differences analysis of health care spending over up to three years post CDHP offer among 13 million person-years of data from 54 large US firms, half of which offered CDHPs. To strengthen the identification, we balance observables over time within firm, by developing weights through a machine learning algorithm, generalized boosted regression. We find that spending is reduced for those in firms offering CDHPs in all three years post offer relative to firms continuing to offer lower-deductible plans. The reductions are driven by spending decreases in outpatient care and pharmaceuticals, with no evidence of increases in emergency department or inpatient care over the three-year window.
Wood, F B; Lyon, B; Schell, M B; Kitendaugh, P; Cid, V H; Siegel, E R
In October 1998, the National Library of Medicine (NLM) launched a pilot project to learn about the role of public libraries in providing health information to the public and to generate information that would assist NLM and the National Network of Libraries of Medicine (NN/LM) in learning how best to work with public libraries in the future. Three regional medical libraries (RMLs), eight resource libraries, and forty-one public libraries or library systems from nine states and the District of Columbia were selected for participation. The pilot project included an evaluation component that was carried out in parallel with project implementation. The evaluation ran through September 1999. The results of the evaluation indicated that participating public librarians were enthusiastic about the training and information materials provided as part of the project and that many public libraries used the materials and conducted their own outreach to local communities and groups. Most libraries applied the modest funds to purchase additional Internet-accessible computers and/or upgrade their health-reference materials. However, few of the participating public libraries had health information centers (although health information was perceived as a top-ten or top-five topic of interest to patrons). Also, the project generated only minimal usage of NLM's consumer health database, known as MEDLINEplus, from the premises of the monitored libraries (patron usage from home or office locations was not tracked). The evaluation results suggested a balanced follow-up by NLM and the NN/LM, with a few carefully selected national activities, complemented by a package of targeted activities that, as of January 2000, are being planned, developed, or implemented. The results also highlighted the importance of building an evaluation component into projects like this one from the outset, to assure that objectives were met and that evaluative information was available on a timely basis, as was
Fiorini, Fulvio; Ameri, Cinzia; Tarchini, Renzo; Granata, Antonio; Zuccardi Merli, Mara
Hospital procedures to stock tools and equipment supplies for day-by-day clinical diagnosis and treatment place physicians to face up with their ones responsibilities. Nephrologists have to deal with dialysis machines, related technology updating and associated consumables. Overall they have to cope with local health service reality, which looks for progressive doctors skill improvement at lowest or no cost at all. Aim of the first part of this review is to analyze all these issues according European Union, Italian and local main lines and associated laws. Moreover, will be reviewed purchase strategies always looking at patient wellness as final aim of the entire process. They will be illustrated sequences of administrative measures, recent Central Commissioning Headquarters, and laws that since 2006 have defined the related procedures (i.e. open, limited, negotiated, and competitive).
Fujita, Daisuke; Kanaoka, Midori
The purpose of the study is to elucidate the relationship between social support, health care consciousness and mental health in developing the industrial health education aimed at improving the health habits of male employees. A questionnaire survey concerning health practices, mental health based on the General Health Questionnaire, social support from social support networks, and health care consciousness based on the Health Locus of Control was conducted on male employees in three companies in Osaka Prefecture. A total of 1,634 questionnaires were collected. Analyses by age group showed that in all age groups, the higher the social support score, the more favorable the mental health became and the stronger the family care in health care consciousness became. The better the mental health, the greater the number of good health practices was and the lower the fortune dependence in health care consciousness tended to be. The results of the study reconfirm the previous findings that it is necessary to put the mental health of male employees in good condition before everything else in effectively developing health education aimed at improving their health habits. This study also indicates that the level of perception of social support and their internal control of self and family in health care consciousness are definitely related to the stability of subjects' mental health. It is therefore presumed that measures to raise the revel of perception of social support are important since they may improve the mental health of subjects.
Hieke, S; Kuljanic, N; Wills, J M; Pravst, I; Kaur, A; Raats, M M; van Trijp, H C M; Verbeke, W; Grunert, K G
Health claims and symbols are potential aids to help consumers identify foods that are healthier options. However, little is known as to how health claims and symbols are used by consumers in real-world shopping situations, thus making the science-based formulation of new labelling policies and the evaluation of existing ones difficult. The objective of the European Union-funded project Role of health-related CLaims and sYMBOLs in consumer behaviour (CLYMBOL) is to determine how health-related information provided through claims and symbols, in their context, can affect consumer understanding, purchase and consumption. To do this, a wide range of qualitative and quantitative consumer research methods are being used, including product sampling, sorting studies (i.e. how consumers categorise claims and symbols according to concepts such as familiarity and relevance), cross-country surveys, eye-tracking (i.e. what consumers look at and for how long), laboratory and in-store experiments, structured interviews, as well as analysis of population panel data. EU Member States differ with regard to their history of use and regulation of health claims and symbols prior to the harmonisation of 2006. Findings to date indicate the need for more structured and harmonised research on the effects of health claims and symbols on consumer behaviour, particularly taking into account country-wide differences and individual characteristics such as motivation and ability to process health-related information. Based on the studies within CLYMBOL, implications and recommendations for stakeholders such as policymakers will be provided.
Hieke, S; Kuljanic, N; Wills, J M; Pravst, I; Kaur, A; Raats, M M; van Trijp, H C M; Verbeke, W; Grunert, K G
Health claims and symbols are potential aids to help consumers identify foods that are healthier options. However, little is known as to how health claims and symbols are used by consumers in real-world shopping situations, thus making the science-based formulation of new labelling policies and the evaluation of existing ones difficult. The objective of the European Union-funded project Role of health-related CLaims and sYMBOLs in consumer behaviour (CLYMBOL) is to determine how health-related information provided through claims and symbols, in their context, can affect consumer understanding, purchase and consumption. To do this, a wide range of qualitative and quantitative consumer research methods are being used, including product sampling, sorting studies (i.e. how consumers categorise claims and symbols according to concepts such as familiarity and relevance), cross-country surveys, eye-tracking (i.e. what consumers look at and for how long), laboratory and in-store experiments, structured interviews, as well as analysis of population panel data. EU Member States differ with regard to their history of use and regulation of health claims and symbols prior to the harmonisation of 2006. Findings to date indicate the need for more structured and harmonised research on the effects of health claims and symbols on consumer behaviour, particularly taking into account country-wide differences and individual characteristics such as motivation and ability to process health-related information. Based on the studies within CLYMBOL, implications and recommendations for stakeholders such as policymakers will be provided. PMID:25750587
Wang, Wen; Zhang, Zhiheng; Yang, Guiling; Wang, Qiang
A quantitative risk assessment was carried out to characterise the health risk from nickel (Ni) via dietary exposure for Chinese consumers. Ni contamination in foods was investigated by conducting a survey and a literature review. The daily diet of the public was categorised into nine food groups and the consumption data for each group were obtained from a nationwide survey. Deterministic and probabilistic methods were applied to calculate the target hazard quotients (THQs) by comparing the estimated dietary Ni intake with respect to the tolerable daily intake (TDI). The average estimated daily Ni intake (μg kg(-1) bw day(-1)) for men, women, 2-3-year-old children and 4-17-year-old children were 7.2, 7.3, 17.1 and 10.0, respectively. The consumption of cereals, beans, vegetables and marine products contributed significantly to the total daily intake of Ni. The mean THQ values (95% confidence interval) and the probability of dietary Ni exposure higher than the TDI were 0.60 (0.58-0.62) and 8.2% for men, 0.61 (0.59-0.63) and 8.4% for women, 1.35 (1.32-1.39) and 72.0% for 2-3-year-old children, and 0.87 (0.82-0.91) and 28.5% for 4-17-year-old children, respectively. This study showed a potential health risk from Ni via dietary exposure for Chinese consumers, especially among children.
Lancaster, K; Seear, K; Treloar, C; Ritter, A
For over twenty years there have been calls for greater 'consumer' participation in health decision-making. While it is recognised by governments and other stakeholders that 'consumer' participation is desirable, barriers to meaningful involvement nonetheless remain. It has been suggested that the reifying of 'evidence-based policy' may be limiting opportunities for participation, through the way this discourse legitimates particular voices to the exclusion of others. Others have suggested that assumptions underpinning the very notion of the 'affected community' or 'consumers' as fixed and bounded 'policy publics' need to be problematised. In this paper, drawing on interviews (n = 41) with individuals closely involved in Australian drug policy discussions, we critically interrogate the productive techniques and constitutive effects of 'evidence-based policy' and 'consumer participation' discourses in the context of drug policy processes. To inform our analysis, we draw on and combine a number of critical perspectives including Foucault's concept of subjugated knowledges, the work of feminist theorists, as well as recent work regarding conceptualisations of emergent policy publics. First, we explore how the subject position of 'consumer' might be seen as enacted in the material-discursive practices of 'evidence-based policy' and 'consumer participation' in drug policy processes. Secondly, we consider the centralising power-effects of the dominant 'evidence-based policy' paradigm, and how resistance may be thought about in this context. We suggest that such interrogation has potential to recast the call for 'consumer' participation in health policy decision-making and drug policy processes.
Fears, Robin; ter Meulen, Volker
Direct-to-consumer (DTC) genetic testing services raise scientific, regulatory and ethical questions. A report was prepared by consultation with an expert Working Group and published by the academies of science (European Academies of Science Advisory Council, EASAC) and medicine (Federation of European Academies of Medicine, FEAM). This report reviews current scientific evidence, ascertains the principles that should underpin the options for action by policy-makers, and discusses the potential for devising proportionate and flexible regulation that enables future innovation, taking account of the work of other expert groups, most notably the European Society of Human Genetics. EASAC-FEAM concluded that DTC genetic testing has little clinical value at present, and expresses especial caution in several specific respects, for example relating to testing for high penetrance, serious disorders, prenatal screening, nutrigenomic and pharmacogenetic testing. It was emphasised that regulation must be on the basis that claims about the link between genetic marker and disease are scientifically valid. Other key issues to address include quality assurance (that includes the professional interpretation of results), transparent supply of accurate information, consideration of the implications for established health services, and clarification of consent procedures for any use of data for research purposes. There are important implications: for the European Commission, in revising the Directive on In Vitro Diagnostic Medical Devices; for professional bodies, in supporting training and guideline development; for the broader research community, in generating the evidence base; and for the public health community, in improving the routine translation of research advances into clinical practice.
Rippe, James M.
Fructose-containing sugars, including fructose itself, high fructose corn syrup (HFCS), and sucrose have engendered considerable controversy. The effects of HFCS and sucrose in sugar-sweetened beverages, in particular, have generated intense scientific debate that has spilled over to the public. This controversy is related to well-known differences in metabolism between fructose and glucose in the liver. In addition, research studies have often been conducted comparing pure fructose and pure glucose even though neither is consumed to any appreciable degree in isolation in the human diet. Other evidence has been drawn from animal studies and epidemiologic or cohort studies. Few randomized controlled trials (RCTs) have compared HFCS with sucrose (the 2 sugars most commonly consumed in the human diet) at dosage amounts within the normal human consumption range. This review compares results of recently concluded RCTs with other forms of evidence related to fructose, HFCS, and sucrose. We conclude that great caution must be used when suggesting adverse health effects of consuming these sugars in the normal way they are consumed and at the normal amounts in the human diet, because RCTs do not support adverse health consequences at these doses when employing these sugars. PMID:24228199
de Vries, Fred J.; Kester, Liesbeth; Sloep, Peter; van Rosmalen, Peter; Pannekeet, Kees; Koper, Rob
Higher education staff involved in e-learning often struggle with organising their student support activities. To a large extent this is due to the high workload involved with such activities. We distinguish support related to learning content, learning processes and student products. At two different educational institutions, surveys were…
Xiao, Qian; Savage, Grant T; Zhuang, Weiling
This study aims at replicating and extending Xiao and Savage's (2008) research to understand the multidimensional aspect of HMOs distinguished by HMOs' consumer-friendliness, and their relationship to consumers' preventive care utilization. This study develops a dynamic model to consider both concurrent and time lagging effects of HMOs' consumer-friendliness. Our data analysis discloses similar relationship patterns as revealed by Xiao and Savage. Additionally, our findings reveal the time-series changes of the influence of HMOs' consumer-friendliness that either the effects of early experienced HMOs' consumer-friendliness wear out totally or HMOs' consumer-friendly characteristics on the concurrent term contain most of the explanatory power.
A new class of patient-driven health care services is emerging to supplement and extend traditional health care delivery models and empower patient self-care. Patient-driven health care can be characterized as having an increased level of information flow, transparency, customization, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects. The potential exists to both improve traditional health care systems and expand the concept of health care though new services. This paper examines three categories of novel health services: health social networks, consumer personalized medicine and quantified self-tracking.
A new class of patient-driven health care services is emerging to supplement and extend traditional health care delivery models and empower patient self-care. Patient-driven health care can be characterized as having an increased level of information flow, transparency, customization, collaboration and patient choice and responsibility-taking, as well as quantitative, predictive and preventive aspects. The potential exists to both improve traditional health care systems and expand the concept of health care though new services. This paper examines three categories of novel health services: health social networks, consumer personalized medicine and quantified self-tracking. PMID:19440396
Objective The goal of this paper is to describe the successful application of a use case-based evaluation approach to guide the effective design, evaluation and redesign of inexpensive, commercial, off-the-shelf consumer health informatics (CHI) interventions. Design Researchers developed four CHI intervention use cases representing two distinct patient populations (patients with diabetes with high blood pressure, post-bariatric surgery patients), two commercial off-the-shelf CHI applications (Microsoft HealthVault, Google Health), and related devices (blood pressure monitor, pedometer, weight scale). Three patient proxies tested each intervention for 10 days. Measurements The patient proxies recorded their challenges while completing use case tasks, rating the severity of each challenge based on how much it hindered their use of the intervention. Two independent evaluators categorized the challenges by human factors domain (physical, cognitive, macroergonomic). Results The use case-based approach resulted in the identification of 122 challenges, with 12% physical, 50% cognitive and 38% macroergonomic. Thirty-nine challenges (32%) were at least moderately severe. Nine of 22 use case tasks (41%) accounted for 72% of the challenges. Limitations The study used two patient proxies and addressed two specific patient populations and low-cost, off-the-shelf CHI interventions, which may not perfectly generalize to a larger number of proxies, actual patient populations, or other CHI interventions. Conclusion CHI designers can employ the use case-based evaluation approach to assess the fit of a CHI intervention with patients' health work, in the context of their daily activities and environment, which would be difficult or impossible to evaluate by laboratory-based studies. PMID:21727206
Reed, Mary E; Graetz, Ilana; Fung, Vicki; Newhouse, Joseph P; Hsu, John
Consumer-directed health plans are plans with high deductibles that typically require patients to bear no out-of-pocket costs for preventive care, such as annual physicals or screening tests, in order to ease financial barriers and encourage patients to seek such care. We surveyed people in California who had a consumer-directed health plan and found that fewer than one in five understood that their plan exempted preventive office visits, medical tests, and screenings from their deductible, meaning that this care was free or had a modest copayment. Roughly one in five said that they had delayed or avoided a preventive office visit, test, or screening because of cost. Those who were confused about the exemption were significantly more likely to report avoiding preventive visits because of cost concerns. Special efforts to educate consumers about preventive care cost-sharing exemptions may be necessary as more health plans, including Medicare, adopt this model.
Luzuriaga, María José; Spinelli, Hugo
This paper analyzes problems experienced by policy-holders of voluntary private health insurance plans in Argentina when insurance companies fail to comply with the Consumer Protection Code. The sample consisted of consumer complaints filed with the Consumer Protection Bureau and rulings by the Bureau from 2000 to 2008. One striking issue was recurrent non-compliance with services included in the Mandatory Medical Program and the companies' attempts to blame policy-holders. According to the study, the lack of an information system hinders scientific studies to adequately address the problem. Thus, a comparison with studies on health insurance in other Latin American countries highlighted the importance of such research, the relationship to health systems, constraints on use and denial of citizens' rights to healthcare, and the increasing judicialization of healthcare provision.
Rothman, Brian; Leonard, Joan C; Vigoda, Michael M
The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data
Petit, Olivia; Merunka, Dwight; Anton, Jean-Luc; Nazarian, Bruno; Spence, Charles; Cheok, Adrian David; Raccah, Denis; Oullier, Olivier
Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI) focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula), reward value (orbitofrontal cortex), and self-control (inferior frontal gyrus), and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum). Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched. PMID:27428267
Petit, Olivia; Merunka, Dwight; Anton, Jean-Luc; Nazarian, Bruno; Spence, Charles; Cheok, Adrian David; Raccah, Denis; Oullier, Olivier
Taking into account how people value the healthiness and tastiness of food at both the behavioral and brain levels may help to better understand and address overweight and obesity-related issues. Here, we investigate whether brain activity in those areas involved in self-control may increase significantly when individuals with a high body-mass index (BMI) focus their attention on the taste rather than on the health benefits related to healthy food choices. Under such conditions, BMI is positively correlated with both the neural responses to healthy food choices in those brain areas associated with gustation (insula), reward value (orbitofrontal cortex), and self-control (inferior frontal gyrus), and with the percent of healthy food choices. By contrast, when attention is directed towards health benefits, BMI is negatively correlated with neural activity in gustatory and reward-related brain areas (insula, inferior frontal operculum). Taken together, these findings suggest that those individuals with a high BMI do not necessarily have reduced capacities for self-control but that they may be facilitated by external cues that direct their attention toward the tastiness of healthy food. Thus, promoting the taste of healthy food in communication campaigns and/or food packaging may lead to more successful self-control and healthy food behaviors for consumers with a higher BMI, an issue which needs to be further researched.
Hofferth, Sandra L; Pinzon, Angela M
Nonresidential father investment of time and money has been shown to ameliorate the negative consequences of family dissolution on children's behavior and achievement; however, no research has shown whether this investment also has positive effects on child health. Using data from the Early Childhood Longitudinal Survey, Kindergarten cohort, this research uses a two-wave cross-lagged model to examine how child support and contact are associated with maternal reports of children's physical health over time following parental separation. Child support in kindergarten is not associated with child health in third grade. Instead, children who are healthier in kindergarten receive greater financial support from their father. Although contact and child support are positively related, greater contact is not associated with better child health.
NCI's Center for Global Health announced grants that will support the development and validation of low-cost, portable technologies. These technologies have the potential to improve early detection, diagnosis, and non-invasive or minimally invasive treatm
Pomeranz, Jennifer L
Consumption of sugar-sweetened beverages (SSBs) has increased worldwide. As public health studies expose the detrimental impact of SSBs, consumer protection and public health advocates have called for increased government control. A major focus has been on restricting marketing of SSBs to children, but many innovative policy options--legally defensible ways to regulate SSBs and support public health--are largely unexplored. We describe the public health, economic, and retail marketing research related to SSBs (including energy drinks). We review policy options available to governments, including mandatory factual disclosures, earmarked taxation, and regulating sales, including placement within retail and food service establishments, and schools. Our review describes recent international initiatives and classifies options available in the United States by jurisdiction (federal, state, and local) based on legal viability.
Purcell, Maureen K.; Harris, M. Camille
Healthy aquatic ecosystems are home to a diversity of plants, invertebrates, fish and wildlife. Aquatic animal populations face unprecedented threats to their health and survival from climate change, water shortages, habitat alteration, invasive species and environmental contaminants. These environmental stressors can directly impact the prevalence and severity of disease in aquatic populations. For example, periodic fish kills in the upper Chesapeake Bay Watershed are associated with many different opportunistic pathogens that proliferate in stressed fish populations. An estimated 80 percent of endangered juvenile Puget Sound steelhead trout die within two weeks of entering the marine environment, and a role for disease in these losses is being investigated. The introduction of viral hemorrhagic septicemia virus (VHSV) into the Great Lakes—a fishery worth an estimated 7 billion dollars annually—resulted in widespread fish die-offs and virus detections in 28 different fish species. Millions of dying sea stars along the west coast of North America have led to investigations into sea star wasting disease. U.S. Geological Survey (USGS) scientists are assisting managers with these issues through ecological investigations of aquatic animal diseases, field surveillance, and research to promote the development of mitigation strategies.
Simons, Megan; Tyack, Zephanie
With advances in wound care technology, there is a trend toward patients undertaking specialist burns treatment in an outpatient capacity. Photographic scar evaluation is a part of this trend in some health services because it permits scar assessment by different health professionals, both within and across outpatient services, to assess the impact of scar management strategies. The aim of this study was to explore the parameters considered integral to scar assessment when completing photographic scar evaluation. First, opinions were sought from 38 burn health professionals in 2 tertiary pediatric hospitals who participated in focus groups where in-person and in-photograph scar rating were completed using three burn scar rating scales (modified Vancouver scar scale, Manchester scar scale, and patient and observer scar assessment scale) presented with a standard format and instructions. Second, 36 occupational therapists and physiotherapists from Australia and New Zealand completed questionnaires. Third, 10 healthcare consumers from 1 tertiary pediatric hospital participated in face-to-face or telephone interviews. Parameters believed to be assessed using photographic evaluation of burns scarring were vascularity, surface area, color, contour, height, and overall opinion. However, surface area was considered questionable as an indicator of scar maturity. These parameters mostly differ from those considered important in a burn scar outcome measure when rating scars in-person: height/thickness, vascularity, color, pliability, joint function, and patient/client opinion. A categorical scale with visual descriptors, as well as specific strategies to improve photographic technique, may go some way to addressing the perceived difficulty in rating these parameters using burn scar photographs.
Selva-Sevilla, Carmen; Gonzalez-Moral, Maria Luisa; Tolosa-Perez, Maria Teresa
Background: Clinical practice protocols should consider both the psychological criteria related to a patient’s satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT. Methods: A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed. Results: Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty. Conclusion: The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed. PMID:27303347
Liang, Bryan A
Background Direct-to-consumer advertising (DTCA), linked to inappropriate medication use and higher health care expenditures, is the fastest growing form of pharmaceutical marketing. DTCA is legal only in the United States and New Zealand. However, the advent of online interactive social media “Web 2.0” technologies—that is, eDTCA 2.0—may circumvent DTCA legal proscriptions. Objective The purpose of this study was to assess the prevalence of DTCA of leading pharmaceutical company presence and drug product marketing in online interactive social media technologies (eDTCA 2.0). Methods We conducted a descriptive study of the prevalence of eDTCA 2.0 marketing in the top 10 global pharmaceutical corporations and 10 highest grossing drugs of 2009. Results All pharmaceutical companies reviewed (10/10, 100%) have a presence in eDTCA 2.0 on Facebook, Twitter/Friendster, sponsored blogs, and really simple syndication (RSS) feeds. In addition, 80% (8/10) have dedicated YouTube channels, and 80% (8/10) developed health care communication-related mobile applications. For reviewed drugs, 90% (9/10) have dedicated websites, 70% (7/10) have dedicated Facebook pages, 90% (9/10) have health communications-related Twitter and Friendster traffic, and 80% (8/10) have DTCA television advertisements on YouTube. We also found 90% (9/10) of these drugs had a non-corporate eDTCA 2.0 marketing presence by illegal online drug sellers. Conclusion Pharmaceutical companies use eDTCA 2.0 to market themselves and their top-selling drugs. eDTCA 2.0 is also used by illicit online drug sellers. Regulators worldwide must take into account the current eDTCA 2.0 presence when attempting to reach policy and safety goals. PMID:21880574
Tu, Ha T; May, Jessica H
As consumers face more incentives to make cost-conscious medical care decisions, some policymakers cite self-pay markets as models for consumer shopping. An analysis of the LASIK market revealed limited shopping overall, despite the fact that patients pay the full cost. For other self-pay procedures, consumers shop even less, for reasons ranging from urgency, to costs of obtaining price quotes, to quality concerns that prompt many consumers to rely on word-of-mouth recommendations. Given that consumer shopping is not prevalent in most self-pay markets, we expect the extent of shopping to be even more limited for many services covered by insurance.
Climie, Emma; Altomare, Alyssa A.
There are a growing number of children who begin to develop mental concerns during the school-age years. As such, it is important that schools recognize and understand mental health issues and are actively engaged in supporting these students. This article provides a review of mental health in schools, highlighting the importance of school-health…
Decision makers using environmental decision support tools are often confronted with information that predicts a multitude of different human health effects due to environmental stressors. If these health effects need to be contrasted with costs or compared with alternative scena...
Mittler, Jessica N; Martsolf, Grant R; Telenko, Shannon J; Scanlon, Dennis P
Context Policymakers and practitioners continue to pursue initiatives designed to engage individuals in their health and health care despite discordant views and mixed evidence regarding the ability to cultivate greater individual engagement that improves Americans’ health and well-being and helps manage health care costs. There is limited and mixed evidence regarding the value of different interventions. Methods Based on our involvement in evaluating various community-based consumer engagement initiatives and a targeted literature review of models of behavior change, we identified the need for a framework to classify the universe of consumer engagement initiatives toward advancing policymakers' and practitioners' knowledge of their value and fit in various contexts. We developed a framework that expanded our conceptualization of consumer engagement, building on elements of two common models, the individually focused transtheoretical model of behavior and the broader, multilevel social ecological model. Finally, we applied this framework to one community's existing consumer engagement program. Findings Consumer engagement in health and health care refers to the performance of specific behaviors (“engaged behaviors”) and/or an individual's capacity and motivation to perform these behaviors (“activation”). These two dimensions are related but distinct and thus should be differentiated. The framework creates four classification schemas, by (1) targeted behavior types (self-management, health care encounter, shopping, and health behaviors) and by (2) individual, (3) group, and (4) community dimensions. Our example illustrates that the framework can systematically classify a variety of consumer engagement programs, and that this exercise and resulting characterization can provide a structured way to consider the program and how its components fit program goals both individually and collectively. Conclusions Applying the framework could help advance the field
Marshall, Carter L.
Focus in this preventive medicine monograph for health professionals is on consumer health education and the current and potential effects of mass communication on the quality of medical care. Following an introduction, the content is presented in four chapters. Chapter 1 covers the state of the art in consumer health education and discusses three…
One in five Australians has a diagnosable mental illness and the impact of the illness on the individual, their family, and the community is significant. Since comprehensive nursing was introduced in the 1980s there have been repeated concerns raised regarding the preparedness of graduates from Australian undergraduate nursing programs to care for people who have a mental illness. In 2009, despite a recent comprehensive national review of the mental health/illness content in pre-registration curricula, these concerns remain. The nursing profession must have a responsibility to the global community to ensure that registered nurses are educated to meet evolving health challenges and the needs of the health consumer in the 21st Century. The purpose of this paper is to highlight the prevalence and impact of mental illness on health care outcomes in all settings and to challenge the profession to acknowledge that mental health nursing content must be a core area of all undergraduate curricula. A nationally coordinated response to address the long standing identified deficits in the educational preparation of comprehensive nurses is now a priority to ensure that nurses remain a major stakeholder group in the delivery of health care and key health informants and decision makers within the global health care arena.
Hoagwood, Kimberly E.; Cavaleri, Mary A.; Olin, S. Serene; Burns, Barbara J.; Slaton, Elaine; Gruttadaro, Darcy; Hughes, Ruth
A comprehensive review of structured family support programs in children's mental health was conducted in collaboration with leadership from key national family organizations. The goals were to identify typologies of family support services for which evaluation data existed and identify research gaps. Over 200 programs were examined; 50 met…
Clemens, Timo; Michelsen, Kai; Brand, Helmut
Since the start of the economic crisis, the European Union's (EU's) predominant discourse has been austerity and fiscal consolidation. The detrimental effects on Europe's health systems and the health status of its citizens are well described. However, little is known about the emerging EU-level initiatives to support national health systems handle the challenges of efficient care provision and system reorganisation aimed to meet their future needs. This review analyses the manner, conditions and prospects of such EU support. First, health system objectives are increasingly entering the EU health policy agenda. Second, professional and patient mobility provisions may support member states (MS) in copying with crisis related health challenges but can potentially acerbate them at the same time. Third, in recent initiatives health system goals are more closely tied to the EU's economic growth narrative. And fourth, health system issues are taken up in existing EU-level structures for debate and exchange between MS. In addition, the design of some policies may have the potential to intensify socioeconomic and health inequalities rather than ameliorate them.
Baudry, Julia; Méjean, Caroline; Péneau, Sandrine; Galan, Pilar; Hercberg, Serge; Lairon, Denis; Kesse-Guyot, Emmanuelle
The dietary and health traits of organic food (OF) consumers have not been comprehensively described. The aim of this study was to identify factors associated with OF consumption. Data were collected from 54 283 participants from the NutriNet-Santé cohort using self-administered web-based questionnaires. Occasional organic food consumers and regular organic food consumers (ROFC) were compared with non-organic food consumers (NOFC) using logistical regression providing an OR and 95 % CI. Adherence to the French food-based guidelines and interactions between nutritional knowledge and OF consumption in adherence to dietary guidelines were investigated. Medical history was also assessed in relation to OF consumption. Compared with NOFC, ROFC were more likely to be vegetarian (OR 9·93; 95 % CI 7·42, 13·29 in women; OR 13·07; CI 7·00, 24·41 in men) and were less likely to be aware of nutritional guidelines regarding meat consumption (OR 0·37; CI 0·34, 0·40 in women; OR 0·41; CI 0·36, 0·47 in men). Compared with NOFC, ROFC had a lower risk of type II diabetes, hypertension and CVD; however, this effect was only significant for men. In contrast, organic consumers were more likely to report food allergies. Consuming OF appeared to affect the relationship between nutritional knowledge and adequate intake of meat/poultry/seafood/eggs and starchy food among both sexes. Our study provides new insights into the diet- and health-related behaviours of OF consumers in a large sample of participants residing in France. This should be taken into account in future studies investigating relationships between health and OF consumption.
Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo
The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.
Morphet, Julia; Innes, Kelli; Munro, Ian; O'Brien, Anthony; Gaskin, Cadeyrn J; Reed, Fiona; Kudinoff, Teresa
Mainstreaming of mental health services (MHS) within the Australian medical system has generated a fundamental transformation in the way consumers and carers access emergency MHS. People present to the Emergency Department (ED) with many health issues which can often include the management of their mental illness, physical co morbidity, or substance use. This paper discusses the issues surrounding access to EDs for clients, families and staff in the context of presentations for mental health problems at a southern metropolitan hospital in Victoria. The pilot project utilised focus groups with mental health care consumers and carers to collaboratively focus on and document the mental health client's 'journey of care' in the ED. There is evidence to suggest from this project that the ED mental health client journey needs continuous improvement and evaluation.
Abraham, Jean M; Feldman, Roger; Carlin, Caroline; Christianson, Jon
We examine the factors that lead employees to search for health plan quality information and the effect of such information on the decision to switch plans. Extending Hirshleifer and Riley's model [Hirshleifer, J., Riley, J.G., 1979. The analytics of uncertainty and information--an expositional survey. Journal of Economic Literature 17 (December (4)), 1375-1421] of the economics of information, we develop a two-equation model of quality information awareness and switching behavior. We estimate the model using data from a random sample of 651 single employees from 16 firms that are members of the Buyers Health Care Action Group, a health care purchasing coalition in the Minneapolis-St. Paul region. Our empirical results do not support either a link between quality information and switching behavior, or between perceived health plan satisfaction and switching. We do, however, find that switching is influenced by changes in premiums and whether an individual has an existing relationship with a health care provider.
Le Bodo, Yann; Paquette, Marie-Claude; Vallières, Maggie; Alméras, Natalie
In the Americas, mean energy intake from added sugar exceeds recent World Health Organization recommendations for free sugars in the diet. As a leading contributor to this excess, sugar-sweetened beverage (SSB) overconsumption represents a risk for the population's health. This article provides an overview of clinical and epidemiological evidence, marketing practices, corporate influence and prevention strategies related to added sugar and SSB. For each aspect of this multidimensional profile, we briefly compare SSB to the case of tobacco pointing to similarities but also major differences. Tobacco control has demonstrated the effectiveness of long term multifaceted prevention strategies in multiple settings supported by strong public policies which may be applied to the consumption of SSB. However, translating these policies to the specific case of SSB is urgently needed, to inform preventive actions, decide which intervention mix will be used, and evaluate the process and impact of the chosen strategy.
Auburn Univ., AL. Dept. of Vocational and Adult Education.
Developed at Auburn University, Alabama, and based on Adult Performance Level (APL) research conducted at the University of Texas, the two teaching modules for adult career education in this curriculum guide are for the health and for the consumer economics curriculum areas. Focus is on development of basic skills in communication, problem…
Nelson, Geoffrey; Ochocka, Joanna; Janzen, Rich; Trainor, John; Goering, Paula; Lomotey, Jonathan
The objective of this study was to evaluate the impacts of participation in mental health Consumer/Survivor Initiatives (CSIs), organizations run by and for people with mental illness. A nonequivalent comparison group design was used to compare three groups of participants: (a) those who were continually active in CSIs over a 36-month period (n =…
Labiner-Wolfe, Judith; Lin, Chung-Tung Jordan; Verrill, Linda
Objective: Evaluate effect of low-carbohydrate claims on consumer perceptions about food products' healthfulness and helpfulness for weight management. Design: Experiment in which participants were randomly assigned 1 of 12 front-of-package claim conditions on bread or a frozen dinner. Seven of the 12 conditions also included Nutrition Facts (NF)…
Fisher, Edwin B.; Ayala, Guadalupe X.; Ibarra, Leticia; Cherrington, Andrea L.; Elder, John P.; Tang, Tricia S.; Heisler, Michele; Safford, Monika M.; Simmons, David
SUBSTANTIAL evidence documents the benefits of peer support provided by community health workers, lay health advisors, promotores de salud, and others. The papers in this supplement, all supported by the Peers for Progress program of the American Academy of Family Physicians Foundation, contribute to the growing body of literature addressing the efficacy, effectiveness, feasibility, reach, sustainability, and adoption of peer support for diabetes self-management. They and additional papers supported by Peers for Progress contribute to understanding how peer support can be implemented in real world settings. Topics include examination of the peers who provide peer support, reaching the hardly reached, success factors in peer support interventions, proactive approaches, attention to emotions, peer support in behavioral health, dissemination models and their application in China, peer support in the patient-centered medical home, research challenges, and policy implications. PMID:26304968
Fisher, Edwin B; Ayala, Guadalupe X; Ibarra, Leticia; Cherrington, Andrea L; Elder, John P; Tang, Tricia S; Heisler, Michele; Safford, Monika M; Simmons, David
SUBSTANTIAL: evidence documents the benefits of peer support provided by community health workers, lay health advisors, promotores de salud, and others. The papers in this supplement, all supported by the Peers for Progress program of the American Academy of Family Physicians Foundation, contribute to the growing body of literature addressing the efficacy, effectiveness, feasibility, reach, sustainability, and adoption of peer support for diabetes self-management. They and additional papers supported by Peers for Progress contribute to understanding how peer support can be implemented in real world settings. Topics include examination of the peers who provide peer support, reaching the hardly reached, success factors in peer support interventions, proactive approaches, attention to emotions, peer support in behavioral health, dissemination models and their application in China, peer support in the patient-centered medical home, research challenges, and policy implications.
Attwood, Carol Ann; Wellik, Kay E
Patients and family members are overwhelmed by the diagnosis of cancer and often do not know where to look for answers, information on the treatment options, or community resources for support during the cancer journey. A unique relationship was forged with a patient and health education librarian at the Mayo Clinic in Arizona and an American Cancer Society navigator, which encouraged collaboration to better meet the informational and supportive healthcare needs of patients. This article addresses the background of the project, the steps taken to establish the relationship, space allocation, and need for confidentiality. The innovations produced by this partnership also are discussed, including development of cancer pathfinders and cancer communication blogs for patients, as well as comarketing of services.
Lenhart, S.W.; Driscoll, R.
In response to a request from the Corporate Medical Consultant to Thomson Consumer Electronics (SIC-3673), Marion, Indiana, a study was undertaken of an illness outbreak in workers at the facility. There were about 1900 workers at the facility, which produced television picture tubes. Production occurred over three shifts, 6 days a week. Charcoal tube sampling indicated the presence of acetone (67641) n-amyl-acetate (628637), n-butyl-acetate (123864), isoamyl-acetate (123922), toluene (108883), 1,1,1-trichloroethane (71556), and trichloroethylene (79016). No contaminants were detected in the bag samples of air collected from the in/house compressed air system. One or more symptoms were reported by 593 (82%) of the workers. Those most commonly reported included headache (68%), sore throat (53%), fatigue (51%), eye irritation (50%), itchy skin (47%), irritated nose (45%), dizziness (45%), unusual taste in mouth (45%), unusual smell (41%) and cough. The authors conclude that symptoms were consistent with stress related health complaints in occupational settings. Concentrations of chemicals measured in the facility would not be expected to produce the effects seen in the outbreak. The authors recommend that trichloroethylene degreasing units be replaced with equipment which uses a less toxic degreasing agent. The facility should hire a full time industrial hygienist.
Witczak, Agata; Pohoryło, Anna; Mituniewicz-Małek, Anna
The occurrence of organochlorine xenobiotics in goat milk is a one of bioindicators of environmental pollution, and, consequently, food contamination. This study estimates contamination level of goat milk produced at two organic farms in years 2009-2013. Analysis covered determination of 18 organochlorine pesticides, including HCH isomers (α, β, γ, δ), DDT and its metabolites, endosulfan and its derivatives, and methoxychlor. Pesticide content was determined using GCMS method. The detected levels of organochlorine residues in goat milk were low, in most cases below 8 ng g(-1) lipids. Among HCH isomers, γ- and β-HCH occurred in the highest concentrations, up to 4.85 ng g(-1) lipids. While among DDT metabolites p,p'-DDD dominated, up to 7.86 ng g(-1) lipids. The detected residues were below the current maximum residue limits (MRLs) for the pesticides. Considering the average milk consumption in Poland, the goat milk from both farms was safe for consumers' health. The lifetime average daily dose (LADD) for the sum of the compounds under study ranged within 1.73 × 10(-5)-1.06 × 10(-4) mg kg bw(-1) d(-1) and were well below the acceptable daily intake (ADI) for particular compounds. This was also confirmed by the values of hazard quotient (HQ), which were very low and ranged within 3.42 × 10(-3)-5.55 × 10(-2).
Morrison, Paul; Meehan, Tom; Stomski, Norman Jay
The present study explores people's experience of living with antipsychotic medication side-effects. Qualitative data were gathered through semistructured interviews with 10 mental health consumers in a community care setting in Australia. The interview transcriptions were content analysed, and enhanced by combining manifest and latent content. Important contextual cues were identified through replaying the audio-recordings. Several main themes emerged from the analysis, including the impact of side-effects, attitudes to the use of medication and side-effects, and coping strategies to manage medication side-effects. Each participant reported between six and seven side-effects on average, which were often pronounced and had a major disruptive impact on their lives. Of these effects, the most commonly mentioned was sedation, which the participants described as leaving them in a 'zombie'-like state. Most participants expressed an attitude of acceptance about the side-effects. The participants' most common strategy to manage side-effects was to change the dosage of the medication. Other common side-effect management strategies involved using other medications to control side-effects, and diverse self-help techniques, the most common of which was relaxation/distraction techniques.
The American College of Medical Informatics rated the lack of willingness to pay for the patient health record (PHR) as the biggest obstacles to its rapid diffusion. Extending research propositions from the decision sciences and political communication, this study tests the influence of different types of emphasis frames on increasing consumer willingness to pay for the PHR. Using a randomized experiment embedded within a probability survey, the effects of 3 different types of emphasis frames (individual-focused, collective-focused, and joint), along with a no-frames control, are tested on a sample of early and later technology adopters. The results indicate a significant relationship between the type of frame and the type of adopter. Early adopters were more susceptible to individual-focused frames that made causal attributions at the individual level, whereas later adopters were significantly influenced by collective-focused frames that made causal attributions at the societal level. Interestingly, the framing effect continued and significantly influenced both early and later adopters' willingness to pay for the PHR. The findings demonstrate the need to carefully communicate the value of a technology to adopters and suggest the possibility of using frames to spur the diffusion of PHRs.
Sampson, Margaret; Cumber, Jordi; Li, Claudia; Pound, Catherine M; Fuller, Ann; Harrison, Denise
Background. YouTube is an increasingly important medium for consumer health information - with content provided by healthcare professionals, government and non-government organizations, industry, and consumers themselves. It is a rapidly developing area of study for healthcare researchers. We examine the methods used in reviews of YouTube consumer health videos to identify trends and best practices. Methods and Materials. Published reviews of consumer-oriented health-related YouTube videos were identified through PubMed. Data extracted from these studies included type of journal, topic, characteristics of the search, methods of review including number of reviewers and method to achieve consensus between reviewers, inclusion and exclusion criteria, characteristics of the videos reported, ethical oversight, and follow-up. Results. Thirty-three studies were identified. Most were recent and published in specialty journals. Typically, these included more than 100 videos, and were examined by multiple reviewers. Most studies described characteristics of the videos, number of views, and sometime characteristics of the viewers. Accuracy of portrayal of the health issue under consideration was a common focus. Conclusion. Optimal transparency and reproducibility of studies of YouTube health-related videos can be achieved by following guidance designed for systematic review reporting, with attention to several elements specific to the video medium. Particularly when seeking to replicate consumer viewing behavior, investigators should consider the method used to select search terms, and use a snowballing rather than a sequential screening approach. Discontinuation protocols for online screening of relevance ranked search results is an area identified for further development.
Mohan, Jai; Razali Raja Yaacob, Raja
Telehealth refers to the integration of information, telecommunication, human-machine interface technologies and health technologies to deliver health care, to promote the heath status of the people and to create health. The Malaysian Telehealth Application will, on completion, provide every resident of the country an electronic Lifetime Health Record (LHR) and Lifetime Health Plan (LHP). He or she will also hold a smart card that will contain a subset of the data in the Lifetime Health Record. These will be the means by which Malaysians will receive "seamless continuous quality care" across a range of health facilities and health care providers, and by which Malaysia's health goal of a nation of "healthy individuals, families and communities" is achieved. The challenges to security and privacy in providing access to an electronic Lifetime Health Record at private and government health facilities and to the electronic Lifetime Health Plan at homes of consumers require not only technical mechanisms but also national policies and practices addressing threats while facilitating access to health data during health encounters in different care settings. Organisational policies establish the goals that technical mechanisms serve. They should outline appropriate uses and access to information, create mechanisms for preventing and detecting violations, and set sanctions for violations. Some interesting innovations have been used to address these issues against the background of the launching of the multimedia supercorridor (MSC) in Malaysia.
Online peer support communities play an important part in many people’s experience of healthcare. They can be particularly significant in behavioral health/mental health due to the difficulties that people may experience in accessing face to face care for these conditions. There is considerable diversity of practice in service management, target group, and moderation practices of online peer support communities. People using the communities also appear to have diverse aims and experiences. This heterogeneity contributes to a relative lack of data about the value and effectiveness of online peer support in behavioral health, although there is significant research into some aspects of these communities. The digital behavioral health service Big White Wall was launched in the UK in 2007, and in the US in 2015, and is focused on delivering moderated peer support. There are considerable differences in health systems between the two countries, and this has been reflected in different experiences of implementation. The value of online peer support could be maximized if systemic challenges to implementation and adoption were addressed more effectively. PMID:28293613
Moskowitz, H R; German, J B; Saguy, I S
This article presents an integrated analysis of three emerging knowledge bases in the nutrition and consumer products industries, and how they may effect the food industry. These knowledge bases produce new vistas for corporate product development, especially with respect to those foods that are positioned as 'good for you.' Couched within the current thinking of state-of-the-art knowledge and information, this article highlights how today's thinking about accelerated product development can be introduced into the food and health industries to complement these three research areas. The 3 knowledge bases are: the genomics revolution, which has opened new insights into understanding the interactions of personal needs of individual consumers with nutritionally relevant components of the foods; the investigation of food choice by scientific studies; the development of large scale databases (mega-studies) about the consumer mind. These knowledge bases, combined with new methods to understand the consumer through research, make possible a more focused development. The confluence of trends outlined in this article provides the corporation with the beginnings of a new path to a knowledge-based, principles-grounded product-development system. The approaches hold the potential to create foods based upon people's nutritional requirements combined with their individual preferences. Integrating these emerging knowledge areas with new consumer research techniques may well reshape how the food industry develops new products to satisfy consumer needs and wants.
Lipworth, Wendy; Kerridge, Ian; Morrell, Bronwen; Forsyth, Rowena; Jordens, Christopher F C
Bioethicists and policymakers are increasingly concerned about the effects on health journalism of relationships between journalists and private corporations. The concern is that relationships between journalists and manufacturers of medicines, medical devices, complementary medicines and food can and do distort health reporting. This is a problem because health news is known to have a major impact on the public's health-related expectations and behaviour. Commentators have proposed two related approaches to protecting the public from potential harms arising from industry-journalist interactions: greater transparency and external regulation. To date, few empirical studies have examined stakeholders' views of industry-journalist relationships and how these should be managed. We conducted interviews with 13 journalists and 12 industry employees, and 2 focus groups with consumers. Our findings, which are synthesised here, provide empirical support for the need for greater transparency and regulation of industry-journalist relationships. Our findings also highlight several likely barriers to instituting such measures, which will need to be overcome if transparency and regulation are to be accepted by stakeholders and have their intended effect on the quality of journalism and the actions of news consumers.
Veprikova, Zdenka; Zachariasova, Milena; Dzuman, Zbynek; Zachariasova, Alena; Fenclova, Marie; Slavikova, Petra; Vaclavikova, Marta; Mastovska, Katerina; Hengst, Daniel; Hajslova, Jana
Mycotoxin contamination of dietary supplements represents a possible risk for human health, especially in the case of products intended for people suffering from certain health conditions. The aim of this study was to assess the extent of this problem based on analyses of a wide set of herbal-based dietary supplements intended for various purposes: (i) treatment of liver diseases (milk thistle); (ii) reduction of menopause effects (red clover, flax seed, and soy); and (iii) preparations for general health support (green barley, nettle, goji berries, yucca, etc.) The analytical method including 57 mycotoxins was based on a QuEChERS-like (quick, easy, cheap, effective, rugged, safe) approach and ultrahigh performance liquid chromatography coupled with tandem mass spectrometry. The main mycotoxins determined were Fusarium trichothecenes, zearalenone and enniatins, and Alternaria mycotoxins. Co-occurrence of enniatins, HT-2/T-2 toxins, and Alternaria toxins was observed in many cases. The highest mycotoxin concentrations were found in milk thistle-based supplements (up to 37 mg/kg in the sum).
Li, Mu; Chapman, Simon; Agho, Kingsley; Eastman, Creswell J
Lack of iodine in the diet can cause a spectrum of conditions, known as iodine deficiency disorders (IDD). While iodized salt has been retailed in Australia since the 1960s, sales have remained low, at approximately 10% of total edible salt sales. Salt has never been promoted, advertised or discounted by retailers or manufacturers. Extensive news coverage of health issues has often been shown to influence consumer behaviour. But can even modest news coverage generate changes in consumer health-related behaviour? We report a significant increase (5.2%) in national iodized salt sales after a brief period of television and newspaper reports about IDD and the benefits of using iodized salt during and after the Australian National Iodine Nutrition Study in 2003 and 2004. We conclude that even brief news media exposure can influence health-related decisions.
Hilsenrath, Peter; Eakin, Cynthia; Fischer, Katrina
Health care reform is directed toward improving access and quality while containing costs. An essential part of this is improvement of pricing models to more accurately reflect the costs of providing care. Transparent prices that reflect costs are necessary to signal information to consumers and producers. This information is central in a consumer-driven marketplace. The rapid increase in high deductible insurance and other forms of cost sharing incentivizes the search for price information. The organizational ability to measure costs across a cycle of care is an integral component of creating value, and will play a greater role as reimbursements transition to episode-based care, value-based purchasing, and accountable care organization models. This article discusses use of activity-based costing (ABC) to better measure the cost of health care. It describes examples of ABC in health care organizations and discusses impediments to adoption in the United States including cultural and institutional barriers.
Sánchez, John Paul; Sola, Orlando; Ramallo, Jorge; Sánchez, Nelson Felix; Dominguez, Kenneth; Romero-Leggott, Valerie
Hispanics represent the fastest growing ethnic segment of the lesbian, gay, bisexual, and transgender (LGBT) community in the United States and are disproportionately burdened by LGBT-related health issues and limited political support from Hispanic medical organizations. Recently, the Latino Medical Student Association, the National Hispanic Medical Association, and the Hispanic Serving Health Professions Schools, representing over 60,000 Hispanic students and providers and 35 institutions, collaborated to support a resolution opposing discrimination based on sexual orientation or gender identity and recognizing the obstacles encountered by LGBTQ Hispanics. The resolution provides an important framework for organizational members and leaders to address LGBT health issues and serve to support a more positive sociopolitical climate for the Hispanic LGBT community nationally and internationally.
Landor, Michael; Benami, Ari; Segev, Nitzan; Loberant, Beth
Species of Hoodia Sweet ex Decne., family Apocynaceae, a southern African succulent plant, have been recognized for their appetite suppressing properties. Products that support appetite and weight control have been developed in Israel from locally cultivated Hoodia spp. To study consumer acceptance, efficacy of, and tolerance for a frozen product based on whole aerial parts of Hoodia parviflora N.E. Br., we initiated and conducted this single-blind, randomized, placebo-controlled consumer trial. Volunteer participants ingested flavored 3 g frozen Hoodia or placebo cubes for 40 days. Subjects were weighed and measured and baseline body-mass index was determined. Adverse events were monitored and eight mild, transient, possible treatment-emergent events were reported. No moderate, severe, or chronic events were reported. On days 1, 10, and 40, subjects self-reported their perceptions of food consumption, hunger development, incidence and control of food cravings, and efficacy of the product. On day 40, the treatment group demonstrated a statistically significant decrease in measured quantitative parameters against the placebo and reported a positive perception of the product.
Crane-Ross, Dushka; Lutz, Wilma J; Roth, Dee
This study examines the relationship between service empowerment and recovery. Service empowerment is defined as the extent to which consumers participate in service decisions and the level of reciprocity and respect within the relationship with their case managers. Assessments were made from two perspectives: consumers and their case managers. Structural equation models were developed to examine the direct and indirect effects of service empowerment on four recovery outcomes: Quality of Life, Level of Functioning, Consumer-Reported Symptomatology, and Case Manager-Reported Symptomatology. Consumers' perceptions of service empowerment were the most powerful predictor of recovery outcomes across the four models. Consumers' and case managers' perceptions were related but the magnitude of the relationship was small, indicating that considerable differences exist between their perceptions of service empowerment.
Chouinard, Maud-Christine; Robichaud-Ekstrand, Sylvie
Social support refers to the presence of individuals providing emotional or material resources. Its four components are: integration, structure, function, and quality. This article presents empirical and theoretical data, as well as criticism of studies which examine the relationship between social support, global health and cardiovascular health, also evaluating direct or moderating contributions to the adoption and maintenance of health behaviours in persons with cardiovascular disease. Concrete implications for nursing practice are reviewed.
Morrison, Ian; Clift, Stephen M.
Purpose: The purpose of this research is to report on an evaluation of a programme of supported education in a Further Education context for students with long-term mental health problems, based on Antonovsky's Salutogenic model of health. The students are referred by the Community Mental Health Team. Design/methodology/approach: Three consecutive…
Fernandes Antunes, Adelio; Xu, Ke; James, Chris D; Saksena, Priyanka; Van de Maele, Nathalie; Carrin, Guy; Evans, David B
There has been recent controversy about whether aid directed specifically to health has caused recipient governments to reallocate their own funds to non-health areas. At the same time, general budget support (GBS) has been increasing. GBS allows governments to set their own priorities, but little is known about how these additional resources are subsequently used. This paper uses cross-country panel data to assess the impact of GBS programmes on health spending in low-income and middle-income countries, using dynamic panel techniques to estimate unbiased coefficients in the presence of serial correlation. We found no clear evidence that GBS had any impact, positive or negative, on government health spending derived from domestic sources. GBS also had no observed impact on total government health spending from all sources (external as well as domestic). In contrast, health-specific aid was associated with a decline in health expenditures from domestic sources, but there was not a full substitution effect. That is, despite this observed fungibility, health-specific aid still increases total government health spending from all sources. Finally, increases in total government expenditure led to substantial increases in domestic government health expenditures.