Description

An onsite recording of this session will be included in the Symposium OnDemand offering. 

The Moderating Effect of Health Literacy on the Impact of a Mobile Remote Monitoring Intervention with Tailored Messages for Breast Cancer Survivors: A Post Hoc Analysis of a Randomized Controlled Trial

Presentation Time: 08:30 AM - 08:45 AM

Abstract Keywords: Mobile Health, Health Equity, Behavioral Change, Patient / Person Generated Health Data (Patient Reported Outcomes)
Primary Track: Applications
Programmatic Theme: Clinical Research Informatics

Women with breast cancer starting adjuvant endocrine therapy were randomized to an app-based remote monitoring intervention with and without tailored educational messages versus enhanced usual care. Among participants with low health literacy randomized to the remote monitoring app with tailored messages, 80% had high AET adherence over 12 months compared with 42.1% in enhanced usual care (p=0.01); there were no significant differences by study arm for those with high health literacy.

Speaker(s):
Ilana Graetz
Emory University

Author(s):
Ilana Graetz - Emory University; Xin Hu, PhD - University of Virginia School of Medicine; Rebecca Krukowski, PhD - University of Virginia Cancer Center; Mehmet Kocak, PhD - International School of Medicine, Istanbul Medipol University; Janeane Anderson, PhD - College of Nursing, University of Tennessee Health Science Center; Teresa Waters, PhD - Augusta University School of Public Health; Andrea Curry, PhD - West Cancer Center; Edward Stepanski, PhD - Ovation.io; Gregory Vidal, MD, PhD - West Cancer Center and Research Institute; Lee Schwartzberg, MD - Renown Institute for Cancer;

Key considerations regarding usability and effective mobile app integration into two electronic health record systems

Presentation Time: 08:45 AM - 09:00 AM

Abstract Keywords: Information Visualization, Nursing Informatics, Interoperability and Health Information Exchange, Global Health, Mobile Health, Usability
Primary Track: Applications
Programmatic Theme: Clinical Informatics

Substitutable Medical Applications and Reusable Technology (SMART)® Applications (app) that are compatible with the Fast Healthcare Interoperability Resources (FHIR)® are the standard for integrating mobile apps and electronic health records (EHR). Our team developed a SMART on FHIR mobile application, Info Viz for Health®, to support clinical HIV-related communication with diverse persons with HIV. Unfortunately, relatively little is known regarding clinician perspectives and preferences of mobile app integration with EHRs, which if not obtained, could render apps integrated into EHRs useless. Our study objectives were to explore the perceptions of clinical EHR users from both a developed (United States (US)) and a developing (Dominican Republic (DR)) setting regarding the usability of our app and identify key factors that researchers and designers should consider when creating apps to integrate with EHRs. We conducted semi-structured in-depth interviews with n=26 clinicians (n=13 per site) who provide HIV-related health education. Interviews were led with rigorously developed guides that contained questions based on Davis’s technology acceptance model and questions to explore characteristics of effective app integration. Interviews were analyzed using qualitative content analysis. Findings indicated high perceived usability of the Info Viz for Health app and several important considerations for effective integration of apps with EHRs were identified. Namely, apps integrated with EHRs must be easy and intuitive to access/use, and must leverage commonly used features of EHRs. These findings will provide valuable information for researchers, organizations, and/or other professionals designing health-related apps for EHR integration.

Speaker(s):
Samantha Stonbraker, PhD, MPH, RN
University of Colorado College of Nursing

Author(s):
Samantha Stonbraker, PhD, MPH, RN - University of Colorado Anschutz Medical Campus; Yazmina Espiritusanto, BA - Clínica de Familia La Romana; Pamela Baez, MD, MSc - Clínica de Familia La Romana; Stefanie Mayorga, BA - University of Colorado College of Nursing; Evelyn Iriarte, PhD - University of Colorado College of Nursing; Mehmet Kazgan, MS, MBA - cliexa, Inc.; Burak Cetin, BS - cliexa, Inc.; Arin Seidlitz, BS - cliexa, Inc.; Kellie Hawkins, MD, MPH - Denver Health and Hospital Authority; Edward Gardner, MD - Denver Health and Hospital Authority; James Mitchell - University of Colorado; Kenrick Cato, PhD, RN, CPHIMS, FAAN - University of Pennsylvania/ Children's Hospital of Philadelphia;

Examining Barriers to the Adoption of a Digital Mental Health Intervention: A Mixed-Methods Study using Thematic Analysis and Machine Learning

Presentation Time: 09:00 AM - 09:15 AM

Abstract Keywords: Mobile Health, Human-computer Interaction, Machine Learning
Primary Track: Applications
Programmatic Theme: Consumer Health Informatics

In our mixed-methods study, we examine barriers to the adoption of Digital Mental Health intervention (DMH) among young adults. We identified digital literacy, access, in-person interaction, and a need for personalization as barriers to DMH adoption. Machine learning insights highlight significant factors influencing engagement, including illegal drug use, and suicide ideation. We recommend integrating AI and real-time support into DMH services, tailored to young adults’ socio-cultural context, to enhance engagement and effectiveness.

Speaker(s):
Ha Na Cho, Ph.D
University of California, Irvine

Author(s):
Ha Na Cho, Ph.D - University of California, Irvine; Kyuha Jung; Kai Zheng, PhD - University of California, Irvine; Daniel Eisenberg, Ph.D. - University of California Los Angeles; Cheryl King, Ph.D. - University of Michigan;

Computationally-guided Qualitative Analysis of User-Generated Data for Different Models of Mobile-Personal Health Records Apps

Presentation Time: 09:15 AM - 09:30 AM

Abstract Keywords: Personal Health Informatics, Human-computer Interaction, Natural Language Processing, Patient Engagement and Preferences, Qualitative Methods
Primary Track: Foundations
Programmatic Theme: Consumer Health Informatics

Mobile Personal Health Records (mPHR) are smartphone apps granting patients portable and continuous access to their medical records on the go, thereby increasing their potential to play an active role in managing their healthcare. An extensive body of literature has focused on understanding user(s) experiences with web-based tethered PHRs (i.e., Patient Portals) offered by healthcare organizations. However, patients' opinions of smartphone-based PHRs have received less attention. Our study aims to understand this gap. We used a computationally-guided qualitative analysis approach to identify latent topics indicating dimensions of user experiences present in app reviews left on popular m-PHR apps available on Google Play and Apple app stores. After following a detailed app selection process, 10 m-PHR, including tethered (n=6) and interconnected (n=4) apps, were selected for analysis. Our findings show similarities in user experiences for HCO-tethered PHRs and HCO-independent interconnected PHRs, and we discuss the design implications concerning the differences.

Speaker(s):
Zainab Balogun, None
University of Maryland Baltimore County

Author(s):

“Getting people access to services is also getting them access to a phone”: Clarifying digital divide dynamics and their consequences in Community Mental Health Care

Presentation Time: 09:30 AM - 09:45 AM

Abstract Keywords: Health Equity, Qualitative Methods, Mobile Health
Primary Track: Applications
Programmatic Theme: Consumer Health Informatics

Access to mental healthcare is increasingly technologically-mediated. People with low socioeconomic status (SES) and serious mental illness (SMI) face lower rates of tech ownership and may lack technological skills, called “digital divides.” Yet, little is known about how digital divides may impact mental healthcare access. Therefore, a qualitative study (ethnographic observations and interviews) was conducted with staff working with low-SES SMI patients using community mental health care (CMH) (N=14). Findings showed that consumers struggled to maintain consistent internet—and thus mental healthcare—access despite owning smartphones. Consumers frequently faced care disruptions due to broken, lost, or uncharged phones. Staff and patients created effortful but ad-hoc workarounds to restore access during technological access disruptions. These solutions frequently occurred after healthcare appointments were missed. Digital divide concepts should accommodate the work necessary to maintain technology access even after ownership and its impact on care access—especially among low-SES SMI patients.

Speaker(s):
Alicia Williamson
School of Information, University of Michigan

Author(s):
Tiffany Veinot, PhD - University of Michigan School of Information; Ella Li, MSI - University of Michigan;

Barriers and Facilitators of Digital Health Use for Self-Management of Hypertensive Disorders by Black Pregnant Women

Presentation Time: 09:45 AM - 10:00 AM

Abstract Keywords: Health Equity, Qualitative Methods, Patient Engagement and Preferences, User-centered Design Methods
Primary Track: Applications
Programmatic Theme: Consumer Health Informatics

Digital health is popular for managing health conditions; however, these applications are often developed with few considerations of the differences across user populations. Tailoring such applications to include cultural considerations could lead to better adoption and adherence in such programs, but a reproducible framework is needed. This study aims to capture Black women’s barriers and facilitators in self-managing hypertensive disorders of pregnancy (HDP) using digital health products. One-on-one interviews were conducted with 17 Black pregnant women with HDP using a semi-structured interview guide. Qualitative data obtained was analyzed using grounded theory and 38 codes were mapped within the four levels of the socioecological model of health. Themes were created that identified barriers and facilitators of the women’s pregnancy experiences and used to influence the feature development of a digital health intervention. Future work will instantiate and validate a framework that provides theoretical constructs for developing culturally tailored digital health interventions.

Speaker(s):
Morgan Foreman, PhD Candidate
UTHealth Houston McWilliams SBMI & IBM Research

Author(s):
Angela Ross, DNP, RN, MPH, PMP, DASM, PHCNS-BC - University of Texas Health McWilliams School of Biomedical Informatics; Angela P.H. Burgess, MD, PhD - UTHealth Houston McGovern Medical School; Sahiti Myneni - University of Texas Health Science Center- Houston; Amy Franklin - The University of Texas Health Science Center - Houston;