Anne M. Turner

The Use of Social Networking Sites for Public Health Practice and Research: A Systematic Review

Background Social networking sites (SNSs) have the potential to increase the reach and efficiency of essential public health services, such as surveillance, research, and communication. Objective The objective of this study was to conduct a systematic literature review to identify the use of SNSs for public health research and practice and to identify existing knowledge gaps. Methods We performed a systematic literature review of articles related to public health and SNSs using PubMed, EMBASE, and CINAHL to search for peer-reviewed publications describing the use of SNSs for public health research and practice. We also conducted manual searches of relevant publications. Each publication was independently reviewed by 2 researchers for inclusion and extracted relevant study data. Results A total of 73 articles met our inclusion criteria. Most articles (n=50) were published in the final 2 years covered by our search. In all, 58 articles were in the domain of public health research and 15 were in public health practice. Only 1 study was conducted in a low-income country. Most articles (63/73, 86%) described observational studies involving users or usages of SNSs; only 5 studies involved randomized controlled trials. A large proportion (43/73, 59%) of the identified studies included populations considered hard to reach, such as young individuals, adolescents, and individuals at risk of sexually transmitted diseases or alcohol and substance abuse. Few articles (2/73, 3%) described using the multidirectional communication potential of SNSs to engage study populations. Conclusions The number of publications about public health uses for SNSs has been steadily increasing in the past 5 years. With few exceptions, the literature largely consists of observational studies describing users and usages of SNSs regarding topics of public health interest. More studies that fully exploit the communication tools embedded in SNSs and study their potential to produce significant effects in the overall population’s health are needed.

From the ground up: information needs of nurses in a rural public health department in Oregon.

OBJECTIVES The research identified and assessed information needs and resources of public health nurses in a local health department. METHODS Semi-structured in-depth interviews were conducted with seventeen public health nurses at a local health department in rural Oregon. Interview transcripts were analyzed using a constant comparative method to assess the information nurses sought and used in their work. RESULTS Public health nurses performed a wide variety of roles and associated tasks. Major themes that emerged from analyses of interview transcripts included: (1) differences in information needs depending on position and role; (2) colleagues as the most efficient and trusted source of information; (3) limitations of existing knowledge-based resources; (4) need for up-to-date and pertinent information; and (5) need for personal computers, basic communications software, and expanded Internet access. CONCLUSIONS Lack of Internet access is a significant barrier to use of information resources, and information tools tailored to meet the needs diverse public health nursing roles and facilitate information sharing among colleagues are needed. Librarians and informaticians can assist by addressing these needs and improving the organization of content and interface design for commonly used websites.

Using Crowdsourcing Technology for Testing Multilingual Public Health Promotion Materials

Background Effective communication of public health messages is a key strategy for health promotion by public health agencies. Creating effective health promotion materials requires careful message design and feedback from representatives of target populations. This is particularly true when the target audiences are hard to reach as limited English proficiency groups. Traditional methods of soliciting feedback—such as focus groups and convenience sample interviews—are expensive and time consuming. As a result, adequate feedback from target populations is often insufficient due to the time and resource constraints characteristic to public health. Objective To describe a pilot study investigating the use of crowdsourcing technology as a method to gather rapid and relevant feedback on the design of health promotion messages for oral health. Our goal was to better describe the demographics of participants responding to a crowdsourcing survey and to test whether crowdsourcing could be used to gather feedback from English-speaking and Spanish-speaking participants in a short period of time and at relatively low costs. Methods We developed health promotion materials on pediatric dental health issues in four different formats and in two languages (English and Spanish). We then designed an online survey to elicit feedback on format preferences and made it available in both languages via the Amazon Mechanical Turk crowdsourcing platform. Results We surveyed 236 native English-speaking and 163 native Spanish-speaking participants in less than 12 days, at a cost of US

Scenario-based design: A method for connecting information system design with public health operations and emergency management

374. Overall, Spanish-speaking participants originated from a wider distribution of countries than the overall Latino population in the United States. Most participants were in the 18- to 29-year age range and had some college or graduate education. Participants provided valuable input for the health promotion material design. Conclusions Our results indicate that crowdsourcing can be an effective method for recruiting and gaining feedback from English-speaking and Spanish-speaking people. Compared with traditional methods, crowdsourcing has the potential to reach more diverse populations than convenience sampling, while substantially reducing the time and cost of gathering participant feedback. More widespread adoption of this method could streamline the development of effective health promotion materials in multiple languages.

An informatics agenda for public health: summarized recommendations from the 2011 AMIA PHI Conference

UNLABELLED Responding to public health emergencies requires rapid and accurate assessment of workforce availability under adverse and changing circumstances. However, public health information systems to support resource management during both routine and emergency operations are currently lacking. We applied scenario-based design as an approach to engage public health practitioners in the creation and validation of an information design to support routine and emergency public health activities. METHODS Using semi-structured interviews we identified the information needs and activities of senior public health managers of a large municipal health department during routine and emergency operations. RESULTS Interview analysis identified 25 information needs for public health operations management. The identified information needs were used in conjunction with scenario-based design to create 25 scenarios of use and a public health manager persona. Scenarios of use and persona were validated and modified based on follow-up surveys with study participants. Scenarios were used to test and gain feedback on a pilot information system. CONCLUSION The method of scenario-based design was applied to represent the resource management needs of senior-level public health managers under routine and disaster settings. Scenario-based design can be a useful tool for engaging public health practitioners in the design process and to validate an information system design.

Designing and remotely testing mobile diabetes video games

The AMIA Public Health Informatics 2011 Conference brought together members of the public health and health informatics communities to revisit the national agenda developed at the AMIA Spring Congress in 2001, assess the progress that has been made in the past decade, and develop recommendations to further guide the field. Participants met in five discussion tracks: technical framework; research and evaluation; ethics; education, professional training, and workforce development; and sustainability. Participants identified 62 recommendations, which clustered into three key themes related to the need to (1) enhance communication and information sharing within the public health informatics community, (2) improve the consistency of public health informatics through common public health terminologies, rigorous evaluation methodologies, and competency-based training, and (3) promote effective coordination and leadership that will champion and drive the field forward. The agenda and recommendations from the meeting will be disseminated and discussed throughout the public health and informatics communities. Both communities stand to gain much by working together to use these recommendations to further advance the application of information technology to improve health.

Breaking the metadata generation bottleneck: preliminary findings

We have investigated game design and usability for three mobile phone video games designed to deliver diabetes education. The games were refined using focus groups. Six people with diabetes participated in the first focus group and five in the second. Following the focus groups, we incorporated the new findings into the game design, and then conducted a field test to evaluate the games in the context in which they would actually be used. Data were collected remotely about game usage by eight people with diabetes. The testers averaged 45 seconds per question and answered an average of 50 total nutrition questions each. They self-reported playing the game for 10–30 min, which coincided with the measured metrics of the game. Mobile games may represent a promising new way to engage the user and deliver relevant educational content.

Scenarios, personas and user stories: User-centered evidence-based design representations of communicable disease investigations

The goal of our 18 month NSDL-funded project is to develop Natural Language Processing and Machine Learning technology which will accomplish automatic metadata generation for individual educational resources in digital collections. The metadata tags that the system will be learning to automatically assign are the full complement of Gateway to Educational Materials (GEM) metadata tags – from the nationally recognized consortium of organizations concerned with access to educational resources. The documents that comprise the sample for this research come from the Eisenhower National Clearinghouse on Science and Mathematics.

Using problem-based learning as a strategy for cross-discipline emergency preparedness training.

PURPOSE Despite years of effort and millions of dollars spent to create unified electronic communicable disease reporting systems, the goal remains elusive. A major barrier has been a lack of understanding by system designers of communicable disease (CD) work and the public health workers who perform this work. This study reports on the application of user-centered design representations, traditionally used for improving interface design, to translate the complex CD work identified through ethnographic studies to guide designers and developers of CD systems. The purpose of this work is to: (1) better understand public health practitioners and their information workflow with respect to CD monitoring and control at a local health agency, and (2) to develop evidence-based design representations that model this CD work to inform the design of future disease surveillance systems. METHODS We performed extensive onsite semi-structured interviews, targeted work shadowing and a focus group to characterize local health agency CD workflow. Informed by principles of design ethnography and user-centered design we created persona, scenarios and user stories to accurately represent the user to system designers. RESULTS We sought to convey to designers the key findings from ethnographic studies: (1) public health CD work is mobile and episodic, in contrast to current CD reporting systems, which are stationary and fixed, (2) health agency efforts are focused on CD investigation and response rather than reporting and (3) current CD information systems must conform to public health workflow to ensure their usefulness. In an effort to illustrate our findings to designers, we developed three contemporary design-support representations: persona, scenario, and user story. CONCLUSIONS Through application of user-centered design principles, we were able to create design representations that illustrate complex public health communicable disease workflow and key user characteristics to inform the design of CD information systems for public health.

An interactive and user-centered computer system to predict physician's disease judgments in discharge summaries

The rapid and effective response to a bioterrorist event requires the coordinated efforts of trained personnel from different agencies. This article describes the design and implementation of a 1-week cross-disciplinary course employing problem-based learning (PBL) for professionals with backgrounds in public health, fire/emergency medical services (EMS), law enforcement, emergency management, and hospital administration. The curriculum provided opportunities for professionals from different disciplines to meet and learn the priorities and resources of partner agencies. In course evaluations, participants rated the training highly and found it applicable to their work and a good use of time and training resources. PBL techniques were successful in fostering cross-agency communication, thereby showing promise as an effective training method for meeting local and national emergency preparedness objectives.