Jeffrey T. Huber

“Partnering with Seniors for Better Health”: computer use and internet health information retrieval among older adults in a low socioeconomic community

PURPOSE This health communication project measured the psychosocial influences of computer anxiety, computer confidence, and computer self-efficacy in older adults at six meal congregate sites. The adults completed a five-week education intervention, based on Banduras self-efficacy model, designed to assist older adults in retrieving and evaluating health information resources on the Internet. METHODS One hundred thirty-seven participants, ages sixty-five and older, were randomized in a controlled, two-group, pre-post, repeated measures design. Participants in the intervention group received a two-hour training session, once a week for five weeks. The Computer Confidence Subscale and Computer Anxiety Subscale of the Computer Attitude Scale and the Computer Self-Efficacy Measure were administered to both groups at three time intervals: at baseline, completion of the five-week intervention, and six weeks after completion of the intervention. Data were analyzed using repeated measures analysis of variance. RESULTS Findings showed a reduction in computer anxiety and increases in computer confidence and computer self-efficacy in retrieving and evaluating online health information (P<0.001). DISCUSSION The study suggests an array of possibilities to engage older adults in the use of Internet health information resources to better contribute to their health, independence, safety, and wellness.

Information Needs and Information-Seeking Behaviors of HIV Positive Men and Women

ABSTRACT Although a portion of the HIV/AIDS population has long been active in seeking out information in support of self-care, little work has been done to examine closely the information needs and information-seeking behaviors of this community relative to the provision of medical reference. This exploratory study provides insight into the types of information HIV positive individuals seek and the resources they consult in gathering information to bolster health and well-being. Having a better understanding of the information needs and information-seeking behaviors of individuals with HIV/AIDS will facilitate information intervention for this community.

Information Needs of Health Care Professionals in an Aids Outpatient Clinic as Determined by Chart Review

OBJECTIVE To examine the information needs of health care professionals in HIV-related clinical encounters, and to determine the suitability of existing information sources to address those needs. SETTING HIV outpatient clinic. PARTICIPANTS Seven health care professionals with diverse training and patient care involvement. METHODS Based on patient charts describing 120 patient encounters, participants generated 266 clinical questions. Printed and on-line information sources were used to answer questions in two phases: using commonly available sources and using all available medical library sources. MEASUREMENTS The questions were divided into 16 categories by subject. The number of questions answered, their categories, the information source(s) providing answers, and the time required to answer questions were recorded for each phase. RESULTS Each participant generated an average of 3.8 clinical questions per chart. Five categories accounted for almost 75% of all questions; the treatment protocols/regimens category was most frequent (24%). A total of 245 questions (92%) were answered, requiring an average of 15 minutes per question. Most (87%) of the questions were answered via electronic sources, even though paper sources were consulted first. CONCLUSIONS The participating professionals showed considerable information needs. A combination of on-line and paper sources was necessary to provide the answers. The study suggests that present-day information sources are not entirely satisfactory for answering clinical questions generated by examining charts of HIV-infected patients.

HIV/AIDS and nutrition: a bibliometric analysis.

ABSTRACT Diet and nutrition are directly involved in patient care protocols that reflect a shift in the treatment of HIV/AIDS as a chronic disease, with an emphasis on quality of life and expanded life trajectory. Research concerning HIV/AIDS and nutrition is multidisciplinary, yielding study results that appear in a wide variety of scholarly journals. The purpose of this research was to employ bibliometric techniques to evaluate the body of literature specific to HIV/AIDS and nutrition as well as to determine content overlap among major bibliographic citation databases.

Quality of published reports of the prognosis of community-acquired pneumonia.

Objective: To systematically assess the quality of published reports of the prognosis of community-acquired pneumonia using a formal quality assessment instrument.Design: Retrospective review of studies published during 1966–1991.Articles: 108 articles related to the prognosis of community-acquired pneumonia retrieved by a computerized search.Intervention: All articles, blinded to author(s), journal title, year of publication, and study institution(s), were independently reviewed by two investigators using a ten-item quality assessment instrument designed to evaluate: 1) identification of the inception cohort (4 items), 2) description of referral patterns (1 item), 3) subject follow-up (2 items), and 4) statistical methods (3 items). Adherence to each of the ten individual quality items and an overall quality score were calculated for all articles and across three time periods.Main results: Among all 108 articles that underwent quality assessment, 30 were published from 1966 to 1979, 61 from 1980 through 1989, and 17 from 1990 through 1991. The mean total quality score of all articles was 0.55 (range 0.22–0.90). There was a significant trend toward improvement in total quality scores over the three time periods (0.50 to 0.56 to 0.65; p<0.001). However, several systematic errors in the study design or reporting of these studies were discovered throughout time: only 3.7% provided comparative information about nonenrolled patients, 28.7% determined whether the study institution was a referral center, 36.1% specified inclusion or exclusion criteria, and 45.5% used appropriate statistical analyses to adjust for more than one prognostic factor.Conclusions: Despite improvement in overall quality of published articles, systematic errors exist in the design and reporting of studies related to the prognosis of community-acquired pneumonia. The quality assessment tool employed in this study could be used to guide the development of high-quality outcomes research in the future.

The literature of women and the acquired immunodeficiency syndrome (AIDS): implications for collection development and information retrieval.

The purpose of the study was to identify the pattern of publication about women and AIDS in scientific journals. Bradford zones were identified in each of six databases. The study determined that journal scatter for this subset of AIDS literature differed from the scatter in the general literature; further, the information indexed in the six electronic sources demonstrated little overlap. Consequently, key journal and newsletter titles identified by this study should form the core of any collection focusing on women and AIDS. The assurance of quality patient care management demands that librarians consult multiple resources for information retrieval that can assist health care providers, patients, and caregivers to enhance quality of life as well as to provide optimum care.

Complementary and Alternative Medicine as Represented in the HIV/AIDS Body of Knowledge: A Bibliometric Analysis

Abstract Although the HIV/AIDS epidemic began more than twenty years ago, there still is no cure for the disease and no vaccine to prevent infection. As with the general population, individuals with HIV/AIDS have sought care using a variety of traditional and nontraditional approaches. The popularity of complementary and alternative interventions among the HIV/AIDS community continues. To understand better the distribution of the HIV/AIDS body of knowledge concerning complementary and alternative medicine (CAM), this study sought to (1) examine the literature specific to the use of complementary and alternative medicine where HIV/AIDS is concerned to determine publication patterns; (2) determine the degree of overlap among bibliographic citation databases that index the literature concerning the use of CAM practices in treating HIV/AIDS; and (3) facilitate access to this body of literature.

Knowledge/Power Transforming the Social Landscape: The Case of the Consumer Health Information Movement

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 foundation for the CHI movement. All are examples of freedom of choice expressed through action and mirror a growing societal determination to exert control over important areas of one’s life. The provision of consumer health information is a necessary support mechanism for that portion of health care focused on investing in risk reduction and shared decision making. As changes in the U.S. health-care system occur over time, access to CHI is likely to remain prominent and increasingly important to the ordinary person. Examining key components of the movement’s origins helps elucidate both present and future trends.

Death and aids: A review of the medico-legal literature

As there is still neither a known cure for the acquired immunodeficiency syndrome (AIDS) nor any vaccine to prevent infection with the human immunodeficiency virus (HIV), an AIDS diagnosis continues to denote a death sentence. One might think that approaching dying, death, and bereavement in the AIDS pandemic would be the same as with other terminal illnesses. However, that is not the case. No other single disease in the history of the American legal system has generated more litigation than this disease. This article examines some of the medico-legal issues associated with AIDS-related death such as estate planning, discrimination, insurance, long-term care, the right to die, and suicide as detailed in medical and legal discourse.

Educational Software Evaluation Process

The Active Digital Library at the Vanderbilt University Medical Center has created and implemented an educational software evaluation process to facilitate the timely recommendation for product acquisition. Using this process, breadth and depth of subject coverage, clarity of presentation, quality of construction, and ease of use are being assessed by content and technical experts. The process uses a team approach, employing a bi-level evaluation instrument based on existing software evaluation forms and system bug reports.