Jonathan Joe

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.

Testing a theory-based mobility monitoring protocol using in-home sensors: a feasibility study.

Mobility is a key factor in the performance of many everyday tasks required for independent living as a person ages. The purpose of this mixed-methods study was to test a theory-based mobility monitoring protocol by comparing sensor-based measures to self-report measures of mobility and assess the acceptability of in-home sensors with older adults. Standardized instruments to measure physical, psychosocial, and cognitive parameters were administered to 8 community-dwelling older adults at baseline, 3-month, and 6-month visits. Semi-structured interviews to characterize acceptability of the technology were conducted at the 3-month and 6-month visits. Technical issues prevented comparison of sensor-based measures with self-report measures. In-home sensor technology for monitoring mobility is acceptable to older adults. Implementing our theory-based mobility monitoring protocol in a field study in the homes of older adults is a feasible undertaking but requires more robust technology for sensor-based measure validation.

Older adults’ attitudes and preferences regarding a multifunctional wellness tool: A pilot study

Objective: To examine older adults’ attitudes toward multifunctional technology tools and specific preferences and expectations that would maximize their utility and usability. Methods: We held three focus group sessions for this pilot study to determine perceptions of older adults toward multifunctional wellness tools, including usefulness and barriers to use. Areas discussed included features that would be wanted or unwanted, form factor and context of use. Recordings were transcribed and qualitative content analysis was performed. Results: Fourteen older adults participated in the focus group sessions. Participants viewed potential uses for wellness tools with regard to their health and health information positively, as they felt currently available tools were lacking. In addition, participants felt that a single-user, smaller, portable device would be more useful than a non-portable multi-user device. Concerns were expressed toward technologies that were difficult to use with aging-related changes, privacy and perceptions of technology. Conclusions: Participants felt generally positively toward a multifunctional wellness tool and would be willing to use one if it were portable, intuitive and had reliable health-related information on the device.

The use of think-aloud and instant data analysis in evaluation research

While health information technologies have become increasingly popular, many have not been formally tested to ascertain their usability. Traditional rigorous methods take significant amounts of time and manpower to evaluate the usability of a system. In this paper, we evaluate the use of instant data analysis (IDA) as developed by Kjeldskov et al. to perform usability testing on a tool designed for older adults and caregivers. The IDA method is attractive because it takes significantly less time and manpower than the traditional usability testing methods. In this paper we demonstrate how IDA was used to evaluate usability of a multifunctional wellness tool, discuss study results and lessons learned while using this method. We also present findings from an extension of the method which allows the grouping of similar usability problems in an efficient manner. We found that the IDA method is a quick, relatively easy approach to identifying and ranking usability issues among health information technologies.

Exploring an informed decision-making framework using in-home sensors: older adults' perceptions.

BACKGROUND Sensor technologies are designed to assist independent living of older adults. However, it is often difficult for older adults to make an informed decision about adopting sensor technologies. OBJECTIVE To explore Bruces framework of informed decision making (IDM) for in-home use of sensor technologies in community-dwelling elders. METHOD The IDM framework guided development of a semi-structured interview. A theory-driven coding approach was used for analysis. RESULTS Participants supported most of the elements of the framework, but not all aspects of each element were addressed. Perceived usefulness of technologies was identified as an area for framework extension. CONCLUSION This paper provides useful information for health care professionals to consider how to enhance IDM of older adults regarding the use of sensor technologies. The results also illuminate elements of the IDM framework that may be critical to facilitating independent living for older adults.

IT-based wellness tools for older adults: Design concepts and feedback

ABSTRACT Objective: To explore older adults’ preferences regarding e-health applications through use of generated concepts that inform wellness tool design. Methods: The 6-8-5 method and affinity mapping were used to create e-health design ideas that were translated into storyboards and scenarios. Focus groups were conducted to obtain feedback on the prototypes and included participant sketching. A qualitative analysis of the focus groups for emerging themes was conducted, and sketches were analyzed. Results: Forty-three older adults participated in six focus group sessions. The majority of participants found the wellness tools useful. Preferences included features that supported participants in areas of unmet needs, such as ability to find reliable health information, cognitive training, or maintaining social ties. Participants favored features such as use of voice navigation, but were concerned over cost and the need for technology skills and access. Sketches reinforced these wants, including portability, convenience, and simplicity. Conclusions: Several factors were found to increase the desirability of such devices including convenient access to their health and health information, a simple, accessible interface, and support for memory issues. Researchers and designers should incorporate the feedback of older adults regarding wellness tools, so that future designs meet the needs of older adults.

Examining Korean and Korean American older adults’ perceived acceptability of home-based monitoring technologies in the context of culture

ABSTRACT Objective: Despite the increasing use of home-based monitoring technologies by older adults, few studies have examined older adults’ acceptance of these technologies, especially among people from diverse cultural groups. The purpose of this study was to explore Korean and Korean American older adults’ attitudes toward and perceptions of home-based monitoring technologies in a cultural context. Methods: A qualitative analysis of focus groups and individual interviews using inductive coding methods and a constant comparative approach for emerging themes was conducted.Results: Several cultural factors that determine the acceptability of home-based monitoring technologies were identified. Most notably, the necessity of living alone due to loosened filial tradition and immigration was a main motivator for adopting these technologies for both Korean and Korean Americans. The level of satisfaction with the health care system or therapeutic interaction affected participants’ perceived need for technologies. Compared with the Korean American group, Korean older adults regarded the government’s role as more important in increasing adoption and use of new technologies. Conclusions: Contextual factors need to be considered when explaining perceptions of home-based monitoring technologies among older adults from various ethnic groups and developing diffusion strategies according to end users’ attitudes, experiences, and cultural backgrounds.

Understanding Older Adults' Perceptions of In-Home Sensors Using an Obtrusiveness Framework

The aim of this study was to determine if dimensions and sub-categories of a previously-tested obtrusiveness framework were represented in interviews conducted with community-dwelling older adults at three- and six-month study visits during an in-home sensor study. Secondary analysis of interviews was performed using a codebook based on an obtrusiveness framework. Eight community-dwelling older adults aged 79---86 participated in 15 interviews. One participant died between the three- and six-month interviews. Some elements of the obtrusiveness framework were present at three months but not at six months, indicating that perceptions of obtrusiveness of in-home sensors may decline over time. Findings highlight the importance of privacy issues and perceived usefulness for sensor technology use and adoption. There is a need to develop an obtrusiveness assessment instrument that enables nuanced measurements based on specific contexts and types of technologies.

Use of Patient Portals

The personal health information management (PHIM) of older adults is poorly understood. We describe initial results from the SOARING (Studying Older Adults & Researching Information Needs and Goals) study at the University of Washington, a participatory design investigation of PHIM in older adults. We conducted in-depth interviews with older adults (n=71) living in a variety of residential settings. A surprising 21% of participants reported using patient portals. Another 17% of participants reported prior use or anticipated use of portals in the future. We identified preferences and needs as well as barriers and facilitators to portal use. Our findings indicate that patient portals designed to target the specific needs for older adults can suport PHIM. We offer recommendations for expanded research.