Judy Stribling

Availability, Use, and Barriers to Cardiac Rehabilitation in LMIC

BACKGROUND Cardiac rehabilitation (CR) is a cornerstone of secondary prevention of ischemic heart disease. It is critically important in low- and middle-income countries (LMIC), where the burden of ischemic heart disease is substantial and growing. However, the availability and utilization of CR in LMIC is not systematically known. OBJECTIVES This study sought to characterize the availability, use, and barriers to the use of CR. METHODS Electronic databases (Cochrane Library, EMBASE, PubMed, Web of Science) were searched from January 1, 1980 to May 31, 2013 for articles on CR in LMIC. Citations on availability, use, and/or barriers to CR were screened for inclusion by title, abstract, and full text. Data were summarized by region or country to determine the characteristics of CR in LMIC and gaps in the peer-reviewed biomedical publications. RESULTS Our search yielded a total of 5,805 citations, of which 34 satisfied full inclusion and exclusion criteria. The total number of CR programs available ranged from 1 in Algeria and Paraguay to 51 in Serbia. Referral rates for CR ranged from 5.0% in Mexico to 90.3% in Lithuania. Attendance rates ranged from 31.7% in Bulgaria to 95.6% in Lithuania, and CR attendance was correlated with higher educational background. The most commonly cited barrier to CR in LMIC was lack of physician referral. CONCLUSIONS Our results illustrate that the published reports reflects heterogeneity of CR availability and use in LMIC. Overall, CR is insufficiently available and underutilized. Further characterization of CR in LMIC, especially in Asia and Africa, is necessary to develop targeted strategies to improve availability and utilization. Patient, physician, and systems factors must be addressed to overcome barriers to participation in CR in LMIC.

Placing wireless tablets in clinical settings for patient education.

OBJECTIVE The authors explored the feasibility and possible benefit of tablet-based educational materials for patients in clinic waiting areas. METHODS We distributed eight tablets preloaded with diagnosis-relevant information in two clinic waiting areas. Patients were surveyed about satisfaction, usability, and effects on learning. Technical issues were resolved. RESULTS Thirty-seven of forty patients completed the survey. On average, the patients were satisfied in all categories. CONCLUSIONS Placing tablet-based educational materials in clinic waiting areas is relatively easy to implement. Patients using tablets reported satisfaction across three domains: usability, education, and satisfaction.

Patient-Centered Rounding in an Inpatient Pediatric Setting

ABSTRACT Clinical Medical Librarians at Weill Cornell Medicine (WCM), Samuel J. Wood Library provide unique health literacy services for patients, families, and caregivers on the Phyllis and David Komansky Center for Children’s Health pediatric floors of New York-Presbyterian Hospital (NYPH) by conducting twice weekly patient rounds and bringing consumer health information and services to bedsides. Although in its infancy, the Pediatric Consumer Librarian Service (PCLS) generates statements of appreciation from patients and parents, enthusiasm among stakeholders, and reports of increased job satisfaction by librarians. We report on experiences, methods, feedback from users, and plans for the future.

Leveraging YouTube to Engage Patients and the Public for Health Education

Consumers increasingly use social media including online videos to seek answers to health questions (1, 2). Among the many online video tools to choose from, YouTube is the most popular and evidence confirms that viewers search for health information there as well (3, 4). The increasing demand for health-related videos provides a unique opportunity for hospital and consumer health librarians to promote heath literacy and deliver patient education. This article describes a project to plan, produce, market, and evaluate our efforts to make clinician-led video presentations available by YouTube.