Olivia Velez

Feasibility Testing of a Web-Based Symptom Self-Management System for Persons Living With HIV

&NA; The purpose of this study was to explore the feasibility of using a Web‐based tool to provide tailored symptom management strategies for persons living with HIV (PLWH) and to estimate the effect size of the tool for future studies. Testing the components of the Web‐based system was done by incorporating a repeated‐measures design measuring the outcomes of symptom frequency and intensity, use of symptom management strategies, and engagement with health care providers. We recruited 42 PLWH; participants were enrolled in the study for 12 weeks and were asked to use the system and complete the questionnaires every 2 weeks. Our results showed that participants who used the strategies were more likely to have a decrease in symptom frequency and intensity. Findings from this feasibility study provide preliminary evidence for the use of a Web‐based HIV symptom management tool with self‐management strategies for individuals living with HIV infection.

Health worker perceptions of integrating mobile phones into community case management of malaria in Saraya, Senegal

BACKGROUND Although community case management of malaria increases access to life-saving care in isolated settings, it contends with many logistical challenges. Mobile phone health information technology may present an opportunity to address a number of these barriers. METHODS Using the wireless adaptation of the technology acceptance model, this study assessed availability, ease of use, usefulness, and job relevance of mobile phones by health workers in Saraya, Senegal. RESULTS This study conducted seven key informant interviews with government health workers, and three focus groups and 76 surveys with lay health workers. Principal findings included that mobile phones are already widely available and used, and that participants valued using phones to address training, stock management, programme reporting, and transportation challenges. CONCLUSIONS By documenting widespread use of mobile phones and health worker perceptions of their most useful applications, this paper provides a framework for their integration into the community case management of malaria programme in Saraya, Senegal.

Predictors of Depression Screening Rates of Nurses Receiving a Personal Digital Assistant-based Reminder to Screen

The purpose of this study was to determine if race/ethnicity, payer type, or nursing specialty affected depression screening rates in primary care settings in which nurses received a reminder to screen. The sample comprised 4,160 encounters in which nurses enrolled in advanced practice training were prompted to screen for depression using the Patient Health Questionnaire (PHQ)-2/PHQ-9 integrated into a personal digital assistant-based clinical decision support system for depression screening and management. Nurses chose to screen in response to 52.5% of reminders. Adjusted odds ratios showed that payer type and nurse specialty, but not race/ethnicity, significantly predicted proportion of patients screened.

Psychometric evaluation of the attitudes toward Handheld Decision Support Software Scale in a sample of nursing students.

Valid measures of attitudes are an important component of developing and testing educational interventions aimed at improving technology acceptance. The aim of this study was to assess the construct validity (factor analysis and discriminant validity), internal consistency reliability (Cronbach α), and responsiveness (independent-samples t test) of the Attitudes toward Handheld Decision Support Software Scale in a sample of 103 nursing students engaged in a set of curricular activities focused on enabling safe and evidence-based nursing practice through the use of information technology. Principal components factor analysis resulted in three factors (ease of use and usefulness, clinical support, and barriers to use) that explained 55.49% of the variance. Internal consistency reliability estimates ranged from .61 to .82. Factor scores did not discriminate between nursing students who owned a PDA and those who did not. There were no significant changes in factors scores over time (responsiveness). This study provides preliminary evidence for the factorial structure of the Handheld Decision Support Software Scale and internal consistency of two of the three factor scales. Further exploration of the construct validity, internal consistency, and responsiveness is warranted.

ANI Emerging Leader Project: Enhancing the Role of Nurses in Zambia Through mHealth.

M obile technology for health (mHealth), a strategy to strengthen the healthcare system and enhance delivery of care in developing African countries, has increased rapidly in the past decade. However, most mHealth projects target community health workers (CHWs) or clients as primary users and do not include important stakeholder groups such as nurses. Also, mHealth applications frequently do not integrate with other health information systems that would enable these projects to achieve their objectives. Nurses have strong health information needs and could benefit from mHealth applications. This is particularly true in lowresource settings, such as developing countries or rural and remote areas, where nurses work across a myriad of clinical specialties, manage clinics, and supervise teams of paid and volunteer workers. As part of the Primary Healthcare to Communities (PHC2C) Project, led by Intrahealth International and partially funded by Johnson & Johnson, we are looking at how mHealth and other health information technologies (HITs) can enhance the role of nurses in Zambia as both clinicians and leaders in the healthcare system by helping them to more effectively manage their responsibilities. Zambia was selected for this project because, in addition to the nursing shortage, Zambia’s healthcare system is burdened with many challenges. For example, there is a high infant mortality rate, with 34 deaths per 1000 births and a maternal mortality rate of 591 per 100 000 live births. There is also a high prevalence of HIV/AIDS with an adult rate of 12.7%. This report outlines findings from a preliminary scoping assessment in Zambia to understand how nurses could benefit from mHealth and other health information tools. Dr Vélez participated in this activity in the spring of 2015 as a focus of her Alliance for Nursing Informatics (ANI) Emerging Leaders project.

A Communicative Landscape of Health Information Needs for Malaria Management in the Millennium Villages Project in Bonsaaso, Ghana

We performed a qualitative study (n=39) mapping the health information needs of stakeholders involved with malaria prevention and treatment in rural Ghana as part of a larger effort to develop integrated, scalable eHealth tools. Initial results can be categorized into four areas: health care delivery, data quality, technical problems and workforce‐related problems. This comprehensive review of information challenges in one area identifies fertile ground for potential improvement using health information technology. Introduction: Health Information Technology has the potential to improve health care in developing countries. Information tools that seamlessly integrate into the workflow of health care workers are essential to achieving this goal. In this paper we present a formative study to identify information gaps and needs of the different stakeholders involved in the prevention and treatment of malaria in rural Ghana. Our study maps the communication chains within the Millennium Villages Project (MVP) malaria program in Ghana with the following objectives: 1) To identify stakeholders that directly influence the halt and reduction of malaria incidence (boundary partners). 2) To identify the tasks related to their work and specifically to outline obstacles and challenges they face. 3) Assess the information needs for new potential eHealth support tools. Methods: This is a qualitative methods study involving interviews with key informants and review of existing documents. We developed a semi‐structured interview instrument. We conducted detailed interviews in the field with 36 persons and three others were performed via Skype. The interviews were conducted in English and Twi. The data were collected using hand‐written notes and some photos were taken of registries, medications, clinics and health workers. All the interviews were recorded and transcribed into English. The transcripts were analyzed using a descriptive content analysis approach. Results: We present initial findings based on a subset of 16 interviews with the remainder to follow. The current challenges were categorized into: health care delivery, data quality, technical problems and workforce‐related problems. Health Care Delivery challenges included difficulty with managing prescriptions, trouble with misdiagnosis, and drug and testing kit shortages. Some workers reported communication issues due to language barriers with the patients and some patients did not attend the clinics when they were referred and were not followed up. Data Quality problems specific to this environment included: poor timeliness of reports due to work overload, and transportation problems in the community. Lengthy and complex manual completion allowed for miscalculations and errors in aggregated data. Data are …