Health Reminders Research Articles

The Effectiveness of Different Health Education Strategies in People with Pre-diabetes: A Randomized Controlled Trial

Background. People with pre-diabetes often lack knowledge of their risks of developing diabetes. In one of our previous study, Multi-Approach Health Education was shown evidence to be effective on health behavior of reducing risks of developing diabetes. However, which one approach is really effective and efficient need further investigation. Purpose. To examine the effects of different intervention strategies on diabetes prevention knowledge, exercise, dietary behavior, and physiological indicators for people with pre-diabetes. Methods. This was a randomly controlled trial. People who received health examination and were found fasting blood glucose higher than normal, between 100 - 125 mg/dl in 2011 were recruited. Three types of intervention were randomly assigned to 3 groups respectively. The control group (n=51) received a health education lecture. One experimental group (n=48) received the identical lecture plus telephone encouragement. The second experimental group (n=41) received the identical lecture plus a health reminder poster in their daily life. The outcomes were evaluated for the change in knowledge of diabetes prevention, exercise behavior, dietary behavior, and physiological outcomes at 6 and 12 weeks after the lecture of three groups, respectively. Results. Three intervention strategies were equally efficacious at inducing positive behavioral changes but overall the magnitudes of physiological changes were the same. In general, the maximum change in parameters was achieved after 6 weeks and maintained in the second 6 weeks of the study. Conclusions. Educating people with pre-diabetes about their condition can have a positive effect upon their health behaviors. However, education lecture coupled with a telephone follow up or plus educational posters were found no more effective than lecture alone. The lecture alone of health education may be enough for people with pre-diabetes, but the long term effect needs further investigation.

Using Health Information Technology to Foster Engagement: Patients’ Experiences with an Active Patient Health Record

ABSTRACTPersonal health records (PHRs) typically employ “passive” communication strategies, such as non-personalized medical text, rather than direct patient engagement in care. Currently there is a call for more active PHRs that directly engage patients in an effort to improve their health by offering elements such as personalized medical information, health coaches, and secure messaging with primary care providers. As part of a randomized clinical trial comparing “passive” with “active” PHRs, we explore patients’ experiences with using an “active” PHR known as HealthTrak. The “passive” elements of this PHR included problem lists, medication lists, information about patient allergies and immunizations, medical and surgical histories, lab test results, health reminders, and secure messaging. The active arm included all of these elements and added personalized alerts delivered through the secure messaging platform to patients for services coming due based on various demographic features (including age and sex) and chronic medical conditions. Our participants were part of the larger clinical trial and were eligible if they had been randomized to the active PHR arm, one that included regular personalized alerts. We conducted focus group discussions on the benefits of this active PHR for patients who are at risk for cardiovascular disease. Forty-one patients agreed to participate and were organized into five separate focus group sessions. Three main themes emerged from the qualitatively analyzed focus groups: participants reported that the active PHR promoted better communication with providers; enabled them to more effectively partner with their providers; and helped them become more proactive about tracking their health information. In conclusion, patients reported improved communication, partnership with their providers, and a sense of self-management, thus adding insights for PHR designers hoping to address low adoption rates and other patient barriers to the development and use of the technology.

Download Alert: What Do Gastroenterology Patients Really Think of Health-Related Smartphone Apps?

Introduction: The aims of this study were to understand patients’ willingness to use different types of health-related smartphone apps and to explore their views on the overall value, usability, feasibility, credibility, obtrusiveness, and safety of these apps. Methods: Questionnaires were distributed to adult patients presenting to a gastroenterology clinic at an academic medical center. Our customized survey contained 20 statements and subjects were asked to indicate their agreement using a 5-point Likert scale. Results: The majority of the participants were female (n=73, 60%) and the mean age was 40.8 years (SD=13.2). The vast majority (n=125, 93%) of our subjects owned a smartphone and 63% (n=85) reported a history of using a health-related app. Subjects were most willing to use health-related apps for health reminders (78%; n=104), learning medical information (74%; n=99), tracking their bowel (54%; n=72) and lifestyle habits (56%; n=74), monitoring their vital signs continuously (55%; n=73), and receiving therapies (48%; n=64). Subjects were however less willing to use apps that could monitor their location (53%; n=71) or social networking activity (55%; n=73). Over half of the subjects were also less willing to use an app if it required them to wear a visible accessory. Most subjects strongly disagreed that a healthrelated app would be hard to learn how to use, interfere with their daily routine, or be embarrassing to use in public. The majority of subjects were willing to use an app they perceived as valuable for their health problems up to 5 minutes a day indefinitely but unwilling to pay out-of-pocket for it. Although most subjects felt that health-related apps could help them and their doctors better manage their medical problems, they were neutral in trusting the quality of these apps. Subjects were more likely to use a smartphone app however if it was recommended by their doctor. Most did not worry that a health-related app would reduce their face-to-face provider time but did worry that their personal information used for an app would fall into the wrong hands. Conclusion: Gastroenterology patients are willing to use and value most types of health-related apps. They perceive this technology as feasible, usable and relatively unobtrusive unless a visible accessory is required. Although the perceived credibility of such apps increases if recommended by a doctor, patients mostly distrust the current quality of health-related apps and are concerned about their privacy.

Ophthalmic patients' utilization of technology and social media: an assessment to improve quality of care.

E-health tools have the potential to improve the quality of care for ophthalmic patients, many of whom have chronic conditions. However, little research has assessed ophthalmic patients' use or acceptance of technological devices and social media platforms for health-related purposes. The present study evaluated utilization of technological devices and social media platforms by eye clinic patients, as well as their willingness to receive health reminders through these technologies. A 31-item paper questionnaire was administered to eye clinic patients (n=843) at an urban, tertiary-care center. Questions focused on technology ownership, comfort levels, frequency of use, and preferences for receiving health reminders. Demographic data were also recorded. Eye clinic patients most commonly owned cellular phones (90%), landline phones (81%), and computers (80%). Overall, eye clinic patients preferred to receive health reminders through phone calls and e-mail and used these technologies frequently and with a high level of comfort. Less than 3% of patients preferred using social networking to receive health reminders. In addition, age was significantly associated with technology ownership, comfort level, and frequency of use (p<0.05). The majority of patients 18-45 years of age preferred to receive appointment reminders via text message (57%) and e-mail (53%). This age group also used these technologies more frequently and with a higher comfort level (p<0.001). These data support the proposal that e-mail and text-messaging e-health tools are likely to be immediately adopted by eye clinic patients and therefore have the greatest potential to improve health outcomes and increase quality of care. Eye clinic patients are interested in these technologies for appointment reminders, general eye and vision health information, asking urgent medical questions, and requesting prescription refills. Future controlled trials could further explore the efficacy of e-health tools for these purposes.

Physician Impressions of Using Text Message Technology to Increase Vaccination Compliance

Immunization schedules are complicated and difficult for parents to remember. Parents are willing to receive text message reminders. However, it is unknown whether physicians are willing to implement such a system. The purpose of this study was to evaluate the feasibility of a text messaging reminder system from the physician's perspective. Surveys were distributed in the winter of 2009-2010 by e-mail, facsimile, and telephone interview to 149 family physicians and pediatricians who provide immunizations in Sedgwick County, Kansas. A 69% response rate was achieved. Nearly all (92%) respondents reported that they currently communicate information about immunization schedules to parents using traditional methods such as verbal reminders or appointment cards; however, none (0%) currently use text or email to generate reminders to parents. Even when asked to assume they had all of the necessary resources, almost one-third (31%) reported that they were "very unwilling" or "unwilling" to use a general text-messaging program, 43% were "neutral" or "undecided," and only 27% were "willing" or "very willing." Physician willingness to use a text-messaging program was not related to their reported gender (χ²(2)=0.224, p=0.894), specialization (χ² (2)=4.363, p=0.113), years in practice (F(2, 91)=0.435, p=0.149), or comfort level with technology (χ²(4)=1.861, p=0.761). There is a hesitancy to implement a text message reminder system for childhood vaccine schedules. This may be due to the lack of empirical evidence supporting the use of this technology for health reminders or the lack of willingness to implement another system. Further investigation is needed to determine why few physicians are willing to implement text messaging for immunization reminders.

Application study on personalized multi -mode preoperative interview

Objective To investigate the effects of personalized multi - mode preoperative interview. Methods A total of 123 cases were selected as control group in urinary surgery department from January to March 2008, they were adult patients with non - local anesthesia who would select a good time for surgery. These patients were treated with interview by nurses on the day before surgery including telling attentions, filling interview record table. 80 inpatients were selected as experimental group in urinary surgery department from April to May. On the day before surgery, catering to the needs of patients, they were offered with personalized visits just like one - to - one interview,health education manuals and reminder cards. Preoperative anxiety , the response rate to anesthesia and operation were compared between two groups. Results In experimental group preoperative anxiety was significant lower than control group, the response rate to anesthesia and operation was significant higher than control group. Conclusions The personalized preoperative interview may enhance the effect of visit,improve the rate of visitation, standardize visit process, and be helpful for the nurses. Key words: Personalized multi- mode; Preoperative interview; Operation room

Would People Pay for Text Messaging Health Reminders?

The aim of this study is to determine the time and financial limitations that people would accept for using a telehealth service consisting of wireless text messaging reminders to improve adherence to a recommended healthy regimen. An empirical study based on a 1-month trial of a prototype system that studied adherence to a specified healthy behaviour was conducted. Fifty-one participants received daily cell phone text messaging reminders on taking one vitamin C pill daily for preventive reasons. At the end of the trial they answered a survey regarding their willingness to pay for and to stay with such a service, if offered. If usage were free, only 45% of the participants would continue to use it for a long indefinite period of time. If the usage were for a fee, 29% of the participants would use the service just a few weeks; 28% would use it an indefinite period of time if they could see its usefulness and if the cost were reasonable. The median amount indicated by the participants as a reasonable monthly fee for such a service was $5. Although the study did not evaluate perceived usefulness to use the telehealth service explicitly, a benefit perception proved to condition participant willingness to use the service and to pay for it, if necessary. If people perceive usefulness, they want to use the service, even for a fee. A free service would not be used if it is not perceived as beneficial.

Health Literacy and Social Support Among Elderly Medicare Enrollees in a Managed Care Plan

This study examined health literacy, social support, and their relations to health status and health care use among older adults. The survey design and data were from a project that examined the prevalence of low health literacy among community-dwelling Medicare beneficiaries enrolled in a national managed care organization. Results indicate that compared to the high health literacy group, enrollees with low health literacy were more likely to receive medical information support and health reminder support. However, they were less likely to receive tangible support for their health care needs. In both health literacy groups, medical information support and health reminder support were associated with lower physical health and mental health status. Tangible support was associated with higher physical and mental health status. Health reminder support was associated with more doctor visits and a lower likelihood of hospitalization in the high health literacy group. Implications for reducing the adverse health consequences of low health literacy among older adults are discussed.

The Transition to Widowhood and the Social Regulation of Health: Consequences for Health and Health Risk Behavior

This study estimates the effects of the transition to widowhood on changes in the social regulation of health and examines the consequences of this association for health and health risk behavior following spousal death. Analysis of longitudinal data from the Changing Lives of Older Couples Study tests the following hypotheses: (a) Widowed individuals experience greater declines in health regulation over time than their married counterparts and (b) the extent to which widowhood undermines health and increases health risk behavior depends on whether it is accompanied by a decline in health regulation. Compared with their continually married counterparts, those who experience the transition to widowhood report a significant decline in the frequency of health reminders and health assistance received from others. The decline in the frequency of health regulation has important consequences for health behavior and health outcomes. Widowhood undermines health and increases health risk behaviors only when it is accompanied by a decline in health regulation. Widowed individuals who experience increases in health regulation show improvements in health and declines in health risk behavior. Interventions targeted at improving the health habits of widowed individuals by mobilizing health-related support systems may be effective at minimizing the negative health consequences of spousal loss.

Patient Acceptance of Educational Voice Messages: A Review of Controlled Clinical Studies

The objective of this study was to evaluate controlled evidence on the impact of automated computer-based telephone messaging technology upon health outcomes, cost savings and acceptance by patients, caregivers and care providers. Systematic searches of electronic databases were conducted to find controlled clinical studies of automated phone messaging used in patient care. Studies were selected based on the three criteria: 1) randomized controlled trials or controlled trials; 2) patients receiving health care related education, information, advice or reminder for a specific action to be taken in their home setting; and 3) use of automated computer-based phone technology to deliver the messages. Information abstracted from studies included information about the institution, persons targeted, intervention and its effect on health outcomes, costs and acceptance by patients and caregivers. A total of nineteen studies were identified for review. Sixteen studies were randomized controlled trials and three were controlled studies with no randomization. Studies were placed in two categories, preventive care education and chronic care studies. Preventive care education studies covered childhood immunizations, medication compliance, influenza vaccinations, tuberculosis and health prevention activities and chronic care studies were related to cholesterol, diabetes, hypertension and congestive heart failure. More than 80% of studies showed significant impact upon measurable health outcomes. Controlled evidence substantiates the efficacy of automated telephone communication in improving the quality of care. Educational voice messages are acceptable in patients and represent an important opportunity to enhance telemedicine and telehealth applications.

Home telecare system integrated with periodic health reminder and medical record & multimedia health information.

The necessity of home telecare system is growing due to increase in desire for health promotion owing to increase in chronic diseases, aged population and medical expenses. Already, we computerized patient's data and offer periodic health reminder to patients for health promotion by using Life-time Health Monitoring Program (LHMP). Our study connected LHMP to the Web on internet by CGI as an electronic medical record; enabling reference to patient's medical records anywhere. The study also made possible video teleconsultation and constructed multimedia database to provide health-related information to the patients. On these bases, a flow chart was developed using the home telecare to practice manage patients with chronic diseases, old patients, and the handicapped. Further standardization in data, establishment of law bases for home telecare system, development of rules for medical fees and active utilization of biomedical telemetry will be needed to extend home telecare system.