High Rates Of Engagement Research Articles

An exploration of profile, perceptions, barriers, and predictors of research engagement among resident doctors: a report from CHARTING study.

Purpose/Aims:This research aimed to study the profile, perceptions, barriers, and predictors of Nigerian resident doctors’ level of engagement in scientific research.Methods:This study was a descriptive cross-sectional quantitative survey of 438 resident doctors in Nigeria. This study forms a part of the big CHARTING Study, the protocol of which was published in “Nigeria Journal of Medicine 2019;28:198-205.”Results:Three hundred and eighteen (72.8%) respondents were male and 119 (27.2%) were female. There were 229 (52.4%) registrars and 208 (47.6%) senior registrars, while residents in surgical versus nonsurgical specialties were 190 (44.5%) and 237 (55.5%), respectively. Three hundred and sixty-eight (85%) respondents had participated previously in research; 67 (15.6%) and 72 (16.6%) had their papers published in local or international journals, respectively; and only 46 (10.6%) had held first authorship positions in peer-reviewed journal publications. The significant barriers to research identified among them included lack of funding, lack of free time, inadequate training/knowledge on research methodology, and the onerous nature of clinical research. The independent predictor of previous engagement with research was years on current job (P = 0.007). This was similar to finding for the first authorship of a peer-reviewed article among the respondents (P = 0.017).Conclusion:This study concludes that publication and grantsmanship rates were very low among the surveyed resident doctors, despite their high rate of engagement in research projects. There is a need for increased research capacity building among resident doctors in Nigeria.

Factors influencing K-pop artists' success on V live online video platform

Korean pop music, commonly referred to as “K-pop,” is a genre that is gaining significant visibility and attention from global listeners. Among various factors that contribute to K-pop's global appeal, this study focuses on social media, particularly online video platforms. Video platforms are important as they enable artists to communicate directly with fans through live videos and encourage grassroots participation from fans. This study specifically focuses on a niche K-pop video platform, V Live, to investigate the factors that contribute to the artists' V Live channel success. By examining factors related to K-pop artists, the artist's V Live activities, and V Live support factors, the study examines 289 K-pop artists' V Live channels using hierarchical regression analysis. The study found that high popularity and fan engagement rates are influenced by K-pop artists' video uploads and the support from V Live and entertainment companies. As more celebrities and K-pop artists use online video platforms to communicate with fans, collaborative and strategic support is needed from not only artists and entertainment companies but also from platform operators to enhance K-pop's global reach.

Relación entre compromiso laboral y valores éticos en trabajadores universitarios del cantón Santo Domingo

El estudio de los valores éticos y el compromiso laboral son de gran importancia para las instituciones, ya que permiten la interacción de las personas de forma sistemática con su organización. Con base en este contexto, la presente investigación se realizó en tres universidades del cantón Santo Domingo, con el propósito de determinar si los valores que conforman la cultura organizacional, se correlacionan con los comportamientos y actitudes que determinan el compromiso de las personas con su institución. Las variables de estudio se obtuvieron a partir de dos cuestionarios estandarizados, que permitieron identificar la congruencia de los valores organizacionales (cuestionario APO) y el compromiso con el trabajo (cuestionario UWES). La medición de los ítems de cada cuestionario se efectuó a partir de escala de Likert con siete opciones de respuesta. La correlación de las variables, se realizó mediante la prueba paramétrica de correlación, para datos ordenados de Pearson y a su vez se realizaron correlaciones parciales para demostrar si las variables de estudio están condicionadas, o moduladas por variables sociodemográficas continuas (edad y años de trabajo). Se obtuvo un alto índice de congruencia y compromiso en estas instituciones de Educación Superior, y condicionalmente la mayoría de las dimensiones de las variables correlacionaron entre sí. Se concluye que las instituciones universitarias no solo promueven los valores que las identifican, sino que los mismos están arraigados en la conducta de su personal demostrando un mayor nivel de compromiso con su institución.

A Mobile- and Web-Based Health Intervention Program for Diabetes and Prediabetes Self-Management (BetaMe/Melon): Process Evaluation Following a Randomized Controlled Trial.

BackgroundTechnology-assisted self-management programs are increasingly recommended to patients with long-term conditions such as diabetes. However, there are a number of personal and external factors that affect patients’ abilities to engage with and effectively utilize such programs. A randomized controlled trial of a multi-modal online program for diabetes self-management (BetaMe/Melon) was conducted in a primary care setting, and a process evaluation was completed at the end of the study period.ObjectiveThis process evaluation aimed to examine the utilization patterns of BetaMe/Melon, identify which components participants found most (and least) useful, and identify areas of future improvement.MethodsProcess evaluation data were collected for intervention arm participants from 3 sources: (1) the mobile/web platform (to identify key usage patterns over the 16-week core program), (2) an online questionnaire completed during the final study assessment, and (3) interviews conducted with a subset of participants following the study period. Participants were classified as “actively engaged” if any usage data was recorded for the participant (in any week), and patterns were reported by age, gender, ethnicity, and diabetes/prediabetes status. The online questionnaire asked participants about the usefulness of the program and whether they would recommend BetaMe/Melon to others according to a 5-point Likert Scale. Of 23 invited participants, 18 participated in a digitally recorded, semistructured telephone interview. Interview data were thematically analyzed.ResultsOut of the 215 participants, 198 (92%) received an initial health coaching session, and 160 (74%) were actively engaged with the program at some point during the 16-week core program. Engagement varied by demographic, with women, younger participants, and ethnic majority populations having higher rates of engagement. Usage steadily declined from 50% at Week 0 to 23% at Week 15. Participants ranked component usefulness as education resources (63.7%), health coaches (59.2%), goal tracking (48.8%), and online peer support (42.1%). Although 53% agreed that the program was easy to use, 64% would recommend the program to others. Interview participants found BetaMe/Melon useful overall, with most identifying beneficial outcomes such as increased knowledge, behavioral changes, and weight loss. Barriers to engagement were program functionality, internet connectivity, incomplete delivery of all program components, and participant motivation. Participants suggested a range of improvements to the BetaMe/Melon program.ConclusionsThe program was generally well received by participants; active engagement was initially high, although it declined steadily. Maintaining participant engagement over time, individualizing programs, and addressing technical barriers are important to maximize potential health benefits from online diabetes self-management programs.Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12617000549325; https://tinyurl.com/y622b27q

Treatment receipt patterns among individuals with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders.

To determine latent classes of treatment receipt among people with comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) and describe each class by demographics, disease characteristics, and psychiatric diagnoses. Participants were National Epidemiologic Survey on Alcohol and Related Conditions-III respondents with lifetime PTSD and SUD (n = 1,349; mean age 40.3; 62.5% female; 30.9% non-White or Hispanic-White). Cross-sectional data were collected using the DSM-5 Alcohol Use Disorder and Associated Disabilities Interview Schedule. Latent class analysis was used to identify subgroups of participants with different patterns of treatment receipt. Of the patients, 36% received at least 1 SUD treatment while 84% received at least 1 mental health (MH) treatment. Six latent classes were identified: no treatment (17.3%), outpatient MH (34.0%), outpatient + inpatient MH (17.9%), SUD (7.3%), SUD + outpatient MH (15.7%), and SUD + outpatient MH + inpatient MH (7.7%). The SUD treatment classes evidenced greater social instability, had higher alcohol use disorder symptom severity, and used more drug types than the non-SUD classes. Classes receiving inpatient MH treatment had a greater incidence of additional comorbid conditions and suicidal behaviors. Across all 6 classes, most respondents met diagnostic criteria for chronic PTSD (overall: 68.9%) while fewer met diagnostic criteria for chronic SUD (overall: 38.7%). Most people with lifetime PTSD and SUD have sought either SUD or MH treatment or both, with substantially greater receipt of MH treatment. This comorbid group has complex clinical presentations that differ depending upon treatment subgroup, and for most, their PTSD persisted despite high rates of treatment engagement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Urgent Need to Respond to HIV- and HCV-Related Risk Practices among Youth in Ottawa Who Smoke Crack

Background: A community-based research project, Project Rock sought to provide evidence to respond to the community-identified need to more fully understand the parameters of the social and risk profiles of youth in Ottawa who smoked crack. Objectives: In this article we examine engagement in HIV and HCV risk-related smoking practices, and experiences accessing safer inhalation supplies with the objective of identifying potential intervention points and associated harm reduction interventions to initiate and support safer inhalation practices. Methods: The study comprised four sequential components – formation and facilitation of a Youth Project team, qualitative interviews, and member checking workshops - each component building on the preceding and all contributing to the final and fourth component of the interviewer-administered quantitative survey from which data for this article are drawn. Eligibility criteria: capable of informed consent; aged between 16 and 25 years; had ever injected drugs or had ever tried crack or had used two or more hard drugs in the three months preceding their interview. Recruitment cards distributed by community agencies, honoraria and debriefing offered. Separate consent obtained for collection of finger prick blood samples for HIV and HCV laboratory testing. Results: 125 young people completed personal interviews in November 2013. This article is restricted to those 97 participants who had smoked crack. High rates of engagement in documented HIV- and HCV-related crack smoking practices were reported including nonuse of mouthpieces, use of non-recommended smoking devices and frequent engagement in equipment sharing; engagement compounded by the heightened confirmed prevalence of HCV. Conclusion: The youth in our study explained the utility of crack in their lives. Given the mental health drivers of engagement, ease of accessibility and availability, engagement in smoking crack is clearly likely to continue, firmly indicating the urgent necessity to ensure its safer use through gender neutral, youth-specific enhanced programming and resource distribution.

Technology-Based Stepped Care to Stem Transgender Adolescent Risk Transmission: Protocol for a Randomized Controlled Trial (TechStep).

BackgroundTransgender youth demonstrate significantly higher rates of engagement in sexual risk behaviors relative to their cisgender or gender-conforming counterparts, including high rates of condomless anal intercourse and engagement in sex work. In addition, transgender youth experience increased physical or sexual abuse, victimization, substance use, mental health disorders, incarceration, and homelessness. Owing to these syndemic health disparities, transgender youth are at substantially increased risk of HIV infection.ObjectiveThis protocol aims to describe a randomized controlled trial (RCT), Adolescent Medicine Trials Network 160 TechStep (N=250), which assesses the differential immediate and sustained effects of each of 3 conditions (text messaging, WebApp, or information-only control) for reducing sexual risk behaviors and increasing pre-exposure prophylaxis (PrEP) uptake among high-risk, HIV-negative transgender youth and young adults (aged 15-24 years).MethodsParticipants will be recruited through web-based (targeted social media sites and apps) and offline (print ads and flyers) advertisements, peer and clinic referrals, and street- and venue-based outreach, and by contacting potential participants who have requested contact for future studies. Participants will be randomized into 1 of the 3 conditions: (1) text messaging, (2) WebApp, or (3) information-only control for 6 months. Assessments will occur at baseline and at 3, 6, and 9 months. Participants who do not show improvements in sexual risk or PrEP uptake at the 3-month assessment will be rerandomized to receive weekly electronic coaching (eCoaching) sessions in addition to their assigned text messaging or WebApp intervention, or remain in the original text messaging or WebApp intervention using a 2:1 ratio. Participants originally assigned to the information-only condition are not eligible for rerandomization.ResultsFunding for TechStep was awarded in June 2017. Phase 1 was approved by the Institutional Review Board (IRB) in April 2018. Recruitment began in November 2018 for phase 1, the formative phase. Initial phase 2 IRB approval came in June 2019. The data collection for phase 2, the RCT, is expected to be completed in April 2021. As of March 2020, 54 participants have been enrolled in TechStep. The final results are anticipated in May 2021.ConclusionsBy providing culturally responsive, technology-based interventions, TechStep aims to improve sexual health outcomes among HIV-negative transgender youth and young adults at high risk of HIV. TechStep will evaluate the efficacy of technology-based interventions for reducing HIV sexual risk behaviors and increasing PrEP initiation, adherence, and persistence. The suite of technology-based interventions developed in TechStep, and assessed for efficacy in a 3-condition RCT, represents an important advancement in intervention science toward developing tailored and scalable interventions for transgender youth and young adults.Trial RegistrationClinicalTrials.gov NCT04000724; http://clinicaltrials.gov/ct2/show/NCT04000724International Registered Report Identifier (IRRID)DERR1-10.2196/18326

Assessing the Credibility and Authenticity of Social Media Content for Applications in Health Communication: Scoping Review.

BackgroundNutrition science is currently facing issues regarding the public’s perception of its credibility, with social media (SM) influencers increasingly becoming a key source for nutrition-related information with high engagement rates. Source credibility and, to an extent, authenticity have been widely studied in marketing and communications but have not yet been considered in the context of nutrition or health communication. Thus, an investigation into the factors that impact perceived source and message credibility and authenticity is of interest to inform health communication on SM.ObjectiveThis study aims to explore the factors that impact message and source credibility (which includes trustworthiness and expertise) or authenticity judgments on SM platforms to better inform nutrition science SM communication best practices.MethodsA total of 6 databases across a variety of disciplines were searched in March 2019. The inclusion criteria were experimental studies, studies focusing on microblogs, studies focusing on healthy adult populations, and studies focusing on either source credibility or authenticity. Exclusion criteria were studies involving participants aged under 18 years and clinical populations, gray literature, blogs, WeChat conversations, web-based reviews, non-English papers, and studies not involving participants’ perceptions.ResultsOverall, 22 eligible papers were included, giving a total of 25 research studies. Among these studies, Facebook and Twitter were the most common SM platforms investigated. The most effective communication style differed depending on the SM platform. Factors reported to impact credibility included language used online, expertise heuristics, and bandwagon heuristics. No papers were found that assessed authenticity.ConclusionsCredibility and authenticity are important concepts studied extensively in the marketing and communications disciplines; however, further research is required in a health context. Instagram is a less-researched platform in comparison with Facebook and Twitter.

Cancer and COVID-19: Patients' and psychologists' reflections regarding psycho-oncology service changes.

Cancer and COVID-19: Patients' and psychologists' reflections regarding psycho-oncology service changes.

The Great Escape. Centenarians’ exceptional health

Centenarians escapers are those who reached 100years of age without the diagnosis of any of the common age-related diseases and exploring their characteristics will inform about successful ageing. No previous study has examined centenarians free of common chronic diseases amongst New Zealand centenarians. Retrospective observational cross-sectional review of a national dataset determining the prevalence of depression, dementia, diabetes and hypertension, smoking, physical activity and social relationships among older adults (aged 60-99years) and centenarians. Participants were all older New Zealanders living independently in the community who completed the international Residential Assessment Instrument-Home Care (interRAI-HC) assessment during the study's 5-year period (July 2013-June 2018). The assessments of 292 centenarians (mean age 101.03, SD 1.27years) and 103,377 elderly (mean age 81.7, SD 5.7years) were analysed. Compared to the elderly, centenarians were more likely to be female (74.7%, compared with 59.3% elderly, p < 0.001). Centenarians free of common chronic diseases did not differ from other centenarians on any of the analysed variables. Reduction in smoking rates and steady high rates of social engagement were associated with reaching a centenarian status free of common chronic diseases compared with older adults. Not smoking and being socially engaged throughout older age were associated with being a centenarian free of common chronic diseases. This study adds to our understanding the complexities of attaining exceptional longevity.

Use of Facebook to Serve Information Needs of Persons with Diabetes in the Philippines amid the COVID-19 Pandemic.

ObjectivesThe use of Facebook (FB) to share and gather information on diabetes is commonplace but no data is available on its use among Filipinos during the COVID-19 pandemic. We sought to determine the engagement from instructional slide decks on diabetes and its management shown on two Philippine-based FB pages under the Enhanced Community Quarantine (ECQ).MethodologyWe used Insights data from the slide decks and slide shows shown on the Philippine Society of Endocrinology, Diabetes and Metabolism’s (PSEDM) public FB page and the Endocrine Witch’s FB page. The slide set contained a mix of mostly images and text on COVID-19 and Diabetes, dietary advice, medications and self-care in the setting of the ECQ where access to insulin, ambulatory clinics and healthy food is limited. Data was summarized in terms of post clicks, reactions, shares and comments. Total engagement rate was computed.ResultsWe noted a high engagement rate (4-15%) in both public FB pages with higher engagement rates in slides shown in the Filipino language for most topics. The slides that gathered more shares and reactions were primarily those containing general information on COVID-19 and diabetes, nutrition including the safety of canned goods, as well as sick day rules.ConclusionIn the setting of the ECQ, the use of image and text-based slide-decks on the PSEDM and Endocrine Witch FB pages to communicate health information yielded high engagement.

Digital Care for Chronic Musculoskeletal Pain: 10,000 Participant Longitudinal Cohort Study

BackgroundChronic musculoskeletal pain has a vast global prevalence and economic burden. Conservative therapies are universally recommended but require patient engagement and self-management to be effective.ObjectiveThis study aimed to evaluate the efficacy of a 12-week digital care program (DCP) in a large population of patients with chronic knee and back pain.MethodsA longitudinal observational study was conducted using a remote DCP available through a mobile app. Subjects participated in a 12-week multimodal DCP incorporating education, sensor-guided exercise therapy (ET), and behavioral health support with 1-on-1 remote health coaching. The primary outcome was pain measured by the visual analog scale (VAS). Secondary measures included engagement levels, program completion, program satisfaction, condition-specific pain measures, depression, anxiety, and work productivity.ResultsA total of 10,264 adults with either knee (n=3796) or low back (n=6468) pain for at least three months were included in the study. Participants experienced a 68.45% average improvement in VAS pain between baseline intake and 12 weeks. In all, 73.04% (7497/10,264) participants completed the DCP into the final month. In total, 78.60% (5893/7497) of program completers (7144/10,264, 69.60% of all participants) achieved minimally important change in pain. Furthermore, the number of ET sessions and coaching interactions were both positively associated with improvement in pain, suggesting that the amount of engagement influenced outcomes. Secondary outcomes included a 57.9% and 58.3% decrease in depression and anxiety scores, respectively, and 61.5% improvement in work productivity. Finally, 3 distinct clusters of pain response trajectories were identified, which could be predicted with a mean 76% accuracy using baseline measures.ConclusionsThese results support the efficacy and scalability of a DCP for chronic low back and knee pain in a large, diverse, real-world population. Participants demonstrated high completion and engagement rates and a significant positive relationship between engagement and pain reduction was identified, a finding that has not been previously demonstrated in a DCP. Furthermore, the large sample size allowed for the identification of distinct pain response subgroups, which may prove beneficial in predicting recovery and tailoring future interventions. This is the first longitudinal digital health study to analyze pain outcomes in a sample of this magnitude, and it supports the prospect for DCPs to serve the overwhelming number of musculoskeletal pain sufferers worldwide.

Feasibility of Using an LVAD App to Engage Patients in Recovery Post Implant Discharge

VAD clinicians are highly utilized for routine questions from patients post implant discharge. Our team sought to develop an electronic monitoring system for LVAD patients similar to other surgical platforms to reduce healthcare utilization, increase patient engagement, and achieve behaviors to promote shared management of the LVAD system. Our institution utilized the Twistle™ automated patient engagement application to send customized messages to LVAD patients post index hospitalization who had an IOS or Android supported phone. Messaging was sent daily x 2 weeks, every other day x 2 weeks for a maximum of 22 entries in the first 30 days. Patients entered VAD data, activity time and answered questions regarding fatigue, shortness of breath, dizziness and swelling. If a positive response was entered, the app prompted the patient to rate the symptom. Any messaging from the patient resulting in a negative response instructed the patient to call the VAD clinic. Fourteen LVAD patients participated (mean age 39 years, 91% male, 92% supported by HeartMate3™). The average patient engagement was 87%, 2 patients (14%) were readmitted within 30 days and the most reported symptom was fatigue. Nine (64%) patients chose to continue Twistle™ use after 30 days. Based on this small sample there was a tendency for patients with increased symptoms to be readmitted within 30 days. Digital technology in the form of an LVAD app can be used to assess LVAD data alongside symptoms with a high rate of engagement. Use of an LVAD app has potential to improve patient care and identify high risk VAD patients to prevent readmission.

Adapted Physical Educators’ Perspectives of Educational Research

ABSTRACT Purpose: Educational research often provides insight into the potential best practices to use within the classroom setting. Yet, limited information is available on teachers’ perspectives toward research in the field of adapted physical education (APE). The current study examined adapted physical educators’ perceptions toward research. Method: Sixty general physical education and APE associations within the United State of America were emailed a survey adapted from the National Center for Research Policy and Practice. Results: One hundred twenty-four adapted physical educators were included within the study. Spearmen correlations and frequency counts of open-ended responses were used to analyze the data. Overall, findings indicated that a majority of participants had conducted research, with most participants mentioning it helped them learn more about a particular issue they were facing. Adapted physical educators reported a high rate of engagement with research and that research has a positive impact on important issues, such as behavior management and advocating for students with disabilities. Although positive overall perceptions toward educational research were reported, several items that related to the usefulness and accessibility of research were ranked quite low. In addition, it was found that higher levels of education and years of experience were correlated with lower perceptions toward the validity and usefulness of research. Conclusion: This study highlights the important role research plays in the practice of adapted physical educators; however, researchers need to present their research findings in a more practical way for teachers to translate to their own situations.

Who can we reach and who can we keep? Predictors of intervention engagement and adherence in a cluster randomized controlled trial in South Africa

BackgroundEngaging and retaining young men in community-based interventions is highly challenging. The purpose of this study was to investigate the individual factors that predict intervention engagement and adherence in a sample of at-risk South African men.MethodsBaseline data were collected as a part of a cluster randomised control trial (RCT) situated in Khayelitsha and Mfuleni, two peri-urban settlements situated on the outskirts of Cape Town, South Africa. Neighbourhoods were randomised to one of three intervention conditions. We performed univariate descriptive statistics to report neighbourhood and individual socio-demographic factors, and ran multivariate models, adjusting for entry of study, to determine if high adherence and consistency of engagement with the intervention were associated with socio-behavioural demographics and risk behaviours, such as hazardous substance use, gangsterism, and criminal activity.ResultsTotal of 729 men were on average 22.5 years old (SD 2.8), with a mean of 10 years of education. More than half of the sample were single (94%), lived with their parents (66%) and had an income below ~$30 (52%). The overall mean of adherence is 0.41 (SD 0.24) and mean of consistency of engagement is 0.61 (SD 0.30). Our data indicated that completing more years of education, living with parents, and having higher socioeconomic status were significantly associated with higher rates of engagement and adherence. Men with a history of gang membership demonstrated higher levels of adherence and consistent engagement with the intervention, compared with other men who were recruited to the intervention. Crucially, our data show that young men with a history of substance use, and young men who report symptoms of depression and high levels of perceived stress are equally likely as other young men to adhere to the intervention and attend intervention sessions consistently.ConclusionOur results may contribute to a better understanding of young men’s patterns of engagement and adherence to public health interventions. The results may have important implications for policy and practice, as they may be useful in planning more effective interventions and could potentially be used to predict which young men can be reached through community-based interventions.Trial registrationClinicalTrials.gov registration, NCT02358226. Prospectively registered 24 November 2014.

Enhancing patient navigation with contingent financial incentives for substance use abatement in persons with HIV and substance use.

Substance use can interfere with HIV treatment. A previous multisite clinical trial (Metsch et al., 2016) tested 2 behavioral interventions designed to improve treatment engagement in people with comorbid HIV and drug or heavy alcohol use. Clinical trial participants were randomized to treatment as usual (N = 264), patient navigation (PN; N = 266), or PN with contingency management (PN + CM; N = 271) for 6 months. PN + CM patients could earn financial incentives both for entering substance use disorder (SUD) treatment and for submitting urine and breath samples negative for opioids, stimulants, and alcohol. This secondary analysis compared frequencies of treatment entry and sample submission in the PN versus PN + CM groups and examined associations with viral suppression (defined as ≤200 copies/mL). Incentives were associated with a higher percentage of patients entering SUD treatment (PN = 25.5%; PN + CM = 47.6%; p < .001), a higher percentage submitting samples for drug testing (PN median = 2, interquartile range [IQR] = 0.5; PN + CM median = 8, IQR = 5.1; p < .0001) and a higher percentage submitting samples negative for targeted drugs and alcohol (PN median = 1, IQR = 0.3; PN + CM median = 6, IQR = 2.9; p < .0001). Within the PN + CM group, up to 58% of those with high rates of engagement in activities were virally suppressed at 6 months versus 24-29% in subgroups with lowest engagement. In conclusion, CM was feasibly incorporated into PN for persons with HIV and SUD and was associated with higher rates of engagement in targeted substance use abatement activities. CM has the potential to improve health outcomes in this population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Use of a telehealth follow-up system to facilitate treatment and discharge of emergency department patients with severe cellulitis.

Novel long-acting lipoglycopeptide antibiotics allow for the treatment and discharge of selected emergency department (ED) patients with cellulitis who require intravenous antibiotics. Telehealth systems have shown success in remote management of dermatologic conditions; we implemented a telehealth follow-up program for patients diagnosed with cellulitis in the ED, treated with single-dose dalbavancin, and discharged. This was a prospective, multi-center observational study. Patients were included based on clinical criteria and ability to complete follow-up using a smartphone and enroll in an online care portal. We examined the rate of successful telehealth follow-up at 24- and 72-hour intervals from discharge. We also examined the ED return rate within 14days, reviewed any visits to determine cause of return, and for admission. 55 patients were enrolled. 54/55 patients completed at least one telehealth follow up encounter (98.2%). 13 patients (23.6%) had a return ED visit within 14days; no patients required admission for worsening cellulitis. Patient engagement in the telehealth program decreased over time; there was an approximately 11% decrease in engagement between the 24 and 72-hour follow-up call, and a 15% decrease in engagement between the 24 and 72-hour image upload. Patients over 65 had a lower rate of image upload (31%) than younger patients (80.6%). A telehealth follow-up system for discharged emergency department patients with cellulitis demonstrated high rates of engagement. In these patients who -may have otherwise required admission for intravenous antibiotics, telehealth-facilitated outpatient management resulted in a low ED return rate and no inpatient admissions for cellulitis.

Trust and acceptance of a virtual psychiatric interview between embodied conversational agents and outpatients

Virtual agents have demonstrated their ability to conduct clinical interviews. However, the factors influencing patients’ engagement with these agents have not yet been assessed. The objective of this study is to assess in outpatients the trust and acceptance of virtual agents performing medical interviews and to explore their influence on outpatients’ engagement. In all, 318 outpatients were enroled. The agent was perceived as trustworthy and well accepted by the patients, confirming the good engagement of patients in the interaction. Older and less-educated patients accepted the virtual medical agent (VMA) more than younger and well-educated ones. Credibility of the agent appeared to main dimension, enabling engaged and non-engaged outpatients to be classified. Our results show a high rate of engagement with the virtual agent that was mainly related to high trust and acceptance of the agent. These results open new paths for the future use of VMAs in medicine.

Romanian Community in Austria. Social and economic Integration

Migration is a social phenomenon that has profoundly affected Romanian society for the last three decades. Due to migration, in some receiving states, more representative communities of Romanians began to develop. One of these communities is that of the Romanians in Austria, which in recent years has developed steadily, becoming the second-largest minority community in this country. The influencing factors and the contextual environment influenced both the immigration and the socio-economic integration of the Romanians into the Austrian society. Evidence of this integration is given by a high rate of engagement in the labour market, entrepreneurship and the school system. Romanians are not only a well-integrated community, but also human capital that plays a particularly important role in certain areas of socio-economic life in Austria.

Keeping It Fresh With Hip-Hop Teens: Promising Targeting Strategies for Delivering Public Health Messages to Hard-to-Reach Audiences.

Despite overall declines in youth cigarette use, tobacco use inequities exist by race/ethnicity. Health communication campaigns can be effective in changing tobacco-related attitudes, intentions, and behaviors and can be used to address tobacco use inequities by targeting young people who are at high risk for tobacco use. In 2015, the U.S. Food and Drug Administration launched Fresh Empire, the first tobacco public education campaign designed to reach primarily African American, Hispanic, and/or Asian American/Pacific Islander youth ages 12 to 17 years who identify with the Hip-Hop peer crowd. This article presents an overview of two targeting strategies-(a) influencers on social media and (b) paid digital and social media advertisements-that Fresh Empire uses to reach its audience and increase message credibility that can inform future campaigns targeting hard-to-reach populations. These strategies help the campaign expand its reach, be authentic, and increase engagement with the target audience. Microinfluencers are selected for their alignment with Hip-Hop values and high engagement rates; local influencers are teens recruited to promote the campaign in their communities; and digital and social ads are purchased with a minimum number of in-target guaranteed impressions. Across both strategies, metrics have met or exceeded expectations, including a sentiment analysis that revealed 87.3% of comments on microinfluencer posts were positive. Initial findings suggest that the tobacco prevention messages have reached the target population and resonated positively, which may help to increase message credibility and improve receptivity to tobacco prevention messages.