Message Reminders Research Articles

Android-based File Management System

Android based file management system is a study about file management for SPAMAST-Digos Campus the system was developed for merging file management and communication using android device. The system has a notification feature which is very useful for sending Information message. It includes Local Area Network for users that are not connected to the internet. The application can also be used as an information system with complete details of the files that is easy for the users to locate the recorded files. The objectives of the study focused on its six aspects, namely: The development and design of Android-based File Management System, attendance sheet, memorandum and Letters, development of module that can send notification to the users, development of module that can manage files, development of module that sends notifications such as reminder message, warning message and information message, development of module that records the complete details of files and development of module that records the profile of the admin and user.

Using Electronic Health Record Alerts to Increase Safety Planning with Youth At-Risk for Suicide: A Non-randomized Trial

No study to date has examined the effectiveness of integrating clinical decision support tools, like electronic health record (EHR) alerts, into the clinical care of youth at-risk for suicide. This study aimed to examine the feasibility and acceptability of using an EHR alert to increase clinicians’ use of safety planning with youth at-risk for suicide in an outpatient pediatric psychiatry clinic serving an urban low-income Latino community. An alert intervention was developed to remind clinicians to complete a safety plan whenever they documented that their patient endorsed suicidal ideation, plan, or attempt during a visit in EHR notes. The alert appeared as a separate window containing a reminder message to complete a safety plan once a clinician finished visit documentation. There were 69 at-risk patients between the ages of 13–21 in the intervention period (M = 15.71; SD = 1.86; 66.7% female) and 64 (M = 15.38; SD = 1.93; 68.6% female) in the control period. Logistic regression analyses indicated that patients in the intervention period were significantly more likely than patients in the control period to receive a safety plan (p < .01). The pattern of results remained the same after adjusting for demographic variables (p = .01). Forty clinicians also completed a questionnaire assessing their satisfaction with the EHR alert, indicating moderate satisfaction (M = 3.01; SD = 0.63; range = 1.11–4.11). EHR alerts are associated with changes in clinicians’ behavior and improved compliance with best clinical practices for at-risk youth.

Design and content validation of a set of SMS to promote seeking of specialized mental health care within the Allillanchu Project.

The aim of this study was to design and develop a set of, short message service (SMS) to promote specialized mental health care seeking within the framework of the Allillanchu Project. The design phase consisted of 39 interviews with potential recipients of the SMS, about use of cellphones, and perceptions and motivations towards seeking mental health care. After the data collection, the research team developed a set of seven SMS for validation. The content validation phase consisted of 24 interviews. The participants answered questions regarding their understanding of the SMS contents and rated its appeal. The seven SMS subjected to content validation were tailored to the recipient using their name. The reminder message included the working hours of the psychology service at the patient's health center. The motivational messages addressed perceived barriers and benefits when seeking mental health services. The average appeal score of the seven SMS was 9.0 (SD±0.4) of 10 points. Participants did not make significant suggestions to change the wording of the messages. Five SMS were chosen to be used. This approach is likely to be applicable to other similar low-resource settings, and the methodology used can be adapted to develop SMS for other chronic conditions.

Customized recommendations and reminder text messages for automated, computer-based treatment during methadone.

The Recovery Line is an automated, computer-based intervention based on cognitive behavioral therapy (CBT) designed to provide real-time assistance by phone for patients in methadone maintenance. Preliminary efficacy findings were promising, however, as with other computer-based systems for substance use disorder, patient system use was less than recommended. Development and evaluation of system functions to increase patient engagement and use is needed. Thus, we conducted two randomized trials to evaluate system functions designed to increase patient use of the Recovery Line among methadone-maintained patients with continued illicit drug use. In Trial 1 (n = 60), patients received customized, system use recommendations or no recommendations on each Recovery Line call. Ratings of system usability were higher for customized recommendations (CR), but number of calls and total call time did not differ by condition. Trial 2 evaluated characteristics of reminder messages (message frame and reminder latency). Participants (N = 67) received gain- and loss-frame reminder messages, and were randomly assigned to immediate, short, or long term message latency. Although message framing had no effect, gender interacted with latency condition such that females did not differ by message latency, while males had significantly greater total contact time in the short latency conditions. Number of calls differed by condition over time such that the shorter latencies led to greater calls initially, but dissipated over time. Overall the study indicates that computer-based self-management systems can be adapted to increase patient engagement and use. (PsycINFO Database Record

SMS education for the promotion of diabetes self-management in low & middle income countries: a pilot randomized controlled trial in Egypt

BackgroundDue to the ubiquity of mobile phones in low and middle income countries, we aimed to examine the feasibility of SMS education among diabetic patients in Egypt, and assess the impact of educational text messages, compared to traditional paper-based methods, on glycemic control and self-management behaviors.MethodsWe conducted a 12-week randomized controlled trial at Misr University for Science & Technology hospital in Cairo-Egypt. Known as MUST diabetes awareness program, patients were included if they had diabetes, owned a mobile phone, and could read SMS messages or lived with someone that could read for them. Intervention patients received daily messages and weekly reminders addressing various diabetes care categories. We expected greater improvement in their glycemic control compared to controls who only received paper-based educational material. The primary outcome was the change in HbA1c, measured by the difference between endpoint and baseline values and by the number of patients who experienced at least 1% reduction from baseline to endpoint. Key secondary outcomes included blood glucose levels, body weight, treatment and medication adherence, self-efficacy, and diabetes knowledge. Data were analyzed using ANCOVA, chi-square, and t-tests.ResultsThirty four intervention and 39 control patients completed the study. Over 12 weeks, 3880 messages were sent. Each intervention patient received 84 educational and 12 reminder messages plus one welcome message. Our primary outcome did not differ significantly (Δ 0.290; 95% CI -0.402 to 0.983; p = 0.406) between groups after 3 months, demonstrating a mean drop of −0.69% and −1.05% in the control and intervention group respectively. However, 16 intervention patients achieved the targeted 1% drop versus only 6 controls, suggesting clear association between study group and 1% HbA1c reductions (chi-square = 8.655; df = 1; p = 0.003). Secondary outcomes seemed in favor of intervention patients at endpoint, with considerable improvements in treatment and medication adherence, self-efficacy, and knowledge scores. Participants also indicated full satisfaction with the program.ConclusionsSMS education is a feasible and acceptable method for improving glycemic control and self-management behaviors among Egyptian diabetics. However, whether it is more effective than traditional paper-based methods needs further investigation.Trial registrationClinicalTrials.govNCT02868320. Registered 9 August 2016. Retrospectively registered.

Text Messaging for Improving Antiretroviral Therapy Adherence: No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults.

To assess the effectiveness of Short Message Service (SMS) reminder messages on antiretroviral and cotrimoxazole prophylaxis adherence among HIV-positive youths as well as the relative effectiveness of SMS with and without a response option. Eligible HIV-positive patients aged 15 to 22 years at 2 HIV clinics in Kampala, Uganda, participated in a year-long parallel individual-randomized controlled trial and were assigned in a 1-to-1-to-1 ratio to a weekly SMS message group, weekly SMS message with response option group, or a usual-care control group. We enrolled 332 participants. Electronically measured mean adherence was 67% in the control group, 64% in the 1-way SMS group (95% confidence interval [CI] = 0.77, 1.14), and 61% in the 2-way SMS group (95% CI = 0.75, 1.12) in an intent-to-treat analysis. Results for secondary outcomes and complete-case analysis were similarly statistically insignificant across groups. Despite previous evidence that interventions using SMS reminders can promote antiretroviral therapy adherence, this study shows that they are not always effective in achieving behavior change. More research is needed to find out for whom, and under what conditions, they can be beneficial. ClinicalTrials.gov identifier: NCT00830622.

Effect of text messages to improve health literacy on medication adherence in patients with type 2 diabetes mellitus: A randomized controlled pilot trial.

ABSTRACTIt has been suggested that low health literacy (HL) is associated with poor medication adherence. This study aimed to examine the effect of a text message-based HL intervention to promote medication adherence, compared with text messages that only sent medication reminders, in patients with type 2 diabetes. This was a single-center, open-label, randomized (1:1) controlled pilot study. The study period was 6 months. Intervention group was sent HL related text messages, compared to the reminder messages that were sent to the control group. The primary outcome was the difference in the change rate of scores on the Morisky Eight-Item Medication Adherence Scale (MMAS-8). Forty-one participants were randomized into the intervention (n = 21) and control (n = 20) groups and completed the 6-month follow-up. Although almost participants read and understood the information provided in the messages, no significant difference was observed between groups for the primary outcome (p = 0.78). Our results suggested that medication adherence at 6 months after discharge in patients with type 2 diabetes did not significantly change by text messages, which aimed to improve their HL levels.

Digital immunization registry: evidence for the impact of mHealth on enhancing the immunization system and improving immunization coverage for children under one year old in Vietnam.

The Vietnam National Expanded Program on Immunization (NEPI) has been successfully implementing a nationwide immunization system since 1985. From the start, the program has increased the immunization coverage rate; however, data on immunization coverage in Vietnam are gathered and aggregated from commune health centers in routine, paper-based reports, which have shortcomings. Also, calculations of coverage are inconsistent at subnational levels, which lead to uncertainty about the size of the target population used as the denominator in coverage calculations. The growth of mobile networks in Vietnam provides an opportunity to apply mHealth to improve the immunization program. In 2012, PATH and the Vietnam NEPI developed and piloted a digital immunization registry, ImmReg, to overcome the challenges of the paper system. A final evaluation was conducted in 2015 to assess the impact of ImmReg, including its use of SMS reminders, on improving the immunization program. The study population comprised all children born in Ben Tre province in September and October of 2013, 2014, and 2015, representing pre-intervention, post-intervention, and one year post-intervention, respectively. Data exported from ImmReg were used to compare the immunization rate, dropout rate, and timeliness of vaccination before and after the intervention. Additionally, a rapid survey was conducted to understand the willingness of parents with children due for vaccination to pay for SMS reminder messages on the immunization schedule. Timely administration of oral polio vaccine, Quinvaxem, and measles 1 vaccine significantly increased over time from baseline to post-intervention to one year post-intervention. In particular, the timeliness of vaccination with the third dose of Quinvaxem increased from 53.6% to 65.8% to 77.2%. For measles 1 vaccine, the rate increased from 70.4% to 76.2% to 92.3%. In addition, the dropout rate from Quinvaxem 1 to Quinvaxem 3 declined from 4.2% in 2013 to 0% in 2015, and the dropout rate from Bacillus Calmette-Guérin (BCG) to measles 1 fell from 12.8% in 2013 to 0% in 2015. Full immunization coverage of children under one year old increased significantly from 75.4% in 2013 to 81.7% in 2014 to 99.2% in 2015. Also, survey results indicated that 93.3% of interviewees were willing to pay for SMS reminders for immunization. A digital immunization registry that includes SMS reminders can improve immunization coverage and timeliness of vaccination, thereby strengthening the quality and effectiveness of immunization programs. Integrating this system into the national health information system and leveraging it for other health programs, such as maternal and child health and nutrition as well as infectious disease control, can bring more benefits to the health care system in Vietnam.

Persuasive texts for prompting action: Agency assignment in HPV vaccination reminders.

Vaccination reminders must both inform and persuade, and text messages designed for this purpose must do so in 160 characters or less. We tested a strategy for improving the impact of HPV vaccination text message reminders through strategic wording. In an experiment conducted in community settings, 167 Spanish-speaking Latina mothers reviewed text message reminders that assigned the cause or "agency" for HPV transmission to their daughters or the virus, and assigned protection agency to the mothers or the vaccine. Reminder messages framing transmission as an action of the virus prompted mothers to perceive the threat as more severe than messages describing their daughters as the cause. Assigning transmission agency to the virus also held a persuasive advantage in boosting mothers' intentions to seek vaccination, particularly when the message cast mothers as agents of protection rather than the vaccine.

Patient Perceptions on Facilitating Follow-Up After Heart Failure Hospitalization.

Timely follow-up after hospitalization for heart failure (HF) is recommended. However, follow-up is suboptimal, especially in lower socioeconomic groups. Patient-centered solutions for facilitating follow-up post-HF hospitalization have not been extensively evaluated. Face-to-face surveys were conducted between 2015 and 2016 among 83 racially diverse adult patients (61% African American, 34% Caucasian, and 5% Other) hospitalized for HF at a university hospital centered in a low-income area of Columbus, Ohio. Patient perceptions of methods to facilitate follow-up post-HF hospitalization and likelihood of using interventions were investigated using a Likert scale: 1=very much to 5=not at all. Results were analyzed by Wilcoxon signed-rank test with Bonferroni correction. The response rate was 82%. The annual household income was <$35 000 for 49% of patients. An appointment near the patient's home was the most desired intervention (77%), followed by reminder message (73%), transportation to appointment (63%), and elimination of copayment (59%). Interventions most likely to be used if provided were similarly ranked: reminder message (48%), appointment near home (46%), elimination of copay (46%), and transportation to appointment (39%). There were significant differences (P=0.001) in high-ranking interventions related to location (appointment near home, transportation, home appointment) and reminder for visit compared with low-ranking interventions related to time (weekend appointment, appointment after 5 pm) and telemedicine. Among this cohort of racially diverse low-income patients hospitalized with HF, an appointment near the patient's home and a reminder message were the most desired interventions to facilitate follow-up. Further study of similar populations nationwide is warranted.

The impacts of email reminder/recall on adolescent influenza vaccination

BackgroundWe sought to: (1) explore the feasibility of using email for seasonal influenza vaccination reminders to parents of adolescents and (2) assess influenza vaccination rates among adolescents whose parents were randomized to either receive or not receive email reminders. MethodsEmail addresses were obtained for parents of patients 10–18years from 4 practices in Michigan. Addresses were randomized to either receive email reminders, or not. Reminder messages were sent during October 2012-March 2013 (Season 1) and October 2013-March 2014 (Season 2). Vaccination status was determined 60days following the last email reminder for each season using the statewide Michigan Care Improvement Registry (MCIR); per protocol bivariate and multivariate logistic regression analyses were conducted to evaluate reminder notification. ResultsAfter email cleaning, testing, and matching with MCIR, approximately half of email addresses (2348 of 5312 in Season 1; 3457 of 6549 in Season 2) were randomized. Bivariate analyses found that influenza vaccination within 60days after notification date was similar among those notified (34%) versus not notified (29%) in both Season 1 (p=0.06) and Season 2 (39% vs. 37%, p=0.20). However, multivariate models adjusted for season, site, and receipt of notification in two seasons found a higher likelihood of influenza vaccination among children that received notification (aOR=1.28, 95% CI=1.09, 1.51); in addition, differences in influenza vaccination were also observed between practice sites (range: p=0.15 to p<0.001). ConclusionsWe found that practice-based email influenza vaccine reminders to parents of adolescents are feasible, but not without complications. Our study demonstrates that email reminders from practices can yield increases in influenza vaccination rates among adolescents. Practices should consider email as an option for influenza reminders and establish business practices for collecting and maintaining patient email addresses.This study is registered at www.ClinicalTrials.gov id #NCT01732315.

Online survey: A national study with school principals

School principals are busy people. From a government perspective they are also strategic stakeholders of information products and services, which government agencies deliver to school communities in order to achieve higher levels of quality and equity in education. In the context of user-centered ICT developments, public organizations find online surveys to be a reliable and cost effective means for gathering information on the needs and perceptions of its citizens. This study aims to understand the influence of email scheduling on the response rate and response time for an online survey, focusing on a representative sample of 1000 school principals at public and private schools in Chile. It also adds an exploratory inquiry (n = 100) into embedding a survey in an email, as opposed to sending it via a link. In line with previous research, the findings reveal the non-significant effect of weekday and daytime emails on response rate and response time. They also reveal that a reminder message can have a significant effect on response rate and that there was no difference in response rate between surveys embedded in an email and surveys sent via a link. Significant differences are found in the response rate and response time between urban and rural schools. The implications for bridging the information gap in online consultations are discussed.

Rates, Delays, and Completeness of General Practitioners' Responses to a Postal Versus Web-Based Survey: A Randomized Trial.

BackgroundWeb-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs).ObjectiveOur aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs’ preventive practices.MethodsThis randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study.ResultsAmong the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P<.001), but median response time was much shorter (1 day vs 1-3 weeks, P<.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P<.001).ConclusionsWeb-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs’ participation in surveys while reducing costs.

Investigating the Perceptions of Care Coordinators on Using Behavior Theory-Based Mobile Health Technology With Medicaid Populations: A Grounded Theory Study.

BackgroundMedicaid populations are less engaged in their health care than the rest of the population, translating to worse health outcomes and increased health care costs. Since theory-based mobile health (mHealth) interventions have been shown to increase patient engagement, mobile phones may be an optimal strategy to reach this population. With increased development of theory-based mHealth technology, these interventions must now be evaluated with these medically underserved populations in a real-world setting.ObjectiveThe aim of our study was to investigate care coordinators’ perceived value of using a health behavior theory-based mHealth platform with Medicaid clients. In particular, attention was paid to the perceived impact on patient engagement. This research was conducted using the patient-provider text messaging (short message service, SMS) platform, Sense Health (now Wellpass), which integrates the transtheoretical model (TTM), also called the stages of change model; social cognitive theory (SCT); supportive accountability; and motivational interviewing (MI).MethodsInterviews based in grounded theory methodology were conducted with 10 care managers to understand perceptions of the relationship between mHealth and patient engagement.ResultsThe interviews with care managers yielded a foundation for a grounded theory model, presenting themes that suggested 4 intertwined correlative relationships revolving around patient engagement: (1) A text messaging (short message service, SMS) platform supplements the client-care manager dynamic, which is grounded in high quality, reciprocal-communication to increase patient engagement; (2) Texting enhances the relationship between literacy and access to care for Medicaid patients, increasing low-literacy patients’ agency to access services; (3) Texting enhances communication, providing care managers with a new means to support their clients; and (4) Reminders augment client accountability, leading to both increased motivation and readiness to change behaviors, as well as an improved client-care manager relationship.ConclusionsMessaging platform features tied to health behavior theory appear to be effective in improving patient engagement. Two-way communication (supportive accountability), trusted relationships (supportive accountability, SCT), personalized messages (TTM), and patient input (TTM, SCT, MI) appeared as the most relevant components in achieving desired outcomes. Additionally, reminder messages were noted as especially useful in making Medicaid patients accountable and in turn engaging them in their health and health care. These findings convey suggested elements for inclusion in other mHealth interventions aiming to improve patient engagement in Medicaid populations.

An experimental comparison of mobile texting programs to help young adults quit smoking

Text messaging interventions may offer promise for health systems, but we need more evidence. We investigated efficacy of three text messaging programs in helping smokers quit. Arm 1 had cessation assessment and quit date reminder messages. Arm 2 had Arm 1 messages plus quit date preparation messages. Arm 3 had Arm 1 and Arm 2 messages plus 6 weeks of post-quit date messaging. Smokers aged 18–29 interested in quitting were randomly assigned to a study arm. We surveyed participants at baseline, and at 3, 8, 20, and 32 weeks (n = 4,027). At 8 weeks, scores on psychological measures were higher in Arm 3 than in Arm 2 or Arm 1. Seven-day smoking abstinence was higher in Arms 3 and 2 than in Arm 1 after controlling for background and psychological measures. Arm 3 affected quitting the most, suggesting motivational text messages before, on, and after an individual’s quit date may increase quitting.

Abstract A26: Culturally Grounded HPV Vaccine Decision Narratives and Communication Channel Preferences among African-American, Vietnamese, and Latina Young Adult Women attending Planned Parenthood Clinics

Abstract Prevention of cervical cancer is of utmost importance to women's health given that it accounts for the second most common cancer death among women worldwide with an estimated 19,000 HPV related cancer cases in women annually in the U.S., 12,200 newly diagnosed cervical cancer cases, and 4,290 deaths. HPV associated cervical cancer disparities remain with highest incidence of cervical cancer among U.S. Latina, African American, and Vietnamese young adults coupled with lowest screening rates. HPV is a necessary contributor to cervical cancer as well as anogenital, penile, and orophayngeal cancers. The point prevalence among U.S. women aged 14-59 is 45% among young adult women particularly minority women. The purpose of this study was to adapt an HPV vaccine intervention, originally designed for college women, to the community setting. Three pilot studies are in the process (Vietnamese and Latina women are being interviewed summer 2016 in Orange County, CA and will be reported on at conference) or completed (Muslim African American women were interviewed in Philadelphia, PA, summer 2015) – at Planned Parenthood. All interviews focus on two aspects of adapting the HPV vaccine intervention: eliciting vaccine decision narratives and collecting preferences on communication channels to effectively reach young adult women. In a collaboration between Planned Parenthood of Orange County (PPOC), UCI, and CSUF, a pilot study (N=50; 25 Vietnamese and 25 Latina women aged 18-26) will be implemented during the summer of 2016. We report at this time, on an ongoing collaboration with Planned Parenthood of Philadelphia with the aim of developing a culturally targeted intervention for African American young adult women (including Muslim African American). A Narrative Engagement Framework (NAF) guided interviews eliciting vaccine decision narratives. Semi-structured interviews (N=26 young adult women) elicited HPV vaccine decision narratives and asked about communication channel preferences for receiving vaccine reminder messages. Interviews were conducted over a month between June 18-July 16 2015. Purposive sampling was used to interview a majority vaccinated (N=15) and minority unvaccinated (N=9) to uncover barriers as well interview two PP staff to gain a clinic staff perspective on prevalence of HPV and vaccination. Women were spontaneously recruited from the waiting room and received $20 cash card as compensation for their time (a 30 minute interview). A grounded theory, inductive approach was used to analyze data for vaccination decision themes, motivation for vaccinating, and/or critical sources or events that led to vaccinating. Three independent coders read and re-read data for emerging decision stories and channel preferences. Memo writing occurred during and within days of the interviews. A majority of women (92%) were sexually active with few using condoms (67% did not use). Results on decision stories revealed several key themes: Stories of staying healthy (I really care about my health), keeping female reproductive parts healthy (so that you can have children), stories of experiencing an abnormal Pap smear, stories of family or co-workers getting cancer and HPV, getting the word out about vaccination (stories of “unawareness”), Planned Parenthood providers not bringing up vaccinating for HPV among young adults, HPV as an invisible disease that can damage your insides, the need to talk with your male friends and with your doctor to raise awareness, and stories about protecting yourself from cancer. Emergent themes on communication channels and health kiosk use included: How time is spent in the waiting room, familiarity with food but not health kiosks, the importance of having health kiosks be interactive and engaging, unfamiliarity with QR codes, and willingness to receive health messages via texting. An interactive, engaging health kiosk with four decision story one-minute videos is in development. The intervention was adapted on several dimensions: visual adaptation (some actresses in videos wear hijab/veil); stylistic language adaptation; using a Philadelphia accent; content adaptation: Linking vaccine messages with health child bearing messages. Interviews with PP staff revealed the lack of policy and financial incentives for PP clinics to offer HPV vaccination. Themes and challenges from Philadelphia pilot work inform the OC pilot study. Policy implications of this research include exploring the role for expansion of the Family PACT to cover HPV vaccination at Planned Parenthood clinics in OC that serve as the number one provider of women's health and serve communities of lower socioeconomic status. Citation Format: Suellen Hopfer, Samantha Garcia, Huong Duong. Culturally Grounded HPV Vaccine Decision Narratives and Communication Channel Preferences among African-American, Vietnamese, and Latina Young Adult Women attending Planned Parenthood Clinics. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A26.

Efficacy and safety of a medication dose reminder feature in a digital health offering with the use of sensor-enabled medicines

ObjectivesOver one-half of patients with chronic diseases, such as hypertension and type 2 diabetes (DM), do not take medicines as prescribed. This study assessed the efficacy and safety of “seeing” versus “not seeing” medication dose reminders regarding medication adherence and risk for overdose. DesignPost hoc analysis. Setting and participantsOutpatient setting. Adult subjects (18 years of age or older) with uncontrolled hypertension and DM. Main outcome measuresSubjects enrolled in this institutional review board–approved study were assigned to either use digital health (DH) with the use of sensor-enabled medicines (coencapsulated medicines with an ingestible sensor) for 4 or 12 weeks or receive usual care based on a cluster-randomized design. All subjects were followed for 12 weeks. Subjects using DH were included in the post hoc study consisting of an efficacy analysis and a safety analysis. A main efficacy outcome of comparison of subjects taking medicine with or without “seeing” DH medication dose reminders was assessed. Safety analysis assessed risk of overdosing after DH medication dose reminders. ResultsIn 57 subjects included in the efficacy analysis, DH device reminder messages were associated with a 16 ± 16% increase (75 ± 18% when seeing vs. 59 ± 24% when not seeing mobile dose reminders) in medication taking if not taken before dose reminder. The mean overall adherence for all subjects was 86 ± 12%; the mean on-time adherence was 69.7 ± 19.7%. Subjects with lower adherence benefited more from seeing DH reminder messages. In the safety study (n = 74 subjects and 24,426 medication ingestions), no events of overdoses related to DH medication dose reminders occurred. ConclusionThis study demonstrates benefits of DH medication dose reminders to improve medication adherence, especially in patients with lower adherence; DH medication dose reminders also appear to be safe.

Gender differences in timing of reminder messages for automated, CBT-based treatment for methadone

Gender differences in timing of reminder messages for automated, CBT-based treatment for methadone

Effects of Full Matrix Color Changeable Message Signs on Legibility and Roadway Hazard Visibility

Transportation agencies are considering public–private partnerships as they struggle to fund infrastructure and operations improvements. The national Manual on Uniform Traffic Control Devices (MUTCD) allows acknowledgments of private sponsors on static signs. The legibility and visibility impacts of including logos of sponsors on changeable message signs (CMSs) were examined. Thirty drivers participated in a closed-course study during daytime and nighttime conditions. Full-sized full matrix color LED signs were used to display travel time and safety reminder messages with and without sponsor acknowledgment logos. Single- and dual-phase messages were tested. The measures of effectiveness were legibility distance for target words on the signs and roadway hazard object detection distance. Legibility distances of the CMS messages were notably greater than those of retroreflective traffic signs and well above the MUTCD threshold of 30 ft/in. During the day, the median legibility index was approximately 60 ft/in. At night, the index was approximately 45 ft/in. Sponsor logos had no significant effect on the legibility distances of travel time signs. Sponsor logos had a small effect on the legibility distance of safety message signs with a blue background but not on those with a black background. The use of sponsor logos marginally affected object detection for certain object locations. The results of this study, coupled with an earlier driving simulation evaluation showing no cognitive distraction due to logos, support the use of sponsorship acknowledgment signs on CMSs. An open road evaluation is planned before statewide implementation is enabled.

A Multisite Survey Study of EMR Review Habits, Information Needs, and Display Preferences among Medical ICU Clinicians Evaluating New Patients.

The electronic chart review habits of intensive care unit (ICU) clinicians admitting new patients are largely unknown but necessary to inform the design of existing and future critical care information systems. We conducted a survey study to assess the electronic chart review practices, information needs, workflow, and data display preferences among medical ICU clinicians admitting new patients. We surveyed rotating residents, critical care fellows, advanced practice providers, and attending physicians at three Mayo Clinic sites (Minnesota, Florida, and Arizona) via email with a single follow-up reminder message. Of 234 clinicians invited, 156 completed the full survey (67% response rate). Ninety-two percent of medical ICU clinicians performed electronic chart review for the majority of new patients. Clinicians estimated spending a median (interquartile range (IQR)) of 15 (10-20) minutes for a typical case, and 25 (15-40) minutes for complex cases, with no difference across training levels. Chart review spans 3 or more years for two-thirds of clinicians, with the most relevant categories being imaging, laboratory studies, diagnostic studies, microbiology reports, and clinical notes, although most time is spent reviewing notes. Most clinicians (77%) worry about overlooking important information due to the volume of data (74%) and inadequate display/organization (63%). Potential solutions are chronologic ordering of disparate data types, color coding, and explicit data filtering techniques. The ability to dynamically customize information display for different users and varying clinical scenarios is paramount. Electronic chart review of historical data is an important, prevalent, and potentially time-consuming activity among medical ICU clinicians who would benefit from improved information display systems.