Touchscreen Computer Research Articles

MHealth Clinic Appointment PC Tablet: Implementation, Challenges and Solutions.

Patients requiring daily intravenous (IV) home parenteral nutrition (HPN) would benefit from in-home professional observation to improve self-care, to assess, detect and prevent serious complications. The study aims are to assess the viability and utility of conducting mobile healthcare (mHealth) videoconference assessments with patients managing lifelong daily 12-hour IV nutrition infusions in their homes. The challenges and solutions to implementing mobile personal computer (PC) tablet based clinic appointments are described. A wireless Apple iPad Mini™ mobile touch-screen tablet computer with 5 mega-pixel camera was loaned to patients. Each tablet had Polycom RealPresence software and a fourth generation (4G) mobile telecommunications data plan. These supported audio-visual mobile videoconferencing encrypted connections between health professionals in their offices and HPN patients and their family members in their homes. Patients' and professionals' evaluations of their mHealth clinic experiences are collected. Patients (mean age = 41.9, SD = 2.8 years) had been prescribed 12-hour home parenteral nutrition (HPN) infusions daily due short bowel disorders. Patients had been on HPN from 1 to 10 years (M=4, SD=3.6). Evaluation of clinic appointments revealed that 100% of the patients (n=45) and the professionals (n=6) indicated that they can clearly hear and easily see one another. The mHealth audio-visual interactions were highly rated by patients and family members. Professionals highly rated their ability to obtain a medical history and visual inspection of patients. Several challenges were identified and recommendations for resolutions are described. All patients and professionals highly rated the iPad mHealth clinic appointments for convenience and ease of communicating between homes and offices. An important challenge for all mHealth visits is the clinical professional's ability to make clinically accurate judgments about what they observed and heard from the patients. Following our solutions for obtaining clear visuals with the iPad can improve ability to make clinical assessments.

Telecare as Institutional Interaction: Checking up on the Client and Creating Continuity

This article studies the functions of telecare-mediated discussions in mental health floating support services. Home Screen, the telecare studied, is a touchscreen computer software that enables real-time audiovisual contact between users. The results indicate that Home Screen functions as a medium to discuss and check clients’ current situation and to sum up and plan their goals. The functions of Home Screen are not stable, but instead they are produced and negotiated in the interaction. Portraying Home Screen as a transitional device, this article supports the view that telecare enables clients to remain in their homes while receiving the care needed.

NMR data visualization, processing, and analysis on mobile devices.

Touch-screen computers are emerging as a popular platform for many applications, including those in chemistry and analytical sciences. In this work, we present our implementation of a new NMR 'app' designed for hand-held and portable touch-controlled devices, such as smartphones and tablets. It features a flexible architecture formed by a powerful NMR processing and analysis kernel and an intuitive user interface that makes full use of the smart devices haptic capabilities. Routine 1D and 2D NMR spectra acquired in most NMR instruments can be processed in a fully unattended way. More advanced experiments such as non-uniform sampled NMR spectra are also supported through a very efficient parallelized Modified Iterative Soft Thresholding algorithm. Specific technical development features as well as the overall feasibility of using NMR software apps will also be discussed. All aspects considered the functionalities of the app allowing it to work as a stand-alone tool or as a 'companion' to more advanced desktop applications such as Mnova NMR.

Comparison of Socio-Demographic Characteristics of a Computer Based Breastfeeding Educational Intervention Among Rural Hispanic Women.

Examine association between socio-demographic characteristics and breastfeeding knowledge, self-efficacy and breastfeeding attrition prediction among rural Hispanic women. 46 rural Hispanic women, aged 18-38years were enrolled from Regional West Medical Center, Scottsbluff, Nebraska. Intervention (n=23) and attention control groups (n=23) received bi-lingual breastfeeding education using touch screen computer and printed educational material. Participants were enrolled during last 6weeks of pregnancy. Follow up assessments were at days 3 and 7, weeks 2 and 6, and months 3 and 6 postpartum. More than half of participants were single and had 10-12years of education. Less than half of them had ever breastfed their children. No differences in knowledge, self-efficacy and intent to breastfeed scores were seen between two groups. Significant positive association was seen between self-efficacy and intent to breastfeed. Self-efficacy is an important predictor of intent to breastfeed among rural Hispanic women.

A cross-sectional study of radiation oncology outpatients' concern about, preferences for, and perceived barriers to discussing anxiety and depression.

Although elevated psychological distress is commonly reported among cancer patients, our understanding of patients' preferences for, and perceived barriers to, accessing psychological support from key cancer care providers is limited. The aim of this study was to assess cancer patients' level of concern about, and willingness to discuss, their anxiety and depression. Radiation oncology outpatients completed a touchscreen computer survey with questions assessing their concern about and willingness to discuss anxiety and depression. Among consenting respondents (n = 145), 51% (95% CI: 43%-59%) were concerned about their levels of anxiety, and 34% (95% CI: 26%-42%) about their levels of depression. If experiencing anxiety or depression, 92% (95% CI: 87%-96%) would want to discuss this with their general practitioner (GP), and 60% (95% CI: 52%-68%) with their cancer doctor. Almost half of the 58 respondents who would not want to discuss anxiety or depression with their cancer doctor indicated that this was because there were more important things to talk about during their appointment. The majority of cancer patients undergoing radiotherapy would be willing to discuss anxiety and depression with their cancer doctor and GP. These findings provide additional support for service delivery models in which GPs and oncologists play key roles in initiating and coordinating discussions about cancer patients' psychosocial concerns.

A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS)

BackgroundSubstance use screening is widely encouraged in health care settings, but the lack of a screening approach that fits easily into clinical workflows has restricted its broad implementation. The Substance Use Brief Screen (SUBS) was developed as a brief, self-administered instrument to identify unhealthy use of tobacco, alcohol, illicit drugs, and prescription drugs. We evaluated the validity and test-retest reliability of the SUBS in adult primary care patients. MethodsAdults aged 18-65 years were enrolled from urban safety net primary care clinics to self-administer the SUBS using touch-screen tablet computers for a test-retest reliability study (n = 54) and a 2-site validation study (n = 586). In the test-retest reliability study, the SUBS was administered twice within a 2-week period. In the validation study, the SUBS was compared with reference standard measures, including self-reported measures and oral fluid drug tests. We measured test-retest reliability and diagnostic accuracy of the SUBS for detection of unhealthy use and substance use disorder for tobacco, alcohol, and drugs (illicit and prescription drug misuse). ResultsTest-retest reliability was good or excellent for each substance class. For detection of unhealthy use, the SUBS had sensitivity and specificity of 97.8% (95% confidence interval [CI], 93.7-99.5) and 95.7% (95% CI, 92.4-97.8), respectively, for tobacco; and 85.2% (95% CI, 79.3-89.9) and 77.0% (95% CI, 72.6-81.1) for alcohol. For unhealthy use of illicit or prescription drugs, sensitivity was 82.5% (95% CI, 75.7-88.0) and specificity 91.1% (95% CI, 87.9-93.6). With respect to identifying a substance use disorder, the SUBS had sensitivity and specificity of 100.0% (95% CI, 92.7-100.0) and 72.1% (95% CI, 67.1-76.8) for tobacco; 93.5% (95% CI, 85.5-97.9) and 64.6% (95% CI, 60.2-68.7) for alcohol; and 85.7% (95% CI, 77.2-92.0) and 82.0% (95% CI, 78.2-85.3) for drugs. Analyses of area under the receiver operating curve (AUC) indicated good discrimination (AUC 0.74-0.97) for all substance classes. Assistance in completing the SUBS was requested by 11% of participants. ConclusionsThe SUBS was feasible for self-administration and generated valid results in a diverse primary care patient population. The 4-item SUBS can be recommended for primary care settings that are seeking to implement substance use screening.

Staying safe in the community: adaptation of WaySafe to help probationers make better decisions about their health risks

Transition from incarceration to the community is a critical time for offenders, especially those with substance abuse problems. Many succumb to temptation to return to drug use and possibly risky needle sharing, and engaging in risky sex activities. This critical time period entails substantial health risks for the offender as well as significant risks to public health. Well-established and consistent use of HIV/HBV/HCV risk reduction prevention programs with continuity of care do not exist in most criminal justice treatment systems because of lack of policy development and integration between institution and community-based corrections, health, and social service agencies. Interventions targeting re-entry are crucial because of the likelihood for risk behaviors to increase upon return to the community. Approaches for community correction populations are needed that have the capability of addressing motivational, social, and cognitive deficits. This presentation discusses an approach to translating ideas from the prison-based WaySafe curriculum into community settings for probationers who have recently completed residential, intensive outpatient, or prison-based substance abuse treatment. The adapted intervention, StaySafe, will be based on evidence-based cognitive principles, including TCU Mapping Enhanced Counseling techniques designed to improve decision-making skills regarding health risk behaviors during the critical first 6 months under community supervision. It is being designed to be self-administered by participating probationers during downtime, either prior to or following meetings with their probation officers. An important goal in the adaptation and testing of StaySafe is to have a sustainable, evidence-based product for probation departments that can be administered with minimal staff training and time that is engaging and easy to use by probationers, requires minimal maintenance, and is free to probation departments (other than the cost of the touch-screen computers). In this presentation, we describe the StaySafe intervention and the adaptation process from a prison-based group curriculum to a community corrections-based individualized approach. The adaptation process borrows ideas from the ADAPT-ITT framework [1]. We will describe initial results from focus groups and interviews with probationers and probation officers on problems and successes in probation, logistical issues with delivering interventions in probation settings, and results of a “theater” test of elements of StaySafe to gauge participant reactions.

Missed opportunities: general practitioner identification of their patients’ smoking status

BackgroundIn order to provide smoking cessation support to their patients in line with clinical practice guidelines, general practitioners must first ascertain whether their patients’ use tobacco. This study examined (i) the sensitivity, specificity, positive predictive value and negative predictive value of general practitioner detection of smoking, and (ii) the general practitioner and patient characteristics associated with detection of tobacco use.MethodsEligible patients completed a touchscreen computer survey while waiting for an appointment with their general practitioner. Patients self-reported demographic characteristics, medical history, and current smoking status. Following the patient’s consultation, their general practitioner was asked to indicate whether the patient was a current smoker (yes/no/unsure/not applicable). Smoking prevalence, sensitivity, specificity, positive predictive value and negative predictive values (with 95% confidence intervals) were calculated using patient self-report of smoking status as the gold standard. Generalised estimating equations were used to examine the general practitioner and patient characteristics associated with detection of tobacco use.ResultsFifty-one general practitioners and 1,573 patients in twelve general practices participated. Patient self-report of smoking was 11.3% compared to general practitioner estimated prevalence of 9.5%. Sensitivity of general practitioner assessment was 66% [95% CI 59–73] while specificity was 98% [95% CI 97–98]. Positive predictive value was 78% [95% CI 71–85] and negative predictive value was 96% [95% CI 95–97]. No general practitioner factors were associated with detection of smoking. Patients with a higher level of education or who responded ‘Other’ were less likely to be detected as smokers than patients who had completed a high school or below level of education.ConclusionDespite the important role general practitioners play in providing smoking cessation advice and support, a substantial proportion of general practitioners do not know their patient’s smoking status. This represents a significant missed opportunity in the provision of preventive healthcare. Electronic waiting room assessments may assist general practitioners in improving the identification of smokers.

Development of a culturally appropriate computer-delivered tailored Internet-based health literacy intervention for Spanish-dominant Hispanics living with HIV.

BackgroundLow health literacy is associated with poor medication adherence in persons with human immunodeficiency virus (HIV), which can lead to poor health outcomes. As linguistic minorities, Spanish-dominant Hispanics (SDH) face challenges such as difficulties in obtaining and understanding accurate information about HIV and its treatment. Traditional health educational methods (e.g., pamphlets, talking) may not be as effective as delivering through alternate venues. Technology-based health information interventions have the potential for being readily available on desktop computers or over the Internet. The purpose of this research was to adapt a theoretically-based computer application (initially developed for English-speaking HIV-positive persons) that will provide linguistically and culturally appropriate tailored health education to Spanish-dominant Hispanics with HIV (HIV + SDH).MethodsA mixed methods approach using quantitative and qualitative interviews with 25 HIV + SDH and 5 key informants guided by the Information-Motivation-Behavioral (IMB) Skills model was used to investigate cultural factors influencing medication adherence in HIV + SDH. We used a triangulation approach to identify major themes within cultural contexts relevant to understanding factors related to motivation to adhere to treatment. From this data we adapted an automated computer-based health literacy intervention to be delivered in Spanish.ResultsCulture-specific motivational factors for treatment adherence in HIV + SDH persons that emerged from the data were stigma, familismo (family), mood, and social support. Using this data, we developed a culturally and linguistically adapted a tailored intervention that provides information about HIV infection, treatment, and medication related problem solving skills (proven effective in English-speaking populations) that can be delivered using touch-screen computers, tablets, and smartphones to be tested in a future study.ConclusionUsing a theoretically-grounded Internet-based eHealth education intervention that builds on knowledge and also targets core cultural determinants of adherence may prove a highly effective approach to improve health literacy and medication decision-making in this group.

Implementation intentions and colorectal screening: a randomized trial in safety-net clinics.

Low-income and racial/ethnic minority populations experience disproportionate colorectal cancer (CRC) burden and poorer survival. Novel behavioral strategies are needed to improve screening rates in these groups. The study aimed to test a theoretically based "implementation intentions" intervention for improving CRC screening among unscreened adults in urban safety-net clinics. Randomized controlled trial. Adults (N=470) aged ≥50 years, due for CRC screening, from urban safety-net clinics were recruited. The intervention (conducted in 2009-2011) was delivered via touchscreen computers that tailored informational messages to decisional stage and screening barriers. The computer then randomized participants to generic health information on diet and exercise (Comparison group) or "implementation intentions" questions and planning (Experimental group) specific to the CRC screening test chosen (fecal immunochemical test or colonoscopy). The primary study outcome was completion of CRC screening at 26 weeks based on test reports (analysis conducted in 2012-2013). The study population had a mean age of 57 years and was 42% non-Hispanic African American, 28% non-Hispanic white, and 27% Hispanic. Those receiving the implementation intentions-based intervention had higher odds (AOR=1.83, 95% CI=1.23, 2.73) of completing CRC screening than the Comparison group. Those with higher self-efficacy for screening (AOR=1.57, 95% CI=1.03, 2.39), history of asthma (AOR=2.20, 95% CI=1.26, 3.84), no history of diabetes (AOR=1.86, 95% CI=1.21, 2.86), and reporting they had never heard that "cutting on cancer" makes it spread (AOR=1.78, 95% CI=1.16, 2.72) were more likely to complete CRC screening. The results of this study suggest that programs incorporating an implementation intentions approach can contribute to successful completion of CRC screening even among very low-income and diverse primary care populations. Future initiatives to reduce CRC incidence and mortality disparities may be able to employ implementation intentions in large-scale efforts to encourage screening and prevention behaviors.

PMS75 - Qualitative Equivalence Between A Paper and Electronic Tablet Version of the Womac®Nrs3.1 and Patient Global Assessment

Prior equivalence work with the WOMAC® scale was published for the VAS scale and older touchscreen computer technology. Additional equivalence evaluation of the WOMAC®NRS3.1 and the Patient Global Assessment (PGA) in a newer tablet with stylus was needed to document suitability of this mode of data collection for these instruments in upcoming clinical trials. A cross-sectional qualitative study was conducted involving cognitive and usability interviews with patients diagnosed with osteoarthritis of the hip or knee who were taking pain medication for their condition. Interviews were conducted in two waves of 10 participants each, with revisions to the PGA made in between the rounds, which allowed for changes to the electronic version to be evaluated. Mean age of the sample (N=20) was 66 years, (range 43-78), 90% over 60 years old; 60% were female; 95% were white; 75% were retired; 70% had completed secondary school or some college, while 30% had completed college or a post-graduate degree. In wave 1, minor issues were found with completing the WOMAC®, mainly with using the stylus to select responses and glare on the screen. There were no issues identified in interpreting the response scale. For the PGA, 50% (5/10) used the wrong recall period (48 hours or longer). The PGA recall period was revised from “at this time” to “over the past 24 hours” and bolded for emphasis. In wave 2, similar issues with glare and stylus response were found, while 80% used the correct recall period on the PGA, with 20% using 48 hours. The study showed excellent qualitative equivalence between the paper and electronic WOMAC® with only minor usability issues. The two wave study design provided the opportunity to detect and make changes to the PGA recall period and formatting that showed improvement in the second wave.

Validating and extending the three process model of alertness in airline operations.

Sleepiness and fatigue are important risk factors in the transport sector and bio-mathematical sleepiness, sleep and fatigue modeling is increasingly becoming a valuable tool for assessing safety of work schedules and rosters in Fatigue Risk Management Systems (FRMS). The present study sought to validate the inner workings of one such model, Three Process Model (TPM), on aircrews and extend the model with functions to model jetlag and to directly assess the risk of any sleepiness level in any shift schedule or roster with and without knowledge of sleep timings. We collected sleep and sleepiness data from 136 aircrews in a real life situation by means of an application running on a handheld touch screen computer device (iPhone, iPod or iPad) and used the TPM to predict sleepiness with varying level of complexity of model equations and data. The results based on multilevel linear and non-linear mixed effects models showed that the TPM predictions correlated with observed ratings of sleepiness, but explorative analyses suggest that the default model can be improved and reduced to include only two-processes (S+C), with adjusted phases of the circadian process based on a single question of circadian type. We also extended the model with a function to model jetlag acclimatization and with estimates of individual differences including reference limits accounting for 50%, 75% and 90% of the population as well as functions for predicting the probability of any level of sleepiness for ecological assessment of absolute and relative risk of sleepiness in shift systems for safety applications.

Contextual repetition facilitates word learning via fast mapping

The current study explores whether contextual repetition during fast mapping facilitates word learning. Three-year-old children completed fast mapping and test trials using a touchscreen computer. For half of the children, the non-targets (competitors) repeated across learning trials and for other children there was no repetition. All children received the same test trials. Children who experienced contextual repetition, that is, children for whom the competitors repeated during the initial fast mapping task, demonstrated word learning. These data demonstrate that children's word learning is facilitated by the presence of extraneous yet predictable information in the initial fast mapping task.

F03 Characterising Upper Limb Movements In Huntington's Disease And The Impact Of Restricted Visual Cues

Background Voluntary motor deficits are a common feature in Huntington’s disease (HD), characterised by movement slowing and performance inaccuracies. This deficit may be exacerbated when visual cues are restricted. Aims To characterise the upper limb motor profile in HD with various levels of difficulty, with and without visual targets. Methods/techniques Nine pre-symptomatic HD (pre-HD), nine early symptomatic HD (symp-HD) and nine matched controls completed a motor task incorporating Fitts’ law, a model of human movement enabling the quantification of movement timing, via the manipulation of task difficulty (i.e., target size, and location). The task required participants to make reciprocal movements between two circular targets, presented on a touch screen computer. After 10 movements, visual cues were removed, and participants continued movements based on their recollection of target location. Results/outcome Symp-HD showed significantly prolonged movement times compared with controls and pre-HD. Furthermore, movement planning was significantly impaired in symp-HD, compared with controls and pre-HD, evidenced by prolonged dwell times (time stationary between movements). Speed and accuracy were comparable across groups, suggesting that group differences observed in movement time and dwell time were evident over and above simple performance measures. No group differences were observed between cue conditions (with or without visual targets), suggesting that the restriction of visual cues may not result in a global deficit of motor planning. Conclusions Collectively these findings provide evidence of a deficiency in motor planning in symp-HD, suggesting that dwell time in particular may provide a more sensitive measure of motor dysfunction than speed and/or accuracy alone.

Acceptability of health information technology aimed at environmental health education in a prenatal clinic

ObjectiveTo describe the acceptability of an interactive computer kiosk that provides environmental health education to low-income Latina prenatal patients. MethodsA mixed-methods approach was used to assess the acceptability of the Prenatal Environmental Health Kiosk pregnant Latina women in Salinas, CA (n=152). The kiosk is a low literacy, interactive touch-screen computer program with an audio component and includes graphics and an interactive game. ResultsThe majority had never used a kiosk before. Over 90% of women reported that they learned something new while using the kiosk. Prior to using the kiosk, 22% of women reported their preference of receiving health education from a kiosk over a pamphlet or video compared with 57% after using the kiosk (p<0.01). Qualitative data revealed: (1) benefit of exposure to computer use; (2) reinforcing strategy of health education; and (3) popularity of the interactive game. ConclusionThe Prenatal Environmental Health Kiosk is an innovative patient health education modality that was shown to be acceptable among a population of low-income Latino pregnant women in a prenatal care clinic. Practice implicationsThis pilot study demonstrated that a health education kiosk was an acceptable strategy for providing Latina prenatal patients with information on pertinent environmental exposures.

Teaching two teenagers with autism spectrum disorders to request the continuation of video playback using a touchscreen computer with the function of automatic response to requests

This study used a standard touchscreen computer with a newly developed Communication Request and Automatic Response Assistive Program (CRARAP) software package to evaluate whether two people with autism spectrum disorders (ASDs) would be able to actively perform communication requests to continue their preferred environmental stimulation. The CRARAP software was specifically developed for this study to combine the functions of a standard touchscreen computer with a speech-generating device (SGD) and the feature of automatic response to requests. A multiple probe design across participants was adopted in this study. The results show that both participants significantly improved their target responses in terms of performing the correct alternative communication request during the intervention phase, and retained this effective performance in the maintenance phase. The practical and developmental implications of the findings are discussed.

Social and nonsocial category discriminations in a chimpanzee (Pan troglodytes) and American black bears (Ursus americanus).

One captive adult chimpanzee and 3 adult American black bears were presented with a series of natural category discrimination tasks on a touch-screen computer. This is the first explicit comparison of bear and primate abilities using identical tasks, and the first test of a social concept in a carnivore. The discriminations involved a social relationship category (mother/offspring) and a nonsocial category involving food items. The social category discrimination could be made using knowledge of the overarching mother/offspring concept, whereas the nonsocial category discriminations could be made only by using perceptual rules, such as "choose images that show larger and smaller items of the same type." The bears failed to show above-chance transfer on either the social or nonsocial discriminations, indicating that they did not use either the perceptual rule or knowledge of the overarching concept of mother/offspring to guide their choices in these tasks. However, at least 1 bear remembered previously reinforced stimuli when these stimuli were recombined, later. The chimpanzee showed transfer on a control task and did not consistently apply a perceptual rule to solve the nonsocial task, so it is possible that he eventually acquired the social concept. Further comparisons between species on identical tasks assessing social knowledge will help illuminate the selective pressures responsible for a range of social cognitive skills.

A computer-based screening method for distress in patients with multiple sclerosis: a feasibility study.

BackgroundIn multiple sclerosis (MS) patients, symptoms of anxiety, depression, pain, and cognitive impairment are highly prevalent and contribute to lower wellbeing. As these physical and psychological symptoms of distress often stay unnoticed, regular screening could offer possibilities to identify and refer impaired patients to appropriate care.ObjectiveThe aim of our study was to pilot a new computer-based method in 43 MS patients to efficiently screen for a variety of psychological and physical symptoms of distress.MethodsData on feasibility and psychological and physical distress (anxiety, depression, fatigue, physical disability, cognitive functioning) were collected via a touch screen computer. Referral to psychosocial care and rehabilitation was retrospectively checked.ResultsThe results demonstrated that most patients (35/40, 88%) considered the screening meaningful and the system easily usable (37/40, 93%). Average completion time of the screening was below 8 minutes. Many patients (35/40, 88%) had elevated distress levels, of whom the majority was referred.ConclusionsThese findings imply that computer-based screening for MS-related distress incorporated in clinical care is feasible and aids to identify psychological or physical needs. A randomized controlled trial with follow-up should address whether this screening method could be more effective than routine care, and whether it can improve costs and efficiency of care.

A cross-sectional survey assessing the acceptability and feasibility of self-report electronic data collection about health risks from patients attending an Aboriginal Community Controlled Health Service.

BackgroundAboriginal Australians experience significantly worse health and a higher burden of chronic disease than non-Aboriginal Australians. Electronic self-report data collection is a systematic means of collecting data about health risk factors which could help to overcome screening barriers and assist in the provision of preventive health care. Yet this approach has not been tested in an Aboriginal health care setting. Therefore, the aim of this study was to examine the acceptability and feasibility of a health risk questionnaire administered on a touch screen laptop computer for patients attending an Aboriginal Community Controlled Health Service (ACCHS).MethodsIn 2012, consecutive adult patients attending an ACCHS in rural New South Wales, Australia, were asked to complete a health risk survey on a touch screen computer. Health risk factors assessed in the questionnaire included smoking status, body mass index, and level of physical activity. The questionnaire included visual cues to improve accuracy and minimise literacy barriers and was completed while participants were waiting for their appointment.ResultsA total of 188 participants completed the questionnaire, with a consent rate of 71%. The mean time taken to complete the questionnaire was less than 12 minutes. Over 90% of participants agreed that: the questionnaire instructions were easy to follow; the touch screen computer was easy to use; they had enough privacy; the questions were easy to understand; they felt comfortable answering all the questions.ConclusionsResults indicate that the use of a touch screen questionnaire to collect information from patients about health risk factors affecting Aboriginal Australians is feasible and acceptable in the ACCHS setting. This approach has potential to improve identification and management of at-risk individuals, therein providing significant opportunities to reduce the burden of disease among Aboriginal Australians.

Agreement between HADS classifications and single-item screening questions for anxiety and depression: a cross-sectional survey of cancer patients.

We assessed agreement between reported anxiety and depression levels of cancer patients using (i) single self-report items and (ii) the Hospital Anxiety and Depression Scale (HADS). We also explored whether anxiety and depression assessment by (i) single self-report items or (ii) the HADS was most strongly associated with a preference to be offered professional assistance. The proportion of patients indicating that they would accept (or were currently using) professional support if they were experiencing anxiety or depression was also examined. A consecutive sample of cancer patients undergoing radiotherapy at four metropolitan public hospitals in Australia completed a touch screen computer survey. A consecutive subsample of patients attending three of these treatment centres answered additional questions about psychological support preferences. Of 304 respondents, 54% [95% confidence interval (CI) 48% to 60%] perceived that they were currently experiencing mild to severe anxiety and depression. 22% (95% CI 18% to 27%) indicated a preference to be offered professional help. There was moderate agreement between the HADS and single-item responses for categorisation of anxiety and depression. Patient-perceived mild to severe anxiety and depression levels appeared to be the best measure for identifying those with a preference to be offered professional assistance. Of a subsample of 193 respondents, 89% (95% CI 84% to 93%) indicated that if they were experiencing anxiety or depression, they would accept (or were currently using) professional support. Single-item screening in a cancer care setting may not adequately capture clinical anxiety and depression. However, single-items assessing patients' perceived levels of anxiety and depression are useful indicators of whether patients want to be offered, and are likely to accept, psychosocial care.