Virtual Support Research Articles

Effects of a Digital Diabetes Prevention Program: An RCT

In light of the need to expand the reach and access of clinically proven digital Diabetes Prevention Programs (d-DPPs) and the need for rigorous evidence of effectiveness, the purpose of this study was to determine the effectiveness of a digital Diabetes Prevention Program for improving weight, HbA1c, and cardiovascular risk factors among people with prediabetes compared to enhanced standard care plus waitlist control. This was a single-blind RCT among participants at risk of developing type 2 diabetes and included 12 months of follow-up. A total of 599 volunteer patients with prediabetes were recruited primarily through electronic medical records and primary care practices. Participants were randomized to either a d-DPP (n=299) or a single-session small-group diabetes-prevention education class (n=300) focused on action planning for weight loss. The d-DPPs consisted of 52 weekly sessions, lifestyle coaching, virtual peer support, and behavior tracking tools. The primary outcome was a change in HbA1c from baseline to 12 months using intent-to-treat analyses. On the basis of multiple comparisons of endpoints, 95% CIs are presented and 2-sided p<0.025 was required for statistical significance. Secondary outcomes included body weight and cardiovascular disease risk factors. Among 599 randomized participants (mean age=55.4 years, 61.4% women), 483 (80%) completed the study. The d-DPPs produced significantly greater reductions in HbA1c (0.08%, 95% CI= -0.12, -0.03) and percentage change in body weight (-5.5% vs -2.1%, p<0.001) at 12 months. A greater proportion of the d-DPPs group achieved a clinically significant weight loss ≥5% (43% vs 21%, p<0.001), and more participants shifted from prediabetes to normal HbA1c range (58% vs 48%, p=0.04). Engagement in d-DPPs was significantly related to improved HbA1c and weight loss. This d-DPPs demonstrated clinical effectiveness and has significant potential for widespread dissemination and impact, particularly considering the growing demand for telemedicine in preventive healthcare services. This study is registered at www. gov (ClinicalTrials.gov Identifier: NCT03312764).

BIPOC Art Therapists: Antiracism Work Through the Virtual Circle

In the wake of 2020’s racial tension and civil unrest in the United States, Black, Indigenous, and People of Color (BIPOC) art therapists and graduate students found themselves in need of support from like-minded, social justice-oriented peers. A virtual monthly peer support group called the BIPOC Art Therapists’ Circle was formed. A different member selected reading materials to which members created response art. Outcomes of the Circle include: shared experience of oppression; connection and empowerment through art sharing; safety; emotional support and validation; vulnerability and authenticity; widened perspectives; and motivation to advocate outside of circle meetings. The experience of the BIPOC circle confirms its critical importance as a source of support for BIPOC art therapists and students.

Paradoxes of Social Support in Virtual Support Communities: A Mixed-Method Inquiry of the Social Dynamics in Health and Wellness Facebook Groups

From parenting to health and wellness, the number of virtual support communities (VSCs) keeps growing. The interactive marketing discipline has primarily documented the positive social dynamics of VSCs: communities provide informational and socio-emotional support that helps members achieve their goals. Yet evidence is mounting that VSCs also exhibit judgment and pressure that ultimately hurt community relationships and engagement. We adopted a mixed-methods approach: a qualitative phase, comprised of netnography and interviews, to explore members’ experiences of a VSC and its complex social dynamics, followed by a quantitative phase to test the emerging model with cross-sectional survey data collected from members of a large number of health- and wellness-related VSCs. The two studies provide empirical evidence of many paradoxical social dynamics of VSCs and their relational and engagement consequences. We find that positive group perceptions can generate the social empathy that ensures the group's informational value is helpful to members’ goals; however, we also find that negative group perceptions create social pressure that can be helpful to relational and engagement outcomes if it increases social empathy but can also be detrimental if it turns into angst. Our findings contribute to research on VSCs, inform interactive marketing practices, and suggest further research opportunities on the social dynamics of VSCs.

Digital and virtual support in the hermeneutic case-based learning in health professional education: A systematic review

Digital and virtual support in the hermeneutic case-based learning in health professional education: A systematic review Abstract. Background: Nowadays, the digitization dominates almost all aspects of our lives, especially in the nursing field. The medial-supported teaching design program helps learners to be prepared for the digital challenges of their professional field. In addition, the concept of hermeneutic casework provides nurses with an expertise that can be applied individually and case-related. Virtual simulations can represent a realistic case scenario and extend the conventional concept of casework with modern technology. Aim: The aim of the review is, to identify national and international used types of virtual and digital medias in connection with the method of hermeneutic casework and describe its usefulness in health education. Methods: A literature review according to the design of a systematic review in the databases CINAHL, MEDLINE via PubMed, Cochrane and Springer Link has been conducted and complemented by the snowball principle. Results: Eleven publications were analysed. The results show predominantly positive effects, which can be divide into eleven areas. Conclusion: The use of virtual patients is considered in both empirical and media-didactic research as an effective and an efficient learning arrangement. In a positive and a negative sense, the results depend from the didactic and methodological preparation, the design of the learning modules and the quality of the medium as well as the teaching.

Moms, Memes, and Mitigating Pandemic Stress: Exploring Themes and Implications in an Academic Mamas’ Facebook Group

This article pairs autoethnography with a thematic analysis of memes in a private Facebook group made up of academic mothers during the first year of the COVID-19 pandemic. The analysis illustrates the challenges members faced during the pandemic related to their roles as mothers, academics, caregivers, and partners and how they used memes as a mechanism for virtual support in 2020 and 2021. Group members used memes to communicate about four primary themes: the stress and humor that arose from pandemic conditions, mothering during the pandemic, work–life tensions, and pressures for research productivity. Throughout the themes, humor offered a foundation for support and connection. The analysis provides insights into the potential for professional support networks online and how humor, shared via social media, can create space for vulnerability and connection among colleagues. The authors also consider the ambivalent dynamics that online social support offers. While it may reduce tension and provide emotional comfort, it also has the potential to uphold gendered expectations at home and at work.

Feasibility of a tailored and virtually supported home exercise program for people with multiple myeloma using a novel eHealth application.

IntroductioneHealth exercise interventions have the unique ability to leverage the benefits of in-person programming (tailoring and supervision) with the benefits of home programming (flexibility). There may be a role for eHealth-delivered exercise for people with multiple myeloma (MM), as exercise tailoring and supervision are critical for successful outcomes due to the significant impacts/risks of myeloma-related side effects. The purpose of this study was to determine the safety, feasibility, and preliminary efficacy of a 12-week virtually supported eHealth exercise program.MethodsParticipants with MM completed a 12-week virtually supported home exercise program involving virtually supervised group workouts, independent workouts, and aerobic exercise. Tailoring was facilitated by the functionality of HEAL-Me, a novel eHealth app. Participants completed virtual fitness assessments and questionnaires at baseline and week 12.ResultsTwenty-nine participants consented, 26 completed all follow-up testing (90%). Exercise adherence was 90% (group), 83% (independent), and 90% (aerobic). No serious adverse events (grade ≥3) occurred. Significant improvements were found for quality of life and physical fitness. There was a high level of program/app satisfaction: 96% of participants agreed or strongly agreed that the exercise program was beneficial, 93% found it enjoyable, 89% were satisfied or very satisfied with delivery through the HEAL-Me app, and 48% felt that the eHealth program helped them manage cancer-related symptoms and side-effects.ConclusionAn eHealth intervention that is individually tailored and includes virtual supervision and active support from the healthcare team is feasible and acceptable to people with MM. The findings from this study warrant investigation using a large-scale randomized controlled trial.

ОРГАНИЗАЦИОННО-ПЕДАГОГИЧЕСКИЕ УСЛОВИЯ ФОРМИРОВАНИЯ ГОТОВНОСТИ БУДУЩИХ ИНЖЕНЕРОВ К НАУЧНО-ИССЛЕДОВАТЕЛЬСКОЙ ДЕЯТЕЛЬНОСТИ

In the modern conditions of the development of the education system in the country, fundamentally new requirements are being put forward for the goals, content and management of the education system. The training of highly qualified specialists capable of effectively solving the tasks of developing not only professional activity, but also science is possible only with the close relationship of the educational process with research activities. Innovations of the fourth-generation FGOS include the individualization of educational trajectories, including at the request of enterprises in those regions where there is a shortage of engineering personnel, as well as updating the standard, taking into account the priorities of scientific and technological development of the country. In this regard, the issue of high-quality training of engineering personnel who would be capable of creating new technologies necessary for society becomes urgent. One of the effective ways of forming exercising their control is the research activities of students. We conducted an experimental study to identify the effectiveness of the implementation of organizational and pedagogical conditions in the process of managing the research activities of future engineers at the Department of Biomedical Engineering of Orenburg State University. The following organizational and pedagogical conditions were tested: enriching the content of engineering disciplines with research contexts; using design technologies as a means of developing students’ research potential; implementation of student-teacher networking based on information and virtual support in the form of a web resource. The results of the study showed that under the influence of the proposed organizational and pedagogical conditions, there is a positive trend in indicators that determine the readiness of future engineers for research activities. Successful testing of the proposed organizational and pedagogical conditions in the educational process shows a real opportunity to increase the effectiveness of scientific activity of university students in order to improve higher professional education.

Virtual inertia support in the microgrid, its research challenges and its technology potentials in recent years

Virtual inertia support in the microgrid, its research challenges and its technology potentials in recent years

S128: CONTINUOUS QUALITY IMPROVEMENT IN PAEDIATRIC SICKLE CELL DISEASE

Background: Sickle cell disease (SCD) is characterised by severe episodic pain requiring prompt and effective analgesia. However, SCD patients frequently experience poor quality of care due to lack of awareness of the condition among non- specialist staff, pre-conceived biases and unfounded allegation of drug-seeking behaviour. Several reports and surveys using Patient Reported Experience Measure (PREM) tools indicate widespread prevalence of ineffective pain relief in emergency department(ED), poor access to psychological therapies and poor funding for service development. Aims: To use a validated PREM tool to survey patients or carers of sickle cell disease within the paediatric service of a Specialist Haemoglobinopathy Team. To use an established Continuous Quality Improvement (CQI) methodology (5-D’s-define, describe, design, deliver, digest) to ensure sustained improvement in patient- reported areas of service deficit. Methods: The PREM survey was conducted as part of a network- wide initiative in 2018. The survey responses were analysed and problem scores created for specialist care, emergency care, ward-based care, information and support. These problem areas were categorised into domains where further improvement action was needed. CQI tools were used to map the patient journey within Emergency Department (ED) when presenting with pain followed by thematic analysis to identify potential improvements in the patient journey. Results: The PREM survey analysis identified three domains for improvement: Domain A: To improve the effectiveness of pain relief and quality of empathic and informed care to paediatric sickle cell patients and their families in ED. We developed multi-disciplinary teaching videos with patient involvement and patient information material based on ED/pain/sickle staff feedback. Excellent engagement from all staff groups obtained. Patient involvement in ED teaching video was well received. Thematic analysis of ED process mapping highlighted need for sustained staff education and re-writing ED pain protocol to align with current practice. Pre-conceived biases were identified among staff with respect to attributing drug-seeking behaviour to patients during severe sickle cell pain. Domain B: To improve the information presented to children regarding SCD and the care services available in our trust We developed child friendly Information leaflets targeting primary school age and secondary school age readers Domain C: To improve the availability of, and access to, mental health services for paediatric SCD patients. We developed virtual parent support groups and psychological health screening for adolescent patients in clinics. We organised a ‘Tree of Life’ (ToL) patient empowerment workshop. The parent support groups were well attended. Plans are in place to continue ToL workshops and support groups on a regular basis. Future work: A rapid improvement workshop is being planned to engage a wider multi-disciplinary team to engender a culture of empathy in line with our trust values. Further input from workshop is expected to identify and implement sustainable goals. We plan to undertake a repeat PREM survey following the end of this CQI project to understand the impact and the implemented improvements.

Cluster randomised controlled trial to assess a tailored intervention to reduce antibiotic prescribing in rural China: study protocol

IntroductionUp to 80% of patients with respiratory tract infections (RTI) attending healthcare facilities in rural areas of China are prescribed antibiotics, many of which are unnecessary. Since 2009, China has...

Electric Power System Stabilization by Virtual Inertia and Fast Grid Frequency Support of Grid-Following Virtual Synchronous Generator

The Virtual Synchronous Generator (VSG) can give virtual inertia and imitate primary control of the synchronous generator. This paper focuses on grid-following (GFL) type VSG for easy parallel operation compared to voltage source inverter. The grid frequency support of GFL-VSG can be achieved by controlling active power output using frequency deviation. However, this control causes the delay because of feedback for the virtual inertia. This paper proposes the GFL-VSG with the parallel installation of the governor and swing equation to reduce the delay. The numerical simulation was carried out to verify its effect and grid frequency support of the proposed GFL-VSG. The result shows that grid frequency support by GFL-VSG is faster compared with the conventional method, and the gate frequency is more stable with multiple several VSGs.

Improving Social-Emotional Health: Expansion of Teacher and Student Wellbeing during the COVID-19 Crisis in Honduras

The Honduran education system was caught off guard when COVID-19 struck the country. With effectively no training or preparation and very few resources, educators across the country began providing distance learning classes in mid-March 2020. Overnight, educators faced significant obstacles in their quest to keep young people studying—teaching classes to students they could not see and engaging young people who lacked technology. Teachers and students began to experience social-emotional problems. This field note describes how the United States Agency for International Development's Asegurando la Educación project transitioned in-person social and emotional learning (SEL) activities in 135 schools to provide virtual SEL support to hundreds of thousands of beneficiaries across the county. We outline the SEL interventions that contributed to the lowest national dropout rate in five years, and enrollment rates in Asegurando's 135 schools some 5 percent higher than the national average. Finally, we believe this field note will contribute to the evidence base for how SEL can improve mental health and school retention during future crises.

Virtual inertia support in the microgrid, its research challenges and its technology potentials in recent years

Virtual inertia support in the microgrid, its research challenges and its technology potentials in recent years

Challenges in accessing maternal and child health services during COVID-19 and the potential role of social networking technologies.

BackgroundThe COVID-19 pandemic causes new challenges to women and their babies who still need to access postnatal care amidst the crisis. The novel application of social network technologies (SNTs) could potentially enhance access to healthcare during this difficult time.ObjectivesThis study describes the challenges experienced in accessing maternal and child health services by women with limited or no education during this COVID-19 pandemic and discusses the potential of SNTs to support maternal and child health amidst this crisis.MethodsWe administered surveys to women who had recently given birth in a rural setting and interviewed a purposively selected subset to ascertain their experiences of accessing maternal and child health services during the COVID-19 pandemic. Our analysis involved descriptive analysis of quantitative data using STATA 13 to describe study participants’ characteristics, and content analysis of qualitative data to derive categories describing maternal health challenges.ResultsAmong 50 women, the median age was 28 years (interquartile range 24–34), 42 (84%) completed upper primary education. Access to the health facility was constrained by transport challenges, fear of contracting COVID-19, and delays at the facility. Due to the COVID-19 crisis, 42 (84%) women missed facility visits, 46 (92%) experienced financial distress, 43 (86%) had food insecurity, and 44 (88%) felt stressed. SNTs can facilitate remote and timely access to health services and information, and enable virtual social connections and support.ConclusionSNTs have the potential to mitigate the challenges faced in accessing maternal and child health services amidst the ongoing COVID-19 pandemic.

198 A Novel ‘Virtual Simulation’ for The Advanced Life Support Group, Making a Dream a Reality: A Beginner’s Guide

In the UK, it is a requirement for staff involved in paediatric critical care to remain up to date with advanced paediatric life support (APLS). To do so there is an expectation to participate in face-to-face courses on a four-yearly basis. The Advanced Life Support Group (ALSG), an organization dedicated to supporting professional education, sought to add to their resources in line with advances in online capabilities. With stakeholder input, the goal emerged to develop an engaging, interactive and entirely novel educational product. Here we present the pilot stages of our project.The aim of this project was to produce an educationally effective and novel product that learners of APLS would engage with and enjoy.Stage 1 involved determining clearly defined learning objectives mapped to the APLS curriculum. At a round table with stakeholders, educationalists, and a technologist an outline of the project was formed and the scenario of a sick baby with bronchiolitis chosen for a pilot. Informed by literature on serious game design, a branching narrative was created. Stage 2 involved collating resources. A photoshoot at Leicester Royal Infirmary A&amp;E (Accident and Emergency) created a set of images. A video shoot at the Royal London Hospital A&amp;E generated a series of videos. These were then edited and used to create a Microsoft PowerPoint slide set. Voiceovers to text, sound effects to add a hospital atmosphere and questions were then added. Stage 3 involved taking this draft and translating it into an interactive final product utilizing Articulate Software. This enabled its usage across smartphone, desktop, and laptop devices. Testing followed with anonymous online feedback informed by the 7Is framework We launched the pilot version at the RCPCH (Royal College of Paediatrics and Child Health) Conference 2021. Feedback was collected from delegates and continues to be collected via online participants. It is hoped that ongoing quality improvement cycles will assist in assuring a finished fully functional online virtual advanced paediatric life support simulation for release in 2022. Further stakeholder review is pending. Thus far it has been met with universal approval, i.e. all learners questioned expressed that they would like to utilize this novel style of education again. The average duration to complete the virtual simulation was 15 minutes. All learners rated their knowledge and skills in APLS to be either unchanged/revised or improved. Finally, interactivity online was felt to need improvement by most participants. Interactivity is key if high levels of engagement are to be achieved. Future testing will determine whether any educational impact is maintained across time. The current pilot version can be accessed at the following webpage

Motivators, Barriers, and Opportunity for E-Health to Encourage Physical Activity in Axial Spondyloarthritis: AQualitative Descriptive Study.

Physical activity is fundamental in the management of axial spondyloarthritis (SpA); however, evidence suggests that patients with axial SpA are not adhering to physical activity recommendations. E-health technology (e.g., telephone reminders and mobile text messaging) can increase participation in physical activity. The aims of this study were as follows: 1) to understand perspectives of the importance of physical activity in the management of axial SpA; 2) to describe factors associated with physical activity adherence; and 3) to explore the role of e-health technology to facilitate physical activity in patients with axial SpA. Semistructured interviews were conducted with axial SpA patients attending an urban academic rheumatology clinic. Interviews were audio recorded and transcribed verbatim. Data were analyzed using thematic principles. Systematic labeling of the data set was completed using an inductive approach until saturation of emergent themes. Twelve patient interviews were completed. Most respondents were male (83.3%) with a mean ± SD age of 45.5 ± 12.5 years and a mean ± SD disease duration of 21.5 ± 14.9 years. Participants defined physical as any activity involving physical exertion. The role of physical activity in axial SpA management was well recognized and included symptom relief, pharmacologic synergy, and impact on general health. Motivators included a growth mindset, social support networks, and facility access. Barriers included fear of disease progression, life demands, and environmental restrictions. Feedback, electronic reminders, and virtual support networks were key components of e-health technology to facilitate engagement in physical activity. The results of this study provide a foundation to guide development of patient-centered e-health technology interventions to increase physical activity uptake in patients with axial SpA.

Project VITAL: A Statewide Initiative Using Technology to Impact Social Isolation

Project VITAL leverages customized technology to enhance connection, engagement, education and support to individuals with dementia and their caregivers. The goal was to positively impact social isolation, stress, and well-being and help mitigate the effects of isolation experienced during the pandemic and beyond. Phase One included three components designed to impact connection, engagement, education and support. It’s Never Too Late provided 300 customized tablets to 150 care communities to facilitate connections to family members and increase individualized, person-centered engagement. Project ECHO, a video-based learning platform, educated and supported care community staff. Virtual education and support were offered to family caregivers at home. Phase Two provided the program to an additional 150 care communities and added online professional training/certification. Phase Three focuses on 150 family caregivers and individuals with dementia living at home. In addition to connection and individualized engagement, family caregivers now had direct access to virtual programs and services.

Alzheimer’s Disease Research and Outreach in the New Normal: Transitioning to the Virtual World

Following disruptions to research, clinical trials, and support for individuals with Alzheimer’s disease and related dementias (ADRD), 2020 taught us important lessons about the need for creativity, flexibility, and resourcefulness during an urgent and global public health crisis. The COVID-19 pandemic showed that we have knowledge and technology that can be rapidly implemented, adopted, and utilized by many sectors to allow the continued care and research of our older adult population with ADRD. Thus, this symposium will address virtual methods that are transforming ADRD research and support. First, Dr. Rhodus will discuss the implementation of online assessments in clinical trials at an Alzheimer’s Disease Research Center and the effects of sociodemographic disparities in online accessibility. Next, Dr. Bazzano will describe methods of remote collection of brain health data through tablets, smartphones, and wearables in the Bogalusa Heart Study. Then, Dr. Andersen will report on the transition from in-person to virtual assessments of cognitive and physical function in centenarian studies and address strategies for inclusivity of individuals with limited technology experience. Next, Dr. Fazio will introduce Project VITAL which aims to impact social isolation by increasing accessibility to virtual education and support for care community staff, family caregivers, and individuals with dementia. Finally, Dr. Penfold will report on the translation of a paper-based, face-to-face intervention for reducing caregiver burden into a self-directed online learning program. Overall, these presentations highlight successes and challenges in incorporating virtual-based methods to maintain engagement with participants, individuals with ADRD, and caregivers during the pandemic and beyond.

Promoting Self-Care in Caregivers of Older Adults Living With Chronic Illness: The iCare4Me Study

Informal caregivers provide a substantial amount of social support to older adults which can be stressful and lead to poor self-care. When stressed, caregivers of persons living with chronic illness are less vigilant and less motivated to engage in self-care behaviors that are important for maintaining their own physical and emotional health. Support interventions can encourage self-care by helping caregivers to focus on values, solve problems, and transform their goals into action. In this symposium, we will discuss the iCareMe study, a randomized controlled trial (RCT) (NCT03988621) that tests a virtual support intervention which utilizes health coaching to increase self-care behaviors in caregivers of older adults living with chronic illnesses, such as heart failure and dementia. The first session will discuss the translation of self-care theory to the basis for the “Virtual Caregiver Coach for You” (ViCCY) intervention and will provide an overview of the iCare4Me randomized control trial designed for caregivers of persons living with advanced heart failure. The second session will describe the adaptation of the iCare4Me RCT to caregivers of persons living with dementia. The third session will highlight findings from a qualitative descriptive study examining the characteristics of effective health coaching used in these two RCTs. Finally, the last session will share findings from a cross-sectional analysis examining moderators of self-care in heart failure caregivers. Together, these presentations will illustrate the unique and innovative approach that iCare4Me has taken to improve self-care in caregivers of older adults living with chronic illness.

Supporting Educational Needs of Older Adult Learners: Strategies for Virtual Transitioning and Student Engagement

The pandemic has revealed a multitude of challenges disproportionately impacting older adults, including older adult learners. Institutions of higher education are uniquely positioned to respond to various challenges using the guiding framework of the Age-Friendly University global initiative. This presentation highlights how preexisting university student support practices and services were adapted to provide older adult learners with guidance for navigating their educational needs during the pandemic. Specifically, it expands on strategies utilized by Adult Learner Programs and Services to effectively pivot to virtual services to support the advising and programming needs of older adult learners. Survey data identifying areas of interest for virtual programming for older adult students will be explored. Recommendations will be discussed for promoting effective transitioning to virtual support systems, preserving student engagement and intergenerational learning, and advocating for aging to remain central to university diversity and inclusion initiatives.