Quantitative Web-based Survey Research Articles

A Survey Assessing Nonalcoholic Fatty Liver Disease Knowledge Among Hepatologists and Non-Hepatologists in China.

A global increase in nonalcoholic fatty liver disease (NAFLD) prevalence has been observed in the last decade. This study assesses knowledge, awareness, and clinical practice gaps of hepatologists and non-hepatologists in NAFLD management across hospitals in China. A web-based quantitative survey was conducted, and participants included hepatologists (gastroenterologists and infectious disease specialists) and non-hepatologists (internal medicine specialists, cardiologists, and pharmacists) from various hospitals across China. In total, 1627 healthcare practitioners (HCPs) responded to the survey. This included 658 hepatologists and 969 non-hepatologists. In comparison to 92.6% hepatologists, only 58.0% of non-hepatologists were aware of NAFLD. A higher proportion of hepatologists (82.8%) performed screening for NAFLD compared to non-hepatologists (56.9%). Majority of the hepatologists (70%) and non-hepatologists (67%) were aware of the four primary recommendations for managing NAFLD. Only 11% of hepatologists did not manage NAFLD patients, mainly because they felt they did not have enough time (66.7%). Of the 36% non-hepatologists who did not manage NAFLD, 78.4% stated that NAFLD is not their specialty, and 38.6% were not familiar with the treatment options. Most hepatologists were aware of and agreed to performing screening for NAFLD compared to non-hepatologists. Both hepatologists and non-hepatologists exhibited similar level of understanding on NAFLD management. However, a small percentage of both hepatologists and non-hepatologists admitted that they did not manage NAFLD patients because they were not familiar with available treatment options. This underscores the importance of further educating HCPs involved in managing NAFLD.

Physician awareness and understanding of chronic inflammatory demyelinating polyradiculoneuropathy in Japan: a web-based study

ObjectivesTo investigate potential knowledge gaps between neurologists and non-specialists and identify challenges in the current management of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), with a focus on ‘early diagnosis’ and ‘appropriate...

The economic burden of individuals living with generalized myasthenia gravis and facing social determinants of health challenges.

Better understanding the impact of social determinants of health (SDOH) barriers from the patient perspective is crucial to improve holistic patient support in generalized myasthenia gravis (gMG), a rare autoimmune disorder with high disease and treatment burden. The objective of this study was to identify economic challenges experienced by individuals living with gMG and SDOH barriers to better address current unmet needs. Adults (18-75 years) living with gMG and experiencing SDOH barriers in the United States were recruited to a mixed-methods study including qualitative interviews and a web-based quantitative survey. Quotas were implemented to include a balanced spread of baseline demographic categories including insurance type, living environment, and employment status among the study sample. Direct and indirect economic challenges were identified by degree of concern. The survey was completed by 38 individuals living with gMG, the majority of whom were enrolled in public insurance and not employed. The most commonly reported major economic concerns were managing funds for emergency care (66%), loss of income (61%), and non-medical expenses (58%), highlighting the diversity of economic challenges. Individuals who were using public insurance plans, living in non-urban environments, and unemployed experienced pronounced challenges around managing non-medical costs and accessing government assistance. Both direct and indirect costs were emphasized as major concerns among individuals living with gMG and SDOH barriers. Increasing access to relevant, personalized, and holistic resources, including care management, should be prioritized to improve disease management and outcomes for individuals living with gMG.

Co-Design of a Voice-Based Digital Health Solution to Monitor Persisting Symptoms Related to COVID-19 (UpcomingVoice Study): Protocol for a Mixed Methods Study.

Between 10% and 20% of people with a COVID-19 infection will develop the so-called long COVID syndrome, which is characterized by fluctuating symptoms. Long COVID has a high impact on the quality of life of affected people, who often feel abandoned by the health care system and are demanding new tools to help them manage their symptoms. New digital monitoring solutions could allow them to visualize the evolution of their symptoms and could be tools to communicate with health care professionals (HCPs). The use of voice and vocal biomarkers could facilitate the accurate and objective monitoring of persisting and fluctuating symptoms. However, to assess the needs and ensure acceptance of this innovative approach by its potential users-people with persisting COVID-19-related symptoms, with or without a long COVID diagnosis, and HCPs involved in long COVID care-it is crucial to include them in the entire development process. In the UpcomingVoice study, we aimed to define the most relevant aspects of daily life that people with long COVID would like to be improved, assess how the use of voice and vocal biomarkers could be a potential solution to help them, and determine the general specifications and specific items of a digital health solution to monitor long COVID symptoms using vocal biomarkers with its end users. UpcomingVoice is a cross-sectional mixed methods study and consists of a quantitative web-based survey followed by a qualitative phase based on semistructured individual interviews and focus groups. People with long COVID and HCPs in charge of patients with long COVID will be invited to participate in this fully web-based study. The quantitative data collected from the survey will be analyzed using descriptive statistics. Qualitative data from the individual interviews and the focus groups will be transcribed and analyzed using a thematic analysis approach. The study was approved by the National Research Ethics Committee of Luxembourg (number 202208/04) in August 2022 and started in October 2022 with the launch of the web-based survey. Data collection will be completed in September 2023, and the results will be published in 2024. This mixed methods study will identify the needs of people affected by long COVID in their daily lives and describe the main symptoms or problems that would need to be monitored and improved. We will determine how using voice and vocal biomarkers could meet these needs and codevelop a tailored voice-based digital health solution with its future end users. This project will contribute to improving the quality of life and care of people with long COVID. The potential transferability to other diseases will be explored, which will contribute to the deployment of vocal biomarkers in general. ClinicalTrials.gov NCT05546918; https://clinicaltrials.gov/ct2/show/NCT05546918. DERR1-10.2196/46103.

Sexual Health Outcomes of Adolescent and Young Adult Colorectal Cancer Survivors and Their Partners: Protocol of a Dyadic Mixed Methods Study

Sexual dysfunction represents a critical aspect of quality of life for adolescent and young adult cancer survivors. Studies have consistently documented that adolescents and young adults report greater psychological and physical morbidity than older survivors and healthy peers, including elevated rates of sexual dysfunction, often accompanied by lower satisfaction with sex life and delays in meeting sexual milestones. Moreover, sexual dysfunction, body image concerns, and fertility status affect their confidence in being both physically and emotionally intimate. Despite this evidence, limited research has investigated the influence of psychosocial and interpersonal factors on sexual health outcomes reported by this group. This constitutes a significant gap in the provision of comprehensive sexual health care for adolescent- and young adult-onset cancer survivors, especially since greater emphasis has been recently placed on the biopsychosocial model of sexuality and dyadic approaches to intervention and treatment. In comparison to other cancer types, the incidence of colorectal cancer (CRC) has been increasing at an alarming rate for the adolescent and young adult group. Patients with early-onset CRC experience elevated rates of sexual dysfunction, psychological distress, and social and physical burden, often resulting from issues with bowel control, incontinence, and body image. This study uses an explanatory sequential mixed methods approach to (1) characterize sexual function, sexual distress, dyadic coping, infertility-related distress, relationship and mental health outcomes of adolescent and young adult CRC survivors within the first 5 years post diagnosis and their partners; (2) examine the reciprocal influence of sexual function and dyadic coping behaviors on sexual distress; and (3) identify interpersonal or couple characteristics associated with coping with sexual dysfunction and its associated distress. Participating couples (n=60) will complete a quantitative web-based survey investigating sexual function, sexual distress, dyadic coping, infertility-related distress, emotional functioning, relationship satisfaction, and body image (cancer survivors only). A subset of 20 couples will participate in an in-depth dyadic interview with 2 members of the research team to further explore couple-based strategies implemented to cope with cancer-related sexual dysfunction and distress. The study received institutional review board approval. Recruitment and enrollment of couples began in July 2022. Results will provide a deeper understanding of the challenges couples experience as they navigate sexual intimacy after CRC treatment by highlighting the role of interpersonal processes. These findings will inform a dyadic intervention for young couples at risk of greater sexual distress in the aftermath of CRC. DERR1-10.2196/41831.

Evaluation of under-testing and under-diagnosis of tick-borne encephalitis in Germany

BackgroundTick-borne encephalitis (TBE), a viral infectious disease affecting the central nervous system, potentially resulting in prolonged neurological symptoms and other long-term sequelae. Case identification can be challenging as TBE can be associated with non-specific symptoms, and even in cases consistent with typical TBE symptoms, the rate of laboratory testing to confirm cases is unknown. This study assessed real-world TBE laboratory testing rates across Germany.MethodsIn this retrospective cross-sectional study, physicians provided data on TBE decision-making, laboratory testing (serological), and diagnostics behavior via in-depth qualitative interviews (N = 12) or a web-based quantitative survey of their patient medical records (N = 166). Hospital-based physicians who specialized in infectious disease, intensive care unit, emergency room, neurology, or pediatrics with experience managing and ordering testing for patients with meningitis, encephalitis, or non-specific central nervous system symptoms in the past 12 months were included. Data were summarized via descriptive statistics. TBE testing and positivity rates were assessed for the aggregate sample of 1400 patient charts and reported by presenting symptoms, region, and tick bite exposure.ResultsTBE testing rates ranged from 54.0% (non-specific neurological symptoms only) to 65.6% (encephalitis symptoms only); the percentage of TBE positive results ranged from 5.3% (non-specific neurological symptoms only) to 36.9% (meningitis symptoms only). TBE testing rates were higher among those with a tick bite history and/or who presented with headache, high fever, or flu-like symptoms.ConclusionsThe findings of this study suggest that patients with typical TBE symptoms are likely under-tested, thus likely leading to under-diagnosis in Germany. To ensure appropriate case identification, TBE testing should be consistently integrated into routine practice for all patients who present with relevant symptoms or exposure to common risk factors.

Continuing professional development of Jordanian physiotherapists: A survey of activities, facilitators and barriers

BACKGROUND: Engagement in continuing professional development (CPD) has recently become a mandatory requirement for practice in Jordan. This was part of the Jordanian government strategy to advance healthcare. AIMS The study aimed to draw the landscape of CPD for Jordanian physiotherapists. The activities, attitudes, and workplace environment related to CPD were explored. METHODS: A quantitative web-based survey was used to collect data. The survey was open for potential participants for three months from 29/01/2020. Only physiotherapists practicing in Jordan; and involved in direct patient care were invited to take part. Descriptive analysis was performed. RESULTS: Eighty-six Physiotherapists representing multiple cities in Jordan completed the survey. The percentage of female participants was 52.3%. Most participants were general physiotherapists (N = 42). Around 13% held a post graduate qualification. Most participants fulfilled the required number of CPD hours. The main driver for engagement in CPD was advancing knowledge (N = 47, 55%), followed by improving patients’ care (N = 22, 26%), and maximising opportunities for employment or promotion. Participants engaged with local workshops, reading articles in medical journals, and attending theoretical lectures in the workplace. The main barriers to engage with CPD were the high financial burden (N = 65, 76%), inability to travel (N = 40, 47%), and time limitations (N = 33, 38%). CONCLUSION: This study is the first to provide evidence of the activities, motivators, and barriers to CPD in a sample of Jordanian physiotherapists. Findings are important in informing healthcare policymaking. It offers directions to maximise the impact of CPD.

Empowering American Indian and Alaska Native youth to lead measurement development of an indigenous adolescent wellbeing measure: A protocol paper.

American Indian and Alaska Native youth research has rarely included young people from within these populations as co-designers. In addition to the lack of youth involvement, most findings focus on presenting statistics around disparity vs. focusing on this population's unique strengths and resiliency. The research design of this protocol aims to fill this gap in the current literature. To address this discrepancy, a multipronged approach to youth and young adult participatory research was implemented. These prongs included a virtual gathering where the Nominal Group Technique was conducted and an assembly of a Youth Research Design Team. Lastly, the research team will implement a protocol developed by the Research Design Team. The Research Design Team plans to conduct qualitative interviews and distribute a web-based quantitative survey with a raffle as respondent compensation. This protocol is a preliminary phase to developing a wellbeing measure for AIAN youth. Having an operationalized definition of wellness from AIAN youth will fill a gap in the current body of research with optimism that this will lead to additional studies exploring the AIAN youth voice.

Opportunities and barriers for food intake in older age - a Norwegian perspective.

The ageing processes occur slowly over time and are often not detectable by the individual. Thus, preparing for dietary needs in later years should start at an earlier age than most people realise. This study aims at better understanding what characterises food-related practices in active, home-living older adults, in order to identify food-related factors that act as barriers and those that promote healthy ageing. Three experiments were conducted: First, a web-based quantitative survey to collect information about home-living older adults' food-related behaviours (67+ years, N = 1,005). Second, two focus groups with respondents 67-74 years (N = 7) and 75-84 years (N = 6) to elicit aspects not adequately covered in the survey. Third, 10 individual interviews to provide in-depth insights. Two distinct groups were identified in the survey; 67-79 years and 80+ years. The older age group experienced more barriers and restrictions in food intake and food-related behaviours compared to the younger group. Good taste, routines and social settings were important for appetite and food intake. Using a mixed-methods approach proved valuable for extracting information and a better understanding of what impacts on food-related aspects amongst older adults. Strategies for upholding a healthy food intake involve establishing daily routines and meeting arenas where older adults can socialise and eat food together. This study confirmed that knowledge of older adults' physical needs, barriers and abilities must be a part in preparation for a healthy diet.

Motivation for Cambodian Students Aspiring to Become Nurses

Objective: This study examines the reasons for nursing students to choose nursing as a career in Cambodia. Cross-sectional quantitative web-based questionnaire survey was used to collect data (English and Khmer versions, anonymous, five-item descriptive questionnaire). The participants were undergraduate nursing students [n=33 (20 ± 3.2years); males: 11, females: 22] at the National University of Cambodia. Questionnaire items included age, sex, “Why did you decide to become a nurse?” “What influenced you the most to become a nurse?” and “What is your goal after graduation?” Methods: Data in English and Khmer were translated into Japanese using Google Translate, and content analysis was conducted according to the methodology of Berelson, B. The criterion of analysis was compared with the study findings of Ichiyanagi [1]. Results: In comparison with Japanese students who were mainly motivated “to help others,” the most common motivation for Cambodian students was “to help the country.” In both countries, the target of the motivation to be “helpful” was different. Additionally, 75% of the students answered “family” when asked about the factors that influenced their motivation. Furthermore, regarding the goals of Cambodian nursing students after graduation, many of them answered “I want to continue my studies to develop the nursing field.” Conclusion: This study examined motivation for Cambodian students aspiring to become nurses as a career. As a result of combining similar contents, the categories were divided into six each. Cambodian nursing students were motivated to help their country, protect their families and develop nursing care.

Determining Acceptance of e-Mental Health Interventions in Digital Psychodiabetology Using a Quantitative Web-Based Survey: Cross-sectional Study.

BackgroundDiabetes is a very common chronic disease that exerts massive physiological and psychological burdens on patients. The digitalization of mental health care has generated effective e-mental health approaches, which offer an indubitable practical value for patient treatment. However, before implementing and optimizing e-mental health tools, their acceptance and underlying barriers and resources should be first determined for developing and establishing effective patient-oriented interventions.ObjectiveThis study aims to assess the acceptance of e-mental health interventions among patients with diabetes and explore its underlying barriers and resources.MethodsA cross-sectional study was conducted in Germany from April 9, 2020, to June 15, 2020, through a web-based survey for which patients were recruited via web-based diabetes channels. The eligibility requirements were adult age (18 years or older), a good command of the German language, internet access, and a diagnosis of diabetes. Acceptance was measured using a modified questionnaire, which was based on the well-established Unified Theory of Acceptance and Use of Technology (UTAUT) and assessed health-related internet use, acceptance of e-mental health interventions, and its barriers and resources. Mental health was measured using validated and established instruments, namely the Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-2, and Distress Thermometer. In addition, sociodemographic and medical data regarding diabetes were collected.ResultsOf the 340 participants who started the survey, 261 (76.8%) completed it and the final sample comprised 258 participants with complete data sets. The acceptance of e-mental health interventions in patients with diabetes was overall moderate (mean 3.02, SD 1.14). Gender and having a mental disorder had a significant influence on acceptance (P<.001). In an extended UTAUT regression model (UTAUT predictors plus sociodemographics and mental health variables), distress (β=.11; P=.03) as well as the UTAUT predictors performance expectancy (β=.50; P<.001), effort expectancy (β=.15; P=.001), and social influence (β=.28; P<.001) significantly predicted acceptance. The comparison between an extended UTAUT regression model (13 predictors) and the UTAUT-only regression model (performance expectancy, effort expectancy, social influence) revealed no significant difference in explained variance (F10,244=1.567; P=.12).ConclusionsThis study supports the viability of the UTAUT model and its predictors in assessing the acceptance of e-mental health interventions among patients with diabetes. Three UTAUT predictors reached a notable amount of explained variance of 75% in the acceptance, indicating that it is a very useful and efficient method for measuring e-mental health intervention acceptance in patients with diabetes. Owing to the close link between acceptance and use, acceptance-facilitating interventions focusing on these three UTAUT predictors should be fostered to bring forward the highly needed establishment of effective e-mental health interventions in psychodiabetology.

Understanding the impact of the relationship quality on customer loyalty: the moderating effect of online service recovery

PurposeThe purpose of this study is to examine the impact of the relationship quality on customer loyalty. The moderating role played by online service recovery in this study is further discussed.Design/methodology/approachA quantitative Web-based survey study was conducted to statistically test these relationships among relationship quality, service recovery and customer loyalty. Data collected from 183 respondents were taken for analysis through partial least squares.FindingsThe findings reveal that relationship quality has significant influence on customer loyalty, whereas service recovery has moderated effect on the relationship between relationship quality and customer loyalty.Research limitations/implicationsThe respondents of this study were recruited from online panels; thus, a purposive sample could be a biased indication of the characteristics of the actual population. Therefore, it is suggested that future researchers enroll subjects from a statistical population that accurately represents the entire population and, in addition, that they collect more responses to increase the generalizability of the findings.Practical implicationsBecause failures in service delivery are inevitable, recovery of such encounters thus represents a significant challenge for service firms. Hence, this study proposes concrete suggestions for firms to manage and operate e-commerce websites, as well as to enhance relationship quality and customer loyalty.Originality/valueService failures have been the bane of e-commerce, compelling customers to either abandon transactions entirely or switch to a physical competitor. Many firms have realized the importance of maintaining strong relationships with customers to enhance their loyalty. However, previous literature has a few studies conducted on the relationships among service recovery, relationship quality and customer loyalty in the e-commerce context. Therefore, it is meaningful to identify these relationships.

Patient perspectives on living with severe asthma in Denmark and Sweden

ABSTRACT Background: Severe asthma has an acknowledged impact on health-related quality of life (HRQOL) and is associated with substantial health care costs. This study aimed to investigate the patients’ own experiences of the disease, perceptions of HRQOL, and awareness of disease management. Methods: This study included severe asthma patients in Sweden and Denmark. A quantitative Web-based survey and qualitative in-depth interviews (IDIs) were conducted. The survey included St. George’s Respiratory Questionnaire (SGRQ), Asthma Control Test (ACT), Work Productivity and Activity Impairment (WPAI), and a study-specific questionnaire on quality of care and disease awareness. Telephone-based IDIs were conducted by medical interviewers following a semi-structured interview guide. Results: A total of 93 patients participated in the Web survey, and 33 participated in the IDIs. In the survey, the vast majority (77%; 72/93) had uncontrolled asthma (ACT<20). Mean total SGRQ score was 47.4 (59.7 symptom, 53.7 activity, 39.9 impact scores). Nearly 60% were treated in primary care. The IDIs revealed a long path to diagnosis, substantial and constant need for adaptations because of disease limitations, high burden on family members, social restrictions, and sick leaves and income losses. Patient awareness about guidelines, treatment goals, and available therapies was poor, and a low level of satisfaction by primary health care was seen. Conclusions: The vast majority of this severe asthma population had uncontrolled asthma and poor access to lung expert physicians. Impaired HRQOL despite patients’ adaptations was indicated. These findings highlight the need for structured patient education and greater access to units with disease-specific knowledge.

Measurement of Economic Abuse Among Women Not Seeking Social or Support Services and Dwelling in the Community.

Scholars have defined economic abuse (EA) as tactics used by abusive partners to undermine the self-sufficiency and economic self-efficacy of survivors of intimate partner violence (IPV). However, no measures of EA have been tested in non-IPV-service seeking samples. The current study assesses the psychometric properties of the Scale of Economic Abuse (SEA)-12 (Postmus, Plummer, & Stylianou, 2016) in a nonservice seeking sample of adult females attending community college. A quantitative web-based survey was administered to a simple random sample of female community college students (n = 435). Analyses included confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). CFA indicated a poor fit for the three-factor model of the SEA-12 in this sample. The results of the EFA found a single factor model retaining four items (the Scale of Economic Abuse-Short, or SEAS). Women are experiencing EA outside of IPV service-seeking populations, and that tactics of economic control seem to be central to EA in this sample.

Food and health related characteristics of active home-living elderly in Norway

AbstractBackgroundThe large increase in the elderly population in the Western world is challenging traditional social and welfare structures. Health issues following a natural aging process increase the load on health and welfare services, making it imperative to reduce negative effects of aging and enabling elderly to stay active and live home longer. The aim of this study was to investigate food-related characteristics of active home-living elderly that can provide advice for strategic health promoting measures for this group.Material and methodsA quantitative web-based survey measuring food and health related behaviour, was administered to a sample of elderly, 67 years and older, in Norway. 1005 elderly participated in the study, 50/50 male/female, age distribution 67–74 years (70%), 75–79 years (19%), and 80 + (11%). In addition, two focus groups and 12 in-depth interviews were conducted.ResultsWomen showed higher general health interest than men and enjoyed food more (p &lt; 0,001). Almost everyone consumed at least three regular meals, following fixed routines. They reported dietary practices and knowledge that closely fit the dietary advice from the Health Authorities. 25% reported avoiding certain foods, and 65% took daily dietary supplements. Only 4% reported no physical activity at all. These respondents had higher BMI and age distribution than the rest of the sample. In general, reported health status of the sample was good, and they scored high (7,8) on a scale from 1–10 for how satisfied they were with life. With increasing age, the respondents expressed needs for more dietary advice and special foods as well as a decrease in appetite and fruit and vegetable consumption. The seniors indicated that eating with others was important for food enjoyment and appetite. The qualitative studies confirmed this, but that the advantage of social meals did not include eating with strangers.DiscussionIn order to provide knowledge that can promote and uphold a better life in the future for elderly consumers, active, home-living elderly in generally good health were recruited for this study. Characteristics of this group involved healthy daily meal routines, an active lifestyle and a social life. These activities improve appetite and feelings of well-being. Strategies enabling elderly to adapt and uphold these activities are necessary to avoid severe decline in food intake and activity as the aging process progresses.

Oncologist decision drivers in stage III non-small cell lung cancer: Outcomes of a web-based survey.

35 Background: Clinical guidelines seek to optimize patient care. We investigated how oncologists manage stage III non-small cell lung cancer (NSCLC) patients from diagnosis through treatment decision-making and drivers impacting guideline adherence. Methods: A sample of US medical oncologists (n=150) participated in a 38-question, 25-min web-based quantitative survey in January 2019. Participation required at least 3 yrs in practice and 3 stage III NSCLC patients treated in the prior 6-mo period. Results: Surveyed oncologists (82% community; 18% academic), on average, had 15 yrs of clinical experience and treated 20 stage III NSCLC patients in the prior 6 mos. Time from first treatment decision to initiation averaged &gt;2–4 wks in 31% and &gt;4 wks in 20% of patients, respectively. Oncologists recommend definitive concurrent chemoradiation therapy (cCRT) in 48% of unresectable stage III NSCLC patients. Reasons for not recommending cCRT include patient unlikely to tolerate cCRT (64% of oncologists), presence of a targetable mutation (41%), patient inability to travel consistently to receive treatment/inconvenient dosing (41%), and patient cost/affordability (34%). Eighteen percent of unresectable stage III NSCLC patients decline recommended cCRT. Fifty-five percent of patients who receive cCRT go on to receive consolidation immunotherapy (IO). Insurance challenges led to oncologists not recommending consolidation IO in 19% of patients. In the 85% of oncologists who conduct EGFR or PD-L1 testing, positive EGFR or negative PD-L1 tests are reasons for not recommending consolidation IO in 27% of patients (12% and 15%, respectively). Over half (55%) of unresectable stage III NSCLC patients who receive definitive cCRT also receive consolidation chemotherapy, which is no longer recommended in guidelines. Patients receiving consolidation CT were less likely to receive consolidation IO than the overall cohort of patients receiving cCRT (42% vs. 55%). Conclusions: Oncologists reported important variances in guidelines and standards of care related to the stage III NSCLC patient treatment journey. While some deviations from both are expected, there may be areas of focus for quality improvement initiatives.

Needs Analysis for a Parenting App to Prevent Unintentional Injury in Newborn Babies and Toddlers: Focus Group and Survey Study Among Chinese Caregivers.

BackgroundWith the growing popularity of mobile health technology, app-based interventions delivered by smartphone have become an increasingly important strategy toward injury prevention.ObjectiveThis study aimed to develop a framework supporting the design of an app-based intervention to prevent unintentional injury, targeted for caregivers of Chinese children aged 0 to 6 years.MethodsA theory-based mixed-method study, including focus groups and Web-based quantitative survey, was performed. Adult caregivers who care for children aged 0 to 6 years and own a smartphone were recruited into 2 sequential stages of research. First, focus groups were conducted among the caregivers at community health care centers and preschools from December 2015 to March 2016. Focus groups (8-10 participants per group) explored awareness, experiences, and opinions of caregivers toward using an app to prevent unintentional injury among children. Second, based on the focus groups findings, a Web-based quantitative survey was designed and distributed to caregivers in November 2016; it collected information on specific needs for the app-based intervention. Thematic analysis and quantitative descriptive analyses were performed.ResultsIn total, 12 focus groups were completed, involving 108 caregivers. Most participants expressed a strong desire to learn knowledge and skills about unintentional child injury prevention and held positive attitudes toward app-based interventions. Participants expressed multiple preferences concerning the app-based intervention, including their contents, functions, interactive styles, installation and registration logistics, and privacy protection and information security. Following the focus groups, 1505 caregivers completed a WeChat-based quantitative survey, which generated roughly similar results to those of focus groups and added numerical metrics concerning participants’ preferences on what to learn, when to learn it, and how to learn it. A detailed framework was established involving 5 components: (1) content design, (2) functional design, (3) interactive style, (4) installation and registration logistics, and (5) privacy protection and information security, and 15 specific requirements.ConclusionsWe developed a framework that can be used as a guide to design app-based interventions for parents and caregivers, specifically for unintentional injury prevention of children aged 0 to 6 years.

Profiling UAE Youth Travel: Application of Push and Pull Theory

Youth in the GCC countries have higher economic resources compared to their peers in other areas of the world. Existing studies have mainly focused on American, European and Asian youth travelers with different cultural background, preferences and behavior from Arab youth. In response to the emerging youth travel market in the rich GCC countries, this study sets out to fill the gap in research in this regard. The purpose of the study is to highlight the main factors that motivate Emirati youth to travel, the main information resources they use and their tendency to purchase packaged tours. The study applied the push and pull motivational theory to define the most significant UAE youth travel motives. A quantitative web-based survey was used to collect the required data. The findings of this study have proved that pull factors are more significant determinants for UAE youth travel than the push factors. Besides, it was revealed that the majority of UAE youth depend on the internet for travel information. Finally, the study finding shows that UAE youth prefer independent travel over packaged trips. The findings of the study have many implications for tourism suppliers and marketers who wish to target this lucrative market.

A Web-Based Survey Assessing the Attitudes of Health Care Professionals in Germany Toward the Use of Telemedicine in Pregnancy Monitoring: Cross-Sectional Study.

BackgroundThe demand for fetal monitoring and constant reassurance is high in pregnant women. Consequently, pregnant women use various health apps and are more likely to visit emergency departments due to subjective but nonurgent complaints. However, electronic health (eHealth) and mobile health (mHealth) solutions are rarely used to prevent nonurgent emergency consultations. To implement modern care solutions, a better understanding of the attitudes, fears, and hopes of health care professionals toward eHealth and mHealth is needed.ObjectiveThe aim of this study was to investigate the attitudes of health care professionals in obstetrics toward telemedicine.MethodsA quantitative Web-based survey on health care professionals in obstetrics in Germany was conducted. The participants included nurses, midwives, and physicians of all age groups and job positions working in hospitals that provide various levels of health care. The questionnaire comprised 24 questions about the characteristics of the study population, views about emergency consultations in obstetrics, attitude toward telemedicine, job satisfaction, and sleeping behavior.ResultsIn total, 244 health care professionals participated in the Web-based survey. In general, health care professionals were skeptical (170/233, 72.9%) about the use of telemedicine in obstetrics; however, 55.8% (130/233) recognized its potential. Moreover, 72% (62/86) of physicians were optimistic in using apps for pregnancy monitoring, whereas 36.1% (47/130) of nonphysicians (P<.001) were not. Significantly, more nonphysicians rejected such developments (75/130, 57.7% rejected) compared with physicians (24/86, 28%; P<.001). We also found that obstetricians with more than 10 years of work-experience are more skeptical; however, approximately 49% (18/37) of them believed that telemedicine could reduce nonurgent emergency consultations, whereas 73.2% (106/145) of obstetricians with less than 5 years of experience (P=.01) thought otherwise. Our survey revealed a high job satisfaction and a prevalence of regular sleeping problems of 45.9% (91/198) among health care professionals in obstetrics. Surprisingly, both job satisfaction and sleeping problems were independent from the number of night shifts per month (P=.77 and P=.99, respectively). Yet, 56.6% (112/198) of the survey participants thought they would be happier with their job if they had to work fewer night shifts per month.ConclusionsOur study reveals an ambivalent attitude toward the use of telemedicine among health care professionals in obstetrics in Germany at the moment. Efforts to promote the use of telemedicine should focus on nurses and midwives because these groups are the most skeptical. By contrast, particularly young physicians recognize the potential of apps in patient care and would like to use such technology in pregnancy monitoring.

Health Care Workers’ Risk Perceptions and Willingness to Report for Work during an Influenza Pandemic

The ability and willingness of health care workers to report for work during a pandemic are essential to pandemic response. The main contribution of this article is to examine the relationship between risk perception of personal and work activities and willingness to report for work during an influenza pandemic. Data were collected through a quantitative Web-based survey sent to health care workers on the island of Montreal. Respondents were asked about their perception of various risks to obtain index measures of risk perception. A multinomial logit model was applied for the probability estimations, and a factor analysis was conducted to compute risk perception indexes (scores). Risk perception associated with personal and work activities is a significant predictor of intended presence at work during an influenza pandemic. This means that correcting perceptual biases should be a public policy concern. These results have not been previously reported in the literature. Many organizational variables are also significant.