Tools for Electronic or Personal Health Records
- Automated Access To Healthcare Information: VeriChips's Implantable RFID Microchip
Author
R. Seelig, VeriChip Corporation, Delray Beach, FL.
Background
Chronic illnesses such as seizure disorders, stroke,
diabetes, COPD, cardiac conditions, or Alzheimer's disease
frequently initiate medical emergencies, and present with
communication barriers due to confusion, loss of consciousness,
impaired speech, or memory loss. This can cause treatment
delays, unnecessary tests, and even medical errors. The
challenge is to reliably obtain important information when the
ability to impart it is lacking. Options to provide information
include wallet cards, medical jewelry, dial-up numbers, even
keychain USB drives. Most often they are not available when
emergencies arise; the data is incomplete, conflicting, or out
of date.
Methods
A recently FDA approved implantable RFID microchip can
offer a solution. This device provides an automated web-enabled
gateway from the individual to a secure password protected
database containing identity information, family contact data,
and links to medical information. Information is stored on a
secure database not on the microchip maintaining privacy and
facilitating its updating and expansion. The patient is scanned
upon presentation to the ED while vital signs are taken.
Results
To date 20 individuals have been implanted. No adverse
events occurred during the procedure or in follow-up. The
defined scanning protocol was accepted by the ED staff. The
automated interface between the patient and the EMR has been
validated and utilized.
Discussion
Considerable early progress has been made towards
reaching the objective of digital medical record adoption and
pervasive access to needed information. The RFID technology
described can facilitate information access, thereby maximizing
the utility, and acceptance of the electronic medical record
initiative. Individuals unable to verbalize or remember are at a
significant disadvantage in the healthcare delivery system
compared with those individuals not similarly impaired. By
"speaking" for a patient, the implanted RFID technology offers
an empowering option to obtain a comparable level of care by
rapidly and accurately furnishing important or even lifesaving
information.
-
Diabetes System To Access Record (D-STAR): An Online Patient Portal
To Improve and Sustain Diabetes Self-Care
Author
S.E.
Ross, University of Colorado Health Sciences Center, Denver,
CO.
Background
Diabetes-STAR (Diabetes-System To Access Records) is
an integrated patient portal which includes (1) the ability to
request appointments, medication refills, and referrals, (2)
secure electronic messaging with clinicians and practice staff,
(3) patient access to electronic medical records, and (4)
diabetes self-management support. Diabetes-STAR is an extension
of SPPARO, the patient-accessible medical record at University
of Colorado Hospital. Diabetes-STAR provides key information
from the medical record in a patient-friendly format. It also
encourages patients to assess self-care behaviors (eating well,
exercising regularly, diet, avoiding smoking, and taking
medications regularly), and provides step-by-step assistance in
setting goals to improve self-care behavior. As part of
goal-setting, patients are assisted in setting achievable goals,
identifying likely barriers, and developing strategies to
overcome those barriers. Patients get automatic electronic
follow-up of goals in 2 weeks, and their primary care doctors
are kept informed about these activities between visits. A
randomized controlled trial of this system is ongoing.
Methods
N/A
Results
N/A
Discussion
N/A
-
IHS Health Information Technology Solution
Authors
G.H. Hays1;
C.C. Lamer2.
1Indian Health Service, Office of Information
Technology, Phoenix, AZ;
2Cherokee Indian Hospital, Cherokee,
NC.
Background
Resource and Patient Management System (RPMS) is a
fully-integrated, robust, and time-tested electronic healthcare
information system for cost-effective management of clinical,
administrative, and patient encounter-related financial
information in Indian Health Service (IHS) and Tribally-operated
healthcare facilities. More than 50 certified software
applications support a diverse array of patient care, community
health, and quality assessment needs for health programs serving
over 560 federally- recognized Tribes in 35 U.S. states.
Methods
This presentation will highlight select components of
the IHS RPMS/Health Information Technology Solution that support
prevention and quality healthcare delivery for elders.
Demonstrations of the IHS Electronic Health Record, the Clinical
Reporting System, and emerging telehealth initiatives will
overview new information technology tools developed to support
an integrated model of patient, community, and
population-perspective care.
Results
N/A
Discussion
The Indian Health Service is a Federal agency whose
stated goal is "to assure that comprehensive,
culturally-acceptable personal and public health services are
available and accessible to American Indian and Alaska Native
people." The mission of the Indian Health Service is "to raise
the physical, mental, social, and spiritual health of American
Indians and Alaska Natives to the highest level." The IHS Health
Information Technology Solution is a suite of tools that allows
clinicians, administrators, and program leaders to improve both
individual and collective success in meeting the agency's
mission and goal.
- MyHealtheVet
Author
V. Price, VHA Office of Information;
Department of Veterans Affairs, Silver Spring, MD.
Background
My HealtheVet is a secure, online environment where
veterans, their advocates and health care providers may come
together to optimize veterans' health care. Web technology
combines essential personal health record information and online
health resources to enable and encourage patient/clinician
collaboration.
Methods
Web-based personal health record open to VA members.
Results
Today, veterans can enter a robust, self entered
personal health record, access a trusted source of consumer
health information that is in agreement with VA clinical
practice guidelines, and refill their prescriptions online.
Veterans can keep all their personal health information in one
place and share it as they wish. They can enter personal health
information (including medications, health events, appointments,
military health history, etc.) and record and track health
readings (e.g., blood pressure, blood sugar) over time. Coming
features (currently available in pilot) include access to VA
electronic health record information (e.g., labs, medications,
appointments) and delegation. The veteran will be able to give a
delegate (health care providers, family members or veteran
advocates) access to see and/or manage as much (or as little) of
their personal health information as they desire. By this time
next year, all of this functionality will be available
nationally.
Discussion
N/A
-
WebMD Personal Health Manager
Author
B. Lawson, WebMD,
Portland, OR.
Background
The rise of consumer directed health plans has
empowered people to take a more active role in managing their
own health. In this demonstration, see how online health portals
enable consumers to easily evaluate plans, providers and
treatment options. The demonstration will also show how
personalized, profile-driven content allows consumers to make
more timely, relevant and effective decisions.
Methods
N/A
Results
N/A
Discussion
N/A
Tools for Healthy Eating and Being Active
-
Cookin' Up Health: An Interactive Nutrition Program
Author
I.A.
Tessaro, West Virginia University, Morgantown, WV.
Background
Cookin' Up Health is a culturally targeted and
individualized tailored nutrition intervention that uses a
computer-based interactive format appropriate for a low-income,
low- literate, rural population of women many of whom have
limited access to the "digital society." The program emphasizes
increasing vegetable and fruit intake and decreasing fat
consumption, focusing on enhancing behavioral capability and
self-efficacy and on the benefits, barriers and cues to action
to initiate behavior change. This intervention modality was
chosen to reach women in communities with limited resources,
lack of transportation, and few nutrition educators.
Methods
Using a cooking show theme, Cookin' Up Health
demonstrates step-by-step meal preparation and emphasizes
healthy selection and portion control. Users watch native West
Virginia cooks prepare healthy variations on traditional West
Virginia favorites and are introduced to new healthy recipes.
Woven in with the recipes are information and tips on nutrition.
The program is not dependent on the user's reading skills. All
directions and information are audio-based, with text-based
reproduction of key audio points where appropriate. Users
interact with the program by touching the screen rather than
using a keyboard or mouse. Content is presented through a
combination of full-screen, full-motion video and pictorial
animation with audio voiceover.
Results
Focus groups were conducted with women in two rural
counties in West Virginia to guide the development of the
intervention. Cookin' Up Health is being used in health care
clinics, churches and communities and in West Virginia WISEWOMAN,
a multilevel educational intervention for low-income women.
Discussion
New technologies offer an avenue for reaching
individuals who may have difficulty seeking health information
through traditional means. By providing this program through an
interactive modality, users gain knowledge and skills to prepare
healthy foods appropriate for their culture through active
learning, and have the opportunity to engage in and build
confidence in using information technology.
-
Mi Dieta: Culturally- And Linguistically-Appropriate Online
Programs To Improve Diet and Weight-Management Among Hispanics
Author
D.G.
Schroeder, Emory University / DrTango, Atlanta, GA.
Background
Hispanics are the fastest growing demographic group
in U.S. Poor diets, low physical activity, overweight and
obesity-related diseases (e.g. diabetes) are prevalent among
this population. Tailored, culturally- and linguistically
appropriate (CLAS) health information technologies have
tremendous potential for improving the diets, physical activity
levels and weight-related health conditions of minorities. With
funding from Robert Wood Johnson Foundation Health
e-Technologies Initiative, we are rigorously evaluating the
potential of Spanish-language, interactive technologies to
improve the health of minority patients, community and managed
care members and employees.
Methods
Surveys of online Hispanics (n=100,000+) that have
completed an interactive diet, fitness and health evaluation as
part of MiDieta(TM). Focus groups of Hispanics regarding body
image, dieting and weight management preferences and
experiences. Randomized trial in collaboration with two managed
care plans (AtlantiCare, NJ and Blue Cross Blue Shield of
Florida, FL).
Results
Hispanics are online and actively using health
information technologies at a much higher rate than their SES or
literacy levels would portend. Hispanics are actively using
online diet and weight management services in Spanish. They
prefer diet and wellness problems that are tailored to their
traditional cooking patterns and foods. Quasi-experimental
results find significant and sustained weight loss for Hispanics
that use interactive applications. The baseline results of the
randomized trial will be reported.
Discussion
The highly personalized and interactive nature of
health information technologies allow for an extremely tailored
and culturally-appropriate interventions around diet, fitness
and weight management. Hispanics and other minority groups are
enthusiastic about the fact that they can receive such guidance
based on their culture, language and foods. Broadband and mobile
technologies, which are both used widely by Hispanics, will
provide even greater opportunities for delivery of
culturally-specific health communications at a low-cost.
-
5 A Day @ Work Website
Author
E. Kavanaugh-Dougherty, Produce
for Better Health Foundation, Wilmington, DE.
Background
5 A Day @ Work is a newly developed SBIR funded
website, created by Klein Buendel, in partnership with Produce
for Better Health Foundation. Produce for Better Health
Foundation (PBH) a nonprofit organization whose mission is to
lead the way to achieving increased daily consumption of fruits
and vegetables is offering this website as part of a Worksite
Nutrition Program.
Methods
The PBH Nutrition Worksite Program is a value-added
component to any corporate wellness initiative as it is
specifically designed to educate employees about the importance
of fruits and vegetables in their daily diets. The program helps
employees make healthy food choices and guides wellness
professionals on how to create an environment that offers
increased choices with fruits and vegetables for healthy
nutrition. The program focuses on an internet-based module to
make implementing the program interactive and turnkey.
Results
Each employee will be able to privately track their own
weight, physical activity and fruit and vegetable consumption.
Wellness professionals will also have access to the same
information through aggregate data. Recognizing the importance
of continually educating your wellness professional the program
offers information on how to start other programs and will offer
your managers access to an online nutrition health newsletter,
nutrition research, policy updates and PBH webinars. To learn
more, visit www.5aday.org/educators/wellness or contact
Elizabeth Kavanaugh-Dougherty at 302-235-2329
Discussion
N/A
- Get Fit on Route 66: A Fun, Online Way To Be Physically
Active
Author
T. Selby, AARP, Washington, DC.
Background
Tricia Selby, AARP, will give an overview of an
innovative online physical activity program called Get Fit on
Route 66. The site can be found at
http://aarp.getfitonroute66.com. Get Fit on Route 66 is designed
to help AARP's 35 million members increase their daily physical
activity level.
Methods
The goal of the program is for users to travel the
2,448 miles of the legendary Route 66 from Chicago to Santa
Monica by recording their exercise minutes. Time spent walking,
biking, swimming, and playing tennis count as exercise minutes.
Anyone can participate, whether a person is already active or
just beginning to be active.
Results
The presentation will address the initial pilot testing
and evaluation results; and, the recent usability study
conducted on this novel approach to promoting physical activity
among people 50 and over.
Discussion
The discussion will include the implementation and
2004 launch of this successful model for AARP members and
describe some of the unique and fun features of the program. The
presentation will also briefly describe an AARP online walking
program called Step Up to Better Health and how this program has
enabled AARP members, with the help of a step counter, to
increase the number of steps they take each day.
- incentaHEALTH,
LLC/HEALTHspot: Employee Weight Loss Program
Author
J.D. Rule,
incentaHEALTH, LLC,
Denver, CO.
Background
incentaHEALTH has created an automated corporate
employee weight loss program that compensates employees to lose
weight. (The corporation is paying the employee a portion of the
health care savings resulting from the employee's corresponding
weight loss.) Central to the program is an automated weigh
station called HEALTHspot (patent pending) that weighs and
identifies the employee. The data is collected at the worksite
and securely transmitted to the incentaHEALTH data center via
the Internet. The participating employee receives daily emails
supporting a nutrition/exercise program. incentaHEALTH maintains
all data and reports the aggregated results to the corporation
on a quarterly basis. Once per quarter, participating employees
return to the HEALTHspot terminal to weigh in. Successful
employees, who lose weight, receive a monthly check based on
their amount of weight loss.
Methods
The following is a high-level sequence describing
participation in the program: 1. The employee weighs in on the
digital scale. 2. The employee is photographed by the digital
camera. 3. The participant receives daily emails that are
educational, motivational, and provide guidance in how to eat
healthy foods and exercise properly. 4. Once per quarter,
participating employees return to the HEALTHspot terminal at
their workplace to weigh in and check their progress. 5. If
employees lose weight, they receive an incentive check. 6. This
process is repeated each quarter.
Results
A review of the results data for all clients
demonstrated that 77% of the active participants had lost
weight. Average weight loss had increased from 6.5 pounds in Q1
to 11.5 pounds in Q4.
Discussion
As health care costs spiral out of control in the
U.S., companies are searching for solutions to reduce these
health care costs. Since each overweight and obese employee can
cost employers up to $1,500 per year in extra costs, an
automated corporate weight loss program such as incentaHEALTH is
perfectly positioned to address this need.
Back to Top
-
MetaKenkoh: An Internet Game For Overweight Children
Authors
D.
Southard1; B. Southard1.
1Health Management Consultants of VA,
Inc., Blacksburg, VA.
Background
Fifteen percent of children are overweight in the
United States, almost twice the number 20 years ago. Overweight
children are increasingly being diagnosed with Type II diabetes,
formerly known as the "adult" form of diabetes. Overweight
children are also at higher risk for high blood pressure, high
cholesterol, and orthopedic problems, as well as psychological
problems, such as low self-esteem. Overweight children are also
more likely to become overweight adults, with higher risks for
heart disease, stroke, hypertension, diabetes, and some types of
cancers.
Methods
In response to this epidemic, the National Institute of
Child Health and Human Development funded Health Management
Consultants of VA, Inc. to develop MetaKenkoh, an
Internet-based, activity-contingent game for children 9-11 years
of age. The game promotes physical activity through the use of
pedometers that are used to relate game performance with
children's own daily activity. Children earn points ("ergs") for
steps taken each day. Parents of children playing the game
complete an on-line Parent Checklist regarding their children's
TV viewing and video/computer game play time, number of cans of
soda and servings of fruits/vegetables consumed, and number of
steps taken each day. This data is then converted into "ergs"
for children to use as "energy" to play the game. An associated
parent website includes graphs displaying parents' and
children's progress with activity and diet, links to related
sites on the Internet, a discussion group to facilitate social
support among parents, and health promotion tools to better
manage their own health (HeartLinks).
Results
N/A
Discussion
N/A
-
USDA's Interactive Tools Translate Nutrition Policy Into
Practice (My Pyramid.gov)
Author
W. Juan, United States Department of Agriculture,
Alexandria, VA.
Background
The U.S. Department of Agriculture released the new
MyPyramid food guidance system (FGS) to reflect the 2005 Dietary
Guidelines for Americans.
Methods
Integral components of the FGS are two interactive
tools, an introductory tool MyPyramid Plan from
MyPyramid.gov
and an advanced tool, MyPyramidTracker.gov. These interactive
tools provide personalized nutrition and physical activity
information and guidance to consumers. The FGS personalizes
nutrition guidance for Americans into a "total diet" that meets
nutrient needs from food sources and aims to moderate or limit
dietary components often consumed in excess.
Results
The Web site MyPyramid.gov helps consumers to make
smart choices from each food group and to find their balance
between food and physical activity. With MyPyramid Plan,
consumers can enter their age, gender, and select one of the
three physical activity levels (less than 30 minutes, 30 to 60
minutes, and more than 60 minutes a day) to receive a
recommendation for caloric intake and the amounts (in ounces and
cups) to eat from each food group. There is a wealth of
information and specific tips related to each of the food groups
and to physical activity. MyPyramid Tracker is an interactive
dietary and physical activity assessment tool. Consumers can
assess their diet quality, physical activity status and
personalized messages with additional links to various health
topics. Daily Estimated Energy Requirement is calculated based
on the consumer's age, gender, weight, height, and physical
activity level. The energy balance feature automatically
calculates the consumer's energy imbalance between the total
amount of energy expended and the energy consumed. The consumer
can save his/her daily data as well as the average for up to a
year.
Discussion
Use of this tool helps consumers better understand
their energy balance status and enhances the link between good
nutrition and regular physical activity.
Tools for Risk Assessment and Decision Support
-
Computer-Based Smoking Cessation Interventions: 123 Smokefree and
Smokefree Partners
Author
L.
Swartz, Oregon Center for Applied Science, Eugene, OR.
Background
Traditional smoking cessation interventions range
from the individualized physician-initiated interventions, or
group and individual counseling, to the broader population-based
pamphlets and public message campaigns. Drawbacks to these
methods include the high cost of delivery as well as a lack of
specificity to the smoker's individual needs. Computer-based
smoking cessation interventions hold promise; they can be
inexpensive to deliver; fidelity of implementation can be
maintained; and messages may be tailored to the individual.
Methods
Over the past 10 years, we have developed three
computer-based smoking cessation interventions, including
Internet-delivered interventions. Program materials were
tailored on a variety of variables including Prochaska's Stage
of Change, demographics (race/ethnicity, gender, age), smoking
habits, and previous quitting experience. Program time frames
ranged from a single-visit, a repeatable browser experience, to
a guided 21-day intervention with project staff contact and
automated feedback. All were heavily video-based with narration
and testimonials from smokers. Development phases for each
project included extensive focus groups, and each was evaluated
in a randomized clinical trial.
Results
Results from each prior project influenced the content
and development of the subsequent project. All of the
interventions showed promising results in attitudinal measures
and self-reported behavior. Although the structured 21-day
program is still in evaluation (12-month follow-up data is still
being collected), this program appears to be the most successful
of the three approaches in helping smokers maintain abstinence.
Discussion
Issues around accessing and acceptability of
computer-based interventions are still developing, and
evaluating Internet programs can be challenging. However,
well-designed, evidence-based computer-based interventions offer
a promising means for assisting smokers to quit.
-
Health Literacy Initiative: "BJC Help For Your Health"
Author
K.A. Killion, BJC HealthCare, St. Louis, MO.
Background
All "Help for Your Health" offerings are now listed
at a central source –
www.bjchelpforyourhealth.org. The site
provides a comprehensive listing of all available programs and a
brief history of offerings since the inception of "Help for Your
Health" in 2003. Interactive features enable employees to ask
questions of a resident chef or registered dietitian and to
access nutritious and tasty recipes.
Methods
Via an interactive website, individual sections feature
descriptions of programs including the low-dose aspirin
initiative, upcoming health fair dates, Health Hall of Fame
nominations and winners, mammography, medical premium discount,
smoking cessation and partnerships with Schnucks, Subway, St.
Louis Science Center, Weight Watchers and YMCA. Additional
sections highlight "Help for Your Health" medical adviser Brian
Grus, M.D., and Morisson's improved cafeteria selections,
nutritional content, informative Lunch and Learns and a body
mass index calculator.
Results
N/A
Discussion
"Help for Your Health" extends beyond physical
health to highlight programs available under "Growth Workshops"
that focus on relationship and family issues, personal growth,
stress and burnout, finances, workplace issues and alcohol or
substance abuse. The "Health Information" section, provided by
Health Fitness Corporation, provides a wealth of medical and
wellness information to benefit the entire family. For a complete
summary, visit www.bjchelpforyourhealth.org. Stay tuned for
'Help for Your Kids' Health' and 'Help for Your Mental Health'
in 2006.
-
Health-e-AME: Evaluation Of A Faith-Based Website Targeting
African-Americans With Chronic Disease
Author
M.P. Laken, Medical University of South Carolina, Charleston, SC.
Background
Older African Americans, who are at risk of chronic
disease, often lack access to information on how to reduce risk
of chronic disease and the complications. Community-based
Participatory Research (CBPR) aims to establish collaborative
partnerships between community organizations and academic
institutions to reach vulnerable populations with
culturally-specific and evidence-based programs. A partnership
between the 7th Episcopal District African Methodist Episcopal (AME)
Church and two universities was established through a memorandum
of understanding that outlines the mission and principles of the
partnership. A unique website,
health-e-ame.com, was developed
jointly to reduce the digital divide and health disparities in a
large faith community comprising almost 25% of African Americans
in South Carolina.
Methods
Pastors were encouraged to make the internet available
in their church. The website was promoted at meetings and
distributed on t-shirts, magnets, notepads, water bottles, and
print material. Annual telephone surveys of 572 adult members
from 21 randomly selected churches assessed use of the
internet/website and chronic disease status.
Results
Almost 62% have a chronic disease. Use of the internet
rose from 54% to 56% and use of the AME website doubled from
7.5% to 14.2% over the first two years of the program. Several
participant characteristics were associated with use of the
internet at the follow-up assessment. Notable predictors
(p<0.01) included: better general health (OR=1.5); younger age
(OR=3.1); and lack of hypertension (OR=2.5) and diabetes
(OR=3.1).
Discussion
The results of the survey were discussed among the
partners. New initiatives were explored to increase intention to
use the internet and the website by older members with chronic
disease. This presentation will focus on the process by which
evidenced-based planning is implemented by a large faith
community and two universities in line with CBPR principles.
-
Interactive Web-Based Cancer Health Literacy To Increase
Cancer Screening
Authors
S. Godin1; S.H. Weiss2; G. Marcie3.
1East
Stroudsburg University, E. Stroudsburg, PA;
2UMDNJ-New Jersey
Medical School, Newark, NJ;
3National Cancer Institute,
Philadelphia, PA.
Background
This presentation describes the development of a
county-wide, web-based "cancer community toolbox". Within this
website, there are a variety of tools useful to the
cancer-services community and residents of the county. One of
the tools includes interactive educational modules that allow
users to explore and educate themselves on the risk factors,
signs and symptoms, and screening strategies for melanoma and
bladder, breast, colorectal, cervical, and prostate cancers.
Methods
Within each module, the educative material is presented
at the 8th-9th grade reading level. Throughout the modules,
interactive questioning is used to measure comprehension of the
educative material. Embedded within the program are questions
assessing whether cancer screens have been received. If
appropriate, social marketing messages are provided, based on
local BRFSS data, that advertises the normative screening
behavior of others within the county. In addition, these
messages encourage users to consider obtaining cancer screens
while providing information about screening locations. The
transtheoretical model is used as a theoretical anchor for all
educational content. For example, those assessed to be within
the "pre-contemplation stage" will be provided factual
information; whereas, those assessed to be within the "decision/determination stage" will be provided encouragement,
along with testimonies from others who have gone for cancer
screening. Throughout the educational modules, data on the
users' behaviors and answers are continuously collected and
stored within a database. These data will be analyzed to
determine the overall efficacy of the web-based toolbox in
improving cancer health literacy and referral to cancer
screening facilities within the county.
Results
N/A
Discussion
N/A
-
On-Line Screening For Risky Alcohol Use
Author
C.D. Girard, Join Together - Boston University School of Public Health,
Boston, MA.
Background
Many people don't realize they have an alcohol
problem, or are at risk for one, because no one has asked about
their drinking patterns. Research shows that screenings and
brief interventions (SBIs) can be very effective in prompting
those whose alcohol consumption is risky to cut back, learn more
about their drinking or seek help. Preliminary research on
Internet-based SBI points to significant potential to reach more
individuals with effectiveness equal to in-person screenings.
Methods
In 2001, Join Together launched a free alcohol
consumption self-assessment website –
www.AlcoholScreening.org.
The site has 3 sections: the screening tool, based on the WHO's
alcohol use disorders identification test (AUDIT); the Learn
More section, a collection of information on alcohol abuse; and
the Find Help section, a national treatment provider database.
The site urges those whose drinking is harmful to take positive
action, which is measured by the user choosing the Learn More or
Get Help sections of the site after receiving personalized
feedback.
Results
From April, 2001 through June, 2005 over 307,000 people
completed Alcohol Screening Questionnaires. The Boston
University School of Public Health site data evaluation found
that, in a 14-month period, almost 40,000 adults completed the
questionnaire about their own drinking patterns. More than half
had alcohol screening results consistent with alcohol abuse or
dependence; similar proportions of women and men were hazardous
drinkers. Visitors with possible alcohol abuse or dependence
were more likely to visit a part of the Web site designed for
those seeking additional help.
Discussion
A well-publicized, easy-to use, research-based SBI
Web site can attract many users, most of whom are drinking
excessively. Many of these users will also take advantage of
referral information after receiving individualized feedback.
-
Positive Aging Resource Center
Author
N. Downing, Positive
Aging Resource Center, Boston, MA.
Background
www.positiveaging.org was created by the Positive
Aging Resource Center (PARC) to educate older adults,
caregivers, and geriatric health care providers on mental health
and healthy aging. The website has two distinct sections- one
designed for older adults and their caregivers (consumers), and
another dedicated to serving the needs of health care
professionals.
Methods
The PARC consumer website emphasizes that good mental
health is a vital aspect of positive aging, along with
maintaining a healthy lifestyle, and staying connected to one's
community. The site also deals with difficult issues such as
grief, social isolation, and life changes that can contribute to
anxiety, depression, alcoholism and gambling. This is done in a
novel and unique way through the use of "peer narrators" to
introduce information.
www.positiveaging.org/consumer was
designed specifically for an elderly audience to be accessible
and "senior-friendly," exceeding federal accessibility
requirements. For seniors, larger buttons with larger type,
higher contrast graphics, scalable font sizes, and consistent
placement of navigation make the website more accessible to
individuals with lower vision or difficulty using a mouse.
Consistent page layout and prompts help older adults move from
one place to another on the site without feeling lost or
overwhelmed.
Results
The PARC provider website provides "one stop shopping"
for geriatric and mental health professionals. This includes
access to in-depth information on exemplary programs in
geriatric mental health care, links to evidence based practices
in mental health and aging, downloadable and printable versions
of common screening and assessment instruments and links to
trainings and upcoming conferences.
Discussion
N/A
-
SymTrend'S Electronic Diaries And Personal Health Records
For Symptom Tracking & Charting: Applications For
Self-Monitoring Of Wellness And Cancer
Author
M. Levine, SymTrend, Inc.,
Belmont, MA.
Background
SymTrend is an Internet subscription service for
health, self-management. A PDA option enables outside-the-home
use. For persons living with cancer, SymTrend facilitates: 1)
daily routine, health status recording with a customizable
diary, 2) analyzing personal health trends for treatment
adjustment, and 3) compiling a centralized care record from
multiple providers and sites. The value of these services
changes over time.
Methods
During treatment, SymTrend's personal trend charts
support the monitoring of medication benefits versus side
effects. This closer monitoring can attenuate, or even prevent,
toxicity, disability, and discomfort. It shows how downturns may
be exacerbated by, or result from, life stressors, increased
activity, or mood change. This clarity supports better problem
management at an early problem stage, which elevates user
morale. During remission, SymTrend charts alert the user to
slower, more insidious, downward trends, which may signal a
recurrence, or another illness. Compiled over months and years,
SymTrend's secure, centralized care record facilitates
communication among all concerned.
Results
It provides a comprehensive, multi-provider history of
symptoms, services, procedures, findings, medications, and other
illnesses. This compilation can be reformatted for a particular
review focus. This reformatting feature makes the record easier
to read than a jumble of records from different sources. As a
patient with multiple myeloma reported: "Maintaining a log of my
daily feelings and reactions was invaluable, particularly when
meeting with doctors or others, months after the events.
Depending upon my condition at different stages of treatment, it
was not always clear, even just weeks later, what really
transpired."
Discussion
N/A
-
Your Disease Risk
Author
M. Samplin-Salgado, Harvard Center
for Cancer Prevention, Boston, MA.
Background
Your Disease Risk (www.yourdiseaserisk.harvard.edu)
offers users the chance to find out their risk of twelve
cancers, heart disease, diabetes, stroke, and osteoporosis and
get personalized tips for preventing them. "Your Disease Risk
pulls all these important diseases into one place and offers
people consistent, practical prevention messages for each," says
Dr. Graham Colditz, Director of the Harvard Center for Cancer
Prevention. "The far-reaching benefits of a healthy lifestyle
become apparent as people click through the site and see that a
single risk factor can impact their risk of many
diseases--something we hope will inspire them to make healthy
behavior changes."
Methods
Users fill out brief questionnaires and get
descriptions of their risk in the form of a colored bar graph.
The bar graph is a 7-level scale that compares users to typical
men or women their age. Users can click on personalized
strategies to learn where to focus their prevention efforts and
how to make lifestyle changes. With each click, the bar graph
shrinks, and users watch their risk drop.
Results
Launched in July of 2004, Your Disease Risk was
developed with the same evidence-based, consensus approach used
for the original cancer site, Your Cancer Risk. Epidemiologists,
clinicians, and other faculty experts from the Harvard medical
community reviewed the current scientific evidence for each
disease, identifying the established and probable risk factors
of each. This information was then used to develop calculations
that generate a person's risk of disease compared to population
averages by age and sex.
Discussion
N/A
Tools for Information Access
-
BenefitsCheckUpRx (BCURx)
Author
W. Zenker, National Council
of the Aging, Washington, DC.
Background
BenefitsCheckUpRx (BCURx) is a sophisticated, yet
simple and easy-to-use web-based service that screens for likely
eligibility for hundreds of public and private healthcare
programs, and facilitates enrollment by providing direct access
to over 250 application forms (eforms, fillable PDF's and for
some, online enrollment).
Methods
The screening is quick, free and confidential. BCURx
offers State specific recommendations for the optimal
combination of public and private programs to save consumers
money. It is directly available to consumers through the web and
a special "Organization Edition" is available to nonprofit
intermediaries that offer counseling and enrollment assistance.
The Organization Edition includes special management features
and client follow-up tools.
Results
In addition to identifying the programs that a person
may be eligible to receive, BenefitsCheckUp also provides a
detailed description of the programs, local contacts for
additional information (typically the addresses and phone
numbers of where to apply for the programs), and materials to
help successfully apply for each program.
Discussion
N/A
-
Healia®: A Next Generation Search Engine To
Enhance Access To High Quality And Relevant Health Information
Author
T. Eng, Healia, Inc., Bellevue, WA.
Background
Up to 80 percent of Internet users have used it for
health information and 81 percent of "healthseekers" first use a
search engine to find health information. A major challenge for
consumers is to sift through the millions of generic search
results provided by the major search engines to find high
quality and individually relevant content. In addition, searches
within certain health topics (e.g., alternative medicine,
nutrition, dieting and weight loss) show that most of the top
results—and nearly all associated ads—from major commercial
search engines are associated with questionable organizations
and/or unproven products and services.
Methods
A literature review of information quality, information
retrieval, and health literacy and focus groups were conducted
to define requirements for an improved health search engine.
Algorithms and methods for machine assessment of quality and
other attributes of Web content were developed to ensure that
the highest quality and most relevant results are presented to
the user. In an independent, blinded trial, three clinicians
evaluated the quality of results returned by Healia®, Google™,
and another health search engine in response to nine health
questions. The clinicians scored each result according to its
relevancy to the question, content accuracy, and the
trustworthiness of the source.
Results
Every physician rated Healia® higher than the other
search engines on each dimension of quality. Healia® was rated
significantly higher than the other search engines in overall
quality of search results (p<.005).
Discussion
Generic search engines are not sufficient for many
health queries, especially when information quality is critical.
Search tools that improve access to quality health information
and address the varied health information needs of diverse
populations can play an important role in enhancing prevention,
health literacy, and informed decision making. Healia® R&D was
funded by the National Cancer Institute.
- Cancelled.
-
The Prevention Communication Research Database (PCRD)
Author
M.
Saucer, IQ Solutions/HHS Office of Disease Prevention and
Health Promotion, Rockville, MD.
Background
Launched in April 2005, the Prevention Communication
Research Database (PCRD), a project of the Office of Disease
Prevention and Health Promotion (ODPHP), Department of Health
and Human Services (HHS), is a searchable collection of audience
research conducted or sponsored by HHS agencies. The PCRD is
designed to provide access to communication research findings
that may not be widely known or distributed. Making the research
available may provide program planners and health communication
specialists with insight into different audiences in relation to
key prevention issues such as physical activity, healthy eating,
tobacco use, and substance abuse.
Methods
The PCRD contains reports on prevention, and does not
contain reports related to outcomes or process studies. Program
planners and health communication specialists at the Federal,
State, and local levels can use this database find recent HHS-funded
audience research studies; shape audience research design and/or
proposals; improve understanding of intended audiences; and
maximize resources by decreasing or eliminating the need to
conduct similar research studies. HHS staff are encouraged to
submit and share Federal research reports to increase: the body
of knowledge available on key prevention issues; information
available to grantees and contractors; awareness of research
conducted or sponsored by HHS agencies.
Results
The PCRD currently features 44 reports on priority
prevention topics. Web tracking data indicates steady and
significant interest in the PCRD. During the last three-month
period for which data are available, the PCRD received
approximately 40,000 page hits and 27,0000 page views per month
and 5400 site visits and 1500 unique visitors per month with 330
or approximately 20% of those visitors returning to the site
more than once during the month.
Discussion
The PCRD provides a new approach to providing public
access to unpublished communication research. ODPHP plans to
conduct two surveys of site visitors in the next 12-month period
to evaluate satisfaction with the online resource.
-
VERTICES: GIS Mapping
Author
W. Im, VERTICES, New
Brunswick, NJ.
Background
Geographic Information Systems (GIS)
technology provides the ability to examine health-related
datasets for spatial components that might otherwise be
overlooked. For example, it is apparent that the geographic
distribution of physicians and their patients, the locations of
healthcare facilities, demographics and transportation networks
become much clearer when displayed on a map. What is less
apparent is how these geographic distributions interact to
create overall patterns of health and illness at the local,
state or federal levels. GIS allows us to examine these
interactions and predict how addressing service gaps or
targeting specific populations might impact the overall health
of a population. Significant strides were made in recent years
to broaden the reach of GIS, primarily by simplifying the use of
the systems. Nevertheless, a number of obstacles still prevent
the widespread adoption of GIS technology. The main obstacle
remains the high total ownership cost of a desktop GIS,
including software, maintenance and support costs, hardware
costs, and specialized GIS training costs. A web-based GIS
allows users to access GIS through a common Internet browser. It
significantly lowers the implementation costs per user. System
maintenance is centralized and minimized, and specialized GIS
training needs are reduced. Dr. Im has developed several
web-based GIS applications suitable for use in public health.
These applications provide health resources, community and
neighborhood information online in an interactive mapping
format. Each application enables users to update their own
information via a secured web access. Thus, all available
information is displayed and updated in real time.
Methods
N/A
Results
N/A
Discussion
N/A
-
Focus Group Study Provides Insight Into How Public
Health Professionals Prefer To Seek Prevention Information
Authors
I. Auston1;
L. Sedlar1; S. Baker2; H. Ross2.
1National Institutes of Health
(NIH), National Library of Medicine, Bethesda, MD;
2Public
Health Foundation, Washington, DC.
Background
Public health and community organizations require
evidence-based information to achieve better prevention results
for diseases like diabetes, asthma, cancer, or heart disease.
But many health professionals have a difficult time finding the
time to sift through large quantities of research and related
prevention information. In 2001, the National Information Center
on Health Services Research and Healthcare Technology (NICHSR),
a component of the National Library of Medicine (NLM), and the
Public Health Foundation (PHF) developed the Information Access
Project (http://phpartners.org/hp), a website to help public
health professionals more easily find the latest evidence-based
information on the effectiveness of various health promotion and
disease prevention approaches for a variety of diseases
(including stroke, nutrition, etc.)
Methods
In 2005, PHF evaluated the Healthy People 2010
Information Access Project website via a focus group study with
public health professionals from the Washington D.C. metro area.
The focus groups' purpose was to determine how public health
professionals view and use the site and to recommend changes to
NLM on improvements that can be made.
Results
Some findings include: (1) public health professionals
prefer to gather evidence-based information from 'trusted
sources;' (2) focus group participants viewed the site as a
'good starting point' for an information search; (3)
pre-formulated searches for information related to a variety of
health problems (physical fitness, diabetes, heart disease,
etc.) is a time saver and; (4) a major barrier was the site's
organization around Healthy People 2010 objectives.
Discussion
Further discussion of findings from focus group
sessions with recommendations will be presented.
-
Promoting Equity In Health Information: A Community Outreach
Collaboration
Author
K.L. Pomerantz, Health Information
Partners, Washington, DC.
Background
In 2000, Partners for Health Information launched a
community health information outreach program to bring ehealth
resources into neighborhood health centers for providers and
patients. Partners collaborated with the centers, service
learning students, and community advocates to reach 4500 people.
Methods
In 2003, funded by the National Library of Medicine,
our partners created Health Information Partners (HIPS), a
coalition of 15 organizations dedicated to advancing health
information literacy and equity. Members include the state adult
education agency, primary care coalitions, the Project of
Intermediate Advocates, public libraries, the AHEC, a university
library, a public health school, the local public health
association, peer educators, and health centers. Our members
contribute skills from the fields of adult education, library
science, and health; material resources including a mobile
technology classroom, libraries, training centers, and staff;
and vast community relationships. The principles of community
based participatory research (inclusion, multi-racial/ethnic
collaboration, and shared decision making) guide us.
Results
We reach a diverse, multi-jurisdictional region with
formal classes, outreach visits, and health advocacy. HIPS
members meet monthly and develop training curricula, promotional
materials, funding proposals, and evaluations. A community
assessment affirmed community interest in improving health
information access and skills. During its first year, HIPS held
14 monthly planning meetings, bimonthly community forums, and a
minimum of two training classes and ten outreach visits each
month. Preliminary evaluation data show that all learners have
increased their awareness of reliable health resources, acquired
basic web navigation skills, identified web evaluation criteria,
and intended to share resources with families and colleagues.
Several learners have become trainers and HIV community
educators.
Discussion
Our model of outreach, collaboration, and peer
education allow us to bring reliable health information to
communities often excluded from ehealth.
-
Using Technology And Behavioral Psychology To Facilitate
Behavior Change
Authors
K.M. Yaeger1; R.M. London2.
1University of
Wisconsin Hospital, Madison, WI;
2Diabetes and Wellness
Foundation, Stoughton, WI.
Background
Maintaining long term commitment and motivation to:
increase fitness, reduce weight, improve A1Cs, and improve
self-care behaviors in obese pre-diabetes and type-2 diabetes
patients is a challenge. Email and discussion board support was
evaluated as part of a 20-week lifestyle psychosocial change
program that was piloted at the UW Health Diabetes Clinic for
persons with pre-diabetes and Type-1/Type 2 diabetes. The goals
of the program were to: (1) reduce barriers to lifestyle change,
(2) improve fitness, (3) improve lifestyle decision making,
coping, and environment management skills, (4) improve healthy
eating skills, and (5) keep participants committed to lifestyle
change goals through continuous email contact with the
facilitators.
Methods
Weekly Emails, of a fixed format, were used to review
the programs key knowledge points, self-care skills, and provide
inspiration throughout the 20-week program. Given the option at
the end of the program, the entire group elected to continue to
receive support and educational emails for up to 1 year after
the program ended.
Results
Weekly session evaluations revealed that all members of
the group found the use of inspirational and education review
emails important in keeping them motivated and increasing their
ability to change behaviors. Monthly email surveys assessing the
value of email support for the participants suggests they are
finding email helpful in maintaining commitment and motivation
in changing their lifestyles to reduce weight, improve fitness,
and improve self-care.
Discussion
Internet and cell phone technology holds promise for
helping to facilitate long-term behavior lifestyle change in
people who find change difficult. Email and other technogy can
provide efficient, low-effort, low-cost support approaches to
improve the health decisions of the obese/diabetic patient, and
communication with the healthcare team. Our session will review
our approach to email support as an intervention, and discuss
why our program participants found email support helpful in
their efforts to change lifestyle behaviors.
-
The Salud Public Health Information Pilot Project
Authors
M.Z.
Cassey1; K. Hitchcock1; C. Scherrer1.
1University of Illinois at
Chicago, Chicago, IL.
Background
Healthcare providers struggle to asure culturally
congruent care for immigrant populations at busy clinics. Even
with bilingual providers, the provision of culturally
appropriate health education materials for patients remains
challenging. Health literacy issues may be complicated by
illiteracy presenting the need for auditory health education
materials. The Internet offers unlimited multimedia resources of
varying quality but most clinics face infrastructure restraints
and knowledge deficits when attempting to locate and deliver
culturally appropriate and linguistically relevant auditory and
printed materials.
Methods
After assessing existing patient education materials in
a Chicago Department of Public Health (CDPH) clinic serving a
90% Latino population, health science librarians, nursing
students, & nursing faculty collaborated to identify quality
multi-lingual Internet resources (http://salud.lib.uic.edu) for
adult & women's health, pediatrics, & diabetes. To assure
efficient use of the selected materials, a "train-the-trainer"
model used nursing students as the one-on-one "patient education
instructors" for clinic staff after a training session with the
librarians. Staff were also given one-on-one sessions with
librarians to strengthen knowledge of professional resources.
Point-of-care clinic workstations were established to provide
ready access to the website.
Results
To date, 52 providers have participated in one-on-one
sessions with the librarians. 12 nursing students have presented
project overviews to 45 healthcare providers at six "cluster"
meetings and a presentation has been made to 48 management staff
of CDPH. Patient encounters (24) have been limited since the
workstations were not placed until June 2005. Plans are being
developed to expand the project to the rest of the CDPH clinics.
Discussion
The one-on-one instruction and skill development for
clinic personnel has been the most valuable aspect of this
intervention. The placement of resources without orientation to
the materials will not accomplish dissemination and use of
multicultural patient education materials.
