E-health 4

Alla Inga Spara

• Question: How can drug regimens be simplified to improve orientation? Reduce the number of drugs required by using multipills, which combine multiple components into one pill. Provide clearly labeled sachets containing all the drugs a patient needs to take at a specific time.
• Question: How does drug presentation impact adherence? Marketing, packaging design, and the look, feel, sound, taste, and functionality of drug devices shape perceptions and improve adoption, especially for children.
• Question: What factors help maintain patient engagement? Convenience: Flexibility, transportability, time, and physical effort. Comfort: Complexity of use, feedback to patients, and adherence level tracking.
• Question: What is patient empowerment? A process where patients understand their role, acquire knowledge and skills to manage their health, and participate actively in healthcare in a supportive environment that considers cultural and community differences.
• Question: What are the four fundamental components of patient empowerment? Acquisition of knowledge about their condition and treatment. Understanding their role, rights, and responsibilities in managing health. Developing skills for tasks like self-administering injections or using devices. A collaborative environment fostering empowerment through apps, education, and patient-provider relationships.
• Question: What is collective empowerment? When a group of patients or communities advocate together for improved healthcare, such as lobbying for rare disease research funding or pushing for affordable medications.
• Question: What are issues with advocacy groups? Some groups are independent and represent patient interests, while others may be funded by industries or pharmaceutical companies, raising concerns about their objectivity.
• Question: Why is patient empowerment important? Better Health Outcomes: Empowered patients are more likely to adhere to treatment, leading to improved health. Cost-Effectiveness: Reduces unnecessary healthcare utilization and spending. System Sustainability: Shifts some responsibility to patients, reducing the burden on healthcare systems.
• Question: What are the challenges to patient enablement? Health literacy: Ability to obtain, read, understand, and use healthcare information for decision-making and self-care. Digital literacy: Ability to locate, organize, evaluate, and analyze information using digital technology. Digital divide: Economic and social inequality in accessing and using ICT, influenced by regional differences in resources and infrastructure.
• Question: What are the levels of health literacy? Functional health literacy: Ability to process, appraise, and apply health information to personal circumstances. Interactive health literacy: Cognitive, literacy, and social skills enabling active participation in healthcare. Critical health literacy: Ability to critically analyze and use information to address structural barriers to accessing healthcare.
• Question: Why is health literacy important? Lower health literacy is correlated with more hospital admissions, ER visits, increased healthcare costs, and a higher risk of poor health outcomes.
• Question: What percentage of medical information is forgotten or misunderstood by patients? 40-80% of medical information is forgotten immediately, and half of the retained information is incorrect.
• Question: What is the "Teach-Back" method in health literacy? A method to ensure understanding by asking patients to explain what they learned, e.g., "Tell me why you need this medication" or "Tell me how you take this medication."
• Question: What tools assess health literacy? REALM: Rapid Estimate of Adult Literacy in Medicine. TOFHLA: Test of Functional Health Literacy in Adults. NVS: Newest Vital Sign, a screening tool available in Spanish and English.
• Question: What is digital literacy? A prerequisite for using e-Health, involving skills like locating, organizing, and analyzing digital information effectively.
• Question: What are the six core skills of eHealth literacy? Traditional literacy. Health literacy. Information literacy. Scientific literacy. Media literacy. Computer literacy.
• Question: What is the eHealth Literacy Scale (eHEALS)? An 8-question self-report tool measuring an individual's perceived skills and knowledge in using digital solutions for healthcare.
• Question: What is the difference between intermediaries and apomediaries? Intermediaries: Act as a necessary "in-between" for consumers to access information or services. Apomediaries: Guide consumers to high-quality information or services without being a prerequisite.
• Question: What is personalization in digital health solutions? Personalization involves tailoring digital solutions based on clinical conditions, context of use, digital health literacy, psychosocial variables, and patient preferences. To make it feasible, clusters of patients with similar characteristics are used for group-based personalization.
• Question: What is a Persona? A Persona is a hypothetical archetype of an actual user, representing their goals, motivations, and behaviors throughout the design process. Personas are imaginary but rigorously defined to reflect real user needs.
• Question: Why do we use Personas? Understand Users Better: Empathize with users by understanding motivations, preferences, and pain points. Improve Design Decisions: Provide a user-centered lens to guide feature development. Validate Assumptions: Test assumptions against real-world data. Guide Development: Align features, functionality, and interfaces with user needs. Facilitate Communication: Act as a shared reference for cross-functional teams. Support Usability Testing: Craft scenarios reflecting real-world use cases.
• Question: How can Personas improve healthcare app design? By creating specific Personas, such as a tech-savvy young adult or an elderly patient with limited digital literacy, designers can address the distinct needs of each user group.
• Question: What methods can enrich Persona development? Focus groups: Gather qualitative insights by conducting interviews with patients to identify specific sentences or aspects that make Personas more realistic.
• Question: What is the Kruskal-Wallis test? A non-parametric test used to compare more than two groups (e.g., clusters) for significant differences in distributions.
• Question: How can the Mann-Whitney test be used after the Kruskal-Wallis test? It identifies specific pairs of clusters that differ significantly after attributes pass the Kruskal-Wallis test (p ≤ 0.05).
• Question: What do we expect from an empowered patient? Communicates effectively with healthcare professionals. Accesses and manages health information documents. Has health literacy. Makes informed decisions about personal health. Supports self-care, especially in chronic illness management.
• Question: Why is patient empowerment not linear? A patient can feel empowered in one context but disempowered in another due to varying interactions with people and structures.
• Question: Why is it important for healthcare professionals to support patient empowerment? Professionals must sustain patient interest and adapt to new technologies, data analytics, and evolving competencies needed in modern healthcare.
• Question: Who are e-patients? E-patients are empowered individuals who use online resources to gain knowledge, connect with others, and communicate with healthcare providers during their care process.
• Question: What are the common traits of e-patients? Have one or more chronic conditions. Take an active role in their health and well-being. Possess knowledge on par with or exceeding that of doctors. Active on social media. Have a large global network of other patients. Tech-savvy and open to using e-health and m-health tools.
• Question: What is the Quantified Self (QS) movement? A global movement for users and creators of self-tracking tools, focusing on measuring anything about oneself for personal insights, from heart rate to nail growth. QS emphasizes learning from self-tracking, facilitated but not limited to technology.
• Question: What are the pillars of patient empowerment in PCC (Patient-Centered Care)? Self-management: Patients manage their own health. Shared decision-making: Patients collaborate with healthcare providers. Coaching: Patients are supported through managing, mentoring, and training.
• Question: Why is patient empowerment essential? Empowerment helps individuals: Understand and manage their health. Negotiate with health professionals. Navigate complex healthcare systems. This leads to better health outcomes, shared responsibility, and informed choices.
• Question: What is social learning theory in healthcare? It describes how people learn new behaviors, values, and attitudes by observing others, not just from personal experience.
• Question: What is self-efficacy, and why is it important? Self-efficacy is the belief in one’s ability to perform a task successfully. It is a strong predictor of behavior change, as competence beliefs drive actions.
• Question: What is behavioral medicine? Behavioral medicine integrates: Behavioral science: Understanding psychological and sociological factors. Psychosocial factors: Beliefs, emotions, and relationships. Biomedical science: Biology and medical interventions. Behavioral medicine focuses on changing underlying thoughts, feelings, and beliefs to achieve lasting health-related behavioral change.
• Question: What role does technology play in behavioral medicine? Technology provides tools for: Changing thoughts: E.g., motivational messages in mobile apps. Improving behaviors: E.g., wearable fitness trackers or meal-planning apps.
• Question: What are Just-in-Time Adaptive Interventions (JITAI)? JITAI uses technology, like smartphones or sensors, to: Provide tailored support at the right time. Adjust interventions based on the user’s current context or needs. Example: A fitness app sends reminders when it detects prolonged inactivity.
• Question: What is the difference between a behavioral model and behavioral change theory? Behavioral Model: Focuses on understanding why behaviors occur. Behavioral Change Theory: Focuses on strategies to modify those behaviors.
• Question: What is the Theory of Planned Behavior? The Theory of Planned Behavior assumes that decisions are conscious and planned. Key factors influencing behavior: Attitude: Beliefs about the behavior (e.g., "Cooking healthy is not important"). Subjective Norms: Social pressures (e.g., "My friends will laugh at me if I cook healthy"). Perceived Behavioral Control: Belief in the ability to perform the behavior (e.g., "I don’t know how to cook healthy").
• Question: What is the Theory of Operant Conditioning? A learning process where behavior is shaped by consequences: Reinforcement: Increases behavior frequency through rewards. Punishment: Decreases behavior frequency through negative outcomes. Example: Rewarding a dog with a treat for sitting encourages it to sit more often.
• Question: What is Reinforcement Theory? Reinforcement Theory builds on operant conditioning, stating behavior is influenced by its consequences. Key Idea: Behaviors followed by satisfying outcomes are more likely to occur again, while those followed by discomfort are less likely to be repeated. Example: An employee praised for completing a project is likely to take on similar tasks in the future.
• Question: What is Social Learning Theory? Social Learning Theory emphasizes that learning occurs through: Observational Learning: Watching others' behavior and its outcomes. Internal Mental States: Emotions, beliefs, and motivations influence behavior adoption. Behavior vs. Knowledge: Learning something doesn’t guarantee acting on it. Example: A child learns manners by observing their parents.
• Question: What are the types of observational learning effects? Inhibition: Avoiding a behavior after observing someone refrain from it. Disinhibition: Adopting a disapproved behavior after observing no consequences. Facilitation: Performing a behavior after observing someone else do it, igniting motivation. Observational Learning: Learning a new skill by watching and imitating someone else.
• Question: What are the necessary conditions for effective modeling? Attention: Observers must focus on and identify with the model. Retention: Observers must remember and mentally rehearse the behavior. Reproduction: Observers must have the physical and intellectual ability to replicate the behavior. Motivation/Reinforcement: Observers must have the drive to act.
• Question: What are the behavioral change techniques? Informing: Provide information in a way that helps individuals remember and apply it. Reinforcement: Reward desired behavior immediately upon its performance. Discussing: Encourage sharing of beliefs and experiences to promote behavior change. Social Comparison: Stimulate individuals to compare themselves with others who perform the desirable behavior (e.g., physical activity tracking apps). Fear Appeal: Present materials that elicit fear to motivate behavior change. Skills Training: Allow individuals to practice the desired behavior to build confidence.
• Question: How does persuasion relate to behavior change? Behavior change often involves explicit persuasion, where individuals are convinced to act differently for their own benefit. The goal is not manipulation but to help individuals consciously understand and achieve better behavior.
• Question: What are the advantages of technology over human persuasion? Persistence: Technology can persuade indefinitely without fatigue but must include ethical limits. Anonymity: Users can remain anonymous, which is useful for sensitive issues like mental health or addiction. Manage Large Volumes of Data: Technology processes data (e.g., from sensors) to provide evidence-backed persuasive messages. Scalability: Technology can reach large numbers of people at a low cost. Ubiquity: Technology can deliver messages anytime and anywhere, ensuring timely interventions. Multimodality: Technology presents information via text, audio, video, or combinations, tailoring messages to individual preferences.
• Question: What is the Persuasive System Design (PSD) model? The PSD model, developed by Prof. Harri Oinas-Kukkonen, is a framework for designing systems that influence attitudes, behaviors, or compliance without deception, coercion, or inducements. It is particularly useful in eHealth technology design.
• Question: What are the core principles of the PSD model? Technology is Intentional: Technology serves specific goals or purposes. Commitment and Consistency: Systems persuade by helping users align behavior with their commitments. Incremental Persuasion: Behavioral changes occur gradually, requiring systems to support small steps. Direct and Indirect Routes: Behavior can be influenced consciously (direct) or subconsciously (indirect).
• Question: What are the key design characteristics for persuasive technology in PSD? Unobtrusiveness: Technology integrates seamlessly into daily life. Transparency: The purpose of the system is clear from the beginning. User-Friendliness: Systems should be appealing and easy to use.
• Question: What are the four categories of persuasive elements in the PSD model? Primary Task Support: Helps users achieve goals by simplifying processes. Dialogue Support: Focuses on interaction between the system and users. Credibility Support: Enhances trust in the system. Social Support: Provides or supplements social networks for motivation.
• Question: What are the elements of Primary Task Support in the PSD model? Tunneling: Guides users through specific processes to reduce fear or uncertainty. Self-Monitoring: Tracks user progress to help achieve goals. Rehearsal: Allows users to practice behaviors (e.g., medication instructions). Reduction: Breaks tasks into smaller, manageable steps.
• Question: What are the elements of Dialogue Support in the PSD model? Reminders: Prompts users to meet goals or perform target behaviors. Liking: Ensures the system is visually appealing and likeable. Social Role: Adopts roles like a coach or expert to build trust.
• Question: What are the elements of Credibility Support in the PSD model? Expertise: Demonstrates the system’s knowledge and authority. Third-Party Endorsements: Features endorsements from trusted organizations or individuals. Real-World Feel: Highlights the people or organization behind the system. Verifiability: Provides easy access to external verification sources like scientific studies.
• Question: What are the elements of Social Support in the PSD model? Social Comparison: Allows users to compare progress or behaviors with others. Normative Influence: Uses peer pressure to encourage compliance. Cooperation: Encourages users to work together toward shared goals.
• Question: What is the difference between telehealth and telemedicine? Telemedicine: Focuses on delivering healthcare services via technology (e.g., video consultations). Telehealth: A broader term encompassing telemedicine, patient education, automated systems, and other health-related services.
• Question: What are the subdomains of telehealth? Teleradiology: Remote interpretation of radiological images. Teleophthalmology: Remote care for eye conditions like diabetic retinopathy. Telepsychiatry: Remote mental health services. Correctional Telehealth: Healthcare for prisoners. Teleconsultation: Communication between healthcare providers or with patients. Telepresence: High-speed, multimodal interactions like robotic-assisted surgery (e.g., telesurgery).
• Question: What are the clinical aims of telehealth services? Emergency/Urgency: Quick response to emergencies (e.g., transmitting ECGs from ambulances). Relevant Pathologies: Specialized remote assistance for specific diseases. Diagnosis and Care: Transmitting patient data instead of physically transporting patients. Monitoring: Tracking vital parameters for at-risk patients (e.g., heart rate, glucose levels).
• Question: What are the advantages of telehealth? Reduces travel costs and delays. Increases healthcare access in rural or underserved areas. Provides convenience for patients and providers. Minimizes risk of contagion by reducing in-person visits.
• Question: What are the challenges of telehealth? High equipment and operational costs. Poor image quality in some systems. Network issues, such as congestion. Solution: MultiProtocol Label Switching (MPLS) to prioritize clinical data traffic.
• Question: What are the types of communication in telehealth? Synchronous Communication: Real-time interaction (e.g., video calls). Asynchronous Communication: Store-and-forward mechanisms for later review (e.g., radiology images). Electronic Messaging: Emails or app-based messaging with security and delivery challenges. Remote Monitoring: Collecting and transmitting health data (e.g., blood pressure readings).
• Question: What are some specific telehealth domains? Teleradiology: Most mature field, focusing on radiological image interpretation. Teleophthalmology/Teledermatology: Remote care for diabetic retinopathy or skin conditions. Telecardiology: Monitoring for conditions like atrial fibrillation.
• Question: What are the emerging trends in telehealth? Shift from acute care to chronic condition management. From hospital-centered care to home-based and mobile-enabled care. Focus on increasing access, convenience, and cost reduction.
• Question: What are the limitations of telehealth? Clinical Issues: Lack of thoroughness in virtual visits. Social Issues: Digital divide affecting certain populations. Reimbursement: Limited coverage for remote monitoring and rural areas. Licensure: Restrictions requiring full licensure in every state for out-of-state care.
• Question: What key technologies support telehealth? Self-Tracking: Fitness trackers or mobile apps for patient-monitored data. Remote Interpretation (RI): Asynchronous data capture and analysis, especially in teleradiology. Cardiac Implantable Electronic Devices (CIEDs): Class I-A recommended strategy for remote cardiac monitoring.
• Question: What is the significance of telehealth? Telehealth bridges physical distances, reduces costs, and improves outcomes. Addressing challenges like reimbursement policies, infrastructure, and digital divides is crucial for its success.

Alla Inga Spara