Project description:ObjectivesThis research studied hospital administrators' and hospital-based health care providers' (collectively, the target group) perceived value of consumer health information resources and of librarians' roles in promoting health information literacy in their institutions.MethodsA web-based needs survey was developed and administered to hospital administrators and health care providers. Multiple health information literacy curricula were developed. One was pilot-tested by nine hospital libraries in the United States and Canada. Quantitative and qualitative methods were used to evaluate the curriculum and its impact on the target group.ResultsA majority of survey respondents believed that providing consumer health information resources was critically important to fulfilling their institutions' missions and that their hospitals could improve health information literacy by increasing awareness of its impact on patient care and by training staff to become more knowledgeable about health literacy barriers. The study showed that a librarian-taught health information literacy curriculum did raise awareness about the issue among the target group and increased both the use of National Library of Medicine consumer health resources and referrals to librarians for health information literacy support.ConclusionsIt is hoped that many hospital administrators and health care providers will take the health information literacy curricula and recognize that librarians can educate about the topic and that providers will use related consumer health services and resources.
Project description:BackgroundThe role of consent for research use of health information is contentious. Most discussion has focused on when project-specific consent may be waived but, recently, a broader range of consent options has been entertained, including broad opt-in for multiple studies with restrictions and notification with opt-out. We sought to elicit public values in this matter and to work toward an agreement about a common approach to consent for use of personal information for health research through deliberative public dialogues.MethodsWe conducted seven day-long public dialogues, involving 98 participants across Canada. Immediately before and after each dialogue, participants completed a fixed-response questionnaire rating individuals' support for 3 approaches to consent in the abstract and their consent choices for 5 health research scenarios using personal information. They also rated how confident different safeguards made them feel that their information was being used responsibly.ResultsBroad opt-in consent for use of personal information garnered the greatest support in the abstract. When presented with specific research scenarios, no one approach to consent predominated. When profit was introduced into the scenarios, consent choices shifted toward greater control over use. Despite lively and constructive dialogues, and considerable shifting in opinion at the individual level, at the end of the day, there was no substantive aggregate movement in opinion. Personal controls were among the most commonly cited approaches to improving people's confidence in the responsible use of their information for research.ConclusionBecause no one approach to consent satisfied even a simple majority of dialogue participants and the importance placed on personal controls, a mechanism should be developed for documenting consent choice for different types of research, including ways for individuals to check who has accessed their medical record for purposes other than clinical care. This could be done, for example, through a web-based patient portal to their electronic health record. Researchers and policy makers should continue to engage the public to promote greater public understanding of the research process and to look for feasible alternatives to existing approaches to project-specific consent for observational research.
Project description:Project Viva: Pregnant women were enrolled in Project Viva between 1999 and 2002 at their first prenatal visit at one of 8 obstetric clinics of Atrius Harvard Vanguard Medical Associates, a multispecialty group practice in eastern Massachusetts. Eligible mothers were fluent in English, had singleton gestations, were <22 weeks gestation, and had no plans to move away from the study area. Research staff performed in-person study visits with participating mothers in the first (median gestational age 9.9 weeks) and second (median gestational age 28.1 weeks) trimesters of pregnancy, and with mothers and children during the first few days after delivery, during infancy (median age 6.3 months), in early childhood (median age 3.3 years), mid-childhood (median age 7.7 years), and adolescence (median age13 years). In this analysis, we will use data from 188 mother-child pairs in Project Viva with available information on prenatal PFAS concentrations, available umbilical cord serum samples at delivery, and outcomes of interest. Please contact Nicole Bornkamp at Nicole_Bornkamp@harvardpilgrim.org for questions related to the subject characteristics and outcomes. This research was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of The Director, National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Project Viva is an ECHO cohort which is supported by the following ECHO Program Collaborators: ECHO Coordinating Center: Duke Clinical Research Institute, Durham, North Carolina: Smith PB, Newby KL, Benjamin DK; U2C OD023375 ECHO Data Analysis Center: Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland: Jacobson LP; Research Triangle Institute, Durham, North Carolina: Parker CB; U24 OD023382 North Carolina Human Health Exposure Analysis Resource Hub: Research Triangle Institute: Fennell T, University of North Carolina at Chapel Hill: Sumner S, University of North Carolina at Charlotte: Du X; U2C ES030857 Human Health Exposure Analysis Resource Coordinating Center: Westat, Inc., Rockville, Maryland: O’Brien B; U24 ES026539
Project description:BackgroundIn much of sub-Saharan Africa, male partners play influential roles in women's access to maternal-child healthcare, including prevention of mother-to-child transmission of HIV services. We explored male partner perspectives on women's access to maternal-child healthcare in North-Central Nigeria.MethodsThree focus groups were conducted with 30 men, purposefully-selected on the basis of being married, and rural or urban residence. Major themes explored were men's maternal-child health knowledge, gender power dynamics in women's access to healthcare, and peer support for pregnant and postpartum women. Data were manually analyzed using Grounded Theory, which involves constructing theories out of data collected, rather than applying pre-formed theories.ResultsMean participant age was 48.3 years, with 36.7% aged <40 years, 46.7% between 41 and 60 years, and 16.6% over 60 years old. Religious affiliation was self-reported; 60% of participants were Muslim and 40% were Christian. There was consensus on the acceptability of maternal-child health services and their importance for optimal maternal-infant outcomes. Citing underlying patriarchal norms, participants acknowledged that men had more influence in family health decision-making than women. However, positive interpersonal couple relationships were thought to facilitate equitable decision-making among couples. Financial constraints, male-unfriendly clinics and poor healthcare worker attitudes were major barriers to women's access and male partner involvement. The provision of psychosocial and maternal peer support from trained women was deemed highly acceptable for both HIV-positive and HIV-negative women.ConclusionsStrategic engagement of community leaders, including traditional and religious leaders, is needed to address harmful norms and practices underlying gender inequity in health decision-making. Gender mainstreaming, where the needs and concerns of both men and women are considered, should be applied in maternal-child healthcare education and delivery. Clinic fee reductions or elimination can facilitate service access. Finally, professional organizations can do more to reinforce respectful maternity care among healthcare workers.
Project description:Information and Communication Technologies (ICTs) have been utilised globally for advancing social and economic development. As information becomes key to enlightening development initiatives, the role of mobile technology-based ICT services is becoming more significant. The aim of this study was to design and implement a mHealth data model with an intention of improving mothers' knowledge of Reproductive and Child Health (RCH) services in rural environments and to remind mothers who do not have access to mobile phones to attend antenatal care.The methodology adopted in this research was participatory action research. A phased approach was utilised to answer the research question. The phases were: diagnosis of the problem, action planning, action taking, evaluation and reflection. The study was conducted in Chamwino district of Dodoma region, Tanzania. Reproductive and Child Health sections of Buigiri dispensary and Chamwino health centre were purposively selected. Data were collected through key informant interviews, document review, focus group discussion and observation. Content analysis methods were utilised during analysis. Consequently, the data model was designed, implemented and evaluated.Challenges of information dissemination in low resource settings noted in this study are: mobile phone ownership and access of mothers, vertical coordination of health services and low staffing levels of health workers. Mothers who do not own mobile phones can leverage phone ownership of community leaders, TBAs, CHWs and relatives. This in turn facilitates communication of health messages to mothers.Although this study was conducted in a low resource setting, mobile network coverage was good and thus SMS technology could be used. Research should be conducted on how to disseminate similar information in remote areas without mobile coverage.
Project description:The Coronavirus (COVID-19) pandemic has led to a rapidly growing 'infodemic' of health information online. This has motivated the need for accurate semantic search and retrieval of reliable COVID-19 information across millions of documents, in multiple languages. To address this challenge, this paper proposes a novel high precision and high recall neural Multistage BiCross encoder approach. It is a sequential three-stage ranking pipeline which uses the Okapi BM25 retrieval algorithm and transformer-based bi-encoder and cross-encoder to effectively rank the documents with respect to the given query. We present experimental results from our participation in the Multilingual Information Access (MLIA) shared task on COVID-19 multilingual semantic search. The independently evaluated MLIA results validate our approach and demonstrate that it outperforms other state-of-the-art approaches according to nearly all evaluation metrics in cases of both monolingual and bilingual runs.
Project description:The information that people need to protect and manage their own health and the health of those for whom they are responsible is a fundamental element of an effective people-centred healthcare system. Achieving universal health coverage (UHC) requires universal access to essential health information. While it was recently recognised by the World Medical Association, universal access to essential health information is not yet reflected in official monitoring of progress on UHC for the sustainable development goals (SDGs). In this paper, we outline key features that characterise universal access to essential health information and indicate how it is increasingly achievable. We highlight the growing evidence of the impact of wider access to practical and actionable information on health for the public, carers and frontline health workers and provide illustrative, evidence-based, examples of how increasing access to essential health information can accelerate the achievement of UHC and other health targets of the SDGs. The paper ends with an assessment of reasons why universal access to essential health information has not yet been achieved, and an associated call to action to key stakeholders-such as governments, multilaterals, funding bodies, policy-makers, health professionals and knowledge intermediaries-to explicitly recognise the foundational role of universal access to essential health information for achieving UHC and the rest of the health SDGs, to include it in the relevant SDG target and associated monitoring indicators, and to incorporate actions in their own policies and programmes to promote and enable this access.