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An Ecological Approach to Smart Homes for Health Care Services: Conceptual Framework of a Smart Servicescape Wheel.

ABSTRACT: BACKGROUND:Smart homes are considered effective solutions for home health care for the elderly, as smart home technologies can reduce care costs and improve elderly residents' independence. To develop a greater understanding of smart homes for health care services (SHHSs), this study accentuated the necessity of ecological approaches with an emphasis on environmental constraints. This study was based on 2 rationales: (1) users are inclined to perceive the service quality and service experience from environments (ie, servicescape) owing to the intangibility of health care and the pervasiveness of smart home technologies, and (2) both service domains are complex adaptive systems in which diversified and undefined service experiences-not only a few intended service flows-can be generated by complex combinations of servicescape elements. OBJECTIVE:This study proposed the conceptual framework of a Smart Servicescape Wheel (SSW) as an ecological approach delineating the extensive spectrum of environmental constraints in SHHSs. METHODS:The SSW framework was established based on a literature review. RESULTS:Generally divided by perceptible and imperceptible servicescapes, the SSW consists of the perceptible Physical scape (ie, hardware components, environmental cues, and human states) and Social scape (ie, service relationships and social relationships) as well as the imperceptible Datascape (ie, computing intelligence, databases, and communication networks). Following the ecological approach, each category of the SSW is subdivided and defined at the level of components or functions. CONCLUSIONS:The SSW's strengths lie in the various application opportunities for SHHSs. In terms of service planning and development, the SSW can be utilized to (1) establish the requirements for SHHS development, (2) associate with work domain analysis by defining component layers, and (3) understand the real contexts of SHHSs for the enhanced prediction of diverse service experiences. Regarding service management, it can be applied to develop measurement items for the operation and evaluation of SHHSs.

SUBMITTER: Kang HJ

PROVIDER: S-EPMC6384540 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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An Ecological Approach to Smart Homes for Health Care Services: Conceptual Framework of a Smart Servicescape Wheel.

Kang Hyo-Jin HJ Han Jieun J Kwon Gyu Hyun GH

JMIR mHealth and uHealth 20190208 2

<h4>Background</h4>Smart homes are considered effective solutions for home health care for the elderly, as smart home technologies can reduce care costs and improve elderly residents' independence. To develop a greater understanding of smart homes for health care services (SHHSs), this study accentuated the necessity of ecological approaches with an emphasis on environmental constraints. This study was based on 2 rationales: (1) users are inclined to perceive the service quality and service expe ...[more]

PMID: 30735145

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Project description:BACKGROUND:With the 40th anniversary of the Declaration of Alma-Ata, a global effort is underway to re-focus on strengthening primary health care systems, with emphasis on leveraging community health workers (CHWs) towards the goal of achieving universal health coverage for all. Institutionalizing effective, sustainable community health systems is currently limited by a lack of standard metrics for measuring CHW performance and the systems they work within. Developed through iterative consultations, supported by the Bill & Melinda Gates Foundation and in partnership with USAID and UNICEF, this paper details a framework, list of indicators, and measurement considerations for monitoring CHW performance in low- and middle-income countries. METHODS:A review of peer-reviewed articles, reports, and global data collection tools was conducted to identify key measurement domains in monitoring CHW performance. Three consultations were successively convened with global stakeholders, community health implementers, advocates, measurement experts, and Ministry of Health representatives using a modified Delphi approach to build consensus on priority indicators. During this process, a structured, web-based survey was administered to identify the importance and value of specific measurement domains, sub-domains, and indicators determined through the literature reviews and initial stakeholder consultations. Indicators with more than 75% support from participants were further refined with expert qualitative input. RESULTS:Twenty-one sub-domains for measurement were identified including measurement of incentives for CHWs, supervision and performance appraisal, data use, data reporting, service delivery, quality of services, CHW absenteeism and attrition, community use of services, experience of services, referral/counter-referral, credibility/trust, and programmatic costs. Forty-six indicators were agreed upon to measure the sub-domains. In the absence of complete population enumeration and digitized health information systems, the quality of metrics to monitor CHW programs is limited. CONCLUSIONS:Better data collection approaches at the community level are needed to strengthen management of CHW programs and community health systems. The proposed list of metrics balances exhaustive and pragmatic measurement of CHW performance within primary healthcare systems. Adoption of the proposed framework and associated indicators by CHW program implementors may improve programmatic effectiveness, strengthen their accountability to national community health systems, drive programmatic quality improvement, and plausibly improve the impact of these programs.

Project description:Over the past century, the environment of the Gulf of Mexico has been significantly altered and impaired by extensive human activities. A national commitment to restore the Gulf was finally initiated in response to the unprecedented Deepwater Horizon oil spill in 2010. Consequently, there is a critical need for an assessment framework and associated set of indicators that can characterize the health and sustainability of an ecosystem having the scale and complexity of the Gulf. The assessment framework presented here was developed as an integration of previous ecological risk- and environmental management-based frameworks for assessing ecosystem health. It was designed to identify the natural and anthropogenic drivers, pressures, and stressors impinging on ecosystems and ecosystem services, and the ecological conditions that result, manifested as effects on valued ecosystem components. Four types of societal and ecological responses are identified: reduction of pressures and stressors, remediation of existing stressors, active ecosystem restoration, and natural ecological recovery. From this conceptual framework are derived the specific indicators to characterize ecological condition and progress toward achieving defined ecological health and sustainability goals. Additionally, the framework incorporates a hierarchical structure to communicate results to a diversity of audiences, from research scientists to environmental managers and decision makers, with the level of detail or aggregation appropriate for each targeted audience. Two proof-of-concept studies were conducted to test this integrated assessment and decision framework, a prototype Texas Coastal Ecosystems Report Card, and a pilot study on enhancing rookery islands in the Mission-Aransas Reserve, Texas, USA. This Drivers-Pressures-Stressors-Condition-Responses (DPSCR4 ) conceptual framework is a comprehensive conceptual model of the coupled human-ecological system. Much like its predecessor, the ecological risk assessment framework, the DPSCR4 conceptual framework can be tailored to different scales of complexity, different ecosystem types with different stress regimes, and different environmental settings. Integr Environ Assess Manag 2019;15:544-564. © 2019 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

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An Ecological Approach to Smart Homes for Health Care Services: Conceptual Framework of a Smart Servicescape Wheel.

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An Ecological Approach to Smart Homes for Health Care Services: Conceptual Framework of a Smart Servicescape Wheel.

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