An experience selecting quality features of apps for people with disabilities using abductive approach to explanatory theory generation.
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ABSTRACT:
SUBMITTER: Larco A
PROVIDER: S-EPMC8356648 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundOver 1.3 billion people, or 16% of the world's population, live with some form of disability. Recent studies have reported that people with disabilities (PwD) might not be receiving state-of-the-art treatment for cancer as their non-disabled peers; our objective was to systematically review this topic.MethodsA systematic review was undertaken to compare cancer outcomes and quality of cancer care between adults with and without disabilities (NIHR Prospero register ID number: CRD42022281506). A search of the literature was performed in July 2022 across five databases: EMBASE, Medline, Cochrane Library, Web of Science and CINAHL databases. Peer-reviewed quantitative research articles, published in English from 2000 to 2022, with interventional or observational study designs, comparing cancer outcomes between a sample of adult patients with disabilities and a sample without disabilities were included. Studies focused on cancer screening and not treatment were excluded, as well as editorials, commentaries, opinion papers, reviews, case reports, case series under 10 patients and conference abstracts. Studies were evaluated by one reviewer for risk of bias based on a set of criteria according to the SIGN 50 guidelines. A narrative synthesis was conducted according to the Cochrane SWiM guidelines, with tables summarizing study characteristics and outcomes. This research received no external funding.ResultsThirty-one studies were included in the systematic review. Compared to people without disabilities, PwD had worse cancer outcomes, in terms of poorer survival and higher overall and cancer-specific mortality. There was also evidence that PwD received poorer quality cancer care, including lower access to state-of-the-art care or curative-intent therapies, treatment delays, undertreatment or excessively invasive treatment, worse access to in-hospital services, less specialist healthcare utilization, less access to pain medications and inadequate end-of-life quality of care.DiscussionLimitations of this work include the exclusion of qualitative research, no assessment of publication bias, selection performed by only one reviewer, results from high-income countries only, no meta-analysis and a high risk of bias in 15% of included studies. In spite of these limitations, our results show that PwD often experience severe disparities in cancer care with less guideline-consistent care and higher mortality than people without disabilities. These findings raise urgent questions about how to ensure equitable care for PwD; in order to prevent avoidable morbidity and mortality, cancer care programs need to be evaluated and urgently improved, with specific training of clinical staff, more disability inclusive research, better communication and shared decision-making with patients and elimination of physical, social and cultural barriers.
| S-EPMC10718463 | biostudies-literature
Project description:Item quality is crucial to psychometric analyses for cognitive diagnosis. In cognitive diagnosis models (CDMs), item quality is often quantified in terms of item parameters (e.g., guessing and slipping parameters). Calibrating the item parameters with only item response data, as a common practice, could result in challenges in identifying the cause of low-quality items (e.g., the correct answer is easy to be guessed) or devising an effective plan to improve the item quality. To resolve these challenges, we propose the item explanatory CDMs where the CDM item parameters are explained with item features such that item features can serve as an additional source of information for item parameters. The utility of the proposed models is demonstrated with the Trends in International Mathematics and Science Study (TIMSS)-released items and response data: around 20 item linguistic features were extracted from the item stem with natural language processing techniques, and the item feature engineering process is elaborated in the paper. The proposed models are used to examine the relationships between the guessing/slipping item parameters of the higher-order DINA model and eight of the item features. The findings from a follow-up simulation study are presented, which corroborate the validity of the inferences drawn from the empirical data analysis. Finally, future research directions are discussed.
| S-EPMC10971092 | biostudies-literature
Project description:BackgroundLow milk production is one of the main reasons for premature breastfeeding cessation. Smartphone apps have the potential to assist mothers with promoting, interpreting, tracking, or learning about milk production. It is not known whether breastfeeding apps contain high-quality, engaging, and diverse content and features that could be used by mothers to increase their breastfeeding self-efficacy and answer their questions about milk production.ObjectiveThe overarching objective of this study was to identify and evaluate features and content within breastfeeding apps that could be used by mothers to increase breastfeeding self-efficacy and answer their questions about milk production. The secondary objectives were to quantify the diversity of representation of breastfeeding experiences within breastfeeding apps and to define the type of organization that is most likely to create free apps and/or apps with high-quality, engaging, and diverse features and content related to milk production.MethodsBreastfeeding apps were identified in the Apple App Store. All features that assist mothers with tracking, promoting, or interpreting milk production in the first 0-6 months postpartum were noted. Every screen containing educational information about milk production was identified and saved for review. Images of mothers and caretakers within the selected screenshots were assessed. Three scoresheets informed by Social Cognitive Theory were created to evaluate all identified features, educational content, and images representing the breastfeeding experience.ResultsForty-one breastfeeding apps were reviewed. Only seven apps contained both features and educational content related to milk production. Thirteen apps that contained educational content related to milk production received a mean combined content and cultural diversity score of 15.3 of 78. Of the 48 photos reviewed in screenshots that contained educational content on milk production, 87.5% (n=42) were of white women and their infants. For-profit companies and large organizations were most likely to create free apps and apps that received high scores on the combined content and diversity or features scoresheet, respectively.ConclusionsFeatures and educational content related to milk production and breastfeeding imagery within breastfeeding apps were evaluated using three novel scoresheets informed by Social Cognitive Theory. Few apps contained both features that promote breastfeeding self-efficacy and high-quality, engaging, educational content with images of diverse caretakers. Thus, it is likely that parents, especially those from minority or low-income groups, have limited options when selecting a breastfeeding app. App developers could use the scoresheets and findings in this review to develop breastfeeding apps that assist mothers with interpreting, tracking, or learning about milk production through high-quality and engaging features, content, and imagery.
| S-EPMC6715395 | biostudies-literature
Project description:‘All models are wrong but some are useful’ Box (Robustness in statistics, Elsevier, pp 201–236, 1979). But, how to find those useful ones starting from an imperfect model? How to make informed data-driven decisions equipped with an imperfect model? These fundamental questions appear to be pervasive in virtually all empirical fields—including economics, finance, marketing, healthcare, climate change, defense planning, and operations research. This article presents a modern approach (builds on two core ideas: abductive thinking and density-sharpening principle) and practical guidelines to tackle these issues in a systematic manner. Supplementary Information The online version contains supplementary material available at 10.1007/s10203-023-00390-5.
| S-EPMC10062281 | biostudies-literature
Project description:Use of patient-reported outcome measures (PROMs) may increase the involvement of young people with developmental disabilities in their healthcare decisions and healthcare-related research. Young people with developmental disabilities may have difficulty completing PROMs because of extraneous assessment demands that require additional cognitive processes. However, PROM design features may mitigate the impact of these demands. We identified and evaluated six pediatric PROMs of self-care and domestic life tasks for the incorporation of suggested design features that can reduce cognitive demands. PROMs incorporated an average of 6 out of 11 content, 7 out of 14 layout, and 2 out of 9 administration features. This critical review identified two primary gaps in PROM design: (1) examples and visuals were not optimized to reduce cognitive demands; and (2) administration features that support young people's motivation and self-efficacy and reduce frustration were underutilized. Because assessment demands impact the validity of PROMs, clinicians should prospectively consider the impact of these demands when selecting PROMs and interpreting scores. WHAT THIS PAPER ADDS:Patient-reported outcome measure (PROM) design features can reduce assessment demands related to cognitive processes. Pediatric PROMs underutilize design features that decrease cognitive demands of self-reporting.
| S-EPMC5771952 | biostudies-literature
Project description:People with intellectual disabilities (ID) depend on their environment for support to live healthily. The characteristics of healthy settings for people with ID are unknown. This study aims to conceptualize healthy settings for people with ID by conducting an international and multidisciplinary concept mapping study. As theoretical framework the settings approach, an ecological model with a whole system focus toward health promotion, was used. The integrative mixed-methods approach of this study involved concept mapping with researchers specialized in healthcare for people with ID and researchers specialized in healthy settings. The 41 participants generated statements that were later sorted and rated. Findings encompass 13 clusters relating to the social environment, the physical environment and societal preconditions. Specific factors of healthy settings for people with ID include: (i) universal design of the physical environment, (ii) the role of care professionals in the social environment to empower people with ID, (iii) possibilities for care providers to contribute to a health-promoting setting and (iv) preconditions that allow people to engage in society. These factors can be used in strategies to apply the approach in practice and give directions to put in place policies on developing enabling environments and decreasing health inequities.
| S-EPMC7414853 | biostudies-literature
Project description: Not available
| S-EPMC6543590 | biostudies-literature
Project description:BACKGROUND:Persons with speech, language, and/or voice disabilities (collectively referred to as communication disabilities (CD)) represent 10% of the US population, yet their healthcare outcomes have not been described. Generally, research shows that persons with disabilities have poorer health and healthcare outcomes than their non-disabled peers. OBJECTIVES:To examine the health and healthcare outcomes of persons with CD compared to persons without CD. DESIGN:Retrospective cohort study of the 2012 National Health Interview Survey, which contained the first supplemental questions on CD. We compared proportional differences in outcomes; logistic and ordered logistic regression assessed the outcome measures across CD categories, controlling for demographics, non-communication disabilities, and chronic conditions. Findings are weighted to permit national inferences. PARTICIPANTS:Adults (??18 years old) were divided into 4 mutually exclusive groups: people with voice disabilities only; speech/language disabilities only; speech/language and voice disabilities; and people without CD. MAIN MEASURES:Chronic health conditions; self-rated health; access to care; unmet needs for care; healthcare utilization. KEY RESULTS:Adults with CD more frequently had ??1 chronic condition (voice 67.9%, speech/language 68.6%, speech/language and voice 79.9%, no CD 50.1%, p?<?0.001) and reported fair/poor health (voice 19.5%, speech/language 32.5%, speech/language and voice 48.3%, no CD 11.2%, p?<?0.001) compared to those without CD. Adults with CD more frequently utilized healthcare compared to those without CD. However, persons with CD endorsed greater difficulties accessing care than those without CD, including identifying a usual source of care, trouble finding a physician, and delaying or foregoing care (e.g., delayed due to availability of care: voice 26.1%, speech/language 37.2%, speech/language and voice 30.8% no CD 16.1%, p?<?0.001). CONCLUSIONS:Persons with CD are medically complex and experience greater challenges accessing healthcare than persons without CD. Healthcare providers need support and tools to provide equitable care that addresses the medical needs of persons with CD.
| S-EPMC6258615 | biostudies-literature
Project description:Radiology specific clinical decision support systems (CDSS) and artificial intelligence are poorly integrated into the radiologist workflow. Current research and development efforts of radiology CDSS focus on 4 main interventions, based around exam centric time points-after image acquisition, intra-report support, post-report analysis, and radiology workflow adjacent. We review the literature surrounding CDSS tools in these time points, requirements for CDSS workflow augmentation, and technologies that support clinician to computer workflow augmentation. We develop a theory of radiologist-decision tool interaction using a sequential explanatory study design. The study consists of 2 phases, the first a quantitative survey and the second a qualitative interview study. The phase 1 survey identifies differences between average users and radiologist users in software interventions using the User Acceptance of Information Technology: Toward a Unified View (UTAUT) framework. Phase 2 semi-structured interviews provide narratives on why these differences are found. To build this theory, we propose a novel solution called Radibot-a conversational agent capable of engaging clinicians with CDSS as an assistant using existing instant messaging systems supporting hospital communications. This work contributes an understanding of how radiologist-users differ from the average user and can be utilized by software developers to increase satisfaction of CDSS tools within radiology.
| S-EPMC10896537 | biostudies-literature
Project description:Knowledge sharing positively and significantly improves academics' research, instruction and community service. The study of knowledge sharing in Saudi higher education is limited and offers little guidance to administrators, as well as faculty on how to capitalize on knowledge sharing and utilize it to their own and organizations' benefits. This research presents findings from an original quantitative study testing a structural equation model linking social cognitive theory to knowledge sharing collection and donation measured by validated scales from the extant literature. Community characteristics including altruism and reputation carry significant positive effects on knowledge sharing collection and donation. Similarly, personal outcomes expectations possess a moderate positive effect on knowledge sharing collection and donation. Self-efficacy in knowledge sharing emerged as an important predictor of knowledge sharing activities among Saudi academics. The findings suggest the need for developing professional training seminars on using social media for knowledge sharing in formal departmental and college settings. Further, the results confirm the relevance of social cognitive theory for the study of knowledge sharing. This creates the need for Saudi universities to invest in mentorship programs using digital platforms where personal and community outcomes' expectations are likely to improve among academics thereby increasing knowledge sharing activity.
| S-EPMC7978371 | biostudies-literature