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Article: Understanding Barriers and Facilitators to Living Kidney Donation Within a Sociotechnical Systems Framework.

Crenshaw, Rachel / Woods, Cary / Koizumi, Naoru / Dave, Hitarth S / Gentili, Monica / Saleem, Jason J

2024 , Page(s) 10497323231224706

Abstract: The objective of this study was to investigate factors influencing one's decision to become a live kidney donor under the framework of sociotechnical systems, by expanding the focus to include larger organizational influences and technological ... ...

Abstract	The objective of this study was to investigate factors influencing one's decision to become a live kidney donor under the framework of sociotechnical systems, by expanding the focus to include larger organizational influences and technological considerations. Semi-structured interviews were conducted with live kidney donors who donated through University of Louisville Health, Trager Transplant Center, a mid-scale transplant program, in the years 2017 through 2019. The interview transcripts were analyzed for barriers and facilitators to live kidney donation within a sociotechnical system. The most salient facilitators included: having an informative, caring, and available care team; the absence of any negative external pressure toward donating; donating to a family or friend; and the ability to take extra time off work for recovery. The most recurrent barriers included: short/medium-term (<1 year) negative health impacts because of donation; the need to make minor lifestyle changes (e.g., less alcohol consumption) after donation; and mental health deterioration stemming from the donation process. The sociotechnical systems framework promotes a balanced system comprised of social, technical, and environmental subsystems. Assessing the facilitators and barriers from the sociotechnical system perspective revealed the importance of and opportunities for developing strategies to promote integration of technical subsystem, such as social media apps and interactive AI platforms, with social and environmental subsystems to enable facilitators and reduce barriers effectively.
Language	English
Publishing date	2024-01-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1275716-0
ISSN	1552-7557 ; 1049-7323
ISSN (online)	1552-7557
ISSN	1049-7323
DOI	10.1177/10497323231224706
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Article: Automated Text Messaging During COVID-19: Patient Feedback to Increase Adoption.

Whealin, Julia M / Saleem, Jason J / Armstrong, Christina M / Roth, Jennifer / Herout, Jennifer

Journal of technology in behavioral science

2023 , Page(s) 1–11

Abstract: Automated text messaging interventions can effectively improve self-care and were used to support the U.S. Veterans Health Administration's (VHA) public health outreach during the COVID pandemic. Currently, significant gaps exist in knowledge about VHA ... ...

Abstract	Automated text messaging interventions can effectively improve self-care and were used to support the U.S. Veterans Health Administration's (VHA) public health outreach during the COVID pandemic. Currently, significant gaps exist in knowledge about VHA patients' texting protocol preferences that may impact user receptivity, engagement, and effectiveness. This study qualitatively evaluated patient suggestions to improve two VHA Covid-related texting interventions and preferences for future text message protocols. We reviewed cross-sectional type-written survey responses from patients receiving either the "Coronavirus Precautions" or the "Coping During COVID" multi-week text protocols. Two team members independently and inductively coded all responses allowing for an upward abstraction of qualitative data. Nine hundred five patients (72.8% male) responded to the open-response item questions targeted by this research. An item that sought feedback to improve protocol acceptability generated thirteen distinct descriptive categories (inter-rater reliability 83.5%). Codable feedback showed, for example, that patients desired to manipulate message frequency and to have a more sophisticated interaction with messages. Patients' suggestions for future automated text messaging protocols yielded nine distinct topic areas. Patients offered suggestions that may impact receptivity and engagement of future automated text message protocols, particularly as they relate to outreach during a public health crisis. In addition, patients offered specific topics they would like to see in future text message protocols. We discuss how the findings can be used to increase engagement in current and post-pandemic public health interventions.
Language	English
Publishing date	2023-02-23
Publishing country	Switzerland
Document type	Journal Article
ISSN	2366-5963
ISSN	2366-5963
DOI	10.1007/s41347-023-00305-6
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Article ; Online: Veteran and Staff Experience from a Pilot Program of Health Care System-Distributed Wearable Devices and Data Sharing.

Saleem, Jason J / Wilck, Nancy R / Murphy, John J / Herout, Jennifer

Applied clinical informatics

2022 Volume 13, Issue 3, Page(s) 532–540

Abstract: Objective: The growing trend to use wearable devices to track activity and health data has the potential to positively impact the patient experience with their health care at home and with their care team. As part of a pilot program, the U.S. Department ...

Abstract	Objective: The growing trend to use wearable devices to track activity and health data has the potential to positively impact the patient experience with their health care at home and with their care team. As part of a pilot program, the U.S. Department of Veterans Affairs (VA) distributed Fitbits to Veterans through four VA medical centers. Our objective was to assess the program from both Veterans' and clinicians' viewpoints. Specifically, we aimed to understand barriers to Fitbit setup and use for Veterans, including syncing devices with a VA mobile application (app) to share data, and assess the perceived value of the device functions and ability to share information from the Fitbit with their care team. In addition, we explored the clinicians' perspective, including how they expected to use the patient-generated health data (PGHD). Methods: We performed semi-structured interviews with 26 Veterans and 16 VA clinicians to assess the program. Responses to each question were summarized in order of frequency of occurrence across participants and audited by an independent analyst for accuracy. Results: Our findings reveal that despite setup challenges, there is support for the use of Fitbits to engage Veterans and help manage their health. Clinicians believed there were benefits for having Veterans use the Fitbits and expected to use the PGHD in a variety of ways as part of the Veterans' care plans, including monitoring progress toward health behavior goals. Veterans were overwhelmingly enthusiastic about using the Fitbits; this enthusiasm seems to extend beyond the 3 month "novelty period." Conclusion: The pilot program for distributing Fitbits to Veterans appears to be successful from both Veterans' and clinicians' perspectives and suggests that expanded use of wearable devices should be considered. Future studies will need to carefully consider how to incorporate the PGHD into the electronic health record and clinical workflow.
MeSH term(s)	Delivery of Health Care ; Humans ; Information Dissemination ; Pilot Projects ; United States ; United States Department of Veterans Affairs ; Veterans ; Wearable Electronic Devices
Language	English
Publishing date	2022-05-25
Publishing country	Germany
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	1869-0327
ISSN (online)	1869-0327
DOI	10.1055/s-0042-1748857
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Article ; Online: Performance, workload, and usability in a multiscreen, multi-device, information-rich environment.

Saleem, Jason J / Weiler, Dustin T

PeerJ. Computer science

2018 Volume 4, Page(s) e162

Abstract: Potential benefits of multiscreen and multiple device environments were assessed using three different computing environments. A single factor, within-subject study was conducted with 18 engineering students in a laboratory experiment. Three levels for ... ...

Abstract	Potential benefits of multiscreen and multiple device environments were assessed using three different computing environments. A single factor, within-subject study was conducted with 18 engineering students in a laboratory experiment. Three levels for the computing environment factor included one with a desktop computer with a single monitor (control, condition A); one with a desktop with dual monitors, as well as a single tablet computer (condition B); and one with a desktop with a single monitor, as well as two tablet computers (condition C). There was no statistically significant difference in efficiency or workload when completing scenarios for the three computing environments. However, a dual monitor desktop with a single tablet computer (B) was the ideal computing environment for the information-rich engineering problem given to participants, supported by significantly fewer errors compared to condition C and significantly higher usability ratings compared to conditions A and C. A single desktop monitor with two tablet computers (C) did not provide any advantage compared to a single desktop monitor (A).
Language	English
Publishing date	2018-09-10
Publishing country	United States
Document type	Journal Article
ISSN	2376-5992
ISSN (online)	2376-5992
DOI	10.7717/peerj-cs.162
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Article ; Online: Ten factors to consider when developing usability scenarios and tasks for health information technology.

Russ, Alissa L / Saleem, Jason J

Journal of biomedical informatics

2018 Volume 78, Page(s) 123–133

Abstract: The quality of usability testing is highly dependent upon the associated usability scenarios. To promote usability testing as part of electronic health record (EHR) certification, the Office of the National Coordinator (ONC) for Health Information ... ...

Abstract	The quality of usability testing is highly dependent upon the associated usability scenarios. To promote usability testing as part of electronic health record (EHR) certification, the Office of the National Coordinator (ONC) for Health Information Technology requires that vendors test specific capabilities of EHRs with clinical end-users and report their usability testing process - including the test scenarios used - along with the results. The ONC outlines basic expectations for usability testing, but there is little guidance in usability texts or scientific literature on how to develop usability scenarios for healthcare applications. The objective of this article is to outline key factors to consider when developing usability scenarios and tasks to evaluate computer-interface based health information technologies. To achieve this goal, we draw upon a decade of our experience conducting usability tests with a variety of healthcare applications and a wide range of end-users, to include healthcare professionals as well as patients. We discuss 10 key factors that influence scenario development: objectives of usability testing; roles of end-user(s); target performance goals; evaluation time constraints; clinical focus; fidelity; scenario-related bias and confounders; embedded probes; minimize risks to end-users; and healthcare related outcome measures. For each factor, we present an illustrative example. This article is intended to aid usability researchers and practitioners in their efforts to advance health information technologies. The article provides broad guidance on usability scenario development and can be applied to a wide range of clinical information systems and applications.
MeSH term(s)	Computer Systems ; Electronic Health Records/standards ; Humans ; Medical Informatics/standards ; User-Computer Interface
Language	English
Publishing date	2018-01-09
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2057141-0
ISSN	1532-0480 ; 1532-0464
ISSN (online)	1532-0480
ISSN	1532-0464
DOI	10.1016/j.jbi.2018.01.001
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Article ; Online: Clinician Perspectives on Unmet Needs for Mobile Technology Among Hospitalists: Workflow Analysis Based on Semistructured Interviews.

Savoy, April / Saleem, Jason J / Barker, Barry C / Patel, Himalaya / Kara, Areeba

JMIR human factors

2022 Volume 9, Issue 1, Page(s) e28783

Abstract: Background: The hospitalist workday is cognitively demanding and dominated by activities away from patients' bedsides. Although mobile technologies are offered as solutions, clinicians report lower expectations of mobile technology after actual use.: ... ...

Abstract	Background: The hospitalist workday is cognitively demanding and dominated by activities away from patients' bedsides. Although mobile technologies are offered as solutions, clinicians report lower expectations of mobile technology after actual use. Objective: The purpose of this study is to better understand opportunities for integrating mobile technology and apps into hospitalists' workflows. We aim to identify difficult tasks and contextual factors that introduce inefficiencies and characterize hospitalists' perspectives on mobile technology and apps. Methods: We conducted a workflow analysis based on semistructured interviews. At a Midwestern US medical center, we recruited physicians and nurse practitioners from hospitalist and inpatient teaching teams and internal medicine residents. Interviews focused on tasks perceived as frequent, redundant, and difficult. Additionally, participants were asked to describe opportunities for mobile technology interventions. We analyzed contributing factors, impacted workflows, and mobile app ideas. Results: Over 3 months, we interviewed 12 hospitalists. Participants collectively identified chart reviews, orders, and documentation as the most frequent, redundant, and difficult tasks. Based on those tasks, the intake, discharge, and rounding workflows were characterized as difficult and inefficient. The difficulty was associated with a lack of access to electronic health records at the bedside. Contributing factors for inefficiencies were poor usability and inconsistent availability of health information technology combined with organizational policies. Participants thought mobile apps designed to improve team communications would be most beneficial. Based on our analysis, mobile apps focused on data entry and presentation supporting specific tasks should also be prioritized. Conclusions: Based on our results, there are prioritized opportunities for mobile technology to decrease difficulty and increase the efficiency of hospitalists' workflows. Mobile technology and task-specific mobile apps with enhanced usability could decrease overreliance on hospitalists' memory and fragmentation of clinical tasks across locations. This study informs the design and implementation processes of future health information technologies to improve continuity in hospital-based medicine.
Language	English
Publishing date	2022-01-04
Publishing country	Canada
Document type	Journal Article
ISSN	2292-9495
ISSN (online)	2292-9495
DOI	10.2196/28783
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Article: Veteran and Staff Experience from a Pilot Program of Health Care System–Distributed Wearable Devices and Data Sharing

Saleem, Jason J. / Wilck, Nancy R. / Murphy, John J. / Herout, Jennifer

Applied Clinical Informatics

2022 Volume 13, Issue 03, Page(s) 532–540

Abstract	Objective: The growing trend to use wearable devices to track activity and health data has the potential to positively impact the patient experience with their health care at home and with their care team. As part of a pilot program, the U.S. Department of Veterans Affairs (VA) distributed Fitbits to Veterans through four VA medical centers. Our objective was to assess the program from both Veterans' and clinicians' viewpoints. Specifically, we aimed to understand barriers to Fitbit setup and use for Veterans, including syncing devices with a VA mobile application (app) to share data, and assess the perceived value of the device functions and ability to share information from the Fitbit with their care team. In addition, we explored the clinicians' perspective, including how they expected to use the patient-generated health data (PGHD). Methods: We performed semi-structured interviews with 26 Veterans and 16 VA clinicians to assess the program. Responses to each question were summarized in order of frequency of occurrence across participants and audited by an independent analyst for accuracy. Results: Our findings reveal that despite setup challenges, there is support for the use of Fitbits to engage Veterans and help manage their health. Clinicians believed there were benefits for having Veterans use the Fitbits and expected to use the PGHD in a variety of ways as part of the Veterans' care plans, including monitoring progress toward health behavior goals. Veterans were overwhelmingly enthusiastic about using the Fitbits; this enthusiasm seems to extend beyond the 3 month “novelty period.” Conclusion: The pilot program for distributing Fitbits to Veterans appears to be successful from both Veterans' and clinicians' perspectives and suggests that expanded use of wearable devices should be considered. Future studies will need to carefully consider how to incorporate the PGHD into the electronic health record and clinical workflow.
Keywords	remote monitoring ; wearable device ; patient-generated health data ; virtual care
Language	English
Publishing date	2022-05-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ISSN	1869-0327
ISSN (online)	1869-0327
DOI	10.1055/s-0042-1748857
Database	Thieme publisher's database

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Article ; Online: Development and cross-sectional evaluation of a text message protocol to support mental health well-being.

Whealin, Julia M / Saleem, Jason J / Vetter, Brian / Roth, Jennifer / Herout, Jennifer

Psychological services

2021 Volume 20, Issue 3, Page(s) 657–667

Abstract: Coping with stressors related to the coronavirus disease (COVID) pandemic has caused major mental health challenges. Text message interventions are identified as helpful for promoting health behavior self-management. Drawing from cognitive-behavioral ... ...

Abstract	Coping with stressors related to the coronavirus disease (COVID) pandemic has caused major mental health challenges. Text message interventions are identified as helpful for promoting health behavior self-management. Drawing from cognitive-behavioral theory (CBT), U.S. Veterans Health Administration staff developed a 20-week automated text messaging protocol called "Coping During COVID" to support veterans' self-care during the pandemic. This project evaluated attitudes about and perceived helpfulness of the protocol among 651 veterans. A cross-sectional evaluation quantitatively assessed COVID-related stressors as well as reported use, acceptability, attitudes, and perceived helpfulness of the protocol via a self-administered online questionnaire. Open-ended questions assessed perceived helpfulness/unhelpfulness of the protocol. Of the 651 veterans (22% of those enrolled in the protocol) who responded to the survey, 73.1% were male and 88.5% were 50 years or over. Ninety percent found the protocol messages helpful and about half endorsed various additional benefits, including feeling better, being more educated about coping behaviors, and being better able to focus on positive thoughts. Qualitative feedback was overwhelmingly positive. For example, veterans stated that the protocol "was like having a personal coach giving hints and tips to cope with the boredom every day," that it "gave me reminders of skills I was not using. It helped me focus on the positives," and brought relief from "many hopeless and sad thoughts … the messages from Annie have been a Godsend to me." Overall results suggested that the Coping During COVID text messaging protocol successfully supported the majority of respondents' self-care efforts during the COVID pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
MeSH term(s)	Humans ; Male ; Female ; Text Messaging ; Mental Health ; Cross-Sectional Studies ; COVID-19 ; Adaptation, Psychological
Language	English
Publishing date	2021-12-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2156662-8
ISSN	1939-148X ; 1541-1559
ISSN (online)	1939-148X
ISSN	1541-1559
DOI	10.1037/ser0000601
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Article ; Online: The effect of role assignment in high fidelity patient simulation on nursing students: An experimental research study.

Weiler, Dustin T / Gibson, Andrea L / Saleem, Jason J

Nurse education today

2018 Volume 63, Page(s) 29–34

Abstract: Background: Previous studies have evaluated the effectiveness of high fidelity patient simulators (HFPS) on nursing training; however, a gap exists on the effects of role assignment on critical thinking, self-efficacy, and situation awareness skills in ... ...

Abstract	Background: Previous studies have evaluated the effectiveness of high fidelity patient simulators (HFPS) on nursing training; however, a gap exists on the effects of role assignment on critical thinking, self-efficacy, and situation awareness skills in team-based simulation scenarios. Objectives: This study aims to determine if role assignment and the involvement level related to the roles yields significant effects and differences in critical thinking, situation awareness and self-efficacy scores in team-based high-fidelity simulation scenarios. Design: A single factorial design with five levels and random assignment was utilized. Setting: A public university-sponsored simulation center in the United States of America. Participants: A convenience sample of 69 junior-level baccalaureate nursing students was recruited for participation. Methods: Participants were randomly assigned one of five possible roles and completed pre-simulation critical thinking and self-efficacy assessments prior to the simulation beginning. Playing within their assigned roles, participants experienced post-partum hemorrhaging scenario using an HFPS. After completing the simulation, participants completed a situation awareness assessment and a post-simulation critical thinking and self-efficacy assessment. Results: Role assignment was found to have a statistically significant effect on critical thinking skills and a statistically significant difference in various areas of self-efficacy was also noted. However, no statistical significance in situation awareness abilities was found. Conclusions: Results support the notion that certain roles required the participant to be more involved with the simulation scenario, which may have yielded higher critical thinking and self-efficacy scores than roles that required a lesser level of involvement.
MeSH term(s)	Awareness ; Clinical Competence ; Education, Nursing, Baccalaureate ; Female ; High Fidelity Simulation Training/methods ; Humans ; Male ; Self Efficacy ; Students, Nursing/psychology ; Thinking ; United States
Language	English
Publishing date	2018-04
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1062570-7
ISSN	1532-2793 ; 0260-6917
ISSN (online)	1532-2793
ISSN	0260-6917
DOI	10.1016/j.nedt.2018.01.012
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Article ; Online: Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta-analysis.

Saleem, Kanwal / Ting, Ee Lynn / Loh, Andre J W / Baggaley, Rachel / Mello, Maeve B / Jamil, Muhammad S / Barr-Dichiara, Magdalena / Johnson, Cheryl / Gottlieb, Sami L / Fairley, Christopher K / Chow, Eric P F / Ong, Jason J

Journal of the International AIDS Society

2023 Volume 26, Issue 4, Page(s) e26049

Abstract: Introduction: Of 37.7 million people living with HIV in 2020, 6.1 million still do not know their HIV status. We synthesize evidence on concurrent HIV testing among people who tested for other sexually transmitted infections (STIs).: Methods: We ... ...

Abstract	Introduction: Of 37.7 million people living with HIV in 2020, 6.1 million still do not know their HIV status. We synthesize evidence on concurrent HIV testing among people who tested for other sexually transmitted infections (STIs). Methods: We conducted a systematic review using five databases, HIV conferences and clinical trial registries. We included publications between 2010 and May 2021 that reported primary data on concurrent HIV/STI testing. We conducted a random-effects meta-analysis and meta-regression of the pooled proportion for concurrent HIV/STI testing. Results: We identified 96 eligible studies. Among those, 49 studies had relevant data for a meta-analysis. The remaining studies provided data on the acceptability, feasibility, barriers, facilitators, economic evaluation and social harms of concurrent HIV/STI testing. The pooled proportion of people tested for HIV among those attending an STI service (n = 18 studies) was 71.0% (95% confidence intervals: 61.0-80.1, I Discussion: This review found poor concurrent HIV/STI testing among those already diagnosed with an STI (35.3%) or who had symptoms with STIs (27.1%). Additionally, concurrent HIV/STI testing among those tested for STIs varied significantly according to the testing location, country income level and region of the world. A few potential reasons for these observations include differences in national STI-related policies, lack of standard operation procedures, clinician-level factors, poor awareness and adherence to HIV indicator condition-guided HIV testing and stigma associated with HIV compared to other curable STIs. Conclusions: Not testing for HIV among people using STI services presents a significant missed opportunity, particularly among those diagnosed with an STI. Stronger integration of HIV and STI services is urgently needed to improve prevention, early diagnosis and linkage to care services.
MeSH term(s)	Humans ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Sexual Behavior ; Sexual and Gender Minorities ; HIV Testing
Language	English
Publishing date	2023-05-05
Publishing country	Switzerland
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	2467110-1
ISSN	1758-2652 ; 1758-2652
ISSN (online)	1758-2652
ISSN	1758-2652
DOI	10.1002/jia2.26049
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