E-shopping changes and the state of E-grocery shopping in the US - Evidence from national travel and time use surveys

ObjectivesAlthough research shows that public health is substantially affected during and after disasters, few studies have examined the health effects of Hurricane Harvey, which made landfall on t...

Disparities in Health Effects and Access to Health Care Among Houston Area Residents After Hurricane Harvey.

Latino populations are disproportionately impacted by health disparities and face both connectivity and health literacy challenges. As evidenced by the current global pandemic, access to reliable online health-related information and the ability to apply that information is critical to achieving health equity. Through a qualitative study on how Latino families collaborate to access online health resources, this work frames health literacy as a family-level mechanism. Interviews with parent-child dyads combined with online search tasks reveal how families integrate their individual skillsets to obtain, process, and understand online information about illnesses, symptoms, and even medical diagnoses. As they engage in intergenerational online health information searching and brokering, families creatively navigate information and communication technologies (ICTs) to address a range of health needs. Bilingual children help immigrant parents obtain urgent and non-urgent health information needed to care for other family members. When children are tasked with addressing a health need critical to their parent's wellbeing, they collaborate with their parents to obtain, interpret, and apply online health information. Intergenerational online health information searching and brokering thus reveals family-level strengths that can be leveraged to promote both health and digital literacy among marginalized populations.

Intergenerational Online Health Information Searching and Brokering: Framing Health Literacy as a Family Asset.

An unhealthy diet is among the leading global causes of death and disability. Globally, a range of policies are being implemented to support healthy food choices at a population level, including novel polices in the areas of food marketing, nutrition labelling, and taxation of less healthy foods. There is a need to evaluate and inform the implementation of these policies, including their impact on marginalized population subgroups. The International Food Policy Study (IFPS) consists of repeated cross-sectional surveys conducted in five high and upper-middle income countries: Australia, Canada, Mexico, the United Kingdom, and the United States. In each country, approximately 4000 adults and 1200 children and youth (aged 10-17) were recruited from a global commercial panel to complete an online survey using consistent measures and methodologies across countries. The first annual IFPS surveys were conducted in 2017 with adults; annual surveys for young people aged 10-17 were launched in 2019 in the same countries, as well as Chile. The design of the IFPS surveys creates a framework for evaluating 'natural experiments' in food policies, including comparisons over time within countries implementing the policy, and comparisons with countries in which the policy was not implemented. IFPS surveys have three primary areas of focus: 1) knowledge, attitudes, and beliefs associated with specific policies; 2) diet-related behaviours; and 3) dietary intake, including 24-hour dietary recalls for adults in four of five countries. Surveys also assess food insecurity, income adequacy, sex and gender, race/ethnicity and a range of other measures to assess trends among priority subgroups. Overall, the IFPS project has the potential to address important gaps in national monitoring surveys for dietary patterns, and to evaluate the impact of novel food policies implemented in any of the five countries over the study period.

The Conceptual Framework for the International Food Policy Study: Evaluating the population-level Impact of Food Policy.

The aim of this study was to evaluate an automated trigger algorithm designed to detect potentially adverse events in children with Attention-Deficit/Hyperactivity Disorder (ADHD), who were monitored remotely between visits. We embedded a trigger algorithm derived from parent-reported ADHD rating scales within an electronic patient monitoring system. We categorized clinicians’ alert resolution outcomes and compared Vanderbilt ADHD rating scale scores between patients who did or did not have triggered alerts. A total of 146 out of 1738 parent reports (8%) triggered alerts for 98 patients. One hundred and eleven alerts (76%) required immediate clinician review. Nurses successfully contacted parents for 68 (61%) of actionable alerts; 46% (31/68) led to a change in care plan prior to the next scheduled appointment. Compared to patients without alerts, patients with alerts demonstrated worsened ADHD severity (β = 5.8, 95% CI: 3.5–8.1 [p < 0.001] within 90 days prior to an alert. The trigger algorithm facilitated timely changes in the care plan in between face-to-face visits.

https://www.mdpi.com/2079-9721/7/1/20/pdf

Timely Interventions for Children with ADHD through Web-Based Monitoring Algorithms

Since 2007, the National Health Interview Survey (NHIS) Early Release Program has regularly released preliminary estimates of the percentages of adults and children living in homes with only wireless telephones (also known as cellular telephones, cell phones, or mobile phones). These estimates are the most upto-date estimates available from the federal government concerning the size and characteristics of this population. Estimates in this report are based on the second six months of 2019. During this time period, 61.3% of adults and 70.3% of children lived in wireless-only households. In January 2019, the NHIS launched a redesigned questionnaire. As a result, NHIS data can now be used to estimate the percentage of adults who live in wireless-only households and have their own wireless telephone (wireless-only adults). For July-December 2019, 60.3% of adults were wireless-only adults. Four in five adults aged 25–29 (81.7%) and aged 30-34 (81.1%), and three in four adults renting their homes (75.5%), were wireless-only adults.

Wireless substitution : early release of estimates From the National Health Interview Survey, July-December 2020


 
 National audits aim to reduce variations in quality by stimulating quality improvement. However, varying provider engagement with audit data means that this is not being realised.
 
 
 
 The aim of the study was to develop and evaluate a quality dashboard (i.e. QualDash) to support clinical teams’ and managers’ use of national audit data.
 
 
 
 The study was a realist evaluation and biography of artefacts study.
 
 
 
 The study involved five NHS acute trusts.
 
 
 
 In phase 1, we developed a theory of national audits through interviews. Data use was supported by data access, audit staff skilled to produce data visualisations, data timeliness and quality, and the importance of perceived metrics. Data were mainly used by clinical teams. Organisational-level staff questioned the legitimacy of national audits. In phase 2, QualDash was co-designed and the QualDash theory was developed. QualDash provides interactive customisable visualisations to enable the exploration of relationships between variables. Locating QualDash on site servers gave users control of data upload frequency. In phase 3, we developed an adoption strategy through focus groups. ‘Champions’, awareness-raising through e-bulletins and demonstrations, and quick reference tools were agreed. In phase 4, we tested the QualDash theory using a mixed-methods evaluation. Constraints on use were metric configurations that did not match users’ expectations, affecting champions’ willingness to promote QualDash, and limited computing resources. Easy customisability supported use. The greatest use was where data use was previously constrained. In these contexts, report preparation time was reduced and efforts to improve data quality were supported, although the interrupted time series analysis did not show improved data quality. Twenty-three questionnaires were returned, revealing positive perceptions of ease of use and usefulness. In phase 5, the feasibility of conducting a cluster randomised controlled trial of QualDash was assessed. Interviews were undertaken to understand how QualDash could be revised to support a region-wide Gold Command. Requirements included multiple real-time data sources and functionality to help to identify priorities.
 
 
 
 Audits seeking to widen engagement may find the following strategies beneficial: involving a range of professional groups in choosing metrics; real-time reporting; presenting ‘headline’ metrics important to organisational-level staff; using routinely collected clinical data to populate data fields; and dashboards that help staff to explore and report audit data. Those designing dashboards may find it beneficial to include the following: ‘at a glance’ visualisation of key metrics; visualisations configured in line with existing visualisations that teams use, with clear labelling; functionality that supports the creation of reports and presentations; the ability to explore relationships between variables and drill down to look at subgroups; and low requirements for computing resources. Organisations introducing a dashboard may find the following strategies beneficial: clinical champion to promote use; testing with real data by audit staff; establishing routines for integrating use into work practices; involving audit staff in adoption activities; and allowing customisation.
 
 
 
 The COVID-19 pandemic stopped phase 4 data collection, limiting our ability to further test and refine the QualDash theory. Questionnaire results should be treated with caution because of the small, possibly biased, sample. Control sites for the interrupted time series analysis were not possible because of research and development delays. One intervention site did not submit data. Limited uptake meant that assessing the impact on more measures was not appropriate.
 
 
 
 The extent to which national audit dashboards are used and the strategies national audits use to encourage uptake, a realist review of the impact of dashboards, and rigorous evaluations of the impact of dashboards and the effectiveness of adoption strategies should be explored.
 
 
 
 This study is registered as ISRCTN18289782.
 
 
 
 This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 12. See the NIHR Journals Library website for further project information.


Julian V. Lake

Papers

Wireless substitution : early release of estimates From the National Health Interview Survey, July-December 2020

Design and evaluation of an interactive quality dashboard for national clinical audit data: a realist evaluation