Patients' Perspectives Regarding Digital Health Technology to Support Self-management and Improve Integrated Stroke Care: Qualitative Interview Study.

BACKGROUND: Digital technologies such as mobile apps and robotics have the potential to involve stroke patients better in the care process and to promote self-management. However, barriers exist that constrain the adoption and acceptance of technology in clinical practice. Examples of barriers are privacy concerns, challenges regarding usability, and the perception that there is no need for health-related technology. To address these barriers, co-design can be used to enable patients to reflect on their experiences of a service and to tailor digital technologies to the needs and preferences of end users regarding content and usability. OBJECTIVE: This study aims to explore the perspectives of stroke patients toward how digital health technology could support self-management regarding health and well-being, as well as integrated stroke care. METHODS: A qualitative study was conducted to understand patient perspectives. Data were collected in co-design sessions during the ValueCare study. Patients from a Dutch hospital who experienced an ischemic stroke (n=36) within the past 18 months were invited to participate. Data collection took place between December 2020 and April 2021 via one-to-one telephone interviews. A short self-report questionnaire was used to collect data on sociodemographics, disease-specific information, and technology use. All interviews were audio-taped and transcribed verbatim. The interview data were analyzed using a thematic approach. RESULTS: Patients held mixed attitudes toward digital health technologies. Some patients viewed digital technology as a convenient product or service, while others expressed no desire or need to use technology for self-management or care. Digital features suggested by stroke patients included (1) information about the causes of stroke, medication, prognosis, and follow-up care; (2) an online library with information regarding stroke-related health and care issues; (3) a personal health record by which patients can retrieve and manage their own health information; and (4) online rehabilitation support to empower patients to exercise at home. Regarding the user interface of future digital health technology, patients emphasized the need for easy-to-use and simple designs. CONCLUSIONS: Stroke patients mentioned credible health information, an online library with stroke-related health and care information, a personal health record, and online rehabilitation support as the main features to include in future digital health technologies. We recommend that developers and designers of digital health for stroke care listen to the "voice of the stroke patients" regarding both functionality and the characteristics of the interface. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12877-022-03333-8.

Understanding COVID: Collaborative Government Campaign for Citizen Digital Health Literacy in the COVID-19 Pandemic.

The strategy "Understanding COVID" was a Public Health campaign designed in 2020 and launched in 2021 in Asturias-Spain to provide reliable and comprehensive information oriented to vulnerable populations. The campaign involved groups considered socially vulnerable and/or highly exposed to COVID-19 infection: shopkeepers and hoteliers, worship and religious event participants, school children and their families, and scattered rural populations exposed to the digital divide. The purpose of this article was to describe the design of the "Understanding COVID" strategy and the evaluation of the implementation process. The strategy included the design and use of several educational resources and communication strategies, including some hundred online training sessions based on the published studies and adapted to the language and dissemination approaches, that reached 1056 people of different ages and target groups, an accessible website, an informative video channel, posters and other pedagogical actions in education centers. It required a great coordination effort involving different public and third-sector entities to provide the intended pandemic protection and prevention information at that difficult time. A communication strategy was implemented to achieve different goals: reaching a diverse population and adapting the published studies to different ages and groups, focusing on making it comprehensible and accessible for them. In conclusion, given there is a common and sufficiently important goal, it is possible to achieve effective collaboration between different governmental bodies to develop a coordinated strategy to reach the most vulnerable populations while taking into consideration their different interests and needs.

SHAFE Mapping on Social Innovation Ecosystems.

There have been several initiatives aiming to promote innovation and support stakeholders to increase investments in relevant societal areas connected to Smart Healthy Age-Friendly Environments-SHAFE. However, their impact usually runs shorter than desirable in the mid- and long-term due to the difficulty to identify, map, and connect stakeholders in the different European and world countries that are willing to work for the practical implementation of social innovation around SHAFE. This mapping and connection can contribute to increase awareness of innovation actors on social innovation concepts and, if well disseminated, may also leverage the creation of alliances and synergies between different stakeholders within ecosystems and between ecosystems. Understanding what relevant practices exist, how they are funded, and how they involve citizens and organisations is also key to ensure that business actors have access to social innovation and entrepreneurial knowledge, which is key for future sustainable societal change. The present study developed and implemented a survey replied by 61 organisations from 28 different countries. The results showed relevant inputs regarding different cultural and societal perceptions, including diverse end-user organisations, and will, thus, facilitate multistakeholder engagement, public awareness, and the overall upscaling of social innovation on SHAFE.

Evaluation design of the Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC): a mindfulness-based intervention to promote the self-management of chronic conditions and a healthy lifestyle.

BACKGROUND: The Social Engagement Framework for Addressing the Chronic-disease-challenge (SEFAC) project intends to empower citizens at risk of or with type 2 diabetes (T2DM) and/or cardiovascular disease (CVD) to self-manage their chronic conditions through the SEFAC intervention. The intervention combines the concepts of mindfulness, social engagement and information and communication technology support, in order to reduce the burden of citizens with chronic conditions and to increase the sustainability of the health system in four European countries. METHODS: A prospective cohort study with a 6-month pre-post design will be conducted in four European countries: Croatia, Italy, the Netherlands and the United Kingdom. A total of 360 community-dwelling citizens ≥50 years of age will be recruited; 200 citizens at risk of T2DM and/or CVD in the next 10 years (50 participants in each country) and 160 citizens with T2DM and/or CVD (40 participants in each country). Effects of the intervention in terms of self-management, healthy lifestyle behavior, social support, stress, depression, sleep and fatigue, adherence to medications and health-related quality of life will be assessed. In addition, a preliminary cost-effectiveness analysis will be performed from a societal and healthcare perspective. DISCUSSION: The SEFAC project will further elucidate whether the SEFAC intervention is feasible and (cost-) effective among citizens at risk of and suffering from T2DM and/or CVD in different settings. TRIAL REGISTRATION: ISRCTN registry number is ISRCTN11248135 . Date of registration is 30/08/2018 (retrospectively registered).