Social and self-reflective use of a Web-based personally controlled health management system.

BACKGROUND: Personally controlled health management systems (PCHMSs) contain a bundle of features to help patients and consumers manage their health. However, it is unclear how consumers actually use a PCHMS in their everyday settings. OBJECTIVE: To conduct an empirical analysis of how consumers used the social (forum and poll) and self-reflective (diary and personal health record [PHR]) features of a Web-based PCHMS designed to support their physical and emotional well-being. METHODS: A single-group pre/post-test online prospective study was conducted to measure use of a Web-based PCHMS for physical and emotional well-being needs during a university academic semester. The PCHMS integrated an untethered PHR with social forums, polls, a diary, and online messaging links with a health service provider. Well-being journeys additionally provided information to encourage engagement with clinicians and health services. A total of 1985 students and staff aged 18 and above with access to the Internet were recruited online, of which 709 were eligible for analysis. Participants' self-reported well-being, health status, health service utilization, and help-seeking behaviors were compared using chi-square, McNemar's test, and Student's t test. Social networks were constructed to examine the online forum communication patterns among consumers and clinicians. RESULTS: The two PCHMS features that were used most frequently and considered most useful and engaging were the social features (ie, the poll and forum). More than 30% (213/709) of participants who sought well-being assistance during the study indicated that other people had influenced their decision to seek help (54.4%, 386/709 sought assistance for physical well-being; 31.7%, 225/709 for emotional well-being). Although the prevalence of using a self-reflective feature (diary or PHR) was not as high (diary: 8.6%, 61/709; PHR: 15.0%, 106/709), the proportion of participants who visited a health care professional during the study was more than 20% greater in the group that did use a self-reflective feature (diary: P=.03; PHR: P<.001). CONCLUSIONS: There was variation in the degree to which consumers used social and self-reflective PCHMS features but both were significantly associated with increased help-seeking behaviors and health service utilization. A PCHMS should combine both self-reflective as well as socially driven components to most effectively influence consumers' help-seeking behaviors.

An exploration of knowledge and practice of patient handling among undergraduate occupational therapy students.

PURPOSE: To explore knowledge and practice relating to patient handling among final year occupational therapy students in the Republic of Ireland. METHOD: We conducted a survey of final year students in three out of four occupational therapy programs in the Republic of Ireland (n = 81). The survey measured students' knowledge of manual handling principles and techniques and explored their experiences and ability to apply this knowledge to clinical situations. RESULTS: All students (n = 81) had undertaken training in patient handling. Just under half of students (n = 35, 43.2%) had received additional training outside of the university setting. Overall knowledge of safe patient handling principles techniques and risk assessment was low (Mean Score = 15.71/28; SD = 3.81). Participants who received additional training achieved a lower mean total score (M = 13.89, SD = 3.54) than those who only undertook university-based training (M = 18.11; SD = 2.66; t(79) = -5.87; p < 0.05). The majority of participants reported intermittent use of taught principles while on clinical practice placements (n = 50, 61.8%) Reasons for not using taught principles included; selection of alternative technique by supervisor (n = 30, 56.6%); lack of available equipment (n = 13, 24.5%) and lack of time (n = 13, 24.5%). CONCLUSIONS: While occupational therapy students in Ireland receive training in safe patient handling they appear to have limited knowledge of best practice and experience difficulties in applying their learning to clinical situations. There is an urgent need to consider the effectiveness of current educational strategies in this area. Implications for Rehabilitation Safe patient handling is a key component in preventing musculoskeletal injury among rehabilitation professionals The extent to which pre-professional training prepares rehabilitation professionals to practice safe patient handling is unclear Occupational therapy students in this study had limited knowledge of safe patient handling and had difficulty applying their learning to clinical practice Alternative education models are required to support development of safe patient handling skills. Educators may wish to consider how safe patient handling can be embedded across curricula to avoid the challenges of once off instruction and massed practice.

The influence of social networking sites on health behavior change: a systematic review and meta-analysis.

OBJECTIVE: Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors. MATERIALS AND METHODS: Five databases were scanned using a predefined search strategy. Studies were included if they focused on patients/consumers, involved an SNS intervention, had an outcome related to health behavior change, and were prospective. Studies were screened by independent investigators, and assessed using Cochrane's 'risk of bias' tool. Randomized controlled trials were pooled in a meta-analysis. RESULTS: The database search retrieved 4656 citations; 12 studies (7411 participants) met the inclusion criteria. Facebook was the most utilized SNS, followed by health-specific SNSs, and Twitter. Eight randomized controlled trials were combined in a meta-analysis. A positive effect of SNS interventions on health behavior outcomes was found (Hedges' g 0.24; 95% CI 0.04 to 0.43). There was considerable heterogeneity (I(2) = 84.0%; T(2) = 0.058) and no evidence of publication bias. DISCUSSION: To the best of our knowledge, this is the first meta-analysis evaluating the effectiveness of SNS interventions in changing health-related behaviors. Most studies evaluated multi-component interventions, posing problems in isolating the specific effect of the SNS. Health behavior change theories were seldom mentioned in the included articles, but two particularly innovative studies used 'network alteration', showing a positive effect. Overall, SNS interventions appeared to be effective in promoting changes in health-related behaviors, and further research regarding the application of these promising tools is warranted. CONCLUSIONS: Our study showed a positive effect of SNS interventions on health behavior-related outcomes, but there was considerable heterogeneity. Protocol registration The protocol for this systematic review is registered at http://www.crd.york.ac.uk/PROSPERO with the number CRD42013004140.