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1.
Trials ; 20(1): 318, 2019 Jun 03.
Article in English | MEDLINE | ID: mdl-31159849

ABSTRACT

BACKGROUND: Melanoma is common; 15,906 people in the UK were diagnosed with melanoma in 2015 and incidence has increased fivefold in 30 years. Melanoma affects old and young people, with poor prognosis once metastatic. UK guidelines recommend people treated for cutaneous melanoma receive extended outpatient, hospital follow up to detect recurrence or new primaries. Such follow up of the growing population of melanoma survivors is burdensome for both individuals and health services. Follow up is important since approximately 20% of patients with early-stage melanoma experience a recurrence and 4-8% develop a new primary; the risk of either is highest in the first 5 years. Achieving Self-directed Integrated Cancer Aftercare (ASICA) is a digital intervention to increase total-skin-self-examination (TSSE) by people treated for melanoma, with usual follow up. METHODS: We aim to recruit 240 adults with a previous first-stage 0-2C primary cutaneous melanoma, from secondary care in North-East Scotland and the East of England. Participants will be randomised to receive the ASICA intervention (a tablet-based digital intervention to prompt and support TSSE) or control group (treatment as usual). Patient-reported and clinical data will be collected at baseline, including the modified Melanoma Worry Scale (MWS), the Hospital Anxiety and Depression Scale (HADs), the EuroQoL 5-dimension 5-level questionnaire (EQ-5D-5 L), and questions about TSSE practice, intentions, self-efficacy and planning. Participants will be followed up by postal questionnaire at 3, 6 and 12 months following randomization, along with a 12-month review of clinical data. The primary timepoint for outcome analyses will be12 months after randomisation. DISCUSSION: If the ASICA intervention improves the practice of TSSE in those affected by melanoma, this may lead to improved psychological well-being and earlier detection of recurrent and new primary melanoma. This could impact both patients and National Health Service (NHS) resources. This study will determine if a full-scale randomised controlled trial can be undertaken in the UK NHS to provide the high-quality evidence needed to determine the effectiveness of the intervention. ASICA is a pilot study evaluating the effectiveness of the practice of digitally supported TSSE in those affected by melanoma. TRIAL REGISTRATION: Clinical Trials.gov, NCT03328247 . Registered on 1 November 2017.


Subject(s)
Early Detection of Cancer/methods , Melanoma/diagnosis , Neoplasm Recurrence, Local/diagnosis , Randomized Controlled Trials as Topic , Adult , Aftercare , Data Interpretation, Statistical , Humans , Melanoma/psychology , Outcome Assessment, Health Care , Pilot Projects , Sample Size , Self-Examination , Surveys and Questionnaires
2.
Diabet Med ; 30(12): 1420-32, 2013 Dec.
Article in English | MEDLINE | ID: mdl-23870009

ABSTRACT

INTRODUCTION: With increasing evidence available on the importance of physical activity in the management of Type 2 diabetes, there has been an increase in technology-based interventions. This review provides a systematic and descriptive assessment of the effectiveness of technology to promote physical activity in people with Type 2 diabetes. For this review, technology included mobile phones and text messages, websites, CD-ROMs and computer-learning-based technology, and excluded telephone calls. METHODS: A systematic literature search was conducted to retrieve articles from January 2001 to March 2013 using the following databases: the Cochrane Library, EMBASE, MEDLINE, PsycINFO and PubMed. Articles had to describe an intervention that used technology to promote physical activity in people with Type 2 diabetes. A methodological quality assessment of the studies was conducted and data synthesis was performed. RESULTS: In total, 15 articles were eligible for review: web-based (9), mobile phone (3), CD-ROM (2) and computer based (1). All studies found an increase in physical activity but only nine were significant. The use of a personal coach, logbooks and reinforcement strategies such as phone calls and email counselling were found to be effective components for behaviour change. No studies were ranked as low in terms of methodological quality. CONCLUSIONS: Technology-based interventions to promote physical activity are effective; using further methods to promote participant adherence is associated with greater benefit. Further research should look into strategies to enhance adherence and sustainability in order to increase the effectiveness of technology-based physical activity intervention in diabetes care.


Subject(s)
Cell Phone , Diabetes Mellitus, Type 2/therapy , Exercise , Health Promotion/methods , Internet , Text Messaging , Female , Humans , Male , Patient Compliance/statistics & numerical data , Patient Satisfaction/statistics & numerical data , Physical Fitness , Reminder Systems , Self Care
3.
Top Health Inf Manage ; 20(4): 67-77, 2000 May.
Article in English | MEDLINE | ID: mdl-10977143

ABSTRACT

One of the main goals of a radiology department is to optimize patient throughput. We have observed a number of factors that reduce patient throughput, one of them being suboptimal system usage. In this article, we distinguish and discuss two ways to reduce suboptimal operation: improved design of the user-interface and active support for learning during system usage, i.e., during examinations. We outline the rationale for this by looking at the current situation and trends in radiology departments. We have based our work firmly on the principles of user-centered design. Observations, task modeling, user involvement, and prototyping have been undertaken.


Subject(s)
Efficiency, Organizational , Radiology Department, Hospital/standards , Radiology Information Systems , User-Computer Interface , Humans , Inservice Training
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