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1.
Health Promot Int ; 39(2)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38430508

RESUMO

Governments have adopted unprecedented measures to assist in slowing the spread of the COVID-19 pandemic, but compliance varies among individuals. This UK study uses latent profile analysis to identify four classes of individuals on factors believed to influence compliance. Those who sought health information from authoritative sources and actively sought information from multiple sources were most compliant. Profile differences in compliance and vaccination status were also primarily driven by trust in healthcare institutions over trust in government. These findings contribute to understanding compliance profiles and emphasise the importance of authoritative information and trust in healthcare systems.


Assuntos
COVID-19 , Humanos , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Reino Unido , Governo , Instalações de Saúde
2.
Int J Dermatol ; 62(4): 524-533, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36707877

RESUMO

BACKGROUND: Three-dimensional (3D) total-body photography is a recent advance in melanoma early detection that can aid in monitoring and identifying new and changing skin lesions over time. METHODS: A cross-sectional survey of adults living in metropolitan and rural areas of Australia was conducted to assess perceptions of 3D total-body photography. Participants completed a survey detailing their previous use of skin cancer photography, personal skin checking history, perceptions of 3D total-body photography, and willingness to pay. Participants were also asked to describe the potential barriers and facilitators of 3D total-body photography in their own words. RESULTS: A total of 1056 participants completed the survey, with 739 (70%) from metropolitan areas of Australia and 317 (30%) from rural areas. Most participants (95%, n = 1004/1056) indicated they would consider using 3D total-body photography if it became commercially available at their regular medical practice. Most participants indicated 3D total-body photography would be effective to identify suspicious skin spots (94%, n = 995/1056), monitor lesion changes (94%, n = 997/1056), and reduce skin cancer related anxiety (90%, n = 950/1055). In open-ended feedback, participants (87%, n = 918/1056) identified perceived benefits, including more comprehensive screenings, earlier detection, and less human error. Participants (84%, n = 889/1056) also identified potential barriers to 3D total-body photography, including cost, accessibility and availability, trust in the technology, and digital security concerns. CONCLUSIONS: Participant feedback indicated a high level of acceptance and confidence in the technology. To facilitate clinical translation, addressing consumer-identified barriers to 3D total-body photography will be vital.


Assuntos
Melanoma , Dermatopatias , Neoplasias Cutâneas , Adulto , Humanos , Estudos Transversais , Detecção Precoce de Câncer/métodos , Melanoma/diagnóstico , Melanoma/patologia , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Fotografação
3.
AI Ethics ; 3(1): 145-153, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35634256

RESUMO

We argue that a perfect storm of five conditions heightens the risk of harm to society from artificial intelligence: (1) the powerful, invisible nature of AI, (2) low public awareness and AI literacy, (3) rapid scaled deployment of AI, (4) insufficient regulation, and (5) the gap between trustworthy AI principles and practices. To prevent harm, fit-for-purpose regulation and public AI literacy programs have been recommended, but education and government regulation will not be sufficient: AI-deploying organizations need to play a central role in creating and deploying trustworthy AI in line with the principles of trustworthy AI, and taking accountability to mitigate the risks.

4.
Dermatology ; 238(2): 358-367, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34515087

RESUMO

OBJECTIVE: To investigate consumer preference and willingness to pay for mobile teledermoscopy services in Australia. METHODS: Consumers who were taking part in a randomised controlled trial comparing mobile teledermoscopy and skin self-examination were asked to complete a survey which incorporated a discrete choice experiment (DCE) and a contingent valuation question. Responses were used to determine their willingness to pay for mobile teledermoscopy services in Australia and their overall service preferences. RESULTS: The 199 consumers who responded were 71% female and had a mean age of 42 years (range, 18-73). The DCE results showed that consumers prefer a trained medical professional to be involved in their skin cancer screening. Consumers were willing to pay AUD 41 to change from a general practitioner reviewing their lesions in-person to having a dermatologist reviewing the teledermoscopy images. Additionally, they were willing to pay for services that had shorter waiting times, that reduced the time away from their usual activities, and that have higher accuracy and lower likelihood of unnecessary excision of a skin lesion. When asked directly about their willingness to pay for a teledermoscopy service using a contingent valuation question, the majority (73%) of consumers selected the lowest two value brackets of AUD 1-20 or AUD 21-40. CONCLUSION: Consumers are willing to pay out of pocket to access services with attributes such as a dermatologist review, improved accuracy, and fewer excisions.


Assuntos
Comportamento do Consumidor , Telemedicina , Adulto , Austrália , Dermoscopia/métodos , Feminino , Humanos , Masculino , Autoexame/métodos , Telemedicina/métodos
5.
Int J Med Inform ; 149: 104414, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33639328

RESUMO

OBJECTIVE: Many governments are using contact tracing mobile applications (CTMAs) yet public adoption of such systems has been relatively low. The main objective of this paper is to profile adopters (and non-adopters) of Australia's COVIDSafe CTMA. MATERIALS AND METHODS: We use latent profile analysis to examine predictors of CTMA download behaviour. Specifically, we draw on a representative Australian sample (N = 2575) to examine the interplay between age, education, income, dispositional desire for privacy and political ideology on download behaviour. We examine trust in government as a mediating mechanism between profiles and download behaviour. RESULTS: Our analysis produces seven profiles. Trust in government mediates the relationship between most profiles and download behaviour. A combination of wealth and education appear to be key explanatory factors of CTMA download behaviour. Two profiles -- comprising individuals with high income and education -- had the highest rates of download behaviour. Profiles with low download percentages comprised politically left-leaning participants with average to low income and education. CONCLUSION: Our findings clearly indicate the profiles of people who are (not) likely to download a CTMA. Practical ways to improve widespread adoption include providing structural support to the more vulnerable members of society, making clear the societal benefits of downloading CTMAs, and engaging in bipartisan promotion of such apps.


Assuntos
COVID-19 , Aplicativos Móveis , Austrália , Busca de Comunicante , Humanos , Privacidade
6.
Front Med (Lausanne) ; 8: 818096, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35111789

RESUMO

Precision prevention of advanced melanoma is fast becoming a realistic prospect, with personalized, holistic risk stratification allowing patients to be directed to an appropriate level of surveillance, ranging from skin self-examinations to regular total body photography with sequential digital dermoscopic imaging. This approach aims to address both underdiagnosis (a missed or delayed melanoma diagnosis) and overdiagnosis (the diagnosis and treatment of indolent lesions that would not have caused a problem). Holistic risk stratification considers several types of melanoma risk factors: clinical phenotype, comprehensive imaging-based phenotype, familial and polygenic risks. Artificial intelligence computer-aided diagnostics combines these risk factors to produce a personalized risk score, and can also assist in assessing the digital and molecular markers of individual lesions. However, to ensure uptake and efficient use of AI systems, researchers will need to carefully consider how best to incorporate privacy and standardization requirements, and above all address consumer trust concerns.

7.
Lancet Digit Health ; 2(3): e129-e137, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-33334577

RESUMO

BACKGROUND: Skin self-examinations supplemented with mobile teledermoscopy might improve early detection of skin cancers compared with naked-eye skin self-examinations. We aimed to assess whether mobile teledermoscopy-enhanced skin self-examination can improve sensitivity and specificity of self-detection of skin cancers when compared with naked-eye skin self-examination. METHODS: This randomised, controlled trial was done in Brisbane (QLD, Australia). Eligible participants (aged ≥18 years) had at least two skin cancer risk factors as self-reported in the eligibility survey and had to own or have access to an iPhone compatible with a dermatoscope attachment (iPhone versions 5-8). Participants were randomly assigned (1:1), via a computer-generated randomisation procedure, to the intervention group (mobile dermoscopy-enhanced self-skin examination) or the control group (naked-eye skin self-examination). Control group and intervention group participants received web-based instructions on how to complete a whole body skin self-examination. All participants completed skin examinations at baseline, 1 month, and 2 months; intervention group participants submitted photographs of suspicious lesions to a dermatologist for telediagnosis after each skin examination and control group participants noted lesions on a body chart that was sent to the research team after each skin examination. All participants had an in-person whole-body clinical skin examination within 3 months of their last skin self-examination. Primary outcomes were sensitivity and specificity of skin self-examination, patient selection of clinically atypical lesions suspicious for melanoma or keratinocyte skin cancers (body sites examined, number of lesions photographed, types of lesions, and lesions missed), and diagnostic concordance of telediagnosis versus in-person whole-body clinical skin examination diagnosis. All primary outcomes were analysed in the modified intention-to-treat population, which included all patients who had a clinical skin examination within 3 months of their last skin self-examination. This trial was registered with the Australian and New Zealand Clinical Trials Registry, ACTRN12616000989448. FINDINGS: Between March 6, 2017, and June 7, 2018, 234 participants consented to enrol in the study, of whom 116 (50%) were assigned to the intervention group and 118 (50%) were assigned to the control group. 199 participants (98 participants in the intervention group and 101 participants in the control group) attended the clinical skin examination and thus were eligible for analyses. Participants in the intervention group submitted 615 lesions (median 6·0 per person; range 1-24) for telediagnosis and participants in the control group identified and recorded 673 lesions (median 6·0 per person; range 1-16). At the lesion level, sensitivity for lesions clinically suspicious for skin cancer was 75% (95% CI 63-84) in the intervention group and 88% (95% CI 80-91) in the control group (p=0·04). Specificity was 87% (95% CI 85-90) in the intervention group and 89% (95% CI 87-91) in the control group (p=0·42). At the individual level, the intervention group had a sensitivity of 87% (95% CI 76-99) compared with 97% (95% CI 91-100) in the control group (p=0·26), and a specificity of 95% (95% CI 90-100) compared with 96% (95% CI 91-100) in the control group. The overall diagnostic concordance between the telediagnosis and in-person clinical skin examination was 88%. INTERPRETATION: The use of mobile teledermoscopy did not increase sensitivity for the detection of skin cancers compared with naked-eye skin self-examination; thus, further evidence is necessary for inclusion of skin self-examination technology for public health benefit. FUNDING: National Health and Medical Research Council (Australia).


Assuntos
Dermoscopia/métodos , Aplicativos Móveis , Autoexame , Neoplasias Cutâneas/patologia , Telemedicina , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Medição de Risco , Neoplasias Cutâneas/epidemiologia , Adulto Jovem
8.
BMC Health Serv Res ; 20(1): 815, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32873295

RESUMO

BACKGROUND: Telemedicine improves access to health care services enabling remote care diagnosis and treatment of patients at a distance. However, the implementation of telemedicine services often pose challenges stemming from the lack of attention to change management (CM). Health care practitioners and researchers agree that successful telemedicine services require significant organizational and practice change. Despite recognizing the importance of the "people-side" of implementation, research on what constitutes best practice CM strategies for telemedicine implementations remains fragmented, offering little cohesive insight into the specific practices involved in the change process. We conducted a systematic scoping review of the literature to examine what and how CM practices have been applied to telemedicine service implementation, spanning a variety of health care areas and countries. METHODS: Three bibliographic databases (CINAHL, PubMed, and ISI Web of Science) and four specialist telehealth journals were searched. To keep the review manageable and relevant to contemporary telemedicine technologies and contexts, the search was limited to articles published from 2008 to 2019. Forty-eight articles were selected for inclusion. RESULTS: From the 48 articles, 16 CM practices were identified relating to either strategic or operational aspects of telemedicine implementations. We identify the key CM practices that are recognized in the broader CM literature as essential for successful and sustained change but are not commonly reported in telemedicine implementation studies. We draw on the CM literature to provide a comprehensive process-based, researched-informed, organizing framework to guide future telemedicine service implementations and research. CONCLUSIONS: Our findings suggest that the slow rate of adoption of telemedicine may be due to a piecemeal approach to the change process, and a lack of understanding of how to plan, manage and reinforce change when implementing telemedicine services.


Assuntos
Gestão de Mudança , Telemedicina/métodos , Atenção à Saúde , Serviços de Saúde , Humanos
9.
Dermatology ; 236(2): 90-96, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32114570

RESUMO

BACKGROUND: Previous cross-sectional research indicates high acceptance of mobile teledermoscopy-enhanced skin self-examination (SSE) by consumers based on the technology acceptance model (TAM) domains: perceived usefulness, ease of use, compatibility, attitude and intention, subjective norms, facilitator, and trust. However, no study has assessed this outcome longitudinally among people who actually used the technology in their own homes. METHODS: Participants were living in Brisbane, Australia, aged 18 years or older, and at high risk of skin cancer. Participants randomly assigned to the intervention group (n = 98) completed a self-administered questionnaire on mobile teledermoscopy acceptance for skin cancer detection both before use and after performing mobile teledermoscopy-enhanced SSE in their homes. The survey included a 25-item scale assessing seven TAM domains. Item scores ranged from 5 (strongly agree) to 1 (strongly disagree). Participants also answered survey questions on satisfaction with use of teledermoscopy, and a 9-item "thoughts about melanoma" scale that measures cancer worry. RESULTS: Participants were 19-73 years old, had high skin cancer risk, blue or grey eyes (53.1%), fair or very fair skin (88.8%), and previous skin cancer treatments (61.2%). Participants were more accepting of mobile teledermoscopy at baseline: mean TAM score of 4.15 (SE 0.05); their level of acceptance decreased significantly after teledermoscopy use: mean score 3.94 (SE 0.05; p = 0.001). In linear regression analysis, the decrease in TAM scores was similar across demographic and skin cancer risk categories. Ninety-two percent (n = 90) of participants agreed that mobile teledermoscopy was easy to use. The mean score of the "thoughts about melanoma" scale did not change significantly from baseline to follow-up. CONCLUSION: Consumers had high TAM scores before they used mobile teledermoscopy within a randomised control trial. At the end of the intervention period, TAM scores decreased, although participants' average score still indicated "agreement" that mobile teledermoscopy was acceptable.


Assuntos
Atitude Frente a Saúde , Dermoscopia , Detecção Precoce de Câncer/métodos , Autoexame/métodos , Neoplasias Cutâneas/diagnóstico , Telemedicina , Adulto , Idoso , Austrália , Biotecnologia , Comportamento do Consumidor , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Exame Físico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Adulto Jovem
10.
Telemed J E Health ; 26(11): 1406-1413, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32058835

RESUMO

Background: Technological advances have given rise to virtual health care services, resulting in a shift in how traditional health care services are being delivered. Consumers are increasingly demanding efficient access to health care information and services irrespective of time and distance, which is further driving the digitization of health care. This digital economy has created new opportunities for innovative new business models to meet the needs of these new markets. This study explores several in-use business models of virtual health care service platforms that incorporate mobile teledermoscopy (MTD) technologies. By comparing the different building blocks of these commercial ventures, we provide insights on business model choices and discuss the elements that contribute to economically sustainable and viable service offerings incorporating MTD applications. Materials and Methods: We searched the literature on teledermatology, complemented by searches using Google and other mobile app store platforms, and identified seven commercial ventures using teledermoscopy. We analyzed the building blocks of each business model by using an adapted version of Ash Maurya's Lean Canvas and Alexander Osterwalder's Business Model Canvas. Results: We identified three business elements that support the viability, sustainability, and growth of online dermatology services: developing key partnerships, clinician involvement in the design and implementation process, and managing the medico-legal risks and liabilities that are relevant for each country. Conclusions: Leveraging mobile technologies to deliver virtual health care present new business opportunities for health care providers. A better understanding of the business features associated with existing commercial ventures may increase uptake and improve financial viability of MTD applications as a complementary tool to traditional patient care models.


Assuntos
Aplicativos Móveis , Telemedicina , Atenção à Saúde , Humanos , Encaminhamento e Consulta , Tecnologia
11.
J Telemed Telecare ; 26(10): 590-606, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31216211

RESUMO

INTRODUCTION: Rural children are likely to benefit from the telehealth delivery of multidisciplinary allied healthcare. This study aimed to (a) identify the scope of literature describing the telehealth delivery of allied health services to children living in rural areas and (b) understand the extent to which implementation - that is, specific activities designed to put telehealth into practice - has been investigated in such literature. METHODS: Systematic scoping review methodology was used to locate studies in which telehealth delivered allied health services to children aged 0-12 who lived rurally (January 1998-January 2018). Two reviewers screened the studies, extracted data and appraised quality with Critical Skills Appraisal Programme checklists. Databases searched were PubMed, MEDLINE, CINAHL, PsycINFO, ERIC and Cochrane Library. RESULTS: Data were extracted from 23 papers (two randomised controlled trials, one pseudorandomised controlled trial, one non-randomised experimental trial, two interrupted time series without parallel control groups, 10 case series and seven studies of diagnostic yield). Most were level III (n = 4) or IV (n = 17) when classified according to National Health and Medical Research Council guidelines. One study met all Critical Skills Appraisal Programme quality criteria. Allied healthcare interventions were aimed at improving functioning in communication (n = 10), behaviour and socio-emotional domains (n = 8) and identifying hearing concerns (n = 5). Many studies (n = 12) identified implementation facilitators, largely training and equipment. Only one study referred to an explicit framework for telehealth implementation (user-centred design). DISCUSSION: Future research should target occupational therapy, physiotherapy, dietetics and social work, and determine the implementation factors and models likely to create successful telehealth services for this population.


Assuntos
Atenção à Saúde/organização & administração , Terapia Ocupacional , Pediatria , Serviços de Saúde Rural/organização & administração , Telemedicina , Ocupações Relacionadas com Saúde , Pessoal Técnico de Saúde , Criança , Pré-Escolar , Serviços de Saúde , Humanos , Lactente , Recém-Nascido , População Rural
12.
Aust J Rural Health ; 27(5): 419-426, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31571313

RESUMO

OBJECTIVE: To examine allied health client, provider and community referrer perceptions of telehealth for the delivery of rural paediatric allied health services to facilitate adoption. DESIGN: A qualitative design employed semistructured interviews with the three key stakeholder groups. SETTING: Stakeholders were associated with BUSHkids (The Royal Queensland Bush Children's Health Scheme), a not-for-profit organisation serving children and families in Queensland, Australia. PARTICIPANTS: Thirty-nine stakeholders (12 clients, 16 providers and 11 community referrers). MAIN OUTCOME MEASURES: Participants were asked about familiarity with telehealth, willingness to use telehealth and perceived barriers and facilitators to telehealth acceptability. RESULT: Fifty-nine percent of participants had experienced telehealth and 77 percent were willing to use it. Participants perceived that technology problems were a barrier to telehealth, that children would not be able to concentrate on or enjoy telehealth sessions, that relationships and communication would be inferior to in-person sessions, and that telehealth was inappropriate for disciplines employing physical touch. Participants identified access to health services as a key benefit of telehealth, said that technology problems could be worked around, and said that telehealth services could be supported with internal partners (eg, assistants) and external partners (eg, local medical centres). They also identified a variety of telehealth benefits to families (eg, convenience, privacy). CONCLUSION: Overall, telehealth was acceptable to stakeholders. Providers need training to facilitate child participation online and identify alternatives to physical touch. Co-learning opportunities should be used to address low provider and referrer self-efficacy.


Assuntos
Adoção , Atitude do Pessoal de Saúde , Serviços de Saúde da Criança/organização & administração , Atenção à Saúde/organização & administração , Serviços de Saúde Rural/organização & administração , Telemedicina , Adulto , Idoso , Criança , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Queensland
13.
Digit Health ; 5: 2055207619828225, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30792879

RESUMO

OBJECTIVE: The aim of the study is to evaluate healthcare practitioners' views on and satisfaction with (i) digital image acquisition and storage and (ii) store-and-forward teledermoscopy services for the diagnosis of skin cancer in their clinical practice. METHODS: An online survey was conducted among 59 healthcare practitioners (GPs (n=17), dermatologists (n=22), dermatology registrars (n=18), a dermatology research fellow (n=1) and a plastic surgeon (n=1)) to assess usability of digital image acquisition and storage for when the imaging process is conducted by the healthcare practitioners themselves, or by their patients. The study identifies the enablers and barriers of this emerging mode of medical practice. A thematic analysis was used to extract key themes from open-ended responses, which involved identifying themes and patterns within and across participants. RESULTS: Thirty-four healthcare practitioners (58%) had previously used a mobile dermatoscope within their practice. Participants most appreciated its use in their practice for lesion monitoring (59%) and record keeping (39%). Challenges reported were the increased time to support the additional workload (45%), technical issues (33%) and cost of equipment (27%). Practitioners were unsure (36%) or did not advocate teledermoscopy for direct-to-consumer use (41%). Only 23% supported the use of direct-to-consumer teledermoscopy. CONCLUSION: While most practitioners are receptive to mobile teledermoscopy, there was less support for patient-initiated use, whereby the patient controls the imaging process. As technology improves rapidly it is important to evaluate practitioners' acceptance and satisfaction of evolving telehealth services, moving forward with models of practice where healthcare practitioners and other healthcare providers will feel comfortable engaging in telehealth services.

14.
Dermatology ; 235(1): 4-10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30404081

RESUMO

BACKGROUND: Mobile teledermoscopy may facilitate skin self-examinations (SSEs) and further improve monitoring and detection of melanoma. OBJECTIVE: To assess consumer acceptability and expectations of a mobile health app used to: (i) instruct SSE and (ii) conduct consumer-performed mobile teledermoscopy. METHODS: People aged 18 years and above were invited to participate in either (i) an online survey or (ii) focus group in Brisbane, Australia. Participants were asked about their SSE practices, mobile teledermoscopy acceptance, and app design and functionality. The online survey responses and focus group discussions were coded by two researchers who conducted thematic analysis. RESULTS: Four focus groups were held with a total of 28 participants; 88 participants completed the online survey. The mean ages of participants in the focus group and online survey were 46 and 38 years, respectively. There were more males in the focus groups (61%, 17/28) compared to the online survey (19%, 17/88). Regular SSEs were conducted by 56 (64%) of the online survey participants. Barriers to SSE were forgetfulness (44%), low self-perceived risk of melanoma (25%) and low confidence in conducting SSEs (25%). The large majority of online survey participants (95%) would consider sending photos of their skin lesions to a medical practitioner via an app. Focus group participants reported that they would accept using mobile teledermoscopy; however, they would prefer to use it to monitor lesions between face-to-face consultations. CONCLUSIONS: Overall, participants had positive views on using mobile teledermoscopy to send images of skin lesions to a dermatologist or other medical practitioner.


Assuntos
Telefone Celular , Melanoma/diagnóstico , Aplicativos Móveis , Fotografação , Autoexame/psicologia , Neoplasias Cutâneas/diagnóstico , Telemedicina/métodos , Adulto , Dermoscopia , Detecção Precoce de Câncer/métodos , Feminino , Grupos Focais , Humanos , Masculino , Melanoma/psicologia , Pessoa de Meia-Idade , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , Exame Físico/métodos , Consulta Remota/métodos , Neoplasias Cutâneas/psicologia
15.
Dermatology ; 235(1): 11-18, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30404085

RESUMO

Patients often detect melanoma themselves; therefore, regular skin self-examinations (SSEs) play an important role in the early detection and prompt treatment of melanoma. Mobile teledermoscopy is a technology that may facilitate consumer SSEs and rapid communication with a dermatologist. This paper describes the planned randomised controlled trial of an intervention to determine whether mobile technologies can help improve the precision of SSE in consumers. A randomised controlled trial will be conducted to evaluate mobile teledermoscopy-enhanced SSE versus naked-eye SSE. Participants in each group will conduct three home whole-body SSEs at baseline, 1 and 2 months, then present for a clinical skin examination (CSE) by a doctor after the 2-month SSE. Specifically, participants will identify skin lesions that meet the AC (asymmetry and colour) rule for detecting a suspicious skin spot. The primary outcomes are sensitivity and specificity of the skin lesions selected by the participants as needing attention by a doctor, compared to the clinical diagnosis by the dermatologist that will serve as the reference standard for this analysis. For the mobile teledermoscopy-enhanced SSE group, researchers will assess the number, location and type of lesions (1) sent by the participant via mobile teledermoscopy, (2) found at CSE or (3) missed by the participant. For the naked-eye SSE group, researchers will assess the number, location and type of lesions (1) recorded on their body chart by the participant, (2) found at CSE or (3) missed by the participant. Secondary outcomes are based on participants' self-reported data via online questionnaires.


Assuntos
Dermoscopia/métodos , Detecção Precoce de Câncer/métodos , Melanoma/diagnóstico , Autoexame/métodos , Neoplasias Cutâneas/diagnóstico , Telemedicina , Protocolos Clínicos , Humanos , Aplicativos Móveis , Autorrelato
16.
J Telemed Telecare ; 24(10): 683-689, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30343653

RESUMO

Introduction Internationally, teledermoscopy has been found to have clinical and economic efficacy. This study aims to identify the attributes of a mobile teledermoscopy service that consumers prefer. This preliminary study was set within a broader randomised control trial (RCT) investigating the effectiveness of direct to consumer mobile teledermoscopy. Methods We undertook a discrete choice experiment (DCE). The DCE comprised 24 choice sets, divided into in two blocks of 12. For each choice set, respondents were asked to make discrete choices between two opt-out choices and two skin cancer screening service options described by seven attributes. A mixed logit model was used to estimate preferences for skin cancer screening services. Consumer preferences weights were used to calculate marginal willingness-to-pay (WTP) for skin cancer screening services. Results The DCE was completed by 113 consumer respondents. Consumers' preference for dermatologist involvement in their diagnosis, increased accuracy, and reduced excisions were all statistically significant in driving choice between service models. Consumers preferred having a professional involved in their skin cancer screening, rather than performing a self-examination. Consumers were only WTP $1.18 to change from a GP visit to mobile teledermoscopy (diagnosis using a phone camera). However, they were WTP $43 to have their results reviewed by a dermatologist rather than a GP, and $117 to increase the chance of detecting a melanoma if it was present from 65-75% to 95%. Conclusion Skin cancer screening services which are delivered by health professionals, rather than skin self-examination, are preferred by consumers. Consumers were willing to pay for their preferred skin cancer screening method, especially if a dermatologist was involved.


Assuntos
Comportamento do Consumidor/estatística & dados numéricos , Dermoscopia/métodos , Triagem e Testes Direto ao Consumidor/métodos , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/organização & administração , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Telemedicina/métodos , Adulto , Austrália , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
17.
J Telemed Telecare ; 23(9): 770-779, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28728502

RESUMO

Surveys are a common method for assessing patient and clinician perceptions, attitudes and outcomes of telehealth. However, inadequacies in both the conduct and reporting of survey studies are common in telehealth research. This article provides clinicians and researchers with practical guidance on the appropriate selection, use and reporting of survey tools for telehealth research. We identify common survey outcomes and instruments used in telehealth research, and methods to assess the validity and psychometric properties of survey tools. Enhancing the quality and reporting of telehealth research is important to improve our understanding of which telehealth-supported models of care improve outcomes and for which patient groups.


Assuntos
Projetos de Pesquisa/normas , Inquéritos e Questionários/normas , Telemedicina/normas , Pesquisas sobre Atenção à Saúde , Acessibilidade aos Serviços de Saúde , Humanos
18.
J Appl Psychol ; 101(8): 1134-50, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27123697

RESUMO

Cumulating evidence from 112 independent studies (N = 7,763 teams), we meta-analytically examine the fundamental questions of whether intrateam trust is positively related to team performance, and the conditions under which it is particularly important. We address these questions by analyzing the overall trust-performance relationship, assessing the robustness of this relationship by controlling for other relevant predictors and covariates, and examining how the strength of this relationship varies as a function of several moderating factors. Our findings confirm that intrateam trust is positively related to team performance, and has an above-average impact (ρ = .30). The covariate analyses show that this relationship holds after controlling for team trust in leader and past team performance, and across dimensions of trust (i.e., cognitive and affective). The moderator analyses indicate that the trust-performance relationship is contingent upon the level of task interdependence, authority differentiation, and skill differentiation in teams. Finally, we conducted preliminary analyses on several emerging issues in the literature regarding the conceptualization and measurement of trust and team performance (i.e., referent of intrateam trust, dimension of performance, performance objectivity). Together, our findings contribute to the literature by helping to (a) integrate the field of intrateam trust research, (b) resolve mixed findings regarding the trust-performance relationship, (c) overcome scholarly skepticism regarding the main effect of trust on team performance, and (d) identify the conditions under which trust is most important for team performance. (PsycINFO Database Record


Assuntos
Comportamento Cooperativo , Processos Grupais , Análise e Desempenho de Tarefas , Confiança , Humanos
19.
PLoS One ; 11(4): e0153205, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27111546

RESUMO

Two studies investigated the role of group allegiances in contributing to the failure of institutions to appropriately respond to allegations of child sexual abuse. In Study 1, 601 participants read a news article detailing an allegation of child sexual abuse against a Catholic Priest. Catholics were more protective of the accused-and more skeptical of the accuser-than other participants, an effect that was particularly pronounced among strongly identified Catholics. In Study 2 (N = 404), the tendency for Catholics to be more protective of the accused and more skeptical of the accuser than non-Catholics was replicated. Moreover, these effects held independently of the objective likelihood that the accused was guilty. Overall, the data show that group loyalties provide a psychological motivation to disbelieve child abuse allegations. Furthermore, the people for whom this motivation is strongest are also the people who are most likely to be responsible for receiving and investigating allegations: highly identified ingroup members. The findings highlight the psychological mechanisms that may limit the ability of senior Church figures to conduct impartial investigations into allegations of child abuse within the Church.


Assuntos
Abuso Sexual na Infância , Identificação Social , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Catolicismo , Criança , Clero , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação
20.
Stress Health ; 32(3): 231-43, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25066108

RESUMO

Employing the social-exchange theoretical framework, we examined the effect of employees' awareness of stress-reduction interventions on their levels of psychological strain, job satisfaction, organizational commitment, perceptions of senior management trustworthiness and procedural justice. We present longitudinal panel data from 869 employees who completed questionnaires at two time points at 13 Australian universities. Our results show that employees who reported an awareness of stress-reduction interventions undertaken at their university scored lower on psychological strain and higher on job satisfaction and commitment than those who were unaware of the interventions. The results suggest that simply the awareness of stress interventions can be linked to positive employee outcomes. The study further revealed that senior management trustworthiness and procedural justice mediate the relationship between awareness and employee outcomes. Copyright © 2014 John Wiley & Sons, Ltd.


Assuntos
Emprego/psicologia , Satisfação no Emprego , Cultura Organizacional , Lealdade ao Trabalho , Gestão de Recursos Humanos , Estresse Psicológico/psicologia , Adulto , Humanos , Estresse Psicológico/prevenção & controle , Universidades
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