Is Twitter a forum for disseminating research to health policy makers?

Findings from scientific research largely remain inside the scientific community. Research scientists are being encouraged to use social media, and especially Twitter, for dissemination of evidence. The potential for Twitter to narrow the gap on evidence translated into policy presents new opportunities. We explored the innovative question of the feasibility of Twitter as a tool for the scientific community to disseminate to and engage with health policy makers for research impact. We created a list of federal "health policy makers." In December 2014, we identified members using several data sources, then collected and summarized their Twitter usage data. Nearly all health policy makers had Twitter accounts. Their communication volume varied broadly. Policy makers are more likely to push information via Twitter than engage with constituents, although usage varied broadly. Twitter has the potential to aid the scientific community in dissemination of health-related research to health policy makers, after understanding how to effectively (and selectively) use Twitter.

Influencing public policy to improve the lives of older Americans.

Aging of the U.S. population raises numerous public policy issues about which gerontological researchers, policy experts, and practitioners have much to contribute. However, the means by which aging-related public policy is influenced are not always apparent. Drawing on experience working in the U.S. Senate and other settings as Health and Aging Policy Fellows, the authors outline the formal and informal processes by which public policy is shaped in the U.S. Congress. Many who seek to influence public policy do so by telling legislators what they want. A less obvious path to policy influence is for gerontologists to offer their expertise to legislators and their staff. The authors provide specific recommendations for how gerontologists can establish productive and ongoing relationships with key legislative players. The authors also emphasize the importance of collaboration with advocacy groups and with local and state stakeholders to advance aging-related public policy to improve the lives of older Americans.

A comparison of video-based resident-family communication in a nursing home and a congregate living facility.

OBJECTIVE: To explore user perceptions of videophone communication in different long-term care settings by comparing interview transcripts of a study involving residents of a congregate living facility (CLF) and family members with findings of a case study involving a resident of a skilled nursing facility (SNF) and family member. METHODS: Semistructured interviews by telephone and in person were conducted with residents and family members, with both studies using an interview guide with similar questions. RESULTS: All themes found in the SNF study were also identified in the CLF data. There was consistency between studies in preferences for videophones (over telephones) for affective-oriented conversations and perceptions of acceptable usability. Both yielded generally acceptable technical quality, although 2 of 8 CLU participants' concerns were likely barriers to adoption. CONCLUSION: Consistency in findings lends validity to the earlier SNF findings and suggests some degree of reliability across these settings. Additional insights were gained in the CLF study, a new context in the resident-family videophone communication literature. The theoretical framework of social presence and communication bandwidth holds promise as applied, but further explication and operationalization are needed.

Physician attitudes toward SMS/Text messaging in medicine.

Family practice physicians' use and attitudes toward SMS or text messaging and handheld devices in medicine were measured. Our findings showed that handhelds are used mostly for personal information management (PIM) and references on the device. One-third used SMS, mostly for communicating with colleagues, and almost two-thirds were favorable to this modality, including for searching MEDLINE. Findings support continued focus on improving text input interface and information presentation on small screens to reduce misunderstanding.

Use of videophones for distant caregiving: an enriching experience for families and residents in long-term care.

The objective of this study was to explore the role of videophone technology in enhancing the distant caregiving experience of and communication between residents of a long-term care facility and their family members. Ten participants-4 residents of an independent retirement facility and 6 family members-were recruited. A videophone was installed in each resident's apartment, and another was mailed to the remote family member. Participants were asked to conduct a videocall at least once per week for 3 months. Exit interviews assessed general impressions of videophone communication, the relationship between residents and family members, stress, burden, and isolation. Participants were enthusiastic and emphasized a sense of closeness, the inclusion of the resident in family interactions, and reduced feelings of guilt and isolation as key benefits. New models of care are needed to challenge the existing paradigm, which often excludes distant caregivers from the care process. Technology can facilitate this process by bridging geographic distance.

Senior residents' perceived need of and preferences for "smart home" sensor technologies.

OBJECTIVES: The goal of meeting the desire of older adults to remain independent in their home setting while controlling healthcare costs has led to the conceptualization of "smart homes." A smart home is a residence equipped with technology that enhances safety of residents and monitors their health conditions. The study aim is to assess older adults' perceptions of specific smart home technologies (i.e., a bed sensor, gait monitor, stove sensor, motion sensor, and video sensor). METHODS: The study setting is TigerPlace, a retirement community designed according to the Aging in Place model. Focus group sessions with fourteen residents were conducted to assess perceived advantages and concerns associated with specific applications, and preferences for recipients of sensor-generated information pertaining to residents' activity levels, sleep patterns and potential emergencies. Sessions were audio-taped; tapes were transcribed, and a content analysis was performed. RESULTS: A total of fourteen older adults over the age of 65 participated in three focus group sessions Most applications were perceived as useful, and participants would agree to their installation in their own home. Preference for specific sensors related to sensors' appearance and residents' own level of frailty and perceived need. Specific concerns about privacy were raised. CONCLUSIONS: The findings indicate an overall positive attitude toward sensor technologies for nonobtrusive monitoring. Researchers and practitioners are called upon to address ethical and technical challenges in this emerging domain.

Obtrusiveness of information-based assistive technologies as perceived by older adults in residential care facilities: a secondary analysis.

With the anticipated growth in the older adult population in the next few years, information designers are examining new ways for assistive technologies to support independent living and quality of life for adults as they age. Central to the role of assistive technology to support and enhance quality of life is the development of non-obtrusive technologies. Despite the importance of non-obtrusiveness to the design of assistive technologies, there remains no standard definition of obtrusiveness or measurement instrument. A conceptual framework for obtrusiveness in home telehealth technologies has recently been proposed but has not yet been tested empirically. This project performed a secondary analysis of focus group and interview data to explore the presence of the dimensions of the obtrusiveness framework in older adults' responses to information-based assistive technologies in residential care facilities. We found the existing data contained examples of each dimension (physical, usability, privacy, function, human interaction, self-concept, routine, and sustainability) and 16 of the 22 subcategories proposed by the obtrusiveness framework. These results provide general support for the framework, although further prospective validation research is needed. Potential enhancements to the framework are proposed.

Videophone communication between residents and family: a case study.

OBJECTIVES: This case study examines the uses, perceived advantages and disadvantages, and expectations of videophone communication by a nursing home resident and a geographically distant family member. METHODS: Interviews were conducted with these participants, one in person and one by phone. RESULTS: Themes identified suggest that, with the added visual component, there are additional uses and psychosocial benefits of videophone communication when compared to the telephone for both nursing home residents and family members. CONCLUSION: The study suggests that the use of the technology is not only feasible in an institutional setting but also beneficial. Further research with larger groups is supported.

Exploring underutilization of videophones in hospice settings.

The aim of this study was to evaluate hospice providers' attitudes and perceptions regarding videophone technology in settings where the technology was introduced but underutilized. Specifically, the project seeks to provide an in-depth understanding of attitudes and perceptions that may lead to failure of a telehealth implementation in the hospice setting in the context of the technology acceptance model. Two hospice agencies were selected as a purposive sample. Both agencies had acquired videophones that were meant to be integrated into care delivery but ultimately were underutilized or never used. Interviews with staff were conducted over the telephone. The interview guide was constructed to capture staff perceptions and attitudes concerning videophone technology. Interviews were audiotaped and transcribed for content analysis. A total of 17 (n = 17) participants (2 hospice administrators, 1 hospice management staff, 10 nurse case managers, and 4 social workers) were interviewed. Participants found videophones to be useful in hospice care but expressed specific practical challenges, such as lack of equipment reliability, lack of human resources, and lack of clarity pertaining to caregiver eligibility criteria. While perceived usefulness of videophones was high among respondents, practical concerns can be interpreted as lack of perceived ease of use. Findings indicate that the Technology Acceptance Model (TAM) provides a good framework for an understanding of telehealth underutilization. Staff perceived that videophones were useful, but they were discouraged by their perception that the videophones were not reliable or easy to use and by their uncertainty about the cases that they were best suited for. Lessons learned are integrated into a randomized clinical trial currently under development.

Defining obtrusiveness in home telehealth technologies: a conceptual framework.

The literature of home telehealth technology recommends that systems be designed to minimize their obtrusiveness to end users. However, this term is neither explicitly defined nor consistently used. This paper presents a definition of the concept of obtrusiveness. Within this definition, twenty-two categories of what may be perceived as obtrusive in home telehealth technology are proposed based on a review of the literature. These categories are grouped into eight dimensions. This effort represents an initial step toward developing measures of obtrusiveness associated with home telehealth technology. A validated and reliable instrument would allow for evaluation of individual applications as well as theory-building across applications.

A telehealth case study of videophone use between family members.

This case study extends beyond the institution-centric provider-patient dyad to examine telehealth communication between a nursing home resident and a geographically distant family member. The participants communicated regularly for three months by videophone. They found technical performance and usability acceptable and were generally satisfied with this application of telehealth technology. They assumed a strong role in self-remedying technical and usability problems they experienced. Potential implications associated with such use of telehealth technology by residence-based patients and their significant others, and the self-directedness displayed by participants in this case study, are discussed.