A global examination of ecological niche modeling to predict emerging infectious diseases: a systematic review.

Introduction: As emerging infectious diseases (EIDs) increase, examining the underlying social and environmental conditions that drive EIDs is urgently needed. Ecological niche modeling (ENM) is increasingly employed to predict disease emergence based on the spatial distribution of biotic conditions and interactions, abiotic conditions, and the mobility or dispersal of vector-host species, as well as social factors that modify the host species' spatial distribution. Still, ENM applied to EIDs is relatively new with varying algorithms and data types. We conducted a systematic review (PROSPERO: CRD42021251968) with the research question: What is the state of the science and practice of estimating ecological niches via ENM to predict the emergence and spread of vector-borne and/or zoonotic diseases? Methods: We searched five research databases and eight widely recognized One Health journals between 1995 and 2020. We screened 383 articles at the abstract level (included if study involved vector-borne or zoonotic disease and applied ENM) and 237 articles at the full-text level (included if study described ENM features and modeling processes). Our objectives were to: (1) describe the growth and distribution of studies across the types of infectious diseases, scientific fields, and geographic regions; (2) evaluate the likely effectiveness of the studies to represent ecological niches based on the biotic, abiotic, and mobility framework; (3) explain some potential pitfalls of ENM algorithms and techniques; and (4) provide specific recommendation for future studies on the analysis of ecological niches to predict EIDs. Results: We show that 99% of studies included mobility factors, 90% modeled abiotic factors with more than half in tropical climate zones, 54% modeled biotic conditions and interactions. Of the 121 studies, 7% include only biotic and mobility factors, 45% include only abiotic and mobility factors, and 45% fully integrated the biotic, abiotic, and mobility data. Only 13% of studies included modifying social factors such as land use. A majority of studies (77%) used well-recognized ENM algorithms (MaxEnt and GARP) and model selection procedures. Most studies (90%) reported model validation procedures, but only 7% reported uncertainty analysis. Discussion: Our findings bolster ENM to predict EIDs that can help inform the prevention of outbreaks and future epidemics. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier (CRD42021251968).

Health Insurance Literacy and Medical Care Avoidance Among International Students: A Case Study.

Objectives: This research examines the health insurance literacy and healthcare utilization of international students attending a university in the US Midwest. Methods: One hundred and forty-three undergraduate and graduate students attending a midsize metropolitan university in the Midwest completed an online survey in early 2022. Results: Many students surveyed could not identify the definitions of basic terms, such as copay. Furthermore, about 80% of students surveyed could not determine their financial responsibilities in two medical settings. Regression results show that the continent they are from and the length of their stay in the United States significantly predict their understanding of key health insurance terms. More than half of the international students surveyed indicated they often feel confused about their health insurance (57.34%). Only about 20% have delayed or skipped care due to unfamiliarity with the health insurance system. Conclusion: The health insurance literacy of most international students at the midwestern university we surveyed is not ideal. This and possibly other universities in the United States should take more initiatives to help their international students understand the health insurance system.

Influence of Social Determinants of Health on Heart Failure Outcomes: A Systematic Review.

Background Prior research suggests an association between clinical outcomes in heart failure (HF) and social determinants of health (SDoH). Because providers should identify and address SDoH in care delivery, we evaluated how SDoH have been defined, measured, and evaluated in studies that examine HF outcomes. Methods and Results Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, databases were searched for observational or interventional studies published between 2009 and 2021 that assessed the influence of SDoH on outcomes. Selected articles were assessed for quality using a validated rating scheme. We identified 1373 unique articles for screening; 104 were selected for full-text review, and 59 met the inclusion criteria, including retrospective and prospective cohort, cross-sectional, and intervention studies. The majority examined readmissions and hospitalizations (k=33), mortality or survival (k=29), and success of medical devices and transplantation (k=8). SDoH examined most commonly included race, ethnicity, age, sex, socioeconomic status, and education or health literacy. Studies used a range of 1 to 9 SDoH as primary independent variables and 0 to 7 SDoH as controls. Multiple data sources were employed and frequently were electronic medical records linked with national surveys and disease registries. The effects of SDoH on HF outcomes were inconsistent because of the heterogeneity of data sources and SDoH constructs. Conclusions Our systematic review reveals shortcomings in measurement and deployment of SDoH variables in HF care. Validated measures need to be prospectively and intentionally collected to facilitate appropriate analysis, reporting, and replication of data across studies and inform the design of appropriate, evidence-based interventions that can ameliorate significant HF morbidity and societal costs.

Assessing perceived effectiveness of career development efforts led by the women in American Medical Informatics Association Initiative.

OBJECTIVE: We sought to ascertain perceived factors affecting women's career development efforts in the American Medical Informatics Association (AMIA) and to provide recommendations for improvements. MATERIALS AND METHODS: Data were collected using a 27-item survey administered via the AMIA newsletter and other social channels. Survey questions comprised 3 demographics, 15 Likert-scale, and 9 open-ended items. Likert-scale responses were summarized across respondent ages, career stages, and career domains, and open-ended responses were thematically analyzed. RESULTS: We received survey responses from 109 AMIA women members. Our findings demonstrate that AMIA had made strides in promoting career development, and the most effective AMIA efforts included social events (83%), panel discussions (80%), and scientific sessions (79%). However, despite these efforts, women members perceived that gender-specific challenges persisted within AMIA, and recognized the need for increased networking opportunities (96%), raising awareness of gender-specific challenges (95%), and encouraging gender proportional representation in leadership (92%). DISCUSSION: International and national biomedical informatics professional communities have put forth efforts to address gender-specific issues in career development. Yet, our study identified that some of these, including the deep-rooted gender power hierarchy and bias, are still perceived as profound in AMIA. CONCLUSION: Even though existing career development efforts for women are highly effective, important perceived gender-specific career development issues require further attention and investigation to improve existing AMIA activities.

Community Health Worker Impact on Knowledge, Antenatal Care, And Birth Outcomes: A Systematic Review.

OBJECTIVES: Community health worker (CHW) interventions have been shown to be effective in areas of maternal and child health (MCH), mostly in relation to infant and neonatal mortality. The specific aims of this review were to expand outcomes to include improving knowledge related to pregnancy and infant health and the receipt of antenatal care (ANC), along with birth outcomes. We also summarized the role, characteristics and activities of CHWs in interventions conducted in settings with demonstrated improvements in key MCH outcomes. METHODS: Articles were retrieved from: PubMed, CINAHL, Global Health, Scopus, Web of Science, and the Cochrane Library from January 2008 through 2018. We included evaluation studies that utilized CHWs as all or part of an intervention to improve outcomes, were printed in English, and published in peer-reviewed journals. RESULTS: Initial electronic database search identified 816 studies and 123 studies met inclusion criteria for full text review. The quality assessment resulted in 0 strong-, 19 moderate-, and 25 weak-rated studies. In most interventions, CHWs were a component of a larger intervention. The majority of the studies (n = 10) found that a CHW intervention can have a positive impact on outcomes. CHW interventions showed improvements in knowledge and ANC. When combined with clinical services, the interventions positively impacted birth outcomes. Most conducted home visits and utilized CHW that were members of the community. CONCLUSIONS FOR PRACTICE: CHWs serve an important role as health educators conducting home visits as a member of the community they serve. They should also continue to collaborate with clinical providers to address MCH outcomes.

Design and evaluation of a Women in American Medical Informatics Association (AMIA) leadership program.

The objective is to report on the design and evaluation of the inaugural Women in AMIA Leadership Program. A year-long leadership curriculum was developed. Survey responses were summarized with descriptive statistics and quotes selected. Twenty-four scholars participated in the program. There was a significant increase in perceived achievement of learning objectives after the program (P < .0001). The largest improvement was in leadership confidence and presence in work interactions (modal answer Neutral in presurvey from 21 responses rose to Agree in postsurvey from 24 responses). Most (92% of 13) scholars clarified leadership vision and goals and (83% of 18) would be Very Likely to recommend the program to others. The goals of the program-developing women's leader identity, increasing networks, and accumulating experience for future programs-were achieved. The second leadership program is on its way in the United States and Australia. This study may benefit organizations seeking to develop leadership programs for women in informatics and digital health.

A Novel Partnership Between Physicians and Medical Librarians During the COVID-19 Pandemic.

An ongoing collaboration between physicians and librarians provided critical information during the COVID-19 pandemic. A development team, which consisted of the hospital and medical school disaster preparedness medical director, the medical library director, professional librarians, and the Departments of IT and Marketing in a multi-state healthcare system worked together to develop a shared website to distribute and curate timely resources during COVID-19. The initial impacts of this collaboration and the website show the benefits of this novel partnership.

Implementation and Evaluation of the Value of Improved and Sustained Information Access by Library Expertise (VISIBLE) Program.

OBJECTIVE: To increase knowledge of National Library of Medicine resources by using a train-the-trainer approach. METHODS: Workshops were held in spring 2016 to increase knowledge of 4 National Library of Medicine tools. Data were collected before the workshop and immediately, 3 months, and 1 year after the workshop. Knowledge questions were scored as 1 point per question; an aggregated knowledge score could range from 0 to 16 points. A paired t test assessed the change in knowledge from before to after the workshop. RESULTS: Four workshops were hosted, with a total of 74 attendees. The response rate for the surveys ranged from 50% to 100%. Knowledge scores changed significantly from 7.2 to 11.9 (t = 15, P < .001). One year after the workshop, more of the participants reported having informally trained others (56.8%) than reported providing 1 or more formal training session (8.1%)(P < .001). CONCLUSION: Objective measures of knowledge and information dissemination showed that the National Library of Medicine workshop was successful and resulted in both short- and long-term gains. This workshop could be repeated with other populations to further disseminate information regarding the National Library of Medicine tools, which could help improve disaster response.

Educating the Public Health Workforce: A Scoping Review.

The aim of this scoping review was to identify and characterize the recent literature pertaining to the education of the public health workforce worldwide. The importance of preparing a public health workforce with sufficient capacity and appropriate capabilities has been recognized by major organizations around the world (1). Champions for public health note that a suitably educated workforce is essential to the delivery of public health services, including emergency response to biological, manmade, and natural disasters, within countries and across the globe. No single repository offers a comprehensive compilation of who is teaching public health, to whom, and for what end. Moreover, no international consensus prevails on what higher education should entail or what pedagogy is optimal for providing the necessary education. Although health agencies, public or private, might project workforce needs, the higher level of education remains the sole responsibility of higher education institutions. The long-term goal of this study is to describe approaches to the education of the public health workforce around the world by identifying the peer-reviewed literature, published primarily by academicians involved in educating those who will perform public health functions. This paper reports on the first phase of the study: identifying and categorizing papers published in peer-reviewed literature between 2000 and 2015.

Defining Information Quality Into Health Websites: A Conceptual Framework of Health Website Information Quality for Educated Young Adults.

BACKGROUND: Today's health care environment encourages health care consumers to take an active role in managing their health. As digital natives, young educated adults do much of their health information management through the Internet and consider it a valid source of health advice. However, the quality of information on health websites is highly variable and dynamic. Little is known about the understandings and perceptions that young educated adults have garnered on the quality of information on health websites used for health care-related purposes. OBJECTIVE: To fill this gap, the aim of this study was to develop a conceptual framework of health website information quality with quality dimensions (ie, criteria) and associated quality drivers (ie, attributes) specified in the context of young educated adults' use of health websites for health care-related purposes. This aim was achieved by (1) identifying information quality dimensions of health websites from the perspective of young educated adults; (2) identifying the importance ratings of these quality dimensions; and (3) constructing a framework of health website information quality with quality dimensions and associated drivers specified in the context of young educated adults' use of health websites for health care-related purposes. METHODS: The study employed both qualitative and quantitative methods. Methods included semistructured group interviews and an individual quality assessment exercise grounded in visiting various websites and responding to Likert scale questions regarding the importance ratings of information quality dimensions and open-ended questions with specifying website quality drivers. Study participants included junior and senior undergraduate and graduate students in business, allied health, and public health majors. Qualitative, open-coding procedures were used to develop the conceptual framework reflecting the participants' means of assessing information quality on health websites. RESULTS: Five dimensions of information quality for health websites were identified: Completeness of information, Understandability of information, Relevance of information, Depth of information, and Accuracy of information. Completeness of information and Understandability of information were rated as the two most important quality dimensions by the study participants. Results indicated that these five information quality dimensions for health websites were supported by the following main driver themes: Content, Design, Links, Consumer resources, Search functionality, Supporting references, User focus, Content FAQ, Open access, Policy statements, and Site performance. CONCLUSIONS: This study contributes to the literature by developing a health website information quality conceptual framework with quality dimensions and associated drivers specified for a young educated adult population. The detailed quality drivers supporting the corresponding quality dimensions provide a rich picture of young educated adults' perceptions on health website information quality. This framework can be used to guide the development of health websites, as well as the foundation for a means to evaluate health information from existing health websites with young educated adults as the target audience.

The peer-reviewed literature on undergraduate education for public health in the United States, 2004-2014.

The education of undergraduate college students in the field of public health has burgeoned over the past decade. Professional literature in peer-reviewed journals is one indicator of the status of a field of study and its related body of knowledge. It is also a mechanism for sharing information among professionals about challenges, issues, experiences, and best practices. The purpose of the literature review conducted here was to describe the status of the peer-reviewed literature over the past decade pertaining to the education of undergraduates about the field of public health in the United States (U.S.). A literature search was conducted of three databases: PubMed, Scopus, and ERIC. Inclusion criteria were publication date from January 1, 2004 through July 31, 2014; written in the English language; pertaining to undergraduate education in the U.S.; and a focus on public health as the primary discipline. Public health was searched as an overarching discipline; articles focused on sub-disciplines or other health professions disciplines were excluded. The search resulted in 158 articles. Each of the authors reviewed the abstracts for all articles and read full articles when necessary. The result was 23 articles that were then considered in depth. The articles were categorized according to their primary theme: curriculum, courses, learning objectives (N = 14); evaluation of teaching method (N = 3); case study (N = 3); career path and advising (N = 2); accreditation (N = 1). Year of publication and journal were also examined. The results of the literature search lead to several observations about how the peer-reviewed literature has been used to date and how it could be used to advance the emerging field of undergraduate education for public health.

Challenges and Opportunities with Empowering Baby Boomers for Personal Health Information Management Using Consumer Health Information Technologies: an Ecological Perspective.

"Baby Boomers" (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.

Analysis of the literature pertaining to the education of public health professionals.

A well-educated workforce is essential to the infrastructure of a public health system (1). At a time when global focus on public health is increasing, a severe shortage of public health professionals is projected (2). A strong educational framework is thus imperative to ensure the capacity and capability of the worldwide public health workforce for the future. The education of those who work in public health is spread across disciplines, subject-specific training programs and types of academic institutions. In the 2011 report on the Health Professionals for a New Century, Frenk and Chen comment that, compared to medicine and nursing, public health has done the least to examine what and how it teaches (3). This does not bode well for meeting the demands of the public health workforce for the future. The purpose of the study reported here is to analyze the state of pedagogy pertaining to the education of the public health workforce as evidenced by published literature. The focus is on "professionals," defined as those who have formal education, are self-governing, and can work independently.

Disparities by race and ethnicity in cancer survivor stories available on the web.

BACKGROUND: The rapid growth of eHealth could have the unintended effect of deepening health disparities between population subgroups. Most concerns to date have focused on population differences in access to technology, but differences may also exist in the appropriateness of online health content for diverse populations. OBJECTIVE: This paper reports findings from the first descriptive study of online cancer survivor stories by race and ethnicity of the survivor. METHODS: Using the five highest-rated Internet search engines and a set of search terms that a layperson would use to find cancer survivor stories online, we identified 3738 distinct sites. Of these, 106 met study criteria and contained 7995 total stories, including 1670 with an accompanying photo or video image of the survivor. Characteristics of both websites and survivor stories were coded. RESULTS: All racial minority groups combined accounted for 9.8% of online cancer survivor stories, despite making up at least 16.3% of prevalent cancer cases. Also notably underrepresented were stories from people of Hispanic ethnicity (4.1%), men (35.7%), survivors of colon cancer (3.5%), and older adults. CONCLUSIONS: Because racial/ethnic minority cancer survivors are underrepresented in survivor stories available online, it is unlikely that this eHealth resource in its current form will help eliminate the disproportionate burden of cancer experienced by these groups.

The Mobile Reference Service: a case study of an onsite reference service program at the School of Public Health.

The School of Public Health at Saint Louis University is located at a greater distance from the library than other programs on the main medical center campus. Physical distance diminishes the ease of access to direct reference services for public health users. To bridge the gap, the library developed the Mobile Reference Service to deliver on-site information assistance with regular office hours each week. Between September 2006 and April 2007, a total of 57 in-depth reference transactions took place over 25 weeks, averaging 2 transactions per week in a 2-hour period. Overall reference transactions from public health users went up 28%, while liaison contacts with public health users doubled compared to the same period the year before. The Mobile Reference Service program has improved library support for research and scholarship, cultivated and strengthened liaison relationships, and enhanced marketing and delivery of library resources and services to the Saint Louis University School of Public Health.

Intention to use and actual use of electronic information resources: further exploring Technology Acceptance Model (TAM).

Following up a previous study that examined public health students' intention to use e-resources for completing research paper assignments, the present study proposed two models to investigate whether or not public health students actually used the e-resources they intended to use and whether or not the determinants of intention to use predict actual use of e-resources. Focus groups and pre- and post-questionnaires were used to collect data. Descriptive analysis, data screening, and Structural Equation Modeling (SEM) techniques were used for data analysis. The study found that the determinants of intention-to-use significantly predict actual use behavior. Direct impact of perceived usefulness and indirect impact of perceived ease of use to both behavior intention and actual behavior indicated the importance of ease of use at the early stage of technology acceptance. Non-significant intention-behavior relationship prompted thoughts on the measurement of actual behavior and multidimensional characteristics of the intention construct.

Understanding intention to use electronic information resources: A theoretical extension of the technology acceptance model (TAM).

This study extended the Technology Acceptance Model (TAM) by examining the roles of two aspects of e-resource characteristics, namely, information quality and system quality, in predicting public health students' intention to use e-resources for completing research paper assignments. Both focus groups and a questionnaire were used to collect data. Descriptive analysis, data screening, and Structural Equation Modeling (SEM) techniques were used for data analysis. The study found that perceived usefulness played a major role in determining students' intention to use e-resources. Perceived usefulness and perceived ease of use fully mediated the impact that information quality and system quality had on behavior intention. The research model enriches the existing technology acceptance literature by extending TAM. Representing two aspects of e-resource characteristics provides greater explanatory information for diagnosing problems of system design, development, and implementation.

An analysis of the specialized literature in the field of telemedicine.

We studied all articles in journals specializing in telemedicine and indexed in MEDLINE. Non-peer-reviewed journals or those that were in print for less than five years were excluded. The two journals which met the inclusion criteria were the Journal of Telemedicine and Telecare (JTT) and the Telemedicine Journal and E-Health (TJE). For each article we examined the Medical Subject Heading (MeSH) terms, the country of the first author and the study type. In October 2004, there were 1321 articles listed: 993 in the JTT (75%) and 328 in the TJE (25%). The majority of papers were classified as general journal articles; the number classified as clinical trials was very low (4%). Based on the MeSH term, teleradiology was one of the most widely studied application areas (14%). The Internet was used in 137 publications (10%) as a MeSH term. Of all papers, 24% were from the USA, followed by 21% from the UK and 12% from Australia. However, 47 countries contributed the other one-third of papers (9% country unknown). The present study shows that publications in telemedicine cover a wide range, both geographically and in terms of clinical disciplines. This suggests that the field of telemedicine is maturing.

Evidence-based retrieval in evidence-based medicine.

OBJECTIVE: Clinical decisions based on a meta-analysis that is based on an ineffective retrieval strategy may have serious negative consequences for patients. The study objective was to investigate the extent to which meta-analyses report proof of their retrieval strategies' effectiveness. METHODS: The authors examined a random sample (n = 100) of articles in the 1996 to 2002 full-text subset of Ovid MEDLINE indexed as "meta-analysis." We classified the articles in three ways: the article (A) reported both a retrieval strategy in sufficient detail (such that it could be repeated) and with evidence of the strategy's effectiveness, (B) reported a retrieval strategy in sufficient detail but not with evidence of the strategy's effectiveness, or (C) neither reported a strategy in detail nor evidence of the strategy's effectiveness. Articles classified as (A) were further classified according to the level of evidence reported. RESULTS: Of the eighty-nine articles in our final analysis, six (6.7%) were classified as category (A), fifty-seven (64%) as (B), and twenty-six (29%) as (C). Articles in category (A) reported a previously validated search, a published strategy, or strategy based on expert opinion. CONCLUSION: Peer-review standards must be developed that require authors of meta-analyses to report evidence for the effectiveness of their retrieval strategies.