A saúde mental na transição parental e a utilização da internet mediada pelos enfermeiros / Mental health in the parental transition and the use of the internet mediated by nurses

Enquadramento: A transição parental pode ter um significado relevante na saúde mental dos pais. Facilitar esta transição é uma importante função dos enfermeiros. A informoterapia pode beneficiar tomadas de decisão parentais. Um portal orientado para a promoção das competências parentais administrado pela internet, integrado no plano de cuidados individual, pode promover competências parentais, neste caso, relativamente à segurança do recém-nascido. Objetivos: Definir um modelo de dados relativo às oportunidades de desenvolvimento do conhecimento parental sobre segurança do recém-nascido articulado com a ontologia de enfermagem, definir conteúdos multimédia necessários para uma literacia promotora da transição parental saudável. Metodologia: Análise de conteúdo ao material usado nos cursos de preparação e apoio à parentalidade e gravidez em funcionamento nos anos 2020 e 2021, no âmbito das Unidades de Cuidados na Comunidade dos Centros de Saúde da Boavista e de Paranhos. O processo de análise foi realizado por 3 investigadores sem modelo de análise à priori. Resultados: Relativamente ao conhecimento sobre segurança, foram identificadas duas categorias: segurança rodoviária e segurança não rodoviária. Na categoria segurança rodoviária foram definidas vinte subcategorias do conhecimento. Para cada subcategoria determinaram-se questões a colocar aos pais e o elenco de respostas indicativas de conhecimento facilitador ou potencial para melhorar o conhecimento. Conclusões: O conhecimento associado à transição parental pode ser alterado pela ação do enfermeiro através da informoterapia. O uso da internet mediado pelo enfermeiro pode promover a literacia em saúde como parte do processo de cuidados, facilitando a mestria dos pais e a perceção da sua saúde mental. (AU)

Background: Parental transition can impact parents’ mental health. Facilitating this transition process is an essential role of nurses. Information therapy can benefit parental decision-making. A website oriented towards the promotion of parenting skills administered over the internet, integrated into the individual care plan, can promote parenting skills such as newborn safety. Objectives: To define a data model regarding the opportunities for developing parental knowledge about newborn safety, articulated with a nursing ontology, and to define multimedia content appropriated for literacy that promotes a healthy parental transition. Methodology: A content analysis on the material used in parenting and pregnancy courses was carried out under the scope of Boavista and Paranhos Health Centers in 2020 and 2021. The analysis was performed by three independent researchers without a prior analysis model. Results: In the domain of parents’ knowledge about newborn safety, two categories were identified: newborn safety in traffic and newborn safety other than traffic. In the newborn safety in the traffic category, twenty subcategories of knowledge were identified. For each subcategory, a set of questions were defined to be answered by parents and a set of possible answers that represents accurate knowledge and lack of knowledge on each issue. Conclusions: Parents’ knowledge about newborn safety can be modified by nursing therapeutics using information therapy. Nurse-mediated internet use can promote health literacy as part of the care process by facilitating parents’ mastery and perception of their mental health. (AU)

Chapitre 6. Identité physique et identité numérique à l'ère de la distanciation sociale.

The “social distancing” of the Covid-19 crisis has brought to the forefront a phenomenon that has been at work since the rise of the Web: people exchange goods and services, express themselves and meet each other more and more without being physically present. The question of digital identity then emerges. What place do we occupy on the networks? What control do people have over their image? What place do writings occupy in the definition of this digital «image» of oneself? What is the understanding of the plurality of identities that the same person can have online? This article proposes a reflection on these different questions by distinguishing digital identities with and without physical persons.

An Efficient Hybrid Job Scheduling Optimization (EHJSO) approach to enhance resource search using Cuckoo and Grey Wolf Job Optimization for cloud environment.

Cloud computing has now evolved as an unavoidable technology in the fields of finance, education, internet business, and nearly all organisations. The cloud resources are practically accessible to cloud users over the internet to accomplish the desired task of the cloud users. The effectiveness and efficacy of cloud computing services depend on the tasks that the cloud users submit and the time taken to complete the task as well. By optimising resource allocation and utilisation, task scheduling is crucial to enhancing the effectiveness and performance of a cloud system. In this context, cloud computing offers a wide range of advantages, such as cost savings, security, flexibility, mobility, quality control, disaster recovery, automatic software upgrades, and sustainability. According to a recent research survey, more and more tech-savvy companies and industry executives are recognize and utilize the advantages of the Cloud computing. Hence, as the number of users of the Cloud increases, so did the need to regulate the resource allocation as well. However, the scheduling of jobs in the cloud necessitates a smart and fast algorithm that can discover the resources that are accessible and schedule the jobs that are requested by different users. Consequently, for better resource allocation and job scheduling, a fast, efficient, tolerable job scheduling algorithm is required. Efficient Hybrid Job Scheduling Optimization (EHJSO) utilises Cuckoo Search Optimization and Grey Wolf Job Optimization (GWO). Due to some cuckoo species' obligate brood parasitism (laying eggs in other species' nests), the Cuckoo search optimization approach was developed. Grey wolf optimization (GWO) is a population-oriented AI system inspired by grey wolf social structure and hunting strategies. Make span, computation time, fitness, iteration-based performance, and success rate were utilised to compare previous studies. Experiments show that the recommended method is superior.

Evaluating the Alignment and Quality of Microgreens Training Materials Available on the Internet: A Content Analysis.

Interest in microgreens, young, edible seedlings of a variety of vegetables, spices, and herbs, is growing worldwide. A recent national survey of the U.S. microgreen industry reported 48% of 176 growers learned to grow microgreens by viewing websites and videos on the internet. However, it is unknown if the content related to growing microgreens is aligned with regulations and clearly presented. The aim of this research was to conduct a content analysis to determine alignment with the Food Safety and Modernization Act Produce Safety Rule (PSR)and the presentation quality of existing microgreen training materials available on the internet. Microgreen training materials were collected using two search engines - Google and YouTube. A deductive approach was used to inform the development of three coding manuals to evaluate the training materials meeting the eligibility criteria. One was used to determine the alignment of the content and was based on the PSR. The other two manuals were used to determine the presentation quality of Google and YouTube training materials according to CDC's Quality E-learning Checklist. A total of 223 training materials (86 Google and 137 YouTube), which fulfilled the inclusion criteria, were selected for the analysis. The results of the alignment with the PSR revealed that both sources minimally covered food safety principles with several areas minimally or not addressing specific information (e.g., water testing, worker training, environmental monitoring, and record keeping). In addition, some food safety information was unclear or presented conflicting information (e.g., requirement of washing microgreens, cleaning and sanitization methods, seed treatment methods, and waste management). The Google and YouTube quality scoring systems resulted in a mean quality score of 15.81 and 22 of a maximum score of 28, respectively. These findings indicate the quality and alignment with the PSR of microgreen training materials need to be improved.

Perceived social support and compliance on stay-at-home order during COVID-19 emergency in Nepal: an evidence from web-based cross-sectional study.

BACKGROUND: After COVID-19 was declared a Public Health Emergency of International Concern by WHO, several non-pharmaceutical interventions were adopted for containing the virus. Success to which largely depend upon citizens' compliance to these measures. There is growing body of evidence linking social support with health promoting behaviour. Hence, this research aimed to study the effects on compliance with stay-at-home order in relation to their perceived social support. METHODS: A web-based cross-sectional study was conducted among adult participants aged 18 years and above residing in Bagmati Province, Nepal. A convenient non-probability sampling method was adopted to select the required number of samples. The questionnaire was developed through an extensive review of literature, and consultations with the research advisor, subject experts, as well as peers and converted to online survey form using Google Forms. Perceived social support was measured using the Multidimensional Scale of Perceived Social Support (MSPSS) scale whereas compliance was assessed using a single screening question. Statistical analysis was performed using SPSS version 20 involving both the descriptive and inferential statistics. RESULTS: Two fifth (40.2%) of the participants reported poor compliance with stay-at-home order which was found higher among participants who were not vaccinated against COVID-19 compared to those vaccinated (p value < 0.05). A significant difference was observed between sex and perceived support (p value < 0.05) with higher proportion (80.8%) of female participants reporting perceived support from family, friends, and significant others in comparison to male participants. CONCLUSION: Overall, the results of this study suggest that the perceived support from family is higher compared to others. Further evidence might be helpful to understand contextual factors on compliance with public health measures. Tailoring behaviour change messages as per the community needs would help the response in such emergencies. The findings from this study might be useful as one of the evidence base for formulating plans and policy during emergencies of similar nature.

Internet Media and Universal Trust: An Analysis of the Impact on the Psychology of Social Interaction among Chinese Netizens.

Objectives: With the rapid advancement of the "Internet +" era, network media have an increasingly greater influence on human production and lifestyle. However, the network security situation has become more serious, which has affected the trust of netizens in society. In this study, we explore the interaction between online media and universal trust, and further analyze the social psychological impact on Chinese netizens. Methods: We collected data from the "China General Social Survey" (CGSS) in 2017, using a 4-stage unequal probability sampling. We set 3 hypotheses and used a binary logistic regression model for data analysis. Results: We found that the universal trust of respondents who use online media as their main source of information is lower than that of traditional media, while social interaction and class status have a significant weakening effect on the negative impact of online media and its universal trust. Conclusions: These results contribute to further expansion of the theoretical and practical implications. The use of data ensures robust research conclusions; we propose factors that increase Chinese netizens' trust in online media.

Aboriginal and Torres Strait Islander Women's Access to and Interest in mHealth: National Web-based Cross-sectional Survey.

BACKGROUND: Health programs delivered through digital devices such as mobile phones (mobile health [mHealth]) have become an increasingly important component of the health care tool kit. Aboriginal and Torres Strait Islander women of reproductive age are likely to be caring for children and family members and needing health care, but little is known about their access to and interest in mHealth. OBJECTIVE: The objectives of this study were to investigate Aboriginal and Torres Strait Islander women's ownership of digital devices, access to the internet, current mHealth use, and interest and preferences for future mHealth. We examined the factors (age, remoteness, caring for a child younger than 5 years, and level of education) associated with the ownership of digital devices, use of internet, and interest in using a mobile phone to improve health. This study also examines if women are more likely to use mHealth for topics that they are less confident to talk about face-to-face with a health professional. METHODS: A national web-based cross-sectional survey targeting Aboriginal and Torres Strait Islander women of reproductive age (16-49 years) was performed. Descriptive statistics were reported, and logistic regressions were used to examine the associations. RESULTS: In total, 379 women completed the survey; 89.2% (338/379) owned a smartphone, 53.5% (203/379) a laptop or home computer, 35.6% (135/379) a tablet, and 93.1% (353/379) had access to the internet at home. Most women used social media (337/379, 88.9%) or the internet (285/379, 75.2%) everyday. The most common modality used on the mobile phone for health was Google (232/379, 61.2%), followed by social media (195/379, 51.5%). The most preferred modality for future programs was SMS text messaging (211/379, 55.7%) and social media (195/379, 51.4%). The most preferred topics for future mHealth programs were healthy eating (210/379, 55.4%) and cultural engagement (205/379, 54.1%). Women who were younger had greater odds of owning a smartphone, and women with tertiary education were more likely to own a tablet or laptop. Older age was associated with interest to use telehealth, and higher educational attainment was associated with interest for videoconferencing. Most women (269/379, 70.9%) used an Aboriginal medical service and overall reported high rates of confidence to discuss health topics with a health professional. Overall, women showed a similar likelihood of selecting a topic in mHealth whether they were or were not confident to talk to a health professional about that. CONCLUSIONS: Our study found that Aboriginal and Torres Strait Islander women were avid users of the internet and had strong interest in mHealth. Future mHealth programs for these women should consider utilizing SMS text messaging and social media modalities and including content on nutrition and culture. A noteworthy limitation of this study was that participant recruitment was web-based (due to COVID-19 restrictions).

NDEx IQuery: a multi-method network gene set analysis leveraging the Network Data Exchange.

MOTIVATION: The investigation of sets of genes using biological pathways is a common task for researchers and is supported by a wide variety of software tools. This type of analysis generates hypotheses about the biological processes that are active or modulated in a specific experimental context. RESULTS: The Network Data Exchange Integrated Query (NDEx IQuery) is a new tool for network and pathway-based gene set interpretation that complements or extends existing resources. It combines novel sources of pathways, integration with Cytoscape, and the ability to store and share analysis results. The NDEx IQuery web application performs multiple gene set analyses based on diverse pathways and networks stored in NDEx. These include curated pathways from WikiPathways and SIGNOR, published pathway figures from the last 27 years, machine-assembled networks using the INDRA system, and the new NCI-PID v2.0, an updated version of the popular NCI Pathway Interaction Database. NDEx IQuery's integration with MSigDB and cBioPortal now provides pathway analysis in the context of these two resources. AVAILABILITY AND IMPLEMENTATION: NDEx IQuery is available at https://www.ndexbio.org/iquery and is implemented in Javascript and Java.

Using Theoretical Models of Problematic Internet Use to Inform Psychological Formulation: A Systematic Scoping Review.

BACKGROUND: Empirical research has been produced on the topic of 'Internet Addiction' or 'Problematic Internet Use' (PIU) for more than 20 years, with a variety of theoretical approaches suggested by scholars to account for the behaviour. However, the discourse has been fraught with debate around construct definition, measurement, and validity. AIMS: This review aimed to systematically review the extant literature on the topic of PIU, to identify the published psychological theories in the area, and to synthesise the findings to produce actionable information for practicing psychologists as well as academics. METHOD: Given the breadth of the aims, a scoping review methodology was utilised. Four major reference libraries (Scopus, Proquest, Pubmed, Technology Research Database) were searched using a string of relevant terms. RESULTS: Of 1412 initial search results, eighteen theories were included in the study. Nine theories related to generalised PIU, seven related to specific Internet use issues, such as online gaming or social media, while two theories took account of both a generalised and specific view. Data were analysed using Formulation-Based Thematic Analysis (FBTA) to synthesise theory elements under the deductive headings of Predisposing, Precipitating, Maintaining, and Protective factors. DISCUSSION: The lack of protective factors against PIU was a prominent finding. The utility of the psychological formulation approach, particularly in an area fraught with conceptual debate and frustration with traditional medical classification systems, is emphasised.

Patient-reported burden and overall impact of dry eye disease across eight European countries: a cross-sectional web-based survey.

OBJECTIVE: Dry eye disease (DED) is a multifactorial disease involving the tears and ocular surface. It impacts a patient's quality of life (QoL) and ability to perform daily activities. This study assessed the burden of self-reported DED among adults in eight European countries. DESIGN: Online cross-sectional survey. SETTING: General population in France, Italy, Germany, Greece, the Netherlands, Portugal, Spain and Sweden. PARTICIPANTS: Adults aged ≥18 years with (n=6084) and without (n=6161) self-reported DED were recruited via emails and screened. MAIN OUTCOME MEASURES: All participants completed National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and EuroQol-5 Dimension-5 Level Questionnaire (EQ-5D-5L). All DED participants completed the Eye Dryness Score (EDS) Visual Analogue Scale, and Ocular Comfort Index and Work Productivity and Activity Impairment Questionnaire: Specific Health Problem questionnaires. In addition, half of the respondents with DED completed Survey A (Impact of Dry Eye on Everyday Life) and the other half completed Survey B (Standard Patient Evaluation of Eye Dryness Questionnaire) and Dry Eye Questionnaire-5. RESULTS: Participants with self-reported DED had lower functional vision and lower overall health status than participants without self-reported DED as measured by the NEI-VFQ and EQ-5D-5L, respectively.Increasing self-reported DED severity as measured by the EDS was shown to correspond with worse symptom severity/frequency, lower functional vision, higher impact on work productivity, daily activities and QoL. CONCLUSION: This study showed that patients' reported burden of self-reported DED was similar across the eight European countries. Those with self-reported DED reported lower health status and functional vision compared to those without self-reported DED and these parameters worsen with increasing disease severity.

Machine learning algorithms distinguish discrete digital emotional fingerprints for web pages related to back pain.

Back pain is the leading cause of disability worldwide. Its emergence relates not only to the musculoskeletal degeneration biological substrate but also to psychosocial factors; emotional components play a pivotal role. In modern society, people are significantly informed by the Internet; in turn, they contribute social validation to a "successful" digital information subset in a dynamic interplay. The Affective component of medical pages has not been previously investigated, a significant gap in knowledge since they represent a critical biopsychosocial feature. We tested the hypothesis that successful pages related to spine pathology embed a consistent emotional pattern, allowing discrimination from a control group. The pool of web pages related to spine or hip/knee pathology was automatically selected by relevance and popularity and submitted to automated sentiment analysis to generate emotional patterns. Machine Learning (ML) algorithms were trained to predict page original topics from patterns with binary classification. ML showed high discrimination accuracy; disgust emerged as a discriminating emotion. The findings suggest that the digital affective "successful content" (collective consciousness) integrates patients' biopsychosocial ecosystem, with potential implications for the emergence of chronic pain, and the endorsement of health-relevant specific behaviors. Awareness of such effects raises practical and ethical issues for health information providers.

Readability of patient and family education materials on pediatric surgical association websites.

PURPOSE: Globally, pediatric surgical association websites present patient/family education materials on an extensive list of conditions, including descriptions of the condition, signs and symptoms, diagnostic modalities, and treatment options. The purpose of this project was to assess the readability of pediatric surgical association websites' patient/family education materials. METHODS: With IRB approval, we accessed all patient/family education materials on pediatric surgical association websites from around the globe and used multiple grade-level assessments and readability assessments to determine the reading level at which the information is presented. RESULTS: The American Pediatric Surgical Association (APSA) website and the British Association of Paediatric Surgeons (BAPS) present publicly accessible patient/family education materials. Seventy-four (74) conditions on APSA's website were analyzed. Three grade-level assessments and the Flesch Reading Ease assessment indicated that the articles are written at high school reading levels. No articles were available in languages other than English. BAPS presented 6 conditions, most of which were more readable than their APSA counterparts. CONCLUSIONS: Our analysis indicates that the patient/family education materials available on pediatric surgical association websites may not be written at a level that is comprehensible by the general population. Potential solutions include re-writing the materials with an emphasis on readability and presenting materials in languages other than English. LEVEL OF EVIDENCE: V.

Effects of resourcefulness on internet game addiction among college students: The mediating role of anxiety and the moderating role of gender.

Introduction: The mechanism of internet game addiction is unclear. Whether anxiety mediates between resourcefulness and internet game addiction and whether gender affect its mediation role have not been studied previously. Methods: A total of 4,889 college students from a college in southwest China were included in this study to complete the investigation, in which three questionnaires were used for evaluation. Results: Pearson's correlation analysis indicated a remarkable negative correlation between resourcefulness with internet game addiction and anxiety, as well as a significant positive correlation between anxiety and this addiction. The structural equation model confirmed the mediation role of anxiety. The multi-group analysis confirmed the moderating role of gender in the mediation model. Discussion: These findings have advanced the results of existing studies, indicating the buffering effect of resourcefulness on internet game addiction and revealing the potential mechanism of this relationship.

The Heterogeneous Impact of Internet Use on Older People's Mental Health: An Instrumental Variable Quantile Regression Analysis.

Objectives: Whether Internet use improves older people's health is an open question. This study empirically investigated the impact of Internet use on older people's mental health with a focus on the heterogeneity among subgroups. Method: Data come from the 2018 China Health Retirement Longitudinal Study (n = 8,505). An instrumental variable quantile regression method (IVQR) combines the instrumental variable and quantile regression to resolve the endogeneity and heterogeneity generally challenged in ordinary least squares (OLS). Results: Although Internet use generally improves older people's mental health, there is enormous heterogeneity in the effects on older adults with different mental health conditions. Specifically, Internet use only has a mitigating impact on older adults with poor mental health. Those heterogeneities are also found between rural and urban residents but not between genders. Conclusion: Our findings shed light on active and healthy aging strategies. Two policy priorities include, on the one hand, the Internet user environment should be improved in parallel with Internet technology; on the other hand, multiple measurements are urgent to be developed to deal with the heterogeneity and unevenness of the impact of Internet technology on older people.

Testing effects of partner support and use of oral contraception during relationship formation on severity of nausea and vomiting in pregnancy.

BACKGROUND: A recent study focusing on dietary predictors of nausea and vomiting in pregnancy (NVP) found that women with higher levels of partner support, and those who had used oral contraception (OC) when they met the father, both tended to report less severe NVP compared with previous non-users or those with less supportive partners. We provide a further test of these factors, using a large sample of women from four countries who retrospectively scored their NVP experience during their first pregnancy. METHODS: We recruited women who had at least one child to participate in a retrospective online survey. In total 2321 women completed our questionnaire including items on demographics, hormonal contraception, NVP, and partner support. We used general linear models and path analysis to analyse our data. RESULTS: Women who had used OC when they met the father of their first child tended to report lower levels of NVP, but the effect size was small and did not survive adding the participant's country to the model. There was no relationship between NVP and partner support in couples who were still together, but there was a significant effect among those couples that had since separated: women whose ex-partner had been relatively supportive reported less severe NVP. Additional analyses showed that women who were older during their first pregnancy reported less severe NVP, and there were also robust differences between countries. CONCLUSIONS: These results provide further evidence for multiple influences on women's experience of NVP symptoms, including levels of perceived partner support.

The Relationship Between How Participants Articulate Their Goals and Accomplishments and Weight Loss Outcomes: Secondary Analysis of a Pilot of a Web-Based Weight Loss Intervention.

BACKGROUND: In behavioral weight loss interventions, participants are asked to set weekly goals to support long-term habits that lead to weight loss. Although participants are asked to set and accomplish weekly goals, we do not know how often they do this and whether doing so is associated with weight loss. Web-based weight loss interventions allow for the analysis of participant engagement data, including how participants articulate their goals and accomplishments. OBJECTIVE: Using engagement data from a web-based weight loss intervention, we examined whether participants articulating their goals and accomplishments in measurable and repeating terms were associated with greater weight loss. METHODS: Adults with overweight or obesity received a 12-week Facebook-delivered weight loss intervention based on the Diabetes Prevention Program Lifestyle Intervention. Participants replied to conversation threads that queried about their goals and accomplishments. Two independent coders classified participants' posts that articulated goals or accomplishments as measurable or repeating. Crude and age-adjusted linear regression models were used to examine the relationship between the frequency of post type and percent weight loss. RESULTS: Participants (N=53; n=48, 91% female; n=48, 91% non-Hispanic White) were on average 46.2 (SD 10.5) years old with a mean BMI of 32.4 (SD 4.8) kg/m2. Over 12 weeks, participants shared a median of 4 (IQR 1-8) posts that reported goals and 10 (IQR 4-24) posts that reported accomplishments. Most participants shared ≥1 post with a goal (n=43, 81%) and ≥1 post with an accomplishment (n=47, 89%). Each post reporting a goal was associated with 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing ≥1 post with a repeating goal was associated with an average of 2.2% greater weight loss (95% CI -3.9% to -0.4%). Each post with a repeating goal was associated with an average of 0.5% greater weight loss (95% CI -1.0% to 0.0%). Sharing ≥1 post with measurable and repeating goals was associated with an average of 1.9% greater weight loss (95% CI -3.7% to -0.2%). Sharing each post with an accomplishment was associated with an average of 0.1% greater weight loss (95% CI -0.1% to 0.0%). Every post with an accomplishment that was repeating was associated with an average of 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing other types of goals and accomplishments was not associated with weight loss. CONCLUSIONS: In a web-based weight loss intervention, stating goals in repeating or both measurable and repeating terms was associated with greater weight loss, but simply stating them in measurable terms was not. For accomplishments, only those articulated in repeating terms were associated with greater weight loss. Posts about one-time goals and accomplishments represent an opportunity to encourage planning for future behaviors. Future research should examine if stating goals and accomplishments in repeating terms signals habit formation.

Training Health Care Practitioners to Include Family Caregivers With Web-Based Learning Modules.

Background Caregivers play a key role in supporting patient health; however, they have largely been excluded from participating in health care teams. This paper describes development and evaluation of web-based training for health care professionals about including family caregivers, implemented within the Department of Veterans Affairs Veterans Health Administration. Systematically training health care professionals constitutes a critical step toward shifting to a culture of purposefully and effectively utilizing and supporting family caregivers for better patient and health system outcomes. Methods Module development included Department of Veterans Affairs health care stakeholders and consisted of preliminary research and a design approach to set the framework, followed by iterative, collaborative team processes to write the content. Evaluation included pre- and postassessments of knowledge, attitudes, and beliefs. Results Overall, 154 health professionals completed pretest questions and 63 additionally completed the posttest. There was no observable change in knowledge. However, participants indicated a perceived desire and need for practicing inclusive care as well as an increase in self-efficacy (belief in their ability to accomplish a task successfully under certain conditions). Conclusion This project demonstrates the feasibility of developing web-based training to improve the beliefs and attitudes of health care professionals about inclusive care. Training constitutes one step toward shifting to a culture of inclusive care, and research should identify longer-term effects and other evidence-based interventions.