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161.
Brittany O. Dulmage Lisa Akintilo Leah J. Welty Matthew M. Davis Maria Colavincenzo Shuai Xu 《The American journal of medicine》2018,131(9):1130-1134.e6
IMPORTANCE
Residency applicants often use social media to discuss the positive and negative features of prospective training programs. An examination of the content discussed by applicants could provide guidance for how a medical education faculty can better engage with prospective trainees and adapt to meet the educational expectations of a new generation of digital-native physicians.OBJECTIVE
The objective was to identify unstructured social media data submitted by residency applicants and categorize positive and negative statements to determine key themes.DESIGN
The study design was qualitative analysis of a retrospective cohort.SETTING
Publicly available datasets were used.PARTICIPANTS
The participants were anonymized medical trainees applying to residency training positions in 9 specialties—dermatology, general surgery, internal medicine, obstetrics/gynecology, plastic surgery, otolaryngology, physical medicine and rehabilitation, pediatrics, and radiology—from 2007 to 2017.MAIN OUTCOMES AND MEASURES
After we developed a standardized coding scheme that broke comments down into major features, themes, and subthemes, all unstructured comments were coded by two independent researchers. Positive and negative comments were coded separately. Frequency counts and percentages were recorded for each identified feature, theme, and subtheme. The percent positive and negative comments by specialty were also calculated.RESULTS
: Of the 6314 comments identified, 4541 were positive and 1773 were negative. Institution was the most commonly cited major feature in both the positive (n?=?767 [17%]) and negative (n?=?827 [47%]) comments. Geography was the most cited theme, and City, Cost of Living, and Commute were commonly cited subthemes. Training was the next most cited major feature in both positive (n?=?1005 [22%]) and negative (n?=?291 [16%]) comments, with Clinical Training being more commonly cited compared to Research Opportunities. Overall, 72% of comments from all were positive; however, the percent of comments that were positive comments varied significantly across the 9 specialties. Pediatrics (65%), dermatology (66%), and internal medicine (68%) applicants were more likely to express negative comments compared with the global average, but physical medicine and rehabilitation (85%), radiology (82%), otolaryngology (81%), and plastic surgery (80%) applicants were more likely to express positive comments.CONCLUSIONS AND RELEVANCE
This qualitative analysis of positive and negative themes as posted by applicants in recent matching years is the first and provides new detailed insights into the motivations and desires of trainees. 相似文献162.
163.
164.
Mun Young Chang Jeong-Whun Kim Chae-Seo Rhee 《Allergy, asthma & immunology research》2015,7(2):141-147
PurposeThe internet has become one of the most important media outlets used to obtain health information. Therefore, the quality of health information available on the internet is very important. We evaluated the quality of internet-derived health information on allergic rhinitis, rhinitis and sinusitis and compared these results to those of previous studies performed five years ago.MethodsThe terms "allergic rhinitis (AR)", "rhinitis" and "sinusitis" were searched among the four most commonly used search engines in South Korea. These websites were evaluated according to the author, the Journal of the American Medical Association (JAMA) benchmarks, the DISCERN questionnaire and the Allergic rhinitis and its Impact on Asthma (ARIA) 2008 Update.ResultsA total of 120 websites were obtained and analyzed. For all diseases, "Oriental physician" had the largest portion (almost half of all websites), followed by "Western physician". Based on analyses using the JAMA benchmark, "Attribution" and "Disclosure" were ignored in almost all surveyed websites. According to the scores of the DISCERN question, the majority of websites did not supply appropriate references for their health information, and information on the negative aspects of treatment such as risks and uncertainty was not provided in several websites. In an analysis based on the ARIA 2008 Update concepts, 65% of websites pertaining to health information on AR contained unreliable information.ConclusionsThe quality of health information on the internet was not acceptable. Thus, governmental regulation or control to improve the quality of health information is required. 相似文献
165.
Tomas Rozbroj Anthony Lyons Marian Pitts Anne Mitchell Helen Christensen 《Journal of medical Internet research》2015,17(3)
BackgroundE-therapies for depression and anxiety rarely account for lesbian and gay users. This is despite lesbians and gay men being at heightened risk of mood disorders and likely to benefit from having access to tailored self-help resources.ObjectiveWe sought to determine how e-therapies for depression and anxiety could be improved to address the therapeutic needs of lesbians and gay men.MethodsWe conducted eight focus groups with lesbians and gay men aged 18 years and older. Focus groups were presented with key modules from the popular e-therapy “MoodGYM”. They were asked to evaluate the inclusiveness and relevance of these modules for lesbians and gay men and to think about ways that e-therapies in general could be modified. The focus groups were analyzed qualitatively using a thematic analysis approach to identify major themes.ResultsThe focus groups indicated that some but not all aspects of MoodGYM were suitable, and suggested ways of improving e-therapies for lesbian and gay users. Suggestions included avoiding language or examples that assumed or implied users were heterosexual, improving inclusiveness by representing non-heterosexual relationships, providing referrals to specialized support services and addressing stigma-related stress, such as “coming out” and experiences of discrimination and harassment. Focus group participants suggested that dedicated e-therapies for lesbians and gay men should be developed or general e-therapies be made more inclusive by using adaptive logic to deliver content appropriate for a user’s sexual identity.ConclusionsFindings from this study offer in-depth guidance for developing e-therapies that more effectively address mental health problems among lesbians and gay men. 相似文献
166.
Royer F Cook Rebekah K Hersch Dana Schlossberg Samantha L Leaf 《Journal of medical Internet research》2015,17(3)
BackgroundRecent evidence supports the efficacy of programs that promote improvements in the health practices of workers 50 years and older who are at higher risk for chronic diseases than younger workers are. Internet-based programs that promote healthy practices have also shown promise and, therefore, should be especially appropriate for workers aged 50 years and older.ObjectiveThe purpose of the research was to evaluate the effectiveness of HealthyPast50, a fully automated Web-based health promotion program based on social cognitive theory and aimed specifically at workers 50 years and older.MethodsThe randomized controlled trial was conducted across multiple US offices of a large global information technology company. The sample included 278 employees aged 50 to 68 who were recruited online and randomly assigned to the Web-based HealthyPast50 program or to a wait-list control condition. Self-report measures of diet, physical activity, stress, and tobacco use were collected online before and 3 months after the program group was given access to the program. Use data included number of log-ins and number of pages accessed. The primary analysis was multiple linear regression, following intent-to-treat principles with multiple imputation using the Markov chain Monte Carlo (MCMC) approach for nonmonotone missing data. Potential moderators from demographic characteristics and program dosage effects were assessed using multiple linear regression models. Additional analyses were conducted on complete (nonimputed) cases, excluding program participants who used the program for less than 30 minutes.ResultsRetention rates were good for both groups: 80.4% (111/138) for the program group and 94.3% (132/140) for the control group. Program group participants spent a mean of 102.26 minutes in the program (SD 148.32), logged in a mean of 4.33 times (SD 4.28), and viewed a mean of 11.04 pages (SD 20.08). In the analysis of the imputed dataset, the program group performed significantly better than the control group on diet behavioral change self-efficacy (estimated adjusted difference [Δ]=0.16, P=.048), planning healthy eating (Δ=0.17, P=.03), and mild exercise (Δ=1.03, P=.01). Moderator and dosage analyses of the dataset found no significant program effects. Analyses of the nonimputed dataset comparing program users with controls found additional significant program effects on eating practices (Δ=0.09, P=.03), exercise self-efficacy (Δ=0.12, P=.03), exercise planning (Δ=0.18, P=.03), and aging beliefs (Δ=0.17, P=.01). Moderator analysis of this dataset also found significant moderator effects of gender on multiple measures of exercise.ConclusionsA Web-based health promotion program showed promise for making a significant contribution to the short-term dietary and exercise practices of older working adults. Gender effects suggest that the program effects on exercise are due mainly to improvements among women. 相似文献
167.
Carys A Pugh Kim M Summers B Mark C Bronsvoort Ian G Handel Dylan N Clements 《Journal of medical Internet research》2015,17(4)
Background
Internet-based data collection relies on well-designed and validated questionnaires. The theory behind designing and validating questionnaires is well described, but few practical examples of how to approach validation are available in the literature.Objective
We aimed to validate data collected in an ongoing Internet-based longitudinal health study through direct visits to participants and recall of their health records. We demonstrate that despite extensive pre-planning, social desirability can still affect data in unexpected ways and that anticipation of poor quality data may be confounded by positive validation.Methods
Dogslife is a large-scale, Web-based longitudinal study of canine health, in which owners of Labrador Retrievers were recruited and questioned at regular intervals about the lifestyle and health of their dogs using an Internet-based questionnaire. The Dogslife questionnaire predominantly consists of closed-answer questions. In our work, two separate validation methodologies were used: (1) direct interviews with 43 participants during visits to their households and (2) comparison of owner-entered health reports with 139 historical health records.Results
Our results indicate that user-derived measures should not be regarded as a single category; instead, each measurement should be considered separately as each presents its own challenge to participants. We recommend trying to ascertain the extent of recall decay within a study and, if necessary, using this to guide data collection timepoints and analyses. Finally, we recommend that multiple methods of communication facilitate validation studies and aid cohort engagement.Conclusions
Our study highlighted how the theory underpinning online questionnaire design and validation translates into practical data issues when applied to Internet-based studies. Validation should be regarded as an extension of questionnaire design, and that validation work should commence as soon as sufficient data are available. We believe that validation is a crucial step and hope our suggested guidelines will help facilitate validation of other Internet-based cohort studies. 相似文献168.
Cecilie Varsi Mirjam Ekstedt Deede Gammon Cornelia M Ruland 《Journal of medical Internet research》2015,17(11)
Background
Although there is growing evidence of the positive effects of Internet-based patient-provider communication (IPPC) services for both patients and health care providers, their implementation into clinical practice continues to be a challenge.Objective
The 3 aims of this study were to (1) identify and compare barriers and facilitators influencing the implementation of an IPPC service in 5 hospital units using the Consolidated Framework for Implementation Research (CFIR), (2) assess the ability of the different constructs of CFIR to distinguish between high and low implementation success, and (3) compare our findings with those from other studies that used the CFIR to discriminate between high and low implementation success.Methods
This study was based on individual interviews with 10 nurses, 6 physicians, and 1 nutritionist who had used the IPPC to answer messages from patients.Results
Of the 36 CFIR constructs, 28 were addressed in the interviews, of which 12 distinguished between high and low implementation units. Most of the distinguishing constructs were related to the inner setting domain of CFIR, indicating that institutional factors were particularly important for successful implementation. Health care providers’ beliefs in the intervention as useful for themselves and their patients as well as the implementation process itself were also important. A comparison of constructs across ours and 2 other studies that also used the CFIR to discriminate between high and low implementation success showed that 24 CFIR constructs distinguished between high and low implementation units in at least 1 study; 11 constructs distinguished in 2 studies. However, only 2 constructs (patient need and resources and available resources) distinguished consistently between high and low implementation units in all 3 studies.Conclusions
The CFIR is a helpful framework for illuminating barriers and facilitators influencing IPPC implementation. However, CFIR’s strength of being broad and comprehensive also limits its usefulness as an implementation framework because it does not discriminate between the relative importance of its many constructs for implementation success. This is the first study to identify which CFIR constructs are the most promising to distinguish between high and low implementation success across settings and interventions. Findings from this study can contribute to the refinement of CFIR toward a more succinct and parsimonious framework for planning and evaluation of the implementation of clinical interventions.ClinicalTrial
Clinicaltrials.gov NCT00971139; http://clinicaltrial.gov/ct2/show/NCT00971139 (Archived by WebCite at http://www.webcitation.org/6cWeqN1uY) 相似文献169.
170.
Mary Rocheleau Rajani Shankar Sadasivam Kate Baquis Hannah Stahl Rebecca L Kinney Sherry L Pagoto Thomas K Houston 《Journal of medical Internet research》2015,17(1)