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Philosophiae Doctor - PhD / This study sought to investigate the information needs of selected HIV and AIDS health organisations in Zimbabwe with a view to proposing a framework for developing an information access platform. ICTs can play a pivotal role in improving access to HIV and AIDS information and in coordinating HIV and AIDS activities in Zimbabwe. However, the development of ICTs in Zimbabwe’s health sector has been haphazard and idiosyncratic to a plethora of HIV and AIDS organisations operating in Zimbabwe. This study proposes a framework for the development of ICTs for accessing HIV and AIDS information in Zimbabwe. The needs-based framework was proposed after evaluating the information needs of healthcare workers and current health information technologies. An integrated theoretical framework incorporating the General System Theory, the Social Construction of Technology theory and the HOT-fit model was used to frame the study.

The increasing use of health information technology (HIT) is due to a rising interest in improving the quality of health care. HIT has the potential to reduce cost and transform services. Proper clinical support systems will contribute to the meaningful use of HIT systems by providing a wide array of data to clinicians for the diagnosis and treatments. Clinical guidelines, created by a consensus of experts, can be put in place to assist physicians in making clinical decisions. Delphi methods are commonly used to create consensus from surveys completed by a team of experts. Image-based studies could create guidelines that standardize severity, deformity or other clinical classifications. As these studies were traditionally conducted using paper-based media, the cost and time requirement often make the process impractical. Using state of the art Web 2.0 technologies, a web-based system can aid medical researchers in conducting image-based Delphi studies for improved clinical guidelines and decision support.

The purpose of this research study is to examine the effect of public information sources on an individual's satisfaction with the search process undertaken to select a physician. A quasiexperimental research design was adopted to randomly divide the medical staff of a large central Florida medical group into control and intervention groups of approximately 77 physicians each. The intervention involved insertion of the website address to online physician report cards on to each intervention group physician’s profile in the physician directory on the medical group's website. After two months, data were collected consisting of all individuals who had scheduled first-time appointments with one of the medical group's physicians during the two-month intervention period. A random sample of patients was drawn from each group and sample members were mailed a 62-item questionnaire along with a cover letter, summary of the research and postage-paid reply envelope. A total of 706 questionnaires were mailed and 61 completed questionnaires were returned, an 8.64% response rate. Intent-to-treat analysis was conducted using independent-samples t-tests to compare the research study’s continuous variables' mean scores for control and intervention group participants. The analysis revealed no significant difference in scores for control and intervention groups with the exceptions that the control group was somewhat more committed to conducting a search and selecting a new physician. The control group said the physician's communications skills influenced their satisfaction with the search and selection of a new physician quite a lot while the intervention group said physician communication skills somewhat influenced their satisfaction with search and selection. iv Results of the covariance structure analysis demonstrated that information use and level of commitment to search and select a new physician independently predict search satisfaction. As information use and search commitment increase, a patient's satisfaction with the search increases as well. Furthermore, as information use increases, the variety of information sources relied upon or used also increases. The findings support the alternative hypothesis that the positive or direct effect of physician report cards is demonstrated in the time and cost of patient search for a physician for both intervention and control groups. One other alternative hypothesis was partially supported, i.e., the effect of household income is confirmed in patient search and satisfaction in selecting a physician. The alternative hypotheses that proposed that physician report cards are more likely to be used to search for a medical specialist and that physician experience, office location and accepted insurance effect patient search and selection of a physician were not tested. Two other alternative hypotheses were rejected. The research findings also indicated that predictors of health care information search satisfaction vary based upon the environment and contextual factors in which the search is conducted.

Finding health information online continues to help patients understand new symptoms. However, incomplete information or advice that errs on the site of caution can cause distress or anxiety and prompt visits to a doctor. Cyberchondria, a new phenomenon, is defined as excessive compulsive searching for health information online that leads to distress and increase utilization of healthcare services. Grounded theory guided the conception of a mixed method study to investigate cyberchondria and symptom appraisal within Emergency Departments. A questionnaire and interviews were used to collect data from patients visiting a local Emergency Room. Results showed 63.3% of respondents looked up their symptoms online before their visit, and exhibited higher levels of cyberchondria and health anxiety than those who did not (p .001, p .004), and that health information consulted online can impact the decision to seek out immediate care. Strategies are needed to improve and promote quality online sources to benefit both seekers and services.

Effective patient-provider communication (PPC) involves conveying sufficient information to a patient such that the treatment is agreed upon and implemented accurately. Furthermore, a patient must feel adequately involved in the treatment process. With the advent of the COVID-19 pandemic, many clinical visits were shifted online. Although telemedicine was successful in meeting pandemic-specific goals, such as lowering personal contact, it changes the communicative context. Both patients and providers get less input from body language (nonverbal communication) and rely more on verbal communication. Furthermore, the number of telemedicine visits conducted remains elevated over pre-pandemic levels. Much of what is known about effective PPC is derived from studies in in-person contexts, with little information available in virtual contexts. Given that even occasional lapses in optimal PPC can have severe effects on patient outcomes, it is essential to understand PPC in various settings to optimize patient outcomes in the long run. This study was a secondary data analysis of the UCF Student Health Services Patient Satisfaction Questionnaire. A total of 6645 survey results from January 2021 to November 2022 were analyzed to compare patient perceptions of PPC variables and overall satisfaction with the clinical visit. The results indicated that there was no statistically significant difference in overall satisfaction and PPC variables between telemedicine and in-person visits. However, the results revealed that different PPC variables contributed to overall satisfaction with telemedicine and in-person visits. Keywords: patient-provider communication, telemedicine, telehealth, COVID-19, patient satisfaction, college

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