The thesis aims to map the health information behaviour of parents. Behaviour of parents represents a significant part in the life of child and therefore the attention of this thesis is focused on this topic. Its theoretical part introduces the areas characterising the topic - information behaviour, models and process of information behaviour, health, health literacy and phenomena affecting information behaviour (such as advertisement in health service or information overload). The research part contains a methodological basis of work and describes the research design. In the final part, analytical results of the interviews are elaborated.

The population of older adults is growing worldwide, particularly in North America. Health information technology (HIT) is a group of technologies and systems that enhance care by electronically storing, managing, and exchanging data. HIT presents opportunities to support older adults' healthcare needs in communities and long-term care (LTC) environments. Despite their potential benefits, these technologies remain limited in LTC and older adults' healthcare contexts. Evidence is scattered on the factors that affect older adults' adoption of HIT. Little research has investigated the adoption of these technologies by formal healthcare providers and the technologies' impacts on LTC. A multi-method approach was employed in this thesis research, using a combination of a systematic qualitative review, an inductive semi-qualitative Delphi survey, and a quantitative deductive study to manage each research question in order to address these gaps. The systematic literature review used the PRISMA guidelines to identify and critically appraise studies that examined the effect of various HIT adoption factors among older adults in the community. The search involved five databases and a combination of keywords, resulting in the selection of critically appraised articles based on their evidence level and research rigor. A coding scheme was developed to extract information from the selected articles. The results showed that the main factors affecting HIT adoption by older adults relate to performance expectancy, effort expectancy, and high price/cost value. It also highlighted the importance of considering privacy/security and product design when evaluating HIT adoption by older adults. In light of the limited available studies on HIT adoption and impacts in the context of LTC, a Delphi study was developed to collect data from key formal healthcare providers (i.e., nurses) working in LTC at one of the largest and most progressive older adult healthcare facilities in Ontario, Canada. The Delphi study aimed to identify and prioritize the key factors that affect nurses' adoption of new technologies in support of older adults' care. A panel of nurses was solicited to participate in the Delphi study, which involved three rounds of data collection: brainstorming, narrowing down, and ranking. A total of 20 nurses completed the Delphi study, and the top factors that the LTC nurses identified were mainly related to the organizational and technological dimensions, including the complexity of HIT, the training and support provided, the interoperability of HIT systems, the cost of implementation, and the availability of HIT infrastructure. For the last part of this research, quantitative secondary data analysis was conducted on a Canadian national survey of nurses to examine their perceived impacts of HIT adoption by nurses in LTC. The survey included questions related to the current state of electronic medical records (EMR) and EMR adoption, the state of virtual care technologies, attitudes and perceptions related to access and the impact of the adoption of digital health technologies in practice, benefits and effects of EMR adoption, and barriers preventing nurses from getting total value from electronic health. A subset of 166 nursing homes/long-term care facilities/older adult residences and homecare nurses were selected for this analysis. Data management and analysis were conducted using IBM SPSS v28. The results showed that HIT adoption by nurses in LTC was positively associated with perceived benefits and organizational support. However, HIT adoption was negatively associated with perceived complexity and privacy/security concerns. This thesis research suggests that HIT adoption by older adults and nurses in LTC is complex and multifaceted, requiring attention to individual, organizational, and technological factors. There is a need for improved communication and collaboration among LTC team members and better working conditions to improve staff well-being and reduce turnover. The findings from the systematic review and Delphi study contribute to the theoretical understanding of the factors influencing the adoption of HIT in LTC facilities. The survey results provide valuable insights into the current state of HIT use in LTC facilities and can be used to inform the development of targeted interventions to improve HIT adoption and use. Overall, this study contributes to the growing body of knowledge on HIT adoption in LTC facilities and provides important recommendations for policymakers, administrators, and LTC staff to improve the use of HIT and ultimately enhance the quality of the care supplied to LTC residents.

No description available.

Medical researchers utilize data sharing agreements (DSA) to communicate privacy policies that govern the treatment of data in their collaboration. Expression of privacy policies in DSAs have been achieved through the use of natural and policy languages. However, ambiguity in natural language and rigidness in policy languages make them unsuitable for use in collaborative medical research. Our goal is to develop an unambiguous and flexible form of expression of privacy policies for collaborative medical research. In this thesis, we developed a DSA Privacy Ontology to express privacy policies in medical research. Our ontology was designed with hierarchy structure, lightweight in expressivity, closed world assumption in interpretation, and the reuse of other ontologies. The design allows our ontology to be flexible and extensible. Being flexible allows our ontology to express different types of privacy policies. Being extensible allows our ontology to be mapped to other linkable ontologies without the need to change our existing ontology. We demonstrate that our ontology is capable of supporting the DSA in a collaborative research data sharing scenario through providing the appropriate vocabulary and structure to log privacy events in a linked data based audit log. Furthermore, through querying the audit log, we can answer privacy competency questions relevant to medical researchers. / Thesis / Master of Science (MSc)

Doctor of Philosophy / Department of Agricultural Economics / Vincent R. Amanor-Boadu / Public health policies seek to address health issues that pose significant concerns to public health policymakers. Because these initiatives have economic costs, economic agents’ response to them would be driven by the outcome of their benefit-cost assessment of the policies. Therefore, the congruence between perception and reality of economic agents’ health becomes important in evaluating the potential effectiveness of these initiatives. This research sought to determine the extent of congruence between objective and subjective health status at the individual level. The results would contribute to the framing and implementation of health policies that have higher probability of adoption by economic agents. The National Health and Nutrition Examination Survey (NHANES) 2005-2006 data were used for this research. The dependent variables defined in the study are subjective health status perception and objective metrics of individuals’ health status proxied by their body mass index (BMI), waist circumference, high density lipoprotein (HDL) cholesterol level, and fasting blood glucose. The nature of these dependent variables demanded that both categorical dependent variable and ordinary least squares models be employed in the estimation of the models. Chow tests were used to determine the extent of congruence between perception and reality of respondents’ health status. The study did not find any differences between perception and reality based on waist circumference but the same could not be said about BMI. Additionally, there were differences between subjective health perceptions and objective measures of health status based on receiving information about their health status from a health care professional. If it is assumed that the cost of responding to health policies are reduced with higher congruence between subjective and objective health status, then this study’s results suggest that policy must begin with increasing the objective information that people have about their health. While the provision of this information at the individual level could be expensive, it will improve the success rate of health promotion initiatives. The increase in these initiatives’ success should contribute to a reduction in the nation’s health care costs attributable to lifestyle related diseases such as obesity.

Information technology is ubiquitous in society and industry; however, healthcare is just beginning to explore how health information technology (HIT) can be optimized to support quality care. HIT can assist with standardizing care delivery, increasing access to evidence-based medicine, improving accuracy and ease of documentation, and assisting with patient education. Advanced Practice Registered Nurses (APRNs), specifically nurse practitioners (NPs) and certified nurse midwives (CNMs), play a pivotal role in the healthcare delivery system. To be effective practitioners, providers must manage, integrate, and assimilate a multitude of knowledge with each patient encounter. HIT can serve as the channel through which the NP and CNM provides cost-effective, efficient, and quality care. However, healthcare providers have been slow to adopt and implement HIT resources. We know that adoption of HIT by healthcare providers is varied among provider and practice settings. However, few studies have examined the impact on and utilization of information technology by APRNs, specifically nurse practitioners and certified nurse midwives.The purpose of this research was to investigate the utilization and influence of HIT on the clinical decision making of Kentucky nurse practitioners and nurse midwives (Kentucky APRNs). A descriptive cross-sectional design using survey methodology and convenience sampling was employed. Participants were asked to complete an author-modified, web-based survey tool that was based on current research. The 40-question tool was designed to explore providers' attitudes and perceptions of technology, determine their knowledge and utilization of various electronic and traditional print medical resources, and assess the penetration of and daily usage of HIT in practice.This study revealed information related to Kentucky APRN's utilization and influence of HIT on clinical decision making. Establishing exploratory Kentucky APRN findings will assist in evaluating further HIT utilization in Kentucky. Findings suggested that APRNs in Kentucky are beginning to explore the benefits of HIT; however, additional research will be required to identify the true penetration and utilization of technology in Kentucky. Although additional research is needed, HIT appears to be having an overall impact on the clinical practice of Kentucky APRNs.

Shared electronic health record (EHR) systems constitute an important Telemedicine and e-Health application. Successful implementation of shared health records calls for a satisfactory level of security. This is invariably achieved through applying and enforcing strict, and often quite complicated, rules and procedures in the access process. For this reason, information security strategy for EHR systems is needed to be in place. This research reviewed the definition of different terms that related to electronically stored and shared health records and delineated related information security terms leading to a definition of an information security strategy. This research also made a contribution to understanding information security strategy as a significant need in EHR systems. A major case study of the National Programme for IT (NPfIT) in England is used to be the container of other two sub-case studies in two different Acute Trusts. Different research methods used: participant observation and networking, semi-structured interviews, and documentary analysis. This research aimed to provide a comprehensive understanding to the information security strategy of England’s EHR system by presenting its different information security issues such as consent mechanisms, access control, sharing level, and related legal and regulatory documents. Six factors that influence the building of an information security strategy in EHR systems, were identified in this research, political, social, financial, technical, clinical and legal. Those factors are considered to be driving the strategy directly or indirectly. EHR systems are technical-clinical systems, but having other factors (than technical and clinical) that drive this technical-clinical system is a big concern. This research makes a significant contribution by identifying these factors, and in addition, this research shows not only how these factors can influence building the information security strategy, but also how they can influence each other. The study of the mutual influence among the six factors led to the argument that the most powerful factor is the political factor, as it directly or indirectly influences the remaining five factors. Finally, this research proposes guidelines for building an information security strategy in EHR systems. These guidelines are presented and discussed in the form of a framework. This framework was designed after literature analysis and after completing the whole research journey. It provides a tool to help putting the strategy in line by minimising the influence of various factors that may steer the strategy to undesirable directions.

Class of 2017 Abstract / Objectives: To assess the change in efficiency and accuracy of the medication reconciliation process at the Pima County Adult Detention Center (PCADC) after implementation of a Health Information Exchange (HIE) and also to identify the percentage of patients whose medication data is available in the HIE Methods: This program evaluation was a retrospective comparison of the traditional self-reported method of medication reconciliation to the HIE method. It compared the number and types of medication discovered for each patient using the traditional medication reconciliation collection data (the self-reported method) and the new database query method (HIE method) Results: 200 samples were randomly selected (100 random detainees and 100 with known medical record in the HIE database) to participate in the study. A total of 150 patients (61%) were retrieved from the HIE database, of which 100 were from the control group and 50 from the random group. The total numbers of medications that these 150 patients contributed was 284. Mean completeness of self-reported medications was 54% while HIE yielded an average of 99% (χ2; p<0.0001). 9 patients (4%) had both self-reported medications and medications within the HIE database in which 17 medications (62%) compared to the self-reporting method with 14 medications (52%) sharing the same name. There were no medication dose matches between self-reported medications and HIE queried medications. Conclusions: The addition of an HIE database to the existing self-reporting process of collecting a detainee’s medication reconciliation provides a more comprehensive and accurate medical record

Limited health literacy is a barrier to understanding health information. Simplifying text can reduce this barrier and possibly other known disparities in health. Unfortunately, few tools exist to simplify text with demonstrated impact on comprehension. By leveraging modern data sources integrated with natural language processing algorithms, we are developing the first semi-automated text simplification tool. We present two main contributions. First, we introduce our evidence-based development strategy for designing effective text simplification software and summarize initial, promising results. Second, we present a new study examining existing readability formulas, which are the most commonly used tools for text simplification in healthcare. We compare syllable count, the proxy for word difficulty used by most readability formulas, with our new metric ‘term familiarity’ and find that syllable count measures how difficult words ‘appear’ to be, but not their actual difficulty. In contrast, term familiarity can be used to measure actual difficulty.

Skogberg, N. (2016). Young adults’ experiences and opinions of health information. A survey study. Bachelor thesis in Public Health Science. Department of Occupational and Public Health Science. Faculty of Health and Occupational Studies. University of Gävle, Sweden. Objective: The objective of this study was to explore the experiences and opinions of health information among 40-100 young adults, aged 18-25 years. Method: A cross-sectional survey study was conducted, using a questionnaire in paper form as well as using a web questionnaire. Results: The results showed that the social media (for example Facebook and Instagram) was both the most used and preferred source of information. Most of the respondents thought that the information they found was useful and that the information was appealing and/or interesting. However, the majority of the respondents did feel that the information they found was lacking something. Conclusions: Social media can be a useful tool to reach out with health information to young adults. It is important that the information is perceived as accessible, reliable and credible. It is also important to make sure that young adults have access to information which has a scientific basis. / Syftet med denna studie var att undersöka unga vuxnas (18-25 år) erfarenheter av och åsikter om hälsoinformation. Studien rörde information som unga vuxna stött på under de senaste två månaderna före studiens genomförande. Faktorer som källor till hälsoinformation, informationens användbarhet samt om informationen ansågs vara tilltalande och/eller intressant undersöktes. Metoden var en enkätundersökning som genomfördes på en högskola i Mellansverige och som även skapades i webbform och delades på det sociala mediet Facebook. Huvudresultatet av studien visade att sociala medier (till exempel Facebook och Instagram) var den främsta källan till hälsoinformation bland unga vuxna och att sociala medier även var den mest föredragna källan i denna åldersgrupp. Anledningar till detta var bland annat att informationen ansågs vara lättillgänglig, att den når ut till många, att sociala medier används mycket för information och att källan är miljövänlig. Resultatet visade även att de flesta respondenter ansåg att informationen de funnit var användbar och att informationen var tilltalande och/eller intressant. Det kunde bero på att informationen kändes inspirerande och motiverande, användbar i ett framtida yrke, trovärdig, att funderingar besvarades, att svar var konkreta och direkta samt att layouten var bra. Majoriteten av respondenterna kände dock att något saknades i informationen de funnit. Det som ansågs saknas i en del av informationen var till exempel bakgrund, statistik, undersökningar, primärkällor och spårbara källor, tillförlitlighet och relevans samt praktiska råd. Slutsatserna av studien var bland annat att sociala medier kan vara ett användbart verktyg för att nå ut till unga vuxna med en tillförlitlig och vetenskapligt baserad hälsoinformation. Det är även viktigt att informationen är lättillgänglig och trovärdig och att unga vuxna kan finna den information de söker.