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Information technology (IT) has become pervasive in the healthcare industry. Many view the Internet as a strategic healthcare tool. The Medical Records Institute suggests that Internet-based health applications (IHA), for example, electronic health records, e-prescribing, and mobile health are the goals of most healthcare organizations (2002). The use of the Internet for electronic medical records, e-billing and patient scheduling can enable the health care industry to reduce its inefficiencies and errors in care delivery (HlMSS/IBM Leadership Survey, 2000). While the use of IT in healthcare has increased tremendously, key players, specifically physicians still have not fully embraced the valuable resource of the Internet. Despite the purported advantages of lT investments in healthcare many doctors do not widely use Internet-based health applications in their clinical practices. Physicians often misunderstand the functions and full potential of the Internet (Wang & Song, 1997). Health & Health Care 20 I0 report that less than 5% of physicians use computers to record all clinical information for an average patient. The present study examined physicians' intentions to adopt Internet-based health applications for use in their clinical practices. This research reports on the test-retest reliability of the extended Technology Acceptance Model-TAM2 (Venkatesh & Davis, 2000). Data were collected from a survey of pediatricians to evaluate the effectiveness and appropriateness of the model in the medical environment. Results from the study indicate that TAM2 is appropriate but not completely applicable to the unique characteristic of physicians. The test-retest indicated reliable results with the exception of the result demonstrability construct. The results of multiple regression analyses indicated that perceived ease of use was not significant in predicting physicians' behavioral intentions in this study. As theorized the primary predictor variable perceived usefulness was a strong determinant of intention to use. Results indicate that physicians tend to be pragmatic in their IT acceptance decisions. Physicians focus more on the technology's usefulness rather than its ease of use. This dissertation discusses the implications, limitations and presents possible explanations for the inconsistencies within the extended technology acceptance model when it is applied to a professional group not commonly examined in IS research. / Thesis (Ph. D.)--University of Hawaii at Manoa, 2002. / Includes bibliographical references (leaves 168-180). / Mode of access: World Wide Web. / Also available by subscription via World Wide Web / xv, 180 leaves, bound ill. 29 cm

Thesis (M.S.)--Brandeis University, 2009. / Title from PDF title page (viewed on May 29, 2009). Includes bibliographical references.

Thesis (M.S.)--Brandeis University, 2009. / Title from PDF title page (viewed on May 29, 2009). Includes bibliographical references.

Abstract: Family history (FH) is a risk factor for many conditions that can affect pediatric patients. While there is no evidence of the clinical utility of FH taking in pediatrics and there is no standard of care as to FH taking, many suggestions were made as to what conditions should be covered in a pediatric FH assessment. There is also no evidence of the current practice. In this study the Theoretical Domains Framework was applied to FH taking and used to conduct semi-structured interviews with pediatricians to explore their FH taking practice. The pediatricians reported similar FH taking habits. Their FH taking was reported to include a wide range of conditions and determinants of health, and they used this information for a broad range of clinical tasks. FH taking in pediatric practice was reported to be complex and embedded with other aspects of practice. Résumé: Les antécédents familiaux (AF) sont des facteurs de risque pour plusieurs maladies affectant les patients pédiatriques. Alors qu'il n'y a ni données probantes concernant l'utilité des AF en pédiatrie ni normes pour la prise d'AF, plusieurs ont fait des suggestions quant à ce qui devrait être couvert par la prise d'AF. Il n'y a pas de données probantes décrivant la pratique actuelle de prise d'AF en pédiatrie. Dans cette étude, le Theoretical Domains Framework a été appliqué à la prise d'AF et utilisé afin de diriger des entrevues semi-structurées avec des pédiatres, dans le but de décrire leur pratique actuelle. Les pédiatres ont dit avoir des habitudes semblables quant à la prise d'AF. Cette dernière inclut plusieurs maladies et déterminants de la santé, et ils utilisent cette information pour plusieurs tâches. La prise d'AF en pédiatrie a été décrite comme étant complexe et très intégrée à leur pratique entière.

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder often treated by pediatricians or family practice physicians. ADHD knowledge held by treating physicians may be an important predictor in patient outcomes. This study examined ADHD knowledge and common assessment and treatment practices of pediatricians and family practice physicians via a national survey sent to members of the American Academy of Pediatrics and the American Academy of Family Physicians. Mailings included the Knowledge of Attention Deficit Disorders Scale--Revised (KADDS-R) arid a demographic/practice questionnaire. Although both physician types reported utilizing assessment and treatment methods consistent with current ADHD practice guidelines, findings suggested that pediatricians had greater ADHD knowledge than did family physicians. Physicians who had completed a behavioral pediatric rotation or training specific to ADHD had greater knowledge than physicians who had not done so. The number of new ADHD evaluations conducted monthly was also related to ADHD knowledge. Implications for future research examining ADHD knowledge, training, and outcomes are discussed.

The adherence to published guidelines for diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD) by primary care pediatricians (PDs) and family practice physicians (FPs), particularly those in rural areas, has not been well documented. This study examined survey responses from PDs and FPs who serve southern Appalachia (northeast Tennessee, southwest Virginia and Kentucky, and western North Carolina) regarding key practice parameters in line with the current American Academy of Pediatrics guidelines. Results showed that both PDs and FPs reported adhering to most of the diagnosis and treatment guidelines. PDs were more likely than FPs to report using both parent and teacher input in diagnosis and reported prescribing different medications for ADHD to some degree. Both practice areas reported ongoing access to continuing medical education, which is a means to enhancing care of ADHD patients. Implications for primary care are given with attention to the limited availability of PDs in rural areas and future areas of research in rural mental healthcare are suggested.

L’ostéopathie connaît une popularité croissante au Québec. Cependant, la collaboration interprofessionnelle (CIP) entre les médecins et les ostéopathes est un phénomène relativement nouveau et encore peu étudié. Cette étude mixte séquentielle explicative vise à : 1) décrire la situation actuelle au Québec en termes de collaboration entre les médecins et les ostéopathes impliqués auprès de la clientèle pédiatrique et 2) explorer les facteurs facilitants et les barrières à la CIP. Méthodologie : Le volet quantitatif a été réalisé à l’aide de questionnaires postaux destinés à tous les médecins et ostéopathes œuvrant auprès d’une clientèle pédiatrique. Vingt et un entretiens semi-dirigés ont par la suite été réalisés. Les données recueillies dans les questionnaires ont été analysées à l’aide de statistiques descriptives et de modèles de régression alors qu’une analyse thématique a été effectuée pour le contenu des entretiens. Résultats : Au total, 274 médecins (14 %) et 297 ostéopathes (42 %) ont complété les questionnaires. Dix de ces médecins et 11 ostéopathes ont participé aux entretiens. Les références en ostéopathie sont associées à la présence d’une relation professionnelle (rapport de cote (RC) 4,10 (intervalle de confiance (IC) à 95 % 2,12; 7,95), p < 0,001), aux consultations personnelles (RC 2,58 (IC 95 % : 1,35; 4,93), p = 0,004), à la pratique en milieu non hospitalier (RC 1,89 (IC 95 % :1,03; 3,47), p = 0,040) et à la connaissance du rôle de l'ostéopathe (RC 1,22 (IC 95 % :1,01 ; 1,47), p = 0,042). Les facteurs facilitants additionnels mentionnés sont les expériences positives rapportées par les parents, la formation antérieure en santé et l’expertise en pédiatrie de l’ostéopathe, le respect des limites professionnelles et la complémentarité des soins, la sécurité perçue de l'ostéopathie ainsi que les demandes de communications interprofessionnelles émises par les parents. Le langage, la difficulté de vulgarisation, le contexte organisationnel et légal, l'incertitude quant aux rôles, la rareté des interactions interprofessionnelles et les données probantes limitées dans le domaine ostéopathique constituent les principales barrières à la CIP. Conclusion : Une certaine collaboration existe déjà entre les médecins et ostéopathes, mais l’optimisation de cette collaboration pose encore plusieurs défis. Dans le contexte actuel de processus d’encadrement de la profession d’ostéopathe par l’Office des professions du Québec et de la création d’un premier programme universitaire, ces résultats pourront guider les efforts visant la promotion d’une collaboration productive et des soins sécuritaires axés sur le patient. / Abstract: Osteopathy is growing in popularity in Quebec. Interprofessional collaboration (IPC) between physicians and osteopaths is a new phenomenon and information about it is scarce. This explanatory sequential mixed-methods study aimed to 1) describe current collaborative practices between physicians and osteopaths involved with pediatric patients and 2) explore enablers of and barriers to the development of IPC. Methods: Postal questionnaires about collaborative practices were first sent to all physicians and osteopaths working with pediatric patients in Quebec. Semi-structured individual interviews were then conducted with a subset of 21 participants. The data collected in the questionnaires were analyzed using descriptive statistics and regression models, while a thematic analysis was carried out for the content of the interviews. Results: A total of 274 physicians (14%) and 297 osteopaths (42%) completed the survey while 10 of those physicians and 11 osteopaths were purposely selected for interviews. Osteopathic referral was positively associated with having a professional relationship (odds ratio [OR] 4.10 (95% confidence interval [CI] 2.12; 7.95), p < 0.001), personal consultation (OR 2.58 (95% CI 1.35; 4.93), p = 0.004), community-based practice (OR 1.89 (95% CI 1.03; 3.47), p = 0.040), and knowledge about role of osteopathy (OR 1.22 (95% CI 1.01; 1.47), p = 0.042). Additional enablers identified by respondents include: positive experiences reported by parents; the osteopath having had pediatric experience or previous training as an allied health practitioner; mutual respect for professional boundaries and complementarity; perceived safety of osteopathy; and parents’ requests for interprofessional communication. The main barriers to IPC include: language; difficulties communicating findings of osteopathic palpation assessment; organizational and legal contexts; uncertainty regarding one another’s roles, lack of interprofessional interactions; and limited scientific evidence. While some collaboration currently exists between physicians and osteopaths, optimizing these relationships and interactions still poses several challenges. In the current context of the pending regulation and standardization of osteopathic training in Quebec, these results could be used to guide efforts to promote productive collaboration and safe patient-oriented care.

The adherence to published guidelines for diagnosis and treatment of Attention-Deficit Hyperactivity Disorder (ADHD) by primary care pediatricians (PDs) and family practice physicians (FPs), particularly those in rural areas, has not been well documented. This study examined survey responses from PDs and FPs who serve southern Appalachia (northeast Tennessee, southwest Virginia and Kentucky, and western North Carolina) regarding key practice parameters in line with the current American Academy of Pediatrics guidelines. Results showed that both PDs and FPs reported adhering to most of the diagnosis and treatment guidelines. PDs were more likely than FPs to report using both parent and teacher input in diagnosis and reported prescribing different medications for ADHD to some degree. Both practice areas reported ongoing access to continuing medical education, which is a means to enhancing care of ADHD patients. Implications for primary care are given with attention to the limited availability of PDs in rural areas and future areas of research in rural mental healthcare are suggested.

Thesis (M.Sc.)--Memorial University of Newfoundland, Faculty of Medicine, 1998. / Typescript. Bibliography: leaves 101-107.