Matching Items (61)
Description
Integrating behavioral and physical health is the key to value-based care. Little is known about data sharing preferences and consent practices for individuals with behavioral health conditions. This study focuses on identifying behavioral health provider perceptions about patient data sharing practices, preferences and perceived impact on care resulting from enhanced patient control of record types during consent for data sharing.
ContributorsHiestand, Megan (Author) / Grando, Adela (Thesis director) / Murcko, Anita (Committee member) / Sharp, Richard (Committee member) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2017-12
Description
While type 2 diabetes (T2D) rates have soared, the number of Americans classified as ‘prediabetic’ has also increased. Despite this, current preventative approaches are costly and often not without undue side-effects. Instead, behavioral lifestyle approaches hold promise in reducing conversion rates of T2D as the latest treatment option that could mitigate and transform disease management. However, present interventions do not possess the scope necessary for implementation in a realistic, scalable way that can target the large at-risk population.
The application (app) “BeWell24” mitigates this diabetes risk through targeting sleep, physical activity, sedentary behavior, and diet, and is being delivered through mHealth technology to attenuate the higher-risk of the prediabetic Veteran population. In order for full scale dissemination, this thesis examines a provider perspective of the ‘Post-intervention interview guide’, performed with a Phoenix Veterans Affairs Health Care System (PVAHCS) provider. It then suggests revisions to the interview guide based on the provider’s interview and existing literature. This thesis also emphasizes the rationale behind these proposed changes to be organized in line with the iPARIHS framework (integrated Promoting Action on Research Implementation in Health Services).
Overall, the provider responded positively to BeWell24 and the ‘Post-intervention interview guide’, with constructive suggestions for each question in the interview guide. The main theme of the provider’s answers and comments were to prioritize efficiency and preserve standard clinical flow. A revised interview guide is provided, which prospectively presents as a more brief and focused interview organized by the iPARIHS framework. This revised interview guide could aid in the clarity of provider responses, specifically for the prospective interviews of the ongoing larger BeWell24 study and future studies.
The application (app) “BeWell24” mitigates this diabetes risk through targeting sleep, physical activity, sedentary behavior, and diet, and is being delivered through mHealth technology to attenuate the higher-risk of the prediabetic Veteran population. In order for full scale dissemination, this thesis examines a provider perspective of the ‘Post-intervention interview guide’, performed with a Phoenix Veterans Affairs Health Care System (PVAHCS) provider. It then suggests revisions to the interview guide based on the provider’s interview and existing literature. This thesis also emphasizes the rationale behind these proposed changes to be organized in line with the iPARIHS framework (integrated Promoting Action on Research Implementation in Health Services).
Overall, the provider responded positively to BeWell24 and the ‘Post-intervention interview guide’, with constructive suggestions for each question in the interview guide. The main theme of the provider’s answers and comments were to prioritize efficiency and preserve standard clinical flow. A revised interview guide is provided, which prospectively presents as a more brief and focused interview organized by the iPARIHS framework. This revised interview guide could aid in the clarity of provider responses, specifically for the prospective interviews of the ongoing larger BeWell24 study and future studies.
ContributorsWojtas, Abby Ann (Author) / Buman, Matthew (Thesis director) / Larouche, Miranda (Committee member) / Epstein, Dana (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Introduction: There is currently a lack of industry-wide gold standardization in accelerometer study
protocols, including within sleep-focused studies. This study seeks to address accuracy of
accelerometer data in detection of the beginnings and ends of sleep bouts in young adults with
polysomnography (PSG) corroboration. An existing algorithm used to differentiate valid/invalid wear
time and detect bouts of sleep has been modified with the goal of maximizing accuracy of sleep bout
detection. Methods: Three key decisions and thresholds of the algorithm have been modified with three
experimental values each being tested. The main experimental variable Sleepwindow controls the
amount of time before and after a determined bout of sleep that is searched for additional sedentary
time to incorporate and consider part of the same sleep bout. Results were compared to PSG and sleep
diary data for absolute agreement of sleep bout start time (START), end time (END) and time in bed
(TIB). Adjustments were made for outliers as well as sleep latency, snooze time, and the sum of both.
Results: Only adjustments made to a sleep window variable yielded altered results. Between a 5-, 15-,
and 30-minute window, a 15-minute window incurred the least error and most agreement to
comparisons for START, while a 5-minute window was best for END and TIB. Discussion: Contrary
to expectation, corrections for snooze, latency, and both did not substantially improve agreement to
PSG. Algorithm-derived estimates of START and END always fell after sleep diary and PSG both,
suggesting either participants’ sedentary behavior beginning and ends were at a delay from sleep and
wake times, or the algorithm estimates consistently later times than appropriate. The inclusion of a
sleep window variable yields substantial variety in results. A 15-minute window appears best at
determining START while a 5-minute window appears best for END and TIB. Further investigation on
the optimal window length per demographic and condition is required.
protocols, including within sleep-focused studies. This study seeks to address accuracy of
accelerometer data in detection of the beginnings and ends of sleep bouts in young adults with
polysomnography (PSG) corroboration. An existing algorithm used to differentiate valid/invalid wear
time and detect bouts of sleep has been modified with the goal of maximizing accuracy of sleep bout
detection. Methods: Three key decisions and thresholds of the algorithm have been modified with three
experimental values each being tested. The main experimental variable Sleepwindow controls the
amount of time before and after a determined bout of sleep that is searched for additional sedentary
time to incorporate and consider part of the same sleep bout. Results were compared to PSG and sleep
diary data for absolute agreement of sleep bout start time (START), end time (END) and time in bed
(TIB). Adjustments were made for outliers as well as sleep latency, snooze time, and the sum of both.
Results: Only adjustments made to a sleep window variable yielded altered results. Between a 5-, 15-,
and 30-minute window, a 15-minute window incurred the least error and most agreement to
comparisons for START, while a 5-minute window was best for END and TIB. Discussion: Contrary
to expectation, corrections for snooze, latency, and both did not substantially improve agreement to
PSG. Algorithm-derived estimates of START and END always fell after sleep diary and PSG both,
suggesting either participants’ sedentary behavior beginning and ends were at a delay from sleep and
wake times, or the algorithm estimates consistently later times than appropriate. The inclusion of a
sleep window variable yields substantial variety in results. A 15-minute window appears best at
determining START while a 5-minute window appears best for END and TIB. Further investigation on
the optimal window length per demographic and condition is required.
ContributorsMartin, Logan Rhett (Author) / Buman, Matthew (Thesis director) / Toledo, Meynard John (Committee member) / Kurka, Jonathan (Committee member) / College of Health Solutions (Contributor) / Barrett, The Honors College (Contributor)
Created2019-12
Description
Mobile health or "mHealth" defines a broad spectrum of medical or public health practice supported by mobile devices. The patient's perception of mobile health applications is the key point in confronting whether or not patients will utilize the tools at their disposal As such, the primary aim of this study was to examine participant feedback through quantitative and qualitative measures using the Therapy Evaluation Questionnaire and a patient interview, respectively, to further understand the patient rated acceptability of using BeWell24 and SleepWell24 for improving health outcomes. For BeWell24, it was hypothesized that patients who received the Multicomponent version would report higher acceptability scores than those randomized to the Health Education version. Furthermore, in regard to SleepWell24, it was hypothesized that the SleepWell24 patient would provide positive feedback and suggestions regarding their own experience with the SleepWell24 app. Data from this thesis was pulled from two ongoing randomized controlled trials currently being conducted at the Phoenix Veteran Affairs Health Care Service (PVACHS) and Mayo Clinic hospitals. Means, standard deviations, frequencies, and percentages were commuted to summarize demographics and TEQ scores. In addition, key concepts from a qualitative interview with a SleepWell24 participant were derived. The results showed a greater acceptability of the multicomponent versions of BeWell24 and SleepWell24 but a lower TEQ score of perceived usability. mHealth implementations pose a potential to become an important part of the health sector for establishing innovative approaches to delivering care, and while benefits have been highly praised, it is clear that the perceptions of mHealth must be positive if the technology is to transcend into a practical clinical setting.
ContributorsJimenez, Asael (Author) / Buman, Matthew (Thesis director) / Epstein, Dana (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Prescription opioid abuse has become a serious national problem. To respond to the opioid epidemic, states have created prescription drug monitoring programs (PDMPs) to monitor and reduce opioids use. We conducted a systematic literature review to better understand metrics used to quantify the effect that PDMPs have had on reducing opioid abuse, and solutions and challenges related to the integration of PDMPs with EHRs. Lessons learned can help guide federal and state-based efforts to better respond to the current opioid crisis.
ContributorsPonnapalli, Aditya Somayajulu (Author) / Murcko, Anita (Thesis director) / Grando, Adela (Committee member) / Wertheim, Pete (Committee member) / Biomedical Informatics Program (Contributor) / School of Human Evolution and Social Change (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
The proliferation of interconnected and networked medical devices has resulted in the development of innovative Medical Cyber-Physical Systems (MCPS). MCPS are life-critical, distributed systems that are utilized to monitor and control healthcare organizations in order to provide a more coordinated, cohesive care-continuum focused on the whole patient resulting in better outcomes, and a happier, healthier patient. Medical Cyber Physical (MCPS) systems are life-critical, networked systems used to monitor and control healthcare and medical devices in order to provide more coordinated and cohesive care for the patient. Cyber-securing MCPS is difficult due to their complex and interconnected nature, and this project sets about analyzing current security requirements for MCPS using an ontology and exploration techniques, and developing a risk assessment and monitoring framework to better secure such systems.
ContributorsLamp, Josephine Ann (Author) / Ahn, Gail-Joon (Thesis director) / Rubio-Medrano, Carlos (Committee member) / School of Film, Dance and Theatre (Contributor) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
Title: A Mobile Health Application for Tracking Patients' Health Record Abstract Background: Mobile Health (mHealth) has recently been adopted and used in rural communities in developing countries to improve the quality of healthcare in those areas. Some organizations use mHealth application to track pregnancy and provide routine checkups for pregnant women. Other organizations use mHelath application to provide treatment and counseling services to HIV/AIDs patients, and others are using it to provide treatment and other health care services to the general populations in rural communities. One organization that is using mobile health to bring primary care for the first time in some of the rural communities of Liberia is Last Mile Health. Since 2015, the organization has trained community health assistants (CHAs) to use a mobile health platform called Data Collection Tools (DCTs). The CHAs use the DCT to collect health data, diagnose and treat patients, provide counseling and educational services to their communities, and for referring patients for further care. While it is true that the DCT has many great features, it currently has many limitations such as data storage, data processing, and many others. Objectives: The goals of this study was to 1. Explore some of the mobile health initiatives in developing countries and outline some of the important features of those initiatives. 2. Design a mobile health application (a new version of the Last Mile Health's DCT) that incorporates some of those features that were outlined in objective 1. Method: A comprehensive literature search in PubMed and Arizona State University (ASU) Library databases was conducted to retrieve publications between 2014 and 2017 that contained phrases like "mHealth design", "mHealth implementation" or "mHealth validation". For a publication to refer to mHealth, the publication had to contain the term "mHealth," or contains both the term "health" and one of the following terms: mobile phone, cellular phone, mobile device, text message device, mobile technology, mobile telemedicine, mobile monitoring device, interactive voice response device, or disease management device. Results: The search yielded a total of 1407 publications. Of those, 11 publications met the inclusion criteria and were therefore included in the study. All of the features described in the selected articles were important to the Last Mile Health, but due to issues such as internet accessibility and cellular coverage, only five of those features were selected to be incorporated in the new version of the Last Mile's mobile health system. Using a software called Configure.it, the new version of the Last Mile's mobile health system was built. This new system incorporated features such as user logs, QR code, reminder, simple API, and other features that were identified in the study. The new system also helps to address problems such as data storage and processing that are currently faced by the Last Mile Health organization.
ContributorsKarway, George K. (Author) / Scotch, Matthew (Thesis director) / Kaufman, David (Committee member) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
As science has progressed, sleep deficiency has been discovered to be associated with declines in both mental and physical health, and similarly, sleep deficiency has been noted as a public safety concern with 20 percent of motor vehicle crashes linked to driving while drowsy. The National Sleep Foundation has identified that 62 percent of Americans do nothing to address their sleep deficiency, and with a society that normalizes coping mechanisms such as napping and caffeine consumption, it is easy to see why nothing has been done to resolve this issue. Nevertheless, with sleep technology falling in the hands of more and more Americans this thesis aims to explore how these technologies are being adopted and how the introduction of sleep-oriented features for established products may lead to more sleep conscious consumers.
ContributorsSmith, Keaton (Author) / Burgman, Roland (Thesis director) / Buman, Matthew (Committee member) / Department of Management and Entrepreneurship (Contributor) / Barrett, The Honors College (Contributor)
Created2020-12
Description
The purpose of this study was to examine the overall maintenance of behavior during the 12 to 24 month period of the Stand&Move@Work study and the impact of implementation factors (i.e., facilitators, advocate activity, and the amount of strategies used) on behavior change. The design of the study was a cluster randomized trial which was facilitated by researchers for the first 12 months of the study. The primary aim of the study was to examine the maintenance of behavior change (i.e., sitting time) at the 12 month and 24 month marks using objectively measured sedentary behavior (activPAL micro). The secondary aim of the study was to examine the impact of implementation factors (i.e., facilitators, advocate activity, and the amount of strategies used) on behavior change during the 12 through 24 months maintenance period. Participants (N=630) included full-time, caucasian, middle-aged office workers. For the primary aim, descriptive means were used to cluster for observations within-persons and were adjusted for age, gender, race, job-type, and ordering effects.. For the secondary aim, descriptive means adjusted for workplace culture and environment were computed. At the 24 month mark, participants spent 280.67 ± 87.67 min/8hr workday sitting and 161.94 ± 85.87 min/8hr workday standing. The top performing worksites displayed reductions in sitting time which largely translated into standing time by about 30 minutes per 8 hour workday at 24 months. Feasibility findings indicated that implementation strategies do not show differences between the top 25% and bottom 25% performing worksites. This study provides insight to implementation strategies for interventions in the workplace.
ContributorsTong, Alyssa Taylor (Author) / Buman, Matthew (Thesis director) / Larouche, Miranda (Committee member) / Estabrooks, Paul (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
Phylogenetic analyses that were conducted in the past didn't have the ability or functionality to inform and implement useful public health decisions while using clustering. Models can be constructed to conduct any further analyses for the result of meaningful data to be used in the future of public health informatics. A phylogenetic tree is considered one of the best ways for researchers to visualize and analyze the evolutionary history of a certain virus. The focus of this study was to research HIV phylodynamic and phylogenetic methods. This involved identifying the fast growing HIV transmission clusters and rates for certain risk groups in the US. In order to achieve these results an HIV database was required to retrieve real-time data for implementation, alignment software for multiple sequence alignment, Bayesian analysis software for the development and manipulation of models, and graphical tools for visualizing the output from the models created. This study began by conducting a literature review on HIV phylogeographies and phylodynamics. Sequence data was then obtained from a sequence database to be run in a multiple alignment software. The sequence that was obtained was unaligned which is why the alignment was required. Once the alignment was performed, the same file was loaded into a Bayesian analysis software for model creation of a phylogenetic tree. When the model was created, the tree was edited in a tree visualization software for the user to easily interpret. From this study the output of the tree resulted the way it did, due to a distant homology or the mixing of certain parameters. For a further continuation of this study, it would be interesting to use the same aligned sequence and use different model parameter selections for the initial creation of the model to see how the output changes. This is because one small change for the model parameter could greatly affect the output of the phylogenetic tree.
ContributorsNandan, Meghana (Author) / Scotch, Matthew (Thesis director) / Liu, Li (Committee member) / Biomedical Informatics Program (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05