Health Information Systems Research Centre - Journal Articles

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    A digital substance-use harm reduction intervention for students in higher education (MyUSE): Protocol for project development
    (JMIR Publications, 2020-08) Dick, Samantha; Vasiliou, Vasilis S.; Davoren, Martin P.; Dockray, Samantha; Heavin, Ciara; Linehan, Conor; Byrne, Michael; University College Cork
    Background: Digital interventions have been identified as a possible tool for reducing the harm caused by illicit drug use among students attending higher education (ie, college students). However, the success of interventions in this area has been hampered by a lack of user involvement and behavior change theory in their design. The My Understanding of Substance use Experiences (MyUSE) project combines a rigorous user-centered design (UCD) methodology and a robust behavioral change framework to develop a digitally delivered harm reduction intervention for illicit drug use among students in higher education. Objective: This project aims to design and develop a digital intervention that targets drug use–related harm among students in higher education. Methods: The MyUSE project will take place over 3 phases. The first phase was exploratory in nature, involving 3 systematic reviews, a large survey, and student workshops to gather a comprehensive evidence base to guide the project. The second phase is the development stage of the project, involving the use of the Behavior Change Wheel theoretical framework to determine the behavior change techniques of the intervention and the use of the UCD methodology to guide the development of the digital intervention. The third phase is the evaluation stage, whereby the intervention will undergo a 5-stage evaluation process to comprehensively evaluate its impacts. Results: The exploratory phase 1 of the MyUSE project was completed in December 2018. Phase 2 is currently underway, and phase 3 is due to begin in September 2020. Conclusions: Higher education institutions (HEIs) are ideally placed to intervene and support students in the area of illicit drug use but are constrained by limited resources. Current digital interventions in this area are sparse and have several weaknesses. The MyUSE project combines a UCD approach with a robust behavior change framework to develop a digitally delivered intervention that is economically viable, effective in changing behavior, usable and acceptable to students, and able to sustain long-term implementation in HEIs.
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    A systematic review of the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students
    (BMC, 2019-09-09) Dick, Samantha; Whelan, Eadaoin; Davoren, Martin P.; Dockray, Samantha; Heavin, Ciara; Linehan, Conor; Byrne, Michael; University College Cork
    Background: Illicit substance misuse is a growing public health problem, with misuse peaking among 18–25 year-olds, and attendance at third-level education identified as a risk factor. Illicit substance misuse has the potential to harm mental and physical health, social relationships, and impact on academic achievements and future career prospects. Digital interventions have been identified as a vehicle for reaching large student populations and circumventing the limited capacity of student health services for delivering face-to-face interventions. Digital interventions have been developed in the area of alcohol and tobacco harm reduction, reporting some effectiveness, but the evidence for the effectiveness of digital interventions targeting illicit substance misuse is lacking. This review aims to systematically identify and critically appraise studies examining the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. Methods: We systematically searched ten databases in April 2018 using keywords and database specific terms under the pillars of “mHealth,” “substance misuse,” and “student.” To be eligible for inclusion, papers had to present a measure of illicit substance misuse harm reduction. Included articles were critically appraised and included in the qualitative synthesis regardless of quality. Results: A total of eight studies were included in the qualitative synthesis. Studies reported harm reduction in terms of substance misuse or initiation, as consequences or problems associated with substance misuse, or as correction of perceived social norms. Overall, five out of the eight studies reported at least one positive outcome for harm reduction. The critical appraisal indicated that the study quality was generally weak, predominantly due to a lack of blinding of study participants, and the use of self-reported substance misuse measures. However, results suggest that digital interventions may produce a modest reduction in harm from illicit substance misuse. Conclusions: The results of this review are positive, and support the need for further high-quality research in this area, particularly given the success of digital interventions for alcohol and tobacco harm reduction. However, very few studies focused solely on illicit substances, and those that did targeted only marijuana. This suggests the need for further research on the effectiveness of this type of intervention for other illicit substances. Trial registration: This review is registered on PROSPERO, ID number: CRD42018097203.
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    Evaluating the effectiveness of clinical decision support systems: the case of multimorbidity care
    (Taylor & Francis, 2013-04-23) Grace, Audrey; Mahony, Carolanne; O'Donoghue, John; Heffernan, Tony; Molony, David; Carroll, Thomas
    General Practitioners (GPs) and healthcare systems, worldwide, are overwhelmed by the growing number of patients with multimorbidity, particularly in light of the additional complexity and costs involved in treating these patients. While it has been proven that clinical decision support systems (CDSS) play a key role in supporting healthcare decisions, there is little research into their role in the case of multimorbidity. This study examines practice systems currently used in Ireland and evaluates their effectiveness in such circumstances. The findings uncover a number of deficiencies, including: (1) the lack of provision of integrated medical guidelines for multiple chronic diseases within the CDSS, (2) the inability to centralise the patient rather than the disease, (3) the difficulty in seamlessly integrating CDSS into the patient consultation, and (4) the lack of adequate training of GPs on how best to use CDSS in multimorbidity decision making. The study underlines the need for further research into CDSS and multimorbidity, and highlights some of the key issues that must be addressed in order to improve how CDSS support the care of multimorbid patients.
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    Contextual barriers to mobile health technology in African countries: a perspective piece
    (Journal of Mobile Technology in Medicine Inc., 2015-01) O'Connor, Yvonne; O'Donoghue, John; Seventh Framework Programme
    On a global scale, healthcare practitioners are now beginning to move from traditional desktop-based computer technologies towards mobile computing environments[1]. Consequently, such environments have received immense attention from both academia and industry, in order to explore these promising opportunities, apparent limitations, and implications for both theory and practice[2]. The application of mobile IT within a medical context, referred to as mobile health or mHealth, has revolutionised the delivery of healthcare services as mobile technologies offer the potential of retrieving, modifying and entering patient-related data/information at the point-of-care. As a component of the larger health informatics domain mHealth may be referred as all portable computing devices (e.g. mobile phones, mobile clinical assistants and medical sensors) used in a healthcare context to support the delivery of healthcare services.
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    Starting with small health data opportunities for mHealth in Africa
    (WIT Press, 2016) Heavin, Ciara; O'Connor, Yvonne; Irish Research Council
    The need to obtain data to understand effective and available child mortality-reducing control measures in rural areas of developing countries is great. Evidence shows that this challenge can potentially be overcome with the increased availability of Information and Communication Technology (ICT) to support the data/information/ knowledge needs of healthcare delivery services in low resource settings. Recognising the benefits of ICT and the need for improvements in the Nigerian health sector, this paper outlines the plans for the technical feasibility assessment of the IMPACT (usIng Mobile Phones for Assessing, Classifying and Treating sick children) smartphone application to capture, store and analyse of child health assessment data. IMPACT is a secure, scalable, user friendly mobile health (mHealth) innovation that is being developed to support ‘small data’ capabilities within the context of healthcare in the community in Enugu State, Nigeria, Africa. Notwithstanding the heightened focus on ‘big data’ in health, this research is interested in investigating the opportunities associated with doing ‘small healthcare data’ well, with the long term view of building to the big data scenario for healthcare in the community in Enugu. This paper outlines the plan for the IMPACT project considering the implications for health data, knowledge management in healthcare and the big data opportunities to support disease surveillance, healthcare delivery and resourcing and healthcare practitioner education.