ABSTRACT
Purpose: COVID-19 has caused a shift toward consumer-facing technology such as mobile health (mHealth) applications. However, most mHealth apps do not use accessible language. Standardized terminologies have potential to solve this problem but have not been simplified for consumer use. Methods: We used a standardized health terminology, the Omaha System, as the framework to develop the Simplified Omaha System Terms (SOST) for use within a mHealth application, MyStrengths + MyHealth. Plain language principles informed the SOST development in three phases, a community-validation focus group enabled feedback from diverse end-users, a readability assessment provide validation to the desired goal readability level. Results: The community-validation members (n = 19) ages ranged from 22 to 74;51% male, 84% people of color, and 21% college educated. The reading level of the final SOST averaged 3.86 on the Coleman–Liau Index (fourth grade). A case study showed meaningful whole-person health data were generated in a community-led study during COVID-19. Conclusions: Community validation and readability assessment demonstrated accessible language for a clinical terminology. The SOST was deployed successfully in MyStrengths + My Health and in a community-led study. The Omaha System as a framework for the SOST may enable the data to be integrated with clinical datasets. Future research should focus on validation of SOST in additional languages and integration within electronic health platforms. © 2022 The Authors.
ABSTRACT
Background: The SARS-CoV-2 pandemic accelerated health disparities in chronic kidney disease (CKD). Here, we describe risk factors and access to care surrogates (area deprivation index-ADI) for clinical outcomes among SARS-CoV-2-tested patients in the CURE-CKD Registry. Methods: We formed a COVID-19 Sub-Registry within CURE-CKD (1/1-6/30/2021;N=171,988) of patients with CKD, diabetes (DM)/pre-DM, or hypertension (HTN) with SARS-CoV-2 testing at UCLA Health (UCLA;N=17,884) and Providence St. Joseph Health (PSJH;N=154,104). Statistical analyses and fitted multivariable logistic regression models were adjusted for age and sex. The UCLA cohort included analyses for acute kidney injury (AKI), ADI (for poor housing, education, income), Charlson Comorbidity Index (CCI), and severe COVID-19 disease. Results: Odds ratios (OR) of COVID-19 positivity for the combined UCLA + PSJH population, as well as OR of having severe COVID-19 disease in the UCLA cohort are presented (Table). OR[95%CI] for AKI were higher for ages ≥80 years (1.77[1.14-2.46]), ADI by state (1.12[1.06-1.18]), CKD (12.20[8.46-17.58]) and pre-existing DM (3.65[2.62-5.08]), p<0.001. In the UCLA CURE-CKD population, AKI was associated with severe COVID-19 (r=0.26) and ICU admissions (r=0.29). Mortality was associated with severe COVID-19 disease (r=0.5). Conclusions: Non-White and/or LatinX race/ethnicity, ADI, CKD, DM, and older age were associated with higher risks of COVID-19 positivity, disease severity, and mortality in CURE-CKD. Efforts on viral screening, timely COVID-19 diagnosis, and optimal care delivery for patients with or at-risk for CKD are needed.