Addressing Data Absenteeism and Technology Chauvinism in the Use of Gamified Wearable Gloves Among Older Adults: Moderated Usability Study.

BACKGROUND: Digital health technologies have the potential to improve health outcomes for older adults, especially for those recovering from stroke. However, there are challenges to developing these technologies, such as data absenteeism (where older adults' views are often underrepresented in research and development) and technology chauvinism (the belief that sophisticated technology alone is the panacea to addressing health problems), which hinder their effectiveness. OBJECTIVE: In this study, we aimed to address these challenges by developing a wearable glove integrated with culturally relevant exergames to motivate older adults to exercise and, for those recovering from stroke, to adhere to rehabilitation. METHODS: We conducted a moderated usability study with 19 older adults, of which 11 (58%) had a history of stroke. Our participants engaged in a 30-minute gameplay session with the wearable glove integrated with exergames, followed by a quantitative survey and an in-depth interview. We used descriptive analysis to compare responses to the System Usability Scale between those who had a history of stroke and those who did not. In addition, we analyzed the qualitative interviews using a bottom-up thematic analysis to identify key themes related to the motivations and barriers regarding the use of wearable gloves for rehabilitation and exercise. RESULTS: Our study generated several key insights. First, making the exergames exciting and challenging could improve exercise and rehabilitation motivation, but it could also have a boomerang effect, where participants may become demotivated if the games were very challenging. Second, the comfort and ease of use of the wearable gloves were important for older adults, regardless of their stroke history. Third, for older adults with a history of stroke, the functionality and purpose of the wearable glove were important in helping them with specific exercise movements. CONCLUSIONS: Our findings highlight the importance of providing contextual support for the effective use of digital technologies, particularly for older adults recovering from stroke. In addition to technology and usability factors, other contextual factors such as gamification and social support (from occupational therapists or caregivers) should be considered to provide a comprehensive approach to addressing health problems. To overcome data absenteeism and technology chauvinism, it is important to develop digital health technologies that are tailored to the needs of underserved communities. Our study provides valuable insights for the development of digital health technologies that can motivate older adults recovering from stroke to exercise and adhere to rehabilitation.

Communication barriers faced by pharmacists when managing patients with hypertension in a primary care team: a qualitative study.

BACKGROUND: As primary care pharmacists take on an increasingly important and collaborative role in managing patients with chronic diseases, communication barriers with patients and healthcare colleagues have emerged. This study aimed to explore the communication barriers faced by pharmacists when managing patients with hypertension in a primary care team. METHODS: Twelve pharmacists working in five government primary care clinics were interviewed by a researcher using a topic guide. The interviews were audio-recorded, transcribed verbatim and subjected to thematic analysis. RESULTS: Pharmacists' management of patients with hypertension was found to be affected by communication challenges at three different levels: between pharmacists and patients, pharmacists and physicians, and physicians and patients. Barriers to communication between pharmacists and patients include language barrier, physical disabilities, medication brand changes, and specific challenges faced during video consultations. Barriers to communication between pharmacists and physicians include lack of access to patient information across institutions on the electronic medical records (EMR), inadequate and inappropriate documentation by physicians, and disruptive and ineffective phone calls by pharmacists to physicians. Barriers to communication between physicians and patients had a spillover effect on pharmacists; these barriers included language barrier, patients not discussing medication nonadherence with physicians, and conflicting advice given by physicians and pharmacists. CONCLUSIONS: The communication barriers pharmacists faced when managing patients with hypertension involved multiple stakeholders. Many of the challenges resulted in patients having difficulty understanding and adhering to their management plan. Effective interventions to foster stronger interprofessional relationships and create a conducive platform of communication should be developed to address these communication barriers.

The Augmented Cognitive Mediation Model: Examining Antecedents of Factual and Structural Breast Cancer Knowledge Among Singaporean Women.

As knowledge acquisition is an important component of health communication research, this study examines factors associated with Singaporean women's breast cancer knowledge using an augmented cognitive mediation model. We conducted a nationally representative study that surveyed 802 women between the ages of 30 and 70 using random-digit dialing. The results supported the augmented cognitive mediation model, which proposes the inclusion of risk perception as a motivator of health information seeking and structural knowledge as an additional knowledge dimension. There was adequate support for the hypothesized paths in the model. Risk perception was positively associated with attention to newspaper, television, Internet, and interpersonal communication. Attention to the three media channels was associated with interpersonal communication, but only newspaper and television attention were associated with elaboration. Interpersonal communication was positively associated with structural knowledge, whereas elaboration was associated with both factual and structural knowledge. Differential indirect effects between media attention and knowledge dimensions via interpersonal communication and elaboration were found. Theoretical and practical implications are discussed.