REDCap Delivery of a Web-Based Intervention for Patients With Voice Disorders: Usability Study.

BACKGROUND: Web-based health interventions are increasingly common and are promising for patients with voice disorders because web-based participation does not require voice use. To address needs such as Health Insurance Portability and Accountability Act compliance, unique user access, the ability to send automated reminders, and a limited development budget, we used the Research Electronic Data Capture (REDCap) data management platform to deliver a patient-facing psychological intervention designed for patients with voice disorders. This was a novel use of REDCap. OBJECTIVE: We aimed to evaluate the usability of the intervention, with this intervention serving as a use case for REDCap-based patient-facing interventions. METHODS: We used REDCap survey instruments to develop the web-based voice intervention modules, then conducted usability evaluations using (1) heuristic evaluations by 2 evaluators, and (2) formal usability testing with 7 participants, consisting of predetermined tasks, a think-aloud protocol, ease-of-use measurements, a product reaction card, and a debriefing interview. RESULTS: Heuristic evaluations found strengths in visibility of system status and real-world match, and weaknesses in user control and help documentation. Based on this feedback, changes to the intervention were made before usability testing. Overall, usability testing participants found the intervention useful and easy to use, although testing revealed some concerns with design, content, and terminology. Some concerns were readily addressed, and others required adaptations within REDCap. CONCLUSIONS: The REDCap version of a complex web-based patient-facing intervention performed well in heuristic evaluation and formal usability testing. REDCap can effectively be used for patient-facing intervention delivery, particularly if the limitations of the platform are anticipated and mitigated.

User Experience in Health & Medicine: Building Methods for Patient Experience Design in Multidisciplinary Collaborations.

Health and medical contexts have emerged as an important area of inquiry for researchers at the intersection of user experience and technical communication. In addressing this intersection, this article advocates and extends patient experience design or PXD (Melonçon, 2017) as an important framework for user experience research within health and medicine. Specifically, this article presents several PXD insights from a task-based usability study that examined an online intervention program for people with voice problems. We respond to Melonçon's call (2017) to build PXD as a framework for user experience and technical communication research by describing ways traditional usability methods can provide PXD insights and asking the following question: What insights can emerge from combining traditional usability methods and PXD research? In addressing this question, we outline two primary methodological and practical considerations we found central to conducting PXD research: 1) engaging patients as participants, and 2) leveraging multidisciplinary collaboration.

Relationships among commercial practices and author conflicts of interest in biomedical publishing.

Recently, concerns have been raised over the potential impacts of commercial relationships on editorial practices in biomedical publishing. Specifically, it has been suggested that certain commercial relationships may make editors more open to publishing articles with author conflicts of interest (aCOI). Using a data set of 128,781 articles published in 159 journals, we evaluated the relationships among commercial publishing practices and reported author conflicts of interest. The 159 journals were grouped according to commercial biases (reprint services, advertising revenue, and ownership by a large commercial publishing firm). 30.6% (39,440) of articles were published in journals showing no evidence of evaluated commercial publishing relationships. 33.9% (43,630) were published in journals accepting advertising and reprint fees; 31.7% (40,887) in journals owned by large publishing firms; 1.2% (1,589) in journals accepting reprint fees only; and 2.5% (3,235) in journals accepting only advertising fees. Journals with commercial relationships were more likely to publish articles with aCOI (9.2% (92/1000) vs. 6.4% (64/1000), p = 0.024). In the multivariate analysis, only a journal's acceptance of reprint fees served as a significant predictor (OR = 2.81 at 95% CI, 1.5 to 8.6). Shared control estimation was used to evaluate the relationships between commercial publishing practices and aCOI frequency in total and by type. BCa-corrected mean difference effect sizes ranged from -1.0 to 6.1, and confirm findings indicating that accepting reprint fees may constitute the most significant commercial bias. The findings indicate that concerns over the influence of industry advertising in medical journals may be overstated, and that accepting fees for reprints may constitute the largest risk of bias for editorial decision-making.

Catalyzing Transdisciplinarity: A Systems Ethnography of Cancer-Obesity Comorbidity and Risk Coincidence.

Effectively addressing wicked health problems, that is, those arising from complex multifactorial biological and socio-economic causes, requires transdisciplinary action. However, a significant body of research points toward substantial difficulties in cultivating transdisciplinary collaboration. Accordingly, this article presents the results of a study that adapts Systems Ethnography and Qualitative Modeling (SEQM) in response to wicked health problems. SEQM protocols were designed to catalyze transdisciplinary responses to national defense concerns. We adapted these protocols to address cancer-obesity comorbidity and risk coincidence. In so doing, we conducted participant-observations and interviews with a diverse range of health care providers, community health educators, and health advocacy professionals who target either cancer or obesity. We then convened a transdisciplinary conference designed to catalyze a coordinated response. The findings offer productive insights into effective ways of catalyzing transdisciplinarity in addressing wicked health problems action and demonstrate the promise of SEQM for continued use in health care contexts.

Losing Weight on Reality TV: A Content Analysis of the Weight Loss Behaviors and Practices Portrayed on The Biggest Loser.

A number of weight loss-related reality television programs chronicle the weight loss experience of obese individuals in a competitive context. Although highly popular, such shows may misrepresent the behavior change necessary to achieve substantial weight loss. A systematic, quantitative content analysis of Seasons 10-13 (n = 66 episodes) of The Biggest Loser was conducted to determine the amount of time and number of instances that diet, physical activity, or other weight management strategies were presented. The average episode was 78.8 ± 15.7 min in length. Approximately 33.3% of an episode, representing 1,121 segments, portrayed behavioral weight management-related content. Within the episode time devoted to weight management content, 85.2% was related to physical activity, 13.5% to diet, and 1.2% to other. Recent seasons of The Biggest Loser suggest that substantial weight loss is achieved primarily through physical activity, with little emphasis on modifying diet and eating behavior. Although physical activity can impart substantial metabolic health benefits, it may be difficult to create enough of an energy deficit to induce significant weight loss in the real world. Future studies should examine the weight loss attitudes and behaviors of obese individuals and health professionals after exposure to reality television shows focused on weight loss.

To weigh or not to weigh: the relationship between self-weighing behavior and body image among adults.

Given the high prevalence of overweight and obesity in the U.S., identifying behaviors that aid or hinder weight control efforts continues to be a research priority. Body weight monitoring is a technique used in many popular weight management programs. However, how weight monitoring-particularly self-weighing behavior-relates to psychological constructs like body image is poorly understood. Participants included 268 undergraduates (190 women, 78 men) at a midwestern university who completed questionnaires about self-weighing behavior and body image (multidimensional body-self relations questionnaire; eating disorder examination-questionnaire: weight and shape concern subscales). Among women, more frequent self-weighing was associated with greater appearance orientation, overweight preoccupation, and shape concern. Among men, more frequent self-weighing was associated with greater body areas satisfaction, health and fitness orientation, and positive health evaluation. Results suggest that self-weighing is a fairly common behavior, but its relationship with body image is complex and gender-specific.