RESUMO
Implementation efforts to increase adoption of health technologies (e.g., telehealth, mobile health, electronic health records, patient portals) have commonly focused on increasing the adoption of specific health technologies in specific service lines. To facilitate adoption of multiple health technologies across a hospital setting, four Virtual Health Resource Centers (VHRCs) were established to provide clinical adoption support to healthcare staff and patients in four hospitals in a large healthcare system. This study spanned a 3-year period, with the first half including pre-implementation efforts, and the second half involved in implementation efforts. In order to compare sites to the national population, a binomial regression was used which allowed for adjustment of relevant covariates (e.g., differences in number of enrollees, level of complexity of facility). The pre-implementation phase and the initial year-and-a-half of the implementation phase resulted in an increase in internal facilitators' knowledge and skills of virtual care technologies, an increase in facilitator and site capacity, and high levels of adherence to implementation strategies were maintained across sites. Virtual care utilization increased across all sites and across the healthcare system during the implementation phase; however, a comparison to the increase in national level virtual care utilization metrics yielded no meaningful difference. While many implementation strategies aim to increase the adoption of a particular health technology product (e.g., a particular app or remote monitoring use case), the establishment of VHRCs may increase efficiencies in delivery of virtual care training and consultation to healthcare staff and patients, which may increase capacity and decrease barriers to adoption. However, due to the impact of the COVID-19 pandemic on the need for rapid adoption of technology and decreased in person care and services, it is not yet known the longer term impact that the establishment of VHRCs may have on the sustained adoption of health technologies.
RESUMO
Previous research has shown that romantic relationships can lead to the cognitive inclusion of a romantic partner into one's own self-representation, resulting in blurred boundaries between self and intimate other. Recent work suggests that this self-other integration process encompasses the two dimensions of the self-the conceptual and the bodily self. In line with this, it has been proposed that romantic love is associated with cognitive states that blur or reduce the saliency of self-boundaries in the bodily domain. The present study tested this hypothesis by investigating the influence of the self-other integration process in romantic love on passability judgments of door-like apertures, an action-anticipation task that rests on the representation of bodily boundaries. Romantically involved and single participants estimated whether they could pass through apertures of different widths. Moreover, inclusion of romantic partner in the self was assessed using the Inclusion of Other in the Self (IOS) scale. The pattern of correlation and the ratio between participants' shoulder width and aperture judgments did not differ between romantically involved participants and singles. However, our results revealed that in romantically involved participants, the relationship between individuals' shoulder width and aperture judgements was moderated by IOS scores. A greater inclusion of romantic partner in the self was associated with a weaker prediction of aperture judgment by participants' shoulder width. A similar moderating effect of the intensity of romantic feelings (as measured by the passionate love scale) on shoulder width-aperture judgment relationship was found. IOS scores, but not romantic feelings, also moderated aperture judgments made for another individual (third person perspective). Together, these findings are consistent with the view that inclusion of romantic partner in the self triggers cognitive states affecting self-boundaries in the bodily domain.
