The design and implementation of a multi-center, pragmatic, individual-level randomized controlled trial to evaluate Baby2Home, an mHealth intervention to support new parents.

BACKGROUND: Becoming a parent is a transformative experience requiring multiple transitions, including the need to navigate several components of health care, manage any mental health issues, and develop and sustain an approach to infant feeding. Baby2Home (B2H) is a digital intervention built on the collaborative care model (CCM) designed to support families during these transitions to parenthood. OBJECTIVES: We aim to investigate the effects of B2H on preventive healthcare utilization for the family unit and patient-reported outcomes (PROs) trajectories with a focus on mental health. We also aim to evaluate heterogeneity in treatment effects across social determinants of health including self-reported race and ethnicity and household income. We hypothesize that B2H will lead to optimized healthcare utilization, improved PROs trajectories, and reduced racial, ethnic, and income-based disparities in these outcomes as compared to usual care. METHODS: B2H is a multi-center, pragmatic, individual-level randomized controlled trial. We will enroll 640 families who will be randomized to: [1] B2H + usual care, or [2] usual care alone. Preventive healthcare utilization is self-reported and confirmed from medical records and includes attendance at the postpartum visit, contraception use, depression screening, vaccine uptake, well-baby visit attendance, and breastfeeding at 6 months. PROs trajectories will be analyzed after collection at 1 month, 2 months, 4 months, 6 months and 12 months. PROs include assessments of stress, depression, anxiety, self-efficacy and relationship health. IMPLICATIONS: If B2H proves effective, it would provide a scalable digital intervention to improve care for families throughout the transition to new parenthood.

Patient Room Design: A Qualitative Evaluation of Attributes Impacting Health Care Professionals.

The focus of this research was to identify what attributes of patient room designs are most beneficial to health care professionals and to explore whether particular professionals hold certain beliefs about patient room attributes. Acute care, progressive care, and intensive care patient room designs were analyzed through the use of pre- and postoccupancy evaluations of a cardiovascular service line. Fourteen focus groups and 1 interview among 74 health care professionals were conducted. Qualitative analysis of the data was guided by a multidimensional framework. A descriptive quantitative assessment was additionally made to reveal positive, negative, or neutral trends and determine the frequency of attributes discussed. The findings revealed outcomes in 4 primary areas: (1) clearance around the bed; (2) visibility; (3) access to the bathroom/bathroom configuration; and (4) access to daylight/views of the exterior. This study identified 8 additional categories. Outcomes illustrate perceptions from a myriad of health care professionals, but the nurses, therapists, and interdisciplinary members of the care team station offered the greatest depth of information. As patient room designs continue to evolve, building on evidence gathered as new or established models are evaluated will become increasingly important.

Designing for Efficiency: Examining the Impact of Centralized and Decentralized Nurse Stations on Interdisciplinary Care Processes.

OBJECTIVE: This study examined the impact of centralized and decentralized unit designs on an interdisciplinary team's perceptions of efficiency through the use of a preoccupancy and postoccupancy evaluation of a cardiovascular unit. BACKGROUND: During the premove study, the service line was housed across 4 separate locations, each with a centralized nurses' station. The postmove design was housed on 1 floor with decentralized stations. METHODS: For this qualitative study, 14 focus groups and 1 interview were conducted. Analysis of the data was guided by a developed framework for efficiency classified into 7 categories. RESULTS: Outcomes reveal that efficiency was impacted by issues including walking, access to supplies and equipment, proximity to staff, and overall unit configuration and size. CONCLUSIONS: Although the design of the decentralized unit positions staff members closer to patients, many feel isolated while the centralized units seemed to better promote staff proximity and access to supplies.

I Sought It, I Reddit: Examining Health Information Engagement Behaviors among Reddit Users.

Given the wide use of social media, these platforms have become important channels for understanding health-related information engagement processes. Reddit is a social media platform dedicated to user-generated content and discourse around the world. However, little research exists regarding use of the platform. Guided by the diffusion of innovation theory, the purpose of this study was to analyze Reddit users' behaviors on the platform related to perceptions of information credibility, health information seeking, and behavioral enactment of information found. Data were collected via survey from Reddit users around the world (n = 389). Data suggest that although Reddit use and perceived information credibility are unrelated to acting on the information found on Reddit, users who are specifically seeking health-related information are more likely to enact the information in their lives. Implications from the findings suggest important considerations for communication scholars, media advocates, and health promotion practitioners.