Health Information Technology Commons^™

Online Risks For Youth And Families, Brandon T. Mcdaniel Phd, Jessica Pater Phd

Health Services and Informatics Research

Parkview Mirro Center for Research and Innovation

Executive Statement

Recent congressional attention has focused on the online risks of youth [1]. Parents, caregivers, and families are often unprepared to handle many of these risks, and parents/caregivers also experience some of these risks themselves. Although not an exhaustive list, risks can include cyberbullying, social comparisons, exposure to sexualized content, gambling addiction, Internet addiction, self-harm, and negative impacts on family and personal relationships [1]. Internal platform policies and design features are not enough to fully address key aspects of risky online behavior and potentially harmful digital habits. Additionally, current public policies and …

Behavioral Health Grants Overview 2022, Parkview Health

Health Services and Informatics Research

2022 List of Externally and Internally Funded Research for our Behavioral Health Outreach Initiatives.

Our Mission: To strengthen awareness around mental health, support needs in our community, reduce stigma, and encourage people to connect with care.

New-Onset Psychosis Following Covid-19 Infection In A Patient With No Psychiatric History: A Longitudinal Case Report., Matthew Runyan, Jay Fawver, Amanda Coupe, Michelle Drouin

Health Services and Informatics Research

BACKGROUND: Viral infection, including COVID-19, has been implicated as a potential cause of various neurobehavioral issues. An increasing number of case reports suggest that current or recent COVID-19 infection may cause new onset of psychotic symptoms in some individuals, potentially related to viral inflammation or infection of the nervous system.

CASE PRESENTATION: A 26-year-old woman with no psychiatric history presented with severe psychotic symptoms days after recovery from a mild COVID-19 infection. No other etiologies for psychosis were identified via diagnostic testing, review of medical history, or interviews with family. Her symptoms persisted for approximately two months, requiring three inpatient …

Designing Displays Of Cardiac Implantable Electronic Device Sensor Data With Patients Who Have Heart Failure With Reduced Ejection Fraction, Carly Daley Phd, Shauna Wagner Bsn, Rn, Ryan Ahmed Ms, Romisa Rohani Ghahari Phd, Tammy Toscos Phd, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

Background: Cardiac implantable electronic devices (CIEDs) are important life-saving and therapeutic devices for patients with heart failure with reduced ejection fraction (HFrEF). These devices capture a multitude of data, including factors that have potential to indicate worsening heart failure. Patients may be interested to monitor sensor data from their device as part of heart failure self-care, and are key stakeholders in designing visualizations and displays for interpretation of the data.

Objectives: The objective of this study was to explore the presentation of HF-related CIED sensor data in a small participatory design session with people who have HFrEF and CIEDs.

Methods: …

Self-Regulation As A Protective Factor For Diabetes Distress And Adherence In Youth With Type 1 Diabetes During The Covid-19 Pandemic., Alison L Miller, Dana K. Albright Phd, Katherine W Bauer, Hurley O Riley, Marisa E Hilliard, Julie Sturza, Niko Kaciroti, Sharon L Lo, Katy M Clark, Joyce M Lee, Emily M Fredericks

Health Services and Informatics Research

OBJECTIVE: The COVID-19 pandemic increased economic, social, and health stressors for families, yet its impacts on families of youth with chronic conditions, such as type 1 diabetes (T1D), are not well understood. Self-regulation (SR)-or the capacities to control emotions, cognition, and behavior in response to challenge-is known to support T1D management and coping in the face of stress. Strong SR may have protected youth with T1D from the impacts of pandemic-related stressors. This study compared youth and parent emotional functioning and T1D management before and after the pandemic's onset in relation to family pandemic-related stress and youth SR.

METHODS: Parents …

Moment-To-Moment Observation Of Parental Media Use And Parent-Child Interaction: Quality And Media Multitasking, Lisa Linder, Brandon T. Mcdaniel Phd, Heather Jaffe

Health Services and Informatics Research

Mobile media proliferation throughout society has infused and complicated environments that formerly were interaction rich (e.g., waiting rooms, restaurants, and playgrounds) with the presence of smart devices. Ethnographic studies have indicated that parental use negatively impacts parent-child interaction quality. The current study reviews and expands on previous research through observing systematically parent-child interaction quality throughout the course of an entire meal (30-140 minutes). Utilizing five-minute intervals, across 93 parent-child dyads, we assessed both within- and between-person moment-to-moment changes in parenting quality (i.e., parental positivity, negativity, and engagement) in the context of parental media use. Between-person, only positivity appeared to decrease …

"It's A Mess Sometimes": Patient Perspectives On Provider Responses To Healthcare Costs, And How Informatics Interventions Can Help Support Cost-Sensitive Care Decisions., Olivia K Richards, Bradley E Iott, Tammy Toscos, Jessica Pater, Shauna Wagner, Tiffany C Veinot

Health Services and Informatics Research

OBJECTIVE: We investigated patient experiences with medication- and test-related cost conversations with healthcare providers to identify their preferences for future informatics tools to facilitate cost-sensitive care decisions.

MATERIALS AND METHODS: We conducted 18 semistructured interviews with diverse patients (ages 24-81) in a Midwestern health system in the United States. We identified themes through 2 rounds of qualitative coding.

RESULTS: Patients believed their providers could help reduce medication-related costs but did not see how providers could influence test-related costs. Patients viewed cost conversations about medications as beneficial when providers could adjust medical recommendations or provide resources. However, cost conversations did not …

Integrating Pharmacists In Hfref Outpatient Care To Improve Use Of Guideline-Directed Medical Therapy, Roy Robertson Md, Mindy Flanagan Phd, Kris Howard Pharmd, Elizabeth Meisberger Pharmd, Emily Keltner Bs, Ma, Lovekirat Singh Ms, Carly Daley Phd, Shauna Wagner Bsn, Rn, Tammy Toscos Phd, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

Background: Guideline directed medical therapy (GDMT) is the cornerstone of reducing mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF); however, uniform prescribing remains low. There is potential for multidisciplinary care teams, including pharmacists, to improve GDMT use in outpatient care for patients with HFrEF. Investigation is needed to understand the impact of pharmacists in outpatient HFrEF care on GDMT prescribing.

Objectives: To examine the impact of integrating a pharmacist into an outpatient cardiology setting on GDMT prescription rates during HFrEF-related clinic visits.

Methods: This retrospective chart review study examined cardiology clinic visits (HF clinic, “general …

Health Informatics Interventions To Minimize Out-Of-Pocket Medication Costs For Patients: What Providers Want., Karalyn A Kiessling, Bradley E Iott, Jessica Pater, Tammy Toscos, Shauna Wagner, Laura M Gottlieb, Tiffany C Veinot

Health Services and Informatics Research

OBJECTIVE: To explore diverse provider perspectives on: strategies for addressing patient medication cost barriers; patient medication cost information gaps; current medication cost-related informatics tools; and design features for future tool development.

MATERIALS AND METHODS: We conducted 38 semistructured interviews with providers (physicians, nurses, pharmacists, social workers, and administrators) in a Midwestern health system in the United States. We used 3 rounds of qualitative coding to identify themes.

RESULTS: Providers lacked access to information about: patients' ability to pay for medications; true costs of full medication regimens; and cost impacts of patient insurance changes. Some providers said that while existing cost-related …

Mindful Parenting And Parent Technology Use: Examining The Intersections And Outlining Future Research Directions, Melissa A. Lippold, Brandon T. Mcdaniel Phd, Todd M. Jensen

Health Services and Informatics Research

Popular media attention and scientific research in both mindful parenting and technology use in the context of parenting has expanded in the 21st century; however, these two streams of research have largely evolved separately from one another. Thus, in this conceptual paper, we integrate the research on mindful parenting with that on parents’ technology use and parenting to examine how parent technology use may impact or be linked with aspects of mindful parenting. Mindful parenting theory outlines five key components: listening with full attention, self-regulation in the parent–child relationship, emotional awareness of self and child, nonjudgmental acceptance of self and …

Neuropsychological Outcomes In Individuals With Type 1 And Type 2 Diabetes., Nathaniel M Putnam, Evan L Reynolds, Mousumi Banerjee, Kara Mizokami-Stout, Dana K. Albright Phd, Joyce Lee, Rodica Pop-Busui, Eva L Feldman, Brian C Callaghan

Health Services and Informatics Research

OBJECTIVE: To determine the prevalence of neuropsychological outcomes in individuals with type 1 diabetes compared to individuals with type 2 diabetes or without diabetes, and to evaluate the association of diabetes status and microvascular/macrovascular complications with neuropsychological outcomes.

PATIENTS AND METHODS: We used a nationally representative healthcare claims database of privately insured individuals (1/1/2001-12/31/2018) to identify individuals with type 1 diabetes. Propensity score matching was used as a quasi-randomization technique to match type 1 diabetes individuals to type 2 diabetes individuals and controls. Diabetes status, microvascular/macrovascular complications (retinopathy, neuropathy, nephropathy, stroke, myocardial infarction, peripheral vascular disease, amputations), and neuropsychological outcomes …

Perhaps It Was Too Soon: College Students' Reflections On The Timing Of Their Sexual Debut., Susan Sprecher, Lucia F O'Sullivan, Michelle Drouin, Julie Verette-Lindenbaum, Marion C Willetts

Health Services and Informatics Research

Early sexual debut has been a focus of social scientific research due to its association with adverse circumstances and negative outcomes. However, there has been a recent shift to considering not only chronological age, but also the degree to which the event is viewed to be optimally timed (i.e., the perception that it occurred at the "right time" versus too soon). The purpose of this study was to assess how individual/family background variables and contextual aspects of the experience (including partner and relationship aspects) are associated with both the actual age at sexual debut and the perceived acceptability of the …

Maternal Nighttime Phone Use And Impacts On Daily Happiness And Exhaustion., Brandon T. Mcdaniel Phd, Elizabeth L Adams, Emily E Hohman, Victor P. Cornet Ms, Lauren Reining, Zachary Kaiser

Health Services and Informatics Research

Brief Report

The Disrupt: A Measure Of Parent Distraction With Phones And Mobile Devices And Associations With Depression, Stress, And Parenting Quality., Brandon T. Mcdaniel Phd

Health Services and Informatics Research

Abstract

The landscape of modern parenting has shifted as an increasing number of parents have and utilize smartphones and other mobile devices throughout the day. A validated measure of parent distraction with these devices is needed in the field. It is important to have a validated measure of parent distraction with mobile devices (e.g., phubbing, technoference), as this distraction can be common at times and could negatively impact the quality of parenting that children receive. In the current study, I developed a brief, parent-reported survey measure of parent distraction (DISRUPT), examined its reliability and validity (convergent, divergent) in two survey …

Work-Related Technoference At Home And Feelings Of Work Spillover, Overload, Life Satisfaction And Job Satisfaction, Brandon T. Mcdaniel Phd, Kimberly Oconner, Michelle Drouin

Health Services and Informatics Research

The purpose of this study is to examine whether work-related technology use outside of work and around family members could produce technoference or phubbing, where time spent with family members is interrupted by or intruded upon by technology use. The authors also examined its impact on work-to-family spillover, feelings of overload, life satisfaction and job satisfaction for workers.


Via an online survey, the authors assessed the frequency of technoference due to work, work-to-family spillover, feelings of overload, life satisfaction and job satisfaction. The authors’ analytic sample included US parents (95 fathers and 88 mothers) who worked for pay and experienced …

Romance And Dating In The Digital Age: Impacts Of Computer-Mediated Communication And A Global Pandemic., Jayson L Dibble, Brandon T. Mcdaniel Phd

Health Services and Informatics Research

Guest Editorial

Scholars have described communication to be the currency, if not the lifeblood, of human relationships in general and romantic relationships more specifically. Through communication romantic relationships are solicited, established, maintained, and dissolved. For example, if prospective partners are to find one another, they must first communicate their desire and availability for romance. With a centuries-long history of intertwining between communication mediums and pursuit of romance—even the earliest newspapers included personal sections1—it was no surprise when the Internet and digital technologies became coopted for love and sexual expression. In short, whatever uses people may have for digital …

“You Phubbed Me For That?” Reason Given For Phubbing And Perceptions Of Interactional Quality And Exclusion, Brandon T. Mcdaniel Phd, Eric Wesselmann

Health Services and Informatics Research

Abstract

When someone focuses on their phone, rather than the person in front of them (“phubbing” or “technoference”), this can lead to feelings of exclusion and dissatisfaction. Few studies have examined this phenomenon experimentally using a confederate during face-to-face interactions, and to our knowledge the published research has yet to examine the role that attributional information may have on the effects of being phubbed. Thus, we conducted an experiment investigating how attributional information influenced the effects of phone use on feelings of exclusion and interactional quality during a face-to-face interaction. We randomly assigned 99 young adults into one of three …

Noninvasive Hemoglobin Level Prediction In A Mobile Phone Environment: State Of The Art Review And Recommendations., Kamrul Hasan Md, Masanul Aziz Md, Ishrak Islam Zarif Md, Mahmudul Hasan, Mma Hashem, Shion Guha Phd, Richard R Love, Sheikh Ahamed

Health Services and Informatics Research

BACKGROUND: There is worldwide demand for an affordable hemoglobin measurement solution, which is a particularly urgent need in developing countries. The smartphone, which is the most penetrated device in both rich and resource-constrained areas, would be a suitable choice to build this solution. Consideration of a smartphone-based hemoglobin measurement tool is compelling because of the possibilities for an affordable, portable, and reliable point-of-care tool by leveraging the camera capacity, computing power, and lighting sources of the smartphone. However, several smartphone-based hemoglobin measurement techniques have encountered significant challenges with respect to data collection methods, sensor selection, signal analysis processes, and machine-learning …

Examining The Roles Of Marital Status And Sex On Communication With Backburners On Social Media, Michelle Drouin, Irum Abbasi, Jayson L. Dibble, Brandon T. Mcdaniel Phd

Health Services and Informatics Research

ABSTRACT

In this study, we examined the prevalence of and communication with backburners (romantic alternatives) within a sample of both married (n= 188) and casually dating (n = 230) men and women in the United States. We also examined the roles of relationship length, commitment, sex, and marital status in the number of backburners reported and their communication with backburners, generally, as well as their communication with their most desired backburner. Extending previous studies using undergraduates, we found that commitment level was unrelated to the number of reported backburners. However, commitment was negatively related to the amount …

The Relationship Between Dark Triad Personality Traits And Sexting Behaviors Among Adolescents And Young Adults Across 11 Countries., Mara Morelli, Flavio Urbini, Dora Bianchi, Roberto Baiocco, Elena Cattelino, Fiorenzo Laghi, Piotr Sorokowski, Michal Misiak, Martyna Dziekan, Heather Hudson, Alexandra Marshall, Thanh Truc T Nguyen, Lauren Mark, Kamil Kopecky, René Szotkowski, Ezgi Toplu Demirtaş, Joris Van Ouytsel, Koen Ponnet, Michel Walrave, Tingshao Zhu, Ya Chen, Nan Zhao, Xiaoqian Liu, Alexander Voiskounsky, Nataliya Bogacheva, Maria Ioannou, John Synnott, Kalliopi Tzani-Pepelasi, Vimala Balakrishnan, Moses Okumu, Eusebius Small, Silviya Pavlova Nikolova, Michelle Drouin, Antonio Chirumbolo

Health Services and Informatics Research

BACKGROUND: Sexting is an increasingly common phenomenon among adolescents and young adults. Some studies have investigated the role of personality traits in different sexting behaviors within mainstream personality taxonomies like Big Five and HEXACO. However, very few studies have investigated the role of maladaptive personality factors in sexting. Therefore, the present study investigated the relationship between Dark Triad Personality Traits and experimental (i.e., sharing own sexts), risky (i.e., sexting under substance use and with strangers), and aggravated sexting (i.e., non-consensual sexting and sexting under pressure) across 11 countries.

METHODS: An online survey was completed by 6093 participants (Mage = 20.35; …

Technoference: Parent Mobile Device Use And Implications For Children And Parent-Child Relationships., Brandon T. Mcdaniel Phd

Health Services and Informatics Research

The increase in the prevalence of smartphones and mobile devices has spurred changes in the caregiving environment of infants and young children, as phones and mobile devices are used at times during caregiving and in caregiving spaces. This use could create disruptions and cause distractions during parenting (termed technoference). This article summarizes the potential impacts on parent responsiveness and the experiences of infants and young children. Yet, it also warns that it is important to consider the reason for and type of parent use. Finally, the article ends with practical tips for working with parents concerning mobile device use.

How Parents And Their Children Used Social Media And Technology At The Beginning Of The Covid-19 Pandemic And Associations With Anxiety., Michelle Drouin, Brandon T. Mcdaniel Phd, Jessica Pater, Tammy Toscos Phd

Health Services and Informatics Research

In this study, we examined parents' (n = 260) perceptions of their own and their children's use of social media and other types of communication technologies in the beginning stages of coronavirus disease 2019 (COVID-19) related sanctions (e.g., social distancing) in the United States. We also examined associations between social media and technology use and anxiety. On average, parents reported that both they and their children (especially teenagers aged 13-18) had increased technology and social media use since the beginning of social distancing. Moreover, even after controlling for demographic factors, structural equation models showed that parents and children with …

Improving Social Determinants Of Health Screening Implementation Through Collaboration: Leveraging A Clinical-Academic Partnership., Bradley E. Iott Mph, Ms, Jessica Pater Phd, Ms, Shauna Wagner Bsn, Rn, Tammy Toscos Phd, Tiffany Veinot Phd, Mls

Health Services and Informatics Research

Problem Addressed and Project Purpose Motivated by the transition to value-based payment models, 1 there are growing efforts to capture information about patients’ social determinants of health (SDOH) in United States (US) healthcare and provide subsequent services targeted at those health-related social risk factors. The collection of data about social risk factors creates opportunities for healthcare providers to make referrals to social service agencies to address individual patients’ needs and to tailor treatment plans to individuals’ specific needs, a goal of precision health2,3. Hence, by accurately and appropriately collecting SDOH data from patients and actionably displaying these data to providers, …

Technology And Workflow Recommendations To Improve Use Of Guideline Directed Medical Therapy For Heart Failure With Reduced Ejection Fraction., Roy Robertson Md, Ryan Ahmed, Tammy Toscos Phd, Victor P. Cornet Ms, Shauna Wagner, Sarah Colletta, Carly Daley, Michael Mirro Md

Health Services and Informatics Research

BACKGROUND: Optimal use of Guideline Directed Medical Therapy (GDMT) is the cornerstone of reducing mortality and morbidity in heart failure patients with reduced ejection fraction (HFrEF). Interventions targeted at increasing GDMT use are necessary to improve outcomes. Integration of a pharmacist in specialty clinics may improve GDMT use; However, the potential benefit may be underrealized due to constraints in technology use and workflow.

PROJECT INTENT: To understand existing processes and explore workflow optimization opportunities to enhance use of GDMT prescription for patients with HFrEF.

METHODOLOGY: Teams of 2 researchers performed contextual inquiry4 during in-situ, 2-hour observations with 5 physicians, 3 …

Consensual Sexting Among College Students: The Interplay Of Coercion And Intimate Partner Aggression In Perceived Consequences Of Sexting., Tara L Cornelius, Kathryn M Bell, Tylor Kistler, Michelle Drouin

Health Services and Informatics Research

Recent empirical data suggests that the majority of adolescents and emerging adults utilize digital technology to engage with texting and social media on a daily basis, with many using these mediums to engage in sexting (sending sexual texts, pictures, or videos via digital mediums). While research in the last decade has disproportionately focused on the potential risk factors and negative consequences associated with sexting, the data are limited by failing to differentiate consensual from non-consensual sexting and account for potential influences of intimate partner aggression (IPA) and sexting coercion in these contexts. In the current study, we assessed the positive …

Engaging Patients In Atrial Fibrillation Management Via Digital Health Technology: The Impact Of Tailored Messaging., Tammy Toscos Phd, Amanda Coupe, Shauna Wagner, Ryan Ahmed, Amelia Roebuck, Mindy Flanagan, Michelle Drouin, Michael Mirro Md

Health Services and Informatics Research

Patients with atrial fibrillation (AF) demonstrate persistent knowledge gaps regarding their condition and a substandard adherence to oral anticoagulant (OAC) medication, which contribute to thromboembolic stroke and other clot-related complications. Tailored patient education and medication reminders may help reduce these negative health outcomes. We sought to improve disease knowledge and medication adherence among a sample of AF patients using tailored education and nudges. The intervention leveraged three digital health technologies: a patient portal, an electronic-prescribing data feed, and a smart pill bottle. The content of the educational messaging, nudges, and cadence were tailored according to findings from our user-centered design …

Parents’ Feelings About School Reopening During Covid-19: Survey Results From Northeast Indiana, Mindy Flanagan Phd, Brandon T. Mcdaniel Phd, Michelle Drouin Phd, Jessica Pater Phd, Tammy Toscos Phd

Health Services and Informatics Research

A report compiled by a team from the Health Services and Informatics Research Group. Assess concerns and attitudes related to child(ren)’s return to school amid the COVID-19 pandemic among parents in Northeast Indiana. Method, results, and conclusion of survey results.

Untold Stories In User-Centered Design Of Mobile Health: Practical Challenges And Strategies Learned From The Design And Evaluation Of An App For Older Adults With Heart Failure., Victor Philip Cornet, Tammy Toscos Phd, Davide Bolchini, Romisa Rohani Ghahari, Ryan Ahmed, Carly Daley, Michael J. Mirro Md, Richard J Holden

Health Services and Informatics Research

BACKGROUND: User-centered design (UCD) is a powerful framework for creating useful, easy-to-use, and satisfying mobile health (mHealth) apps. However, the literature seldom reports the practical challenges of implementing UCD, particularly in the field of mHealth.

OBJECTIVE: This study aims to characterize the practical challenges encountered and propose strategies when implementing UCD for mHealth.

METHODS: Our multidisciplinary team implemented a UCD process to design and evaluate a mobile app for older adults with heart failure. During and after this process, we documented the challenges the team encountered and the strategies they used or considered using to address those challenges.

RESULTS: We …

The Role Of Parent Self-Regulation In Youth Type 1 Diabetes Management., Katherine W Bauer, Marisa E Hilliard, Dana K. Albright Phd, Sharon L Lo, Emily M. Fredericks, Alison L Miller

Health Services and Informatics Research

PURPOSE OF REVIEW: Youth with strong self-regulation (SR), or the ability to manage thoughts, emotions, and behaviors, engage in more effective type 1 diabetes (T1D) management. However, while parent support and engagement are critical to ensuring positive youth T1D outcomes, it is rarely considered that parents' SR may also influence youth T1D management. If this is the case, novel interventions to improve parents' SR or ensure adequate support for parents with SR challenges offer great potential to improve family functioning and youth T1D management.

RECENT FINDINGS: Theoretical and preliminary empirical evidence suggests that parental SR impacts family processes that support …

Can Nurses Help Improve Self-Care Of Patients Living With Atrial Fibrillation? A Focus Group Study Exploring Patients' Disease Knowledge Gaps., Tammy Toscos Phd, Amanda Coupe, Shauna Wagner, Michelle Drouin, Amelia Roebuck, Carly Daley, Maria D. Carpenter, Michael Mirro Md

Health Services and Informatics Research

Aims: To identify knowledge gaps and preferences for educational material to improve nurse-patient communication and self-care.

Design: Using a mixed-methods design, we conducted focus groups and quantitative surveys.

Methods: We conducted three focus groups with atrial fibrillation (AF) patients and support persons (

Results: Although most participants had adequate health literacy, most reported gaps in AF knowledge. Participants lacked disease-related knowledge and were unsure how to manage health behaviours (e.g. diet and exercise). Few felt they received adequate education from their healthcare provider. Results emphasize the need for consistent information from nursing staff, in lay language, via both electronic and …