Background The number of patient online reviews (PORs) has grown significantly, and PORs have played an increasingly important role in patients’ choice of health care providers. Objective The objective of our study was to systematically review studies on PORs, summarize the major findings and study characteristics, identify literature gaps, and make recommendations for future research. Methods A major database search was completed in January 2019. Studies were included if they (1) focused on PORs of physicians and hospitals, (2) reported qualitative or quantitative results from analysis of PORs, and (3) peer-reviewed empirical studies. Study characteristics and major findings were synthesized using predesigned tables. Results A total of 63 studies (69 articles) that met the above criteria were included in the review. Most studies (n=48) were conducted in the United States, including Puerto Rico, and the remaining were from Europe, Australia, and China. Earlier studies (published before 2010) used content analysis with small sample sizes; more recent studies retrieved and analyzed larger datasets using machine learning technologies. The number of PORs ranged from fewer than 200 to over 700,000. About 90% of the studies were focused on clinicians, typically specialists such as surgeons; 27% covered health care organizations, typically hospitals; and some studied both. A majority of PORs were positive and patients’ comments on their providers were favorable. Although most studies were descriptive, some compared PORs with traditional surveys of patient experience and found a high degree of correlation and some compared PORs with clinical outcomes but found a low level of correlation. Conclusions PORs contain valuable information that can generate insights into quality of care and patient-provider relationship, but it has not been systematically used for studies of health care quality. With the advancement of machine learning and data analysis tools, we anticipate more research on PORs based on testable hypotheses and rigorous analytic methods. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42018085057; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=85057 (Archived by WebCite at http://www.webcitation.org/76ddvTZ1C)
Women living with HIV (WLH) bear a disproportionate burden of cervical cancer and may face challenges understanding health information. The purpose of this study was to assess the influence of health literacy on WLH cervical cancer screening knowledge and behaviors. WLH were recruited from clinic- and community-based settings in the southeastern USA. The majority of women completing a questionnaire assessing factors related to cervical cancer were African American (90 %). About 38 % of women reported low health literacy. Compared to women with high health literacy, these women were more likely to report having had ≥2 Pap tests during the year after HIV diagnosis (p=0.02), and less likely to have had a Pap test <1 year previously (p=0.05). There was no difference in cervical cancer or human papillomavirus knowledge among those with low versus high health literacy. Results revealed mixed finding on the influence of health literacy on screening knowledge and behaviors.
Introduction Mental health-related problems are a significant cause of attrition during Basic Combat Training (BCT). Evidence in civilian populations suggests that physical fitness is associated with psychological benefits in civilians, but little is known about the association between physical fitness and psychological adjustment during BCT. Methods This study prospectively examined the association between physical fitness and depressive symptoms in 300 BCT soldiers from May to July, 2012 at Fort Jackson, Columbia, SC. Soldiers completed a baseline Army Physical Fitness Test (APFT) and survey within one week of arriving at BCT, and an end of cycle survey after eight weeks of BCT. Soldiers were assigned to the “high” fitness category if they had a passing score on the standard APFT of greater than or equal to 180 points out of 300 points. Soldiers scoring less than 180 points on the APFT were assigned to the “ low” fitness category. Depressive symptoms were measured using the 20-item Center for Epidemiologic Studies Depression Scale. Results In multivariate analyses, adjusting for baseline demographics, self-reported sleep prior to BCT, BCT confidence, Army identification, and depressive symptoms, the odds of reporting depressive symptoms were 60% lower for soldiers in the high fitness category (odds ratio, OR 0.40; 95% confidence interval, CI 0.19–0.84), compared to soldiers in the low fitness category. Conclusions Analogous to other positive outcomes of soldier fitness, improvement of soldier physical fitness prior to BCT might improve soldiers' psychological health outcomes.
Although diabetes education plays an important role in self-management for people living with diabetes, male health “help-seeking” lags far behind women. These gender-related “help-seeking” disparities often result in males being less engaged in their health care, which subsequently leads to poorer health outcomes among males. In this cross-sectional study, we used data from the 2017 Health Information National Trends Survey (HINTS) to identify factors that may contribute to communication inequalities between males and females. A hierarchical {linear/logistic} regression model was used to examine factors associated with online health information seeking among males living with diabetes. The results suggest that education, income, age, identifying as Hispanic, being a smoker, using a device to track progress toward a health-related goal, and using device to seek health information were all related to eHealth sum scores. Future research should consider testing applications among various at-risk groups to determine if the technology itself is becoming a barrier to eHealth.
Objectives To examine the potential moderating effects of explicit racial attitudes and implicit racial attitudes on the relationship between percent of Black county residents and COVID-19 cases and deaths. Methods We collected data from a variety of publicly available sources for 817 counties in the US. (26% of all counties). Cumulative COVID-19 deaths and cases from January 22 to August 31, 2020 were the dependent variables; explicit racial attitudes and implicit racial attitudes served as the moderators; subjective poor or fair health, food insecurity, percent uninsured, percent unemployed, median family income, percent women, percent of Asian county resident, percent of Hispanic county residents, and percent of people 65 or older were controls. Results The percent of Black county residents was positively associated with COVID-19 cases and deaths at the county level. The relationship between percent of Black residents and COVID-19 cases was moderated by explicit racial attitudes and implicit racial attitudes. Conclusions Implicit racial attitudes can take on a shared property at the community level and effectively explain racial disparities. COVID-19 cases are highest when both the percent of Black county residents and implicit racial attitudes are high.
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