eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.
Background and Objectives: This study aimed to assess the impact of interviewing format changes on the family medicine (FM) residency interviewing process. Specifically, we compare applicant cost and time expenditures in traditional in-person, virtual-only, and hybrid interview years. We also report student perceptions of the virtual-only and hybrid interview processes.
Methods: Applicants for first-year FM residency positions via the National Resident Matching Program (NRMP) completed a survey questionnaire in 2019-2020 (in-person interviewing only), 2020-2021 (virtual only), and 2021-2022 (hybrid). Statistical analyses included analysis of variance for questions related to applications, interviews, ranked programs, cost, and time spent. We used thematic analysis to code narrative comments about the interviewing experience for the virtual-only and hybrid years.
Results: Seventy-one FM applicants responded (response rate 63.4%). Costs for the in-person interview year were significantly higher ($2,394.70±$1,961.20) than the virtual ($646.80±$846.60, P=.0001) and hybrid years ($903.30±$793.40, P=.001). Days spent per applicant on in-person interviews was also significantly higher (25.9±7.9,) than virtual (14.9±7.6, P=.0001) and hybrid years (14.3±7.0, P<.0001). For virtual and hybrid years, thematic analyses identified five categories: “feelings related to interviewing,” “suggestions for future,” “convenience/logistics of interviewing,” “perceived fit of program,” and “cost/time of interviewing,” that further elucidated applicant experiences.
Conclusions: Virtual interviewing works well for overall cost and time, but other aspects such as perceived fit with programs and equity need to be considered before residency programs adopt fully virtual or hybrid interviewing in future years.
In nursing home patients, which intervention is most effective in decreasing falls?
EVIDENCE-BASED ANSWERIn patients living in nursing homes, exercise interventions overall can reduce the numbers of falls by 27%, patients who fall by 20%, and recurrent fallers by 30%. Balance exercises (33% reduction) and longterm exercises (20% reduction) are more effective than control group interventions. Exercise combined with other interventions such as medication review and environmental modification can reduce the rate of falls and the number of fallers by 40% and 10%, respectively (SOR: A, meta-analyses of randomized controlled trials).
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