The advancement over web innovation is distinguishment for web applications that amplifies inconsistencies between different web browsers. These incompatibilities supplement cross browser incompatibilities that contain modified look at evolving browsers for a specific web application. For a percentage cases, Cross-Browser Inconsistencies (XBIs) comprises for satisfactory difference, while these might actually prevent clients starting with gaining entrance to and only a web application's purpose for different situations. Therefore, testing procedure of a web provision must a chance to be performed efficiently looking into different browsers with accomplish consistency. Available techniques and tools oblige a significant manual exertion on remember such issues; also furnish restricted help to settling those reason for the issues. In this paper, we recommend a technique to identifying cross-browser issues without human obstruction.
74 Background: Nearly 3 million cancer survivors in the US reside in rural areas. Existing survivorship care models were developed mainly at large academic centers, and thus require adaption to meet the challenging needs of the rural community. Rural cancer survivors (RCS) face issues with coordination of care, decision-making, access to specialty services, supportive care resources, and time and resources required for travel. RCS are at greater risk for social isolation and inadequate emotional support. To address these challenges, many studies propose information technology (IT), mobile, and video solutions. We assessed the potential of online and mobile video technology applications to reduce barriers to survivorship care for RCS, families, and caregivers. Methods: We conducted 2 in-person focus groups with rural care managers, providers, and public health professionals, and one virtual cross-disciplinary focus group of patients, caregivers, and provider stakeholders to evaluate acceptability of video modules. Using a Community-Based Participatory Research approach, we worked with community partners to design and develop materials that adequately addressed their needs. Results: Focus group results indicate that video modules added little value for RCS due to sporadic internet access, limited patient IT literacy, vision and memory problems, and patient difficulty interpreting information. Therefore, we designed and piloted a paper RCS Checklist to be taken to appointments, available in waiting areas or through care managers, and to serve as a guide for shared patient-provider decision-making. The resulting checklist includes evidence-based information about survivorship care goals and approaches, care coordination strategies, information about local cancer supportive services, health insurance reimbursement, state disability policies, psychosocial support, and stress-reduction tips. Conclusions: In some special patient populations like RCS, use of health IT for patient empowerment and care coordination may be a poor choice. Engaging relevant stakeholders in the development of location-specific communication and decision aid materials is paramount to successful engagement of patients and caregivers.
Background: Failed implementation of health programs is common and may contribute to health disparities in resource-poor communities. We aimed to (1) evaluate barriers and facilitators for implementation of cancer survivorship services in rural communities and to (2) identify optimal strategies for successful implementation of survivorship care programs in these settings. Methods: The study design was guided by the Consolidated Framework for Implementation Research (CFIR) and based on the core principles of effective teamwork. We collected qualitative and quantitative data to assess barriers and facilitators to implementation of rural cancer survivorship care (3 focus groups, size 8, 31, and 77). Data were collected using both in-person and web-based approaches (semi-structured interviews, stakeholder surveys, ThinkTank, project online portal, Google Analytics). Stakeholders included cancer survivors, their families and caregivers, local public services administrators, health providers, and allied health-care professionals from rural and remote communities in Upstate New York. Results: Patients reported preferences for cross-region team-based survivorship care and emphasized the importance of including local providers on regional care teams and networks. Synthesis of results was guided by teamwork principles. Most rural patient stakeholders trusted recommendations received from their local providers (n=6, 86%) and preferred receiving care locally (n=6, 86%). Involvement of rural patient navigators (average rank 1.5 out of 5) and county care managers (1.9) was ranked more favorably than reliance on telemedicine alone (3.3) or visiting practice facilitators (3.3). Rural counties that have existing formal and informal networks involved in cancer care scored higher on the metrics of teamwork and demonstrated more advanced readiness to change in regards to survivorship program implementation. Conclusions: Our analysis identified a unique combination of community socio-economic factors, geographic isolation, and limited provider supply common in rural care settings as barriers to optimal delivery of cancer survivorship care in rural settings. We propose teamwork training and facilitation as an innovative implementation strategy to overcome these barriers and minimize their effect on patient access to care. Merging implementation science and team science frameworks could further assist with program adaptation to minimize implementation failure and improve continuity of care for complex cancer pathway management.
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