A Patient-focused Information Design Intervention to Support the Minor Traumatic Brain Injuries (mTBI) Choosing Wisely Canada Recommendation

Dowling, Shawn; Hair, H.; Boudreau, Denise M.; Grigat, D.; Rice, Christopher; Born, Karen; VandenBerg, Stephanie

doi:10.7759/cureus.5877

Cited by 6 publications

(8 citation statements)

References 16 publications

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“…Barriers and enablers were the focus of 12 qualitative,48–59 8 quantitative60–67 and 4 mixed-methods studies 68–71. Studies of barriers and enablers explored testing/treatment in infant bronchiolitis,54 55 68 antibiotic stewardship,53 56 57 62 70 cranial CT scans in minor head injury,49 52 guideline implementation in chest pain51 and syncope,69 urinalysis,56 67 urinary catheter insertion,50 lumbar radiographs in back pain,48 respiratory viral testing,54 potentially inappropriate medications in older patients58 and perspectives about low-value care 59 60 64–66 71…”

Section: Resultsmentioning

confidence: 99%

What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review

Gangathimmaiah,

Drever,

Evans

et al. 2023

BMJ Open

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ObjectivesLow-value care can harm patients and healthcare systems. Despite a decade of global endeavours, low value care has persisted. Identification of barriers and enablers is essential for effective deimplementation of low-value care. This scoping review is an evidence summary of barriers, enablers and features of effective interventions for deimplementation of low-value care in emergency medicine practice worldwide.DesignA mixed-methods scoping review was conducted using the Arksey and O’Malley framework.Data sourcesMedline, CINAHL, Embase, EMCare, Scopus and grey literature were searched from inception to 5 December 2022.Eligibility criteriaPrimary studies which employed qualitative, quantitative or mixed-methods approaches to explore deimplementation of low-value care in an EM setting and reported barriers, enablers or interventions were included. Reviews, protocols, perspectives, comments, opinions, editorials, letters to editors, news articles, books, chapters, policies, guidelines and animal studies were excluded. No language limits were applied.Data extraction and synthesisStudy selection, data collection and quality assessment were performed by two independent reviewers. Barriers, enablers and interventions were mapped to the domains of the Theoretical Domains Framework. The Mixed Methods Appraisal Tool was used for quality assessment.ResultsThe search yielded 167 studies. A majority were quantitative studies (90%, 150/167) that evaluated interventions (86%, 143/167). Limited provider abilities, diagnostic uncertainty, lack of provider insight, time constraints, fear of litigation, and patient expectations were the key barriers. Enablers included leadership commitment, provider engagement, provider training, performance feedback to providers and shared decision-making with patients. Interventions included one or more of the following facets: education, stakeholder engagement, audit and feedback, clinical decision support, nudge, clinical champions and training. Multifaceted interventions were more likely to be effective than single-faceted interventions. Effectiveness of multifaceted interventions was influenced by fidelity of the intervention facets. Use of behavioural change theories such as the Theoretical Domains Framework in the published studies appeared to enhance the effectiveness of interventions to deimplement low-value care.ConclusionHigh-fidelity, multifaceted interventions that incorporated education, stakeholder engagement, audit/feedback and clinical decision support, were administered daily and lasted longer than 1 year were most effective in achieving deimplementation of low-value care in emergency departments. This review contributes the best available evidence to date, but further rigorous, theory-informed, qualitative and mixed-methods studies are needed to supplement the growing body of evidence to effectively deimplement low-value care in emergency medicine practice.

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Section: Resultsmentioning

confidence: 99%

What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review

Gangathimmaiah,

Drever,

Evans

et al. 2023

BMJ Open

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“…The tools of production of infographics are no longer reserved for certain specialists; now amateurs can also try their hand at them. 39 Infographics have been used in the recent past for patient-centered care 22 40 41 42 and public health benefits like prevention of diseases, 43 44 communicating overdose prevention strategies, 45 to increase clinical trial participation 46 47 which allow for a better patient understanding of their health and empowers patients to participate in their healthcare. Recently Chan et al 2 disseminated an infographic delineating the principles of airway management focusing on infection control for healthcare workers in the early COVID‐19 pandemic period.…”

Section: Discussionmentioning

confidence: 99%

Preparing Infographics for Post-publication Promotion of Research on Social Media

Joshi

Gupta

2021

J Korean Med Sci

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Infographics are pictorial representations of information intended to disseminate information quickly and clearly. Their use has increased in the past decade due to wider and easy access to technology. Infographics are being increasingly used for public advisories, disseminating protocols for healthcare professionals, and post-publication promotion of research. Due to their potential to rapidly reach a vast audience, these have gained larger importance during the coronavirus disease 2019 pandemic. Two key aspects determine the quality of infographics, content and visual appeal. In this brief, the authors attempt to delineate the key aspects of designing an infographic, and the freeware that they may have at their disposal for creating informative, appealing, and useful infographics.

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“…web-based educational modules) delivered via touchscreen computer kiosks or tablets ( n = 15) ( Pendleton et al , 2010 ; Price et al , 2010 ; Khan et al , 2011 ; Leijon et al , 2011 ; Yacoub and Mehta, 2011 ; Braam et al , 2012 ; Arora et al , 2013 ; Schwarz et al , 2013 ; Bailey et al , 2016 ; Pineda-del Aguila et al , 2018 ; Dempsey et al , 2019 ; Grant et al , 2019 ; Bertholet et al , 2020 ; Hendricks et al , 2020 ; Callegari et al , 2021 ). Written health information delivered via posters, brochures or handouts ( n = 10) ( Houry et al , 2010 , 2011 ; Pydah and Howard, 2010 ; Giannitsioti et al , 2016 ; Natt et al , 2017 ; Berkhout et al , 2018a ; Ginat and Christoforidis, 2018 ; Dowling et al , 2019 ; Ismail et al , 2019 ; Krebs et al , 2019 ; Kripalani et al , 2019 ) and a combination of types have also been trialled in different settings (i.e. audio-visual information plus written resources; n = 9) ( Chan et al , 2010 , 2015 ; Kharsany et al , 2010 ; Pawar et al , 2016 ; Shepherd et al , 2016 ; Kamimura et al , 2017 ; Asthana et al , 2018 ; Naeem et al , 2019 ; Patino et al , 2019 ).…”

Section: Review Findingsmentioning

confidence: 99%

Do health service waiting areas contribute to the health literacy of consumers? A scoping review

McDonald

Voutier

Govil³

et al. 2023

Health Promotion International

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Health service waiting areas commonly provide health information, resources and supports for consumers; however, the effect on health literacy and related outcomes remains unclear. This scoping review of the literature aimed to explore the use of waiting areas as a place to contribute to the health literacy and related outcomes of consumers attending health appointments. Articles were included if they focussed on health literacy or health literacy responsiveness (concept) in outpatient or primary care health service waiting areas (context) for adult consumers (population) and were published after 2010. Ten bibliographic databases, one full-text archive, dissertation repositories and web sources were searched. The search yielded 5095 records. After duplicate removal, 3942 title/abstract records were screened and 360 full-text records assessed. Data were charted into a standardized data extraction tool. A total of 116 unique articles (published empirical and grey literature) were included. Most articles were set in primary and community care (49%) waiting areas. A diverse range of health topics and resource types were available, but results demonstrated they were not always used by consumers. Outcomes measured in intervention studies were health knowledge, intentions and other psychological factors, self-reported and observed behaviours, clinical outcomes and health service utilization. Intervention studies overall demonstrated positive trends in health literacy-related outcomes, although the benefit declined after 3–6 months. Research on using waiting areas for health literacy purposes is increasing globally. Future research investigating the needs of consumers to inform optimal intervention design is needed.

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A Patient-focused Information Design Intervention to Support the Minor Traumatic Brain Injuries (mTBI) Choosing Wisely Canada Recommendation

Cited by 6 publications

References 16 publications

What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review

What works for and what hinders deimplementation of low-value care in emergency medicine practice? A scoping review

Preparing Infographics for Post-publication Promotion of Research on Social Media

Do health service waiting areas contribute to the health literacy of consumers? A scoping review

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