Designing an Information and Communications Technology Tool With and for Victims of Violence and Their Case Managers in San Francisco: Human-Centered Design Study

Patel, Devika; Sarlati, Siavash; Martin-Tuite, Patrick; Feler, Joshua; Chehab, Lara; Texada, Michael; Marquez, Ruben; Orellana, F Julia; Henderson, Terrell; Nwabuo, Adaobi; Plevin, Rebecca; Dicker, Rochelle; Juillard, Catherine; Sammann, Amanda

doi:10.2196/15866

Cited by 13 publications

(25 citation statements)

References 45 publications

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“…Practitioners should be prepared to provide information about access to prevention education skills training. There is increasing availability of safety skill programs that use digital technology to provide education for those at risk for violence exposure 33,34…”

Section: Discussionmentioning

confidence: 99%

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

2021

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IMPORTANCE Children and youth experience high rates of exposure to violence, which is associated with later poor physical and mental health outcomes. The immediate injuries and impacts from these exposures are often treated in emergency departments and medical offices. OBJECTIVE To characterize, using nationally representative data, the size and characteristics of the child and youth population being seen by medical authorities in the wake of violence exposure. DESIGN, SETTING, AND PARTICIPANTSThe survey study used a representative sample of children and youth aged 2 to 17 years, from 2 waves (2011 and 2014) of the National Survey of Children Exposed to Violence, drawn from a mix of random digit dialing and address-based sampling.Interviews were conducted (1) over the phone with caregivers of young children or (2) directly with the youth aged 10 to 17 years. Data analysis was performed from September to December 2020. MAIN OUTCOMES AND MEASURES Violence exposures were assessed with the 53-item JuvenileVictimization Questionnaire, which had follow-up questions that asked about injury and going "to the hospital, a doctor's office, or some kind of health clinic because of what happened." Additional questions were asked about lifetime and past-year childhood adversities and current trauma symptoms using the Trauma Symptom Checklist and the Trauma Symptom Checklist for Young Children. RESULTSThe combined 2-survey sample had 5187 children and youth who reported a lifetime violence exposure, of whom 45.6% (95% CI, 43.1%-48.2%) were aged 2 to 9 years, and 54.4% (95% CI, 51.8%-56.9%) were aged 10 to 17 years; 53.6% (95% CI, 51.0%-56.2%) were male. Based on the full sample of 8503 children and youth, 3.4% (95% CI, 2.6%-4.4%) had a violence-related medical visit at some time in their lives. The rate of past-year medical visits due to a violence exposure was 1.9% (95% CI, 1.2%-2.7%), equivalent to a point estimate of approximately 1.4 million children and youth. Of those with medical visits, 33.3% (95% CI, 23.1%-45.4%) were aged 2 to 9 years. Those with a past-year visit had higher levels of trauma symptoms (risk ratio, 1.71; 95% CI, 1.44-2.03) adverse childhood experiences (risk ratio, 2.55; 95% CI, 2.34-2.78) and multiple violence exposures (risk ratio, 3.91; 95% CI, 3.22-4.76) compared with the general sample of children and youth. CONCLUSIONS AND RELEVANCEThe estimated large number of violence-related visits with medical professionals offers an opportunity to address a source of frequent injury, and provide counseling and referral for a high-risk segment of the population to treat and prevent further physical and mental health and social consequences.

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Section: Discussionmentioning

confidence: 99%

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

2021

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“…Qualitative data were analyzed by a team of researchers using inductive thematic analysis to determine common themes and insights. A resident researcher with training in Human-Centered Design through the UCSF Better Lab trained the other coders in this method ( 17 , 18 ). Researchers underwent practice rounds during which coding strategy was evaluated.…”

Section: Methodsmentioning

confidence: 99%

“…A resident researcher with training in human-centered design through the UCSF Better Lab trained the other coders in this method. 17,18 Researchers underwent practice rounds during which coding strategy was evaluated. Each researcher developed themes independently, and these were shared with the group along with all raw comments to confirm dependability of thematic analysis.…”

Section: Study Design and Analysesmentioning

confidence: 99%

Patient Perceptions on Barriers and Facilitators to Accessing Low-acuity Surgery During COVID-19 Pandemic

Johnson

Schwartz

Greenberg

et al. 2021

Journal of Surgical Research

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Background The onset of the COVID-19 pandemic led to the postponement of low-acuity surgical procedures in an effort to conserve resources and ensure patient safety. This study aimed to characterize patient-reported concerns about undergoing surgical procedures during the pandemic. Study Design We administered a cross-sectional survey to patients who had their general and plastic surgical procedures postponed at the onset of the pandemic, asking about barriers to accessing surgical care. Questions addressed dependent care, transportation, employment and insurance status, as well as perceptions of and concerns about COVID-19. Mixed methods and inductive thematic analyses were conducted. Results One-hundred and thirty-five patients were interviewed. We identified the following patient concerns: contracting COVID-19 in the hospital (46%), being alone during hospitalization (40%), facing financial stressors (29%), organizing transportation (28%), experiencing changes to health insurance coverage (25%), and arranging care for dependents (18%). Non-white participants were 5 and 2.5 times more likely to have concerns about childcare and transportation, respectively. Perceptions of decreased hospital safety and the consequences of possible COVID-19 infection led to delay in rescheduling. Education about safety measures and communication about scheduling partially mitigated concerns about COVID-19. However, uncertainty about timeline for rescheduling and resolution of the pandemic contributed to ongoing concerns. Conclusion Providing effective surgical care during this unprecedented time requires both awareness of societal shifts impacting surgical patients and system-level change to address new barriers to care. Eliciting patients’ perspectives, adapting processes to address potential barriers, and effectively educating patients about institutional measures to minimize in-hospital transmission of COVID-19 should be integrated into surgical care.

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“…In accordance with the HCD method for qualitative analysis, the researchers then extrapolated 'insight statements' from these themes. Insight statement development is an integral step in the HCD analysis process and involves re-reviewing the notes to understand themes in the context of the individual interviews in order to deduce unique human perspectives, motivations, or tensions from the thematic data 24,25 (Fig. 1).…”

Section: Qualitative Data Collection and Analysismentioning

confidence: 99%

Using a Human-Centered, Mixed Methods Approach to Understand the Patient Waiting Experience and Its Impact on Vulnerable Populations

Liao

Chehab

Neville

et al. 2022

Preprint

Self Cite

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Purpose: To use a mixed methods approach to investigate the patient waiting experience for an underserved population at an outpatient surgical clinic. Methods: We used lean methodology to perform 96 time-tracked observations of the patient journey in clinic, documenting the duration of activities from arrival to departure. We also used human-centered design (HCD) to perform and analyze 43 semi-structured interviews to understand patients’ unmet needs.Results: Patients spent an average of 68.5% of their total clinic visit waiting to be seen. While the average visit was 95.8 minutes, over a quarter of visits (27%) were over 2 hours. Patients waited an average of 24.4 minutes in the waiting room and 41.2 minutes in the exam room; and only spent 19.7% of their visit with an attending provider and 11.8% with a medical assistant. Interviews revealed that patients arrive to their visit already frustrated due to difficulties related to scheduling and attending their appointment. This is exacerbated during the visit due to long wait times, perceived information opacity, and an uncomfortable waiting room, resulting in frustration and anxiety. Conclusions: While time tracking demonstrated that patients spend a majority of their visit waiting to be seen, HCD revealed that patient frustrations span the waiting experience from accessing the appointment to visit completion. These combined findings are crucial for intervention design and implementation for vulnerable populations to improve the quality and experience with healthcare and also address system inefficiencies such as long wait times.

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Designing an Information and Communications Technology Tool With and for Victims of Violence and Their Case Managers in San Francisco: Human-Centered Design Study

Cited by 13 publications

References 45 publications

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

Medical Treatment Following Violence Exposure in a National Sample of Children and Youth

Patient Perceptions on Barriers and Facilitators to Accessing Low-acuity Surgery During COVID-19 Pandemic

Using a Human-Centered, Mixed Methods Approach to Understand the Patient Waiting Experience and Its Impact on Vulnerable Populations

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