Journal of the American Medical Informatics Association
Exploring the contribution of health informatics is an emerging topic in relation to addressing c... more Exploring the contribution of health informatics is an emerging topic in relation to addressing climate change, but less examined is a body of literature reporting on the potential and effectiveness of women participating in climate action supported by digital health. This perspective explores how empowering women through digital health literacy (DHL) can support them to be active agents in addressing climate change risk and its impacts on health and well-being. We also consider the current definitional boundary of DHL, and how this may be shaped by other competencies (eg, environmental health literacy), to strengthen this critical agenda for developed nations and lower-resource settings.
BACKGROUND How to prepare the current and future health workforce for with the possibilities of u... more BACKGROUND How to prepare the current and future health workforce for with the possibilities of using artificial intelligence (AI) in healthcare is a growing concern, as AI applications emerge in various care settings and specialisations. At present, there is no obvious consensus among educators about what needs to be learned, or how this learning may be supported or assessed. OBJECTIVE Our study aimed to explore healthcare educational experts’ ideas and plans for preparing the health workforce to work with AI, and identify critical gaps in curriculum and educational resources, across a national healthcare system. METHODS A survey canvassed expert views on AI education for the health workforce, in terms of educational strategies, subject matter priorities, meaningful learning activities, desired attitudes and skills. 39 senior people from different health workforce subgroups across Australia provided ratings and free-text responses, in late 2020. RESULTS Responses highlighted the im...
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2016
Examine the influence of age at implant on speech perception, language, and speech production out... more Examine the influence of age at implant on speech perception, language, and speech production outcomes in a large unselected paediatric cohort. This study pools available assessment data (collected prospectively and entered into respective databases from 1990 to 2014) from three Australian centers. Children (n = 403) with congenital bilateral severe to profound hearing loss who received cochlear implants under 6 years of age (excluding those with acquired onset of profound hearing loss after 12 mo, those with progressive hearing loss and those with mild/moderate/severe additional cognitive delay/disability). Speech perception; open-set words (scored for words and phonemes correct) and sentence understanding at school entry and late primary school time points. Language; PLS and PPVT standard score equivalents at school entry, CELF standard scores. Speech Production; DEAP percentage accuracy of vowels, consonants, phonemes-total and clusters, and percentage word-intelligibility at sch...
BACKGROUND The advancement of digital health has widened the scope of technology use across multi... more BACKGROUND The advancement of digital health has widened the scope of technology use across multiple frontiers of healthcare services, ranging from personalized therapeutics, mHealth, electronic health record management to telehealth consultations. The World Health Organization (WHO) responded to this by publishing in 2018 an inaugural broad classification framework of Digital Health Interventions (DHIs) used to address contemporary health system needs. OBJECTIVE : The present study describes the adaptation of the WHO framework for application in real-world research to build on this work. The aim is to support the study of clients’ (patients) and healthcare providers’ willingness to engage with a range of technologies in specific health context s via survey method. The study also explores issues of acceptability, experiences, and uptake in a way that is user-friendly for both clients and healthcare providers, systematic (for researchers) and meaningful (for research participants). M...
Studies in health technology and informatics, 2019
Emerging research evidence has demonstrated the potential for digital tools, such as automated la... more Emerging research evidence has demonstrated the potential for digital tools, such as automated language processing technology, to support parent-child interactions. Making use of digital tools can aid measurement of parent interaction metrics, additionally, providing contingent feedback to parents based on their language metrics can facilitate positive changes in their everyday input to their young children. Product innovation aside, there is a distinct lack of understanding about how best to integrate real-world, user design needs and preferences to improve deployment of technologies into routine clinical interventions. The present study explored salient requirements of a wearable language tracking device from the users' perspectives. Mothers of young children and clinicians with experience working in paediatric settings completed a written questionnaire and rated the importance of specific functions and features of a child-worn, language tracking device on a 10-point Likert sc...
Background The advancement of digital health has widened the scope of technology use across multi... more Background The advancement of digital health has widened the scope of technology use across multiple frontiers of health care services, including personalized therapeutics, mobile health, eHealth record management, and telehealth consultations. The World Health Organization (WHO) responded to this in 2018 by publishing an inaugural broad classification framework of digital health interventions (DHIs) used to address contemporary health system needs. Objective This study aims to describe the systematic development of dual survey instruments (clinician and patient) to support data collection, administered in a physiotherapy setting, about perceptions toward DHIs. This is achieved by adapting the WHO framework classification for DHIs for application in real-world research. Methods Using a qualitative item review approach, WHO DHI descriptors were adapted and refined systematically to be used in a survey form. This approach was designed to align with the processes of delivering and rece...
BACKGROUND Gamification in mHealth may be especially useful for engaging children who use hearing... more BACKGROUND Gamification in mHealth may be especially useful for engaging children who use hearing devices in interventions, however it is not known if gamification impacts app quality in this field OBJECTIVE The present study aimed to evaluate app quality and the impact of gamification on currently available free to download apps that utilised auditory training to improve speech perception outcomes for children with hearing aids and/or cochlear implants. METHODS A systematic review of the iOS and Android app store was conducted. Two raters assessed the apps using the user version of the Mobile App Rating Scale (uMARS; Stoyanov et al., 2015) to obtain an overall score of App Quality, and on subscales of Functionality, Information, Aesthetics, and Engagement. RESULTS There were 2431 auditory training apps identified and 38 apps met inclusion criteria. Fifty-five percent of apps included gamification; the most prevalent gamification element was achieving higher ‘levels’. Fifty percent ...
Purpose This retrospective study aimed to amass large data sets to enable statistical comparisons... more Purpose This retrospective study aimed to amass large data sets to enable statistical comparisons of communication outcomes for infants receiving cochlear implants (CIs) before 9 months of age compared to groups who received their first CI between 9 months and 3.5 years of age. Method Speech perception scores and experienced clinicians' observations were used to refine the Categories of Auditory Performance Index (CAPI), thus creating its revised version, namely, the CAPI-Revised (CAPI-R). Standardized and criterion-referenced language data were used to create the novel Categories of Linguistic Performance (CLIP). The association between CAPI-R and CLIP data at two time points post implant (at 2 years of device experience and at 5 years of age) was examined in a large unselected cohort stratified for age at first implant: before 9 months (Group 1), between 9 and 12 months (Group 2), between 13 and 18 months (Group 3), between 19 and 24 months (Group 4), between 25 and 30 months ...
Abstract. The project reported in this paper models a new approach to making health informatics a... more Abstract. The project reported in this paper models a new approach to making health informatics and ehealth education widely available to students in a range of Australian clinical health profession degrees. The development of a Masters level subject uses design-based research to apply educational quality assurance practices which are consistent with university qualification frameworks, and with clinical health profession education standards; at the same time it gives recognition to health informatics as a specialised profession in its own right. The paper presents details of (a) design with reference to the Australian Qualifications Framework and CHIA competencies, (b) peer review within a three-university teaching team, (c) external review by experts from the professions, (d) cross-institutional interprofessional online learning, (e) methods for evaluating student learning experiences and outcomes, and (f) mechanisms for making the curriculum openly available to interested parties...
Studies in health technology and informatics, 2017
Mother-child interactions often give rise to opportunities for early language learning in the con... more Mother-child interactions often give rise to opportunities for early language learning in the context of everyday life. Persuasive technology has the potential to influence maternal language behaviours in the home and promote mothers' active engagement in the development of their children's communication skills. This paper explored maternal perceptions regarding the use of a language tracking wearable (Language Environment Analysis; LENA) device and a parent education smartphone application in an 8-week trial with their young children. Mother/child dyads were enrolled in a feasibility trial designed to obtain objective auditory and linguistic data from each child's naturalistic settings (Control Condition), provide feedback to mothers about their child's home language environment (LENA Feedback Condition), and to explore effectiveness of an app designed to promote meaningful parent/child interactions during daily routines (LENA Feedback and App Condition). The majori...
Journal of the American Medical Informatics Association
Exploring the contribution of health informatics is an emerging topic in relation to addressing c... more Exploring the contribution of health informatics is an emerging topic in relation to addressing climate change, but less examined is a body of literature reporting on the potential and effectiveness of women participating in climate action supported by digital health. This perspective explores how empowering women through digital health literacy (DHL) can support them to be active agents in addressing climate change risk and its impacts on health and well-being. We also consider the current definitional boundary of DHL, and how this may be shaped by other competencies (eg, environmental health literacy), to strengthen this critical agenda for developed nations and lower-resource settings.
BACKGROUND How to prepare the current and future health workforce for with the possibilities of u... more BACKGROUND How to prepare the current and future health workforce for with the possibilities of using artificial intelligence (AI) in healthcare is a growing concern, as AI applications emerge in various care settings and specialisations. At present, there is no obvious consensus among educators about what needs to be learned, or how this learning may be supported or assessed. OBJECTIVE Our study aimed to explore healthcare educational experts’ ideas and plans for preparing the health workforce to work with AI, and identify critical gaps in curriculum and educational resources, across a national healthcare system. METHODS A survey canvassed expert views on AI education for the health workforce, in terms of educational strategies, subject matter priorities, meaningful learning activities, desired attitudes and skills. 39 senior people from different health workforce subgroups across Australia provided ratings and free-text responses, in late 2020. RESULTS Responses highlighted the im...
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2016
Examine the influence of age at implant on speech perception, language, and speech production out... more Examine the influence of age at implant on speech perception, language, and speech production outcomes in a large unselected paediatric cohort. This study pools available assessment data (collected prospectively and entered into respective databases from 1990 to 2014) from three Australian centers. Children (n = 403) with congenital bilateral severe to profound hearing loss who received cochlear implants under 6 years of age (excluding those with acquired onset of profound hearing loss after 12 mo, those with progressive hearing loss and those with mild/moderate/severe additional cognitive delay/disability). Speech perception; open-set words (scored for words and phonemes correct) and sentence understanding at school entry and late primary school time points. Language; PLS and PPVT standard score equivalents at school entry, CELF standard scores. Speech Production; DEAP percentage accuracy of vowels, consonants, phonemes-total and clusters, and percentage word-intelligibility at sch...
BACKGROUND The advancement of digital health has widened the scope of technology use across multi... more BACKGROUND The advancement of digital health has widened the scope of technology use across multiple frontiers of healthcare services, ranging from personalized therapeutics, mHealth, electronic health record management to telehealth consultations. The World Health Organization (WHO) responded to this by publishing in 2018 an inaugural broad classification framework of Digital Health Interventions (DHIs) used to address contemporary health system needs. OBJECTIVE : The present study describes the adaptation of the WHO framework for application in real-world research to build on this work. The aim is to support the study of clients’ (patients) and healthcare providers’ willingness to engage with a range of technologies in specific health context s via survey method. The study also explores issues of acceptability, experiences, and uptake in a way that is user-friendly for both clients and healthcare providers, systematic (for researchers) and meaningful (for research participants). M...
Studies in health technology and informatics, 2019
Emerging research evidence has demonstrated the potential for digital tools, such as automated la... more Emerging research evidence has demonstrated the potential for digital tools, such as automated language processing technology, to support parent-child interactions. Making use of digital tools can aid measurement of parent interaction metrics, additionally, providing contingent feedback to parents based on their language metrics can facilitate positive changes in their everyday input to their young children. Product innovation aside, there is a distinct lack of understanding about how best to integrate real-world, user design needs and preferences to improve deployment of technologies into routine clinical interventions. The present study explored salient requirements of a wearable language tracking device from the users' perspectives. Mothers of young children and clinicians with experience working in paediatric settings completed a written questionnaire and rated the importance of specific functions and features of a child-worn, language tracking device on a 10-point Likert sc...
Background The advancement of digital health has widened the scope of technology use across multi... more Background The advancement of digital health has widened the scope of technology use across multiple frontiers of health care services, including personalized therapeutics, mobile health, eHealth record management, and telehealth consultations. The World Health Organization (WHO) responded to this in 2018 by publishing an inaugural broad classification framework of digital health interventions (DHIs) used to address contemporary health system needs. Objective This study aims to describe the systematic development of dual survey instruments (clinician and patient) to support data collection, administered in a physiotherapy setting, about perceptions toward DHIs. This is achieved by adapting the WHO framework classification for DHIs for application in real-world research. Methods Using a qualitative item review approach, WHO DHI descriptors were adapted and refined systematically to be used in a survey form. This approach was designed to align with the processes of delivering and rece...
BACKGROUND Gamification in mHealth may be especially useful for engaging children who use hearing... more BACKGROUND Gamification in mHealth may be especially useful for engaging children who use hearing devices in interventions, however it is not known if gamification impacts app quality in this field OBJECTIVE The present study aimed to evaluate app quality and the impact of gamification on currently available free to download apps that utilised auditory training to improve speech perception outcomes for children with hearing aids and/or cochlear implants. METHODS A systematic review of the iOS and Android app store was conducted. Two raters assessed the apps using the user version of the Mobile App Rating Scale (uMARS; Stoyanov et al., 2015) to obtain an overall score of App Quality, and on subscales of Functionality, Information, Aesthetics, and Engagement. RESULTS There were 2431 auditory training apps identified and 38 apps met inclusion criteria. Fifty-five percent of apps included gamification; the most prevalent gamification element was achieving higher ‘levels’. Fifty percent ...
Purpose This retrospective study aimed to amass large data sets to enable statistical comparisons... more Purpose This retrospective study aimed to amass large data sets to enable statistical comparisons of communication outcomes for infants receiving cochlear implants (CIs) before 9 months of age compared to groups who received their first CI between 9 months and 3.5 years of age. Method Speech perception scores and experienced clinicians' observations were used to refine the Categories of Auditory Performance Index (CAPI), thus creating its revised version, namely, the CAPI-Revised (CAPI-R). Standardized and criterion-referenced language data were used to create the novel Categories of Linguistic Performance (CLIP). The association between CAPI-R and CLIP data at two time points post implant (at 2 years of device experience and at 5 years of age) was examined in a large unselected cohort stratified for age at first implant: before 9 months (Group 1), between 9 and 12 months (Group 2), between 13 and 18 months (Group 3), between 19 and 24 months (Group 4), between 25 and 30 months ...
Abstract. The project reported in this paper models a new approach to making health informatics a... more Abstract. The project reported in this paper models a new approach to making health informatics and ehealth education widely available to students in a range of Australian clinical health profession degrees. The development of a Masters level subject uses design-based research to apply educational quality assurance practices which are consistent with university qualification frameworks, and with clinical health profession education standards; at the same time it gives recognition to health informatics as a specialised profession in its own right. The paper presents details of (a) design with reference to the Australian Qualifications Framework and CHIA competencies, (b) peer review within a three-university teaching team, (c) external review by experts from the professions, (d) cross-institutional interprofessional online learning, (e) methods for evaluating student learning experiences and outcomes, and (f) mechanisms for making the curriculum openly available to interested parties...
Studies in health technology and informatics, 2017
Mother-child interactions often give rise to opportunities for early language learning in the con... more Mother-child interactions often give rise to opportunities for early language learning in the context of everyday life. Persuasive technology has the potential to influence maternal language behaviours in the home and promote mothers' active engagement in the development of their children's communication skills. This paper explored maternal perceptions regarding the use of a language tracking wearable (Language Environment Analysis; LENA) device and a parent education smartphone application in an 8-week trial with their young children. Mother/child dyads were enrolled in a feasibility trial designed to obtain objective auditory and linguistic data from each child's naturalistic settings (Control Condition), provide feedback to mothers about their child's home language environment (LENA Feedback Condition), and to explore effectiveness of an app designed to promote meaningful parent/child interactions during daily routines (LENA Feedback and App Condition). The majori...
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Papers by Dawn Choo