The role of nurse and physician managers is considered crucial for implementing eHealth intervent... more The role of nurse and physician managers is considered crucial for implementing eHealth interventions in clinical practice, but few studies have explored this. The aim of the current study was to examine the perceptions of nurse and physician managers regarding facilitators, barriers, management role, responsibility, and action taken in the implementation of an eHealth intervention called Choice into clinical practice. Individual qualitative interviews were conducted with six nurses and three physicians in management positions at five hospital units. The findings revealed that nurse managers reported conscientiously supporting the implementation, but workloads prevented them from participating in the process as closely as they wanted. Physician managers reported less contribution. The implementation process was influenced by facilitating factors such as perceptions of benefits from Choice and use of implementation strategies, along with barriers such as physician resistance, contextual factors and difficulties for front-line providers in learning a new way of communicating with the patients. The findings suggest that role descriptions for both nurse and physician managers should include implementation knowledge and implementation skills. Managers could benefit from an implementation toolkit. Implementation management should be included in management education for healthcare managers to prepare them for the constant need for implementation and improvement in clinical practice.
Nearly half of the Norwegian population claim that they would like to use the internet to communi... more Nearly half of the Norwegian population claim that they would like to use the internet to communicate with their general practitioner. A web-based system complying with Norway's strict statutory requirements for the processing of personal data was developed and tested in an effort to assess the implications of this mode of communication. The system was tested for one year in a group practice with six doctors. 200 patients were recruited and randomized into intervention and control groups. Data was collected through questionnaires, interviews and system logs. The 48 patients who used the system sent on average 3.3 messages, the six doctors sent between nine and 65 messages each. Traditional inquiries (visits, telephones) to the doctor averaged 3.2 and 4.5 for the intervention and control group respectively. 41% of the messages were inquiries about health issues, 22% were about renewals of prescriptions and sick leave notes, while 13% were requests for an appointment. Patients and...
Information and communication technologies (ICT) are key to optimizing the outcomes of the Chroni... more Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for increasing the relevance and feasibility of ICT innovation and research in health care. Little is known about how and to what extent CCM and ICT research inform each other to leverage mutual strengths. The current study examines: What characterizes work being done at the crossroads of CCM and ICT research and innovation? Our aim is identify the gaps and potential that lie between the research domains CCM and ICT, thus enabling more substantive questions and opportunities for accelerating improvements in ICT-supported chronic care. Using a scoping study approach, we developed a search strategy applied to medical and technical databases resulting in 1054 titles and abstracts that address CCM and ICT. Aft...
Studies in health technology and informatics, 2007
The Norwegian Centre for Telemedicine (NST) has, over the past two decades, contributed to the de... more The Norwegian Centre for Telemedicine (NST) has, over the past two decades, contributed to the development and implementation of telemedicine and ehealth services in Norway. From 2002, NST has been a WHO Collaboration Center for telemedicine. In August 1996, Norway became the first country to implement an official telemedicine fee schedule making telemedicine services reimbursable by the national health insurer. Telemedicine is widely used in Northern Norway. Since the late 1980's, the University Hospital of North-Norway has experience in the following areas: teleradiology, telepathology, teledermatology, teleotorhinolaryngology (remote endoscopy), remote gastroscopy, tele-echocardiography, remote transmission of ECGs, telepsychiatry, teleophthalmology, teledialysis, teleemergency medicine, teleoncology, telecare, telegeriatric, teledentistry, maritime telemedicine, referrals and discharge letters, electronic delivery of laboratory results and distant teaching for healthcare per...
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 2002
This study investigates the assumption that the Norwegian population's use of Internet health... more This study investigates the assumption that the Norwegian population's use of Internet health services has an impact on health related attitudes and behaviour. In 2000 and 2001, 1,006 and 1,018 subjects were randomly selected from the general population in Norway and interviewed over the telephone. In 2001, a web-based questionnaire was presented to 600 of a 2,800 member Internet panel who reported having used the Internet for health purposes; 79% responded. The proportion of Norwegians who use the Internet for health purposes increased from 19% in 2000 to 31% in 2001. The proportion of those wishing to use e-mail in interaction with their doctor increased from 30% to 45%. Based on information from the Internet, 33% of users in 2001 have asked their doctor specific questions; 11% have suggested a diagnosis, 21% have altered their diet and/or lifestyle; 10% have started with health products or programmes without consulting their doctor. 13% have experienced anxiety, while 48% hav...
We conducted a systematic review of 15 relevant databases for articles about telemedicine. After ... more We conducted a systematic review of 15 relevant databases for articles about telemedicine. After eliminating articles that did not meet the inclusion criteria, 1615 remained for analysis. Three raters coded the articles to assess various theoretical and methodological variables. Only 5% (n = 85) of the telemedicine articles made mention of any theory or paradigmatic approach. Studies commonly reported the objectives (96%) but rarely stated a research question or hypothesis (11%). Randomized selection of the subjects was reported in 11% of patient studies and 4% of studies where providers were the subject. There was a wide range in the number of subjects employed, although the majority of studies were based on sample sizes of less than 100. Only 26% of the studies reported a time frame. Until the telemedicine field adheres to agreed standards of reporting methodological details it will be difficult to draw firm conclusions from review studies.
We conducted a national survey about access to and use of videoconferencing in Norwegian mental h... more We conducted a national survey about access to and use of videoconferencing in Norwegian mental health care. A questionnaire was mailed to 300 institutions, with 113 returned (38%). Attitudes towards videoconferencing were positive. 58 of the respondents had access to videoconferencing equipment. 51 institutions had used videoconferencing in the previous year. Geographical and climatic factors and travel-related strain were predictors of access. Videoconferencing was mostly used for meetings, supervision and lectures, and to a lesser degree was used clinically, with the patient present. 90% of the institutions had experienced videoconferencing as useful. Lack of videoconferencing equipment in collaborating institutions was an inhibiting factor for use. There is a gap between the potential of videoconferencing and its actual utilization in Norway's mental health sector.
This study asks: What theories are employed in telemedicine studies? How might they be categorize... more This study asks: What theories are employed in telemedicine studies? How might they be categorized in ways that help distinguish the knowledge base of telemedicine? Theories in use were identified from a database of telemedicine-related publications between 1990 and 2005. Eighty-three (5% of 1615) articles referred to a theoretical concept. Grounded Theory procedures were used to analyze and categorize theories, while descriptive statistics were used for supplementary information. The proportion of studies with theory was 3% in 1999 and 7% in 2005. The 83 articles were dispersed among 48 of the in total 795 different journals in the original sample. Identified theories were grouped into two main categories; 'shared' (used in two or more studies) and 'lone ranger'. All of the shared theories are social science theories employed without notable adjustments to any uniquely defining features of telemedicine; diffusion, technology acceptance, health behavior, science and technology studies (STS), and economics. Theoretical concepts within the lone ranger category may well address unique features of telemedicine, but have yet to attract the attention of colleagues. The theories identified as 'shared' play an important role, but are inadequate in illuminating any unique features of telemedicine. The future of telemedicine as a field will need to identify its underlying theoretical components. Frameworks employed in the field of evaluation may aid in identifying the types of theories worth articulating in telemedicine.
The study investigates the impact by health-care professionals on a Norwegian Internet discussion... more The study investigates the impact by health-care professionals on a Norwegian Internet discussion forum. A comparison of the same forum in time-periods with either high or low level of professional involvement was performed. The hypothesis was that professional involvement would have marked effects on the interaction in discussion forums; among other things encourage short and factual/practical interaction patterns at the
The adoption of Internet-based patient-provider communication services (IPPC) in health care has ... more The adoption of Internet-based patient-provider communication services (IPPC) in health care has been slow. Patients want electronic communication, and the quality of health care can be improved by offering such IPPCs. However, the rate of enrollment in such services remains low, and the reasons for this are unclear. Knowledge about the barriers to use is valuable during implementation of IPPCs in the health care services, and it can help timing, targeting, and tailoring IPPCs to different groups of patients. The goal of our study was to investigate patients' views of an IPPC that they could use from home to pose questions to nurses and physicians at their treatment facility, and their reported reasons for non-use of the service. This qualitative study was based on individual interviews with 22 patients who signed up for, but did not use, the IPPC. Patients appreciated the availability and the possibility of using the IPPC as needed, even if they did not use it. Their reported reasons for not using the IPPC fell into three main categories: (1) they felt that they did not need the IPPC and had sufficient access to information elsewhere, (2) they preferred other types of communication such as telephone or face-to-face contact, or (3) they were hindered by IPPC attributes such as login problems. Patients were satisfied with having the opportunity to send messages to health care providers through an IPPC, even if they did not use the service. IPPCs should be offered to the patients at an appropriate time in the illness trajectory, both when they need the service and when they are receptive to information about the service. A live demonstration of the IPPC at the point of enrollment might have increased its use. ClinicalTrials.gov NCT00971139; http://clinicaltrial.gov/ct2/show/NCT00971139 (Archived by WebCite at http://www.webcitation.org/6KlOiYJrW).
Children with type 1 diabetes and their parents face rigorous procedures for blood glucose monito... more Children with type 1 diabetes and their parents face rigorous procedures for blood glucose monitoring and regulation. Mobile telecommunication systems show potential as an aid for families' self-management of diabetes. A prototype designed to automatically transfer readings from a child's blood glucose monitor to their parent's mobile phone was tested. In this formative stage of development, we sought insights into the appropriateness of the concept, feasibility of use, and ideas for further development and research. During four months, a self-selected sample of 15 children (aged 9 to 15 years) with type 1 diabetes and their parents (n = 30) used the prototype approximately three times daily. Parent and child experiences were collected through questionnaires and through interviews with 9 of the parents. System use was easily integrated into everyday life, and parents valued the sense of reassurance offered by the system. Parents' ongoing struggle to balance control of their children with allowing independence was evident. For children who measured regularly, use appeared to reduce parental intrusions. For those who measured irregularly, however, parental reminders (eg, "nagging") appeared to increase. Although increased reminders could be considered a positive outcome, they can potentially increase parent-child conflict and thus also undermine proper metabolic control. Parents felt that system appropriateness tapered off with the onset of adolescence, partly due to a potential sense of surveillance from the child's perspective that could fuel oppositional behavior. Parental suggestions for further developments included similar alerts of irregular insulin dosages and automatically generated dietary and insulin dosage advice. User enthusiasm suggests that such systems might find a consumer market regardless of whether or not they ultimately improve health outcomes. Thus, more rigorous studies are warranted to inform guidelines for appropriate use. Potentially fruitful approaches include integrating such systems with theory-based parenting interventions and approaches that can aid in interpreting and responding to experiences of surveillance, virtual presence, and balances of power in e-mediated relationships.
Patient self-management of disease is increasingly supported by technologies that can monitor a w... more Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.
Norwegian psychologists' use of and attitudes towards e-media such as ema... more Norwegian psychologists' use of and attitudes towards e-media such as email and mobile text messaging in interaction with clients (e-therapy) were explored. A two-dimensional scale for measuring attitudes towards e-therapy was developed. A total of 1040 (23%) members of the psychologist association responded to a questionnaire June 2003. Of these, 45% had used e-media in interaction with clients. The mean reported attitude towards e-therapy was neutral, with only 3% of the psychologists feeling that use of e-media between client and therapist is unacceptable. Having a psychodynamic theoretical stance was related to attitudes towards e-therapy. Positive attitude was related to clinical use of email and Short Messages Service (SMS). It appears likely that e-therapy will become more common, and that therapist's attitudes are related to such use.
... We have incorporated the above features in the lifestyle tool mobile health motivation ... ... more ... We have incorporated the above features in the lifestyle tool mobile health motivation ... self: Integration in personality," presented at Perspectives on Motivation: Symposium on Motivation, Lincoln, Nebraska ... [12] B. Fogg, "The future of persuasion is mobile," in Mobile persuasion. ...
The role of nurse and physician managers is considered crucial for implementing eHealth intervent... more The role of nurse and physician managers is considered crucial for implementing eHealth interventions in clinical practice, but few studies have explored this. The aim of the current study was to examine the perceptions of nurse and physician managers regarding facilitators, barriers, management role, responsibility, and action taken in the implementation of an eHealth intervention called Choice into clinical practice. Individual qualitative interviews were conducted with six nurses and three physicians in management positions at five hospital units. The findings revealed that nurse managers reported conscientiously supporting the implementation, but workloads prevented them from participating in the process as closely as they wanted. Physician managers reported less contribution. The implementation process was influenced by facilitating factors such as perceptions of benefits from Choice and use of implementation strategies, along with barriers such as physician resistance, contextual factors and difficulties for front-line providers in learning a new way of communicating with the patients. The findings suggest that role descriptions for both nurse and physician managers should include implementation knowledge and implementation skills. Managers could benefit from an implementation toolkit. Implementation management should be included in management education for healthcare managers to prepare them for the constant need for implementation and improvement in clinical practice.
Nearly half of the Norwegian population claim that they would like to use the internet to communi... more Nearly half of the Norwegian population claim that they would like to use the internet to communicate with their general practitioner. A web-based system complying with Norway's strict statutory requirements for the processing of personal data was developed and tested in an effort to assess the implications of this mode of communication. The system was tested for one year in a group practice with six doctors. 200 patients were recruited and randomized into intervention and control groups. Data was collected through questionnaires, interviews and system logs. The 48 patients who used the system sent on average 3.3 messages, the six doctors sent between nine and 65 messages each. Traditional inquiries (visits, telephones) to the doctor averaged 3.2 and 4.5 for the intervention and control group respectively. 41% of the messages were inquiries about health issues, 22% were about renewals of prescriptions and sick leave notes, while 13% were requests for an appointment. Patients and...
Information and communication technologies (ICT) are key to optimizing the outcomes of the Chroni... more Information and communication technologies (ICT) are key to optimizing the outcomes of the Chronic Care Model (CCM), currently acknowledged as the best synthesis of available evidence for chronic illness prevention and management. At the same time, CCM can offer a needed framework for increasing the relevance and feasibility of ICT innovation and research in health care. Little is known about how and to what extent CCM and ICT research inform each other to leverage mutual strengths. The current study examines: What characterizes work being done at the crossroads of CCM and ICT research and innovation? Our aim is identify the gaps and potential that lie between the research domains CCM and ICT, thus enabling more substantive questions and opportunities for accelerating improvements in ICT-supported chronic care. Using a scoping study approach, we developed a search strategy applied to medical and technical databases resulting in 1054 titles and abstracts that address CCM and ICT. Aft...
Studies in health technology and informatics, 2007
The Norwegian Centre for Telemedicine (NST) has, over the past two decades, contributed to the de... more The Norwegian Centre for Telemedicine (NST) has, over the past two decades, contributed to the development and implementation of telemedicine and ehealth services in Norway. From 2002, NST has been a WHO Collaboration Center for telemedicine. In August 1996, Norway became the first country to implement an official telemedicine fee schedule making telemedicine services reimbursable by the national health insurer. Telemedicine is widely used in Northern Norway. Since the late 1980's, the University Hospital of North-Norway has experience in the following areas: teleradiology, telepathology, teledermatology, teleotorhinolaryngology (remote endoscopy), remote gastroscopy, tele-echocardiography, remote transmission of ECGs, telepsychiatry, teleophthalmology, teledialysis, teleemergency medicine, teleoncology, telecare, telegeriatric, teledentistry, maritime telemedicine, referrals and discharge letters, electronic delivery of laboratory results and distant teaching for healthcare per...
Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række, Jan 30, 2002
This study investigates the assumption that the Norwegian population's use of Internet health... more This study investigates the assumption that the Norwegian population's use of Internet health services has an impact on health related attitudes and behaviour. In 2000 and 2001, 1,006 and 1,018 subjects were randomly selected from the general population in Norway and interviewed over the telephone. In 2001, a web-based questionnaire was presented to 600 of a 2,800 member Internet panel who reported having used the Internet for health purposes; 79% responded. The proportion of Norwegians who use the Internet for health purposes increased from 19% in 2000 to 31% in 2001. The proportion of those wishing to use e-mail in interaction with their doctor increased from 30% to 45%. Based on information from the Internet, 33% of users in 2001 have asked their doctor specific questions; 11% have suggested a diagnosis, 21% have altered their diet and/or lifestyle; 10% have started with health products or programmes without consulting their doctor. 13% have experienced anxiety, while 48% hav...
We conducted a systematic review of 15 relevant databases for articles about telemedicine. After ... more We conducted a systematic review of 15 relevant databases for articles about telemedicine. After eliminating articles that did not meet the inclusion criteria, 1615 remained for analysis. Three raters coded the articles to assess various theoretical and methodological variables. Only 5% (n = 85) of the telemedicine articles made mention of any theory or paradigmatic approach. Studies commonly reported the objectives (96%) but rarely stated a research question or hypothesis (11%). Randomized selection of the subjects was reported in 11% of patient studies and 4% of studies where providers were the subject. There was a wide range in the number of subjects employed, although the majority of studies were based on sample sizes of less than 100. Only 26% of the studies reported a time frame. Until the telemedicine field adheres to agreed standards of reporting methodological details it will be difficult to draw firm conclusions from review studies.
We conducted a national survey about access to and use of videoconferencing in Norwegian mental h... more We conducted a national survey about access to and use of videoconferencing in Norwegian mental health care. A questionnaire was mailed to 300 institutions, with 113 returned (38%). Attitudes towards videoconferencing were positive. 58 of the respondents had access to videoconferencing equipment. 51 institutions had used videoconferencing in the previous year. Geographical and climatic factors and travel-related strain were predictors of access. Videoconferencing was mostly used for meetings, supervision and lectures, and to a lesser degree was used clinically, with the patient present. 90% of the institutions had experienced videoconferencing as useful. Lack of videoconferencing equipment in collaborating institutions was an inhibiting factor for use. There is a gap between the potential of videoconferencing and its actual utilization in Norway's mental health sector.
This study asks: What theories are employed in telemedicine studies? How might they be categorize... more This study asks: What theories are employed in telemedicine studies? How might they be categorized in ways that help distinguish the knowledge base of telemedicine? Theories in use were identified from a database of telemedicine-related publications between 1990 and 2005. Eighty-three (5% of 1615) articles referred to a theoretical concept. Grounded Theory procedures were used to analyze and categorize theories, while descriptive statistics were used for supplementary information. The proportion of studies with theory was 3% in 1999 and 7% in 2005. The 83 articles were dispersed among 48 of the in total 795 different journals in the original sample. Identified theories were grouped into two main categories; 'shared' (used in two or more studies) and 'lone ranger'. All of the shared theories are social science theories employed without notable adjustments to any uniquely defining features of telemedicine; diffusion, technology acceptance, health behavior, science and technology studies (STS), and economics. Theoretical concepts within the lone ranger category may well address unique features of telemedicine, but have yet to attract the attention of colleagues. The theories identified as 'shared' play an important role, but are inadequate in illuminating any unique features of telemedicine. The future of telemedicine as a field will need to identify its underlying theoretical components. Frameworks employed in the field of evaluation may aid in identifying the types of theories worth articulating in telemedicine.
The study investigates the impact by health-care professionals on a Norwegian Internet discussion... more The study investigates the impact by health-care professionals on a Norwegian Internet discussion forum. A comparison of the same forum in time-periods with either high or low level of professional involvement was performed. The hypothesis was that professional involvement would have marked effects on the interaction in discussion forums; among other things encourage short and factual/practical interaction patterns at the
The adoption of Internet-based patient-provider communication services (IPPC) in health care has ... more The adoption of Internet-based patient-provider communication services (IPPC) in health care has been slow. Patients want electronic communication, and the quality of health care can be improved by offering such IPPCs. However, the rate of enrollment in such services remains low, and the reasons for this are unclear. Knowledge about the barriers to use is valuable during implementation of IPPCs in the health care services, and it can help timing, targeting, and tailoring IPPCs to different groups of patients. The goal of our study was to investigate patients' views of an IPPC that they could use from home to pose questions to nurses and physicians at their treatment facility, and their reported reasons for non-use of the service. This qualitative study was based on individual interviews with 22 patients who signed up for, but did not use, the IPPC. Patients appreciated the availability and the possibility of using the IPPC as needed, even if they did not use it. Their reported reasons for not using the IPPC fell into three main categories: (1) they felt that they did not need the IPPC and had sufficient access to information elsewhere, (2) they preferred other types of communication such as telephone or face-to-face contact, or (3) they were hindered by IPPC attributes such as login problems. Patients were satisfied with having the opportunity to send messages to health care providers through an IPPC, even if they did not use the service. IPPCs should be offered to the patients at an appropriate time in the illness trajectory, both when they need the service and when they are receptive to information about the service. A live demonstration of the IPPC at the point of enrollment might have increased its use. ClinicalTrials.gov NCT00971139; http://clinicaltrial.gov/ct2/show/NCT00971139 (Archived by WebCite at http://www.webcitation.org/6KlOiYJrW).
Children with type 1 diabetes and their parents face rigorous procedures for blood glucose monito... more Children with type 1 diabetes and their parents face rigorous procedures for blood glucose monitoring and regulation. Mobile telecommunication systems show potential as an aid for families' self-management of diabetes. A prototype designed to automatically transfer readings from a child's blood glucose monitor to their parent's mobile phone was tested. In this formative stage of development, we sought insights into the appropriateness of the concept, feasibility of use, and ideas for further development and research. During four months, a self-selected sample of 15 children (aged 9 to 15 years) with type 1 diabetes and their parents (n = 30) used the prototype approximately three times daily. Parent and child experiences were collected through questionnaires and through interviews with 9 of the parents. System use was easily integrated into everyday life, and parents valued the sense of reassurance offered by the system. Parents' ongoing struggle to balance control of their children with allowing independence was evident. For children who measured regularly, use appeared to reduce parental intrusions. For those who measured irregularly, however, parental reminders (eg, "nagging") appeared to increase. Although increased reminders could be considered a positive outcome, they can potentially increase parent-child conflict and thus also undermine proper metabolic control. Parents felt that system appropriateness tapered off with the onset of adolescence, partly due to a potential sense of surveillance from the child's perspective that could fuel oppositional behavior. Parental suggestions for further developments included similar alerts of irregular insulin dosages and automatically generated dietary and insulin dosage advice. User enthusiasm suggests that such systems might find a consumer market regardless of whether or not they ultimately improve health outcomes. Thus, more rigorous studies are warranted to inform guidelines for appropriate use. Potentially fruitful approaches include integrating such systems with theory-based parenting interventions and approaches that can aid in interpreting and responding to experiences of surveillance, virtual presence, and balances of power in e-mediated relationships.
Patient self-management of disease is increasingly supported by technologies that can monitor a w... more Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.
Norwegian psychologists' use of and attitudes towards e-media such as ema... more Norwegian psychologists' use of and attitudes towards e-media such as email and mobile text messaging in interaction with clients (e-therapy) were explored. A two-dimensional scale for measuring attitudes towards e-therapy was developed. A total of 1040 (23%) members of the psychologist association responded to a questionnaire June 2003. Of these, 45% had used e-media in interaction with clients. The mean reported attitude towards e-therapy was neutral, with only 3% of the psychologists feeling that use of e-media between client and therapist is unacceptable. Having a psychodynamic theoretical stance was related to attitudes towards e-therapy. Positive attitude was related to clinical use of email and Short Messages Service (SMS). It appears likely that e-therapy will become more common, and that therapist's attitudes are related to such use.
... We have incorporated the above features in the lifestyle tool mobile health motivation ... ... more ... We have incorporated the above features in the lifestyle tool mobile health motivation ... self: Integration in personality," presented at Perspectives on Motivation: Symposium on Motivation, Lincoln, Nebraska ... [12] B. Fogg, "The future of persuasion is mobile," in Mobile persuasion. ...
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Papers by Deede Gammon