Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and... more
Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with ...
Research Interests: Engineering, Computer Science, Medical Informatics, Focus Groups, Electronic Health Records, and 15 moreKenya, Medicine, Humans, Hypertension, Feasibility Studies, Focus Group, Nurses, Model Based Clinical Decision Support Systems, Computer User Interface Design, Clinical Decision Support Systems, Elsevier, Cooperative Behavior, Equipment Failure Analysis, Rural Population, and Medical and Health Sciences
In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to... more
In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to address the human resource challenge of managing hypertension in low- and middle-income countries (LMICs), task-shifting hypertension care from physicians to nurses has been proposed. To support this task-shifting strategy, the Academic Partnership Providing Access to Healthcare (AMPATH) has developed an Android tablet-based electronic Decision Support and Integrated Record-Keeping (DESIRE) tool to record patient data and assist with clinical decision-making. We investigated the usability of the DESIRE tool in the setting of nurse management of hypertension in rural western Kenya through the use of "mock patient" encounters and "think aloud" exercises. Fiftyseven critical incidents were identified and twenty-three design changes were ...
Research Interests: Computer Science, Usability, Electronic Health Records, Kenya, Nursing informatics, and 15 moreMedicine, Systems Integration, Medical errors, Decision support system, Software, Library and Information Studies, Humans, Hypertension, Meaningful Use, Computer User Interface Design, Information Storage and Retrieval, Public health systems and services research, Personal Health Records, Clinical Decision Support Systems, and Rural Population
Hypertension is the leading global risk for mortality. Poor treatment and control of hypertension in low- and middle-income countries is due to several reasons, including insufficient human resources. Nurse management of hypertension is a... more
Hypertension is the leading global risk for mortality. Poor treatment and control of hypertension in low- and middle-income countries is due to several reasons, including insufficient human resources. Nurse management of hypertension is a novel approach to address the human resource challenge. However, specific barriers and facilitators to this strategy are not known. To evaluate barriers and facilitators to nurse management of hypertensive patients in rural western Kenya, using a qualitative research approach. Six key informant interviews (five men, one woman) and seven focus group discussions (24 men, 33 women) were conducted among physicians, clinical officers, nurses, support staff, patients, and community leaders. Content analysis was performed using Atlas.ti 7.0, using deductive and inductive codes that were then grouped into themes representing barriers and facilitators. Ranking of barriers and facilitators was performed using triangulation of density of participant responses...
Research Interests:
In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to... more
In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to address the human resource challenge of managing hypertension in low- and middle-income countries (LMICs), task-shifting hypertension care from physicians to nurses has been proposed. To support this task-shifting strategy, the Academic Partnership Providing Access to Healthcare (AMPATH) has developed an Android tablet-based electronic Decision Support and Integrated Record-Keeping (DESIRE) tool to record patient data and assist with clinical decision-making. We investigated the usability of the DESIRE tool in the setting of nurse management of hypertension in rural western Kenya through the use of "mock patient" encounters and "think aloud" exercises. Fiftyseven critical incidents were identified and twenty-three design changes were ...
Research Interests: Computer Science, Usability, Electronic Health Records, Kenya, Nursing informatics, and 15 moreMedicine, Systems Integration, Medical errors, Software, Library and Information Studies, Humans, Hypertension, Meaningful Use, Computer User Interface Design, Information Storage and Retrieval, Public health systems and services research, Personal Health Records, Clinical Decision Support Systems, Utilization review, and Rural Population
Background To address the human resource challenge of managing hypertension in low- and middle- income countries (LMICs), the Academic Partnership Providing Access to Healthcare (AMPATH) has developed an Android tablet-ba¬¬sed electronic... more
Background To address the human resource challenge of managing hypertension in low- and middle- income countries (LMICs), the Academic Partnership Providing Access to Healthcare (AMPATH) has developed an Android tablet-ba¬¬sed electronic Decision Support and Integrated Record-Keeping (DESIRE) tool to record patient data and assist frontline health workers with clinical decision-making. However, the feasibility of this type of tool for hypertension care has not previously been assessed in a LMIC setting. Objective/Purpose Understanding the feasibility of implementing the DESIRE tool has the potential to broadly impact treatment of non-communicable diseases in LMICs by providing a model for optimization of electronic decision-support in task redistribution among frontline health workers. Methods To evaluate the feasibility of the DESIRE tool, we conducted semi-structured interviews with five nurses, semi-structured interviews with two members of the implementation team, and one focus ...
Research Interests:
Research Interests:
Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and... more
Mobile health (mHealth) applications have recently proliferated, especially in low- and middle-income countries, complementing task-redistribution strategies with clinical decision support. Relatively few studies address usability and feasibility issues that may impact success or failure of implementation, and few have been conducted for non-communicable diseases such as hypertension. To conduct iterative usability and feasibility testing of a tablet-based Decision Support and Integrated Record-keeping (DESIRE) tool, a technology intended to assist rural clinicians taking care of hypertension patients at the community level in a resource-limited setting in western Kenya. Usability testing consisted of "think aloud" exercises and "mock patient encounters" with five nurses, as well as one focus group discussion. Feasibility testing consisted of semi-structured interviews of five nurses and two members of the implementation team, and one focus group discussion with ...
Research Interests: Engineering, Computer Science, Medical Informatics, Focus Groups, Electronic Health Records, and 14 moreKenya, Medicine, Humans, Hypertension, Feasibility Studies, Nurses, Model Based Clinical Decision Support Systems, Computer User Interface Design, Clinical Decision Support Systems, Elsevier, Cooperative Behavior, Equipment Failure Analysis, Rural Population, and Medical and Health Sciences
In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to... more
In sub-Saharan Africa (SSA), cardiovascular disease (CVD) is the leading cause of death among individuals over the age of 30. Hypertension, a major risk factor for CVD, contributes significantly to the CVD burden in SSA. In order to address the human resource challenge of managing hypertension in low- and middle-income countries (LMICs), task-shifting hypertension care from physicians to nurses has been proposed. To support this task-shifting strategy, the Academic Partnership Providing Access to Healthcare (AMPATH) has developed an Android tablet-based electronic Decision Support and Integrated Record-Keeping (DESIRE) tool to record patient data and assist with clinical decision-making. We investigated the usability of the DESIRE tool in the setting of nurse management of hypertension in rural western Kenya through the use of "mock patient" encounters and "think aloud" exercises. Fiftyseven critical incidents were identified and twenty-three design changes were ...