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Journal of Psychosomatic Research May 2020The apparent absence of any specific underlying diseases challenges patient-provider communication about medically unexplained symptoms (MUS). Previous research focused...
OBJECTIVE
The apparent absence of any specific underlying diseases challenges patient-provider communication about medically unexplained symptoms (MUS). Previous research focused on general communication patterns in these interactions; however, an overview of more detailed interactional and linguistic aspects is lacking. This review aims to gain a detailed understanding of communicative challenges in MUS consultations by synthesizing evidence from conversation and discourse analytic research.
METHODS
A systematic review of publications using eight databases (PubMed, Embase, CINAHL, PsychINFO, Web of Science, MLA International Bibliography, LLBA and Communication Abstracts). Search terms included 'MUS', 'linguistics' and 'communication'. Additional studies were identified by contacting experts and searching bibliographies. We included linguistic and/or interactional analyses of natural patient-provider interactions about MUS. Two authors independently extracted the data, and quality appraisal was based on internal and external validity.
RESULTS
We identified 18 publications that met the inclusion criteria. The linguistic and interactional features of MUS consultations pertained to three dimensions: 1) symptom recognition, 2) double trouble potential (i.e. patients and providers may have differing views on symptoms and differing knowledge domains), and 3) negotiation and persuasion (in terms of acceptable explanations and subsequent psychological treatment). We describe the recurrent linguistic and interactional features of these interactions.
CONCLUSIONS
Despite the presence of a double trouble potential in MUS consultations, validation of symptoms and subtle persuasive conduct may facilitate agreement on illness models and subsequent (psychological) treatment.
Topics: Communication; Female; Humans; Linguistics; Male; Medically Unexplained Symptoms; Referral and Consultation
PubMed: 32179304
DOI: 10.1016/j.jpsychores.2020.109994 -
Frontiers in Psychology 2023Guilt appeals are widely used as a persuasive approach in various areas of practice. However, the strength and direction of the persuasive effects of guilt appeals are...
INTRODUCTION
Guilt appeals are widely used as a persuasive approach in various areas of practice. However, the strength and direction of the persuasive effects of guilt appeals are mixed, which could be influenced by theoretical and methodological factors.
METHOD
The present study is a comprehensive meta-analysis of 26 studies using a random-effects model to assess the persuasive effects of guilt appeals. In total, 127 effect sizes from seven types of persuasive outcomes (i.e., guilt, attitude, behavior, behavioral intention, non-guilt emotions, motivation, and cognition) were calculated based on 7,512 participants.
RESULTS
The analysis showed a small effect size of guilt appeals [ = 0.19, 95% CI (0.10, 0.28)]. The effect of guilt appeals was moderated by the theoretical factors related to appraisal and coping of guilt arousal, including attributed responsibility, controllability and stability of the causal factors, the proximity of perceiver-victim relationship, recommendation of reparative behaviors, and different outcome types. The effect was also associated with methods used in different studies.
DISCUSSION
Overall, the findings demonstrated the persuasive effects of guilt appeals, but theoretical and methodological factors should be considered in the design and testing of guilt appeals. We also discussed the practical implications of the findings.
PubMed: 37842697
DOI: 10.3389/fpsyg.2023.1201631 -
Journal of Medical Internet Research Jun 2023Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and... (Review)
Review
BACKGROUND
Taxonomies and models are useful tools for defining eHealth content and intervention features, enabling comparison and analysis of research across studies and disciplines. The Behavior Change Technique Taxonomy version 1 (BCTTv1) was developed to decrease ambiguity in defining specific characteristics inherent in health interventions, but it was developed outside the context of digital technology. In contrast, the Persuasive System Design Model (PSDM) was developed to define and evaluate the persuasive content in software solutions but did not have a specific focus on health. Both the BCTTv1 and PSDM have been used to define eHealth interventions in the literature, with some researchers combining or reducing the taxonomies to simplify their application. It is unclear how well the taxonomies accurately define eHealth and whether they should be used alone or in combination.
OBJECTIVE
This scoping review explored how the BCTTv1 and PSDM capture the content and intervention features of parent-focused eHealth as part of a program of studies investigating the use of technology to support parents with therapy home programs for children with special health care needs. It explored the active ingredients and persuasive technology features commonly found in parent-focused eHealth interventions for children with special health care needs and how the descriptions overlap and interact with respect to the BCTTv1 and PSDM taxonomies.
METHODS
A scoping review was used to clarify concepts in the literature related to these taxonomies. Keywords related to parent-focused eHealth were defined and used to systematically search several electronic databases for parent-focused eHealth publications. Publications referencing the same intervention were combined to provide comprehensive intervention details. The data set was coded using codebooks developed from the taxonomies in NVivo (version 12; QSR International) and qualitatively analyzed using matrix queries.
RESULTS
The systematic search found 23 parent-focused eHealth interventions described in 42 articles from various countries; delivered to parents with children aged 1 to 18 years; and covering medical, behavioral, and developmental issues. The predominant active ingredients and intervention features in parent-focused eHealth were concerned with teaching parents behavioral skills, encouraging them to practice and monitor the new skills, and tracking the outcomes of performing the new skills. No category had a complete set of active ingredients or intervention features coded. The two taxonomies conceptually captured different constructs even when their labels appeared to overlap in meaning. In addition, coding by category missed important active ingredients and intervention features.
CONCLUSIONS
The taxonomies were found to code different constructs related to behavior change and persuasive technology, discouraging the merging or reduction of the taxonomies. This scoping review highlighted the benefit of using both taxonomies in their entirety to capture active ingredients and intervention features important for comparing and analyzing eHealth across different studies and disciplines.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-doi.org/10.15619/nzjp/47.1.05.
Topics: Child; Humans; Behavior Therapy; Delivery of Health Care; Persuasive Communication; Technology; Telemedicine
PubMed: 37342082
DOI: 10.2196/42083 -
Patient Education and Counseling Feb 2024Although health promotion scholars and practitioners frequently employ video-based promotion, its effectiveness remains uncertain due to mixed findings. Nuanced details... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Although health promotion scholars and practitioners frequently employ video-based promotion, its effectiveness remains uncertain due to mixed findings. Nuanced details regarding content and design also remain under-explored.
METHODS
We conducted a comprehensive search across nine databases to identify relevant empirical research articles.
RESULTS
Our systematic review included a total of 54 studies, with 38 studies eligible for meta-analysis. Findings highlight the promising potential of video messaging strategies in promoting health behaviors.
CONCLUSIONS
Future research should focus on designing video content that targets detection behaviors within an appropriate length, guided by robust theoretical frameworks to maximize the efficacy of video promotion. More substantial evidence is needed to assess whether video promotion can achieve similar persuasive effectiveness across diverse cultural, political, and economic circumstances. Factors related to the audience (e.g., distinct psychological and personality influences) and message characteristics (e.g., length, credibility) should be further explored to better elucidate the relationship between video-based health promotion and health outcomes.
PRACTICE IMPLICATIONS
Health practitioners and organizations should incorporate video-based messages in interventions as supplement or alternative means to educate audiences of positive prevention methods, establish accurate attitude and intentions toward prevention behaviors, and increase their vigilance toward risky behaviors.
Topics: Humans; Health Promotion; Health Behavior; Communications Media
PubMed: 38070298
DOI: 10.1016/j.pec.2023.108095 -
Health Communication May 2024This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults. Health messaging...
This systematic review evaluates health messaging strategies for the prevention and cessation of e-cigarette use among youth and young adults. Health messaging strategies were defined as the strategic process of developing messages with the intent to shape, reinforce, or change recipients' health attitudes and behaviors. McGuire's Communication/Persuasion Model guided the analysis of the messaging strategies, focusing on the model's five communication inputs (i.e. source, message, channel, audience, destination) and 14 persuasive outcomes. Nine databases were searched from January 2007 to September 2023. The inclusion criteria encompassed studies in English that presented quantitative data on messaging strategies aimed at discouraging vaping among youth and young adults. Each study was also coded for study characteristics and the utilization of theory. Out of 6,045 studies, 25 met the inclusion criteria. The reviewed studies exhibit a diverse array of research methods and a consistent integration of theories. The review emphasizes the nuanced main and interaction effects of various communication inputs, such as message features and audience characteristics, while also pointing out a research gap in message sources. In addition, the utilization of social media for effective messaging to engage the audience requires further research. Only one study specifically evaluated messaging strategies for vaping cessation. More research is imperative to develop targeted and tailored messages that effectively prevent and reduce vaping, especially among populations at higher risk of vaping-related harms, while also leveraging effective channels and innovative communication technologies to engage the audience.
PubMed: 38742648
DOI: 10.1080/10410236.2024.2352284 -
Geriatric Nursing (New York, N.Y.) 2015The aim is to describe nursing home nurses' perceptions around emergency transfers to hospital. Transfers are costly and traumatic for residents, and efforts are... (Review)
Review
The aim is to describe nursing home nurses' perceptions around emergency transfers to hospital. Transfers are costly and traumatic for residents, and efforts are underway to avoid hospitalization. Nurses play a key role in transfers, yet their views are underreported. A systematic review of qualitative studies was undertaken, guided by Joanna Briggs Institute methods. From seven reviewed studies, it was clear nursing home nurses are challenged by the complexity of the transfer process and understand their need for appropriate clinical knowledge, skills and resources. Communication is important, yet nurses often use persuasive and targeted communication. Ambiguity, strained relationships and negative perceptions of residents' experiences around hospitalization contribute to conflict and uncertainty. Nurses are more confident when there is a plan. Transferring a resident is a complex process and special skills, knowledge and resources are required, but may be lacking. Efforts to formalize the transfer process and improve communication and collaboration amongst all stakeholders is needed and would be well received.
Topics: Attitude of Health Personnel; Communication; Emergency Service, Hospital; Geriatric Nursing; Humans; Nursing Homes; Nursing Staff; Patient Transfer; Qualitative Research
PubMed: 26163012
DOI: 10.1016/j.gerinurse.2015.06.001 -
Journal of Clinical Epidemiology May 2015To identify factors associated with the implementability of clinical practice guidelines (CPGs) and to determine what characteristics improve their uptake. (Review)
Review
OBJECTIVES
To identify factors associated with the implementability of clinical practice guidelines (CPGs) and to determine what characteristics improve their uptake.
STUDY DESIGN AND SETTING
We conducted a realist review, which involved searching multiple sources (eg, databases, experts) to determine what about guideline implementability works, for whom, and under what circumstances. Two sets of reviewers independently screened abstracts and extracted data from 278 included studies. Analysis involved the development of a codebook of definitions, validation of data, and development of hierarchical narratives to explain guideline implementability.
RESULTS
We found that guideline implementability is associated with two broad goals in guideline development: (1) creation of guideline content, which involves addressing the domains of stakeholder involvement in CPGs, evidence synthesis, considered judgment (eg, clinical applicability), and implementation feasibility and (2) the effective communication of this content, which involves domains related to fine-tuning the CPG's message (using simple, clear, and persuasive language) and format.
CONCLUSION
Our work represents a comprehensive and interdisciplinary effort toward better understanding, which attributes of guidelines have the potential to improve uptake in clinical practice. We also created codebooks and narratives of key concepts, which can be used to create tools for developing better guidelines to promote better care.
Topics: Guideline Adherence; Humans; Practice Guidelines as Topic; Translational Research, Biomedical
PubMed: 25684154
DOI: 10.1016/j.jclinepi.2014.12.013 -
Campbell Systematic Reviews Jun 2022Limited knowledge regarding the relative effectiveness of workplace accident prevention approaches creates barriers to informed decision-making by policy makers, public... (Review)
Review
BACKGROUND
Limited knowledge regarding the relative effectiveness of workplace accident prevention approaches creates barriers to informed decision-making by policy makers, public health practitioners, workplace, and worker advocates.
OBJECTIVES
The objective of this review was to assess the effectiveness of broad categories of safety interventions in preventing accidents at work. The review aims to compare effects of safety interventions to no intervention, usual activities, or alternative intervention, and if possible, to examine which constituent components of safety intervention programs contribute more strongly to preventing accidents at work in a given setting or context.
DATE SOURCES
Studies were identified through electronic bibliographic searches, government policy databanks, and Internet search engines. The last search was carried out on July 9, 2015. Gray literature were identified by searching OSH ROM and Google. No language or date restrictions were applied. Searches done between February and July of 2015 included PubMed (1966), Embase (1980), CINAHL (1981), OSH ROM (NIOSHTIC 1977, HSELINE 1977, CIS-DOC 1974), PsycINFO (1806), EconLit (1969), Web of Science (1969), and ProQuest (1861); dates represent initial availability of each database. Websites of pertinent institutions (NIOSH, Perosh) were also searched.
STUDY ELIGIBILITY CRITERIA PARTICIPANTS AND INTERVENTIONS
Included studies had to focus on accidents at work, include an evaluation of a safety intervention, and have used injuries at work, or a relevant proxy, as an outcome measure. Experimental, quasi-experimental, and observational study designs were utilized, including randomized controlled trials (RCTs), controlled before and after (CBA) studies, and observational designs using serial measures (interrupted time series, retrospective cohort designs, and before and after studies using multiple measures). Interventions were classified by approach at the individual or group level, and broad categories based on the prevention approach including modification of: Attitudes (through information and persuasive campaign messaging).Behaviors (through training, incentives, goal setting, feedback/coaching).Physiological condition (by physical training).Climate/norms/culture (by coaching, feedback, modification of safety management/leadership).Structural conditions (including physical environment, engineering, legislation and enforcement, sectorial-level norms). When combined approaches were used, interventions were termed "multifaceted," and when an approach(es) is applied to more than one organizational level (e.g., individual, group, and/or organization), it is termed "across levels."
STUDY APPRAISAL AND SYNTHESIS METHODS
Narrative report review captured industry (NACE), work setting, participant characteristics, theoretical basis for approach, intervention fidelity, research design, risk of bias, contextual detail, outcomes measures and results. Additional items were extracted for studies with serial measures including approaches to improve internal validity, assessments of reasonable statistical approaches (Effective Practice of Organization of Care [EPOC] criteria) and overall inference. Random-effects inverse variance weighted meta-analytic methods were used to synthesize odds ratios, rate ratios, or standardized mean differences for the outcomes for RCT and CBA studies with low or moderate levels of heterogeneity. For studies with greater heterogeneity and those using serial measures, we relied on narrative analyses to synthesize findings.
RESULTS
In total 100 original studies were included for synthesis analysis, including 16 RCT study designs, 30 CBA study designs, and 54 studies using serial measures (ITS study designs). These studies represented 120 cases of safety interventions. The number of participants included 31,971,908 individuals in 59 safety interventions, 417,693 groups/firms in 35 safety interventions, and 15,505 injuries in 17 safety interventions. Out of the 59 safety interventions, two were evaluating national prevention measures, which alone accounted for 31,667,110 individuals. The remaining nine safety interventions used other types of measures, such as safety exposure, safety observations, gloves or claim rates. Strong evidence supports greater effects being achieved with safety interventions directed toward the group or organization level rather than individual behavior change. Engineering controls are more effective at reducing injuries than other approaches, particularly when engineered changes can be introduced without requiring "decision-to-use" by workplaces. Multifaceted approaches combining intervention elements on the organizational level, or across levels, provided moderate to strong effects, in particular when engineering controls were included. Interventions based on firm epidemiologic evidence of causality and a strong conceptual approach were more effective. Effects that are more modest were observed (in short follow-up) for safety climate interventions, using techniques such as feedback or leadership training to improve safety communication. There was limited evidence for a strong effect at medium-term with more intense counseling approaches. Evidence supports regulation/legislation as contributing to the prevention of accidents at work, but with lower effect sizes. Enforcement appears to work more consistently, but with smaller effects. In general, the results were consistent with previous systematic reviews of specific types of safety interventions, although the effectiveness of economic incentives to prevent accidents at work was not consistent with our results, and effectiveness of physiological safety intervention was only consistent to some extent.
LIMITATIONS
Acute musculoskeletal injuries and injuries from more long-time workplace exposures were not always clearly distinguished in research reports. In some studies acute and chronic exposures were mixed, resulting in inevitable misclassification. Of note, the classification of these events also remains problematic in clinical medicine. It was not possible to conduct meta-analyses on all types of interventions (due to variability in approach, context, and participants). The findings presented for most intervention types are from limited sources, and assessment of publication bias was not possible. These issues are not surprising, given the breadth of the field of occupational safety. To incorporate studies using serial measures, which provide the only source of information for some safety interventions such as legislation, we took a systematic, grounded approach to their review. Rather than requiring more stringent, specific criteria for inclusion of ITS studies, we chose to assess how investigators justified their approach to design and analyses, based on the context in which they were working. We sought to identify measures taken to improve external validity of studies, reasonable statistical inference, as well as an overall appropriate inferential process. We found the process useful and enlightening. Given the new approach, we may have failed to extract points others may find relevant. Similarly, to facilitate the broad nature of this review, we used a novel categorization of safety interventions, which is likely to evolve with additional use. The broad scope of this review and the time and resources available did not allow for contacting authors of original papers or seeking translation of non-English manuscripts, resulting in a few cases where we did not have sufficient information that may have been possible to obtain from the authors.
CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS
Our synthesis of the relative effectiveness of workplace safety interventions is in accordance with the Public Health Hierarchy of Hazard Control. Specifically, more effective interventions eliminate risk at the source of the hazard through engineering solutions or the separation of workers from hazards; effects were greater when these control measures worked independently of worker "decision-to-use" at the worksite. Interventions based on firm epidemiological evidence of causality and clear theoretical bases for the intervention approach were more effective in preventing injuries. Less effective behavioral approaches were often directed at the prevention of all workplace injuries through a common pathway, such as introducing safety training, without explicitly addressing specific hazards. We caution that this does not mean that training does not play an essential function in worker safety, but rather that it is not effective in the absence of other efforts. Due to the potential to reach large groups of workers through regulation and enforcement, these interventions with relatively modest effects, could have large population-based effects.
PubMed: 36911341
DOI: 10.1002/cl2.1234 -
Health Research Policy and Systems Mar 2019There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to...
BACKGROUND
There is increased interest in using narratives or storytelling to influence health policies. We aimed to systematically review the evidence on the use of narratives to impact the health policy-making process.
METHODS
Eligible study designs included randomised studies, non-randomised studies, process evaluation studies, economic studies, qualitative studies, stakeholder analyses, policy analyses, and case studies. The MEDLINE, PsycINFO, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Global Health Library, Communication and Mass Media Complete, and Google Scholar databases were searched. We followed standard systematic review methodology for study selection, data abstraction and risk of bias assessment. We synthesised the findings narratively and presented the results stratified according to the following stages of the policy cycle: (1) agenda-setting, (2) policy formulation, (3) policy adoption, (4) policy implementation and (5) policy evaluation. Additionally, we presented the knowledge gaps relevant to using narrative to impact health policy-making.
RESULTS
Eighteen studies met the eligibility criteria, and included case studies (n = 15), participatory action research (n = 1), documentary analysis (n = 1) and biographical method (n = 1). The majority were of very low methodological quality. In addition, none of the studies formally evaluated the effectiveness of the narrative-based interventions. Findings suggest that narratives may have a positive influence when used as inspiration and empowerment tools to stimulate policy inquiries, as educational and awareness tools to initiate policy discussions and gain public support, and as advocacy and lobbying tools to formulate, adopt or implement policy. There is also evidence of undesirable effects of using narratives. In one case study, narrative use led to widespread insurance reimbursement of a therapy for breast cancer that was later proven to be ineffective. Another case study described how the use of narrative inappropriately exaggerated the perceived risk of a procedure, which led to limiting its use and preventing a large number of patients from its benefits. A third case study described how optimistic 'cure' or 'hope' stories of children with cancer were selectively used to raise money for cancer research that ignored the negative realities. The majority of included studies did not provide information on the definition or content of narratives, the theoretical framework underlying the narrative intervention or the possible predictors of the success of narrative interventions.
CONCLUSION
The existing evidence base precludes any robust inferences about the impact of narrative interventions on health policy-making. We discuss the implications of the findings for research and policy.
TRIAL REGISTRATION
The review protocol is registered in PROSPERO International prospective register of systematic reviews (ID = CRD42018085011 ).
Topics: Awareness; Health Policy; Humans; Narration; Persuasive Communication; Policy Making; Thinking
PubMed: 30836972
DOI: 10.1186/s12961-019-0423-4 -
Frontiers in Psychology 2021Media multitasking became increasingly popular over the past decade. As this behavior is intensely taxing cognitive resources, it has raised interest and concerns among...
Media multitasking became increasingly popular over the past decade. As this behavior is intensely taxing cognitive resources, it has raised interest and concerns among academics in a variety of fields. Consequently, in recent years, research on how, when, and why people media multitask has strongly emerged, and the consequences of the behavior for a great variety of outcomes (such as working memory, task performance, or socioemotional outcomes) have been explored. While efforts are made to summarize the findings of media multitasking research until date, these meta, and literature studies focused on specific research subdomains. Therefore, the current study adopted a quantitative method to map all studies in the broad field of media multitasking research. The bibliometric and thematic content analyses helped us identifying five major research topics and trends in the overall media multitasking domain. While media multitasking research started by studying its prevalence, appearance, and predictors, early research within the domain was also interested in the impact of this media consumption behavior on individuals' cognitive control and academic performance. Later on in 2007, scholars investigated the implications of media multitasking on the processing of media- and persuasive content, while its impact on socioemotional well-being received attention ever since 2009. Our analyses indicate that research within the field of media multitasking knows a dominant focus on adolescents, television watching, and cognitive depletion. Based on these findings, the paper concludes by discussing directions for future research.
PubMed: 34248735
DOI: 10.3389/fpsyg.2021.623643