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PubMed2001

The effectiveness of a self-care management interactive multimedia module.

PURPOSE/OBJECTIVES: To develop and test an interactive multimedia module prototype designed to accommodate adults with limited literacy and without computer skills. DESIGN: Experimental, randomized, controlled, pretest, post-test. SETTING: Cancer treatment centers in California, Louisiana (pilot). New Hampshire, Pennsylvania, and Texas. SAMPLE: Outpatients who were at least 18 years old with a minimum fifth-grade reading level; 86 experimental treatment, 88 control. METHODS: Experimental treatment involved use of the interactive multimedia module; the control group received customary Instruction. FINDINGS: As compared to the control group, subjects in the experimental group had significant improvement (p = 0.0001; 257% gain) in self-care ability regardless of age, sex race, education, geographic location, reading ability, computer experience, or preferred learning style; a 6.515% increase in fatigue content covered and 16.775% Increase in instructional duration; and significantly greater benefit from sleep-related activities and a consistent, positive pattern of self-care behavior. CONCLUSIONS: The program is instructionally effective, appropriate for a wide and geographically diverse audience, and feasible for use in the ambulatory setting. IMPLICATIONS FOR NURSING PRACTICE: The interactive multimedia module is an effective, self-directed resource for individualized patient fatigue education.

Adaptation, Psychological↗
PubMed2005

Web-based educational resources for low literacy families in the NICU.

Web-based educational resources for families in the neonatal intensive care unit (NICU)with low health literacy were developed and implemented as prototype web pages using Macromedia Dreamweaver MX. The user interface was designed for a touch-screen platform with voice-recorded messages to incorporate parents' varying literacy levels and computer experience. Cognitive load theory was used to guide the organization and presentation of information. The text was translated to a 6th grade reading level by Flesch-Kincaid Grade Level, MS Word.

Comprehension↗
PubMed2005

Educational interventions--computers for delivering education to children with respiratory illness and to their parents.

Educational interventions for children with asthma can result in both clinical and psychological improvements. However, traditional education programs have been hampered by lack of resources and doubts concerning long-term benefits. Researchers have looked to computer technology to overcome some of these obstacles and respiratory conditions have been the focus for a number of educational computer programs. Computer education packages should have a robust theoretical basis. Many programs aim to improve children's confidence, self-esteem and feelings of control, all of which are linked to compliance and positive health behaviours. The specific skills and knowledge needed for effective self-management also need to be taught in order to equip the child for future independent self-care. Programs tend to be either a stand-alone game, promoting self-regulation and practicing of skills, or an internet-enabled package, which may provide a link to their healthcare provider and/or other people with a similar condition. Computer technology is flexible, can be tailored to individuals' information needs, provides ongoing educational support and promotes active learning. However, there can be problems around accessibility, both in terms of computer ownership and technological literacy. Furthermore, internet sites are largely unregulated and of variable quality. It is essential that educational computer interventions are evidence-based and rigorously evaluated to identify who will benefit most from these packages.

Adolescent↗
PubMed2000

Information and informatics literacy: skills, timing, and estimates of competence.

BACKGROUND: Computing and biomedical informatics technologies are providing almost instantaneous access to vast amounts of possibly relevant information. Although students are entering medical school with increasingly sophisticated basic technological skills, medical educators must determine what curricular enhancements are needed to prepare learners for the world of electronic information. PURPOSE: The purpose was to examine opinions of academic affairs and informatics administrators, curriculum deans and recently matriculated medical students about prematriculation competence and medical education learning expectations. METHODS: Two surveys were administered: an Information Literacy Survey for curriculum/informatics deans and a Computing Skills Survey for entering medical students. RESULTS: Results highlight differences of opinion about entering competencies. They also indicate that medical school administrators believe that most basic information skills fall within the domain of undergraduate medical education. CONCLUSIONS: Further investigations are needed to determine precise entry-level skills and whether information literacy will increase as a result of rising levels of technical competence.

Computer Literacy↗
PubMedDate not supplied

Changing how and what children learn in school with computer-based technologies.

Schools today face ever-increasing demands in their attempts to ensure that students are well equipped to enter the workforce and navigate a complex world. Research indicates that computer technology can help support learning, and that it is especially useful in developing the higher-order skills of critical thinking, analysis, and scientific inquiry. But the mere presence of computers in the classroom does not ensure their effective use. Some computer applications have been shown to be more successful than others, and many factors influence how well even the most promising applications are implemented. This article explores the various ways computer technology can be used to improve how and what children learn in the classroom. Several examples of computer-based applications are highlighted to illustrate ways technology can enhance how children learn by supporting four fundamental characteristics of learning: (1) active engagement, (2) participation in groups, (3) frequent interaction and feedback, and (4) connections to real-world contexts. Additional examples illustrate ways technology can expand what children learn by helping them to understand core concepts in subjects like math, science, and literacy. Research indicates, however, that the use of technology as an effective learning tool is more likely to take place when embedded in a broader education reform movement that includes improvements in teacher training, curriculum, student assessment, and a school's capacity for change. To help inform decisions about the future role of computers in the classroom, the authors conclude that further research is needed to identify the uses that most effectively support learning and the conditions required for successful implementation.

Adolescent↗
PubMed2005

Comparative case study of two biomedical research collaboratories.

BACKGROUND: Working together efficiently and effectively presents a significant challenge in large-scale, complex, interdisciplinary research projects. Collaboratories are a nascent method to help meet this challenge. However, formal collaboratories in biomedical research centers are the exception rather than the rule. OBJECTIVE: The main purpose of this paper is to compare and describe two collaboratories that used off-the-shelf tools and relatively modest resources to support the scientific activity of two biomedical research centers. The two centers were the Great Lakes Regional Center for AIDS Research (HIV/AIDS Center) and the New York University Oral Cancer Research for Adolescent and Adult Health Promotion Center (Oral Cancer Center). METHODS: In each collaboratory, we used semistructured interviews, surveys, and contextual inquiry to assess user needs and define the technology requirements. We evaluated and selected commercial software applications by comparing their feature sets with requirements and then pilot-testing the applications. Local and remote support staff cooperated in the implementation and end user training for the collaborative tools. Collaboratory staff evaluated each implementation by analyzing utilization data, administering user surveys, and functioning as participant observers. RESULTS: The HIV/AIDS Center primarily required real-time interaction for developing projects and attracting new participants to the center; the Oral Cancer Center, on the other hand, mainly needed tools to support distributed and asynchronous work in small research groups. The HIV/AIDS Center's collaboratory included a center-wide website that also served as the launch point for collaboratory applications, such as NetMeeting, Timbuktu Conference, PlaceWare Auditorium, and iVisit. The collaboratory of the Oral Cancer Center used Groove and Genesys Web conferencing. The HIV/AIDS Center was successful in attracting new scientists to HIV/AIDS research, and members used the collaboratory for developing and implementing new research studies. The Oral Cancer Center successfully supported highly distributed and asynchronous research, and the collaboratory facilitated real-time interaction for analyzing data and preparing publications. CONCLUSIONS: The two collaboratory implementations demonstrated the feasibility of supporting biomedical research centers using off-the-shelf commercial tools, but they also identified several barriers to successful collaboration. These barriers included computing platform incompatibilities, network infrastructure complexity, variable availability of local versus remote IT support, low computer and collaborative software literacy, and insufficient maturity of available collaborative software. Factors enabling collaboratory use included collaboration incentives through funding mechanism, a collaborative versus competitive relationship of researchers, leadership by example, and tools well matched to tasks and technical progress. Integrating electronic collaborative tools into routine scientific practice can be successful but requires further research on the technical, social, and behavioral factors influencing the adoption and use of collaboratories.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Computer-assisted tracking of a case management program for the homeless.

Computer scan sheet technology was used to evaluate process and outcome variables in a case management shelter program for the homeless. Clients spent up to four months in this program, working on a number of goal areas, including housing, employment, drugs and alcohol, mental and physical health, and literacy. Using Tele-Form, a computer program that allows scan sheets to be designed on screen, case manager recording forms were developed that allowed interventions to be documented on a daily basis, while psychosocial goal areas were documented on scan sheets at intake and termination. Data from these scan sheets were fed into SPSS, a statistical program for the social sciences. Using the case management tracking guidelines developed by Frankel and LaPorte, 1998, the results of this study showed that scan sheet technology was an effective, efficient, and extremely cost-effective way to track case management. The analysis of the data and subsequent discussion suggested ways about how to make case management evaluation more uniform across the country.

Case Management↗
PubMedDate not supplied

Quality of life assessment for low literacy Latinos: a new multimedia program for self-administration.

Cancer patients who have limited literacy skills or English language proficiency are particularly vulnerable to receiving sub-optimal care. Outcome measurement in these patients may provide new insight into previously undetected problems. This report describes the development and testing of a Spanish language, multimedia program for quality of life (QOL) assessment. Pilot testing was conducted with 30 Latino cancer patients with a range of education levels and computer experience. Patients found the program easy to use and understand. The "Talking Touchscreen" is a practical, user-friendly method that provides greater opportunities to assess QOL in Spanish-speaking patients with a range of literacy skills.

Computer Literacy↗
PubMedDate not supplied

An examination of the evidence-based literacy research in deaf education.

The ability to read and write for a variety of purposes is essential to success in school and in contemporary society. The purpose of this investigation was to conduct an exhaustive review of the literature and a meta-analysis of literacy research in the field of deaf education. Computer and manual searches of 40 years of peer-reviewed journal articles were conducted. A total of 964 articles related to literacy and deafness were identified and examined; 22 articles met the criteria for inclusion in the review. Results indicate that (a) no two studies examined the same dimension of literacy; (b) there was a paucity of well-designed group studies; (c) there were no systematic replication of studies; (d) there is limited data to establish evidenced-based practices. Consequently, increasing the quantity and improving the quality of research in the field is recommended.

Education of Persons with Hearing Disabilities↗
PubMedDate not supplied

Audio computerized self-report interview use in prenatal clinics: audio computer-assisted self interview with touch screen to detect alcohol consumption in pregnant women: application of a new technology to an old problem.

Computer interviewing to obtain sensitive information is not a new concept. However, concerns about the acceptance of computers in disadvantaged populations with potentially low literacy led us to combine audio- and touch-screen technologies with an audio computerized self-report interview to obtain information about alcohol use. This study evaluated acceptance and ease of use by a disadvantaged population of pregnant women in the District of Columbia. Patients attending an initial visit at prenatal clinics answered questions anonymously about their consumption of alcoholic beverages and other personal information. The questionnaire was programmed on a laptop computer. The computer administered the recorded questions via earphones, as well as displayed them on the screen, and patients answered by touching the computer screen. Results were immediately available. A total of 507 women were interviewed, who were primarily African American, non-Hispanic, and never married. Nearly 24% did not complete a high school education, 43% were unemployed, and 30% received public assistance. Most of the women (59%) used computers occasionally (a few days a month) or never. Nearly all patients (96%) reported that the computer was not difficult to use, and approximately 90% liked answering the questions by computer. The study demonstrates that using computers to screen for alcohol use in disadvantaged pregnant populations is feasible and acceptable to the patients.

Adolescent↗
PubMed2005

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

BACKGROUND: The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. METHODS: The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. RESULTS: There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By focusing on the adoption of specific technologies we attempted to interpret correlates in terms of relationships instead of absolute "causals". CONCLUSION: In order to improve access to health care, especially for the majority of Africans living in remote rural areas, there is need to boost the availability and utilization of e-health services. Thus, universal access to e-health ought to be a vision for all countries in the African Region. Each country ought to develop a road map in a strategic e-health plan that will, over time, enable its citizens to realize that vision.

Adult↗
PubMed2003

Computer-Assisted Vocabulary Acquisition: The CSLU Vocabulary Tutor in Oral-Deaf Education.

Deficits in vocabulary have a negative impact on literacy and interpersonal interaction for deaf children. As part of an evaluation, an outcomes assessment was conducted to determine the effectiveness of a computer-based vocabulary tutor in an elementary auditory/oral program. Participants were 19 children, 16 profoundly deaf and 3 hearing. The vocabulary tutor displays line drawings or photographs of the words to be learned while a computer-generated avatar of a "talking head" provides synthesized audiovisual speech driven from text. The computer system also generates printed words corresponding to the imaged items. Through audiovisual reception, children memorized up to 218 new words for everyday household items. After 4 weeks, their receptive vocabulary was tested, using the avatar to speak the name of each item. Most of the students retained more than half of the new words. The freely available vocabulary tutor, whose characteristics can be tailored to individual need, can provide a language-intensive, independent learning environment to supplement classroom teaching in content areas.

Journal Article↗
PubMed2026

Post-intervention effectiveness of a computerized personalized cognitive stimulation program adapted according to cognitive reserve in older adults without cognitive impairment in Primary Care: A randomized clinical trial.

BACKGROUND: Cognitive reserve may influence responsiveness to cognitive interventions, yet it is rarely used to tailor computerized stimulation. OBJECTIVE: To evaluate the effectiveness of a computerized cognitive stimulation program personalized according to cognitive reserve on cognition, reserve-related activities, and digital competence in community-dwelling older adults without cognitive impairment in Primary Care. METHODS: In this randomized clinical trial, 102 adults aged ≥65 years with normal cognitive performance were recruited from three primary care centers in Zaragoza, Spain, and stratified by cognitive reserve level before random allocation to intervention or control. The intervention comprised digital literacy sessions followed by 8 weeks of home-based computerized cognitive stimulation tailored to participants' cognitive reserve profiles and life history. Controls received a single group-based health education session focused on maintaining everyday cognitive activity. Outcomes were assessed at baseline and post-intervention using global cognition (MEC-35), the Cognitive Reserve Questionnaire, the Mobile Device Proficiency Questionnaire-16, and domain-specific neuropsychological tests. A total of 100 participants completed the final evaluation and were included in complete-case analyses. RESULTS: Compared with controls, the intervention group showed greater adjusted post-intervention improvements in global cognition (MEC-35 between-group difference: 1.8 points) and several cognitive measures, including temporal orientation, calculation, attention, praxis, verbal fluency, processing speed, executive functions, and verbal learning. CRQ scores and digital competence also improved, with small-to-large effect sizes. CONCLUSIONS: A computerized cognitive stimulation program adapted according to cognitive reserve appears feasible in Primary Care and may improve cognition, engagement in reserve-related activities, and digital competence in older adults without cognitive impairment.

Humans↗
PubMed1997

A computer-generated test of acuity for multi-handicapped children.

Assessment of visual function in severely intellectually handicapped children is difficult but necessary for educational purposes. The difficulties encountered include: lack of literacy skills; lack of verbal and fine motor skills; and low interest level of the optotypes. A computer-generated test has been developed that helps overcome these difficulties. This test presents pictures equivalent in line width to Snellen, which are manipulated on screen to provide movement and change of size to facilitate non-verbal responses and to increase interest level. Evaluation trials were conducted with 96 cognitively normal children and 37 multi-handicapped children. The computer test facilitated testing of significantly more of the multi-handicapped children. Data from both trial groups indicated a good positive correlation between the computer test and a standard optotype test. Further refinement and evaluation of this computer test is continuing.

Adolescent↗
PubMedDate not supplied

OSHA regulations on universal precautions: a sample training curriculum.

1. Training must be provided to each newly hired employee before that employee can work in a risk environment. Current staff must be trained annually, and additional training must be provided when infection control or universal precaution techniques are revised. 2. Training should include written material, oral presentations, films, videos, computer programs, and audio tapes at the employee's educational, literacy, and language level. Interactive discussion between the trainer and employees is required. 3. Employee evaluation should consist of written pretraining and posttraining tests and a practical demonstration of steps to protect against infectious diseases in the workplace.

Curriculum↗