Ramazzini; Blog on work and health by Annet Lenderink


How to find a good answer to your OSH question?

Ask your questionWorkers have questions on occupational safety and health, but they might have problems finding a good answer online. Ask an expert online may be a good solution. You might try yourself if you speak Dutch at www.arboantwoord.com

Comparing the Use of an Online Expert Health Network against Common Information Sources to Answer Health Questions

Martijn DF Rhebergen1, MSc; Annet F Lenderink2, MD; Frank JH van Dijk1, MD, PhD; Carel TJ Hulshof1,3, MD, PhD Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.02.2012. Read the rest of this entry »

Filed under: Internet resources, Knowledge, Knowledge transfer, , ,

The tale of two ePatients in a very creative way

Other bloggers gave earlier attention to this very creative presentation on the important problem of how to gather and evaluate information as a patient.

A Tale of Two ePatients – Based Upon True Stories – By Val Jones, MD. Presented on October 27, 2009 at the e-Patient Connections 2009 Conference in Philadelphia. http://www.epatient2009.com

Filed under: Internet resources, Knowledge transfer, , ,

Internet Delivered Behavior Change: what works

Internet intervention

Working in the field of knowledge dissemination or knowledge transfer you almost always try to achieve behavior change. The Internet gives a lot of extra possibilities, bur little research is done yet to assess the effect of Internet interventions. This is an interesting example. You can find the complete article on the Internet.

This is the official citation: Brouwer W, Oenema A, Crutzen R, de Nooijer J, de Vries NK, Brug J
An Exploration of Factors Related to Dissemination of and Exposure to Internet-Delivered Behavior Change Interventions Aimed at Adults: A Delphi Study Approach. J Med Internet Res 2008;10(2):e10

And this is the abstract and link to the article:

An Exploration of Factors Related to Dissemination of and Exposure to Internet-Delivered Behavior Change Interventions Aimed at Adults: A Delphi Study Approach
Journal of Medical Internet Research  

The Internet is an attractive medium for delivering individualized, computer-tailored behavior change interventions to large numbers of people. However, the actual numbers of people reached seem to fall behind the high expectations. Insight into factors that determine use of and exposure to these Internet interventions is important to be able to increase the reach and improve exposure.

The aim was to identify potentially important factors that determine whether adults visit an Internet-delivered behavior change intervention, extend their visit, and revisit the intervention.

A systematic, three-round Delphi study was conducted among national and international experts from Internet intervention research and practice, e-marketing/e-commerce, Web design, and technical website development. In the first round, 30 experts completed a structured, open-ended online questionnaire assessing factors that were, in their opinion, important for a first visit, an extended visit, a revisit and for effective promotion strategies. Based on the responses in this first questionnaire, a closed-ended online questionnaire was developed for use in the second round. A total of 233 experts were invited to complete this questionnaire. Median and interquartile deviation (IQD) scores were computed to calculate agreement and consensus on the importance of the factors. The factors for which no consensus was obtained (IQD > 1) were included in the third-round questionnaire. Factors with a median score of six or higher and with an IQD ≤ 1 were considered to be important.

Of the 62 experts invited for the first round, 30 completed the questionnaire (48% response rate); 93/233 experts completed the second-round questionnaire (40% response rate), and 59/88 completed the third round (67% response rate). Being motivated to visit an Internet intervention and perceiving the intervention as personally relevant appeared to be important factors related to a first visit. The provision of tailored feedback, relevant and reliable information, and an easy navigation structure were related to an extended visit. Provision of regular new content and the possibility to monitor personal progress toward behavior change were identified as important factors to encourage a revisit. Primarily traditional promotion strategies, like word-of-mouth by family and friends, a publicity campaign with simultaneous use of various mass media, and recommendation by health professionals, were indicated as effective ways to encourage adults to visit an Internet intervention.

This systematic study identified important factors related to the dissemination of and exposure to Internet interventions aimed at adults. In order to improve optimal use of and exposure to Internet interventions, potential users may need to be motivated to visit such an intervention and the information provided needs to be personally relevant. Furthermore, several (technical) aspects of the intervention itself need to be taken into account when developing Internet interventions.

Filed under: Internet resources, Knowledge transfer,

Communicating low probability risks

This week I read an interesting article on BMC (open access) about communicating low probability risks to patients. This is one of the major challenges being a physician: let people make sense of statistics concerning there own health.

Risk Communication Formats for Low Probability Events: an exploratory study of patient preferences

Background: Clear communication about the possible outcomes of proposed medical interventions is an integral part of medical care. Despite its importance, there have been few studies comparing different formats for presenting probabilistic information to patients, especially when small probabilities are involved. The purpose of this study was to explore the potential usefulness of several new small-risk graphic communication formats.

Methods: Information about the likelihoods of cancer and cancer prevention associated with two hypothetical cancer screening programs were used to create an augmented bar chart, an augmented grouped icon display, a flow chart, and three paired combinations of these formats. In the study scenario, the baseline risk of cancer was 53 per 1,000 (5.3%). The risk associated with cancer screening option A was 38 per 1,000 (3.8%) and the risk associated with screening option B was 29 per 1,000 (2.9%). Both the augmented bar chart and the augmented grouped icon display contained magnified views of the differences in cancer risk and cancer prevention associated with the screening programs. A convenience sample of 29 subjects (mean age 56.4 years; 76% men) used the Analytic Hierarchy Process (AHP) to indicate their relative preferences for the six formats using 15 sequential paired comparisons.

Results: The most preferred format was the combined augmented bar chart + flow diagram (mean preference score 0.43) followed by the combined augmented icon + augmented bar chart format (mean preference score 0.22). The overall differences among the six formats were statistically significant: Kruskal-Wallis Chi Square = 141.4, p < 0.0001. The three combined formats all had statistically significant higher preferences scores than the single format displays (p<0.05).

Conclusions: These findings suggest that patients may prefer combined, rather than single, graphic risk presentation formats and that augmented bar charts and icon displays may be useful for conveying comparative information about small risks to clinical decision makers. Further research to confirm and extend these findings is warranted.

Filed under: Knowledge transfer,


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Annet Lenderink

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