Developing Guidelines for Evaluating Cultural Competency of E-Health Initiatives
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Abstract
Information and communications technologies are transforming how health care institutions, clinicians, advocates, patients and their families, and researchers could collaborate. Little empirical evidence exists on the impact of these social technologies on furthering family health and even less on their capacity to ameliorate health disparities. Health social media tools that help develop, sustain, and strengthen the collaborative health agenda should prove useful at ameliorating healthcare inequities; the linkage should not, however, be taken for granted.
Starting from the premise that technologies should have an impact on health outcomes, in this paper, we categorize emerging social technologies in health care with the purpose of developing evaluation criteria of their ability to foster collaboration and positively impact health care equity. This paper reports the findings of a qualitative research study that included systematic ethnographic observations and analysis of Internet websites. The methodology adapted aspects of the netnographic method (Kozinets, 2010) to systematically assess the social technology tools included in the analysis. The selection or sampling of the cases included in the study followed qualitative research principles. We were particularly interested in selecting exemplars of the dimensions that were emerging as the data was collected and analyzed.
The exemplars include: (1) Knowledge Information Resources, (2) e-Clinical Networks, (3) e-Patient + e-Provider Networks, (4) e-Patient Networks, (5) Health Research Networks, (6) Public Health e-Health and Health Prevention Platforms, (7) Self Tracking, and (8) e-Care Practices.
The qualitative data collection process was guided by an iterative selection of e-health tools through online ethnographic observations, the selection of cases, and the development of categories and criteria supported by consultation with experts in health care and social media to triangulate the data collection and analysis consultation. These experts were recruited through the #HCSM, #HCSMEU, and #HCSMGlobal networks. An open invitation was sent to researchers and clinicians who participated in several social media forums. A dozen experts participated from reviewing the database that the research team was constructing.
Guided by the broad research question of which types of health social media applications or e-health tools may enhance collaboration among patients, caretakers, and health care professionals, we refined the criteria for inclusion of e-health tools based on variables that emerged on an iterative basis. To identify key concepts and themes that related closely to collaboration, the team collected free-text narrative data available publicly on websites focused on the utilization of social media for health care purposes.
The results include a set of categories and criteria to assess, both, collaboration and health equity potential. The study of the websites main features included the identification of a set of variables that was iteratively refined. The variables guiding the evaluation of the collaboration core were authorship, target audience, primary direction of communication, and potential to address health disparities. In the technical core, we assessed the number of hits, interoperability, and usability.
Dilemmas that surfaced in evaluating healthcare social media initiatives are discussed and a series of categories to systematically assess them are recommended. Case analyses serve as examples to illustrate the analytical conclusions. Lines of research that are needed to accurately rate and reliably measure the ability of e-health to address health disparities are proposed.
Starting from the premise that technologies should have an impact on health outcomes, in this paper, we categorize emerging social technologies in health care with the purpose of developing evaluation criteria of their ability to foster collaboration and positively impact health care equity. This paper reports the findings of a qualitative research study that included systematic ethnographic observations and analysis of Internet websites. The methodology adapted aspects of the netnographic method (Kozinets, 2010) to systematically assess the social technology tools included in the analysis. The selection or sampling of the cases included in the study followed qualitative research principles. We were particularly interested in selecting exemplars of the dimensions that were emerging as the data was collected and analyzed.
The exemplars include: (1) Knowledge Information Resources, (2) e-Clinical Networks, (3) e-Patient + e-Provider Networks, (4) e-Patient Networks, (5) Health Research Networks, (6) Public Health e-Health and Health Prevention Platforms, (7) Self Tracking, and (8) e-Care Practices.
The qualitative data collection process was guided by an iterative selection of e-health tools through online ethnographic observations, the selection of cases, and the development of categories and criteria supported by consultation with experts in health care and social media to triangulate the data collection and analysis consultation. These experts were recruited through the #HCSM, #HCSMEU, and #HCSMGlobal networks. An open invitation was sent to researchers and clinicians who participated in several social media forums. A dozen experts participated from reviewing the database that the research team was constructing.
Guided by the broad research question of which types of health social media applications or e-health tools may enhance collaboration among patients, caretakers, and health care professionals, we refined the criteria for inclusion of e-health tools based on variables that emerged on an iterative basis. To identify key concepts and themes that related closely to collaboration, the team collected free-text narrative data available publicly on websites focused on the utilization of social media for health care purposes.
The results include a set of categories and criteria to assess, both, collaboration and health equity potential. The study of the websites main features included the identification of a set of variables that was iteratively refined. The variables guiding the evaluation of the collaboration core were authorship, target audience, primary direction of communication, and potential to address health disparities. In the technical core, we assessed the number of hits, interoperability, and usability.
Dilemmas that surfaced in evaluating healthcare social media initiatives are discussed and a series of categories to systematically assess them are recommended. Case analyses serve as examples to illustrate the analytical conclusions. Lines of research that are needed to accurately rate and reliably measure the ability of e-health to address health disparities are proposed.
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