Yuri Quintana | Harvard University (original) (raw)

Papers by Yuri Quintana

PubMed, 2019

Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a ke... more Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a key challenge in addressing quality of care in maternal health, is the lack of accurate data. We present a review of the difficulties of collecting and analyzing maternal health data. We propose a comprehensive informatics monitoring framework to track progress on the achievement of the international targets and priorities toward ending preventable maternal mortality and improving maternal and child health, that at the same time builds capacity at institutional and country level to collect indicators and to generate actionable and comparable knowledge that facilitates analysis, research, and evidence-based decision making.

Elsevier eBooks, 2017

Global Health Informatics is a growing multidisciplinary field that combines research methods and... more Global Health Informatics is a growing multidisciplinary field that combines research methods and applications of technology to improve healthcare systems and outcomes. Healthcare systems are facing many challenges including a growing population, the increasing complexity of care services, and limited resources to deliver services. These challenges will require more innovative approaches to scale healthcare services to larger numbers of people. This chapter outlines health informatics systems that have been developed to address these problems.

Figure S1. Cross-validation error in ADMIXTURE analyses. The best fit to data occurs at K = 3.

Successfully called markers on the MADCaP Array. This tab-delimited file includes genomic positio... more Successfully called markers on the MADCaP Array. This tab-delimited file includes genomic positions, inclusion criteria, and overlap with other arrays.

Although prostate cancer is the leading cause of cancer mortality for African men, the vast major... more Although prostate cancer is the leading cause of cancer mortality for African men, the vast majority of known disease associations have been detected in European study cohorts. Furthermore, most genome-wide association studies have used genotyping arrays that are hindered by SNP ascertainment bias. To overcome these disparities in genomic medicine, the Men of African Descent and Carcinoma of the Prostate (MADCaP) Network has developed a genotyping array that is optimized for African populations. The MADCaP Array contains more than 1.5 million markers and an imputation backbone that successfully tags over 94% of common genetic variants in African populations. This array also has a high density of markers in genomic regions associated with cancer susceptibility, including 8q24. We assessed the effectiveness of the MADCaP Array by genotyping 399 prostate cancer cases and 403 controls from seven urban study sites in sub-Saharan Africa. Samples from Ghana and Nigeria clustered together, ...

Revista de salud publica del Paraguay, 2021

a trabajadores de nueve hospitales del Paraguay durante la pandemia COVID-19 RESUMEN Introducción... more a trabajadores de nueve hospitales del Paraguay durante la pandemia COVID-19 RESUMEN Introducción: La adherencia a las medidas de bioseguridad por el personal de salud es una estricta necesidad en los tiempos de pandemia por COVID-19. Objetivo: Evaluar el impacto de dos estrategias de instrucción sobre Medidas de Protección Individual a trabajadores de nueve hospitales del Paraguay durante la pandemia COVID-19. Metodología: Estudio cuasi experimental, modelo antes/después, realizado durante los meses de marzo y abril de 2020; se han comparado dos estrategias didácticas sobre medidas de protección individual en trabajadores de nueve hospitales del Paraguay, agrupados en tres conglomerados seleccionados por conveniencia (médicos, enfermería y personal de apoyo). La instrucción y la supervisión fue realizada por neumólogos pertenecientes a los hospitales mediante la aplicación de un protocolo uniforme. Resultados: Fueron incluidos en el estudio 792 individuos. La competencia de lavado de manos (81% vs 79%) después de ambos enfoques didácticos, sin embargo, el desempeño en puesta y retirada de EPI mostró diferencia significativa (60% vs 73% y 56% vs 66%, respectivamente). Hubo disparidad en la tasa de prácticas realizadas después de la reunión de instrucción (76% vs 89%), y aunque el papel del azar en este análisis fue inferior al 5%, es importante tener en consideración esta variable al analizar los desenlaces. Conclusión: Fue posible optimizar el aprendizaje uniforme de protocolos de protección individual con medidas accesibles en algunos grupos estudiados aquí. La retirada de equipo de protección personal constituyó el eslabón más débil de las competencias abordadas en este ensayo. Al ser liderado este proyecto por especialistas de cada hospital se realza la importancia del trabajo en equipo y sentido de compromiso. Palabras clave: Bioseguridad, personal de salud, equipo de protección personal, COVID-19.

Studies in health technology and informatics, 2019

Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a ke... more Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a key challenge in addressing quality of care in maternal health is the lack of accurate data and analytics. Implementing online communities of practice is a way to resolve this, but in low-and middle-income countries this is particularly challenging. We discuss the design of the Alicanto Online Latin-American Community of Practice that focuses on both outcomes and process indicators.

PubMed, 2019

The design of a mobile medication manager within a broader family and elder-centric collaboration... more The design of a mobile medication manager within a broader family and elder-centric collaboration platform faces challenges of usability and wide applicability. To inform the development and use cases of eldercare apps, we present the preliminary results of a usability study of an iOS and Android app intended for both family members and aging adults for the mobile management of medication lists. Seven participants were recorded during the performance of eight typical use-case scenarios of the medication portion of the InfoSAGE app. Audio and video recordings were analyzed for themes and events. The aim of this paper is to help inform future design choices for eldercare mobile apps.

PubMed, Aug 21, 2019

Globally, there is an expanding elderly population, and families are finding it increasingly chal... more Globally, there is an expanding elderly population, and families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the usage patterns of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families. This descriptive analysis describes the types of family networks using the platform and types of functionality most used by elders and their family members.

BMC Medical Informatics and Decision Making, Nov 20, 2018

Background: Longevity creates increasing care needs for healthcare providers and family caregiver... more Background: Longevity creates increasing care needs for healthcare providers and family caregivers. Increasingly, the burden of care falls to one primary caregiver, increasing stress and reducing health outcomes. Additionally, little has been published on adults', over the age of 75, preferences in the development of health information sharing with family members using online platforms. This study aims to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. Methods: This study is an internet-based, open prospective cohort study, enrolling dyad pairs of one adult over the age of 75 with one informal caregiver. Dyads will be offered to use the InfoSAGE online platform without prospective assignment. Participants will consent using an online process that enables participation from any location and shares important study and privacy details. The platform will enable the capture of search queries and tracking of functions such as tasks and discussions. Surveys every six months assess health status, health and social needs, and caregiver burden using validated instruments over a two-year period. We will use a mixed methods approach, utilizing qualitative survey data along with website usage analytic data. Discussion: Analysis of the longitudinal usage and survey data will help to examine the patterns of family communication and health information seeking as the central older adult ages. We will use the study data to inform design recommendations relevant to a complex mixture of users, with special consideration to the needs of older adult users and potential physical limitations.

PubMed, 2012

Since 2006 St. Jude Children's Research Hospital has been developing Cure4Kids for Kids, a school... more Since 2006 St. Jude Children's Research Hospital has been developing Cure4Kids for Kids, a school-based outreach program to educate children about cancer and healthy lifestyles with a focus on cancer prevention. An evaluation of student knowledge acquisition and retention for the program at the Grade-4 level was conducted during the 2010-2011 school year. Preliminary results of this evaluation are outlined with some of the challenges for long-term program evaluation of cancer prevention programs.

PubMed, 2017

Aging creates new information and communication needs for families who are helping to coordinate ... more Aging creates new information and communication needs for families who are helping to coordinate care for frail parents. To identify how information and communication needs evolve with the aging process, we created a living laboratory of families, supported by an online private social network with tools for care coordination. Site registrants are invite to participate in a more in-depth survey-based longitudinal study. In year one, we assessed the feasibility of an online living laboratory. During this first year, 155 individuals registered on InfoSAGE, and 26% opted into the more in-depth longitudinal study. The survey response rate for those in the study was 61%. We present here a descriptive analysis of our early participants and networks, as well as barriers to participation that the study team encountered.

Journal of Cancer Education, Mar 3, 2016

In 2006, St. Jude Children's Research Hospital (M... more In 2006, St. Jude Children's Research Hospital (Memphis, Tennessee) began developing a school-based outreach program known as the St. Jude Cancer Education for Children Program (SJCECP). The aim of this program is to teach Memphis-area children about cells, cancer, and healthy habits that can prevent the development of cancer in adulthood. Initial plans for delivery of the program was for St. Jude staff to present the program at local schools. This plan for disseminating instruction was not feasible due to the limited availability of St. Jude staff. As a next step, during the 2012-2014 academic years, we conducted a study entitled SJCECP2, utilizing the SJCECP curriculum, with the objective of evaluating the impact of the educational intervention on knowledge acquisition and retention among fourth-grade students participating in a modified, teacher-led version of the program. Eighteen teachers and 426 students from 10 local schools in the greater Memphis area participated in the program evaluation. This study used a single-group, pre-test/post-test design to determine the impact of the SJCECP intervention on changes in knowledge scores among fourth-grade students. Testing was on cells, cancer, and healthy living. The mean scores increased from 6.45 to 8.12, 5.99 to 7.65, and 5.92 to 7.96 on cell, cancer, and health behaviors units, respectively (all p values <.001). Preliminary evidence suggests that the SJCECP2 intervention is a useful tool for teachers to improve student knowledge of knowledge of cells, cancer, and healthy living concepts at the fourth-grade level.

Journal of the Association for Information Systems, 2014

The agility literature suggests a positive relationship between IT-investments, agility, and perf... more The agility literature suggests a positive relationship between IT-investments, agility, and performance for firms operating in turbulent contexts. However, agility studies have primarily focused on conceptual concerns, leaving these relationships empirically unexplored. In addition, the literature has focused on for-profit firms operating in commercial markets, thereby leaving other important organizational types unexamined; one such type is the social enterprise (SE). SEs are entrepreneurial organizations with a mission to improve complex social challenges (i.e., healthcare, hunger, education, etc) rather than profit maximization. This void leaves SEs in the dark as to how they can leverage IT to become more agile and improve performance. We draw on the agility perspective to examine how one exemplary SE operating in the context of pediatric global health utilized IT to enhance its agility and improve performance. We identify how the SE's IT-investment decisions resulted in an IT platform that facilitated increased agility in launching new products aimed at improving survival rates of children. Specifically, we analyze how the SE's IT platform positively impacted customer, partnering, and operational agility, and demonstrate how this led to dramatic improvements in performance. Finally, we offer evidence to support positive relationships between IT, agility, and performance in social sector contexts.

Journal of the American Medical Informatics Association, Mar 16, 2023

Journal of Hospital Infection, 2007

In developing countries, continuing education for healthcare staff may be limited by staff shorta... more In developing countries, continuing education for healthcare staff may be limited by staff shortages and lack of sophisticated means of delivery. These limitations have implications for compliance with an important infection control practice, namely good hand hygiene. A comparison was made between the efficacy of two educational tools commonly used in healthcare and practical sanitation settings in developing countries, i.e. videotapes and flipcharts, in delivering hand hygiene education to 67 nurses in a paediatric hospital in El Salvador. Efficacy was measured on the basis of scores obtained in pre- and post-training tests consisting of 10 multiple-choice questions. Half of the nurses received video-based instruction and half received instruction via flipcharts. Both methods of instruction increased participants' knowledge of good hand hygiene, and the extent of knowledge acquisition by the two methods was similar. Feedback obtained from flipchart users six months after training indicated that most of the respondents used the flipchart to teach hand hygiene to patients' families (62.5%), patients (50%) and healthcare workers (43.8%). Flipchart users ranked flipcharts as their favourite educational tool. Flipcharts offer an economical, easy-to-use, non-technological yet effective alternative to videotapes for delivering education in developing countries. Although the use of flipcharts requires a skilled and well-trained instructor, flipcharts could be used more widely to deliver education in resource-poor settings.

PubMed, 2015

People-centered health care seeks an active role for the patient while empowering all other membe... more People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes, quality of life and optimal value for health care investment. This paper reviews some definitions of people-centered health care and various e-health approaches around the world used to implement this vision. The barriers and enablers to implementation this type of approach are explored. This paper provides a proposed research agenda for future implementations of people-centered e-health.

PubMed, 2019

Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a ke... more Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a key challenge in addressing quality of care in maternal health, is the lack of accurate data. We present a review of the difficulties of collecting and analyzing maternal health data. We propose a comprehensive informatics monitoring framework to track progress on the achievement of the international targets and priorities toward ending preventable maternal mortality and improving maternal and child health, that at the same time builds capacity at institutional and country level to collect indicators and to generate actionable and comparable knowledge that facilitates analysis, research, and evidence-based decision making.

Elsevier eBooks, 2017

Global Health Informatics is a growing multidisciplinary field that combines research methods and... more Global Health Informatics is a growing multidisciplinary field that combines research methods and applications of technology to improve healthcare systems and outcomes. Healthcare systems are facing many challenges including a growing population, the increasing complexity of care services, and limited resources to deliver services. These challenges will require more innovative approaches to scale healthcare services to larger numbers of people. This chapter outlines health informatics systems that have been developed to address these problems.

Figure S1. Cross-validation error in ADMIXTURE analyses. The best fit to data occurs at K = 3.

Successfully called markers on the MADCaP Array. This tab-delimited file includes genomic positio... more Successfully called markers on the MADCaP Array. This tab-delimited file includes genomic positions, inclusion criteria, and overlap with other arrays.

Although prostate cancer is the leading cause of cancer mortality for African men, the vast major... more Although prostate cancer is the leading cause of cancer mortality for African men, the vast majority of known disease associations have been detected in European study cohorts. Furthermore, most genome-wide association studies have used genotyping arrays that are hindered by SNP ascertainment bias. To overcome these disparities in genomic medicine, the Men of African Descent and Carcinoma of the Prostate (MADCaP) Network has developed a genotyping array that is optimized for African populations. The MADCaP Array contains more than 1.5 million markers and an imputation backbone that successfully tags over 94% of common genetic variants in African populations. This array also has a high density of markers in genomic regions associated with cancer susceptibility, including 8q24. We assessed the effectiveness of the MADCaP Array by genotyping 399 prostate cancer cases and 403 controls from seven urban study sites in sub-Saharan Africa. Samples from Ghana and Nigeria clustered together, ...

Revista de salud publica del Paraguay, 2021

a trabajadores de nueve hospitales del Paraguay durante la pandemia COVID-19 RESUMEN Introducción... more a trabajadores de nueve hospitales del Paraguay durante la pandemia COVID-19 RESUMEN Introducción: La adherencia a las medidas de bioseguridad por el personal de salud es una estricta necesidad en los tiempos de pandemia por COVID-19. Objetivo: Evaluar el impacto de dos estrategias de instrucción sobre Medidas de Protección Individual a trabajadores de nueve hospitales del Paraguay durante la pandemia COVID-19. Metodología: Estudio cuasi experimental, modelo antes/después, realizado durante los meses de marzo y abril de 2020; se han comparado dos estrategias didácticas sobre medidas de protección individual en trabajadores de nueve hospitales del Paraguay, agrupados en tres conglomerados seleccionados por conveniencia (médicos, enfermería y personal de apoyo). La instrucción y la supervisión fue realizada por neumólogos pertenecientes a los hospitales mediante la aplicación de un protocolo uniforme. Resultados: Fueron incluidos en el estudio 792 individuos. La competencia de lavado de manos (81% vs 79%) después de ambos enfoques didácticos, sin embargo, el desempeño en puesta y retirada de EPI mostró diferencia significativa (60% vs 73% y 56% vs 66%, respectivamente). Hubo disparidad en la tasa de prácticas realizadas después de la reunión de instrucción (76% vs 89%), y aunque el papel del azar en este análisis fue inferior al 5%, es importante tener en consideración esta variable al analizar los desenlaces. Conclusión: Fue posible optimizar el aprendizaje uniforme de protocolos de protección individual con medidas accesibles en algunos grupos estudiados aquí. La retirada de equipo de protección personal constituyó el eslabón más débil de las competencias abordadas en este ensayo. Al ser liderado este proyecto por especialistas de cada hospital se realza la importancia del trabajo en equipo y sentido de compromiso. Palabras clave: Bioseguridad, personal de salud, equipo de protección personal, COVID-19.

Studies in health technology and informatics, 2019

Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a ke... more Most cases of maternal deaths could be avoided with timely access to quality healthcare, but a key challenge in addressing quality of care in maternal health is the lack of accurate data and analytics. Implementing online communities of practice is a way to resolve this, but in low-and middle-income countries this is particularly challenging. We discuss the design of the Alicanto Online Latin-American Community of Practice that focuses on both outcomes and process indicators.

PubMed, 2019

The design of a mobile medication manager within a broader family and elder-centric collaboration... more The design of a mobile medication manager within a broader family and elder-centric collaboration platform faces challenges of usability and wide applicability. To inform the development and use cases of eldercare apps, we present the preliminary results of a usability study of an iOS and Android app intended for both family members and aging adults for the mobile management of medication lists. Seven participants were recorded during the performance of eight typical use-case scenarios of the medication portion of the InfoSAGE app. Audio and video recordings were analyzed for themes and events. The aim of this paper is to help inform future design choices for eldercare mobile apps.

PubMed, Aug 21, 2019

Globally, there is an expanding elderly population, and families are finding it increasingly chal... more Globally, there is an expanding elderly population, and families are finding it increasingly challenging to coordinate care for their older family members. This paper reports on the usage patterns of InfoSAGE, an online private social network that has tools for communication and care coordination for elders and their families. This descriptive analysis describes the types of family networks using the platform and types of functionality most used by elders and their family members.

BMC Medical Informatics and Decision Making, Nov 20, 2018

Background: Longevity creates increasing care needs for healthcare providers and family caregiver... more Background: Longevity creates increasing care needs for healthcare providers and family caregivers. Increasingly, the burden of care falls to one primary caregiver, increasing stress and reducing health outcomes. Additionally, little has been published on adults', over the age of 75, preferences in the development of health information sharing with family members using online platforms. This study aims to assess a novel, Internet based, family-centric communication and collaboration platform created to address the information needs of elders and their informal caregivers in a community setting. Methods: This study is an internet-based, open prospective cohort study, enrolling dyad pairs of one adult over the age of 75 with one informal caregiver. Dyads will be offered to use the InfoSAGE online platform without prospective assignment. Participants will consent using an online process that enables participation from any location and shares important study and privacy details. The platform will enable the capture of search queries and tracking of functions such as tasks and discussions. Surveys every six months assess health status, health and social needs, and caregiver burden using validated instruments over a two-year period. We will use a mixed methods approach, utilizing qualitative survey data along with website usage analytic data. Discussion: Analysis of the longitudinal usage and survey data will help to examine the patterns of family communication and health information seeking as the central older adult ages. We will use the study data to inform design recommendations relevant to a complex mixture of users, with special consideration to the needs of older adult users and potential physical limitations.

PubMed, 2012

Since 2006 St. Jude Children's Research Hospital has been developing Cure4Kids for Kids, a school... more Since 2006 St. Jude Children's Research Hospital has been developing Cure4Kids for Kids, a school-based outreach program to educate children about cancer and healthy lifestyles with a focus on cancer prevention. An evaluation of student knowledge acquisition and retention for the program at the Grade-4 level was conducted during the 2010-2011 school year. Preliminary results of this evaluation are outlined with some of the challenges for long-term program evaluation of cancer prevention programs.

PubMed, 2017

Aging creates new information and communication needs for families who are helping to coordinate ... more Aging creates new information and communication needs for families who are helping to coordinate care for frail parents. To identify how information and communication needs evolve with the aging process, we created a living laboratory of families, supported by an online private social network with tools for care coordination. Site registrants are invite to participate in a more in-depth survey-based longitudinal study. In year one, we assessed the feasibility of an online living laboratory. During this first year, 155 individuals registered on InfoSAGE, and 26% opted into the more in-depth longitudinal study. The survey response rate for those in the study was 61%. We present here a descriptive analysis of our early participants and networks, as well as barriers to participation that the study team encountered.

Journal of Cancer Education, Mar 3, 2016

In 2006, St. Jude Children's Research Hospital (M... more In 2006, St. Jude Children's Research Hospital (Memphis, Tennessee) began developing a school-based outreach program known as the St. Jude Cancer Education for Children Program (SJCECP). The aim of this program is to teach Memphis-area children about cells, cancer, and healthy habits that can prevent the development of cancer in adulthood. Initial plans for delivery of the program was for St. Jude staff to present the program at local schools. This plan for disseminating instruction was not feasible due to the limited availability of St. Jude staff. As a next step, during the 2012-2014 academic years, we conducted a study entitled SJCECP2, utilizing the SJCECP curriculum, with the objective of evaluating the impact of the educational intervention on knowledge acquisition and retention among fourth-grade students participating in a modified, teacher-led version of the program. Eighteen teachers and 426 students from 10 local schools in the greater Memphis area participated in the program evaluation. This study used a single-group, pre-test/post-test design to determine the impact of the SJCECP intervention on changes in knowledge scores among fourth-grade students. Testing was on cells, cancer, and healthy living. The mean scores increased from 6.45 to 8.12, 5.99 to 7.65, and 5.92 to 7.96 on cell, cancer, and health behaviors units, respectively (all p values <.001). Preliminary evidence suggests that the SJCECP2 intervention is a useful tool for teachers to improve student knowledge of knowledge of cells, cancer, and healthy living concepts at the fourth-grade level.

Journal of the Association for Information Systems, 2014

The agility literature suggests a positive relationship between IT-investments, agility, and perf... more The agility literature suggests a positive relationship between IT-investments, agility, and performance for firms operating in turbulent contexts. However, agility studies have primarily focused on conceptual concerns, leaving these relationships empirically unexplored. In addition, the literature has focused on for-profit firms operating in commercial markets, thereby leaving other important organizational types unexamined; one such type is the social enterprise (SE). SEs are entrepreneurial organizations with a mission to improve complex social challenges (i.e., healthcare, hunger, education, etc) rather than profit maximization. This void leaves SEs in the dark as to how they can leverage IT to become more agile and improve performance. We draw on the agility perspective to examine how one exemplary SE operating in the context of pediatric global health utilized IT to enhance its agility and improve performance. We identify how the SE's IT-investment decisions resulted in an IT platform that facilitated increased agility in launching new products aimed at improving survival rates of children. Specifically, we analyze how the SE's IT platform positively impacted customer, partnering, and operational agility, and demonstrate how this led to dramatic improvements in performance. Finally, we offer evidence to support positive relationships between IT, agility, and performance in social sector contexts.

Journal of the American Medical Informatics Association, Mar 16, 2023

Journal of Hospital Infection, 2007

In developing countries, continuing education for healthcare staff may be limited by staff shorta... more In developing countries, continuing education for healthcare staff may be limited by staff shortages and lack of sophisticated means of delivery. These limitations have implications for compliance with an important infection control practice, namely good hand hygiene. A comparison was made between the efficacy of two educational tools commonly used in healthcare and practical sanitation settings in developing countries, i.e. videotapes and flipcharts, in delivering hand hygiene education to 67 nurses in a paediatric hospital in El Salvador. Efficacy was measured on the basis of scores obtained in pre- and post-training tests consisting of 10 multiple-choice questions. Half of the nurses received video-based instruction and half received instruction via flipcharts. Both methods of instruction increased participants' knowledge of good hand hygiene, and the extent of knowledge acquisition by the two methods was similar. Feedback obtained from flipchart users six months after training indicated that most of the respondents used the flipchart to teach hand hygiene to patients' families (62.5%), patients (50%) and healthcare workers (43.8%). Flipchart users ranked flipcharts as their favourite educational tool. Flipcharts offer an economical, easy-to-use, non-technological yet effective alternative to videotapes for delivering education in developing countries. Although the use of flipcharts requires a skilled and well-trained instructor, flipcharts could be used more widely to deliver education in resource-poor settings.

PubMed, 2015

People-centered health care seeks an active role for the patient while empowering all other membe... more People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes, quality of life and optimal value for health care investment. This paper reviews some definitions of people-centered health care and various e-health approaches around the world used to implement this vision. The barriers and enablers to implementation this type of approach are explored. This paper provides a proposed research agenda for future implementations of people-centered e-health.