Carme Carrion - Academia.edu (original) (raw)
Papers by Carme Carrion
BMC Medical Research Methodology
Background Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-... more Background Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information. Objective The study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app’s usability and user experience. Methods A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile p...
BACKGROUND Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-... more BACKGROUND Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information in resource-limited settings can often be due to cultural and societal attitudes to adolescent sexual reproductive health. Innovative approaches, including mobile phone technologies, are needed to address the need for adolescent reproductive health information. OBJECTIVE To design and develop a mobile app prototype to provide confidential adolescent reproductive health information on demand and evaluate its usability and user experience. METHODS A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. Field usability testing enabled the adolescents to provide feedback on the functionality, usability, and usefulness of the app. RESULTS During the usability test, 62 (54.9%) of the adolescents...
JMIR mHealth and uHealth, 2021
Background Adolescents transitioning from childhood to adulthood need to be equipped with sexual ... more Background Adolescents transitioning from childhood to adulthood need to be equipped with sexual reproductive health (SRH) knowledge, skills, attitudes, and values that empower them. Accessible, reliable, appropriate, and friendly information can be provided through mobile phone–based health interventions. Objective This study aims to investigate the effectiveness and impact of an Unstructured Supplementary Service Data (USSD)–based app in increasing adolescents’ knowledge about contraceptives, gender-based stereotypes, sexually transmitted infections (STIs), abstinence, and perceived vulnerability, and helping adolescents make informed decisions about their SRH. Methods A randomized controlled trial (RCT) methodology was applied to investigate the potential of a USSD-based app for providing on-demand SRH information. To be eligible, adolescents aged 15 to 19 years residing in Kibra, Kenya, had to have access to a phone and be available for the 3-month follow-up visit. Participants ...
BACKGROUND There are thousands of health apps available, including for mood disorders. However, t... more BACKGROUND There are thousands of health apps available, including for mood disorders. However, their access is unstructured, and most are never download nor used. Their outcomes are rarely systematically measured and therefore effectiveness is disputed, even potentially damaging. The COVID-19 pandemic has posed and continues to pose a significant burden on population mental health, yet it has also given rise to rapid eHealth development. However, despite increasing reliance on eHealth solutions, major knowledge gaps on their utility and effectiveness persist. OBJECTIVE The main objective of this work was to explore and characterize the current landscape of mobile applications available to treat mood disorders such as depression, bipolar disorder, and dysthymia. METHODS We developed a tool that makes both the Apple App Store and the Google Play Store searchable using keywords and that facilitates the extraction of basic app information of the search results. All app results were fil...
International Journal of Technology Assessment in Health Care, 2017
INTRODUCTION:The use of health apps is rapidly increasing. They intend to promote health or to tr... more INTRODUCTION:The use of health apps is rapidly increasing. They intend to promote health or to treat diseases; in some cases, substituting medical duties. No specific frameworks to assess mHealth solutions in a broad scope and in a comprehensive way have been identified. We aim to propose a framework for mHealth assessment.METHODS:The framework development was based on: •Literature review to identify existing assessment models including the evaluation of health effects•Exploratory analysis with experts and user group discussions•Definition of the assessment model, following the domains of health technology assessment.RESULTS:Existing frameworks are mainly focused on certification criteria. Professionals and users agreed on the need to undertake mHealth assessments as to better inform user decisions. Assessments should be sensible to continuous changes of these technologies and be undertaken by independent organizations.The proposed framework offers a step-by-step process by which an...
JMIR mHealth and uHealth, 2020
Background Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary ... more Background Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary behavior in adolescents is a major priority globally given the current increase in population health challenges of noncommunicable diseases and risk factors such as obesity. Adolescents are highly engaged with mobile technology, but the challenge is to engage them with mobile health (mHealth) technology. Recent innovations in mobile technology provide opportunities to promote a healthy lifestyle in adolescents. An increasingly utilized approach to facilitate increased engagement with mHealth technology is to involve potential users in the creation of the technology. Objective This study aimed to describe the process of and findings from co-designing and prototyping components of the PEGASO Fit for Future (F4F) mHealth intervention for adolescents from different cultural backgrounds. Methods A total of 74 adolescents aged 13 to 16 years from Spain, Italy, and the United Kingdom participat...
BACKGROUND The use of Mobile Applications (apps) for managing overweightness/obesity has increase... more BACKGROUND The use of Mobile Applications (apps) for managing overweightness/obesity has increased over recent years. However, there is a lack of evidence on the efficacy, effectiveness and safety of these apps. The EVALAPPS project will develop and validate an assessment tool for specifically assessing these dimensions in overweightness/obesity management apps. OBJECTIVE To reach a consensus among stakeholders on a comprehensive set of criteria to guide development of the EVALAPPS assessment tool. A modified Delphi process was used in order to: 1) verify the robustness of the criteria identified through a literature review; 2) prioritize a set of the identified criteria. METHODS 31 stakeholders were invited to participate in a 2 round Delphi process with an initial number of 114 criteria identified in the literature. In Round 1 participants rated criteria according to relevance (0 = “I suggest to exclude this criteria”, 5 = “This criterion is extremely relevant”). A criterion was a...
Nutrients, 2019
The prevention of bone mass loss and related complications associated with osteoporosis is a sign... more The prevention of bone mass loss and related complications associated with osteoporosis is a significant public health issue. The Mediterranean diet (MD) is favorably associated with bone health, a potentially modifiable risk factor. The objective of this research was to determine MD adherence in a sample of women with and without osteoporosis. In this observational case-control study of 139 women (64 women with and 75 without osteoporosis) conducted in a primary-care health center in Girona (Spain), MD adherence, lifestyle, physical exercise, tobacco and alcohol consumption, pathological antecedents, and FRAX index scores were analyzed. Logistic multilinear regression modeling to explore the relationship between the MD and bone fracture risk indicated that better MD adherence was associated with a lower bone risk fracture. Non-pharmacological preventive strategies to reduce bone fracture risk were also reviewed to explore the role of lifestyle and diet in bone mass maintenance and ...
JMIR mHealth and uHealth, 2019
Background The use of apps to tackle overweight and obesity by tracking physical and dietary patt... more Background The use of apps to tackle overweight and obesity by tracking physical and dietary patterns and providing recommendations and motivation strategies to achieve personalized goals has increased over recent years. However, evidence of the efficacy, effectiveness, and safety of these apps is severely lacking. Objective The aim of this study was to identify efficacy, safety, and effectiveness criteria used to assess weight control, overweight, and obesity management in mobile health (mHealth) interventions through a systematic review. Methods PubMed, PsycINFO, Scopus, UK Trial Database, ClinicalTrials.gov, and the Cochrane Library were surveyed up to May 2018. All types of clinical studies were considered. A total of 2 independent reviewers assessed quality using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Ratings were used to provide an overall score for each study (low, moderate, or high). Data were synthesized in evidence tables. Results From 233 potentially...
International Journal of Integrated Care, 2019
BackgroundIn conjunction with the World Health Organization (WHO), Universitat Oberta de Cataluny... more BackgroundIn conjunction with the World Health Organization (WHO), Universitat Oberta de Catalunya (UOC) has implemented training in the treatment of cutaneous leishmaniasis (CL) for health professionals in countries where the condition is highly endemic through an interactive on-line course. With three editions of the course successfully completed, we consider assessment of the course’s social impact through analysis of the outcomes beyond knowledge acquisition to be of paramount importance.Methodology/Principal findingsTo this end, we have conducted a study using the Theory of Change theoretical approach, combined with an exploration of students’ experiences through in-depth interviews before, during and after taking the course. These testimonies have been analyzed and classified according to their type of result – outputs, outcomes and longer-term impacts – and distributed along three different levels: individual, collective (meso), and systemic change. Insights about intercultur...
Gaceta Sanitaria, 2019
Objetivo: Conocer la exhaustividad y el tono crítico de las noticias sobre innovaciones médicas p... more Objetivo: Conocer la exhaustividad y el tono crítico de las noticias sobre innovaciones médicas publicadas en la prensa escrita generalista y analizar qué características pueden estar relacionadas. Método: Análisis del contenido de las noticias sobre el descubrimiento, la introducción o la mejora de una innovación médica a través de un cuestionario con diez criterios de exhaustividad que permiten calcular un índice global de exhaustividad. También se analizó el tono crítico de las noticias. Dos investigadores evaluaron de forma independiente las noticias. Resultados: Se analizaron 204 noticias que obtuvieron como puntuación media de exhaustividad 4,5. El 70% se clasificó con un tono crítico optimista. Los criterios de exhaustividad mejor valorados fueron el nivel de detalle sobre la innovación y la correcta diferenciación entre hechos y opiniones. Los criterios peor valorados se refirieron a los posibles conflictos de intereses económicos y a los riesgos potenciales de la innovación. Las variables autor, longitud de la noticia y clasificación de la innovación se relacionaron tanto con la puntuación de exhaustividad como con el tono crítico. El índice de exhaustividad se relacionó además con la patología, el número de fuentes de información y el tono crítico de la noticia, mientrás que el tono crítico se relacionó también con la difusión del periódico y la relevancia de la noticia. Conclusiones: Se identificaron imprecisiones, sesgos o un exceso de optimismo (intencionado o involuntario) en las noticias analizadas. Un mayor detalle en algunos aspectos de las noticias proporcionaría soluciones a muchas de las deficiencias identificadas.
JMIR mHealth and uHealth, 2019
Background: There is mixed evidence to support current ambitions for mobile health (mHealth) apps... more Background: There is mixed evidence to support current ambitions for mobile health (mHealth) apps to improve chronic health and well-being. One proposed explanation for this variable effect is that users do not engage with apps as intended. The application of analytics, defined as the use of data to generate new insights, is an emerging approach to study and interpret engagement with mHealth interventions. Objective: This study aimed to consolidate how analytic indicators of engagement have previously been applied across clinical and technological contexts, to inform how they might be optimally applied in future evaluations. Methods: We conducted a scoping review to catalog the range of analytic indicators being used in evaluations of consumer mHealth apps for chronic conditions. We categorized studies according to app structure and application of engagement data and calculated descriptive data for each category. Chi-square and Fisher exact tests of independence were applied to calculate differences between coded variables. Results: A total of 41 studies met our inclusion criteria. The average mHealth evaluation included for review was a two-group pretest-posttest randomized controlled trial of a hybrid-structured app for mental health self-management, had 103 participants, lasted 5 months, did not provide access to health care provider services, measured 3 analytic indicators of engagement, segmented users based on engagement data, applied engagement data for descriptive analyses, and did not report on attrition. Across the reviewed studies, engagement was measured using the following 7 analytic indicators: the number of measures recorded (76%, 31/41), the frequency of interactions logged (73%, 30/41), the number of features accessed (49%, 20/41), the number of log-ins or sessions logged (46%, 19/41), the number of modules or lessons started or completed (29%, 12/41), time spent engaging with the app (27%, 11/41), and the number or content of pages accessed (17%, 7/41). Engagement with unstructured apps was mostly measured by the number of features accessed (8/10, P=.04), and engagement with hybrid apps was mostly measured by the
Revista espanola de salud publica, Jan 3, 2016
The PEGASO Project aims to design a technological system aimed at European adolescents to promote... more The PEGASO Project aims to design a technological system aimed at European adolescents to promote healthy lifestyles. The objective was to explore teenagers and their parents and teachers perceptions with regards to mobile technology use in promoting a healthier lifestyle, in terms of food and physical activity. Qualitative study based on primary data obtained through four focus groups analysis (three teenager groups between 13 and 15 y and 1 parent/teacher group). Verbatim transcriptions have been analysed following content analysis perspective. Four different categories were identified: 1: social and cultural context, 2: adolescents and health, 3: role of technology in teenagers' lives and 4: use of technology to acquire healthier habits. Each category helped to arise various subcategories linked to the relation between teens and health: holistic health concept, health/disease perception directly related with feeling physically fit and social acceptance. With regards to techno...
International Journal of Integrated Care, 2016
Health research policy and systems / BioMed Central, Jan 19, 2016
Global investment in biomedical research has grown significantly over the last decades, reaching ... more Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, mak...
Educación Médica, 2017
Resumen Introducción y objetivos: La empatía es la capacidad de transmitir comprensión hacia las ... more Resumen Introducción y objetivos: La empatía es la capacidad de transmitir comprensión hacia las emociones de otros individuos. La empatía de los profesionales sanitarios se ha asociado a mejores resultados clínicos y de relación con el paciente. El objetivo del estudio era conocer el nivel de empatía de los estudiantes de Medicina, y su evolución después de recibir un curso sobre Entrevista Clínica y Comunicación. Métodos: Estudio longitudinal prospectivo con intervención (módulo de Comunicación y Entrevista Clínica de un mes de duración) y sin grupo control. La empatía se midió con el cuestionario Índice de Reactividad Interpersonal (IRI) que tiene 2 dimensiones cognitivas (toma de perspectiva y fantasía) y 2 emocionales (preocupación empática y distrés personal). La empatía percibida se obtuvo mediante autoevaluación del 0 al 10. Resultados: Participaron 136 alumnos, un 72% eran mujeres, con una edad media de 20,3 años. La empatía percibida correlacionó con las dimensiones del IRI, excepto con distrés personal. Después de la intervención educativa se observaron incrementos en los hombres en toma de perspectiva (de 16,5 a 17,8; p = 0,005) y en las mujeres en fantasía (de 15,5 a 16,7; p = 0,001), con aumento en ambos sexos de la empatía percibida autoevaluada (de 6,9 a 7,4 en hombres; p = 0,009 y de 7,4 a 7,8 en mujeres; p < 0,001). No se modificaron las dimensiones emocionales de empatía. Conclusiones: Los estudiantes de Medicina no perciben dentro de la empatía el componente de distrés personal, y después de la formación se incrementaron los niveles de empatía cognitiva y percibida.
Medicina Clínica, 2016
La acupuntura es un procedimiento médico con un abanico de indicaciones muy amplio según la OMS. ... more La acupuntura es un procedimiento médico con un abanico de indicaciones muy amplio según la OMS. Sin embargo, toda indicación requiere hoy en día una sólida evidencia científica. Para ello, llevamos a cabo una revisión sistemática desde 2010, fecha de aparición de los criterios STRICTA que normalizaron los ensayos clínicos en el campo de la acupuntura, hasta 2015. Se seleccionaron las revisiones y los metaanálisis de buena o muy buena calidad metodológica según los criterios SIGN y que tuvieran como objetivo principal evaluar la eficacia de la acupuntura en el manejo de cualquier patología. La mayor parte de las 31 revisiones finales trataban sobre enfermedades que cursaban con dolor, principalmente de carácter crónico en las áreas de neurología, traumatología y reumatología. La evidencia actual sustenta su indicación en el tratamiento de las cefaleas, migrañas, lumbalgias, cervicalgias y artrosis. El resto de patologías aún requieren mayores estudios para poder establecer firmes conclusiones.
Gaceta Sanitaria, 2016
The use of clinical practice guidelines in primary care: professional mindlines and control mecha... more The use of clinical practice guidelines in primary care: professional mindlines and control mechanisms El uso de guías de práctica clínica en atención primaria: entre el conocimiento tácito y los mecanismos de control.
BMC Medical Research Methodology
Background Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-... more Background Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information (SRH) in resource-limited settings due to cultural and societal attitudes towards adolescent SRH could be contributing to the negative outcomes. Innovative approaches, including mobile phone technologies, are needed to address the need for reliable adolescent SRH information. Objective The study aimed to co-design a Unstructured Supplementary Service Data (USSD) based mobile app prototype to provide confidential adolescent SRH information on-demand and evaluate the mobile app’s usability and user experience. Methods A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. To participate, an adolescent must have been 15 to 19 years old, resided in Kibra and would be able to access a mobile p...
BACKGROUND Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-... more BACKGROUND Adolescent pregnancies and sexually-transmitted infections continue to impact 15 – 19-year-olds across the globe. The lack of sexual reproductive health information in resource-limited settings can often be due to cultural and societal attitudes to adolescent sexual reproductive health. Innovative approaches, including mobile phone technologies, are needed to address the need for adolescent reproductive health information. OBJECTIVE To design and develop a mobile app prototype to provide confidential adolescent reproductive health information on demand and evaluate its usability and user experience. METHODS A human-centered design methodology was applied. This practice framework allowed the perspectives and feedback of adolescent users to be included in the iterative design process. Field usability testing enabled the adolescents to provide feedback on the functionality, usability, and usefulness of the app. RESULTS During the usability test, 62 (54.9%) of the adolescents...
JMIR mHealth and uHealth, 2021
Background Adolescents transitioning from childhood to adulthood need to be equipped with sexual ... more Background Adolescents transitioning from childhood to adulthood need to be equipped with sexual reproductive health (SRH) knowledge, skills, attitudes, and values that empower them. Accessible, reliable, appropriate, and friendly information can be provided through mobile phone–based health interventions. Objective This study aims to investigate the effectiveness and impact of an Unstructured Supplementary Service Data (USSD)–based app in increasing adolescents’ knowledge about contraceptives, gender-based stereotypes, sexually transmitted infections (STIs), abstinence, and perceived vulnerability, and helping adolescents make informed decisions about their SRH. Methods A randomized controlled trial (RCT) methodology was applied to investigate the potential of a USSD-based app for providing on-demand SRH information. To be eligible, adolescents aged 15 to 19 years residing in Kibra, Kenya, had to have access to a phone and be available for the 3-month follow-up visit. Participants ...
BACKGROUND There are thousands of health apps available, including for mood disorders. However, t... more BACKGROUND There are thousands of health apps available, including for mood disorders. However, their access is unstructured, and most are never download nor used. Their outcomes are rarely systematically measured and therefore effectiveness is disputed, even potentially damaging. The COVID-19 pandemic has posed and continues to pose a significant burden on population mental health, yet it has also given rise to rapid eHealth development. However, despite increasing reliance on eHealth solutions, major knowledge gaps on their utility and effectiveness persist. OBJECTIVE The main objective of this work was to explore and characterize the current landscape of mobile applications available to treat mood disorders such as depression, bipolar disorder, and dysthymia. METHODS We developed a tool that makes both the Apple App Store and the Google Play Store searchable using keywords and that facilitates the extraction of basic app information of the search results. All app results were fil...
International Journal of Technology Assessment in Health Care, 2017
INTRODUCTION:The use of health apps is rapidly increasing. They intend to promote health or to tr... more INTRODUCTION:The use of health apps is rapidly increasing. They intend to promote health or to treat diseases; in some cases, substituting medical duties. No specific frameworks to assess mHealth solutions in a broad scope and in a comprehensive way have been identified. We aim to propose a framework for mHealth assessment.METHODS:The framework development was based on: •Literature review to identify existing assessment models including the evaluation of health effects•Exploratory analysis with experts and user group discussions•Definition of the assessment model, following the domains of health technology assessment.RESULTS:Existing frameworks are mainly focused on certification criteria. Professionals and users agreed on the need to undertake mHealth assessments as to better inform user decisions. Assessments should be sensible to continuous changes of these technologies and be undertaken by independent organizations.The proposed framework offers a step-by-step process by which an...
JMIR mHealth and uHealth, 2020
Background Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary ... more Background Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary behavior in adolescents is a major priority globally given the current increase in population health challenges of noncommunicable diseases and risk factors such as obesity. Adolescents are highly engaged with mobile technology, but the challenge is to engage them with mobile health (mHealth) technology. Recent innovations in mobile technology provide opportunities to promote a healthy lifestyle in adolescents. An increasingly utilized approach to facilitate increased engagement with mHealth technology is to involve potential users in the creation of the technology. Objective This study aimed to describe the process of and findings from co-designing and prototyping components of the PEGASO Fit for Future (F4F) mHealth intervention for adolescents from different cultural backgrounds. Methods A total of 74 adolescents aged 13 to 16 years from Spain, Italy, and the United Kingdom participat...
BACKGROUND The use of Mobile Applications (apps) for managing overweightness/obesity has increase... more BACKGROUND The use of Mobile Applications (apps) for managing overweightness/obesity has increased over recent years. However, there is a lack of evidence on the efficacy, effectiveness and safety of these apps. The EVALAPPS project will develop and validate an assessment tool for specifically assessing these dimensions in overweightness/obesity management apps. OBJECTIVE To reach a consensus among stakeholders on a comprehensive set of criteria to guide development of the EVALAPPS assessment tool. A modified Delphi process was used in order to: 1) verify the robustness of the criteria identified through a literature review; 2) prioritize a set of the identified criteria. METHODS 31 stakeholders were invited to participate in a 2 round Delphi process with an initial number of 114 criteria identified in the literature. In Round 1 participants rated criteria according to relevance (0 = “I suggest to exclude this criteria”, 5 = “This criterion is extremely relevant”). A criterion was a...
Nutrients, 2019
The prevention of bone mass loss and related complications associated with osteoporosis is a sign... more The prevention of bone mass loss and related complications associated with osteoporosis is a significant public health issue. The Mediterranean diet (MD) is favorably associated with bone health, a potentially modifiable risk factor. The objective of this research was to determine MD adherence in a sample of women with and without osteoporosis. In this observational case-control study of 139 women (64 women with and 75 without osteoporosis) conducted in a primary-care health center in Girona (Spain), MD adherence, lifestyle, physical exercise, tobacco and alcohol consumption, pathological antecedents, and FRAX index scores were analyzed. Logistic multilinear regression modeling to explore the relationship between the MD and bone fracture risk indicated that better MD adherence was associated with a lower bone risk fracture. Non-pharmacological preventive strategies to reduce bone fracture risk were also reviewed to explore the role of lifestyle and diet in bone mass maintenance and ...
JMIR mHealth and uHealth, 2019
Background The use of apps to tackle overweight and obesity by tracking physical and dietary patt... more Background The use of apps to tackle overweight and obesity by tracking physical and dietary patterns and providing recommendations and motivation strategies to achieve personalized goals has increased over recent years. However, evidence of the efficacy, effectiveness, and safety of these apps is severely lacking. Objective The aim of this study was to identify efficacy, safety, and effectiveness criteria used to assess weight control, overweight, and obesity management in mobile health (mHealth) interventions through a systematic review. Methods PubMed, PsycINFO, Scopus, UK Trial Database, ClinicalTrials.gov, and the Cochrane Library were surveyed up to May 2018. All types of clinical studies were considered. A total of 2 independent reviewers assessed quality using Scottish Intercollegiate Guidelines Network (SIGN) criteria. Ratings were used to provide an overall score for each study (low, moderate, or high). Data were synthesized in evidence tables. Results From 233 potentially...
International Journal of Integrated Care, 2019
BackgroundIn conjunction with the World Health Organization (WHO), Universitat Oberta de Cataluny... more BackgroundIn conjunction with the World Health Organization (WHO), Universitat Oberta de Catalunya (UOC) has implemented training in the treatment of cutaneous leishmaniasis (CL) for health professionals in countries where the condition is highly endemic through an interactive on-line course. With three editions of the course successfully completed, we consider assessment of the course’s social impact through analysis of the outcomes beyond knowledge acquisition to be of paramount importance.Methodology/Principal findingsTo this end, we have conducted a study using the Theory of Change theoretical approach, combined with an exploration of students’ experiences through in-depth interviews before, during and after taking the course. These testimonies have been analyzed and classified according to their type of result – outputs, outcomes and longer-term impacts – and distributed along three different levels: individual, collective (meso), and systemic change. Insights about intercultur...
Gaceta Sanitaria, 2019
Objetivo: Conocer la exhaustividad y el tono crítico de las noticias sobre innovaciones médicas p... more Objetivo: Conocer la exhaustividad y el tono crítico de las noticias sobre innovaciones médicas publicadas en la prensa escrita generalista y analizar qué características pueden estar relacionadas. Método: Análisis del contenido de las noticias sobre el descubrimiento, la introducción o la mejora de una innovación médica a través de un cuestionario con diez criterios de exhaustividad que permiten calcular un índice global de exhaustividad. También se analizó el tono crítico de las noticias. Dos investigadores evaluaron de forma independiente las noticias. Resultados: Se analizaron 204 noticias que obtuvieron como puntuación media de exhaustividad 4,5. El 70% se clasificó con un tono crítico optimista. Los criterios de exhaustividad mejor valorados fueron el nivel de detalle sobre la innovación y la correcta diferenciación entre hechos y opiniones. Los criterios peor valorados se refirieron a los posibles conflictos de intereses económicos y a los riesgos potenciales de la innovación. Las variables autor, longitud de la noticia y clasificación de la innovación se relacionaron tanto con la puntuación de exhaustividad como con el tono crítico. El índice de exhaustividad se relacionó además con la patología, el número de fuentes de información y el tono crítico de la noticia, mientrás que el tono crítico se relacionó también con la difusión del periódico y la relevancia de la noticia. Conclusiones: Se identificaron imprecisiones, sesgos o un exceso de optimismo (intencionado o involuntario) en las noticias analizadas. Un mayor detalle en algunos aspectos de las noticias proporcionaría soluciones a muchas de las deficiencias identificadas.
JMIR mHealth and uHealth, 2019
Background: There is mixed evidence to support current ambitions for mobile health (mHealth) apps... more Background: There is mixed evidence to support current ambitions for mobile health (mHealth) apps to improve chronic health and well-being. One proposed explanation for this variable effect is that users do not engage with apps as intended. The application of analytics, defined as the use of data to generate new insights, is an emerging approach to study and interpret engagement with mHealth interventions. Objective: This study aimed to consolidate how analytic indicators of engagement have previously been applied across clinical and technological contexts, to inform how they might be optimally applied in future evaluations. Methods: We conducted a scoping review to catalog the range of analytic indicators being used in evaluations of consumer mHealth apps for chronic conditions. We categorized studies according to app structure and application of engagement data and calculated descriptive data for each category. Chi-square and Fisher exact tests of independence were applied to calculate differences between coded variables. Results: A total of 41 studies met our inclusion criteria. The average mHealth evaluation included for review was a two-group pretest-posttest randomized controlled trial of a hybrid-structured app for mental health self-management, had 103 participants, lasted 5 months, did not provide access to health care provider services, measured 3 analytic indicators of engagement, segmented users based on engagement data, applied engagement data for descriptive analyses, and did not report on attrition. Across the reviewed studies, engagement was measured using the following 7 analytic indicators: the number of measures recorded (76%, 31/41), the frequency of interactions logged (73%, 30/41), the number of features accessed (49%, 20/41), the number of log-ins or sessions logged (46%, 19/41), the number of modules or lessons started or completed (29%, 12/41), time spent engaging with the app (27%, 11/41), and the number or content of pages accessed (17%, 7/41). Engagement with unstructured apps was mostly measured by the number of features accessed (8/10, P=.04), and engagement with hybrid apps was mostly measured by the
Revista espanola de salud publica, Jan 3, 2016
The PEGASO Project aims to design a technological system aimed at European adolescents to promote... more The PEGASO Project aims to design a technological system aimed at European adolescents to promote healthy lifestyles. The objective was to explore teenagers and their parents and teachers perceptions with regards to mobile technology use in promoting a healthier lifestyle, in terms of food and physical activity. Qualitative study based on primary data obtained through four focus groups analysis (three teenager groups between 13 and 15 y and 1 parent/teacher group). Verbatim transcriptions have been analysed following content analysis perspective. Four different categories were identified: 1: social and cultural context, 2: adolescents and health, 3: role of technology in teenagers' lives and 4: use of technology to acquire healthier habits. Each category helped to arise various subcategories linked to the relation between teens and health: holistic health concept, health/disease perception directly related with feeling physically fit and social acceptance. With regards to techno...
International Journal of Integrated Care, 2016
Health research policy and systems / BioMed Central, Jan 19, 2016
Global investment in biomedical research has grown significantly over the last decades, reaching ... more Global investment in biomedical research has grown significantly over the last decades, reaching approximately a quarter of a trillion US dollars in 2010. However, not all of this investment is distributed evenly by gender. It follows, arguably, that scarce research resources may not be optimally invested (by either not supporting the best science or by failing to investigate topics that benefit women and men equitably). Women across the world tend to be significantly underrepresented in research both as researchers and research participants, receive less research funding, and appear less frequently than men as authors on research publications. There is also some evidence that women are relatively disadvantaged as the beneficiaries of research, in terms of its health, societal and economic impacts. Historical gender biases may have created a path dependency that means that the research system and the impacts of research are biased towards male researchers and male beneficiaries, mak...
Educación Médica, 2017
Resumen Introducción y objetivos: La empatía es la capacidad de transmitir comprensión hacia las ... more Resumen Introducción y objetivos: La empatía es la capacidad de transmitir comprensión hacia las emociones de otros individuos. La empatía de los profesionales sanitarios se ha asociado a mejores resultados clínicos y de relación con el paciente. El objetivo del estudio era conocer el nivel de empatía de los estudiantes de Medicina, y su evolución después de recibir un curso sobre Entrevista Clínica y Comunicación. Métodos: Estudio longitudinal prospectivo con intervención (módulo de Comunicación y Entrevista Clínica de un mes de duración) y sin grupo control. La empatía se midió con el cuestionario Índice de Reactividad Interpersonal (IRI) que tiene 2 dimensiones cognitivas (toma de perspectiva y fantasía) y 2 emocionales (preocupación empática y distrés personal). La empatía percibida se obtuvo mediante autoevaluación del 0 al 10. Resultados: Participaron 136 alumnos, un 72% eran mujeres, con una edad media de 20,3 años. La empatía percibida correlacionó con las dimensiones del IRI, excepto con distrés personal. Después de la intervención educativa se observaron incrementos en los hombres en toma de perspectiva (de 16,5 a 17,8; p = 0,005) y en las mujeres en fantasía (de 15,5 a 16,7; p = 0,001), con aumento en ambos sexos de la empatía percibida autoevaluada (de 6,9 a 7,4 en hombres; p = 0,009 y de 7,4 a 7,8 en mujeres; p < 0,001). No se modificaron las dimensiones emocionales de empatía. Conclusiones: Los estudiantes de Medicina no perciben dentro de la empatía el componente de distrés personal, y después de la formación se incrementaron los niveles de empatía cognitiva y percibida.
Medicina Clínica, 2016
La acupuntura es un procedimiento médico con un abanico de indicaciones muy amplio según la OMS. ... more La acupuntura es un procedimiento médico con un abanico de indicaciones muy amplio según la OMS. Sin embargo, toda indicación requiere hoy en día una sólida evidencia científica. Para ello, llevamos a cabo una revisión sistemática desde 2010, fecha de aparición de los criterios STRICTA que normalizaron los ensayos clínicos en el campo de la acupuntura, hasta 2015. Se seleccionaron las revisiones y los metaanálisis de buena o muy buena calidad metodológica según los criterios SIGN y que tuvieran como objetivo principal evaluar la eficacia de la acupuntura en el manejo de cualquier patología. La mayor parte de las 31 revisiones finales trataban sobre enfermedades que cursaban con dolor, principalmente de carácter crónico en las áreas de neurología, traumatología y reumatología. La evidencia actual sustenta su indicación en el tratamiento de las cefaleas, migrañas, lumbalgias, cervicalgias y artrosis. El resto de patologías aún requieren mayores estudios para poder establecer firmes conclusiones.
Gaceta Sanitaria, 2016
The use of clinical practice guidelines in primary care: professional mindlines and control mecha... more The use of clinical practice guidelines in primary care: professional mindlines and control mechanisms El uso de guías de práctica clínica en atención primaria: entre el conocimiento tácito y los mecanismos de control.