Seneca Perri Moore - Academia.edu (original) (raw)

Papers by Seneca Perri Moore

Research Square (Research Square), Jul 6, 2020

Background: Traditional antenatal care (ANC) models often do not meet women's needs for informati... more Background: Traditional antenatal care (ANC) models often do not meet women's needs for information, counseling, and support, resulting in gaps in quality and coverage. Group ANC (GANC) provides an alternative, person-centered approach where pregnant women of similar gestational age meet with the same health provider for facilitated discussion. There are few studies that show associations between GANC and various outcomes. Methods: We used mixed methods to evaluate a contextualized GANC model (Lea Mimba Pregnancy Clubs) and to understand implementation experiences at six health facilities in Kakamega County, Kenya. Between April 2018 and January 2019, we tracked 1,652 women who were assigned to 162 GANC cohorts to assess ANC retention. Using an intention-to-treat approach, we conducted baseline (N = 112) and endline surveys (N = 360) with women attending immunization visits to assess outcomes and used time diaries to assess wait times. At endline, we conducted 29 in-depth interviews (IDIs) and three focus group discussions with women who were currently and previously participating in GANC, and 15 IDIs with stakeholders. Results: GANC was associated with enhanced social support, with some evidence for improved knowledge, adoption of healthy behaviors, enhanced self-e cacy, and improved experience of care. Quantitatively, we found strong associations with knowledge of danger signs, women who shared their feelings with other women, knowledge and competence of health workers, respect shown by ANC providers, overall quality of care, and birth preparations. No changes were seen in knowledge of positive behaviors, empowerment, several aspects of the experience of care, ANC retention, early ANC, and other healthy behaviors. Qualitatively, women and stakeholders noted improvements in interactions between health providers and women, improved counseling, increased feelings of empowerment to ask questions and speak freely, and strengthened social networks and enhanced social cohesion among women. Both wait times and counseling times increased in GANC compared to traditional ANC. Conclusions: This is one of the few mixed-methods studies evaluating GANC and offers new measures for experience of care, empowerment, and adoption of healthy behaviors. While more research is required, GANC holds promise for enhancing women's experiences during pregnancy. Modi cations are needed for sustainability and scalability.

BMC Health Services Research, Aug 18, 2022

Following publication of the original article [1], it was noted that due to a typesetting mistake... more Following publication of the original article [1], it was noted that due to a typesetting mistake, an error in the Abstract wasn't corrected. The sentence currently reads: F studies show associations between GANC and various outcomes. The sentence should read: Few studies show associations between GANC and various outcomes. The original article [1] has been corrected. The publisher apologises to the authors and readers for the inconvenience caused by the error.

a 50 breaths/min for children aged 2 to 12 months, 40 breaths/min... more a 50 breaths/min for children aged 2 to 12 months, 40 breaths/min for children aged 12 months to 5 years.b 50 breaths/min for all children (aged 2 months to 5 years).c No cough or difficult breathing, no diarrhea, no ear problem, no measles, no infected skin lesion or lump.Key differences between the IMCI and the new ALgorithm for the MANAgement of Childhood illness (ALMANACH) (section dedicated to the management of acute conditions in children aged 2 months to 5 years).</p

* 10 patients received antibiotics from study clinicians during working hours and 9 from... more * 10 patients received antibiotics from study clinicians during working hours and 9 from routine clinicians out of working hours.Clinical outcome and antimicrobials prescribed in children managed by ALMANACH and standard practice.</p

*Out of working hours, the patient was evaluated and managed by a routine clinician of t... more *Out of working hours, the patient was evaluated and managed by a routine clinician of the HF rather than the study clinician.&This patient is the same as patient n°22 in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0132316#pone.0132316.t004" target="_blank">Table 4</a>.Characteristics of the 19 patients who received antibiotics during re-attendance in the ALMANACH arm.</p

* Diagnosis given by clinicians when they do not classify further the respiratory infect... more * Diagnosis given by clinicians when they do not classify further the respiratory infection.</p

Applied clinical informatics, 2011

Electronic medication administration records (eMARs) have been widely used in recent years. Howev... more Electronic medication administration records (eMARs) have been widely used in recent years. However, formal usability evaluations are not yet available for these vendor applications, especially from the perspective of nurses, the largest group of eMAR users. To conduct a formal usability evaluation of an implemented eMAR. Four evaluators examined a commercial vendor eMAR using heuristic evaluation techniques. The evaluators defined seven tasks typical of eMAR use and independently evaluated the application. Consensus techniques were used to obtain 100% agreement of identified usability problems and severity ratings. Findings were reviewed with 5 clinical staff nurses and the Director of Clinical Informatics who verified findings with a small group of clinical nurses. Evaluators found 60 usability problems categorized into 233 heuristic violations. Match, Error, and Visibility heuristics were the most frequently violated. Administer Medication and Order and Modify Medications tasks h...

AMIA Annual Symposium Proceedings, Apr 16, 2018

Documentation processes have changed substantially with EHR adoption. User satisfaction studies h... more Documentation processes have changed substantially with EHR adoption. User satisfaction studies have focused on usability or cognitive analysis perspectives. Few studies have provided useful information to developers to improve designs. The purpose of this study is to report a 3-pronged approach to deepen understanding of the documentation process, with the intent to provide useful information for future design. This study was conducted in two phases, beginning with cognitive task interviews and observations, followed by post-observation interviews. Twenty-five constructs were identified across the phases, and we observed several patterns of note writing. Participants provided useful information to potentially inform future design. Our study illustrates how electronic documentation serves many clinical processes and is at the core of the medical record. Providers need multiple kinds of notes and ways to display notes. In order to meet provider goals, we must completely re-think the ...

AMIA ... Annual Symposium proceedings. AMIA Symposium, 2017

Global Health Communication, 2015

In Tanzania, significant effort has been made to reduce under-5 mortality rates, and the efforts ... more In Tanzania, significant effort has been made to reduce under-5 mortality rates, and the efforts have been somewhat successful in recent years. Many factors have contributed to the success, such as using standard treatment protocols for sick children. Using mobile technology has become increasingly popular in health care delivery. This study examines whether the use of mobile technology can leverage a standardized treatment protocol to improve the effect of counseling for children's caretakers and result in better understanding of what needs to be done at home after the clinical visit. A randomized cluster design was used in clinics in Dar es Salaam, Tanzania. Children were treated using either test electronic protocols (eIMCI) or control paper (pIMCI) protocols. Providers using the eIMCI protocol were shown to counsel the mother significantly more frequently than providers using the pIMCI protocol. Caretakers receiving care by providers using the eIMCI protocol recalled reporting significantly more problems and advice concering when to return and medications than those receiving care by providers using the pIMCI protocol. There was no significant difference among caretakers regarding the frequency and duration of administering medications. This study indicates the use of mobile technology is an important aide in increasing the delivery and recall of counseling messages. Address correspondence to

Journal of the American Medical Informatics Association : JAMIA, Nov 27, 2016

First, to evaluate the effect of standard vs pictograph-enhanced discharge instructions on patien... more First, to evaluate the effect of standard vs pictograph-enhanced discharge instructions on patients' immediate and delayed recall of and satisfaction with their discharge instructions. Second, to evaluate the effect of automated pictograph enhancement on patient satisfaction with their discharge instructions. Glyph, an automated healthcare informatics system, was used to automatically enhance patient discharge instructions with pictographs. Glyph was developed at the University of Utah by our research team. Patients in a cardiovascular medical unit were randomized to receive pictograph-enhanced or standard discharge instructions. Measures of immediate and delayed recall and satisfaction with discharge instructions were compared between two randomized groups: pictograph (n = 71) and standard (n = 73). Study participants who received pictograph-enhanced discharge instructions recalled 35% more of their instructions at discharge than those who received standard discharge instructio...

Patient Education and Counseling, 2015

Information technology supporting patient self-management has the potential to foster shared acco... more Information technology supporting patient self-management has the potential to foster shared accountability for healthcare outcomes by improving patient adherence. There is growing interest in providing alerts and reminders to patients to improve healthcare self-management. This paper describes a literature review of automated alerts and reminders directed to patients, the technology used, and their efficacy. An electronic literature search was conducted in PubMed to identify relevant studies. The search produced 2418 abstracts; 175 articles underwent full-text review, of which 124 were rejected. 51 publications were included in the final analysis and coding. The articles are partitioned into alerts and reminders. A summary of the analysis for the 51 included articles is provided. Reminders and alerts are advantageous in many ways; they can be used to reach patients outside of regular clinic settings, be personalized, and there is a minimal age barrier in the efficacy of automated reminders sent to patients. As technologies and patients&amp;#39; proficiencies evolve, the use and dissemination of patient reminders and alerts will also change. Automated technology may reliably assist patients to adhere to their health regimen, increase attendance rates, supplement discharge instructions, decrease readmission rates, and potentially reduce clinic costs.

PLOS ONE, 2015

The decline of malaria and scale-up of rapid diagnostic tests calls for a revision of IMCI. A new... more The decline of malaria and scale-up of rapid diagnostic tests calls for a revision of IMCI. A new algorithm (ALMANACH) running on mobile technology was developed based on the latest evidence. The objective was to ensure that ALMANACH was safe, while keeping a low rate of antibiotic prescription. Consecutive children aged 2-59 months with acute illness were managed using ALMANACH (2 intervention facilities), or standard practice (2 control facilities) in Tanzania. Primary outcomes were proportion of children cured at day 7 and who received antibiotics on day 0. 130/842 (15∙4%) in ALMANACH and 241/623 (38∙7%) in control arm were diagnosed with an infection in need for antibiotic, while 3∙8% and 9∙6% had malaria. 815/838 (97∙3%;96∙1-98.4%) were cured at D7 using ALMANACH versus 573/623 (92∙0%;89∙8-94∙1%) using standard practice (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0∙001). Of 23 children not cured at D7 using ALMANACH, 44% had skin problems, 30% pneumonia, 26% upper respiratory infection and 13% likely viral infection at D0. Secondary hospitalization occurred for one child using ALMANACH and one who eventually died using standard practice. At D0, antibiotics were prescribed to 15∙4% (12∙9-17∙9%) using ALMANACH versus 84∙3% (81∙4-87∙1%) using standard practice (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0∙001). 2∙3% (1∙3-3.3) versus 3∙2% (1∙8-4∙6%) received an antibiotic secondarily. Management of children using ALMANACH improve clinical outcome and reduce antibiotic prescription by 80%. This was achieved through more accurate diagnoses and hence better identification of children in need of antibiotic treatment or not. The building on mobile technology allows easy access and rapid update of the decision chart. Pan African Clinical Trials Registry PACTR201011000262218.

Journal of Communication in Healthcare, 2015

Journal of Mobile Technology in Medicine, 2012

ABSTRACT Introduction: Using information technology has become an integral component of the healt... more ABSTRACT Introduction: Using information technology has become an integral component of the health care workplace. Advanced practice nurses entering the field must be prepared to utilize emerging technologies. Current requirements mandate that preparation in the use of information systems must be assimilated into Nurse Practitioner education (AACN, 2006). Incorporating the use of electronic health records (EHR) in hi-fidelity educational simulation cases will enable students to learn how EHR technology may enhance their practice. However, there is a dearth of available literature that describes the process of creating such simulation cases. The purpose of this project was to analyze the process of enhancing hi-fidelity Nurse Practitioner educational simulation with EHR. Methods: Key informant interviews and analysis of existing hi-fidelity simulation cases identified critical components of the enhancement process. Simulation case data were evaluated to determine the optimal EHR content that reflected the desired educational outcomes. Case study information was entered into the EHR in collaboration with hi-fidelity simulation mannequin programmers to direct the flow of the case. Issues with the process and areas of enhancement were indentified. Results: The process of enhancing a simulation case with EHR was defined as beginning when a faculty member established a case and ending when the simulation was ready to run. A crucial step in the process was to differentiate what data were parts of the case history (EHR data) versus what data needed to be discovered by the student at the time of simulation. The simulation needed to reflect the physical aspects of the case, and a realistic progressive flow of information. Additional barriers and results are further described. Implications for nurses: Information system competencies are a critical element of evidence-based practice (Curran, 2003). Currently, requirements of essential advanced practice nursing education mandate that academic institutions incorporate information technology into their curricula (AACN, 2006). Enhancing hi-fidelity simulation cases with the addition of an EHR component is a simple process that any institution can implement, and is one step toward achieving current educational mandates. Curran, C. (2003). Informatics competencies for nurse practitioners. AACN Clinical Issues, 14(3), 320-330. American Association of Colleges of Nursing [AACN]. (2006). The essentials of doctoral education for advanced nursing practice. Retrieved 10/1/2008 from http://www.aacn.nche.edu/dnp/pdf/Essentials.pdf Your uploaded file(s): * EHR NP Sim.doc (29.5KB) - Project paper

Journal of the American Medical Informatics Association, Nov 1, 2014

Objective We developed a novel computer application called Glyph that automatically converts text... more Objective We developed a novel computer application called Glyph that automatically converts text to sets of illustrations using natural language processing and computer graphics techniques to provide high quality pictographs for health communication. In this study, we evaluated the ability of the Glyph system to illustrate a set of actual patient instructions, and tested patient recall of the original and Glyph illustrated instructions.