Role of Psychosocial Factors and Health Literacy in Pregnant Women’s Intention to Use a Decision Aid for Down Syndrome Screening: A Theory-Based Web Survey

Background: Deciding about undergoing prenatal screening is difficult, as it entails risks, potential loss and regrets, and challenges to personal values. Shared decision making and decision aids (DAs) can help pregnant women give informed and values-based consent or refusal to prenatal screening, but little is known about factors influencing the use of DAs. Objective: The objective of this study was to identify the influence of psychosocial factors on pregnant women’s intention to use a DA for prenatal screening for Down syndrome (DS). We also added health literacy variables to explore their influence on pregnant women’s intention. Methods: We conducted a survey of pregnant women in the province of Quebec (Canada) using a Web panel. Eligibility criteria included age >18 years, >16 weeks pregnant, low-risk pregnancy, and having decided about prenatal screening for the current pregnancy. We collected data based on an extended version of the Theory of Planned Behavior assessing 7 psychosocial constructs (intention, attitude, anticipated regret, subjective norm, descriptive norm, moral norm, and perceived control), 3 related sets of beliefs (behavioral, normative, and control beliefs), 4 health literacy variables, and sociodemographics. Eligible women watched a video depicting the behavior of interest before completing a Web-based questionnaire. We performed descriptive, bivariate, and ordinal logistic regression analyses. Results: Of the 383 eligible pregnant women who agreed to participate, 350 pregnant women completed the Web-based questionnaire and 346 were retained for analysis (completion rate 350/383, 91.4%; mean age 30.1, SD 4.3, years). In order of importance, factors influencing intention to use a DA for prenatal screening for DS were attitude (odds ratio, OR, 9.16, 95% CI 4.02-20.85), moral norm (OR 7.97, 95% CI 4.49-14.14), descriptive norm (OR 2.83, 95% CI 1.63-4.92), and anticipated regret (OR 2.43, 95% CI 1.71-3.46). Specific attitudinal beliefs significantly related to intention were that using a DA would reassure them (OR 2.55, 95% CI 1.73-4.01), facilitate their reflections with their spouse (OR 1.55, 95% CI 1.05-2.29), and let them know about the advantages of doing or not doing the test (OR 1.53, 95% CI 1.05-2.24). Health literacy did not add to the predictive power of our model (P values range .43-.92). Conclusions: Implementation interventions targeting the use of a DA for prenatal screening for DS by pregnant women should address a number of modifiable factors, especially by introducing the advantages of using the DA (attitude), informing pregnant women that they might regret not using it (anticipated regret), and presenting the use of DAs as a common practice (descriptive norm). However, interventions on moral norms related to the use of DA should be treated with caution. Further studies that include populations with low health literacy are needed before decisive claims can be made.
Journal of Medical Internet Research

Aanbod patiëntportalen ziekenhuizen nu inzichtelijk op website

​​​In augustus heeft Nictiz de resultaten van een onderzoek naar het gebruik van patiëntportalen door ziekenhuizen in Nederland gepubliceerd. De resultaten zijn nu ook beschikbaar via de website www.hoeonlineisjouwziekenhuis.nl Op de website kunnen ziekenhuizen op eenvoudige wijze bekijken hoe hun online patiënten-dienstverlening zich verhoudt tot die van andere ziekenhuizen. 

Inhaalslag

Ziekenhuizen zijn met een inhaalslag bezig, want enkele jaren geleden waren er nauwelijks nog portalen. In 2016 hebben 22 van de 82 ziekenhuizen een patiëntportaal. Dit is iets meer dan een kwart. 

Mogelijkheden verschillend

Het is opvallend dat de mogelijkheden die de portalen bieden zeer verschillend zijn. Academische ziekenhuizen bieden de meest uitgebreide mogelijkheden aan. Ook regionaal zijn er flinke verschillen. Zo had ten tijde van het onderzoek (juli 2016) geen enkel ziekenhuis in Groningen, Zeeland en Limburg een portaal.

​Update

De website zal jaarlijks worden ge-update. Ziekenhuizen die het komende jaar een patiëntportaal lanceren of de mogelijkheden van hun portaal uitbreiden, kunnen dit zelf melden aan Nictiz via info@nictiz.nl onder vermelding van ‘website patiëntportalen ziekenhuizen’.

Nictiz

The Impact of the Internet on Health Consultation Market Concentration: An Econometric Analysis of Secondary Data

Background: Many markets have traditionally been dominated by a few best-selling products, and this is also the case for the health care industry. However, we do not know whether the market will be more or less concentrated when health care services are delivered online (known as E-consultation), nor do we know how to reduce the concentration of the E-consultation market. Objective: The aim of this study was to investigate the concentration of the E-consultation market and how to reduce its concentration through information disclosure mechanisms (online reputation and self-representation). Methods: We employed a secondary data econometric analysis using transaction data obtained from an E-consultation Website (haodf.com) for three diseases (infantile pneumonia, diabetes, and pancreatic cancer) from 2008 to 2015. We included 2439 doctors in the analysis. Results: The E-consultation market largely follows the 20/80 principle, namely that approximately 80% of orders are fulfilled by nearly 20% of doctors. This is much higher than the offline health care market. Meanwhile, the market served by doctors with strong online reputations (beta=0.207, P<.001) or strong online self-representation (beta=0.386, P<.001) is less concentrated. Conclusions: When health care services are delivered online, the market will be more concentrated (known as the “Superstar” effect), indicating poor service efficiency for society as a whole. To reduce market concentration, E-consultation websites should provide important design elements such as ratings of doctors (user feedback), articles contributed by doctors, and free consultation services (online representation). A possible and important way to reduce the market concentration of the E-consultation market is to accumulate enough highly rated or highly self-represented doctors. Journal of Medical Internet Research

Image from page 372 of “Railway mechanical engineer” (1916)

Image from page 372 of “Railway mechanical engineer” (1916)
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Identifier: railwaymechanica95newy
Title: Railway mechanical engineer
Year: 1916 (1910s)
Authors:
Subjects: Railroad engineering Engineering Railroads Railroad cars
Publisher: New York, N.Y. : Simmons-Boardman Pub. Co
Contributing Library: Carnegie Library of Pittsburgh
Digitizing Sponsor: Lyrasis Members and Sloan Foundation

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es care should betaken to include capital charges both upon the old and newinvestments. Analyses of this character are of the utmost value indetermining whether or not it is wise to make expendituresfor machinery and if prepared in a true businesslike man-ner they will be of great assistance in demonstrating to themanagement just how much can be saved and exactly towhat extent new machinery is justified. Improving a Shop by a Limited Expenditure A Small Production Department Relieves the MachineShop and Insures Maximum Output from New Tools BY G. M. LAWRENCE THERE is little chance for argument about the necessityfor improved shop machinery. Now that the LaborBoard has abolished the National Agreements andlaid down a set of rules which give promise of pavingthe way for industrial peace through local conference andagreement, it is the hope of all shop supervisors that moreconsideration will be given the problem of shop equipment.However natural it is to blame all our troubles on the war

Text Appearing After Image:
Main Rod Brasses, Machined in Shop Order Lots of 30 Pairs and the result of federal control, most shop men know thatthe present lack of efficiency is partly the result of neglectin keeping abreast of the times with needed improvementsin the shop to properly maintain the ever changing loco-motive. For many years, while inventive genius has en-larged and improved the locomotive from a 40 to 60-ton machine to the present magnificent power plant, the shopand terminal facilities for handling the locomotive on alarge number of railroads have practically stood still, leav-ing the inventive mechanic to work out the problem ofmaintenance with equipment 40 years old. Of course someenlargement of terminals, turntables, coaling facilities, etc.,has been made as a result of necessity and electric and oxy-acetylene welding and cutting have been introduced in mostshops, but in too many shop the progress has stopped here.In no department is the neglect more apparent than in themachine shop. To correc

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Livestream Mobile Healthcare 2016 – on demand

livestream

Kijk de livestream terug

Het programma van het uitverkochte Mobile  Healthcare congres 2016 was deels via livestream te zien. Bekijk de livestream terug indien u deze heeft gemist!

Mobile Healthcare 2017

Volgend jaar wordt Mobile Healthcare georganiseerd op 23 november 2017! Wilt u Mobile Healthcare 2017 niet missen en als eerste op de hoogte zijn van programma updates? Laat dan uw gegevens achter!

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Mobile Healthcare Congres & iZone

Vue: slimme bril en activity tracker in één

Vue belooft veel: een bril met een camera-functie, indien gewenst op sterkte, met ingebouwde microfoon en stappenteller, en bovendien een strak ontwerp.

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SmartHealth

Subsidieoproepen lokale aanpak verward gedrag

De eerste 3 subsidieoproepen vanuit het Actieprogramma ‘lokale initiatieven mensen met verward gedrag’ staan online. De deadline voor het indienen van subsidieaanvragen is 6 december 2016 om 14.00 uur.
ZonMw: Nieuws

iOS 10: Je medisch dossier op je iPhone?

Dankzij een upgrade van Apple’s Gezondheid app moet het voor gebruikers makkelijker worden om hun medische dossiers digitaal bij te houden op hun telefoon.

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SmartHealth

Image from page 91 of “Hardware merchandising (August-December 1907)” (1907)

Image from page 91 of “Hardware merchandising (August-December 1907)” (1907)
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Identifier: hardmerchaugdec1907toro
Title: Hardware merchandising (August-December 1907)
Year: 1907 (1900s)
Authors:
Subjects: Hardware industry Hardware Implements, utensils, etc Building
Publisher: Toronto :
Contributing Library: Fisher – University of Toronto
Digitizing Sponsor: Algoma University, Trent University, Lakehead University, Laurentian University, Nipissing University, Ryerson University and University of Toronto Libraries

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THE LONG is the time it wears. It stands the test of heatand frost, wind and rain, and gives your cus-tomers manv years of solid satisfaction. THE SHORT part is the time needed to put it on. A greatdeal of time—which means a great deal ofmoney—is saved to the man who uses SHIELD BRANDREADY ROOFING LOCKERBY ®> McCOMB t>3 SHANNON STREET MONTREAL Sorting the Scrap :>e care fully Not all scrap makes good bar iron—it must hselected to give satisfactory results. London Dar Iron is made only from the choicest scrap,selected by experts. Consumers are unanimous that it has thequality. Orders promptly filled. London Rolling MillsLondon, Canada. n

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Zorgbalans kiest voor glasvezelnetwerk Eurofiber

Ouderenzorgorganisatie Zorgbalans heeft getekend voor de zeer snelle en betrouwbare glasvezelverbindingen van Eurofiber. Met de verbindingen kan Zorgbalans de continuïteit van de ICT-functionaliteit 24/7 garanderen en deze verrijken met nieuwe slimme zorgtoepassingen. Zorgbalans zal het glasvezelnetwerk naar verwachting medio september in gebruik nemen. Zorg op afstand Zorgbalans biedt met 2.700 medewerkers zorg aan ouderen in […]
DigitaleZorg.nl