Use of Social Media for Healthcare Professionals Article Summary

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Use APA style when writing your review. review_article_unit_6.pdf DIGITAL HEALTH Review Article The use of social media among health professionals to facilitate chronic disease self-management with their patients: A systematic review Digital Health Volume 4: 1–13 ! The Author(s) 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/2055207618771416 journals.sagepub.com/home/dhj Gino De Angelis1 , George A Wells2, Barbara Davies3 , Judy King1, Shirin M Shallwani1, Jessica McEwan4, Sabrina Cavallo5 and Lucie Brosseau1,2 Abstract Objective: The objective of this systematic review was to summarize the evidence pertaining to the use of social media by health professionals to facilitate chronic disease self-management with their patients. Methods: A systematic approach was used to retrieve and extract relevant data. A total of 5163 citations were identified, of which seven unique studies met criteria for inclusion; one was a randomized controlled trial, two were prospective cohort studies, and four were qualitative studies. The following social media platforms were evaluated: discussion forums (6 studies) and collaborative project (1 study). Results: The available evidence suggests that health professionals perceived discussion forums and collaborative projects to be useful social media platforms to facilitate chronic disease self-management with patients. No relevant evidence was found regarding the use of other social media platforms. Most studies indicated positive findings regarding health professionals’ intention to use discussion forums, while the one study that used a collaborative project also indicated positive findings with its perceived ease of use as health professionals felt that it was useful to facilitate chronic disease selfmanagement with patients. Mixed findings were seen in regards to health professionals’ perceived ease of use of discussion forums. Use of Social Media for Healthcare Professionals Article Summary The most common barrier to using social media platforms was the lack of time in health professionals’ schedules. Conclusions: Discussion forums and collaborative projects appear to be promising resources for health professionals to assist their patients in self-managing their chronic conditions; however, further research comparing various social media platforms is needed. Keywords Social media, chronic disease, self-management, dissemination, evidence-based practice, patient education Submission date: 12 August 2017; Acceptance date: 21 March 2018 Introduction The prevalence rates of major chronic diseases among Canadian adults continue to increase, and the population over 65 years of age is growing almost four times greater than the overall population.1 Chronic disease has also resulted in signi?cant use of health care services as adults with multiple chronic diseases account for over two-thirds of health care spending.2 Given that 1 School of Rehabilitation Sciences, University of Ottawa, Canada School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada 3 School of Nursing, University of Ottawa, Canada 4 Health Sciences Library, University of Ottawa, Canada 5 School of Rehabilitation, Universite? de Montre?al, Canada 2 Corresponding author: Gino De Angelis, School of Rehabilitation Sciences, University of Ottawa, 451 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada. Email: [email protected] Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https:// us.sagepub.com/en-us/nam/open-access-at-sage). 2 more Canadians are living longer with chronic diseases,1 there is a need for health professionals to promote evidence-based self-management support to their patients. In an e?ort to improve joint partnerships between health professionals and patients for the collaborative care of chronic diseases, health professionals are supplementing traditional patient education by providing technical skills and information allowing their patients to self-manage their chronic conditions.3 Self-management support, such as the provision of personalized feedback, creation of small action plans and goal setting, enlisting social support, and determining goal achievement,4 allows health professionals to complement traditional patient education.3 Selfmanagement support may allow patients to make appropriate decisions and manage their conditions through the use of technical skills and information to identify problems. Use of Social Media for Healthcare Professionals Article Summary 3 There remains a lack of clarity on how health professionals can optimally enhance self-management support5 while addressing many challenges associated with provision including limited time and di?culties with ensuring patients are willing and able to understand instructions.6 New methods to provide successful selfmanagement support to patients are therefore needed to minimize resource demand and improve patient education. Self-management support can be enhanced by online information and communication technologies (ICTs) as chronic disease patients are increasingly using them to access health information7 and these tools appear to be a promising resource allowing new strategies for patients and health professionals to communicate with one another and to educate themselves.8,9 Online ICTs, such as social media, have the potential to reach a broad population,10 and allow for improved social support and knowledge acquisition.10,11 Furthermore, online self-management interventions have been associated with improvements in health behaviors and health status among older patients with chronic diseases.7 Social media have been de?ned as ‘‘a group of online applications that allow for the creation and exchange of content generated by users’’ (p. 1376)12 and have been categorized into the following groups: collaborative projects, content communities, blogs or microblogs, social networking sites, virtual gaming or social worlds,13 and online discussion forums.12 Collaborative projects (e.g., Wikipedia) are ‘‘websites which allow users to add, remove, and change textbased content’’ and ‘‘enable the joint and simultaneous creation of content by many end-users’’ (p. 62).13 Content communities (e.g., YouTube) allow users to share media content such as videos, text, photographs, and presentations.13 Blogs and microblogs (i.e., DIGITAL HEALTH Twitter) are speci?c websites that come in di?erent formats such as reviews of relevant information in one content area, to personal memoirs.13 These forms of social media are typically managed by one individual13 and are usually displayed by date-stamped entries.14 Social networking sites (e.g., Facebook) are ‘‘applications that enable users to connect by creating personal information pro?les, inviting friends and colleagues to have access to those pro?les, and sending e-mails and instant messages between each other’’ (p. 63).13 Virtual game worlds (e.g., Second Life) are ‘‘platforms that replicate a three dimensional environment in which users can appear in the form of personalized avatars and interact with each other as they would in real life’’ Use of Social Media for Healthcare Professionals Article Summary (p. 64), while virtual social worlds ‘‘allow inhabitants to choose their behavior more freely and essentially live a virtual life similar to their real life’’ (p. 64).13 Online discussion forums, sometimes referred to as bulletin boards, allow users to have conversations using posted messages, and have been considered a form of social media as they incorporate user-generated content.12 Social media have demonstrated to be a potentially successful resource tool for patients to self-manage their chronic conditions as it has provided them with empowerment,15 improved health indicators,9 and enhanced patient knowledge and con?dence.16 Social media use among health professionals has also increasingly become popular17,18 and has engaged learners and disseminated accurate information to enhance education.17,19,20 Social media allows for multimedia-sharing (e.g., disease management videos, podcasts and wikis) and has also shown to facilitate public health promotion21 and respond to public health concerns.22 While evidence shows that health professionals are using social media more regularly,17,18 and with a growing need to improve self-management strategies for patients, there is a lack of clarity regarding its use for chronic disease management and the role played by health professionals.9 This systematic review was designed to address this knowledge gap. The objective of this systematic review was to summarize the evidence pertaining to the use of social media by health professionals to facilitate chronic disease self-management with their patients. Speci?cally, the aim of this systematic review was to provide new knowledge on health professionals’ perceived usability and change in practice behavior when using social media to assist patients in self-managing their chronic conditions. Methods This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews De Angelis et al. and Meta-Analyses (PRISMA) guidelines.23 To summarize the evidence, a systematic approach was adopted to retrieve relevant papers from the literature. Articles were selected for this review using the prede?ned selection criteria guided by population, intervention, comparison, outcome, and study design (PICOS) in Table 1. Studies were excluded if they did not meet the selection criteria (Table 1). Duplicate publications, narrative reviews, case series, case reports, data presented in abstract form only, conference proceedings, study protocols, and publications not written in English were also excluded. Use of Social Media for Healthcare Professionals Article Summary Search strategy The literature search was performed by an information specialist. Published literature was identi?ed by searching the following bibliographic databases up to April 2016: Medline, Cochrane Central Register of Controlled Trials, Embase, CINAHL, ERIC, and PsycINFO. The search was performed using terms to identify peer-reviewed research in which social media and chronic disease self-management were important features (see Supplementary Appendix 1). Gray literature (literature that is not commercially published) was conducted by searching Google and other internet search engines to identify any additional web-based Table 1. Selection criteria for systematic review. Population Health professionals (e.g., physicians, nurses, dieticians) Intervention Chronic disease self-management programs disseminated using social media platforms (i.e., collaborative project, blog or microblog, content community, social networking site, virtual world, discussion forum) Comparator Other social media platforms Information and communication technologies (e.g., email, websites) No comparator Outcome Usability (e.g., perceived usefulness and ease of use) Practice behavior change (e.g. barriers, knowledge, skills, social/professional role and identity, optimism, beliefs about capabilities, beliefs about consequences, intentions, memory/attention/decision, environmental context and resources, social influences, and emotion) Study Design Randomized controlled trials (RCTs), non-randomized comparative controlled trials (CCTs), observational studies, qualitative studies 3 publications. In addition, the searches were supplemented by hand searching the bibliographies of key papers. A date limit of 2004 onwards was placed to ensure the most relevant social media technologies were included. Two reviewers independently screened the titles and abstracts of all citations retrieved from the literature search using Covidence (www.covidence.org), an online systematic review tool. Independent reviews of the full-text articles were then performed based on the selection criteria. Disagreements were resolved through discussion until consensus was reached. The study selection process is presented in a PRISMA ?ow diagram (Figure 1). Descriptive data were extracted by one reviewer for each eligible article. The extraction was subsequently veri?ed by a second reviewer. Data extraction forms were designed a priori to document and tabulate relevant study and patient characteristics, study ?ndings and authors’ conclusions. Data from ?gures were not used if they were not explicit. Studies were categorized by the type of social media intervention used as categorized by Hamm et al.12 (Table 2). Given the broad inclusion criteria and heterogeneity of the interventions and methodological characteristics of included studies (PICOS), a meta-analysis was deemed inappropriate, and a narrative synthesis and summary of study ?ndings was therefore conducted. Use of Social Media for Healthcare Professionals Article Summary The outcomes of interest included the usability of social media platforms for chronic disease self-management and practice behavior change among health professionals (Table 1). Quality appraisal of the selected literature One reviewer independently assessed the quality of each study using the Scottish Intercollegiate Guidelines Network (SIGN 50) tool for cohort studies and randomized controlled trials (RCTs),24 and the Critical Appraisal Skills Programme (CASP) tool25 for qualitative studies, which was subsequently checked for accuracy by a second reviewer. Disagreements were resolved through consensus. Risk of bias was assessed at the study level. Summary scores were not calculated, rather the strengths and limitations of each included study were described (see Supplementary Appendix 3). Usability The usability outcomes were guided by the Technology Acceptance Model (TAM2)26 which illustrates that behavior intention to use a system is determined by perceived usefulness and perceived ease of use. Perceived usefulness is de?ned by Venkatesh and Davis26 as ‘‘the extent to which a person believes that DIGITAL HEALTH Identification 4 Records identified through database searching (n = 5,163) Additional records identified through other sources (n = 0) Included Eligibility Screening Records after duplicates removed (n = 4,117) Records screened (n = 4,117) Full-text articles assessed for eligibility (n = 178) Records excluded (n = 3,939) Full-text articles excluded, with reasons (n = 170) Population (24) Intervention (67) Study Design (13) Abstract (66) Studies included in synthesis (n = 8 publications representing 7 unique studies) Figure 1. PRISMA flow diagram of included studies. using the system will enhance his/her job performance’’ (p. 187), and perceived ease of use is de?ned as ‘‘the extent to which a person believes that using the system will be free of e?ort’’ (p. 187). and (l) nature of the behavior. Practice behavior outcomes were categorized by the domains listed above. Practice behavior Results Included studies Practice behavior change outcomes were guided by the Theoretical Domains Framework (TDF).27 The TDF identi?es numerous behavior constructs and consists of 12 domains: (a) knowledge; (b) skills; (c) social/professional role and identity; (d) beliefs about capabilities; (e) beliefs about consequences; (f) motivation and goals; (g) memory, attention and decision processes; (h) environmental context and resources; (i) social in?uences; (j) emotion regulation; (k) behavioral regulation; A total of 5163 citations were identi?ed through the initial database search. After removing duplicates, 4117 publication abstracts and titles were screened. The full texts of 178 articles were assessed; of these, 170 were excluded for the following reasons: irrelevant population (24 studies), irrelevant intervention (67 studies), inappropriate study design (13 studies), and presented as abstract only (66 studies). Two publications28,29 present on ?ndings from one unique study. Qualitative Qualitative Qualitative Nordfeldt S (2012), Sweden Nordqvist C (2009), Sweden Oh H (2011), Use of Social Media for Healthcare Professionals Article Summary Republic of South Korea Wiecha J (2015), United States Online survey, multi-center Prospective cohort Gupta S (2011) and Gupta (2012), Canada, United States, Australia Survey, multi-center Face-to-face or telephone interview, or email communication, single-center Telephone interview, single-center (clinic) Online survey/essay (setting/location not specified) Online survey, multi-center Qualitative Anttila M (2008), Finland Online survey, mailed survey and interviews (location not specified) Data collection Prospective cohort Study design Anhøj J (2004), Denmark Author (year), country Table 2. Characteristics of included studies. Asthma Gout Primary care providers from community health centers, a medical center, and other practices n ¼ 14 An expert panel consisting of four physicians, one out-patient nurse, and 20 in-patient nurses n ¼ 25 Members of two diabetes teams, including seven physicians, eight nurse specialists in diabetes, one nurse, two dieticians, and two social welfare officers n ¼ 20 Members of two pediatric diabetes care teams, including physicians, nurses, dieticians, and a social welfare officer n ¼ 18 Diabetes Diabetes Pulmonologists, primary care physicians, and certified asthma educators from academic and community clinics. Development stage: n ¼ 16; wiki stage: n ¼ 35 Nurses working on nine acute wards in two psychiatric hospitals n ¼ 56 Health care providers that according to the manufacturer’s (AstraZeneca) customer database had received a user name and password for LinkMedica. Survey: n ¼ 131; interview: n ¼ 5 Participants (sample) Asthma Chronic mental illness (psychiatric care) Asthma Chronic disease Discussion forum Discussion forum Discussion forum Discussion forum Collaborative project 6 months Not specified 1 year Not specified 3 weeks 1 month (duration) 1-year follow-up post intervention 1 month Discussion forum Discussion forum Duration/follow-up Social media intervention De Angelis et al. 5 6 The excluded studies are listed in Supplementary Appendix 2. The PRISMA ?ow diagram is shown in (Figure 1). Of the seven unique studies that were included in our systematic review, one was an RCT,30 two were prospective cohort studies,28,29,31 and four were qualitative studies.9,32—34 In regards to the types of social media platforms, six studies9,30—34 assessed discussion forums while one study assessed a collaborative project.28,29 The included studies were conducted in Denmark,31 Finland,32 Canada,28,29 United States,28—30 28,29 34 Australia, Republic of Korea, and Sweden.9,33 The following chronic conditions were assessed: asthma,28—31 chronic mental illness,32 diabetes,9,33 and gout.34 The following health professionals were represented in the included studies: nurses working in acute psychiatric wards,32 diabetes nurses,9,33 out-patient arthritis nurses,34 in-patient arthritis nurses,34 >asthma nurse,30 pulmonologists,28—30 primary care physicians,9,28—31,33,34 certi?ed asthma educators,28,29 and dieticians. Use of Social Media for Healthcare Professionals Article Summary 9,33 Further details regarding the included study characteristics can be found in Table 2. DIGITAL HEALTH assessments were only conducted at one time point. While no e?ort was made to minimize confounding or risk of bias in Anhøj et al.,31 focus groups and development testing was used to identify barriers and analyses were strati?ed by type of health professional in Gupta et al.28,29 There was a clear statement of the aim of the research in all four qualitative studies.9,32—34 The qualitative methodology was appropriate in three studies9,32,33; however, it was unclear whether the methodology used in the study by Oh et al.34 was appropriate as it was based on a structured interview with only one open-ended question. While Nordqvist et al.9 clearly described their reasoning why qualitative methods were used, the o … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10