Development of an Online Contraceptive Decision Aid for Transgender and Gender-Nonconforming Assigned Female at Birth Individuals

Description

Transgender and gender-nonconforming assigned female at birth (AFAB) individuals are consistently excluded when discussing sexual health and contraceptive methods and face unique challenges in accessing sexual healthcare as gender dysphoria heavily influences their decision-making process as well as fear of…

Transgender and gender-nonconforming assigned female at birth (AFAB) individuals are consistently excluded when discussing sexual health and contraceptive methods and face unique challenges in accessing sexual healthcare as gender dysphoria heavily influences their decision-making process as well as fear of discrimination from healthcare providers and settings. The research aim of this project is to develop an online contraceptive decision aid tailored to transgender and gender-nonconforming AFAB individuals. MyChoiceForAll is built using the gaps identified in healthcare research and existing resources provided by Planned Parenthood and Bedsider, alongside feedback from a development focus group. The tool is a four-paged quiz that returns two pages of information and resources for a variety of different contraceptive methods for transgender and gender-nonconforming AFAB individuals as well as connecting them to trans-friendly providers. The evaluation phase includes simulated test cases, a survey, and a second focus group to assess for accuracy, usefulness, usability, and general impressions of the tool. 94.3% of the 105 test cases resulted in an accurate recommendation that aligns with user input. Over 75.00% of survey participants overwhelmingly believed the MyChoiceForAll tool to be beneficial in providing appropriate and inclusive educational material about contraceptives, prompting users for relevant lifestyle, preferences, and gender identity decision factors, and being overall inclusive of users’ gender identity. Evaluation focus group participants believe that MyChoiceForAll performs better overall compared to the Planned Parenthood quiz, Bedsider matrix, and MyContraceptiveChoice in general impressions and inclusivity of transgender and gender-nonconforming individuals and their preferences. In conclusion, MyChoiceForAll accomplishes its goal of developing an accessible and inclusive resource for transgender and gender-nonconforming AFAB individuals in assisting with the birth control selection process.

Date Created
2023-05
Agent

Prototype Decision-Making Tool to Facilitate Patient Selection of a Refractive Eye Surgery Modality

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Description
To address the need for a patient decision aid for refractive eye surgery, EyeChoose, a web-based tool, was developed. The tool provides patient education, assists in selection of a specific surgical modality, generates customized recommendations, and links patients to local…

To address the need for a patient decision aid for refractive eye surgery, EyeChoose, a web-based tool, was developed. The tool provides patient education, assists in selection of a specific surgical modality, generates customized recommendations, and links patients to local surgeons, explicitly targeting the population of college students. I conducted a focus group interview for the needs assessment. I designed a scoring algorithm to provide a customized recommendation of surgical modalities based on a patient’s medical history and personal preferences. I completed a prototype implementation of the tool. Initial data from a validation study indicated that the system achieved 99.18% accuracy in its recommendation of a surgical modality. An evaluation of usefulness and usability, conducted via survey and focus group, also illustrated highly positive responses. Fourteen of sixteen statements in the survey received more than 80% of positive responses. I further examined the two statements that received less than 80% of positive responses to determine whether the responses varied by race, ethnicity, sex, and medical history. The focus group liked the application and found it useful for their needs. Their responses clarified features of the application that users liked/found beneficial and features that users did not like/did not find beneficial. These recommendations will be integrated into the tool as the next step. Future research is required to implement the tool in naturalistic settings and to examine the generalizability of the findings to other populations.
Date Created
2022-05
Agent

EHR-mediated Workflow Analysis and Optimization Framework in PreOp Settings

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Description
Perioperative care has a direct and crucial impact on patient safety and patient outcomes, as well as the financial viability of the healthcare facility. The time pressure and workload of caring patients facing surgery are heavier than caring inpatients of…

Perioperative care has a direct and crucial impact on patient safety and patient outcomes, as well as the financial viability of the healthcare facility. The time pressure and workload of caring patients facing surgery are heavier than caring inpatients of other departments. This workload raises requirements for PreOp nurses, the primary PreOp caregiver, to complete information gathering, screening, and verification tasks accurately and efficiently. EHRs (Electronic Health Record System) have evolved continuously with increasing features to meet newly raised needs and expectations. Many healthcare institutions have undergone EHR conversion since the introduction of first-generation EHRs. Thus, the need for a systematic evaluation of changed information system workflow following conversion is becoming more and more manifest. There are a growing number of methods for analyzing health information technology use. However, few studies provide and apply a standard method to understand the impact of EHR transition and inspire opportunities for improvement. This dissertation focuses on PreOp nurse’s EHR use in PreOp settings. The goals of this dissertation are to: (a) introduce a systematic framework to evaluate EHR-mediated workflow and the impact of the EHR transition; (b) understand the impact of different EHR systems on PreOp nurse’s workflow and preoperative care efficiency; (c) transform the evaluation results into practical user-centered EHR designs. This research draws on computational ethnography, cognitive engineering process and user-centered design concepts to build a practical approach for EHR transition-related workflow evaluation and optimization. Observational data were collected before and after a large-scale EHR conversion throughout Mayo Clinic’s different regional health systems. For a structured computational evaluation framework, the time-efficiency of PreOp nurses’ work were compared quantitatively by means of coding and segmenting nurses’ tasks. Interview data provided contextual information, reflecting practical challenges and opportunities before and after the EHR transition. The total case time, the time spent on EHR, and the task fragmentation were improved after converting to the new EHR system. A trend of standardization of information-related workflow and EHR transition was observed. Notably, the approach helped to identify current new system challenges and pointed out potential optimization solutions.
Date Created
2021
Agent

My Contraceptive Choice: A Decision Support Tool for College Women

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Description

Contraceptive methods are vital in maintaining women’s health and preventing unintended pregnancy. When a woman uses a method that reflects her personal preferences and lifestyle, the chances of low adoption and misuse decreases. The research aim of this project is…

Contraceptive methods are vital in maintaining women’s health and preventing unintended pregnancy. When a woman uses a method that reflects her personal preferences and lifestyle, the chances of low adoption and misuse decreases. The research aim of this project is to develop a web-based decision aid tailored to college women that assists in the selection of contraceptive methods. For this reason, My Contraceptive Choice (MCC) is built using the gaps identified in existing resources provided by Planned Parenthood and Bedsider, along with feedback from a university student focus group. The tool is a short quiz that is followed by two pages of information and resources for a variety of different contraceptive methods commonly used by college women. The evaluation phase of this project includes simulated test cases, a Google Forms survey, and a second focus group to assess the tool for accuracy and usability. From the survey, 130 of the 150 (80.7%) responses believe that the recommendations provided can help them select a birth control method. Furthermore, 136 of the 150 (90.0%) responses believe that the layout of the tool made it easy to navigate. The second focus group feedback suggests that the MCC tool is perceived to be accurate, usable, and useful to the college population. Participants believe that the MCC tool performs better overall compared to the Planned Parenthood quiz in creating a customized recommendation and Bedsider in overall usability. The test cases reveal that there are further improvements that could be made to create a more accurate recommendation to the user. In conclusion, the new MCC tool accomplishes the aim of creating a beneficial resource to college women in assisting with the birth control selection process.

Date Created
2021-05
Agent

Utilization of automated location tracking for clinical workflow analytics and visualization

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Description
The analysis of clinical workflow offers many challenges to clinical stakeholders and researchers, especially in environments characterized by dynamic and concurrent processes. Workflow analysis in such environments is essential for monitoring performance and finding bottlenecks and sources of error. Clinical…

The analysis of clinical workflow offers many challenges to clinical stakeholders and researchers, especially in environments characterized by dynamic and concurrent processes. Workflow analysis in such environments is essential for monitoring performance and finding bottlenecks and sources of error. Clinical workflow analysis has been enhanced with the inclusion of modern technologies. One such intervention is automated location tracking which is a system that detects the movement of clinicians and equipment. Utilizing the data produced from automated location tracking technologies can lead to the development of novel workflow analytics that can be used to complement more traditional approaches such as ethnography and grounded-theory based qualitative methods. The goals of this research are to: (i) develop a series of analytic techniques to derive deeper workflow-related insight in an emergency department setting, (ii) overlay data from disparate sources (quantitative and qualitative) to develop strategies that facilitate workflow redesign, and (iii) incorporate visual analytics methods to improve the targeted visual feedback received by providers based on the findings. The overarching purpose is to create a framework to demonstrate the utility of automated location tracking data used in conjunction with clinical data like EHR logs and its vital role in the future of clinical workflow analysis/analytics. This document is categorized based on two primary aims of the research. The first aim deals with the use of automated location tracking data to develop a novel methodological/exploratory framework for clinical workflow. The second aim is to overlay the quantitative data generated from the previous aim on data from qualitative observation and shadowing studies (mixed methods) to develop a deeper view of clinical workflow that can be used to facilitate workflow redesign. The final sections of the document speculate on the direction of this work where the potential of this research in the creation of fully integrated clinical environments i.e. environments with state-of-the-art location tracking and other data collection mechanisms, is discussed. The main purpose of this research is to demonstrate ways by which clinical processes can be continuously monitored allowing for proactive adaptations in the face of technological and process changes to minimize any negative impact on the quality of patient care and provider satisfaction.
Date Created
2018
Agent
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