329 results on '"Drews, Frank"'
Search Results
302. Communications to Promote Interest and Confidence in COVID-19 Vaccines.
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Thorpe, Alistair, Fagerlin, Angela, Drews, Frank A., Butler, Jorie, Stevens, Vanessa, Riddoch, Marian S., and Scherer, Laura D.
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Purpose: Communicating about COVID-19 vaccine side effects and efficacy is crucial for promoting transparency and informed decision-making, but there is limited evidence on how to do so effectively. Design: A within-subjects experiment. Setting: Online survey from January 21 to February 6, 2021. Subjects: 596 US Veterans and 447 non-Veterans. Intervention: 5 messages about COVID-19 vaccine side effects and 4 messages about COVID-19 vaccine efficacy. Measures: COVID-19 vaccine interest (1 = "I definitely do NOT want the vaccine" to 7 = "I definitely WANT the vaccine" with the midpoint 4 = "Unsure"). Confidence about COVID-19 vaccine efficacy (1= "Not at all confident," 2 = "Slightly confident," 3 = "Somewhat confident," 4 = "Moderately confident," 5 = "Extremely confident"). Results: Compared to providing information about side effects alone (M = 5.62 [1.87]), messages with additional information on the benefits of vaccination (M = 5.77 [1.82], P <.001, d z =.25), reframing the likelihood of side effects (M = 5.74 [1.84], P <.001, d z =.23), and emphasizing that post-vaccine symptoms indicate the vaccine is working (M = 5.72 [1.84], P <.001, d z =.17) increased vaccine interest. Compared to a vaccine efficacy message containing verbal uncertainty and an efficacy range (M = 3.97 [1.25]), messages conveying verbal certainty with an efficacy range (M = 4.00 [1.24], P =.042, d z=.08), verbal uncertainty focused on the upper efficacy limit (M = 4.03 [1.26], P <.001, d z =.13), and communicating the point estimate with certainty (M = 4.02 [1.25], P <.001, d z =.11) increased confidence. Overall, Veteran respondents were more interested (M Veterans = 5.87 [1.72] vs M NonVeterans = 5.45 [2.00], P <.001, d =.22) and confident (M Veterans = 4.13 [1.19] vs M NonVeterans = 3.84 [1.32], P <.001, d =.23) about COVID-19 vaccines than non-Veterans. Conclusions: These strategies can be implemented in large-scale communications (e.g., webpages, social media, and leaflets/posters) and can help guide healthcare professionals when discussing vaccinations in clinics to promote interest and confidence in COVID-19 vaccines. [ABSTRACT FROM AUTHOR]
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- 2022
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303. Human Factors Engineering in the Department of Veterans Affairs
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Purcell, Janine, Williams, Linda, Scott, Jeanie, Russ, Alissa, Drews, Frank, and Speir, Ross
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The Department of Veterans Affairs (VA) health care system currently includes 152 medical centers, with at least one in each state, Puerto Rico, and the District of Columbia. VA operates more than 1,400 sites of care, including 909 ambulatory care and community-based outpatient clinics, 135 community living centers (nursing homes), 47 residential rehabilitation treatment programs, 232 Veterans Centers and 108 comprehensive home-care programs. In 2010, the system supported 75.6 million outpatient visits and 679,000 inpatient admissions.1, 2In 1999, the VA National Center for Patient Safety (NCPS) was established to lead the VA’s patient safety efforts and to develop a culture of healthcare safety throughout the Veterans Health Administration. The NCPS program promotes the use of human factors engineering methods that focus on how users interact with technology. Within the Department of Veterans Affairs various organizations have expanded the use of human factors engineering methods as a key element in addressing patient safety from a systems-based perspective. These entities include a range of groups that work in operational and research domains to identify and mitigate root causes of error with traditional medical devices and healthcare information technology to reduce the likelihood of patient harm while continuing to enhance and advance the design of healthcare tools and environments.The expertise of the panel members includes human factors and biomedical engineering, cognitive psychology, information science, healthcare information technology and informatics, and clinical knowledge of medical technology and nursing. Each panelist will briefly introduce the organization they work in, provide an overview of their human factors activities, and briefly describe example(s) of specific projects, with emphasis on the benefit or lessons learned via these activities. Attendees will learn strategies to apply human factors engineering in healthcare and deepen their understanding of human performance challenges in this domain.
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- 2011
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304. Reduction of phone interruptions post implementation of a central call center in community pharmacies of an academic health system.
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Caffiero, Nicole A, Nickman, Nancy A, Drews, Frank A, King, Jordan B, Moorman, Krystal, and Tyler, Linda S
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ACADEMIC medical centers , *DRUGSTORES , *HOSPITAL pharmacies , *MEDICAL prescriptions , *POCKET computers , *TELEPHONES , *DISTRACTION , *HELPLINES - Abstract
Purpose A pharmacy services call center (PSCC) was implemented to centralize pharmacy phone calls and reduce interruptions of dispensing activities in 7 community pharmacies of an academic health center. An evaluation was conducted to define, quantify, and compare the numbers and types of phone interruptions before and 3 months after PSCC implementation. Methods Through structured, direct observation of pharmacy staff, the numbers and types of "breaks in task" (BIT) due to phone interruptions and other distractions were identified. A standardized data collection tool formatted on tablet computers was used by trained observers to document BIT for 3-hour time blocks on 5 consecutive business days (2 days of pharmacist observation and 3 days of technician observation, for a total of 10 observation days per pharmacy). Results Over 5,000 prescriptions were processed during 414 hours of observation (13.3 prescriptions per observation hour). Overall, BIT due to phone interruptions totaled 2.2 BIT per observation hour, with those interruptions reduced by 46.4% overall after PSCC implementation (by 30.0% in 4 small pharmacies and by 57.5% in 3 large pharmacies). Technicians were more likely than pharmacists to be interrupted by phone vs nonphone BIT (eg, distraction by another technician, pharmacist, or patient). Comparison of phone vs nonphone BIT suggested an overall 46.0% reduction in phone BIT in all pharmacies (reductions of 42.4% and 45.0% in large and small pharmacies, respectively). Conclusion PSCC implementation noticeably decreased the amount of phone interruptions and distractions for employees. [ABSTRACT FROM AUTHOR]
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- 2021
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305. The experience and management of fatigue: A study of mine haulage operators.
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Drews, Frank A., Rogers, W. Pratt, Talebi, Elaheh, and Lee, Shantae
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SURFACE transportation industries ,SOMNOLOGY ,HEALTH of miners ,SOCIOTECHNICAL systems ,SLEEP deprivation ,FATIGUE (Physiology) - Abstract
Fatigue is a relatively well-investigated topic in the surface transportation industry with a research focus on sleep deprivation and disruption. This paper examines fatigue in mining operations. While mine operators are using or currently introducing technology to monitor fatigue, there is little work that focuses on the operators' experience of fatigue and the acceptance of fatigue-monitoring technology. Focus groups were conducted to investigate these topics. The results of this research suggest that current fatigue-monitoring systems lack validity, reliability and user acceptance. Overall, these results emphasize the importance of a socio-technical systems perspective to guide interventions aiming at improving miner health and safety. [ABSTRACT FROM AUTHOR]
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- 2020
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306. A video game controller with skin stretch haptic feedback.
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Guinan, Ashley L., Caswell, Nathaniel A., Drews, Frank A., and Provancher, William R.
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- 2013
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307. Veterans and Nonveterans Coping With Stress During 4 Months of COVID-19.
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Butler, Jorie M., Xuechen Wang, Riddoch, Marian, Thorpe, Alistair, Stevens, Vanessa, Scherer, Laura D., Drews, Frank A., Shoemaker, Holly, and Fagerlin, Angela
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STRESS management , *COVID-19 pandemic , *VETERANS , *COVID-19 , *PSYCHOLOGICAL adaptation - Abstract
PURPOSE Identifying how people have been coping with stress during the COVID-19 pandemic allows us to anticipate how the population may react to similar stressors over time. In this study, we assessed patterns of coping styles among veterans and nonveterans, and stability and change in these strategies at 3 time points during the pandemic. METHODS Using an online survey platform, we circulated a questionnaire at 3 time points during the period when COVID-19 vaccines became widely available (December 2-27, 2020; January 21-February 6, 2021; and March 8-23, 2021). The questionnaire asked participants about their extent of use of 11 coping strategies, and symptoms of anxiety and depression. RESULTS A total of 2,085 participants (50.8% veterans) completed the questionnaire at 1 or more time points and 930 participants (62.8% veterans) completed it at all 3 time points. Cluster analysis identified 3 distinct coping styles: adaptive, distressed, and disengaged. Compared with nonveterans, veterans more commonly had adaptive and disengaged coping styles, and less commonly had a distressed coping style. The majority of the cohort (71.3%) changed coping style at least once during the study period. Participants who used the same coping style across all 3 time points reported lower levels of anxiety and depression. CONCLUSIONS Our data demonstrate a need to better understand the dynamic nature of coping with pandemic-level stressors across time. We did not find patterns of change in coping styles, but our findings point to potential advantages of stability in coping style. It is possible that less adaptive styles that are more stable may be advantageous for mental health. This research has implications for supporting patients dealing with stress in family medicine. [ABSTRACT FROM AUTHOR]
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- 2023
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308. Checking the lists: A systematic review of electronic checklist use in health care.
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Kramer, Heidi S. and Drews, Frank A.
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Objective: We conducted a literature search to examine the effects and experiences surrounding the transition from paper to electronic checklists in healthcare settings. We explore the types of electronic checklists being used in health care, how and where they were evaluated and seek to identify the successes and failures of using electronic checklists in healthcare, including use of checklists to ensure completeness of documentation in the electronic medical record.Background: Formalized checklist use as a memory and decision aid in aviation has resulted in significant increases in safety in that domain. Checklists have also been successfully introduced to reduce errors in some areas of healthcare; however, in some contexts checklists failed to provide some of the expected benefits. Adapting and integrating checklists electronically into the healthcare workflow provides opportunities and challenges that need to be better understood to make checklist adoption a success in health care.Method: We conducted a literature search of the English language literature in MEDLINE using PubMed for peer-reviewed literature of implementation and use of electronic or computerized checklists related to clinical or healthcare use. We reviewed the studies and included in this review those papers that discussed in depth the development process and that conducted controlled studies to assess the effectiveness of checklists and the evaluation of their acceptance in the clinical context.Results: The literature search using the keywords electronic checklist OR computerized checklist returned a total of 23 peer-reviewed papers. Out of these 15 were included in the review, with 8 excluded because they did not evaluate checklist use for patient care.Application: More rigorous application of known principles and methods from Human Computer Interaction research and the behavioral sciences can provide a clearer, more comprehensive understanding of the conditions that affect the development and use of checklists. [ABSTRACT FROM AUTHOR]- Published
- 2017
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309. Translation of Contextual Control Model to chronic disease management: A paradigm to guide design of cognitive support systems.
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Leecaster, Molly K., Weir, Charlene R., Drews, Frank A., Hellewell, James L., Bolton, Daniel, Jones, Makoto M., and Nebeker, Jonathan R.
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Background: Electronic health records (EHRs) continue to be criticized for providing poor cognitive support. Defining cognitive support has lacked theoretical foundation. We developed a measurement model of cognitive support based on the Contextual Control Model (COCOM), which describes control characteristics of an "orderly" joint system and proposes 4 levels of control: scrambled, opportunistic, tactical, and strategic.Methods: 35 clinicians (5 centers) were interviewed pre and post outpatient clinical visits and audiotaped during the visit. Behaviors pertaining to hypertension management were systematically mapped to the COCOM control characteristics of: (1) time horizon, (2) uncertainty assessment, (3) consideration of multiple goals, (4) causal model described, and (5) explicitness of plan. Each encounter was classified for overall mode of control. Visits with deviation versus no deviation from hypertension goals were compared.Results: Reviewer agreement was high. Control characteristics differed significantly between deviation groups (Wilcox rank sum p<.01). K-means cluster analysis of control characteristics, stratified by deviation were distinct, with higher goal deviations associated with more control characteristics.Conclusion: The COCOM control characteristics appear to be areas of potential yield for improved user-experience design. [ABSTRACT FROM AUTHOR]- Published
- 2017
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310. IoT-Enabled Wearable Fatigue-Tracking System for Mine Operators.
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Rogers, W. Pratt, Marques, Joao, Talebi, Elaheh, and Drews, Frank A.
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FATIGUE (Physiology) , *PHENOMENOLOGICAL biology , *CORPORATE culture , *TIME measurements , *MUSCLE fatigue , *DROWSINESS - Abstract
This study explores the possibility of investigating operator fatigue via the use of off-the-shelf wearable devices and custom applications. Fatigue is a complex biological phenomenon, and both subjective and objective data are needed to assess it properly. The development of any application and the assessments of fatigue should be guided by psychological insights. The methods used to conceptualize and develop a fatigue-tracking application on a wearable device are presented. Subjective fatigue data are collected using the Karolinska Sleepiness Scale, while the objective data are collected using reaction time measurements. The development and testing of the application are presented in this paper. Data collected with the system suggest that such a system can potentially replace other, more expensive and intrusive approaches to measure fatigue. Future work on IoT applications will need to examine organizational culture and support to assess the effectiveness of such an approach. [ABSTRACT FROM AUTHOR]
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- 2023
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311. ABSTRACTS.
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Bermúdez, Julio, Agutter, Jim, Foresti, Stefano, Westenskow, Dwayne, Syroid, Noah, Drews, Frank, Tashjian, Elizabeth, West, Ruth, Burke, Jeff, Kerfeld, Cheryl, Mendelowitz, Eitan, Holton, Thomas, Lewis, J. P., Drucker, Ethan, Yan, Weihong, Plautz, Dana, Schlick, Tamar, Miranda, Eduardo Reck, Brouse, Andrew, and Krüger, Norbert
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ART & science - Abstract
Presents abstracts of several articles about art and science. "Between Art, Science and Technology," by Julio Bermúdez et al; "New Ideas Emerge When Collaboration Occurs," by Dana Plautz; "Metadesign as an Emergent Design Culture," by Elisa Giaccardi.
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- 2005
312. A New Metaphor to Display Critical Pulmonary Events during Anesthesia.
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Wachter, S Blake, March, James Agutter, Syroid, Noah D, Drews, Frank A, and Westenskow, Dwayne R
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- 2002
313. Communicating about COVID-19 vaccine development and safety.
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Thorpe, Alistair, Fagerlin, Angela, Butler, Jorie, Stevens, Vanessa, Drews, Frank A., Shoemaker, Holly, Riddoch, Marian S., and Scherer, Laura D.
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COVID-19 vaccines , *VACCINE refusal , *VACCINE development , *VACCINE safety , *VACCINATION , *COVID-19 - Abstract
Purpose: Beliefs that the risks from a COVID-19 vaccine outweigh the risks from getting COVID-19 and concerns that the vaccine development process was rushed and lacking rigor have been identified as important drivers of hesitancy and refusal to get a COVID-19 vaccine. We tested whether messages designed to address these beliefs and concerns might promote intentions to get a COVID-19 vaccine. Method: We conducted an online survey fielded between March 8–23, 2021 with US Veteran (n = 688) and non-Veteran (n = 387) respondents. In a between-subjects experiment, respondents were randomly assigned to a control group (with no message) or to read one of two intervention messages: 1. a fact-box styled message comparing the risks of getting COVID-19 compared to the vaccine, and 2. a timeline styled message describing the development process of the COVID-19 mRNA vaccines. Results: Most respondents (60%) wanted a COVID-19 vaccine. However, 17% expressed hesitancy and 23% did not want to get a COVID-19 vaccine. The fact-box styled message and the timeline message did not significantly improve vaccination intentions, F(2,358) = 0.86, p =.425, ηP2 =.005, or reduce the time respondents wanted to wait before getting vaccinated, F(2,306) = 0.79, p =.453, ηP2 =.005, compared to no messages. Discussion: In this experimental study, we did not find that providing messages about vaccine risks and the development process had an impact on respondents' vaccine intentions. Further research is needed to identify how to effectively address concerns about the risks associated with COVID-19 vaccines and the development process and to understand additional factors that influence vaccine intentions. [ABSTRACT FROM AUTHOR]
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- 2022
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314. Differential gene expression identifies a transcriptional regulatory network involving ER-alpha and PITX1 in invasive epithelial ovarian cancer.
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Li, Yichao, Jaiswal, Sushil K., Kaur, Rupleen, Alsaadi, Dana, Liang, Xiaoyu, Drews, Frank, DeLoia, Julie A., Krivak, Thomas, Petrykowska, Hanna M., Gotea, Valer, Welch, Lonnie, and Elnitski, Laura
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OVARIAN epithelial cancer , *GENE regulatory networks , *NUCLEAR receptors (Biochemistry) , *GENE expression , *ESTROGEN receptors - Abstract
Background: The heterogeneous subtypes and stages of epithelial ovarian cancer (EOC) differ in their biological features, invasiveness, and response to chemotherapy, but the transcriptional regulators causing their differences remain nebulous.Methods: In this study, we compared high-grade serous ovarian cancers (HGSOCs) to low malignant potential or serous borderline tumors (SBTs). Our aim was to discover new regulatory factors causing distinct biological properties of HGSOCs and SBTs.Results: In a discovery dataset, we identified 11 differentially expressed genes (DEGs) between SBTs and HGSOCs. Their expression correctly classified 95% of 267 validation samples. Two of the DEGs, TMEM30B and TSPAN1, were significantly associated with worse overall survival in patients with HGSOC. We also identified 17 DEGs that distinguished stage II vs. III HGSOC. In these two DEG promoter sets, we identified significant enrichment of predicted transcription factor binding sites, including those of RARA, FOXF1, BHLHE41, and PITX1. Using published ChIP-seq data acquired from multiple non-ovarian cell types, we showed additional regulatory factors, including AP2-gamma/TFAP2C, FOXA1, and BHLHE40, bound at the majority of DEG promoters. Several of the factors are known to cooperate with and predict the presence of nuclear hormone receptor estrogen receptor alpha (ER-alpha). We experimentally confirmed ER-alpha and PITX1 presence at the DEGs by performing ChIP-seq analysis using the ovarian cancer cell line PEO4. Finally, RNA-seq analysis identified recurrent gene fusion events in our EOC tumor set. Some of these fusions were significantly associated with survival in HGSOC patients; however, the fusion genes are not regulated by the transcription factors identified for the DEGs.Conclusions: These data implicate an estrogen-responsive regulatory network in the differential gene expression between ovarian cancer subtypes and stages, which includes PITX1. Importantly, the transcription factors associated with our DEG promoters are known to form the MegaTrans complex in breast cancer. This is the first study to implicate the MegaTrans complex in contributing to the distinct biological trajectories of malignant and indolent ovarian cancer subtypes. [ABSTRACT FROM AUTHOR]- Published
- 2021
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315. Demographic, structural, and psychological predictors of risk-increasing and mask wearing behaviors among US adults between December 2020–March 2021.
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Thorpe, Alistair, Zhong, Lingzi, Scherer, Laura D., Drews, Frank A., Shoemaker, Holly, and Fagerlin, Angela
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HEALTH behavior , *CONSPIRACY theories , *HEALTH literacy , *PSYCHOLOGICAL factors , *AT-risk behavior , *MEDICAL masks - Abstract
To assess demographic, structural, and psychological predictors of risk-increasing and risk-decreasing behaviors This study used data from an online longitudinal, three-wave COVID-19 survey (12/20–03/21) regarding the behaviors, attitudes, and experiences of US Veteran (n = 584) and non-Veteran (n = 346) adults. Inability to get groceries delivered emerged as the strongest predictor of more frequent risk-increasing behavior across all timepoints. Other consistent predictors of more frequent risk-increasing behavior and less frequent mask wearing included less worry about getting COVID-19, disbelief in science, belief in COVID-19 conspiracies, and negative perceptions of the state response. No demographic factor consistently predicted risk-increasing behavior or mask wearing, though different demographic predictors emerged for more frequent risk-increasing behaviors (e.g., lower health literacy) and mask-wearing (e.g., older age and urban residence) at certain timepoints. The most frequently endorsed reasons for having contact with others concerned health-related (food, medical care, and exercise) and social needs (seeing friends/family and boredom). These findings highlight key individual-level determinants of risk-increasing behaviors and mask wearing which encompass demographic, structural, and psychological factors. Findings can support public health experts and health communicators promote engagement with risk-reducing behaviors and address key barriers to engaging in these behaviors. • COVID-19 health measures relied on the public to avoid risky behaviors and adopt protective ones. • Having groceries delivered was a key predictor of less frequent risk behaviors. • More COVID-19 worry predicted less risk behaviors and more masking. • Conspiracy beliefs and science distrust predicted more risk behaviors and less masking. • The most frequent reasons for meeting others regarded health and social needs. [ABSTRACT FROM AUTHOR]
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- 2023
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316. Predictors of COVID-19 vaccine uptake: an online three-wave survey study of US adults.
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Thorpe A, Fagerlin A, Drews FA, Shoemaker H, Brecha FS, and Scherer LD
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- Adult, Humans, Eligibility Determination, Health Facilities, Logistic Models, Vaccination, COVID-19 Vaccines, COVID-19
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Background: To effectively promote vaccine uptake, it is important to understand which people are most and least inclined to be vaccinated and why. In this study, we examined predictors of COVID-19 vaccine uptake and reasons for non-vaccination., Methods: We conducted an online English-language survey study in December-2020, January-2021, and March-2021. A total of 930 US respondents completed all surveys. Multiple logistic regression models were run to test whether the early vaccine eligibility, demographic factors, and psychological factors predict getting at least one dose of a COVID-19 vaccination in January-2021 and in March-2021., Results: The proportion of respondents who received ≥ 1-dose of a COVID-19 vaccine increased from 18% (January) to 67% (March). Older age predicted vaccine uptake in January (OR = 2.02[95%CI = 1.14-3.78], p < .001) and March (10.92[6.76-18.05], p < .001). In January, additional predictors were higher numeracy (1.48[1.20-1.86], p < .001), COVID-19 risk perceptions (1.35[1.03-1.78], p = .029), and believing it is important adults get the COVID-19 vaccine (1.66[1.05-2.66], p = .033). In March, additional predictors of uptake were believing it is important adults get the COVID-19 vaccine (1.63[1.15-2.34], p = .006), prior COVID-19 vaccine intentions (1.37[1.10-1.72], p = .006), and belief in science (0.84[0.72-0.99], p = .041). Concerns about side effects and the development process were the most common reasons for non-vaccination. Unvaccinated respondents with no interest in getting a COVID-19 vaccine were younger (0.27[0.09-0.77], p = .016), held negative views about COVID-19 vaccines for adults (0.15[0.08-0.26], p < .001), had lower trust in healthcare (0.59[0.36-0.95], p = .032), and preferred to watch and wait in clinically ambiguous medical situations (0.66[0.48-0.89], p = .007)., Conclusions: Evidence that attitudes and intentions towards COVID-19 vaccines were important predictors of uptake provides validation for studies using these measures and reinforces the need to develop strategies for addressing safety and development concerns which remain at the forefront of vaccine hesitancy., (© 2024. The Author(s).)
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- 2024
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317. Disinfection of central venous access device needleless connectors: A human factors analysis.
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Drews FA, Martinello RA, Hebden JN, St John KH, and Pegues DA
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Objective: Evidence-based central-line-associated bloodstream infection (CLABSI) prevention guidelines recommend the use of an antiseptic scrub to disinfect needleless connectors before device access. Guideline noncompliance may render disinfection ineffective. The goal of this study was to observe needleless-connector disinfection practices and to identify perceived facilitators and barriers to best practices of needleless-connector access., Methods: A human factors mixed-methods study involving nursing focus groups of perceived barriers and facilitators and clinical observations of compliance with instructions and protocols for use of 3.15% chlorhexidine gluconate/70% isopropyl alcohol (CHG/IPA) and 70% isopropyl alcohol (IPA) antisepsis products for central venous access device (CVAD) needleless-connector disinfection was conducted in intensive care units (ICUs) at 2 academic medical centers., Results: Access to the antiseptic product and lesser workload were identified as best-practice facilitators. Barriers were the time required per needleless-connector access and knowledge deficits. Of the 48 observed access events, 77% resulted in needleless-connector disinfection. The observed mean needleless-connector scrubbing times when using IPA were substantially below the recommended time. Drying time after product use was negligible., Conclusions: Lack of access to the disinfection product, emergency situations, and high workload were barriers to needleless-connector disinfection. Observed scrubbing and drying times were shorter than recommended, especially for IPA wipes. These needleless-connector disinfection deficits may increase the risk of CLABSI. Ongoing education and periodic competency evaluation of needleless-connector disinfection, improvement of supply management, and staffing workload are required to imbed and sustain best practices. Further study involving a larger sample size in diverse patient populations is warranted.
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- 2024
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318. Impact of prior COVID-19 infection on perceptions about the benefit and safety of COVID-19 vaccines.
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Thorpe A, Gurmankin Levy A, Scherer LD, Scherer AM, Drews FA, Butler JM, and Fagerlin A
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- Adult, Humans, Communication, Vaccination adverse effects, COVID-19 prevention & control, COVID-19 Vaccines adverse effects, Vaccines
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In this online survey of 1,733 US adults in December 2021, respondents believed COVID-19 vaccines are less beneficial and less safe for someone who had already had COVID-19. Those who experienced COVID-19 after being vaccinated believed that the vaccines are less beneficial and less safe than those who had not. Findings highlight the need to better communicate evolving evidence of COVID-19 vaccine benefit and safety and to tailor communications to peoples' COVID-19 history and vaccination status., (Copyright © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.)
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- 2024
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319. Telehealth Use During the COVID-19 Pandemic Among Veterans and Nonveterans: Web-Based Survey Study.
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Shoemaker HE, Thorpe A, Stevens V, Butler JM, Drews FA, Burpo N, Scherer LD, and Fagerlin A
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Background: In the first year of the COVID-19 pandemic, studies reported delays in health care usage due to safety concerns. Delays in care may result in increased morbidity and mortality from otherwise treatable conditions. Telehealth provides a safe alternative for patients to receive care when other circumstances make in-person care unavailable or unsafe, but information on patient experiences is limited. Understanding which people are more or less likely to use telehealth and their experiences can help tailor outreach efforts to maximize the impact of telehealth., Objective: This study aims to examine the characteristics of telehealth users and nonusers and their reported experiences among veteran and nonveteran respondents., Methods: A nationwide web-based survey of current behaviors and health care experiences was conducted in December 2020-March 2021. The survey consisted of 3 waves, and the first wave is assessed here. Respondents included US adults participating in Qualtrics web-based panels. Primary outcomes were self-reported telehealth use and number of telehealth visits. The analysis used a 2-part regression model examining the association between telehealth use and the number of visits with respondent characteristics., Results: There were 2085 participants in the first wave, and 898 (43.1%) reported using telehealth since the pandemic began. Most veterans who used telehealth reported much or somewhat preferring an in-person visit (336/474, 70.9%), while slightly less than half of nonveterans (189/424, 44.6%) reported this preference. While there was no significant difference between veteran and nonveteran likelihood of using telehealth (odds ratio [OR] 1.33, 95% CI 0.97-1.82), veterans were likely to have more visits when they did use it (incidence rate ratio [IRR] 1.49, 95% CI 1.07-2.07). Individuals were less likely to use telehealth and reported fewer visits if they were 55 years and older (OR 0.39, 95% CI 0.25-0.62 for ages 55-64 years; IRR 0.43, 95% CI 0.28-0.66) or lived in a small city (OR 0.63, 95% CI 0.43-0.92; IRR 0.71, 95% CI 0.51-0.99). Receiving health care partly or primarily at the Veterans Health Administration (VA) was associated with telehealth use (primarily VA: OR 3.25, 95% CI 2.20-4.81; equal mix: OR 2.18, 95% CI 1.40-3.39) and more telehealth visits (primarily VA: IRR 1.5, 95% CI 1.10-2.04; equal mix: IRR 1.57, 95% CI 1.11-2.24)., Conclusions: Telehealth will likely continue to be an important source of health care for patients, especially following situations like the COVID-19 pandemic. Some groups who may benefit from telehealth are still underserved. Telehealth services and outreach should be improved to provide accessible care for all., (©Holly E Shoemaker, Alistair Thorpe, Vanessa Stevens, Jorie M Butler, Frank A Drews, Nicole Burpo, Laura D Scherer, Angela Fagerlin. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.09.2023.)
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- 2023
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320. Aerosol containment device design considerations and performance evaluation metrics.
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Jones RM, Andrus N, Dominguez T, Biggs J, Hansen B, and Drews FA
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- Humans, Personal Protective Equipment, Intubation, Intratracheal methods, Equipment Design, Respiratory Aerosols and Droplets, COVID-19 epidemiology, COVID-19 prevention & control
- Abstract
Background: Spurred by the Coronavirus infectious disease 2019 pandemic, aerosol containment devices (ACDs) were developed to capture infectious respiratory aerosols generated by patients at their source. Prior reviews indicated that such devices had low evidence of effectiveness, but did not address how ACDs should be evaluated, how well they should perform, nor have clearly defined performance standards. Towards developing design criteria for ACDs, two questions were posed: 1) What characteristics have guided the design of ACDs? 2) How have these characteristics been evaluated?, Methods: A scoping review was performed consistent with PRISMA guidelines. Data were extracted with respect to general study information, intended use of the device, device design characteristics and evaluation., Results: Fifty-four articles were included. Evaluation was most commonly performed with respect to device aerosol containment (n = 31, 61%), with only 5 (9%), 3 (6%) and 8 (15%) formally assessing providing experience, patient experience and procedure impact, respectively. Nearly all of the studies that explored provider experience and procedure impact studied intubation. Few studies provided a priori performance criteria for any evaluation metric, or referenced any external guidelines by which to bench mark performance., Conclusion: With respect to aerosol containment, ACDs should reduce exposure among HCP with the device compared with the absence of the device, and provide ≥90% reduction in respirable aerosols, equivalent in performance to N95 filtering facepiece respirators, if the goal is to reduce reliance on personal protective equipment. The ACD should not increase awkward or uncomfortable postures, or adversely impact biomechanics of the procedure itself as this could have implications for procedure outcomes. A variety of standardized instruments exist to assess the experience of patients and healthcare personnel. Integration of ACDs into routine clinical practice requires rigorous studies of aerosol containment and the user experience., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Rachael Jones reports financial support was provided by US Department of Defense. Niles Andrus reports financial support was provided by National Institute for Occupational Safety and Health. Thomas Dominguez reports financial support was provided by US Airforce., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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321. A Novel Application of Risk-Risk Tradeoffs in Occupational Health: Nurses' Occupational Asthma and Infection Risk Perceptions Related to Cleaning and Disinfection during COVID-19.
- Author
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Wilson AM, Mussio I, Chilton S, Gerald LB, Jones RM, Drews FA, LaKind JS, and Beamer PI
- Subjects
- Humans, Disease Susceptibility, Occupational Health, Occupational Exposure, COVID-19 epidemiology, COVID-19 prevention & control, Asthma, Occupational, Occupational Diseases diagnosis
- Abstract
Background: Nurses face the risk of new onset occupational asthma (OA) due to exposures to cleaning and disinfection (C&D) agents used to prevent infections in healthcare facilities. The objective of this study was to measure nurses' preferences when presented with simultaneous OA and respiratory viral infection (e.g., COVID-19) risks related to increased/decreased C&D activities., Methods: Nurses working in healthcare for ≥1 year and without physician-diagnosed asthma were recruited for an online anonymous survey, including four risk-risk tradeoff scenarios between OA and respiratory infection with subsequent recovery (Infect and Recovery) or subsequent death (Infect and Death). Nurses were presented with baseline risks at hypothetical "Hospital 1", and were asked to choose Hospital 2 (increased OA risk to maintain infection risk), Hospital 3 (increased infection risk to maintain OA risk), or indicate that they were equally happy., Results: Over 70% of nurses were willing to increase infection risk to maintain baseline OA risk if they were confident they would recover from the infection. However, even when the risk of infection leading to death was much lower than OA, most nurses were not willing to accept a larger (but still small) risk of death to avoid doubling their OA risk. Age, work experience, and ever having contracted or knowing anyone who has contracted a respiratory viral infection at work influenced choices., Conclusions: We demonstrate the novel application of a risk-risk tradeoff framework to address an occupational health issue. However, more data are needed to test the generalizability of the risk preferences found in this specific risk-risk tradeoff context.
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- 2022
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322. Feature Engineering and Process Mining to Enable Hazard Detection in Health Information Technology.
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Ozmen O, Klasky HB, Omitaomu OA, Olama M, Kuruganti T, Ward M, Scott JM, Laurio A, Drews F, and Nebeker JR
- Abstract
In this work, we aim to enhance the reliability of health information technology (HIT) systems by detection of plausible HIT hazards in clinical order transactions. In the absence of well-defined event logs in corporate data warehouses, our proposed approach identifies relevant timestamped data fields that could indicate transactions in the clinical order life cycle generating raw event sequences. Subsequently, we adopt state transitions of the OASIS Human Task standard to map the raw event sequences and simplify the complex process that clinical radiology orders go through. We describe how the current approach provides the potential to investigate areas of improvement and potential hazards in HIT systems using process mining. The discussion concludes with a use case and opportunities for future applications., (©2020 AMIA - All rights reserved.)
- Published
- 2020
323. When an Alert is Not an Alert: A Pilot Study to Characterize Behavior and Cognition Associated with Medication Alerts.
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Reese TJ, Kawamoto K, Fiol GD, Drews F, Taft T, Kramer H, and Weir C
- Subjects
- Cognition, Drug Interactions, Humans, Pilot Projects, Retrospective Studies, Task Performance and Analysis, User-Computer Interface, Medical Order Entry Systems, Medication Errors prevention & control, Pharmacists psychology
- Abstract
Introduction . Preventable adverse drug events are a significant patient-safety concern, yet most medication alerts are disregarded. Pharmacists encounter the highest number of medication alerts and likely have developed behaviors to cope with alerting inefficiencies. The study objective was to better understand alert override behavior relating to a motivational construct framework. Methods . Mixed-methods study of 10 pharmacists (567 verifications) with eye-tracking observations and retrospective think aloud interviews. Results . Pharmacists spent on average 14 seconds longer verifying orders with alerts than orders without alerts (p<0.001). Verification occurred before alerts were triggered, and no order changes occurred after alerts. Pharmacists reported 62% of alerts as unhelpful and 21% as frustrating. Alert interactions took on average 3.9 seconds. Discussion . Pharmacists anticipate alerts by making appropriate checks and changes before alert prompts. Medication alerts seem to be useful. However, the observed pharmacists' behavior suggests changes in the alert context are needed to match cognition.
- Published
- 2018
324. Warning Triggers in Environmental Hazards: Who Should Be Warned to Do What and When?
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Cova TJ, Dennison PE, Li D, Drews FA, Siebeneck LK, and Lindell MK
- Abstract
Determining the most effective public warnings to issue during a hazardous environmental event is a complex problem. Three primary questions need to be answered: Who should take protective action? What is the best action? and When should this action be initiated? Warning triggers provide a proactive means for emergency managers to simultaneously answer these questions by recommending that a target group take a specified protective action if a preset environmental trigger condition occurs (e.g., warn a community to evacuate if a wildfire crosses a proximal ridgeline). Triggers are used to warn the public across a wide variety of environmental hazards, and an improved understanding of their nature and role promises to: (1) advance protective action theory by unifying the natural, built, and social themes in hazards research into one framework, (2) reveal important information about emergency managers' risk perception, situational awareness, and threat assessment regarding threat behavior and public response, and (3) advance spatiotemporal models for representing the geography and timing of disaster warning and response (i.e., a coupled natural-built-social system). We provide an overview and research agenda designed to advance our understanding and modeling of warning triggers., (© 2016 Society for Risk Analysis.)
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- 2017
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325. Support for contextual control in primary care: a qualitative analysis.
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Weir C, Drews FA, Butler J, Barrus RJ, Jones ML, and Nebeker JR
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- Communication, Electronic Health Records, Hospitals, Veterans, Humans, Qualitative Research, United States, Cognition, Decision Support Systems, Clinical, Medical Records Systems, Computerized, Primary Health Care
- Abstract
Providing support for high-level cognitive performance is largely missing in many decision support designs. Most development in this area is structured to minimize attention, decrease the need for deeper processing and limit intense goal-directed cognitive processing. However, from a dual process perspective, both automatic and deliberative processes need to be supported. The purpose of this qualitative analysis is to explore complex cognitive processing. We used the Contextual Control Model to guide the analysis. Transcripts from 33 taped primary care visits across 4 locations in the VA were analyzed using iterative process of construct and thematic development. Five themes related to high-level cognitive processes were identified: 1) Joint Exchange and Patient Activation; 2) Planning and Proactive Problem Solving; 3) Script and heuristic processing; 4) Time perspectives and 5) Uncertainty management. Results are discussed in terms of the need to support integrated views for complex situation mental models.
- Published
- 2013
326. The orderly and effective visit: impact of the electronic health record on modes of cognitive control.
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Weir C, Drews FA, Leecaster MK, Barrus RJ, Hellewell JL, and Nebeker JR
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- Ambulatory Care, Hospitals, Veterans, Humans, Interviews as Topic, Practice Patterns, Physicians', United States, Cognition, Electronic Health Records statistics & numerical data, Primary Health Care
- Abstract
The clinical Joint Cognitive System (JCS) includes the clinicians, electronic health record (EHR), and other infrastructure that maintain control in the system in the service of accomplishing clinical goals. The purpose of this study is to examine the relationship between levels of control using the COCOM model (scrambled, opportunistic, tactical, and strategic) and patterns of EHR use. Forty-five primary care visits were observed and audio-recorded. Each was coded for COCOM levels of control (IRR = 90%). Screen changes were recorded and time stamped (as either searching or entering). Levels of control were significantly related to preparation intensity (F (2,23) = 6.62; p=0.01), the number of screen changes involved in both searching (F (2,30) = 6.54; p=0.004), and entering information (F (2,22) = 9.26; p=0.001). Combined with the qualitative data, this pattern of EHR usage indicates that the system as designed may not provide effective cognitive support.
- Published
- 2012
327. Informing the design of hemodynamic monitoring displays.
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Doig AK, Drews FA, and Keefe MR
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- Female, Humans, Male, Monitoring, Physiologic instrumentation, Nursing Methodology Research, Critical Care methods, Data Display, Hemodynamics, Nursing Care methods, User-Computer Interface
- Abstract
In the ICU, an extensive array of variables from the hemodynamic monitoring display is routinely analyzed. However, the development of new display technologies is proceeding without adequate study of the monitoring tasks and behaviors of a primary user group--critical-care nurses. Semistructured interviews focusing on the cognitive aspects of the hemodynamic monitoring task were conducted with 14 critical-care nurses. A systematic content analysis of qualitative data identified cognitive tasks that had applicability to the design of monitoring displays. The cognitive tasks of hemodynamic monitoring were (1) selective data acquisition, (2) applying meaning to the variables and understanding relationships between parameters, (3) controlling hemodynamics by titrating medications and intravenous fluids, and (4) monitoring complex trends of multiple interacting variables and patient response to interventions. Recommendations include designing the monitoring display to match the mental constructs and cognitive tasks of the user by applying conceptual meaning to the variables, highlighting relationships between variables, and presenting a "big picture" view of the patient's condition. Monitoring displays must also present integrated trends that illustrate the dynamic relationship between interventions and patient response.
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- 2011
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328. Epinome - a novel workbench for epidemic investigation and analysis of search strategies in public health practice.
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Livnat Y, Gesteland P, Benuzillo J, Pettey W, Bolton D, Drews F, Kramer H, and Samore M
- Subjects
- Decision Support Techniques, Disease Outbreaks, Epidemics, Humans, Public Health, Decision Making, Public Health Practice
- Abstract
We present a novel user-centric visual analytics system that supports investigation of simulated disease outbreak and the study of decision-making. We developed Epinome as part of our research on decision making in public health and in particular, on the evaluation of information search strategies in public health practice. Epinome is a highly dynamic web-based system that provides a platform to track and study subjects' decision making and information search strategies, under controlled and repeatable conditions using simulated disease outbreaks. In this paper we focus on the design and implementation of Epinome and present relevant results from field tests we conducted in Utah and Colorado.
- Published
- 2010
329. Interactive agent based modeling of public health decision-making.
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Parks AL, Walker B, Pettey W, Benuzillo J, Gesteland P, Grant J, Koopman J, Drews F, and Samore M
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- Disease Notification, Disease Outbreaks, Epidemiologic Methods, Humans, Pilot Projects, Professional Competence, Public Health Administration, Software, Whooping Cough transmission, Computer Simulation, Decision Making, Decision Support Techniques, Public Health
- Abstract
Agent-based models have yielded important insights regarding the transmission dynamics of communicable diseases. To better understand how these models can be used to study decision making of public health officials, we developed a computer program that linked an agent-based model of pertussis with an agent-based model of public health management. The program, which we call the Public Health Interactive Model & simulation (PHIMs) encompassed the reporting of cases to public health, case investigation, and public health response. The user directly interacted with the model in the role of the public health decision-maker. In this paper we describe the design of our model, and present the results of a pilot study to assess its usability and potential for future development. Affinity for specific tools was demonstrated. Participants ranked the program high in usability and considered it useful for training. Our ultimate goal is to achieve better public health decisions and outcomes through use of public health decision support tools.
- Published
- 2009
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