11 . Telemonitoring : Using Persuasive Technology to Improve Engagement
John Conway , RN , MSN Ed , DNPc , and Kimberly Shea PhD , RN , CHPN
University of Arizona-College of Nursing
Background : Many healthcare clients struggle to maintain office visits and contiguous communication with primary care providers . This is often related to travel limitations such as extensive distances ( Win , 2015 ), or dehabilitating comorbidities that complicate leaving home ( Morrissey , 2013 ). Telemonitoring is emerging as a viable conduit to extend healthcare capacity by managing chronic healthcare issues while clients remain at home and utilize technology to maintain office visits ( Arizona Telemedicine Program , 2017 ). Although telemonitoring has been successful , concerns for effective client engagement due to lack of understanding technology , client complacency , and failure to report accurate data remains of great concern ( Fairbrother et . al , 2014 ).
Method : Persuasive Technology ( PT ) provides rewards for accurate and effective client engagement when utilizing telemonitoring . Virtual rewards , such as electronic thank you cards , prize points , or access to internet resources are examples of the positive reinforcement inherent to PT ( Venkatesh , Thong , Xu , 2012 ). The purpose is to validate if implementing PT improves client engagement in utilizing TM technology .
Methods : Scoping reviews were conducted to yield a preliminary assessment of existing research associated with PT ’ s effect on improving client engagement in telemonitoring . Reviews included searching CIHNAL , Medline and PubMed databases . Search terminology included the words : telemonitoring and persuasive technology .
Results : Few studies directly examined the use of PT among telemonitoring participants . CIHNAL yielded 502 articles using telemonitoring ; 28 articles using PT , and 0 articles using both terms . Similarly , Medline ( OVID ) yielded 1 article ; PubMed : yielded 0 articles , and the Cochrane Library yielded 0 articles using the combined search terms : persuasive communication & telemedicine .
Conclusions : The paucity of literature regarding PT to promote client engagement in telemonitoring warrants a deeper systematic review , or more importantly , development of mixed method studies to determine the effectiveness of hedonistic rewards on improving client engagement with telemonitoring .
12 . Helping Asthmatic Children in Rural Alabama through Building Relationships with School Districts
Nathan Culmer , PhD , Karen Burgess , MD , Elizabeth Smith , CRNP
The University of Alabama College of Community Health Sciences
Background : Because asthma poses unique challenges to children in terms of their physical and academic involvement in school , children with this condition face additional barriers to success . Furthermore , the management of this condition places added demands on the children themselves , their parents , school nurses and schools in general . In order to reduce this burden , we sought to provide asthma education and training via tele-educational means to groups of school children during their school time to better equip and assist asthmatic school-age children in self-management of their condition . However , the challenges of delivering this information were daunting due to significant demands on time ; fit of the project to student , nurse , and school needs ; and the need to generate appropriate institutional support .
Methods : Our intervention consisted of four remotely delivered educational modules with asthma knowledge assessments before , immediately after , and , when possible , approximately 2 months after the delivery of the education modules .
Results : We developed a strong working relationship with a local school district characterized by an over representation of rural students . Key components of the high-quality working relationship we developed included : strategic partner selection , goal alignment , communication , IT infrastructure and support , adaptability , and advocacy .
Conclusions : Based on very encouraging preliminary data and enthusiasm from district leadership , we are expanding to more schools and exploring clinical interventions to further serve school age children , their parents , school nurses , and the schools themselves .
13 . Overcoming Barriers to Use of Telemedicine in Inpatient Wound Ostomy Care
Mary Ellen Dziedzic , MSN , RN , CWOCN , Michael Cola , BSN , RN , CCRN , Lauren Murphy , MSN , RN , ACNS-BC , Michele Wrazien , MSN , RN , CWOCN , Maurie Tassey , BSN , RN , CWOCN , Michelle Llewellyn , BSN , RN , CWOCN
Geisinger Health System-Geisinger Wyoming Valley Medical Community Medical Center
Background : The wound ostomy department at Geisinger Wyoming valley and Geisinger Community Medical Centers in Northeastern PA are part of the Geisinger Health system . This integrated health care system is on the edge of technology and is a leader in electronic documentation . This wound osto-
39 | Page
11. Telemonitoring: Using Persuasive
Technology to Improve Engagement
John Conway, RN, MSN Ed, DNPc, and
Kimberly Shea PhD, RN, CHPN
University of Arizona-College of Nursing
Background: Many healthcare clients struggle to maintain
office visits and contiguous communication with primary care
providers. This is often related to travel limitations such as
extensive distances (Win, 2015), or dehabilitating comorbidi-
ties that complicate leaving home (Morrissey, 2013). Tele-
monitoring is emerging as a viable conduit to extend
healthcare capacity by managing chronic healthcare issues
while clients remain at home and utilize technology to main-
tain office visits (Arizona Telemedicine Program, 2017). Alt-
hough telemonitoring has been successful, concerns for effec-
tive client engagement due to lack of understanding technol-
ogy, client complacency, and failure to report accurate data
remains of great concern (Fairbrother et. al, 2014).
Method: Persuasive Technology (PT) provides rewards for
accurate and effective client engagement when utilizing tele-
monitoring. Virtual rewards, such as electronic thank you
cards, prize points, or access to internet resources are exam-
ples of the positive reinforcement inherent to PT (Venkatesh,
Thong, Xu, 2012). The purpose is to validate if implementing
PT improves client engagement in utilizing TM technology.
12. Helping Asthmatic Children in Rural
Alabama through Building Relationships
with School Districts
Nathan Culmer, PhD, Karen Burgess, MD,
Elizabeth Smith, CRNP
The University of Alabama College of
Community Health Sciences
Background: Because asthma poses unique challenges to
children in terms of their physical and academic involvement
in school, children with this condition face additional barriers
to success. Furthermore, the management of this condition
places added demands on the children themselves, their par-
ents, school nurses and schools in general. In order to reduce
this burden, we sought to provide asthma education and
training via tele-educational means to groups of school chil-
dren during their school time to better equip and assist asth-
matic school-age children in self-management of their condi-
tion. However, the challenges of delivering this information
were daunting due to significant demands on time; fit of the
project to student, nurse, and school needs; and the need to
generate appropriate institutional support.
Methods: Our intervention consisted of four remotely deliv-
ered educational modules with asthma knowledge assess-
ments before, immediately after, and, when possible, approx-
imately 2 months after the delivery of the education modules.
Methods: Scoping reviews were conducted to yield a prelim-
inary assessment of existing research associated with PT’s
effect on improving client engagement in telemonitoring.
Reviews included searching CIHNAL, Medline and PubMed
databases. Search terminology included the words: telemoni-
toring and persuasive technology. Results: We developed a strong working relationship with a
local school district characterized by an over representation
of rural students. Key components of the high-quality working
relationship we developed included: strategic partner selec-
tion, goal alignment, communication, IT infrastructure and
support, adaptability, and advocacy.
Results: Few studies directly examined the use of PT among
telemonitoring participants. CIHNAL yielded 502 articles using
telemonitoring; 28 articles using PT, and 0 articles using both
terms. Similarly, Medline (OVID) yielded 1 article; PubMed:
yielded 0 articles, and the Cochrane Library yielded 0 articles
using the combined search terms: persuasive communication
& telemedicine. Conclusions: Based on very encouraging preliminary data
and enthusiasm from district leadership, we are expanding to
more schools and exploring clinical interventions to further
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