From Social Networks to Social Medicine: Exploring the role of online interventions [4 Aud 1330...
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Transcript of From Social Networks to Social Medicine: Exploring the role of online interventions [4 Aud 1330...
Urowitz, S.From Social Networks to Social Medicine: Exploring the role of online interventions
• This slideshow, presented at Medicine 2.0’08, Sept 4/5th, 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team
• Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009(www.medicine20congress.com)
• Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at http://www.medicine20congress.com/mp3.php
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Medicine 2.0September 4, 2008
David Wiljer, PhD and Sara Urowitz, PhDPrincess Margaret Hospital/University Health Network;
University of Toronto.
From Social Networks to Social Medicine:From Social Networks to Social Medicine:
Exploring the role of online interventionsExploring the role of online interventions
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The Canadian Health Care System – The Canadian Health Care System –
Universal health care system
Providing health care for a large population
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The Canadian Health Care System – The Canadian Health Care System –
• Privately delivered– comprehensive coverage for medically
necessary hospital and physician services
• Publicly funded– Federal government– 10 Provinces– 3 Territories
Challenge: How to ensure sustainability?
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Empowerment ModelEmpowerment Model
Roberts, Health Expectations, 1999Roberts, Health Expectations, 1999
Individual/ Micro LevelIndividual/ Micro Level
Community /Community /Macro-LevelMacro-Level
Organizational /Organizational /Mediating LevelMediating Level
Psychological DomainsPsychological Domains• Self-esteemSelf-esteem• Individual competenciesIndividual competencies• Self-efficacy Self-efficacy
Collective DomainCollective Domain• Empowered membersEmpowered members• Political actionPolitical action• Redistribution of resourcesRedistribution of resources• Community decision-makingCommunity decision-making
Management DomainsManagement Domains• Shared decision-makingShared decision-making• Ability for individual to Ability for individual to
affect changeaffect change• Increase in “feelings of Increase in “feelings of
power”power”
6Adapted from Kreuter et al., 2000
Clinical Encounter
Experiential Health Information
General Health Information
Personal Health Information
Health Information: Chronic DiseaseHealth Information: Chronic Disease
Generic content
Individualized content
Level of Level of PersonalizationPersonalization
Level of Self-ManagementLevel of Self-Management Low High
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Experiential InformationExperiential Information
Matthew Hurst, 2008
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Experiential InformationExperiential Information
• Overcome the feeling of isolation. • Find similar patients who truly
experience the illness or condition. • Begin to network and become a more
significant stakeholder by informing “others in the system.”
Leonard, Wiljer et al. JHIT, 2008
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Caring Voices: Caring Voices: A National Initiative to A National Initiative to Support and ConnectSupport and Connect
Cancer SurvivorsCancer Survivors
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Why Caring VoicesWhy Caring Voices
• Caring Voices provides an alternative means Caring Voices provides an alternative means for providing and accessing supportive care for providing and accessing supportive care through:through:– Educational resourcesEducational resources– Regular monthly programmingRegular monthly programming– Online chats with experts and other survivorsOnline chats with experts and other survivors– Forums for posting questionsForums for posting questions– ““Friend” matching that provides opportunity to find Friend” matching that provides opportunity to find
people with similar experiencespeople with similar experiences
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Educational ResourcesEducational Resources
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Monthly Events CalendarMonthly Events Calendar
Chats: Real time CommunicationChats: Real time Communication(Survivor:Expert) (Survivor:Survivor(Survivor:Expert) (Survivor:Survivor))
• Average 9 monthly chats
• 35% led/moderated by clinicians– MDs (n=2)– Nurses (n=3)– Allied Health (n=4)
• Additional 24% led by experts in cancer community
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Forums: Asynchronous Forums: Asynchronous CommunicationCommunication
Forum Threads Created
17%
34%
25%
24%
Detection, Diagnosis &Treatment
Living w ith Cancer
Resource LibraryDiscussions:
What's New ?
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People MatchingPeople Matching
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Caring Voices Phase 2Caring Voices Phase 2
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Usability Results (n=8)Usability Results (n=8)
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Agree Neutral Disagree
Easy to use 85% 0% 14%
Liked appearance 86% 14% 0%
Easy to learn the site 86% 0% 14%
Easy to participate in forums
71% 14% 14%
Easy to participate in chats
71% 14% 14%
Receive support from other survivors
86% 14% 0%
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Cumulative Users
98191
261 284 330383
445 489 524575
645703
761845
922 9731046 1090
11471212
13091395
1469
0
200
400
600
800
1000
1200
1400
1600
Pre-L
aunch
Oct-06
Nov-06
Dec-06
Jan-
07
Feb-0
7
Mar-0
7
Apr-0
7
May-0
7
Jun-
07
Jul-0
7
Aug-0
7
Sep-0
7
Oct-07
Nov-07
Dec-07
Jan-
08
Feb-0
8
Mar-0
8
Apr-0
8
May-0
8
Jun-
08
Jul-0
8
Month
Use
rs
User GrowthUser Growth
An average of 49.5 new users An average of 49.5 new users register/monthregister/month
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Page Views and Sessions over Time
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
Oct-06
Nov-06
Dec-06
Jan-07
Feb-07
Mar-07
Apr-07
May-07
Jun-07
Jul-07
Aug-07
Sep-07
Oct-07
Nov-07
Dec-07
Jan-08
Feb-08
Mar-08
Apr-08
May-08
Jun-08
Jul-08
Month
Ses
sion
s
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
500,000
Pag
e V
iew
s Total Sessions
Total Page Views
Web StatsWeb Stats
Number of VisitorsNumber of Visitors
24
44,146
71,188
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
Year
VisitorsVisitors Year Over Year
Oct 06 - Jun 07
Oct 07 - Jun08
61.3% 61.3% increase increase
in the in the number number
of visitorsof visitors
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Lymph Line Study
• To conduct a feasibility study using CaringVoices.ca to provide clinical education
• Gather preliminary data for a randomized control trial to examine the impact of this approach on the physical and emotional well-being of patients.
Funded by CBCRA
Study Consent
Assessment by
clinician
3) DASH
4) FACTB +SP
1) Complete questionnaires
2) Tour of Caring Voices
3) Schedule ~4 clinical visits (according to Standard of Care)
4) Follow-up appointment booked
5) DASH
6) FACTB +SP
Follow-up Appointment
Focus Groups
4 Online Educational
Sessions
1) Fluid Measure
2) Adherence to Care Plan
After Session 4:
2) DASH
3) FACTB+SP
>10% fluid volume
Lymph Line enrolment
Informed of Lymph Line study
If interested…
LymphLine ProtocolLymphLine Protocol
Funded by CBCRA
GYN GalsGYN Gals
• Feasibility study – Explore using CaringVoices.ca as a
platform to deliver group therapy• Women who suffer from distress resulting from
sexual dysfunction related to gynecological cancers
• 12 week intervention• Using education resources and forum postings• One live chat with MD and sex therapist
Classen et al. 2008
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ConclusionsConclusions
• Online communities– are an innovative option for providing
education and support– provide opportunities to support and
sustain social medicine using collaborative relationships
– can benefit and impact on how health care is delivered and researched
28
Contact InformationContact Information
Sara Urowitz, PhDManager
Educational InformaticsPrincess Margaret [email protected] ext. 3810
David Wiljer, PhDDirector
Knowledge Management and Innovation
Princess Margaret [email protected] ext 4703