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From Social Networks to Social Medicine: Exploring the role of online interventions [4 Aud 1330 Urowitz]


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From Social Networks to Social Medicine: Exploring the role of online interventions [4 Aud 1330 Urowitz]

  1. 1. Urowitz, S. From Social Networks to Social Medicine: Exploring the role of online interventions <ul><li>This slideshow, presented at Medicine 2.0’08 , Sept 4/5 th , 2008, in Toronto, was uploaded on behalf of the presenter by the Medicine 2.0 team </li></ul><ul><li>Do not miss the next Medicine 2.0 congress on 17/18th Sept 2009 ( ) </li></ul><ul><li>Order Audio Recordings (mp3) of Medicine 2.0’08 presentations at </li></ul>
  2. 2. Medicine 2.0 September 4, 2008 David Wiljer, PhD and Sara Urowitz, PhD Princess Margaret Hospital/University Health Network; University of Toronto. From Social Networks to Social Medicine: Exploring the role of online interventions
  3. 3. The Canadian Health Care System – <ul><li>Universal health care system </li></ul><ul><li>Providing health care for a large population </li></ul>
  4. 4. The Canadian Health Care System – <ul><li>Privately delivered </li></ul><ul><ul><li>comprehensive coverage for medically necessary hospital and physician services </li></ul></ul><ul><li>Publicly funded </li></ul><ul><ul><li>Federal government </li></ul></ul><ul><ul><li>10 Provinces </li></ul></ul><ul><ul><li>3 Territories </li></ul></ul><ul><li>Challenge: How to ensure sustainability? </li></ul>
  5. 5. Empowerment Model Roberts, Health Expectations, 1999 Individual/ Micro Level Community / Macro-Level Organizational / Mediating Level <ul><li>Psychological Domains </li></ul><ul><li>Self-esteem </li></ul><ul><li>Individual competencies </li></ul><ul><li>Self-efficacy </li></ul><ul><li>Collective Domain </li></ul><ul><li>Empowered members </li></ul><ul><li>Political action </li></ul><ul><li>Redistribution of resources </li></ul><ul><li>Community decision-making </li></ul><ul><li>Management Domains </li></ul><ul><li>Shared decision-making </li></ul><ul><li>Ability for individual to affect change </li></ul><ul><li>Increase in “feelings of power” </li></ul>
  6. 6. Adapted from Kreuter et al., 2000 Clinical Encounter Experiential Health Information General Health Information Personal Health Information Health Information: Chronic Disease Generic content Individualized content Level of Personalization Level of Self-Management Low High
  7. 7. Experiential Information Matthew Hurst, 2008
  8. 8.
  9. 9. Experiential Information <ul><li>Overcome the feeling of isolation. </li></ul><ul><li>Find similar patients who truly experience the illness or condition. </li></ul><ul><li>Begin to network and become a more significant stakeholder by informing “others in the system.” </li></ul>Leonard, Wiljer et al. JHIT, 2008
  10. 10. Caring Voices: A National Initiative to Support and Connect Cancer Survivors
  11. 11. Why Caring Voices <ul><li>Caring Voices provides an alternative means for providing and accessing supportive care through: </li></ul><ul><ul><li>Educational resources </li></ul></ul><ul><ul><li>Regular monthly programming </li></ul></ul><ul><ul><li>Online chats with experts and other survivors </li></ul></ul><ul><ul><li>Forums for posting questions </li></ul></ul><ul><ul><li>“ Friend” matching that provides opportunity to find people with similar experiences </li></ul></ul>
  12. 12.
  13. 13.
  14. 14. Educational Resources
  15. 15. Monthly Events Calendar
  16. 16. Chats: Real time Communication (Survivor:Expert) (Survivor:Survivor ) <ul><li>Average 9 monthly chats </li></ul><ul><li>35% led/moderated by clinicians </li></ul><ul><ul><li>MDs (n=2) </li></ul></ul><ul><ul><li>Nurses (n=3) </li></ul></ul><ul><ul><li>Allied Health (n=4) </li></ul></ul><ul><li>Additional 24% led by experts in cancer community </li></ul>
  17. 17. Forums: Asynchronous Communication
  18. 18. People Matching
  19. 19. Caring Voices Phase 2
  20. 20.
  21. 21. Usability Results (n=8) 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%
  22. 22. User Growth An average of 49.5 new users register/month
  23. 23. Web Stats
  24. 24. Number of Visitors 61.3% increase in the number of visitors
  25. 25. Lymph Line Study <ul><li>To conduct a feasibility study using to provide clinical education </li></ul><ul><li>Gather preliminary data for a randomized control trial to examine the impact of this approach on the physical and emotional well-being of patients. </li></ul><ul><li>Funded by CBCRA </li></ul>
  26. 26. Study Consent <ul><li>Assessment by </li></ul><ul><li>clinician </li></ul><ul><li>DASH </li></ul><ul><li>FACTB +SP </li></ul><ul><li>Complete questionnaires </li></ul><ul><li>Tour of Caring Voices </li></ul><ul><li>Schedule ~4 clinical visits (according to Standard of Care) </li></ul><ul><li>Follow-up appointment booked </li></ul><ul><li>DASH </li></ul><ul><li>FACTB +SP </li></ul>Follow-up Appointment Focus Groups 4 Online Educational Sessions <ul><li>Fluid Measure </li></ul><ul><li>Adherence to Care Plan </li></ul><ul><li>After Session 4: </li></ul><ul><li>DASH </li></ul><ul><li>FACTB+SP </li></ul>>10% fluid volume Lymph Line enrolment Informed of Lymph Line study If interested… LymphLine Protocol Funded by CBCRA
  27. 27. GYN Gals <ul><li>Feasibility study </li></ul><ul><ul><li>Explore using as a platform to deliver group therapy </li></ul></ul><ul><ul><ul><li>Women who suffer from distress resulting from sexual dysfunction related to gynecological cancers </li></ul></ul></ul><ul><ul><ul><li>12 week intervention </li></ul></ul></ul><ul><ul><ul><li>Using education resources and forum postings </li></ul></ul></ul><ul><ul><ul><li>One live chat with MD and sex therapist </li></ul></ul></ul><ul><ul><ul><li>Classen et al. 2008 </li></ul></ul></ul>
  28. 28. Conclusions <ul><li>Online communities </li></ul><ul><ul><li>are an innovative option for providing education and support </li></ul></ul><ul><ul><li>provide opportunities to support and sustain social medicine using collaborative relationships </li></ul></ul><ul><ul><li>can benefit and impact on how health care is delivered and researched </li></ul></ul>
  29. 29. Contact Information <ul><li>Sara Urowitz, PhD </li></ul><ul><li>Manager </li></ul><ul><li>Educational Informatics </li></ul><ul><li>Princess Margaret Hospital </li></ul><ul><li>[email_address] </li></ul><ul><li>416.946.4501 ext. 3810 </li></ul><ul><li>David Wiljer, PhD </li></ul><ul><li>Director </li></ul><ul><li>Knowledge Management and Innovation </li></ul><ul><li>Princess Margaret Hospital </li></ul><ul><li>[email_address] </li></ul><ul><li>416.946.4501 ext 4703 </li></ul>