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PubMed | Foundation of Healthcare Technologies Society, India Foundation of Healthcare Technologies Society and Saveetha Medical College
Type: Journal Article | Journal: Technology and health care : official journal of the European Society for Engineering and Medicine | Year: 2014

Information and Communication Technologies (ICTs) in health is not merely about technology but a means to reach various optimal outcomes across the entire health system.The objective of this pilot study is to assess the perceptions of receiving health messages through SMS among individuals living in rural Indian settings.A convenient sample of 100 individuals aged 18 years and above and living in rural settings of Kuthampakkam village in Chennai, a Southern part of India were enrolled during September 2013. Individuals having the mobile phone and agreeing to participate were enrolled in the study. Individuals with physical and mental challenges or involved in other clinical trials were excluded from the study. Information was gathered on the variables including socio-demographics, individual familiarity with use of technology, mobile phone usage and the perceptions of using SMS for obtaining health information. Information was gathered using a series of quantitative assessments. Descriptive analysis was performed to report means and standard deviations for the continuous variables and frequency analysis was reported for the categorical variables. Analysis of variance (ANOVA) was used to compare the means of the various continuous variables as compared to the chi-square analysis that was performed to compare the frequency distribution for the categorical variables. All analysis was performed using SAS v9.1.A convenient sample of 100 rural individuals was enrolled. The average age of the study participants was 34 years (SD=17), with more than half of them being males (54%; n=54), and 47% (n=47) of them had education less than high school. Results showed that more than half of the individuals had no computers either at home (61%; n=61) or work (68%; n=68). 100{\%} of them had mobile phones in their household. Text messaging was common in more than half of the study participants. Results showed that the majority of the study participants agreed that receiving calls on the mobile phones for receiving health messages would be the most preferred method. Results showed that the individuals in the age group of 21-40 years, males, with some college education, and in the income category of 50,000-1,00,000 were most likely to obtain SMS based health messages.ICT based health programs need to be established so that the audience receives the optimal technological platform program necessary to obtain health messages. This also suggests that future research is needed to determine the population that would actually adopt the use of SMS based health interventions rather than using SMS as a tool for delivery of health information to all.


PubMed | Foundation of Healthcare Technologies Society and Foundation Medicine
Type: Journal Article | Journal: Journal of pharmacy & bioallied sciences | Year: 2016

The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India.The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross-sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal health history, and hormonal disorder issues were investigated.The results have shown that 24% of the participants had complaint of mild to severe hot flushes, half of them had reported heart ailments (49%; n = 74), and disturbed sleep (48%; n = 72). The proportion of overweight/obese participants was higher in married (64%) than widows (41%), and this difference was found statistically significant (P = 0.005). There were no significant differences in MRS scores of obese and nonobese postmenopausal participants.There is a need of developing interactive, user friendly, technology based education module for addressing the chronic ailments of postmenopausal women.


PubMed | Foundation of Healthcare Technologies Society and Saveetha Medical College and Hospital
Type: Journal Article | Journal: Technology and health care : official journal of the European Society for Engineering and Medicine | Year: 2014

The burden of lifestyle related chronic diseases have increased in recent times. The objective of this pilot study was to explore perceptions about using online lifestyle counseling services among individuals living in rural settings in India. A pilot convenient sample of 100 individuals living in rural settings of Chennai with age 18 years and above was enrolled for the study. Information was gathered about socio-demographic characteristics, health behavior, current disease status; familiarity with technology and perceptions about online lifestyle counseling. The average age of the individuals was 34 years (SD=15). More than half of the individuals had access to computers at home and workplace. Individuals indentified various barriers for unable to obtain lifestyle counseling. Nearly 47% of the individuals were interested in obtaining online lifestyle counseling. There is an urgent need for evaluating the role of an online lifestyle counseling intervention among individuals living in rural settings.


PubMed | Foundation of Healthcare Technologies Society and Foundation Medicine
Type: Journal Article | Journal: Journal of natural science, biology, and medicine | Year: 2015

Rural population in developing countries face water, sanitation, and hygiene-related health issues. To objectively highlight these issues, we studied the knowledge, attitude, and practices-related to drinking water and sanitation facilities among the rural population of Chennai, India.A cross-sectional study was designed involving individuals over 18 years of age living in Thandalam village, Chennai, India. Basic information about sociodemographic profile and existing drinking water and sanitation related knowledge, attitude, and practices was collected using a modified version of previously validated questionnaire and analyzed.Forty-five percent of the participants were not following any methods of water treatment and among them half of the participants felt that water available to them was clean and did not require any additional treatment. Twenty-five percent of the participants surveyed did not have access to toilets inside their household.There is a need for intervention to educate individuals about drinking water treatment methods, sanitation, and hand washing practices.


Joshi A.,University of Nebraska Medical Center | Joshi A.,Asian Institute of Public Health | Mehta S.,Foundation of Healthcare Technologies Society | Grover A.,Indian Council of Medical Research | And 3 more authors.
Diabetes Technology and Therapeutics | Year: 2013

Background: Patients' knowledge, attitudes, and behavior play a large role in preventing and managing the risk factors making up metabolic syndrome (MetS). MetS is associated with increased morbidity and mortality per the World Health Organization criteria. The objective of the study was to examine the current health literacy levels, risk perceptions about MetS, and associated management challenges in diverse Indian settings. Subjects and Methods: This cross-sectional study was performed during the period of April-May 2012 by enrolling 125 individuals at risk of MetS from urban, rural, and slum settings in India. A convenience sample was recruited from primary care clinics. In-depth interviews were conducted using ground theory and framework analysis. Individuals 30 years old and above with confirmed diagnosis of obesity, type 2 diabetes mellitus, hypertension, or hypercholesterolemia and willing to participate in the in-depth interviews were included in the study. Individuals involved in other research studies were excluded. Results: Difficulty in understanding healthcare information was commonly reported, especially in rural and slum settings. Only 10% of the individuals perceived lifestyle behaviors as a risk factor of acquiring MetS. Significant disparities were seen among urban, rural, and slum individuals about using diet and exercise as means to manage their MetS. Individuals in slum and rural settings were rarely advised about diet and exercise approaches to manage MetS. Access to appropriate information and direction from the healthcare professionals is lacking. Conclusions: Different perceptions about MetS and its varied management approaches exist across the three settings. An urgent need exists to develop interactive health education programs that can enhance self-management approaches to meet the growing burden of MetS by providing access to right information applicable to individuals living in diverse Indian settings. © Mary Ann Liebert, Inc.


Joshi A.,University of Nebraska Medical Center | Joshi A.,Center for Public Health Informatics | Mehta S.,Center for Public Health Informatics | Mehta S.,Foundation of Healthcare Technologies Society | And 2 more authors.
BMJ Open | Year: 2013

Introduction: The rising prevalence of overweight and obesity has a direct correlation with increasing prevalence of hypertension, dyslipidaemia, type 2 diabetes, metabolic syndrome (MetS) and cardiovascular diseases. Most of the previous studies have been cross-sectional in nature and have looked at the prevalence of metabolic syndrome. Despite the clinical and public health importance of this phenomenon, not enough work has been carried out so far to study and remedy this situation. The objectives of the proposed study is to develop an innovative usercentred informatics platform that will facilitate delivery of a multifactorial intervention after taking into account user sociodemographics, health behaviour, prior disease state and knowledge attitudes and practices. Objective: The objective of the proposed study is to develop an innovative user-centred informatics platform that will facilitate delivery of a multifactorial intervention after taking into account users' sociodemographics, health behaviour, prior disease state and knowledge, attitudes and behaviour. Methods and analysis: A randomised two-group repeated-measures clinical trial design will be used, on 750 subjects from urban, rural and slum areas, in an Indian setting. The study participants will be randomly assigned to either the intervention (computer-based MetS Program, CBMP) or control (printed educational material, PEM) group. Both the groups will undergo screening, learning and evaluation assessments at the time of the visit and at follow-up visits 30, 60 and 90 days after the first visit. Outcomes: The outcomes expected in the intervention group include improvement in Mets-related knowledge, adherence to self-care practices, better quality of life and increased satisfaction with medical care. Ethics and dissemination: The study has been approved by the Institutional Review Board of Asian Institute of Public Health (IRB#621). The proposed study will also help us assess the usefulness and challenges of technology to disseminate health education among diverse users. Findings will be disseminated through peerreviewed publications and national and international conference presentations to various stakeholders and local community health leaders. The ClinicalTrials.gov Identifier is NCT01713465.


Joshi A.,College of Public Administration | Mohan K.,Saveetha University | Mohan K.,Foundation of Healthcare Technologies Society | Grin G.,Center for Public Health Informatics | Perin D.M.P.,College of Public Administration
Journal of Community Health | Year: 2013

Non communicable diseases (NCDs) are now the major cause of death and disability worldwide. It increasingly affects people from developing as well as developed countries. Over the coming decades the burden from NCDs is projected to rise particularly fast in the developing world. There is a lack of optimal data collection about the burden of risk factors related to NCDs especially in the developing countries. To assess the burden of healthcare utilization and out-of-pocket costs associated with NCDs in an Indian setting. A cross sectional study was performed to enroll a convenient sample of 166 participants aged 18 years and above from a tertiary hospital in Punjab, a Northern state of India. The data was gathered during the period of Feb 2010-April 2010. A mixed methods approach was used to assess the burden of diabetes, hypertension, high cholesterol, and their associated risk factors. Further we evaluated the burden of healthcare utilization and out-of-pocket costs associated with these conditions using self-reported assessments. Results showed the average age of the participants was 50 years, 63 % (n = 104) were females, 32 % (n = 53) had education less than high school and 20 % (n = 33) had no formal education. About 96 % of the study participants were living with a partner. Majority of the study participants were non-smokers and 17 % (n = 27) of them reported to have history of alcohol consumption. The majority of the participants had access to cell phones (94 %; n = 156) and about 40 % (n = 66) had computers at home. About 33 % (n = 55) of the study participants had some form of previous knowledge of computers. Majority of the study participants went to the private hospital (47.5 %) for seeking healthcare. About 32 % (n = 53) also sought healthcare from some kind of healthcare professional including a primary care doctor or a nurse or even a pharmacist in a village setting. Doctor visits related to diabetes were higher as compared to the individuals either with hypertension or high cholesterol. However; the out-of-pocket costs of the visit to the healthcare professional were much higher for hypertension than for diabetes or high cholesterol. A strengthened surveillance system, effective inter-sectoral action, and improved access to basic healthcare are pivotal to prevent NCDs. A multifaceted NCDs surveillance system could help us measure the burden of risk factors, its associated health care utilization and out of pocket costs, and further facilitate interventions that can guide evidence based decision making. © 2012 Springer Science+Business Media New York.


Joshi A.,University of Nebraska Medical Center | Puricelli Perin D.M.,University of Nebraska Medical Center | Arora M.,Foundation of Healthcare Technologies Society
Rural and Remote Health | Year: 2013

Introduction: Cancer, cardiovascular disease, chronic respiratory disease, and type 2 diabetes, are responsible for over 50% of worldwide mortality. Chronic diseases have broad negative impacts in developing countries. Contributing to the development of chronic diseases are sedentary lifestyles, poor nutrition and eating habits, and air pollution, among other risk factors. These are also greatly increasing, and obesity has become a global phenomenon. Health promotion, and chronic disease prevention and surveillance, can be achieved through information and communication technologies (ICT), which acquire, disseminate and store health-related information electronically. The portable health information kiosk (PHIK) can be a powerful tool for promoting health education in communities in both urban and rural settings. The objective of the study was to utilize a PHIK as a tool to assess the burden of chronic disease and associated risk factors in diverse settings in India. Methods: A convenience sample was enrolled from three diverse geographical locations including urban, rural and tribal to explore the utilization of a PHIK for chronic disease health risk assessment in a community setting. Cross-sectional data was recorded during the period of March-May 2010 in Rourkela and Bhubaneswar in the state of Orissa, India. Participants were asked to use a touch screen, electronic kiosk that gathered subjective and objective data to understand the burden of chronic diseases and associated risk in the community setting. The subjective data included responses to a series of multiple-choice questions and the objective data was gathered using multiple physiological sensors such as weight, blood sugar and blood pressure. Descriptive analysis was performed using univariate statistics with results for the continuous variables being reported as means and standard deviations while results for the categorical variables were reported as frequency statistics as appropriate. Results: A total of 429 participants aged 18 years and older were enrolled in three different community settings: urban, slum and tribal. Significant differences were seen in the systolic blood pressure of those living in the urban settings as compared with those living in either slum (p=0.04) or tribal settings (p=0.02). Significant differences in the blood sugar levels were seen only among those living in the tribal as compared with the urban settings (p=0.04). Results showed high prevalence of pre-hypertension, stages 1 and 2 hypertension among those living in the slum and tribal settings. Conclusions: The results show the presence of chronic diseases in tribal and slum communities. The assessment of chronic health conditions in these populations is insufficient. Poor infrastructure and lack of qualified personnel are challenges to providing a meaningful service, as low wages, poor living and working conditions are obstacles that prevent the trained workforce from establishing themselves in these areas of extreme need. Health kiosks can be a multifaceted solution, as they can be used to assess health outcomes in areas that normally are not covered due to lack of infrastructure or health personnel, to establish health education modules and inform the local population about them. They can support evidence-based decisions for national and regional programs and policies. © A Joshi, DM Puricelli Perin, M Arora, 2013.


Mudgapalli V.,Foundation of Healthcare Technologies Society | Sharan S.,Foundation of Healthcare Technologies Society | Amadi C.,City University of New York | Joshi A.,City University of New York
Technology and Health Care | Year: 2016

BACKGROUND: Hypertension rates are increasing in India, and prior research has not explored the perception of using mobile based SMS among urban hypertensive individuals living in slum settings in India. OBJECTIVE: To explore the perception of receiving SMS based health messages among hypertensive individuals in urban slums. METHODS: A cross sectional study was conducted during the period of December 2013 in an urban slum setting of South Delhi, New Delhi, India. Eligible study participants included: 45 individuals aged 30 years and above, with confirmed diagnosis of high blood pressure, owned a mobile phone/landline and were willing to participate. RESULTS: Results of our study showed participants (n = 45) had an average age of 48 years (SD = 12), mostly female (64%, n = 29), and currently married (80%, n = 36). Their most common perceived hypertension risk factors included: worry/anxiety/stress (84%, n = 38), and high fat diet (68%, n = 30). Mobile calls were the most preferred mode of receiving lifestyle counseling among study participants (71%, n = 32). Majority preferred to receive counseling in Hindi language (67%, n = 30), and more than half were willing to pay for these services (60%, n = 27). CONCLUSION: Our findings suggest the need for innovations that utilize basic phone platforms, mobile calling feature, and language tailored interventions. © 2016 - IOS Press and the authors. All rights reserved.


PubMed | Foundation of Healthcare Technologies Society and City University of New York
Type: Journal Article | Journal: Technology and health care : official journal of the European Society for Engineering and Medicine | Year: 2016

Hypertension rates are increasing in India, and prior research has not explored the perception of using mobile based SMS among urban hypertensive individuals living in slum settings in India.To explore the perception of receiving SMS based health messages among hypertensive individuals in urban slums.A cross sectional study was conducted during the period of December 2013 in an urban slum setting of South Delhi, New Delhi, India. Eligible study participants included: 45 individuals aged 30 years and above, with confirmed diagnosis of high blood pressure, owned a mobile phone/landline and were willing to participate.Results of our study showed participants (n= 45) had an average age of 48 years (SD = 12), mostly female (64%, n= 29), and currently married (80%, n= 36). Their most common perceived hypertension risk factors included: worry/anxiety/stress (84%, n= 38), and high fat diet (68%, n= 30). Mobile calls were the most preferred mode of receiving lifestyle counseling among study participants (71%, n= 32). Majority preferred to receive counseling in Hindi language (67%, n= 30), and more than half were willing to pay for these services (60%, n= 27).Our findings suggest the need for innovations that utilize basic phone platforms, mobile calling feature, and language tailored interventions.

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