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Effectiveness of a Personalized Health Profile on Specificity of Self-Management Goals Among People Living with HIV in Canada.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Effectiveness of a Personalized Health Profile on Specificity of Self-Management Goals Among People Living with HIV in Canada./
Author:	Mozafarinia, Seyedeh Maryam.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
Description:	288 p.
Notes:	Source: Dissertations Abstracts International, Volume: 83-10, Section: B.
Contained By:	Dissertations Abstracts International83-10B.
Subject:	Infections. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29043473
ISBN:	9798209934875

Effectiveness of a Personalized Health Profile on Specificity of Self-Management Goals Among People Living with HIV in Canada.
Mozafarinia, Seyedeh Maryam.

Effectiveness of a Personalized Health Profile on Specificity of Self-Management Goals Among People Living with HIV in Canada. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 288 p.

Source: Dissertations Abstracts International, Volume: 83-10, Section: B.

Thesis (Ph.D.)--McGill University (Canada), 2021.

This item must not be sold to any third party vendors.

Chronic conditions remain the greatest global health challenge. Some previously known terminal conditions, such as HIV, have transformed into chronic conditions. The burden of chronic conditions has led to the proliferation of many self-management interventions to help patients manage diverse effects of their chronic conditions. Goal setting is one main pillar of self-management yet, little has been reported on goal formulation and the extent of goal exchange between patients and caregivers.People set goals based on their health reference point. Yet not everyone is aware of their reference points. Thereby, the questions raised are whether people living with chronic conditions are ready to set their own self-management goals and whether a health profile could facilitate goal formulation. Taking HIV as an example of a chronic condition, the aim of this thesis is to contribute evidence towards self-management capability of people living with chronic conditions.To achieve this overall goal, this thesis entailed five distinct components.Manuscript 1, entitled "An umbrella review of the literature on the effectiveness of goal setting interventions in improving health outcomes in chronic conditions", provided a comprehensive review of goal setting interventions in the context of chronic disease management. In this work, a total of 7 systematic reviews with 125 primary studies were reviewed to identify the components of goal setting interventions and to estimate the magnitude of goal setting effect on improvement of health outcomes. The evidence was suggestive of little or no likelihood of achieving the intended health outcomes based on the solo effect of goal setting, even though some degrees of change was shown. This umbrella review highlighted that episodic health outcomes or short follow-ups cannot represent the effect of goal setting. In addition, insufficient details of goal setting interventions did not allow disentangling the extent of patients' involvement in the process. Findings of this umbrella review further triggered the question as to whether patients are prepared for setting self-management goals for their real-world condition.Manuscript 2 entitled "Development and usability of a feedback tool, "My Personal Brain Health Dashboard", to improve setting of self‐management goals among people living with HIV in Canada" was inspired by the knowledge-to-action framework and used longitudinal data acquired from a Canadian longitudinal study on multiple domains of quality of life. The aim of the feedback tool (termed Dashboard) was to improve people's understanding of their health reference point by providing meaningful information on their adjustment with chronic condition. Through this work fifteen HIV+ respondents were recruited from Montreal and Vancouver and appropriateness of the Dashboard for goal-setting was tested. The Dashboard was endorsed as a useful tool for setting health-related goals. A total of 85 goals were set, which served as a textual data for expansion of a goal setting lexicon for scoring goal quality presented in subsequent manuscripts.The content and layout of the Dashboard was intended to help improve individuals' ability to reflect on their own health status, make choices, and set self-management goals that would eventually lead to improved health outcomes. Manuscript 3 documented the protocol for a pragmatic trial designed to test this hypothesis.Manuscript 4 entitled "Effectiveness of a personalized health profile on specificity of selfmanagement goals among people living with HIV in Canada: findings from a blinded pragmatic randomized controlled trial" was to estimate whether providing feedback on health outcomes, compared to no feedback, will affect number and specificity of self-defined goals. This study was a subset of a cohort multiple randomized controlled trial which provided access to the participants who were eligible. A total of 110 survey responses (56 in English/54 in French), entailing 421 goals, were analyzed. Findings suggested of no positive effect of the Dashboard on the primary outcomes. Similar performance and goal quality were observed in both groups. This work involved a novel approach towards measuring goal quality where text mining algorithms detected predefined goal criteria. Level of agreement between individual raters and text mining output confirmed text mining's potential to remove hurdles in goal evaluation outside of the face-to-face setting.Lastly, a qualitative secondary analysis was caried out to tackle influences of self-management goals judged by the persons living the condition. Findings of Manuscript 5 entitled "Barriers and enablers to acting on self-management goals among people living with HIV in Canada" informed that HIV+ people are able to report their priorities, areas of challenges, and potential facilitators.Self-management is a powerful idea, provided that it is successfully translated from an idea to the daily reality of people concerned where people's priorities and capacity to change are considered. Self-management at population-base is time and resource intensive. The growing domain of digital health offers opportunities that could be used to help improve self-management skills of people living with chronic conditions. The novel approach towards measuring goal quality presented in this thesis illustrates one example of such opportunity.

ISBN: 9798209934875Subjects--Topical Terms:

1621997
Infections.

Effectiveness of a Personalized Health Profile on Specificity of Self-Management Goals Among People Living with HIV in Canada.
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100 1 $a Mozafarinia, Seyedeh Maryam. $3 3685866
245 1 0 $a Effectiveness of a Personalized Health Profile on Specificity of Self-Management Goals Among People Living with HIV in Canada.
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300 $a 288 p.
500 $a Source: Dissertations Abstracts International, Volume: 83-10, Section: B.
500 $a Advisor: Mayo, Nancy.
502 $a Thesis (Ph.D.)--McGill University (Canada), 2021.
506 $a This item must not be sold to any third party vendors.
520 $a Chronic conditions remain the greatest global health challenge. Some previously known terminal conditions, such as HIV, have transformed into chronic conditions. The burden of chronic conditions has led to the proliferation of many self-management interventions to help patients manage diverse effects of their chronic conditions. Goal setting is one main pillar of self-management yet, little has been reported on goal formulation and the extent of goal exchange between patients and caregivers.People set goals based on their health reference point. Yet not everyone is aware of their reference points. Thereby, the questions raised are whether people living with chronic conditions are ready to set their own self-management goals and whether a health profile could facilitate goal formulation. Taking HIV as an example of a chronic condition, the aim of this thesis is to contribute evidence towards self-management capability of people living with chronic conditions.To achieve this overall goal, this thesis entailed five distinct components.Manuscript 1, entitled "An umbrella review of the literature on the effectiveness of goal setting interventions in improving health outcomes in chronic conditions", provided a comprehensive review of goal setting interventions in the context of chronic disease management. In this work, a total of 7 systematic reviews with 125 primary studies were reviewed to identify the components of goal setting interventions and to estimate the magnitude of goal setting effect on improvement of health outcomes. The evidence was suggestive of little or no likelihood of achieving the intended health outcomes based on the solo effect of goal setting, even though some degrees of change was shown. This umbrella review highlighted that episodic health outcomes or short follow-ups cannot represent the effect of goal setting. In addition, insufficient details of goal setting interventions did not allow disentangling the extent of patients' involvement in the process. Findings of this umbrella review further triggered the question as to whether patients are prepared for setting self-management goals for their real-world condition.Manuscript 2 entitled "Development and usability of a feedback tool, "My Personal Brain Health Dashboard", to improve setting of self‐management goals among people living with HIV in Canada" was inspired by the knowledge-to-action framework and used longitudinal data acquired from a Canadian longitudinal study on multiple domains of quality of life. The aim of the feedback tool (termed Dashboard) was to improve people's understanding of their health reference point by providing meaningful information on their adjustment with chronic condition. Through this work fifteen HIV+ respondents were recruited from Montreal and Vancouver and appropriateness of the Dashboard for goal-setting was tested. The Dashboard was endorsed as a useful tool for setting health-related goals. A total of 85 goals were set, which served as a textual data for expansion of a goal setting lexicon for scoring goal quality presented in subsequent manuscripts.The content and layout of the Dashboard was intended to help improve individuals' ability to reflect on their own health status, make choices, and set self-management goals that would eventually lead to improved health outcomes. Manuscript 3 documented the protocol for a pragmatic trial designed to test this hypothesis.Manuscript 4 entitled "Effectiveness of a personalized health profile on specificity of selfmanagement goals among people living with HIV in Canada: findings from a blinded pragmatic randomized controlled trial" was to estimate whether providing feedback on health outcomes, compared to no feedback, will affect number and specificity of self-defined goals. This study was a subset of a cohort multiple randomized controlled trial which provided access to the participants who were eligible. A total of 110 survey responses (56 in English/54 in French), entailing 421 goals, were analyzed. Findings suggested of no positive effect of the Dashboard on the primary outcomes. Similar performance and goal quality were observed in both groups. This work involved a novel approach towards measuring goal quality where text mining algorithms detected predefined goal criteria. Level of agreement between individual raters and text mining output confirmed text mining's potential to remove hurdles in goal evaluation outside of the face-to-face setting.Lastly, a qualitative secondary analysis was caried out to tackle influences of self-management goals judged by the persons living the condition. Findings of Manuscript 5 entitled "Barriers and enablers to acting on self-management goals among people living with HIV in Canada" informed that HIV+ people are able to report their priorities, areas of challenges, and potential facilitators.Self-management is a powerful idea, provided that it is successfully translated from an idea to the daily reality of people concerned where people's priorities and capacity to change are considered. Self-management at population-base is time and resource intensive. The growing domain of digital health offers opportunities that could be used to help improve self-management skills of people living with chronic conditions. The novel approach towards measuring goal quality presented in this thesis illustrates one example of such opportunity.
520 $a Les maladies chroniques demeurent un defi en sante. Certaines maladies connues comme fatale, telles que le VIH, se sont transformees en maladies chroniques. Les maladies chroniques ont mene a la proliferation d'interventions d'autogestion. La fixation d'objectifs est l'une des principaux piliers de l'autogestion. Tres peu d'etudes ont ete realisees sur la formulation des objectifs et de l'etendue de l'echange d'objectifs entre les patients et les soignants.Les gens se fixent des objectifs en fonction de leur point de reference lie a leur sante en ne connaissant pas leur point de reference. Les questions soulevees sont les suivantes : les personnes vivant avec des maladies chroniques sont-elles pretes a fixer leurs propres objectifs d'autogestion ? et un profil de sante pourrait-il faciliter la formulation des objectifs ? En prenant le VIH comme exemple d'une maladie chronique, l'objectif de cette these est de contribuer aux evidences scientifiques sur la capacite d'autogestion des personnes vivant avec une maladie chronique.Cette these comprend cinq manuscrits.Le Manuscrit 1, intitule " Une revue generale de la litterature sur l'efficacite des interventions de fixation d'objectifs dans l'amelioration des resultats en matiere de sante dans les maladies chroniques ", a fourni une revue complete des interventions de fixation d'objectifs dans le contexte de la gestion des maladies chroniques. Dans ce travail, un total de 7 revues systematiques comprenant 125 etudes primaires a ete examine afin d'identifier les composantes des interventions de fixation d'objectifs et d'estimer l'ampleur de l'effet de la fixation d'objectifs sur l'amelioration des resultats de sante. Les preuves suggerent qu'il est peu ou pas probable d'atteindre les resultats de sante desires en se basant sur l'effet de la fixation d'objectifs seulement, meme si certains degres de changement ont ete demontres. Cette revue generale a mis en evidence que les resultats episodiques en matiere de sante ou les suivis de courte duree ne peuvent pas representer l'effet de la fixation d'objectifs. En outre, le manque de details sur les interventions de fixation d'objectifs n'a pas permis l'appreciation du degre d'implication des patients dans le processus. Les resultats de cette revue generale ont souleve la question de savoir si les patients sont prepares a fixer des objectifs d'autogestion pour leur condition reelle.Le Manuscrit 2 intitule " Developpement et facilite d'utilisation d'un outil de retroaction, "Mon Profil Personnel de Sante du Cerveau", pour ameliorer la fixation d'objectifs d'autogestion chez les personnes vivant avec le VIH au Canada " s'est inspire du cadre de la connaissance a l'action et a utilise des donnees acquises dans le cadre d'une etude longitudinale canadienne sur plusieurs domaines de la qualite de vie. L'objectif de l'outil de retroaction (appele Profil) etait d'ameliorer la comprehension des personnes par rapport a leur point de reference en matiere de sante en leur fournissant des informations significatives sur leur adaptation a leur condition chronique. Dans le cadre de ce travail, quinze personnes seropositives ont ete recrutees a Montreal et a Vancouver et la pertinence du Profil pour la fixation d'objectifs a ete testee. Le Profil a ete approuve comme un outil utile pour fixer des objectifs de sante. Au total, 85 objectifs ont ete fixes, qui ont servi de donnees textuelles pour l'expansion d'un lexique de fixation d'objectifs permettant d'evaluer la qualite des objectifs presentes dans des manuscrits ulterieurs.Le contenu et la presentation du Profil devaient contribuer a ameliorer la capacite des individus a reflechir a leur propre etat de sante, a faire des choix et a fixer des objectifs d'autogestion qui conduiraient a terme a une amelioration des resultats de sante. Le Manuscrit 3 documente le protocole d'un essai pragmatique concu pour verifier cette hypothese.Le Manuscrit 4, intitule " Efficacite d'un profil de sante personnalise sur la specificite des objectifs d'autogestion chez les personnes vivant avec le VIH au Canada : resultats d'un essai controle randomise pragmatique en aveugle " visait a evaluer si le fait de fournir une evaluation sur l'etat de sante, comparativement a l'absence de l'evaluation, aura une influence sur le nombre et la specificite des objectifs definis par le participant. Cette etude etait un sous-etude d'un plus gros essai controle randomise a cohortes multiples, qui a donne acces aux participants admissibles. Un total de 110 reponses a l'enquete (56 en anglais/54 en francais), impliquant 421 objectifs, ont ete analyse. Les resultats suggerent qu'il n'y a pas d'effet positif du Profil sur le resultat principal. Des performances et une qualite d'objectifs similaires ont ete observees dans les deux groupes. Ce travail a implique une nouvelle approche de la mesure de la qualite des objectifs, pour laquelle des algorithmes d'exploration de texte ont detecte des criteres d'objectifs predefinis. Le niveau d'accord entre les evaluateurs individuels et les resultats de l'exploration de texte a confirme le potentiel de l'exploration de texte pour eliminer les obstacles a l'evaluation des objectifs en dehors du cadre du face-a-face.Enfin, une analyse secondaire qualitative a ete realisee pour aborder les influences des objectifs d'autogestion juges par les personnes vivant avec la maladie. Les resultats du Manuscrit 5 intitule " Obstacles et facteurs favorables a l'atteinte des objectifs d'autogestion chez les personnes vivant avec le VIH au Canada " indiquent que les personnes seropositives sont en mesure de faire etat de leurs priorites, de leurs difficultes et de leurs facilitateurs potentiels. L'autogestion est un outil prometteur, a condition, qu'elle soit traduite avec succes d'une idee a la realite quotidienne des personnes concernees et que les priorites et la capacite de changement des personnes sont considerees. L'autogestion au niveau de la population mondiale demande beaucoup de temps et de ressources. Le secteur en plein developpement de la sante numerique offre des possibilites qui pourraient etre utilisees pour aider a ameliorer les competences d'autogestion des personnes vivant avec des maladies chroniques. La nouvelle approche de la mesure de la qualite des objectifs presentee dans cette these est un exemple de cette opportunite.
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