Browsing by Author "Bodke, Kunal"

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    Addressing People and Place Microenvironments in Weight Loss Disparities (APP-Me): Design of a randomized controlled trial testing timely messages for weight loss behavior in low income black and white women
    (Elsevier, 2018) Clark, Daniel O.; Srinivas, Preethi; Bodke, Kunal; Keith, NiCole; Hood, Sula; Tu, Wanzhu; Medicine, School of Medicine
    Background Behavioral interventions for weight loss have been less effective in lower income and black women. These poorer outcomes may in part be related to these women having more frequent exposures to social and physical situations that are obesogenic, i.e., eating and sedentary cues or situations. Objectives Working with obese, lower income black and white women, Addressing People and Place Microenvironments (APP-Me) was designed to create awareness of self-behavior at times and places of frequent eating and sedentary behavior. Design APP-Me is being evaluated in a randomized controlled trial with 240 participants recruited from federally qualified health centers located in a single Midwestern city. All participants complete four weeks of ecological momentary assessments (EMA) of situations and behavior. At the end of the four weeks, participants are randomized to enhanced usual care (UC) or UC plus APPMe. Methods APP-Me is an automated short messaging system (SMS). Messages are text, image, audio, or a combination, and are delivered to participants’ mobile devices with the intent of creating awareness at the times and places of frequent eating or sedentary behavior. The EMA data inform the timing of message deliveries. Summary This project aims to create and test timely awareness messages in a subpopulation that has not responded well to traditional behavioral interventions for weight loss. Novel aspects of the study include the involvement of a low income population, the use of data on time and place of obesogenic behavior, and message delivery time tailored to an individual’s behavioral patterns.
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    Human factors in mental healthcare : A work system analysis of a community-based program for older adults with depression and dementia
    (Elsevier, 2017-10) Heiden, Siobhan M.; Holden, Richard J.; Alder, Catherine A.; Bodke, Kunal; Boustani, Malaz; BioHealth Informatics, School of Informatics and Computing
    Mental healthcare is a critical but largely unexplored application domain for human factors/ergonomics. This paper reports on a work system evaluation of a home-based dementia and depression care program for older adults, the Aging Brain Care program. The Workflow Elements Model was used to guide data collection and analysis of 59 h of observation, supplemented by key informant input. We identified four actors, 37 artifacts across seven types, ten action categories, and ten outcomes including improved health and safety. Five themes emerged regarding barriers and facilitators to care delivery in the program: the centrality of relationship building; the use of adaptive workarounds; performance of duplicate work; travel and scheduling challenges; and communication-related factors. Findings offer new insight into how mental healthcare services are delivered in a community-based program and key work-related factors shaping program outcomes.
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    Rapid Field Testing of Tablet Computers with Older Adults
    (Office of the Vice Chancellor for Research, 2016-04-08) Bodke, Kunal; Holden, Richard J.
    Many older adults experience depressive symptoms or suffer severe mental illnesses such as dementia. “Project T” was created within the eHealth division of an Eskenazi Health aging brain center as a pilot of rapid translational field research on health information technology for older adults with mental health needs. The purpose of Project T was to understand whether and how older adults in the Eskenazi Aging Brain Care (ABC) program are willing and able to use a tablet device and specific applications (“apps”) and functions: video call, self-report surveys, and games. We also tested: 1) the level of instruction, prompting, and demonstration required for participants to perform tablet tasks; and 2) variability in tablet use with age, medical condition, perceived likelihood of tablet acceptance, and assistance from an informal caregiver (e.g., family member). We developed and deployed a field usability test in the Eskenazi ABC patient population. The test assessed completion speed and accuracy, user response to the tablet, difficulties encountered by users, and usability of specific features of the hardware and software. Patients and, when applicable, informal caregivers, were exposed to the tablet in their home or clinic waiting room, in the presence of a clinician and eHealth researchers. The researchers were provided scripted instructions and prompts to guide participants. Researchers recorded both qualitative and quantitative observations. Thirteen participants (eight males, five females) performed the test. On an average 63% used the tablet with instructions and a few required demonstrations. Except one, all participants showed interest in using the tablet. Findings offer directions for designing mobile technologies to support professional, informal, and self-care among older adults with mental health needs.
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    Usability and feasibility of consumer-facing technology to reduce unsafe medication use by older adults
    (Elsevier, 2019) Holden, Richard J.; Campbell, Noll L.; Abebe, Ephrem; Clark, Daniel O.; Ferguson, Denisha; Bodke, Kunal; Boustani, Malaz A.; Callahan, Christopher M.; Medicine, School of Medicine
    Background Mobile health technology can improve medication safety for older adults, for instance, by educating patients about the risks associated with anticholinergic medication use. Objective This study's objective was to test the usability and feasibility of Brain Buddy, a consumer-facing mobile health technology designed to inform and empower older adults to consider the risks and benefits of anticholinergics. Methods Twenty-three primary care patients aged ≥60 years and using anticholinergic medications participated in summative, task-based usability testing of Brain Buddy. Self-report usability was assessed by the System Usability Scale and performance-based usability data were collected for each task through observation. A subset of 17 participants contributed data on feasibility, assessed by self-reported attitudes (feeling informed) and behaviors (speaking to a physician), with confirmation following a physician visit. Results Overall usability was acceptable or better, with 100% of participants completing each Brain Buddy task and a mean System Usability Scale score of 78.8, corresponding to “Good” to “Excellent” usability. Observed usability issues included higher rates of errors, hesitations, and need for assistance on three tasks, particularly those requiring data entry. Among participants contributing to feasibility data, 100% felt better informed after using Brain Buddy and 94% planned to speak to their physician about their anticholinergic related risk. On follow-up, 82% reported having spoken to their physician, a rate independently confirmed by physicians. Conclusion Consumer-facing technology can be a low-cost, scalable intervention to improve older adults’ medication safety, by informing and empowering patients. User-centered design and evaluation with demographically heterogeneous clinical samples uncovers correctable usability issues and confirms the value of interventions targeting consumers as agents in shared decision making and behavior change.