Renae Desai FCPRA

Background: The consideration of health-related quality of life (HRQL) is a hallmark of best practice in HIV care. Information technology offers an opportunity to more closely engage patients with chronic HIV infection in their long-term management and support a focus on HRQL. However, the implementation of patient-reported outcome (PRO) measures, such as HRQL in routine care, is challenged by the need to synthesize data generated by questionnaires, the complexity of collecting data between patient visits, and the integration of results into clinical decision-making processes. Objective: Our aim is to design and pilot-test a multimedia software platform to overcome these challenges and provide a vehicle to increase focus on HRQL issues in HIV management. Methods: A multidisciplinary team in France and Australia conducted the study with 120 patients and 16 doctors contributing to the design and development of the software. We used agile development principles, user-centered design, and qualitative research methods to develop and pilot the software platform. We developed a prototype application to determine the acceptability of the software and piloted the final version with 41 Australian and 19 French residents using 2 validated electronic questionnaires, the Depression, Anxiety and Stress Scale-21 Items, and the Patient Reported Outcomes Quality of Life-HIV. Results: Testing of the prototype demonstrated that patients wanted an application that was intuitive and without excessive instruction, so it felt effortless to use, as well as secure and discreet. Clinicians wanted the PRO data synthesized, presented clearly and succinctly, and clinically actionable. Safety concerns for patients and clinicians included confidentiality, and the potential for breakdown in communication if insufficient user training was not provided. The final product, piloted with patients from both countries, showed that most respondents found the application easy to use and comprehend. The usability testing survey administered found that older Australians had reduced scores for understanding the visual interface (P=.004) and finding the buttons organized (P=.02). Three-fourths of the respondents were concerned with confidentiality (P=.007), and this result was more prevalent in participants with higher anxiety and stress scores (P=.01), as measured by the Depression, Anxiety and Stress Scale-21 Items. These statistical associations were not observed in 15 French patients who completed the same questionnaire. Conclusions: Digital applications in health care should be safe and fit for purpose. Our software was acceptable to patients and shows potential to overcome some barriers to the implementation of PROs in routine care. The design of the clinicians’ interface presents a solution to the problem of voluminous data, both synthesizing and providing a snapshot of longitudinal data. The next stage is to conduct a randomized controlled trial to determine whether patients experience increased satisfaction with care and whether doctors perceive that they deliver better clinical care without compromising efficiency.

Objectives The aim of the study was to assess user acceptability in patients and caregivers with an electronic application designed to input patient reported outcome (ePRO) data, in this instance, the health-related quality of life instrument PROQOL-HIV, prior to clinical consultation. A feature of the application will enable the transfer of ePRO data into clinical software and the patient’s medical record. The aim being to systematically collect ePRO data that can be referenced during a clinical consultation. Methods Thirty-six semi-directive interviews were conducted in several hospitals in France and a private clinic in Australia to determine the initial user acceptability of such an application. In the first part of the interviews researchers described the purpose of the application and questioned patients (n=25) and doctors (n=11) about their computer usage habits and capabilities, their views on envisaged benefits or harms. Results The patients’ showed interest in using electronic health applications in general and in the potential capabilities of the prototype that was demonstrated. Patients envisaged an ‘efficiency gain’ for themselves and for the doctor if the volume of data transmitted was not ‘overwhelming’. Many of the doctors were already using eHealth applications. The application was perceived as potentially time saving during medical consultations but on the other hand could be time consuming if data was voluminous. Doctors asked for a clear presentation of meaningful scores. Confidentiality was a major concern for French patients, particularly migrants; and doctors, but was less striking among Australian interviewees who had confidence in data protection processes. Conclusions The qualitative study was an important part of the app development. Integration of user’s opinions on different aspects of the app such as confidentiality and the result presentation should make the development more efficient.

Public relations scholars have emphasised the role of the Internet, and in particular social media, as a new and effective way for communication professionals to engage with stakeholders on social issues. However, beyond conceptual papers, there has been limited to no empirical evidence that online spaces are indeed more effective when aiming to engage diverse, dispersed communities. This paper aims to address this gap, by examining the social media activities of two seemingly dissimilar communities: the Australian Asbestos Network and the West Australian Anti Nuclear Movement. The authors conclude that in an online advocacy context, communities create issues, as opposed to congregate around carefully crafted communications messages.

Intercultural competence, defined as the skills required for an increasingly globalised world, is poorly understood in both higher education and in its value for different professions. The challenge for educators is how to develop such competence – as a kind of professional knowledge – through the curriculum. This paper explores industry expectations of intercultural competence in public relations graduates in two cities, Singapore and Perth, and offers useful insights into the perceived value of intercultural competence for public relations. The study highlights the need for intercultural competence, as both an understanding of cultural difference and as it applies to professional knowledge, to be incorporated into public relations curricula. The findings highlight the difficulties in offering a ‘national’ curriculum, which is then exported to other countries, and demand educators address the ethnocentric values and narratives of their discipline. These findings are significant given the internationalisation of public relations education and the need to prepare graduates for careers in public relations in a globalised world.

Online communication has become an accepted term amongst Australian public relations practitioners and academics alike. However, effective models by which to research and practice in a virtual environment are yet to be fully developed. Instead, traditional communication techniques have been modified to include new media technology such as websites and corporate blogs and more recently social media, in an attempt to address the ever-growing need for organizations to ‘have an online presence’ or at least online elements to their communication campaigns (Chia, 2006; Kent, Taylor and White, 2002). This paper will argue that simply modifying traditional public relations techniques is an inadequate approach to developing online community engagement campaigns. It will instead demonstrate the necessary interdependence of communications, web technology development and design in order to show how a website designed for online community engagement, might be created. This is a central theme underpinning the rationale behind the development of the Australian Asbestos Network website, an NHMRC funded public health communication initiative due to launch in November 2010 and designed to engage the Australian community on the issue of Asbestos-related diseases and their various causes.