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.

What has been labelled the digital media revolution is now more than ten years old, but a best practice framework to teach transmedia platforms is yet to be developed. Social media and its role in tertiary education has been extensively researched across multiple disciplines, for example marketing (Constantinides & Zinck Stagno, 2011), journalism (Hirst & Treadwell, 2011) and hospitality (Fortune, Spielman, & Pangelinan, 2011), with a focus on fostering student engagement (Rutherford, 2010) and the notion of digital media platforms as interactive study support tools (Saw, Abbott, Donaghey, & McDonald, 2013; Silius et al., 2010; Wolf, 2010). However, there is little empirical research or conceptual guidelines capturing the challenges and opportunities for pedagogy presented by the continuously changing media landscape, despite the recognition that the higher education workforce is struggling to adapt to these significant changes (Fortune et al., 2011; Manca & Ranieri, 2016). Whilst the millennial generation are often assumed to be digital natives, there is a distinct difference between using technology, understanding technology, and utilising it appropriately in a professional context. Hence, this paper critically investigates communication students’ engagement with new technologies (in particular social media platforms) and learning in a transmedia environment. This study is the beginning of a longitudinal project, which aims to develop a comprehensive pedagogical best practice framework to teach transmedia concepts in real-time.

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.

The AIDS 2014 conference in Melbourne declared 'that all women, men, transgender and intersex adults and children are entitled to equal rights and to equal access to HIV prevention, care and treatment, information and services' (AIDS 2014). Along with declarations in relation to gender equality, anti-discrimination and calls for changes to law to support the rights of sufferers around the world, the Melbourne Declaration renewed global support to fight HIV/AIDS. However it was not made explicit what role communication and education would play in relation to these admirable goals. One of the reasons could be the complex nature of any potential solution. Culture, society, economics and the environment play a part in the myriad factors that lead to infection. While there has been a global decline in the rate of HIV infections since 2001, this has not been uniform across the world. Indeed, there are two key factors that suggest
that messages regarding HIV/AIDS awareness and prevention do not reach certain demographics. First, high rates of HIV infection continue to be recorded for young people aged between 15-24 (UN 2014, 35). Second, the rate of infection in developed countries such as Australia has been on the rise in recent years (The Kirby Institute 2013, 9).

Despite targeted campaigns and improved health services, the rate of HIV infections in these groups implies that existing communication methods are lacking. So in this context, can the online environment offer any viable solutions? Despite the progress made in combating HIV/AIDS in the last decade, not much has changed in terms of how the problem is framed. As the United Nations' Millennium Development Goals come to a close in 2015, the same questions regarding HIV/AIDS are still being posed: what methodologies should be used, and how can technology play a part? What is missing in this picture is an examination of what role communications can play in contributing to the fight against HIV/AIDS. We believe that in in this context, online

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.

In the conclusion to The Rise of the Network Society, the distinguished professor of sociology and communications Manuel Castells wrote: Our exploration of emergent social structures across domains of human activity and experience leads to an over-arching conclusion: as an historical trend, dominant functions and processes in the Information Age are increasingly organized around networks. Networks constitute the new social morphology of our societies, and the diffusion of networking logic substantially modifies the operation and outcomes in processes of production, experience, power, and culture. While the networking form of social organization has existed in other times and spaces, the new information technology paradigm provides the material basis for its pervasive expansion throughout the entire social structure (Castells, 2000: 500)...