Protective Behaviors Following Digital COVID-19 Exposure Notifications, Washington State, September 1, 2021, to March 1, 2022.

Context: Digital exposure notification (EN) systems were widely used to supplement public health case investigations and contact tracing during the 2019 coronavirus disease (COVID-19) pandemic. In Washington State, the state Department of Health (DOH) implemented one such system, WA Notify, which generated ENs based on smartphone Bluetooth proximity detection. However, the privacy preserving measures of this technology prevented collection of information on how users responded after seeing an EN on their device.

Evaluation of the effectiveness of Washington State's digital COVID-19 exposure notification system over one pandemic year.

Introduction: Digital exposure notifications are a novel public health intervention used during the COVID-19 pandemic to alert users of possible COVID-19 exposure. We seek to quantify the effectiveness of Washington State's digital exposure notification system, WA Notify, as measured by the number of COVID-19 cases averted during a 1-year period.

Methods: While maintaining individuals' privacy, WA Notify collected data that could be used to evaluate the system's effectiveness.

Use of Digital COVID-19 Exposure Notifications at a Large Gathering: Survey Analysis of Public Health Conference Attendees.

Background: WA Notify was Washington State's smartphone-based COVID-19 digital exposure notification (EN) tool, which was used to help limit the spread of COVID-19 between November 30, 2020, and May 11, 2023. Following the 2022 Washington State Public Health Association Annual Conference, attendees who had WA Notify activated began receiving ENs alerting them to a possible COVID-19 exposure during the conference. A survey was emailed to all conference attendees to measure WA Notify adoption, mechanisms through which attendees received ENs, and self-reported engagement in protective behaviors postexposure.

Fostering Governance and Information Partnerships for Chronic Disease Surveillance: The Multi-State EHR-Based Network for Disease Surveillance.

Context: Electronic health records (EHRs) are an emerging chronic disease surveillance data source and facilitating this data sharing is complex.

Program: Using the experience of the Multi-State EHR-Based Network for Disease Surveillance (MENDS), this article describes implementation of a governance framework that aligns technical, statutory, and organizational requirements to facilitate EHR data sharing for chronic disease surveillance.

Implementation: MENDS governance was cocreated with data contributors and health departments representing Texas, New Orleans, Louisiana, Chicago, Washington, and Indiana through engagement from 2020 to 2022.

Leveraging Electronic Health Record Data for Timely Chronic Disease Surveillance: The Multi-State EHR-Based Network for Disease Surveillance.

Context: Electronic health record (EHR) data can potentially make chronic disease surveillance more timely, actionable, and sustainable. Although use of EHR data can address numerous limitations of traditional surveillance methods, timely surveillance data with broad population coverage require scalable systems. This report describes implementation, challenges, and lessons learned from the Multi-State EHR-Based Network for Disease Surveillance (MENDS) to help inform how others work with EHR data to develop distributed networks for surveillance.

Trading-off privacy and utility: the Washington State experience assessing the performance of a public health digital exposure notification system for coronavirus disease 2019.

Objective: Digital exposure notifications (DEN) systems were an emergency response to the coronavirus disease 2019 (COVID-19) pandemic, harnessing smartphone-based technology to enhance conventional pandemic response strategies such as contact tracing. We identify and describe performance measurement constructs relevant to the implementation of DEN tools: (1) reach (number of users enrolled in the intervention); (2) engagement (utilization of the intervention); and (3) effectiveness in preventing transmissions of COVID-19 (impact of the intervention). We also describe WA State's experience utilizing these constructs to design data-driven evaluation approaches.

Engagement in Protective Behaviors by Digital Exposure Notification Users During the COVID-19 Pandemic, Washington State, January-June 2021.

Objectives: Smartphone-based digital exposure notification (EN) tools were introduced during the COVID-19 pandemic to supplement strained case investigation and contact tracing efforts. We examined the influence of an EN tool implemented in Washington State, WA Notify, on user engagement in behaviors that protect against COVID-19 transmission.

Methods: From January 25 through June 30, 2021, we administered 2 surveys to WA Notify users who received notification of a possible COVID-19 exposure.

Equity and Accessibility of Washington State's COVID-19 Digital Exposure Notification Tool (WA Notify): Survey and Listening Sessions Among Community Leaders.

Background: In November 2020, WA Notify, Washington State's COVID-19 digital exposure notification tool, was launched statewide to mitigate ongoing COVID-19 transmission. WA Notify uses the Bluetooth proximity-triggered, Google/Apple Exposure Notification Express framework to distribute notifications to users who have added or activated this tool on their smartphones. This smartphone-based tool relies on sufficient population-level activation to be effective; however, little is known about its adoption among communities disproportionately impacted by the COVID-19 pandemic or what barriers might limit its adoption and use among diverse populations.

WA Notify: the planning and implementation of a Bluetooth exposure notification tool for COVID-19 pandemic response in Washington State.

Bluetooth exposure notification tools for mobile phones have emerged as one way to support public health contact tracing and mitigate the spread of COVID-19. Many states have launched their own versions of these tools. Washington State's exposure notification tool, WA Notify, became available on November 30, 2020, following a one-month Seattle campus pilot at the University of Washington.

Enhancing patient-provider communication with the electronic self-report assessment for cancer: a randomized trial.

Purpose: Although patient-reported cancer symptoms and quality-of-life issues (SQLIs) have been promoted as essential to a comprehensive assessment, efficient and efficacious methods have not been widely tested in clinical settings. The purpose of this trial was to determine the effect of the Electronic Self-Report Assessment-Cancer (ESRA-C) on the likelihood of SQLIs discussed between clinicians and patients with cancer in ambulatory clinic visits. Secondary objectives included comparison of visit duration between groups and usefulness of the ESRA-C as reported by clinicians.

An automated surveillance and analysis tool for online STI/HIV behaviors.

As part of a preliminary investigation, proof-of-concept software was developed to automatically retrieve, process, and classify online behaviors related to STI/HIV transmission. 300 online sexual solicitations were automatically collected, processed and characterized by the software using a shallow natural language processor. The results of the software analysis were compared with expert manual coding for agreement.

ActiveOptions: leveraging existing knowledge and usability testing to develop a physical activity program website for older adults.

ActiveOptions (http://www.activeoptions.org) is a multi-agency effort to help people remain healthy as they age by providing Web access to information about senior-friendly exercise programs.

Time-tradeoff utilities for identifying and evaluating a minimum data set for time-critical biosurveillance.

Background: Researchers and policy makers are interested in identifying, implementing, and evaluating a national minimum data set for biosurveillance. However, work remains to be done to establish methods for measuring the value of such data.

Purpose: The purpose of this article is to establish and evaluate a method for measuring the utility of biosurveillance data.

Multidisciplinary eHealth survey evaluation methods.

This paper describes the development process of an evaluation framework for describing and comparing web survey tools. We believe that this approach will help shape the design, development, deployment, and evaluation of population-based health interventions. A conceptual framework for describing and evaluating web survey systems will enable the developers of health interventions to identify, select, and use the most appropriate and relevant survey tools.

Evaluation of a mass dispensing exercise in a Cities Readiness Initiative setting.

Purpose: The effectiveness of a point of dispensing (POD) used in a mass dispensing exercise was evaluated.

Methods: Public Health-Seattle & King County (PHSKC), in conjunction with the University of Washington, conducted a functional exercise of mass dispensing plans to test the effectiveness of a POD. Specifically, the organization and maintenance of patient flow, staffing model, signage, and dissemination of public information were evaluated.

Active options: a Web application to help seniors locate fitness resources.

We describe a Web-based survey system that collects information about physical activity programs for elderly adults, and permits elderly users to search for programs that meet their needs. The system is a centralized application that supports multiple regions and facilitates data extraction and analysis.

Electronic Self-report Assessment--Cancer (ESRA-C): Working towards an integrated survey system.

The Clinical Informatics Research Group and Biobehavioral Nursing and Health Systems at the University of Washington are working with interdisciplinary teams to improve patient care and tracking of patient-reported symptoms and outcomes by creating an extensible web-based survey and intervention platform. The findings and cumulative experience from these processes have led to incremental improvements and variations in each new implementation of the platform. This paper presents progress in the first year of a three-year NIH study entitled Electronic Self Report Assessment--Cancer (ESRA-C).

Design and implementation of Cell-PREVEN: a real-time surveillance system for adverse events using cell phones in Peru.

With more clinical trials involving evaluations of new drugs or vaccines, monitoring for early detection of adverse events is essential. The overall goal of this study was to develop an interactive-computer system using cell phones for real-time collection and transmission of adverse events related to metronidazole administration among female sex workers (FSW) in Peru. We developed an application for cell phones in Spanish, called Cell-PREVEN, based on a system from Voxiva Inc.

Mobile eHealth interventions for obesity: a timely opportunity to leverage convergence trends.

Obesity is often cited as the most prevalent chronic health condition and highest priority public health problem in the United States. There is a limited but growing body of evidence suggesting that mobile eHealth behavioral interventions, if properly designed, may be effective in promoting and sustaining successful weight loss and weight maintenance behavior changes. This paper reviews the current literature on the successes and failures of public health, provider-administered, and self-managed behavioral health interventions for weight loss.

Computerized symptom and quality-of-life assessment for patients with cancer part I: development and pilot testing.

Purpose/objectives: To develop and test an innovative computerized symptom and quality-of-life (QOL) assessment for patients with cancer who are evaluated for and treated with radiation therapy.

Design: Descriptive, longitudinal prototype development and cross-sectional clinical data.

Setting: Department of radiation oncology in an urban, academic medical center.

Collection and integration of clinical data for surveillance.

Objective: The syndromic surveillance project at Public Health-Seattle & King County incorporates several data sources, including emergency department and primary care visit data collected and normalized through an automated mechanism. We describe significant changes made in this "second generation" of our system to improve data quality while complying with privacy and state public health reporting regulations.

Methods/results: The system uses de-identified visit and patient numbers to assure data accuracy, while shielding patient identity.

Development and evaluation of public health informatics at University of Washington.

Public Health Informatics (PHI) education began at the University of Washington (UW) with a Summer Institute in 1995. The Biomedical and Health Informatics graduate program, which is housed in the School of Medicine, is an interdisciplinary, multi-school program. It demonstrates the UW's cooperative efforts in advancing informatics, encompassing the schools of public health, medicine, nursing, dentistry, pharmacy, information and graduate schools in computer science.

Critically Appraised Topics (CAT) peer-to-peer network.

A peer-to-peer network of Critically Appraised Topics or CATs would allow sharing of relevant clinical information regarding specific clinical problems among physicians. This proposed network would enable clinicians to develop and share CATs to other users within the network. This poster describes a proposed implementation of a peer-to-peer internet based sharing of critically appraised topics in the Philippines.

Diagnoses, syndromes, and diseases: a knowledge representation problem.

Despite their widespread use, the terms "syndrome", "disease" and "diagnosis" are sometimes utilized improperly and ambiguously, compounding the complexities of medical knowledge representation. The definitions and illustrative examples provided here will be useful for developers of diagnostic expert systems. Description of the Problem Representing medical knowledge is a highly complex endeavor.

A proposed ontology for online healthcare surveys.

This paper results from the research efforts of the Clinical Informatics Research Group in building a generalized system for online survey implementation. Key to the success of any generalized survey system is a standard ontology for the differing components of any survey, particularly those sought to be implemented online, over the World Wide Web. In this paper, we introduce the need for generalized survey authoring tools, discuss our methods for elucidating the different components present in many healthcare instruments and classifying them as per existing standards, and later present our proposed ontology for online surveys in the healthcare domain.