Michelle Smith

All Publications

• Lost in translation: Medication labeling for immigrant families JOURNAL OF THE AMERICAN PHARMACISTS ASSOCIATION Smith, M., Yin, H., Sanders, L. M. 2016; 56 (6): 677–79

  Abstract

  To identify the patient-safety hazards of current medication labeling standards for immigrant and language-minority families.The Latino population in the United States has increased by more than 40% over the past decade and the total child population born to Latino parents will surpass one-half of the population in many states. With recent health care and immigration policies, this demographic shift has a disproportional effect on the Latino families. Research shows that recent Latin American immigrants face disparities when encountering the U.S. pharmacy system. A review of these disparities shows how new policies should be informed when considering new pharmacy regulations to better address the cultural needs of recent Latin American families to improve medication understanding and adherence.To date, research and regulatory requirements for medication safety in the United States have attended insufficiently to the patient-safety risk inherent in providing complex English-language labels to non-English-speaking families, many of whom have limited literacy in their native language. As families move, this patient-safety risk is increased by shifts in pharmacies, which often have different medication-labeling standards. It is important to examine how recent immigrant parents are addressing the medication needs for their children based on their cultural norms and how those cultural practices and acculturation into the U.S. health care system may affect their risk for injury. New research and policy efforts may help to address these barriers to safe medication use.

  View details for DOI 10.1016/j.japh.2016.07.002

  View details for Web of Science ID 000389758900015

  View details for PubMedID 27836127

  View details for PubMedCentralID PMC5648594

• Parents' Perspectives on Using Artificial Intelligence to Reduce Technology Interference During Early Childhood: Cross-sectional Online Survey. Journal of medical Internet research Glassman, J., Humphreys, K., Yeung, S., Smith, M., Jauregui, A., Milstein, A., Sanders, L. 2021; 23 (3): e19461

  Abstract

  BACKGROUND: Parents' use of mobile technologies may interfere with important parent-child interactions that are critical to healthy child development. This phenomenon is known as technoference. However, little is known about the population-wide awareness of this problem and the acceptability of artificial intelligence (AI)-based tools that help with mitigating technoference.OBJECTIVE: This study aims to assess parents' awareness of technoference and its harms, the acceptability of AI tools for mitigating technoference, and how each of these constructs vary across sociodemographic factors.METHODS: We administered a web-based survey to a nationally representative sample of parents of children aged ≤5 years. Parents' perceptions that their own technology use had risen to potentially problematic levels in general, their perceptions of their own parenting technoference, and the degree to which they found AI tools for mitigating technoference acceptable were assessed by using adaptations of previously validated scales. Multiple regression and mediation analyses were used to assess the relationships between these scales and each of the 6 sociodemographic factors (parent age, sex, language, ethnicity, educational attainment, and family income).RESULTS: Of the 305 respondents, 280 provided data that met the established standards for analysis. Parents reported that a mean of 3.03 devices (SD 2.07) interfered daily in their interactions with their child. Almost two-thirds of the parents agreed with the statements "I am worried about the impact of my mobile electronic device use on my child" and "Using a computer-assisted coach while caring for my child would help me notice more quickly when my device use is interfering with my caregiving" (187/281, 66.5% and 184/282, 65.1%, respectively). Younger age, Hispanic ethnicity, and Spanish language spoken at home were associated with increased technoference awareness. Compared to parents' perceived technoference and sociodemographic factors, parents' perceptions of their own problematic technology use was the factor that was most associated with the acceptance of AI tools.CONCLUSIONS: Parents reported high levels of mobile device use and technoference around their youngest children. Most parents across a wide sociodemographic spectrum, especially younger parents, found the use of AI tools to help mitigate technoference during parent-child daily interaction acceptable and useful.

  View details for DOI 10.2196/19461

  View details for PubMedID 33720026

• Pictograms, Units and Dosing Tools, and Parent Medication Errors: A Randomized Study PEDIATRICS Yin, H., Parker, R. M., Sanders, L. M., Mendelsohn, A., Dreyer, B. P., Bailey, S., Patel, D. A., Jimenez, J. J., Kim, K. A., Jacobson, K., Smith, M. J., Hedlund, L., Meyers, N., McFadden, T., Wolf, M. S. 2017; 140 (1)

  View details for DOI 10.1542/peds.2016-3237

  View details for Web of Science ID 000404482500013

• Liquid Medication Dosing Errors by Hispanic Parents: Role of Health Literacy and English Proficiency ACADEMIC PEDIATRICS Harris, L. M., Dreyer, B. P., Mendelsohn, A. L., Bailey, S. C., Sanders, L. M., Wolf, M. S., Parker, R. M., Patel, D. A., Kim, K. Y., Jimenez, J. J., Jacobson, K., Smith, M., Yin, S. 2017; 17 (4): 403-410

  Abstract

  Hispanic parents in the United States are disproportionately affected by low health literacy and limited English proficiency (LEP). We examined associations between health literacy, LEP, and liquid medication dosing errors in Hispanic parents.Cross-sectional analysis of data from a multisite randomized controlled experiment to identify best practices for the labeling/dosing of pediatric liquid medications (SAFE Rx for Kids study); 3 urban pediatric clinics. Analyses were limited to Hispanic parents of children aged ≤8 years with health literacy and LEP data (n = 1126). Parents were randomized to 1 of 5 groups that varied by pairing of units of measurement on the label/dosing tool. Each parent measured 9 doses (3 amounts [2.5, 5, 7.5 mL] using 3 tools [2 syringes in 0.2 or 0.5 mL increments, and 1 cup]) in random order. Dependent variable was a dosing error of >20% dose deviation. Predictor variables included health literacy (Newest Vital Sign) (limited = 0-3; adequate = 4-6) and LEP (speaks English less than "very well").A total of 83.1% made dosing errors (mean [SD] errors per parent = 2.2 [1.9]). Parents with limited health literacy and LEP had the greatest odds of making a dosing error compared to parents with adequate health literacy who were English proficient (trials with errors per parent = 28.8 vs 12.9%; adjusted odds ratio = 2.2 [95% confidence interval 1.7-2.8]). Parents with limited health literacy who were English proficient were also more likely to make errors (trials with errors per parent = 18.8%; adjusted odds ratio = 1.4 [95% confidence interval 1.1-1.9]).Dosing errors are common among Hispanic parents; those with both LEP and limited health literacy are at particular risk. Further study is needed to examine how the redesign of medication labels and dosing tools could reduce literacy- and language-associated disparities in dosing errors.

  View details for Web of Science ID 000401298200010

  View details for PubMedID 28477800

• Liquid Medication Errors and Dosing Tools: A Randomized Controlled Experiment PEDIATRICS Yin, H. S., Parker, R. M., Sanders, L. M., Dreyer, B. P., Mendelsohn, A. L., Bailey, S., Patel, D. A., Jimenez, J. J., Kim, K. A., Jacobson, K., Hedlund, L., Smith, M. C., Harris, L. M., McFadden, T., Wolf, M. S. 2016; 138 (4)

  View details for DOI 10.1542/peds.2016-0357

  View details for Web of Science ID 000384317700019