A cross-sectional study of barriers to personal health record use among patients attending a safety-net clinic.
A cross-sectional study of barriers to personal health record use among patients attending a safety-net clinic.
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DOI：
10.1371/journal.pone.0031888
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Kahn JS
中科院分区：
文献类型：
--
作者：
Hilton JF;Barkoff L;Chang O;Halperin L;Ratanawongsa N;Sarkar U;Leykin Y;Muñoz RF;Thom DH;Kahn JS
个人健康记录（PHR）可以通过提供健康信息的访问和上下文来改善患者的健康。在安全网HIV/AIDS诊所接受治疗的患者中，我们检查了一种假设，即精神健康（MH）或物质使用（SU）状况是参与基于网络的健康信息的障碍，通过同意参加提供个人（PHR）或一般（非PHR）健康信息门户网站的试验以及完成基线研究调查来衡量。参与者接受单独培训，以访问和浏览个性化的在线帐户，并完成研究调查。根据需要，在应计月4至12，我们加强了参与者培训，以鼓励在工作人员的帮助下完成调查。使用逻辑回归模型，我们估计了研究参与和调查完成的比值比，合并MH/SU状态，调整计算机能力水平，研究培训和人口统计学。在2，871名临床患者中，70%患有MH/SU疾病，其中抑郁症（38%）和甲基苯丙胺使用（17%）最常见。中年患者和患有MH/SU疾病的患者在研究参与者中的比例过高（N = 338）。 调查完成在统计学上与MH/SU状态无关（OR，1.85 [95% CI，0.93-3.66]），但在MH/SU状态的患者中往往更高。无论培训水平如何，初级计算机用户的完成率都很低（<50%），但高级用户的完成率足够（>70%）。在参加安全网诊所的患者中，MH/SU条件不是参与基于网络的健康信息的障碍。相反，计算机能力水平有助于识别需要大量计算机培训才能充分参与研究的个人。密集的学习培训不足以使初学计算机的用户完成学习调查。
Personal health records (PHR) may improve patients' health by providing access to and context for health information. Among patients receiving care at a safety-net HIV/AIDS clinic, we examined the hypothesis that a mental health (MH) or substance use (SU) condition represents a barrier to engagement with web-based health information, as measured by consent to participate in a trial that provided access to personal (PHR) or general (non-PHR) health information portals and by completion of baseline study surveys posted there. Participants were individually trained to access and navigate individualized online accounts and to complete study surveys. In response to need, during accrual months 4 to 12 we enhanced participant training to encourage survey completion with the help of staff. Using logistic regression models, we estimated odds ratios for study participation and for survey completion by combined MH/SU status, adjusted for levels of computer competency, on-study training, and demographics. Among 2,871 clinic patients, 70% had MH/SU conditions, with depression (38%) and methamphetamine use (17%) most commonly documented. Middle-aged patients and those with a MH/SU condition were over-represented among study participants (N = 338). Survey completion was statistically independent of MH/SU status (OR, 1.85 [95% CI, 0.93–3.66]) but tended to be higher among those with MH/SU conditions. Completion rates were low among beginner computer users, regardless of training level (<50%), but adequate among advanced users (>70%). Among patients attending a safety-net clinic, MH/SU conditions were not barriers to engagement with web-based health information. Instead, level of computer competency was useful for identifying individuals requiring substantial computer training in order to fully participate in the study. Intensive on-study training was insufficient to enable beginner computer users to complete study surveys.
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影响因子：
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作者：
Sarkar U;Karter AJ;Liu JY;Adler NE;Nguyen R;Lopez A;Schillinger D
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DOI：
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