Digital Information Technology Use and Patient Preferences for Internet-Based Health Education Modalities: Cross-Sectional Survey Study of Middle-Aged and Older Adults With Chronic Health Conditions.
Digital Information Technology Use and Patient Preferences for Internet-Based Health Education Modalities: Cross-Sectional Survey Study of Middle-Aged and Older Adults With Chronic Health Conditions.
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DOI：
10.2196/12243
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发表时间：
2019-04-04
期刊：
影响因子：
4.9
通讯作者：
Crouch, Elizabeth
中科院分区：
文献类型：
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作者：
Gordon, Nancy P;Crouch, Elizabeth
背景：通过基于互联网的健康和移动健康(MHealth)数字信息技术，健康信息、患者教育和自我管理(Health Information and Advisment，HIA)工具越来越多地提供给患有慢性健康状况的成年人。然而，关于患者使用特定类型的健康信息和建议资源的偏好以及偏好和使用如何随年龄组和教育程度的不同而变化的信息有限。目的：本研究的目的是研究在患有慢性健康状况的中老年人中，数字信息技术和获取健康信息和建议的首选方法的使用如何随年龄组和教育程度的不同而不同。方法：该研究使用了9005名45岁至85岁的北加州Kaiser Permanente成员的横断面调查数据，这些成员在2014至2015年间进行了一项邮寄和基于网络的健康调查，表明至少有1种慢性健康状况。结果：45~65岁、66~75岁和76~85岁成年人使用数字信息技术(计算机、智能手机、互联网、电子邮件和应用程序)的比例，过去一年从互联网资源获取健康信息和建议的比例；而对使用基于互联网和mHealth模式获得健康信息和建议感兴趣的人随着年龄的增长而下降。在年龄段内，没有接受过大学教育的成年人中，没有接受过大学教育的成年人对数字信息技术的使用和对基于互联网的mHealth模式的兴趣低于大学毕业生。当我们将分析局限于互联网用户时，年龄最大的和年轻的群体以及受教育程度较低的群体对基于互联网的健康信息和建议模式的偏好差异显著缩小。结论：为患有慢性病的中老年人提供服务的卫生保健提供者和组织不应假设患者，特别是年龄较大和受教育程度较低的患者，希望接触基于互联网的和移动健康资源。此外，增加不使用数字设备和互联网的人与基于互联网的健康信息和建议以及mHealth应用程序的参与度，可能需要工具支持(例如，提供数字信息技术设备、互联网和技能培训)和社会支持。作为以患者为中心的护理的一部分，提供者必须确定他们的患者使用数字信息技术和偏好来获取健康信息和患者教育，而不是常规地将他们转介到基于互联网的资源。对于医疗保健提供者和消费者健康组织来说，同样重要的是对其基于Web的资源进行用户测试，以确保老年人和受教育程度较低的成年人易于使用，并确保患有慢性病的成年人仍然可以使用线下资源轻松获取健康信息和患者教育。
BACKGROUND: Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with chronic health conditions through internet-based health and mobile health (mHealth) digital information technologies. However, there is limited information about patient preferences for using specific types of health information and advice resources and how preferences and usage differ by age group and education.OBJECTIVE: The objective of this study was to examine how use of digital information technologies and preferred methods for obtaining health information and advice varies by age group and education among middle-aged and older adults with chronic health conditions.METHODS: The study used cross-sectional survey data for 9005 Kaiser Permanente Northern California members aged 45 to 85 years who responded to a mailed and Web-based health survey conducted during 2014 and 2015 and indicated having at least 1 chronic health condition. Bivariate analyses and logistic regression models with weighted data were used to estimate and compare the prevalence of digital information technology use, past-year use of internet-based health information and advice resources, and preferences for using internet-based, mHealth, and traditional health information and advice modalities for adults aged 45 to 65 years, 66 to 75 years, and 76 to 85 years.RESULTS: The percentages of adults who used digital information technologies (computers, smartphones, internet, email, and apps), had obtained health information and advice from an internet-based resource in the past year, and who were interested in using internet-based and mHealth modalities for obtaining health information and advice declined with age. Within age group, prevalence of digital information technologies use and interest in internet-based and mHealth modalities was lower among adults with no college education versus college graduates. Differences in preferences for internet-based health information and advice modalities between the oldest and younger groups and those with lower versus higher education were substantially diminished when we restricted analyses to internet users.CONCLUSIONS: Health care providers and organizations serving middle-aged and older adults with chronic health conditions should not assume that patients, especially those who are older and less educated, want to engage with internet-based and mHealth resources. In addition, increasing the engagement of nonutilizers of digital devices and the internet with internet-based health information and advice and mHealth apps might require both instrumental (eg, providing digital information technology devices, internet, and skills training) and social support. As part of patient-centered care, it is important for providers to ascertain their patients' use of digital information technologies and preferences for obtaining health information and patient education rather than routinely referring them to internet-based resources. It is also important for health care providers and consumer health organizations to user test their Web-based resources to make sure they are easy for older and less educated adults to use and to make sure that it remains easy for adults with chronic conditions to obtain health information and patient education using offline resources.