Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention.
Stages of use: consideration, initiation, utilization, and outcomes of an internet-mediated intervention.
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DOI：
10.1186/1472-6947-10-73
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发表时间：
2010-11-23
影响因子：
3.5
通讯作者：
Eysenbach G
中科院分区：
文献类型：
--
作者：
Chiu TM;Eysenbach G
不使用或不使用干预措施是电子保健中的一个重大问题。然而，人们对这种现象的原因知之甚少。本研究以艾森巴赫的“吸引定律”为基础，探讨电子健康服务使用者的使用行为。我们使用了两个理论模型，Andersen的卫生服务利用行为模型和Venkatesh的接受和使用技术的统一理论，探讨与照顾痴呆症家庭成员的照顾者接受和使用互联网介导的干预相关的因素。一个多阶段，纵向设计，遵循一个方便的样本46个家庭照顾者谁收到了电子健康干预。应用这两个理论，使用行为被概念化为四个阶段：考虑，启动，利用（磨损或继续），和结果。根据这些理论选择变量和测量量表来测量照顾者的社会人口背景，技术能力和临床需求。在考虑阶段，认为信息通信技术（ICT）介导的服务易于使用的照顾者更有可能考虑参与研究（p = 0.04）。在启动阶段，照顾者谁表现出更大的技术接受更有可能启动服务早（p = 0.02）。在利用阶段，经常使用者是那些谁有一个更积极的态度，以技术（p = 0.04）和较低的感知照顾者的能力（p = 0.04）相比，非用户。在结果阶段，频繁使用者的感知负担下降，而非使用者的感知负担上升（p = 0.02）。我们说明了一个方法论框架，描述如何发展和扩大理论的流失。拟议的框架强调，必须将电子保健的“使用”和“采用”概念化，将其视为发生在不同阶段的动态、连续和纵向进程，并受不同因素的影响，以预测进入下一阶段的情况。虽然使用行为的影响，主要是由技术因素在初期阶段，临床和技术因素同样重要的后期阶段。使用频率与积极的临床结局相关。一个合理的解释是，干预的好处激励照顾者继续服务和定期使用导致更积极的临床结果。
Attrition, or nonuse of the intervention, is a significant problem in e-health. However, the reasons for this phenomenon are poorly understood. Building on Eysenbach's "Law of Attrition", this study aimed to explore the usage behavior of users of e-health services. We used two theoretical models, Andersen's Behavioral Model of Health Service Utilization and Venkatesh's Unified Theory of Acceptance and Use of Technology, to explore the factors associated with uptake and use of an internet-mediated intervention for caregivers taking care of a family member with dementia. A multiphase, longitudinal design was used to follow a convenience sample of 46 family caregivers who received an e-health intervention. Applying the two theories, usage behavior was conceptualized to form four stages: consideration, initiation, utilization (attrition or continuation), and outcome. The variables and measurement scales were selected based on these theories to measure the sociodemographic context, technology aptitudes, and clinical needs of the caregivers. In the Consideration Stage, caregivers who felt that the information communication technology (ICT)-mediated service was easy to use were more likely to consider participating in the study (p = 0.04). In the Initiation Stage, caregivers who showed greater technology acceptance were more likely to initiate service earlier (p = 0.02). In the Utilization Stage, the frequent users were those who had a more positive attitude toward technology (p = 0.04) and a lower perceived caregiver competence (p = 0.04) compared with nonusers. In the Outcome Stage, frequent users experienced a decline in perceived burden compared with an escalation of perceived burden by nonusers (p = 0.02). We illustrate a methodological framework describing how to develop and expand a theory on attrition. The proposed framework highlighted the importance of conceptualizing e-health "use" and "adoption" as dynamic, continuous, longitudinal processes occurring in different stages, influenced by different factors to predict advancement to the next stage. Although usage behavior was influenced mainly by technological factors in the initial stages, both clinical and technological factors were equally important in the later stages. Frequency of use was associated with positive clinical outcomes. A plausible explanation was that intervention benefits motivated the caregivers to continue the service and regular use led to more positive clinical outcome.
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影响因子：
7.4
作者：
Neil AL;Batterham P;Christensen H;Bennett K;Griffiths KM
通讯作者：
Griffiths KM
在线试验中的方法论挑战。
影响因子：
7.4
作者：
Murray E;Khadjesari Z;White IR;Kalaitzaki E;Godfrey C;McCambridge J;Thompson SG;Wallace P
通讯作者：
Wallace P
影响因子：
2.8
作者：
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通讯作者：
McCarthy, C
影响因子：
9.9
作者：
DeYoung, CG;Spence, I
通讯作者：
Spence, I
影响因子：
5.7
作者：
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通讯作者：
Szapocznik, J