Factors Associated With Self-reported Use of Web and Mobile Health Apps Among US Military Veterans: Cross-sectional Survey.
Factors Associated With Self-reported Use of Web and Mobile Health Apps Among US Military Veterans: Cross-sectional Survey.
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DOI：
10.2196/41767
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发表时间：
2022-12-30
影响因子：
5
通讯作者：
Smith, Bridget M.
中科院分区：
文献类型：
--
作者：
Hogan, Timothy P.;Etingen, Bella;Lipschitz, Jessica M.;Shimada, Stephanie L.;McMahon, Nicholas;Bolivar, Derek;Bixler, Felicia R.;Irvin, Dawn;Wacks, Rachel;Cutrona, Sarah;Frisbee, Kathleen L.;Smith, Bridget M.
尽管它们很流行并且据报道患者对其使用很感兴趣，但健康相关应用程序的使用仍然有限。退伍军人健康管理局 (VHA) 开发了各种应用程序来支持退伍军人；然而，全国范围内的采用率仍然较低。我们研究了 VHA 健康相关应用程序的使用流行程度以及退伍军人如何了解这些应用程序，以确定与其使用相关的因素。作为 VHA 质量改进计划的一部分，我们招募了一批全国退伍军人，以获取他们使用健康技术的反馈，并通过横断面调查收集他们的数据。调查数据由 VHA 管理数据进行补充。我们使用描述性统计数据来检查人口和健康特征、健康相关技术的使用以及退伍军人如何了解应用程序。我们使用双变量分析和多重逻辑回归模型评估了与应用程序使用相关的因素。我们拥有 1259 名退伍军人的完整数据。样本中的大多数为男性（1069/1259，84.9%）、年龄超过 65 岁（740/1259，58.8%）、白人（1086/1259，86.3%）和非西班牙裔（1218/1259，96.7%）。大多数受访者 (1125/1259, 89.4%) 表示使用计算机非常舒适和自信，超过一半 (675/1259, 53.6%) 表示是技术的早期采用者，近一半 (595/1259, 47.3%) 表示使用过 VHA 健康相关应用程序。超过三分之一 (435/1259, 34.6%) 的受访者表示，他们的 VHA 护理团队成员鼓励他们使用与健康相关的应用程序。受访者表示，通过在 VHA 患者门户网站上阅读相关应用程序（468/1259，37.2%）、从 VHA 医疗保健团队了解这些应用程序（316/1259，25.1%）以及在 VHA 网站上阅读相关应用程序（139/1259，11%）来了解可用的 VHA 健康相关应用程序。自我报告使用过 VHA 健康相关应用程序的退伍军人更有可能在 VHA 接受护理（OR [比值比] 1.3，95% CI 1.0-1.7），健康状况较差（根据分层条件社区评分评估；OR 1.1，95% CI 1.0-1.2），报告拥有台式电脑或笔记本电脑（OR 1.8，95% CI 1.0-1.2） 1.1-3.1），患有创伤后应激障碍（OR 1.4，95% CI 1.1-1.9），并报告 VHA 医疗保健团队成员鼓励他们使用这些应用程序（OR 2.7，95% CI 2.1-3.4）。我们发现，退伍军人自我报告的 VHA 健康相关应用程序的使用情况与调查中的多个变量之间存在密切关联。观察到，退伍军人自我报告应用程序使用情况与 VHA 医疗保健团队鼓励使用这些应用程序之间存在最强的关联。报告受到 VHA 护理团队成员鼓励的退伍军人使用 VHA 应用程序的几率比未报告受到此类鼓励的退伍军人高出近 3 倍。我们的研究结果进一步证明，医疗保健系统或医疗团队对应用程序的认可可以对患者的接受和使用产生积极影响。
Despite their prevalence and reported patient interest in their use, uptake of health-related apps is limited. The Veterans Health Administration (VHA) has developed a variety of apps to support veterans; however, uptake remains low nationally. We examined the prevalence of VHA health-related app use and how veterans learned about these apps in order to identify factors associated with their use. As part of a VHA quality improvement initiative, we recruited a national cohort of veterans to obtain feedback on their use of technology for health and collected data from them via a cross-sectional survey. The survey data were supplemented with VHA administrative data. We used descriptive statistics to examine demographic and health characteristics, health-related technology use, and how veterans learned about apps. We assessed factors associated with app use using bivariate analyses and multiple logistic regression models. We had complete data on 1259 veterans. A majority of the sample was male (1069/1259, 84.9%), aged older than 65 years (740/1259, 58.8%), White (1086/1259, 86.3%), and non-Hispanic (1218/1259, 96.7%). Most respondents (1125/1259, 89.4%) reported being very comfortable and confident using computers, over half (675/1259, 53.6%) reported being an early adopter of technology, and almost half (595/1259, 47.3%) reported having used a VHA health-related app. Just over one-third (435/1259, 34.6%) reported that their VHA care team members encouraged them to use health-related apps. Respondents reported learning about available VHA health-related apps by reading about them on the VHA’s patient portal (468/1259, 37.2%), being told about them by their VHA health care team (316/1259, 25.1%), and reading about them on the VHA’s website (139/1259, 11%). Veterans who self-reported having used VHA health-related apps were more likely to receive care at the VHA (OR [odds ratio] 1.3, 95% CI 1.0-1.7), be in worse health (as assessed by Hierarchical Condition Community score; OR 1.1, 95% CI 1.0-1.2), report owning a desktop or laptop computer (OR 1.8, 95% CI 1.1-3.1), have posttraumatic stress disorder (OR 1.4, 95% CI 1.1-1.9), and report having VHA health care team members encourage them to use the apps (OR 2.7, 95% CI 2.1-3.4). We found strong associations between self-reported use by veterans of VHA health-related apps and multiple variables in our survey. The strongest association was observed between a veteran self-reporting app use and having received encouragement from their VHA health care team to use the apps. Veterans who reported receiving encouragement from their VHA care team members had nearly 3 times higher odds of using VHA apps than veterans who did not report receiving such encouragement. Our results add to growing evidence suggesting that endorsement of apps by a health care system or health care team can positively impact patient uptake and use.
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