Racial and ethnic disparities in use of a personal health record by veterans living with HIV
Racial and ethnic disparities in use of a personal health record by veterans living with HIV
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DOI：
10.1093/jamia/ocz024
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发表时间：
2019-08-01
影响因子：
6.4
通讯作者：
Midboe, Amanda M.
中科院分区：
文献类型：
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作者：
Javier, Sarah J.;Troszak, Lara K.;Midboe, Amanda M.
目的：研究与使用我的HealtheVet（MHV）的退伍军人艾滋病病毒感染者。材料和方法：退伍军人健康管理局的行政数据被用来确定一个队列的退伍军人艾滋病病毒感染者在财政年度2011-2017年。进行了描述性分析，以检查人口统计学特征和MHV登记和工具使用的种族/民族差异。卡方检验进行评估种族/民族和MHV登记和工具use.Results之间的关联：登记者的比例最高的是非西班牙裔白色退伍军人感染艾滋病毒（59%），其次是西班牙裔/拉丁裔（55%）和黑人退伍军人感染艾滋病毒（40%）。卡方分析显示：（1）与白色退伍军人相比，黑人和西班牙裔/拉丁裔退伍军人的MHV账户注册显著较低;（2）与白色MHV注册者相比，黑人MHV注册者使用任何MHV工具的可能性较低，包括蓝色按钮记录下载、药物补充、安全消息、实验室和预约视图。与先前对非退伍军人人群使用个人健康记录（PHR）的研究一致，这些研究结果显示，在感染艾滋病毒的退伍军人中使用MHV存在种族和民族不平等。种族和少数民族可能不太可能使用PHR的原因很多，包括PHR隐私问题，教育程度下降，有限的访问internet.Conclusion：这是第一次研究种族和民族的差异，使用MHV工具的退伍军人艾滋病毒感染者和利用退伍军人健康管理局的医疗保健。未来的研究应探讨与种族和少数民族退伍军人中PHR使用减少有关的潜在调节因素，这可以为增加弱势群体中PHR使用的战略提供信息。
Objective: To examine sociodemographic characteristics associated with use of My HealtheVet (MHV) by veterans living with HIV.Materials and Methods: Veterans Health Administration administrative data were used to identify a cohort of veterans living with HIV in fiscal years 2011-2017. Descriptive analyses were conducted to examine demographic characteristics and racial/ethnic differences in MHV registration and tool use. Chi-Square tests were performed to assess associations between race/ethnicity and MHV registration and tool use.Results: The highest proportion of registrants were non-Hispanic White veterans living with HIV (59%), followed by Hispanic/Latino (55%) and Black veterans living with HIV (40%). Chi-Square analyses revealed that: (1) MHV account registration was significantly lower for both Black and Hispanic/Latino veterans in comparison to White veterans and (2) Black MHV registrants were less likely to utilize any MHV tool compared with White MHV registrants including Blue Button record download, medication refills, secure messaging, lab, and appointment views.Discussion: In line with prior research on personal health record (PHR) use among non-veteran populations, these findings show racial and ethnic inequities in MHV use among veterans living with HIV. Racial and ethnic minorities may be less likely to use PHRs for a myriad of reasons, including PHR privacy concerns, decreased educational attainment, and limited access to the internet.Conclusion: This is the first study to examine racial and ethnic disparities in use of MHV tools by veterans living with HIV and utilizing Veterans Health Administration health care. Future research should examine potential moderating factors linked to decreased PHR use among racial and ethnic minority veterans, which could inform strategies to increase PHR use among vulnerable populations.