Teaching elderly adults to use the Internet to access health care information: before-after study.
Teaching elderly adults to use the Internet to access health care information: before-after study.
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DOI：
10.2196/jmir.7.2.e19
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发表时间：
2005-06-30
影响因子：
7.4
通讯作者：
Nolfi DA
中科院分区：
文献类型：
--
作者：
Campbell RJ;Nolfi DA
关于互联网革命性地改变医疗服务的潜力，已经有很多文章。随着年轻人越来越多地利用基于互联网的医疗保健信息，必须确保老年人，特别是那些来自少数民族、低收入和教育背景有限的老年人，能够熟练地使用这一媒介进行医疗保健。本文介绍了一个旨在教老年人使用互联网访问医疗保健信息的计划的结果。其目的是检查培训是否导致参与者的健康观念，他们与医疗保健提供者的互动，健康信息寻求行为和自我保健活动的看法的变化。参与者参加了在大匹兹堡和阿勒格尼县地区的公共图书馆和高级社区中心举办的为期5周的培训课程。每次研讨会的课程持续2小时，包括讲座和实践培训。基线调查在课程开始前进行，5周的随访调查在课程结束后立即进行，最终调查在1年后邮寄。工具包括多维健康控制点（MHLC）量表，它测量三个领域的控制点（内部，外部和机会）;克兰茨健康意见调查（HOS）;和刘，哈特曼和Ware健康价值调查。另外两份问卷包括多项选择和定性问题，旨在衡量参与者的互联网利用率和医疗保健参与水平。健康参与调查与基线调查一起进行。互联网使用调查在1年时进行，包含健康参与调查的几个项目，可以比较基线和1年的反应。在开始培训课程的60名老年人中，42名（平均年龄72岁）完成了整个5周的培训计划和计划后立即进行的5周随访问卷调查，27名完成了1年的随访调查。男性（P = .02）和女性（P =.05）的MHLC机会分项评分以及总HOS信息寻求评分（P =.05）在基线和5周随访结果之间存在统计学显著差异。然而，当使用“末次观察值结转”插补纳入所有60名原始参与者时，这些统计学显著性结果消失。在基线和5周随访调查之间，两种性别的MHLC外部（P = 0.44）和内部（P = 0.97）控制点评分或HOS行为参与子量表（P = 0.65）均无统计学显著变化。对于大多数测量的结果，我们未能显示出强有力的前后效应。老年人可能愿意使用互联网作为一般健康信息的来源;然而，在决定他们的医疗保健时，我们的参与者似乎坚持以医生为中心的护理模式。人口统计和情境变量可能在确定哪些老年人将使用互联网做出有关其医疗保健的行为决策以及在哪些情况下他们会这样做方面发挥重要作用。
Much has been written about the Internet's potential to revolutionize health care delivery. As younger populations increasingly utilize Internet-based health care information, it will be essential to ensure that the elderly become adept at using this medium for health care purposes, especially those from minority, low income, and limited educational backgrounds. This paper presents the results of a program designed to teach elderly adults to use the Internet to access health care information. The objective was to examine whether the training led to changes in participant's perceptions of their health, perceptions of their interactions with health care providers, health information–seeking behaviors, and self-care activities. Participants attended a 5-week training course held in public libraries and senior community centers within the greater Pittsburgh and Allegheny County region. Classes within each seminar lasted 2 hours and consisted of lecture and hands-on training. Baseline surveys were administered prior to the course, 5-week follow-up surveys were administered immediately after the course, and final surveys were mailed 1 year later. Instruments included the Multidimensional Health Locus of Control (MHLC) Scale, which measures three domains of locus of control (internal, external, and chance); the Krantz Health Opinion Survey (HOS); and the Lau, Hartman, and Ware Health Value Survey. Two additional questionnaires included multiple choice and qualitative questions designed to measure participants' Internet utilization and levels of health care participation. The Health Participation Survey was administered with the baseline survey. The Internet Use Survey was administered at the 1-year mark and contained several items from the Health Participation Survey, which allowed comparison between baseline and 1-year responses. Of the 60 elderly adults who began the training course, 42 (mean age 72) completed the entire 5-week training program and the 5-week follow-up questionnaire administered immediately after the program, and 27 completed the 1-year follow-up survey. Statistically significant differences were found between baseline and 5-week follow-up results for MHLC chance subscores in males (P = .02) and females (P = .05), as well as total HOS information seeking scores (P = .05). However, these statistically significant findings disappeared when all 60 original participants were included using a “last observation carried forward” imputation. No statistically significant changes were found between baseline and 5-week follow-up surveys for MHLC external (P = .44) and internal (P = .97) locus of control scores in both genders, or for the HOS behavioral involvement subscale (P = .65). We failed to show robust before-after effects for most of the outcomes measured. Elderly adults may be willing to use the Internet as a source for general health information; however, when making decisions about their health care, our participants seemed to adhere to a physician-centered model of care. Demographic and situational variables may play a large role in determining which seniors will use the Internet for making behavioral decisions about their health care and in which scenarios they will do so.
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影响因子：
3
作者：
BEISECKER, AE;BEISECKER, TD
通讯作者：
BEISECKER, TD
影响因子：
5.7
作者：
GREENFIELD, S;KAPLAN, SH;FRANK, HJL
通讯作者：
FRANK, HJL
影响因子：
50.5
作者：
Butow, PN;Maclean, M;Boyer, MJ
通讯作者：
Boyer, MJ
影响因子：
7.2
作者：
DEGNER, LF;SLOAN, JA
通讯作者：
SLOAN, JA
影响因子：
39.2
作者：
CASSILETH, BR;ZUPKIS, RV;MARCH, V
通讯作者：
MARCH, V