Factors Influencing the Use of a Web-Based Application for Supporting the Self-Care of Patients with Type 2 Diabetes: A Longitudinal Study
Factors Influencing the Use of a Web-Based Application for Supporting the Self-Care of Patients with Type 2 Diabetes: A Longitudinal Study
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DOI：
10.2196/jmir.1603
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发表时间：
2011-07-01
影响因子：
7.4
通讯作者：
Seydel, Erwin R.
中科院分区：
文献类型：
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作者：
Nijland, Nicol;van Gemert-Pijnen, Julia E. W. C.;Seydel, Erwin R.
背景：总体而言，电子保健应用的使用率仍然相当低，用户流失率往往很高。只有有限的信息是关于使用电子健康技术在特定的病人groups.Objective：本研究的目的是探讨影响因素的初步和长期使用的基于Web的应用程序（DiabetesCoach）支持2型糖尿病患者的自我护理。方法：一个混合方法的研究设计被用于一个过程分析的Web应用程序的实际使用超过2年的时间，并确定用户配置文件。研究工具包括日志文件，访谈，可用性测试，和survey.Results：DiabetesCoach主要用于交互功能，如在线监测，个人数据，和病人护士电子邮件联系。这种持续的个人反馈尤其吸引病人;他们感到护士对他们的监控更密切，并鼓励他们在自我管理疾病方面发挥更积极的作用。尽管取得了积极的成果，但Web应用程序的使用受到低注册率和非使用损耗的阻碍。入学的主要障碍是无法上网（146/226，65%）。尽管68%（34/50）的入组者是连续用户，其中32%（16/50）可定义为核心用户（高度活跃），但其余32%（16/50）在整个研究期间未继续使用Web应用程序。长期使用的障碍主要是由于Web应用程序的用户友好性差（缺乏“推送”因素或提醒）和选择“错误”用户;由于天花板效应，管理良好的患者并不是从系统使用中获益最多的患者。更需要护理的患者似乎更多地参与长期使用;高度活跃的用户显着更频繁的药物使用者比低/不活跃的用户（P = 0.005），并有较长的糖尿病病程（P = 0.03）。结论：创新的医疗保健将扩散得更快时，技术是简单易用，并具有适用的组件进行交互。这将预见患者对持续和个性化反馈的需求，特别是对于更需要护理的患者。从这项研究中，几个因素似乎影响了电子健康技术的使用增加：（1）避免选择性入学，（2）利用参与式设计方法，（3）开发持久性的推动因素。进一步的研究应侧重于使用系统的功能和实际使用之间的因果关系，因为这样的观点将提供关于特定技术功能如何吸引和吸引用户的重要证据。
Background: The take-up of eHealth applications in general is still rather low and user attrition is often high. Only limited information is available about the use of eHealth technologies among specific patient groups.Objective: The aim of this study was to explore the factors that influence the initial and long-term use of a Web-based application (DiabetesCoach) for supporting the self-care of patients with type 2 diabetes.Methods: A mixed-methods research design was used for a process analysis of the actual usage of the Web application over a 2-year period and to identify user profiles. Research instruments included log files, interviews, usability tests, and a survey.Results: The DiabetesCoach was predominantly used for interactive features like online monitoring, personal data, and patient-nurse email contact. It was the continuous, personal feedback that particularly appealed to the patients; they felt more closely monitored by their nurse and encouraged to play a more active role in self-managing their disease. Despite the positive outcomes, usage of the Web application was hindered by low enrollment and nonusage attrition. The main barrier to enrollment had to do with a lack of access to the Internet (146/226, 65%). Although 68% (34/50) of the enrollees were continuous users, of whom 32% (16/50) could be defined as hardcore users (highly active), the remaining 32% (16/50) did not continue using the Web application for the full duration of the study period. Barriers to long-term use were primarily due to poor user-friendliness of the Web application (the absence of "push" factors or reminders) and selection of the "wrong" users; the well-regulated patients were not the ones who could benefit the most from system use because of a ceiling effect. Patients with a greater need for care seemed to be more engaged in long-term use; highly active users were significantly more often medication users than low/inactive users (P = .005) and had a longer diabetes duration (P = .03).Conclusion: Innovations in health care will diffuse more rapidly when technology is employed that is simple to use and has applicable components for interactivity. This would foresee the patients' need for continuous and personalized feedback, in particular for patients with a greater need for care. From this study several factors appear to influence increased use of eHealth technologies: (1) avoiding selective enrollment, (2) making use of participatory design methods, and (3) developing push factors for persistence. Further research should focus on the causal relationship between using the system's features and actual usage, as such a view would provide important evidence on how specific technology features can engage and captivate users.