Patient Readiness to Use Internet Health Resources

描述（由申请人提供）：对于美国超过1亿的慢性病患者来说，与他们的医疗团队合作是有效、高质量护理的一部分。正如慢性护理模型所建议的那样，互联网健康资源和交流可以成为改善护理的重要因素。该模式的基石可能是支持提供者文档和沟通的信息技术，以及基于网络的患者自我管理、教育和健康沟通；这种技术可以使患者激活和自我管理。在全国范围内，50%的慢性疾病患者使用互联网。然而，关于促进或阻碍使用互联网卫生资源的因素，或其对消费者的影响，几乎没有信息。为此，我们建议检查这些启动子和障碍，以及使用与疾病结局的关系。我们将开发一种实用的措施，衡量慢性病患者使用基于网络的健康资源的准备程度，根据这些患者实际使用这些资源的日志测试该措施的预测有效性，并直接观察他们对这些资源的使用情况（目标1）。我们将研究网络资源的使用如何与糖尿病患者的临床结果相关（目的2）。这项对慢性病门诊患者使用基于网络的卫生资源偏好的丰富调查，将为寻求将在线环境作为综合疾病管理战略一部分的项目、系统和政策提供信息。尽管Koopman博士在慢性病研究领域经验丰富，但该主题的深远重要性以及该领域对新技能的需求使她获得了拟议的职业发展奖，作为迈向未来转化研究的重要一步。Koopman博士将利用她与她的导师David Mehr博士建立的关系，以及他目前资助的AHRQ工作“使用健康IT来改善门诊慢性病护理”（1R18HS017035-01），该工作旨在评估新的基于网络的交互式患者健康门户网站的有效性。除了拟议的研究之外，该申请的结构化职业发展计划包括仪器开发和人机交互方面的补充培训，以及多学科咨询委员会的科学和职业指导，以及负责任的研究行为方面的持续培训。如果获奖，库普曼博士所在的部门和机构承诺，她将把75%的时间用于这些研究和职业发展活动。该职业发展奖将使库普曼博士获得规模发展和人机交互方面的专业知识。这些专业知识将为拟议的研究提供信息，以确定慢性病门诊患者使用互联网卫生资源的促进因素和障碍。她还将调查互联网健康资源的使用与疾病结果的关系。这些知识将为寻求利用在线环境改善患者护理的项目、系统和政策提供信息。

DESCRIPTION (provided by applicant): For the more than 100 million patients with chronic conditions in the United States, collaborating with their health care team is part of effective, high-quality care. Internet health resources and communication can be an important element in improving care, as suggested by the Chronic Care Model. The model's keystone may be information technology that supports provider documentation and communication, as well as web-based patient self-management, education, and health communication; such technology can enable patient activation and self-management. Nationally, 50 percent of patients with chronic disease use the internet. However, little information is available on what promotes or is a barrier to use of internet health resources, or its effect on the consumer. To that end, we propose to examine these promoters and barriers, as well as the association of use with disease outcomes. We will develop a practical measure of the readiness of ambulatory patients with chronic conditions to use web-based health resources, test the predictive validity of the measure against logs of actual use of these resources by these same patients, and directly observe their use of these resources (Aim 1). We will examine how use of web-based resources is associated with clinical outcomes for patients with diabetes (Aim 2). This rich examination of preferences for use of web-based health resources among ambulatory patients with chronic disease will inform projects, systems, and policies that seek to use the online environment as part of a comprehensive disease management strategy. Although Dr. Koopman is experienced in the area of chronic disease research, the profound importance of this topic and the need for new skills in this area led her to the proposed Career Development Award as an important step toward future translational research. Dr. Koopman will leverage her established relationship with her mentor, Dr. David Mehr, and his currently funded AHRQ work "Using Health IT to Improve Ambulatory Chronic Disease Care" (1R18HS017035-01), which aims to evaluate the effectiveness of a new web-based interactive patient health portal. In addition to the proposed research, this application's structured career development plan includes supplementary training in instrument development and human- computer interaction, as well as scientific and career guidance from a multidisciplinary advisory committee and continued training in the responsible conduct of research. If awarded, Dr. Koopman's department and institution pledge that 75% of her time will be devoted to these research and career development activities. This Career Development Award will allow Dr. Koopman to gain expertise in scale development and in human computer interaction. This expertise will inform the research proposed, to identify promoters and barriers to the use of internet health resources by ambulatory patients with chronic conditions. She will also investigate how use of internet health resources is associated with disease outcomes. This knowledge will inform projects, systems, and policies seeking to use the online environment to improve care for patients.