Feasibility of Alcohol and Tobacco Use Surveillance via Personal Health Records

描述(由申请人提供)：我们项目的目标是评估使用个人对照健康记录(PCHR)中嵌入的调查收集有关酒精和烟草使用的行为自我报告数据的可行性。一项促进个人健康记录的联邦倡议已经在卫生和公众服务部部长一级开始。它为开发新的数据收集系统和工具以及探索将行为报告系统与健康促进和监测相结合的模式提供了一个绝佳的机会。随着PCHR技术的发展、推广和采用，研究它们的使用并为使用它们收集一系列社会和行为数据以进行个人和群体水平的研究至关重要。这可能与收集有关酒精和烟草使用等敏感健康行为的数据特别相关。一家提供全方位服务的医疗提供商(n=25,000名患者)已同意在本研究中向其成员推广INDIVO(以前为PING)PCHR，并为我们提供访问社区和临床数据进行有效性测试的途径。我们将利用这一机会来解决具体目标：1)确定HMO成员是否将参与电子个人控制健康记录系统，并使用该系统报告他们的健康行为；以及2)确定患者是否同意与提供者共享他们已识别的个人健康数据，并与公共卫生当局共享他们的未识别数据，以达到协调护理和公共卫生监测的目的。我们将使用描述性和多变量统计方法对数据进行分析，对系统的参与和使用、数据共享的同意程度进行全面研究，特别关注社会、人口和“数字鸿沟”因素对参与的影响程度，并探索与受试者的社会、人口、知识、态度和信念因素有关的选择和参与偏差在不同健康行为领域的差异。更多地了解这些问题对于理解这些系统在研究中的作用是至关重要的。

DESCRIPTION (provided by applicant): The goal of our project is to assess the feasibility of collecting behavioral self-report data about alcohol and tobacco use using surveys embedded in personally controlled health records (PCHR). A Federal initiative to advance personal health records has begun at the level of the Secretary of HHS. It presents an outstanding opportunity for developing new systems and tools for data collection and for exploring models for integrating behavioral reporting systems with health promotion and surveillance. As development, diffusion and adoption of PCHR technologies progress, it is critical to study their use and provide a 'proof-of-concept' for using them to collect a range of social and behavioral data for individual and population level research. This may be especially relevant to collecting data about sensitive health behaviors such as alcohol and tobacco use. A full- service medical provider (n=25,000 patients) has agreed to promote the INDIVO (formerly PING) PCHR to its members for this study and provide us with access to community and clinical data for validity testing. We will capitalize on this opportunity to address to specific aims: 1) To ascertain whether HMO members will participate in a system for electronic personally controlled health records and use this system to report about their health behaviors; and, 2) To ascertain whether patients will consent to share their identified personal health data with providers and their de-identified data with public health authorities for the purpose of coordinated care and public health surveillance. We will use descriptive and multivariate statistics to analyze the data, conducting a comprehensive study of participation and use of the system, consent for data sharing, paying special attention to the degree to which social, demographic and "digital divide" factors affect participation, and exploring how selection and participation biases related to social, demographic, knowledge- attitude-belief factors of subjects differ across health behavior areas. Learning more about these issues is essential to understanding the utility of these systems for research.