Trends in U.S. Consumers’ Use of E-Health Services: Fine-Grained Results from a Longitudinal, Demographic Survey

Although growth in U.S. consumers’ overall use of e-health is strong, it is being driven by only a portion of the e-health services that are offered through online health portals. Fine-grained, longitudinal analysis of three representative e-health services shows that, while online communication with medical personnel has grown consistently between 2003 and 2012, the purchase of health supplies online plateaued by 2007, and participation in online support groups has been flat since 2003. Socio-economic factors of income and education level continue to have an impact on consumers’ use of e-health; however, differences based on age, sex, and race/ethnicity are trending lower during this period. The findings caution against the common practice of studying e-health adoption principally at the level of online health portals, which can mask substantial variation in adoption trends among the underlying e-health services, and suggest that it is important to update trend studies on a regular basis to maintain currency

Patient’s Utilization of Health Information Technologies for Disease Self-Management

Background: The rapid growth of Health Information Technologies (HITs) provides patients with greater opportunity to take control over their health. HITs utilization has been proven to be a critical component of disease self-management and can result in positive outcomes. Its widespread adoption and utilization is still relatively low among patients with chronic disease. It is important to understand the factors that may impact HITs utilization, such as the perceived Task-Technology Fit (TTF). A very limited number of studies have examined the relationship between HITs utilization and the perceived fit between task and technology in the context of TTF theory. Aims/ Purpose: The purpose of this study was to explore the factors that impact patient utilization of HITs for disease self-management. We examined the relationships between patient demographics and their utilization of HITs in relation to disease self-management and TTF. Methods and Design: A quantitative descriptive correlational research design was used for this data-based study. Data from the most recent Health Information National Trends Survey (HINTS 5, cycle 2) collected in 2018 was used for this study, (N= 3,504). Results: Sociodemographic disparities still exist among patient groups in terms of HITs utilization for disease self-management. Patients with lower education attainment and lower income were less likely to access their online medical records. Also, these study findings show a significant positive relationship between perceived TTF and patient utilization of the various HITs. Open communication and discussions with healthcare provider remain the most frequently reported HIT attribute associated with patient utilization of HITs for disease self-management. Implications: Findings of this study may inform a better understanding of TTF factors. This new knowledge may influence HITs developers to include the patient perspective in future designs. These study findings may also assist researchers in developing tailored interventions that are driven by the unique individual patient technological needs for disease self-management, which in turn, can promote patient safety, improve health outcomes, and enhance the utilization of such technologies

Gender differences in health and medicine information seeking behaviour : a review

Consumers periodically seek information about their health and medicines to increase their knowledge and understanding, and to support self-management. Gender has an impact on people’s attitudes and behaviour; gaining a better understanding of how males and females differ in the way in which they find and use health and medicine information may help to enhance patient-health care provider communication and the information that they receive. Based on a review of the literature, women overall are more active information seekers than men. A number of differences do exist, notably in: sources of information consulted, information desired and degree of engagement in information seeking.peer-reviewe

Using Health Information Technology to Prevent and Treat Diabetes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140360/1/dia.2015.1507.pd

Online Health Information Seeking Behaviors of Hispanics in New York City

Hispanics are the fastest-growing minority group in the United States, but they are the most underserved population in terms of access to online health information. The specific aims of this descriptive, correlational study were to examine factors associated with online health information seeking behaviors of Hispanics and to examine the association between online health information seeking behaviors and health behaviors. The study sample (n=4,070) was recruited from five zip codes in the Washington Heights/Inwood community of New York City for the Washington Heights Inwood Informatics Infrastructure for Comparative Effectiveness Research project. Survey data were collected via interview by bilingual community health workers in three settings: a community center affiliated with Columbia University, households and other community settings, and New York-Presbyterian Ambulatory Care Network clinics. Data were analyzed using logistic and linear regressions. In regards to survey respondents' situational, sociodemographic, and literacy factors (health literacy, computer literacy) associated with their online health information seeking behaviors and those of their household members, the study found that that worse health status (OR=0.42, p<0.001), lack of hypertension (OR=0.60, p<0.01), a high level of education (OR=3.04, p<0.001), and computer literacy (OR=3.78, p < 0.001) were positively associated with respondents online health information seeking behaviors. Health literacy was only positively associated (OR=2.13, p<0.001) in a subsample of respondents (n=2,680) in which it was measured by one item related to understanding written health information. Respondents' factors significantly associated with online health information seeking by household members were: female gender (OR=1.60, p<0.01), younger age (OR=0.75, p<0.01), married (OR=1.36, p<0.01), higher education (OR=1.80, p<0.001), higher computer literacy (OR=2.24, p<0.001), in worse health status (OR=0.592, p<0.001), and presence of serious health problems (OR=1.83, p<0.01). Controlling for factors found to be significant in Aim 1, respondents' online health information seeking behaviors were hypothesized to be positively associated with fruit consumption, vegetable consumption, physical activity, and hypertension medication adherence and negatively associated with alcohol consumption. Hypotheses related to fruit consumption (p<0.05), vegetable consumption (p<0.05), and physical activity (p<0.01) were supported. This study contributes to the understanding of Hispanics' online health information seeking behaviors and provides the foundation for informatics and public health interventions

Health Information Seeking and its Associated Factors among University Students: A Case in a Middle-Income Setting

This paper aims to describe health information seeking behaviour and identify its associated factors among undergraduate university students in developing countries. An online survey is used to collect data from 138 students. The data is analysed using the multivariate logistic regression analysis method. Results reveal that a substantial number of students have sought health information mostly from the Internet. Health literacy, perceived susceptibility to health problems and alcohol consumption are found to be the significant factors influencing health information seeking behaviour. Results provide an understanding of health information seeking behaviour in developing countries

Too old for technology? Use of wearable healthcare devices by older adults and their willingness to share health data with providers

Wearable healthcare devices offer tremendous promise to effectively track and improve the well-being of older adults. Yet, little is known about the use of wearable devices by older adults. Drawing upon a national survey in US with 1481 older adults, we examine the use of wearable healthcare devices and the key predictors of use viz. sociodemographic factors, health conditions, and technology self-efficacy. We also examine if the predictors are associated with elders’ willingness to share health data from wearable devices with healthcare providers. We find low level of wearable use (17.49%) among US older adults. We find significant positive associations between technology self-efficacy, health conditions, and demographic factors (gender, race, education, and annual household income) and use of wearable devices. Men were less likely (OR = 0.62, 95% CI 0.36–1.04) and Asians were more likely (OR = 2.60, 95% CI 0.89–7.64) to use wearables, as did healthy adults (OR = 1.98, 95% CI 1.37–2.87). Those who electronically communicated with their doctors (OR = 1.86, 95% CI 1.16–2.97), and those who searched online for health information (OR = 1.79, 95% CI 1.03–3.10) were more likely to use wearables. Though 80.15% of wearable users are willing to share health data with providers, those with greater technology self-efficacy and favorable attitudes toward exercise are more willing

Building the Science of Healthcare Public Reporting: Integrating Anecdotal Information to Enhance Sensemaking

Anecdotal information about a healthcare consumers\u27 interaction with care providers and hospital facilities is becoming increasingly available to the public in the form of YouTube videos and as discussion posts on peer-support groups. This form of information can potentially jeopardize the utility of reports generated by Federal entities as it potentially diverts consumer attention from more reliable measures of quality. This dissertation investigates how a health consumer\u27s choice of care is influenced by anecdotal information on the care process available on YouTube. This research then investigates the effect of information presentation methods such as narratives and active engagement with quality metrics to support the consumer\u27s ability to comprehend public report information. An initial study investigated the characteristics of information healthcare consumers are searching for on a peer-support group. By analyzing the discussions available on the support community of a major ovarian cancer support group, the Ovarian Cancer National Alliance (OCNA), this study investigated the type of information that newly diagnosed ovarian cancer patients and their supporters seek. Using content analysis, 206 publicly available discussions exchanged on OCNA were analyzed by two researchers. Each discussion point was classified into one of the three broad themes that emerged: ovarian cancer-specific, treatment-related, or coping information. The discussion points were further analyzed using a multinomial logit model to predict the type of the desired information based on the role of the person looking for the information, the disease phase in which the information was sought, the emotional status of the information seeker, and the stage of the cancer. Treatment-related material was the most sought-after information by patients, while coping information was most sought by supporters. When forum posts were negative in tone, the information seekers were more likely to be looking for ovarian cancer-specific information than either treatment-related information or coping information. The second study investigated the effect of the role of the sequence in which such public report statistics and anecdotal information are viewed by health consumers during the sensemaking process. The study used the scenario of a patient looking for health facility-related information and employed a 2 (anecdotal information presented as videos supporting and contradicting public report information) * 2 (phase of introduction of anecdotal information: early, late) between-subjects experimental design. The results found that when the phase of introduction of anecdotal information changed from early to late, and when the anecdotal information contradicted the public reports, the probability of choosing the correct facility changed from 0.41 to 0.69. The probability of choosing the correct facility was reduced by more than half, changing from 0.85 to 0.41, when contradicting, rather than supporting, anecdotal information was presented before the public reports. Participants placed significant emphasis on this initial information and found it difficult to change their initial perceptions when presented with the more reliable public reports. The third study investigated ways to enhance consumer understanding by integrating standardized quality metrics with anecdotal information using user experience design methodologies. Two-hundred individuals participated in this study. This study employed a 2 (public report information presented in the standard way, presented within an anecdote) * 2 (engagement with each quality metric: none, active) between-subjects experimental design. The results of the study found that the probability of choosing the correct facility changes from 0.71 to 0.88 when information was presented within a narrative rather than with the standard public report format. A final study evaluated whether the influential nature of inaccurate anecdotal videos could be attenuated by presenting public report information within a narrative with active engagement. The study used the scenario of a patient looking for dialysis facility-related information and employed between-subjects experimental design - inaccurate anecdotal information was presented either early or late in the sensemaking process. Ninety-eight individuals participated in the study. The results found no significant differences in the choice of the dialysis facility and level of confidence in the choice. Given that narratives have the power to impact choice and comprehension, there exists a need to conduct further investigation to develop comprehensive guidelines for the presentation of narratives that support the use of public report information

Understanding the Digital Gap Among US Adults With Disability: Cross-Sectional Analysis of the Health Information National Trends Survey 2013

BACKGROUND: Disabilities affect more than 1 in 5 US adults, and those with disabilities face multiple barriers in accessing health care. A digital gap, defined as the disparity caused by differences in the ability to use advanced technologies, is assumed to be prevalent among individuals with disabilities. OBJECTIVE: This study examined the associations between disability and use of information technology (IT) in obtaining health information and between trust factors and IT use. We hypothesized that compared to US adults without disabilities, those with disabilities are less likely to refer to the internet for health information, more likely to refer to a health care provider to obtain health information, and less likely to use IT to exchange medical information with a provider. Additionally, we hypothesized that trust factors, such as trust toward health information source and willingness to exchange health information, are associated with IT use. METHODS: The primary database was the 2013 Health Information National Trends Survey 4 Cycle 3 (N=3185). Disability status, the primary study covariate, was based on 6 questions that encompassed a wide spectrum of conditions, including impairments in mobility, cognition, independent living, vision, hearing, and self-care. Study covariates included sociodemographic factors, respondents\u27 trust toward the internet and provider as information sources, and willingness to exchange medical information via IT with providers. Study outcomes were the use of the internet as the primary health information source, use of health care providers as the primary health information source, and use of IT to exchange medical information with providers. We conducted multivariate logistic regressions to examine the association between disability and study outcomes controlling for study covariates. Multiple imputations with fully conditional specification were used to impute missing values. RESULTS: We found presence of any disability was associated with decreased odds (adjusted odds ratio [AOR] 0.65, 95% CI 0.43-0.98) of obtaining health information from the internet, in particular for those with vision disability (AOR 0.27, 95% CI 0.11-0.65) and those with mobility disability (AOR 0.51, 95% CI 0.30-0.88). Compared to those without disabilities, those with disabilities were significantly more likely to consult a health care provider for health information in both actual (OR 2.21, 95% CI 1.54-3.18) and hypothetical situations (OR 1.80, 95% CI 1.24-2.60). Trust toward health information from the internet (AOR 3.62, 95% CI 2.07-6.33), and willingness to exchange via IT medical information with a provider (AOR 1.88, 95% CI 1.57-2.24) were significant predictors for seeking and exchanging such information, respectively. CONCLUSIONS: A potential digital gap may exist among US adults with disabilities in terms of their recent use of the internet for health information. Trust toward health information sources and willingness play an important role in people\u27s engagement in use of the internet for health information. Future studies should focus on addressing trust factors associated with IT use and developing tools to improve access to care for those with disabilities