Engaging adolescents in using online patient portals

IMPORTANCE: Many health care systems offer adolescents access to health information through online patient portals, but few studies have explored how to engage adolescents in using and benefiting from online portals. OBJECTIVE: To determine how US children\u27s hospitals have attempted to encourage adolescent portal use, barriers to engaging adolescents, and ideal future goals for engagement. DESIGN, SETTING, AND PARTICIPANTS: This qualitative study performed structured qualitative interviews with informatics administrators from children\u27s hospitals across the US between February and July 2022. Informatics administrators were employed by US health care systems that managed a children\u27s hospital with at least 50 dedicated pediatrics beds. Data analysis was performed from November 2022 to January 2023. MAIN OUTCOMES AND MEASURES: This study used thematic analysis of (1) current steps that health care systems had taken to engage adolescents in using their online patient portals and (2) barriers to engaging adolescents and ideal future goals and outcomes of engagement. RESULTS: Among 58 total interviews with 65 informatics administrators who represented 63 hospitals across 58 health care systems, 6 themes of approaches to engaging adolescents in portal use were identified: (1) promoting and educating adolescents about portal enrollment, (2) establishing workflows to support enrollment, (3) seeking and incorporating feedback, (4) creating a culture or environment supporting engagement, (5) increasing portal utility, and (6) limited efforts. Barriers to engaging adolescents in portal use related to either (1) stakeholder investment, interest, and capabilities or (2) intersecting technical, ethical, and legal factors. Participants identified 4 ideal future efforts to engage adolescents: (1) develop adaptable private means of communication with adolescents, (2) use adolescent-centric user design, (3) enhance promotion and education about portal use, and (4) simplify and adapt workflows to encourage enrollment. Participants described 3 ideal outcomes of this future engagement: (1) provide education about current health, (2) prepare for transition to adulthood, and (3) improve digital health education of adolescents. CONCLUSIONS AND RELEVANCE: In this qualitative study of informatics administrators, children\u27s hospitals across the US were found to have varying degrees of efforts to engage adolescents in using their portals. Most of these efforts focused on supporting adolescent enrollment, but fewer efforts focused on making the portal useful and interesting to adolescents

mHealth Research Applied to Regulated and Unregulated Behavioral Health Sciences

Behavioral scientists are developing new methods and frameworks that leverage mobile health technologies to optimize individual level behavior change. Pervasive sensors and mobile apps allow researchers to passively observe human behaviors “in the wild” 24/7 which supports delivery of personalized interventions in the real-world environment. This is all possible because these technologies contain an incredible array of sensors that allow applications to constantly record user location and can contextualize current environmental conditions through barometers, thermometers, and ambient light sensors and can also capture audio and video of the user and their surroundings through multiple integrated high-definition cameras and microphones. These tools are a game changer in behavioral health research and, not surprisingly, introduce new ethical, regulatory/legal and social implications described in this article

Exploring children's social and moral behaviour in a technology context

The central argument of this thesis is that disclosure of certain information via computer-mediated communication technologies influence specific behaviours in relation to trust, and betrayal for children and young people. The main aim of this thesis is to extend the computer mediated communication literature by investigating young people‘s use of digital communication devices in an effort to explore interactions between methods of computer mediated communication and young people‘s subsequent social and moral behaviour. The thesis begins with qualitative analyses of data gathered via focus groups to raise a broad range of issues important to the young user rather than the issues deemed important by parents and educators. Young people indicate clearly that they are aware of the safety issues that concern parents and academics eager to protect them from predators. Whilst the single most popular reason they identify for engaging with technology is to communicate, they identify three key areas of concern related to technology use; usage preferences, positive aspects of technology use and negative aspects of technology use. The topics relating to the latter two themes combine social and moral behaviours forming a preliminary framework for understanding behaviour within the HCI agenda. Subjective and objective methodology is implemented, typically via questionnaires and content analysis. In depth examination and assessment of those concerns deemed important to the young user is achieved via questionnaire studies developed from the issues raised in the focus groups. Building upon the preliminary framework identified in the first study, the thesis employs a questionnaire study to examine whether technology has an impact on trust by young people and how any betrayal of trust might impact on their subsequent behaviour. The questionnaire studies reveal that for young people dynamics of trust and forgiveness are functions of both type of medium chosen to convey information, as well as the recipient to whom the information is related. Further investigation confirms that similar elements exist for older users communicating via digital communication technologies. Subsequent investigation reveals that as young users of computer mediated communication adopt each new alternative communication medium, they then manipulate that new medium to fit their communication needs by using them in such a way as to enhance the speed and quality of communication