J. Med. Internet Res. - Which bundles of features in a Web-based personally controlled health management system are associated with consumer help-seeking behaviors for physical and emotional well-being?


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CKGROUND: Personally controlled health management systems (PCHMS), which include a personal health record (PHR), health management tools, and consumer resources, represent the next stage in consumer eHealth systems. It is still unclear, however, what features contribute to an engaging and efficacious PCHMS.OBJECTIVE: To identify features in a Web-based PCHMS that are associated with consumer utilization of primary care and counselling services, and help-seeking rates for physical and emotional well-being concerns.METHODS: A one-group pre/posttest online prospective study was conducted on a university campus to measure use of a PCHMS for physical and emotional well-being needs during a university academic semester (July to November 2011). The PCHMS integrated an untethered personal health record (PHR) with well-being journeys, social forums, polls, diaries, and online messaging links with a health service provider, where journeys provide information for consumer participants to engage with clinicians and health services in an actionable way. 1985 students and staff aged 18 and above with access to the Internet were recruited online. Logistic regression, the Pearson product-moment correlation coefficient, and chi-square analyses were used to associate participants' help-seeking behaviors and health service utilization with PCHMS usage among the 709 participants eligible for analysis.RESULTS: A dose-response association was detected between the number of times a user logged into the PCHMS and the number of visits to a health care professional (P=.01), to the university counselling service (P=.03), and help-seeking rates (formal or informal) for emotional well-being matters (P=.03). No significant association was detected between participant pre-study characteristics or well-being ratings at different PCHMS login frequencies. Health service utilization was strongly correlated with use of a bundle of features including: online appointment booking (primary care: OR 1.74, 95% CI 1.01-3.00; counselling: OR 6.04, 95% CI 2.30-15.85), personal health record (health care professional: OR 2.82, 95% CI 1.63-4.89), the poll (health care professional: OR 1.47, 95% CI 1.02-2.12), and diary (counselling: OR 4.92, 95% CI 1.40-17.35). Help-seeking for physical well-being matters was only correlated with use of the personal health record (OR 1.73, 95% CI 1.18-2.53). Help-seeking for emotional well-being concerns (including visits to the university counselling service) was correlated with a bundle comprising the poll (formal or informal help-seeking: OR 1.03, 95% CI 1.00-1.05), diary (counselling: OR 4.92, 95% CI 1.40-17.35), and online appointment booking (counselling: OR 6.04, 95% CI 2.30-15.85).CONCLUSIONS: Frequent usage of a PCHMS was significantly associated with increased consumer health service utilization and help-seeking rates for emotional health matters in a university sample. Different bundles of PCHMS features were associated with physical and emotional well-being matters. PCHMS appears to be a promising mechanism to engage consumers in help-seeking or health service utilization for physical and emotional well-being matters.

Resumo Limpo

ckground person control health manag system pchms includ person health record phr health manag tool consum resourc repres next stage consum ehealth system still unclear howev featur contribut engag efficaci pchmsobject identifi featur webbas pchms associ consum util primari care counsel servic helpseek rate physic emot wellb concernsmethod onegroup preposttest onlin prospect studi conduct univers campus measur use pchms physic emot wellb need univers academ semest juli novemb pchms integr unteth person health record phr wellb journey social forum poll diari onlin messag link health servic provid journey provid inform consum particip engag clinician health servic action way student staff age access internet recruit onlin logist regress pearson productmo correl coeffici chisquar analys use associ particip helpseek behavior health servic util pchms usag among particip elig analysisresult doserespons associ detect number time user log pchms number visit health care profession p univers counsel servic p helpseek rate formal inform emot wellb matter p signific associ detect particip prestudi characterist wellb rate differ pchms login frequenc health servic util strong correl use bundl featur includ onlin appoint book primari care ci counsel ci person health record health care profession ci poll health care profession ci diari counsel ci helpseek physic wellb matter correl use person health record ci helpseek emot wellb concern includ visit univers counsel servic correl bundl compris poll formal inform helpseek ci diari counsel ci onlin appoint book counsel ci conclus frequent usag pchms signific associ increas consum health servic util helpseek rate emot health matter univers sampl differ bundl pchms featur associ physic emot wellb matter pchms appear promis mechan engag consum helpseek health servic util physic emot wellb matter

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