J. Med. Internet Res. - Social and self-reflective use of a Web-based personally controlled health management system.


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CKGROUND: Personally controlled health management systems (PCHMSs) contain a bundle of features to help patients and consumers manage their health. However, it is unclear how consumers actually use a PCHMS in their everyday settings.OBJECTIVE: To conduct an empirical analysis of how consumers used the social (forum and poll) and self-reflective (diary and personal health record [PHR]) features of a Web-based PCHMS designed to support their physical and emotional well-being.METHODS: A single-group pre/post-test online prospective study was conducted to measure use of a Web-based PCHMS for physical and emotional well-being needs during a university academic semester. The PCHMS integrated an untethered PHR with social forums, polls, a diary, and online messaging links with a health service provider. Well-being journeys additionally provided information to encourage engagement with clinicians and health services. A total of 1985 students and staff aged 18 and above with access to the Internet were recruited online, of which 709 were eligible for analysis. Participants' self-reported well-being, health status, health service utilization, and help-seeking behaviors were compared using chi-square, McNemar's test, and Student's t test. Social networks were constructed to examine the online forum communication patterns among consumers and clinicians.RESULTS: The two PCHMS features that were used most frequently and considered most useful and engaging were the social features (ie, the poll and forum). More than 30% (213/709) of participants who sought well-being assistance during the study indicated that other people had influenced their decision to seek help (54.4%, 386/709 sought assistance for physical well-being; 31.7%, 225/709 for emotional well-being). Although the prevalence of using a self-reflective feature (diary or PHR) was not as high (diary: 8.6%, 61/709; PHR: 15.0%, 106/709), the proportion of participants who visited a health care professional during the study was more than 20% greater in the group that did use a self-reflective feature (diary: P=.03; PHR: P<.001).CONCLUSIONS: There was variation in the degree to which consumers used social and self-reflective PCHMS features but both were significantly associated with increased help-seeking behaviors and health service utilization. A PCHMS should combine both self-reflective as well as socially driven components to most effectively influence consumers' help-seeking behaviors.

Resumo Limpo

ckground person control health manag system pchmss contain bundl featur help patient consum manag health howev unclear consum actual use pchms everyday settingsobject conduct empir analysi consum use social forum poll selfreflect diari person health record phr featur webbas pchms design support physic emot wellbeingmethod singlegroup preposttest onlin prospect studi conduct measur use webbas pchms physic emot wellb need univers academ semest pchms integr unteth phr social forum poll diari onlin messag link health servic provid wellb journey addit provid inform encourag engag clinician health servic total student staff age access internet recruit onlin elig analysi particip selfreport wellb health status health servic util helpseek behavior compar use chisquar mcnemar test student t test social network construct examin onlin forum communic pattern among consum cliniciansresult two pchms featur use frequent consid use engag social featur ie poll forum particip sought wellb assist studi indic peopl influenc decis seek help sought assist physic wellb emot wellb although preval use selfreflect featur diari phr high diari phr proport particip visit health care profession studi greater group use selfreflect featur diari p phr pconclus variat degre consum use social selfreflect pchms featur signific associ increas helpseek behavior health servic util pchms combin selfreflect well social driven compon effect influenc consum helpseek behavior

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