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    Development and evaluation of an internet and personal health record training program for low-income patients with HIV or hepatitis C

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    Authors
    McInnes, D. Keith
    Solomon, Jeffrey L.
    Shimada, Stephanie L.
    Petrakis, Beth A.
    Bokhour, Barbara G.
    Asch, Steven M.
    Nazi, Kim M.
    Houston, Thomas K.
    Gifford, Allen L.
    UMass Chan Affiliations
    Department of Quantitative Health Sciences
    Document Type
    Journal Article
    Publication Date
    2013-03-01
    Keywords
    Bioinformatics
    Epidemiology
    Health Services Research
    Immune System Diseases
    
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    Link to Full Text
    http://dx.doi.org/10.1097/MLR.0b013e31827808bf
    Abstract
    BACKGROUND: Vulnerable populations face difficulties accessing and using the internet and personal health record (PHR) systems for health-related purposes. Populations disconnected from the internet also tend to be disconnected from health care services. OBJECTIVES: To develop and evaluate an intervention to increase skills in health-related internet and PHR use for vulnerable populations with limited computer and internet experience. RESEARCH DESIGN: Preevaluation and postevaluation using quantitative surveys, semistructured interviews, focus groups, and ethnographic observation. SUBJECTS: Fourteen low-income Veterans receiving care at Veterans Affairs medical centers for human immunodeficiency virus or hepatitis C. MEASURES: Internet and PHR use, self-efficacy, patient activation, disease knowledge, predictors of medication adherence. RESULTS: At follow-up one (FU1), mean number of internet for health features used increased from 1.57 to 4.07 (P<0.001) as did number of PHR features, from 0.36 to 2.00 (P<0.001). Mean self-efficacy increased at FU1, from 7.12 to 8.60, (P=0.009) and was maintained at follow-up two (FU2). Patient activation increased only at FU2, from 3.42 to 3.61 (P=0.03). Disease specific knowledge showed borderline increase at FU1, from 67.9% to 72.2% (P=0.05), whereas there were no changes in predictors of medication adherence. Qualitative findings underscored the interest in using internet and PHRs and their contribution to increased engagement in care. Training cost per participant was $287. CONCLUSIONS: Group training of vulnerable patients represents a cost-effective method to increase internet and PHR skills, and improve patient confidence in finding health-related information, making online health-related transactions, and interacting with health care providers.
    Source
    Med Care. 2013 Mar;51(3 Suppl 1):S62-6. doi: 10.1097/MLR.0b013e31827808bf. Link to article on publisher's site
    DOI
    10.1097/MLR.0b013e31827808bf
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46607
    PubMed ID
    23407015
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1097/MLR.0b013e31827808bf
    Scopus Count
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    Population and Quantitative Health Sciences Publications

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