Digital Information Technology Use and Patient Preferences for Internet-Based Health Education Modalities: Cross-Sectional Survey Study of Middle-Aged and Older Adults With Chronic Health Conditions

BACKGROUND Health information, patient education, and self-management (health information and advice, HIA) tools are increasingly being made available to adults with chronic health conditions through internet-based health and mobile health (mHealth) digital information technologies. However, there is limited information about patient preferences for using specific types of health information and advice resources and how preferences and usage differ by age group and education. OBJECTIVE The objective of this study was to examine how use of digital information technologies and preferred methods for obtaining health information and advice varies by age group and education among middle-aged and older adults with chronic health conditions. METHODS The study used cross-sectional survey data for 9005 Kaiser Permanente Northern California members aged 45 to 85 years who responded to a mailed and Web-based health survey conducted during 2014 and 2015 and indicated having at least 1 chronic health condition. Bivariate analyses and logistic regression models with weighted data were used to estimate and compare the prevalence of digital information technology use, past-year use of internet-based health information and advice resources, and preferences for using internet-based, mHealth, and traditional health information and advice modalities for adults aged 45 to 65 years, 66 to 75 years, and 76 to 85 years. RESULTS The percentages of adults who used digital information technologies (computers, smartphones, internet, email, and apps), had obtained health information and advice from an internet-based resource in the past year, and who were interested in using internet-based and mHealth modalities for obtaining health information and advice declined with age. Within age group, prevalence of digital information technologies use and interest in internet-based and mHealth modalities was lower among adults with no college education versus college graduates. Differences in preferences for internet-based health information and advice modalities between the oldest and younger groups and those with lower versus higher education were substantially diminished when we restricted analyses to internet users. CONCLUSIONS Health care providers and organizations serving middle-aged and older adults with chronic health conditions should not assume that patients, especially those who are older and less educated, want to engage with internet-based and mHealth resources. In addition, increasing the engagement of nonutilizers of digital devices and the internet with internet-based health information and advice and mHealth apps might require both instrumental (eg, providing digital information technology devices, internet, and skills training) and social support. As part of patient-centered care, it is important for providers to ascertain their patients’ use of digital information technologies and preferences for obtaining health information and patient education rather than routinely referring them to internet-based resources. It is also important for health care providers and consumer health organizations to user test their Web-based resources to make sure they are easy for older and less educated adults to use and to make sure that it remains easy for adults with chronic conditions to obtain health information and patient education using offline resources.

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Older adults experiences of technology use for socialization during the COVID-19 pandemic: A random cross-sectional survey (Preprint)

10.2196/preprints.28010 ◽

2021 ◽

Author(s):

Kristen R. Haase ◽

Theodore Cosco ◽

Lucy Kervin ◽

Indira Riadi ◽

Megan E. O'Connell

Keyword(s):

Mental Health ◽

Older Adults ◽

British Columbia ◽

Social Isolation ◽

Technology Use ◽

Random Sampling ◽

Population Based ◽

Critical Approach ◽

Cross Sectional Survey ◽

Cross Sectional

BACKGROUND Technology has become the most critical approach to maintain social connectedness during the COVID-19 pandemic. Older adults (over age 65) are perceived as most physiologically vulnerable to COVID-19 and at risk of secondary mental health challenges related to social isolation imposed by virus containment strategies. To mitigate concerns regarding sampling bias we used a random sampling of older adults to understand uptake and acceptance of technologies to support socialization during the pandemic. OBJECTIVE To conduct a random population-based assessment of the barriers and facilitators to engaging in technology use for virtual socialization amongst older adults in the Canadian province of British Columbia during the COVID-19 pandemic. METHODS We conducted a cross-sectional population-based survey using random-digit dialing to participants over age 65 living in British Columbia. Data were analyzed using SPSS, with open-text responses analyzed using thematic analysis. RESULTS Respondents included 400 older adults with an average age of 72 years old and 63.7% female. Most respondents (89.5%) were aware of how to use technology to connect with others and slightly more than half (56%) reported using technology differently to connect with others during the pandemic. 55.9% of respondents reported adopting new technology since the beginning of the pandemic. Older adults reported key barriers to using technology including: (1) lack of access (including finance, knowledge, and age); (2) lack of interest (including a preference for telephone, and a general lack of interest in computers); and (3) physical barriers (resultant of cognitive impairments, stroke, and arthritis). Older adults reported numerous facilitators, including: (1) knowledge of technologies (whether self-taught or via external courses); (2) reliance on others (family, friends, and general internet searching); (3) technology accessibility (including environments, user-friendly technology, and receiving clear instructions); and (4) social motivation (because everyone else is doing it). CONCLUSIONS Much data on older adults use of technology is limited by sampling biases, but the current study that used random sampling demonstrated that older adults used technology to mitigate social isolation during the pandemic. Virtual socialization is most promising to mitigate potential mental health effects related to virus containment strategies. Addressing barriers by mobilizing telephone training and task lists, and mobilizing facilitators described by participants such as facilitated socialization activities are important strategies that can be implemented within and beyond the pandemic to bolster the mental health needs of older adults.

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Comparison of Mobile Health Technology Use for Self-Tracking Between Older Adults and the General Adult Population in Canada: Cross-Sectional Survey

JMIR mhealth and uhealth ◽

10.2196/24718 ◽

2020 ◽

Vol 8 (11) ◽

pp. e24718

Author(s):

Mirou Jaana ◽

Guy Paré

Keyword(s):

Older Adults ◽

Health Care ◽

Technology Use ◽

Chronic Conditions ◽

Mobile Apps ◽

Adult Population ◽

Smart Devices ◽

Cross Sectional Survey ◽

Cross Sectional ◽

General Adult Population

Background The burden of population aging and chronic conditions has been reported worldwide. Older adults, especially those with high needs, experience social isolation and have high rates of emergency visits and limited satisfaction with the care they receive. Mobile health (mHealth) technologies present opportunities to address these challenges. To date, limited information is available on Canadian older adults’ attitudes toward and use of mHealth technologies for self-tracking purposes—an area that is increasingly important and relevant during the COVID-19 era. Objective This study presents contributions to an underresearched area on older adults and mHealth technology use. The aim of this study was to compare older adults’ use of mHealth technologies to that of the general adult population in Canada and to investigate the factors that affect their use. Methods A cross-sectional survey on mHealth and digital self-tracking was conducted. A web-based questionnaire was administered to a national sample of 4109 Canadian residents who spoke either English or French. The survey instrument consisted of 3 sections assessing the following items: (1) demographic characteristics, health status, and comorbidities; (2) familiarity with and use of mHealth technologies (ie, mobile apps, consumer smart devices/wearables such as vital signs monitors, bathroom scales, fitness trackers, intelligent clothing); and (3) factors influencing the continued use of mHealth technologies. Results Significant differences were observed between the older adults and the general adult population in the use of smart technologies and internet (P<.001). Approximately 47.4% (323/682) of the older adults in the community reported using smartphones and 49.8% (340/682) indicated using digital tablets. Only 19.6% (91/463) of the older adults using smartphones/digital tablets reported downloading mobile apps, and 12.3% (47/383) of the older adults who heard of smart devices/wearables indicated using them. The majority of the mobile apps downloaded by older adults was health-related; interestingly, their use was sustained over a longer period of time (P=.007) by the older adults compared to that by the general population. Approximately 62.7% (428/682) of the older adults reported tracking their health measures, but the majority did so manually. Older adults with one or more chronic conditions were mostly nontrackers (odds ratio 0.439 and 0.431 for traditional trackers and digital trackers, respectively). No significant differences were observed between the older adults and the general adult population with regard to satisfaction with mHealth technologies and their intention to continue using them. Conclusions Leveraging mHealth technologies in partnership with health care providers and sharing of health/well-being data with health care professionals and family members remain very limited. A culture shift in the provision of care to older adults is deemed necessary to keep up with the development of mHealth technologies and the changing demographics and expectations of patients and their caregivers.

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Perceived Treatment Satisfaction and Effectiveness Facilitators Among Patients With Chronic Health Conditions: A Self-Reported Survey

Interactive Journal of Medical Research ◽

10.2196/13029 ◽

2020 ◽

Vol 9 (1) ◽

pp. e13029

Author(s):

Kathryn Volpicelli Leonard ◽

Courtney Robertson ◽

Amrita Bhowmick ◽

Leslie Beth Herbert

Keyword(s):

Treatment Satisfaction ◽

Survey Design ◽

Strong Relationship ◽

Chronic Health Conditions ◽

Health Conditions ◽

Perceived Effectiveness ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Chronic Health ◽

Factors Associated

Background Approximately 50% of patients are nonadherent to prescribed medications. Patient perception regarding medication effectiveness has been linked to improved adherence. However, how patients perceive effectiveness is poorly understood. Objective The aim of this study was to elucidate factors associated with perceived treatment satisfaction and effectiveness among patients with chronic health conditions. Methods We conducted a descriptive study using a cross-sectional survey design. We administered a Web-based survey to participants with migraine, multiple sclerosis (MS), or rheumatoid arthritis (RA). Patients were recruited from established online communities of Health Union. Descriptive statistics, correlations, and comparison tests were used to examine outcomes. Results Data were collected from 1820 patients: 567 with migraine, 717 with MS, and 536 with RA. The majority of participants were female (1644/1820, 90.33%), >40 years old (1462/1820, 80.33%), and diagnosed >5 years ago (1189/1820, 65.33%). Treatment satisfaction and perceived medication effectiveness were highly correlated (r=0.90, P<.01). Overall, three temporal factors were positively correlated with satisfaction or perceived effectiveness: time on current medication (satisfaction rs=0.22, P<.01; effectiveness rs=0.25, P<.01), time since diagnosis (satisfaction rs=0.07, P<.01; effectiveness rs=0.09, P<.01), and time on treatment (effectiveness rs=0.08, P<.01). Conclusions Findings validated the strong relationship between treatment satisfaction and perceived effectiveness. Understanding the (1) positive relationship between time and treatment satisfaction and effectiveness and (2) factors associated with determining medication effectiveness can help clinicians better understand the mindset of patients regarding treatment. Clinicians may be better prepared to elicit patient beliefs, which influence medication adherence, for people diagnosed with chronic health conditions.

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Prevalence and Factors Influencing Use of Internet and Electronic Health Resources by Middle-Aged and Older Adults in a US Health Plan Population: Cross-Sectional Survey Study

JMIR Aging ◽

10.2196/11451 ◽

2019 ◽

Vol 2 (1) ◽

pp. e11451 ◽

Cited By ~ 4

Author(s):

Elizabeth Crouch ◽

Nancy P Gordon

Keyword(s):

Older Adults ◽

Health Plan ◽

Health Resources ◽

Survey Study ◽

Middle Aged ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Influencing ◽

Electronic Health ◽

Use Of Internet

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Perceived Treatment Satisfaction and Effectiveness Facilitators Among Patients With Chronic Health Conditions: A Self-Reported Survey (Preprint)

10.2196/preprints.13029 ◽

2018 ◽

Author(s):

Kathryn Volpicelli Leonard ◽

Courtney Robertson ◽

Amrita Bhowmick ◽

Leslie Beth Herbert

Keyword(s):

Treatment Satisfaction ◽

Survey Design ◽

Strong Relationship ◽

Chronic Health Conditions ◽

Health Conditions ◽

Perceived Effectiveness ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Chronic Health ◽

Factors Associated

BACKGROUND Approximately 50% of patients are nonadherent to prescribed medications. Patient perception regarding medication effectiveness has been linked to improved adherence. However, how patients perceive effectiveness is poorly understood. OBJECTIVE The aim of this study was to elucidate factors associated with perceived treatment satisfaction and effectiveness among patients with chronic health conditions. METHODS We conducted a descriptive study using a cross-sectional survey design. We administered a Web-based survey to participants with migraine, multiple sclerosis (MS), or rheumatoid arthritis (RA). Patients were recruited from established online communities of Health Union. Descriptive statistics, correlations, and comparison tests were used to examine outcomes. RESULTS Data were collected from 1820 patients: 567 with migraine, 717 with MS, and 536 with RA. The majority of participants were female (1644/1820, 90.33%), >40 years old (1462/1820, 80.33%), and diagnosed >5 years ago (1189/1820, 65.33%). Treatment satisfaction and perceived medication effectiveness were highly correlated (r=0.90, P<.01). Overall, three temporal factors were positively correlated with satisfaction or perceived effectiveness: time on current medication (satisfaction rs=0.22, P<.01; effectiveness rs=0.25, P<.01), time since diagnosis (satisfaction rs=0.07, P<.01; effectiveness rs=0.09, P<.01), and time on treatment (effectiveness rs=0.08, P<.01). CONCLUSIONS Findings validated the strong relationship between treatment satisfaction and perceived effectiveness. Understanding the (1) positive relationship between time and treatment satisfaction and effectiveness and (2) factors associated with determining medication effectiveness can help clinicians better understand the mindset of patients regarding treatment. Clinicians may be better prepared to elicit patient beliefs, which influence medication adherence, for people diagnosed with chronic health conditions.

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Mobile and Connected Health Technology Needs for Older Adults Aging in Place: Cross-Sectional Survey Study

JMIR Aging ◽

10.2196/13864 ◽

2019 ◽

Vol 2 (1) ◽

pp. e13864 ◽

Cited By ~ 14

Author(s):

Jing Wang ◽

Yan Du ◽

Deidra Coleman ◽

Michelle Peck ◽

Sahiti Myneni ◽

...

Keyword(s):

Older Adults ◽

Aging In Place ◽

Health Technology ◽

Survey Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Connected Health

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Physical multimorbidity patterns and depressive symptoms: a nationwide cross-sectional study in Japan

Family Medicine and Community Health ◽

10.1136/fmch-2019-000234 ◽

2020 ◽

Vol 8 (1) ◽

pp. e000234

Author(s):

Takuya Aoki ◽

Yosuke Yamamoto ◽

Sayaka Shimizu ◽

Shunichi Fukuhara

Keyword(s):

Depressive Symptoms ◽

Cross Sectional Study ◽

Chronic Health Conditions ◽

Health Conditions ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Chronic Health ◽

Japanese Residents ◽

Quota Sampling ◽

Multimorbid Patients

ObjectiveThe associations of physical multimorbidity with depressive symptoms have been investigated in a number of studies. However, whether patterns of chronic physical conditions have comparatively different associations with depressive symptoms remains unclear. This study aimed to investigate the associations of physical multimorbidity patterns with depressive symptoms.DesignThis study was designed as a nationwide cross-sectional survey in Japan.SettingGeneral sample of the Japanese population.ParticipantsAdult Japanese residents were selected by a quota sampling method. Data were analysed from 1788 residents who reported one or more chronic health conditions.ResultsAmong four physical multimorbidity patterns: cardiovascular-renal-metabolic (CRM), skeletal-articular-digestive (SAD), respiratory-dermal (RDE) and malignant-digestive-urologic (MDU), multivariable logistic regression analyses revealed that the RDE pattern showed the strongest association with depressive symptoms (aOR=1.68, 95% CI: 1.21 to 2.31 for the pattern score highest quartile, compared with the lowest quartile), followed by SAD and MDU patterns (aOR=1.41, 95% CI: 1.01 to 1.98 for the SAD pattern score highest quartile; 1.41, 95% CI: 1.01 to 1.96 for the MDU pattern score highest quartile, compared with the lowest quartile). In contrast, the CRM pattern score was not significantly associated with depressive symptoms (aOR=1.31, 95% CI: 0.90 to 1.89 for the pattern score highest quartile, compared with the lowest quartile).ConclusionsPhysical multimorbidity patterns have different associations with depressive symptoms. Among these patterns, patients with the RDE pattern may be at a higher risk for developing depressive symptoms. This study reinforces the evidence that cluster pattern of chronic health conditions is a useful measure for clinical management of multimorbidity as it is differently associated with mental health status, which is one of the crucial outcomes for multimorbid patients.

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Older adults' experiences of technology use for socialization during the COVID-19 pandemic: A regionally representative cross-sectional survey (Preprint)

JMIR Aging ◽

10.2196/28010 ◽

2021 ◽

Author(s):

Kristen R. Haase ◽

Theodore Cosco ◽

Lucy Kervin ◽

Indira Riadi ◽

Megan E. O'Connell

Keyword(s):

Older Adults ◽

Technology Use ◽

Cross Sectional Survey ◽

Cross Sectional

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Comparison of Mobile Health Technology Use for Self-Tracking Between Older Adults and the General Adult Population in Canada: Cross-Sectional Survey (Preprint)

10.2196/preprints.24718 ◽

2020 ◽

Author(s):

Mirou Jaana ◽

Guy Paré

Keyword(s):

Older Adults ◽

Health Care ◽

Technology Use ◽

Chronic Conditions ◽

Mobile Apps ◽

Adult Population ◽

Smart Devices ◽

Cross Sectional Survey ◽

Cross Sectional ◽

General Adult Population

BACKGROUND The burden of population aging and chronic conditions has been reported worldwide. Older adults, especially those with high needs, experience social isolation and have high rates of emergency visits and limited satisfaction with the care they receive. Mobile health (mHealth) technologies present opportunities to address these challenges. To date, limited information is available on Canadian older adults’ attitudes toward and use of mHealth technologies for self-tracking purposes—an area that is increasingly important and relevant during the COVID-19 era. OBJECTIVE This study presents contributions to an underresearched area on older adults and mHealth technology use. The aim of this study was to compare older adults’ use of mHealth technologies to that of the general adult population in Canada and to investigate the factors that affect their use. METHODS A cross-sectional survey on mHealth and digital self-tracking was conducted. A web-based questionnaire was administered to a national sample of 4109 Canadian residents who spoke either English or French. The survey instrument consisted of 3 sections assessing the following items: (1) demographic characteristics, health status, and comorbidities; (2) familiarity with and use of mHealth technologies (ie, mobile apps, consumer smart devices/wearables such as vital signs monitors, bathroom scales, fitness trackers, intelligent clothing); and (3) factors influencing the continued use of mHealth technologies. RESULTS Significant differences were observed between the older adults and the general adult population in the use of smart technologies and internet (P<.001). Approximately 47.4% (323/682) of the older adults in the community reported using smartphones and 49.8% (340/682) indicated using digital tablets. Only 19.6% (91/463) of the older adults using smartphones/digital tablets reported downloading mobile apps, and 12.3% (47/383) of the older adults who heard of smart devices/wearables indicated using them. The majority of the mobile apps downloaded by older adults was health-related; interestingly, their use was sustained over a longer period of time (P=.007) by the older adults compared to that by the general population. Approximately 62.7% (428/682) of the older adults reported tracking their health measures, but the majority did so manually. Older adults with one or more chronic conditions were mostly nontrackers (odds ratio 0.439 and 0.431 for traditional trackers and digital trackers, respectively). No significant differences were observed between the older adults and the general adult population with regard to satisfaction with mHealth technologies and their intention to continue using them. CONCLUSIONS Leveraging mHealth technologies in partnership with health care providers and sharing of health/well-being data with health care professionals and family members remain very limited. A culture shift in the provision of care to older adults is deemed necessary to keep up with the development of mHealth technologies and the changing demographics and expectations of patients and their caregivers.

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