Impact of a Personal Health Record Intervention upon Surveillance Among Colorectal Cancer Survivors: Feasibility Study (Preprint)

2021 ◽  
Author(s):  
Eric Vachon ◽  
Bruce W. Robb ◽  
David A. Haggstrom
Keyword(s):  
Colorectal Cancer ◽  
Feasibility Study ◽  
Self Efficacy ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record ◽  
Post Intervention ◽  
Patient Centered ◽  
Patient Beliefs

BACKGROUND There are currently an estimated 1.5 million individuals living in the United States (US) with colorectal cancer (CRC), and although the five-year survival rate has increased, survivors are at risk for recurrence, particularly within the first 2-3 post-treatment. National guidelines recommend continued surveillance post-resection, in order to identify recurrence early on. Adherence among survivors ranges from 49%-94%. Novel interventions are needed to increase CRC survivors’ knowledge and confidence in managing their cancer and thus increase adherence to follow-up surveillance. OBJECTIVE The objective of this study was to develop and test the feasibility and efficacy of a web-based personal health record (PHR) to increase surveillance adherence among CRC survivors, with patient beliefs about surveillance as secondary outcomes. METHODS A pre- and post-intervention feasibility trial was conducted testing the efficacy of the Colorectal Cancer Survivor (CRCS)-PHR, which had been previously developed using an iterative, user-centered design approach. The CRCS-PHR includes surveillance guidelines, treatment tracking, potential treatment toxicities, as well as a journaling tab and communities to interact with other CRC survivors. A total of 28 stage I-III CRC survivors (9 colon, 18 rectal, 1 unknown) were recruited from an academic medical center in the Midwest US. At enrollment, patient demographics and cancer characteristics were gathered via medical record audit. Following enrollment, patients completed surveys at baseline and 6 months post-intervention asking about adherence to colonoscopy, computed tomography (CT) scan, and carcinoembryonic antigen (CEA) and beliefs about surveillance (barriers, benefits, self-efficacy, and knowledge). Paired t-test analyses were used to compare pre- and post-intervention ratings for each of the four patient beliefs categories and surveillance adherence. RESULTS The average age of the sample was 58 years old, with 57% males and the majority being married and employed full time. We observed a significant increase in adherence to colonoscopy (pre: 52% vs. post: 86%, p<.01) and CEA (67% vs. 95%, p=.01), as well as a slight increase in CT scans (67% vs. 84%, p=.1). The only significant impact on secondary outcome (patient beliefs) was benefits of CEA test (p=.04), as most of the beliefs were high at baseline. CONCLUSIONS This feasibility study lays the groundwork for continued development of the CRCS-PHR to increase CRC surveillance. Patient-centered technologies, such as the CRCS-PHR, represent an important potential approach to improving the receipt of guideline-concordant care and follow-up surveillance, not just for CRC survivors. Researchers should continue to develop patient-centered health technologies with clinician implementation in mind to increase patient self-efficacy and surveillance adherence.

Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics

2017 ◽  
Vol 35 (4) ◽  
pp. 176-185 ◽  
Author(s):  
Eun-Shim Nahm ◽  
Catherine Diblasi ◽  
Eva Gonzales ◽  
Kristi Silver ◽  
Shijun Zhu ◽  
...  
Keyword(s):  
Personal Health Record ◽  
Personal Health ◽  
Health Record ◽  
Patient Centered

scholarly journals Computer Skills Drive Personal Health Record Adoption: A Multi-dimensional Evaluation of Users versus Non-Users (Preprint)

2020 ◽  
Author(s):  
Martina A Clarke ◽  
Ann L Fruhling ◽  
Alvin E Tarrell ◽  
Tamara L Bernard ◽  
John R Windle
Keyword(s):  
Self Efficacy ◽  
Information Technologies ◽  
Personal Health Record ◽  
Patient Activation ◽  
Personal Health ◽  
Health Record ◽  
Health Information Technologies ◽  
Complex Information ◽  
Significant Difference ◽  
Computer Self Efficacy

BACKGROUND In the era of precision medicine, it is critical for health communication efforts to improve the comprehension level of the complex information being presented in the personal health record (PHR). OBJECTIVE To assess and understand the characteristics associated with patients’ choice to use or not use their PHR. METHODS A diverse group of patients with chronic cardiovascular disease was selected to participate in this study. They were screened by race, ethnicity, sex, age and zip code, specifically. Seventy-nine patients participated: 48 PHR users and 31 non-users. They completed seven surveys related to their choice to use or not use the PHR: demographics, patient activation, medication adherence, health literacy, computer self-efficacy, numeracy and graph literacy. RESULTS There is no significant difference between users and non-users in sociodemographic measures: age (P=0.17), sex (P=0.35), education (P=0.068), ethnicity (P=0.43), race (P=0.42), and employment (P=0.75). There is a significant difference between PHR users and PHR non-users in computer self-efficacy (P=0.0053), subjective graph literacy (P=0.0073), subjective numeracy scale (P=0.0074). CONCLUSIONS In this study, we demonstrate that sociodemographic characteristics were not an important factor in patients’ use of their PHR. Our results did demonstrate that there is a difference between PHR users and non-users related to their computer self-efficacy (CSE), graph literacy, and numeracy. This work suggests that incorporating CSE and graph literacy into the design of PHRs is critical. The design of patient facing tools must take into account patients’ preferences and abilities when developing effective user-friendly health information technologies (HIT). CLINICALTRIAL NA

scholarly journals Adoption of a Personal Health Record in the Digital Age: Cross-Sectional Study

10.2196/22913 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22913
Author(s):  
Consuela Cheriece Yousef ◽  
Abin Thomas ◽  
Ahmed O Alenazi ◽  
Sumaya Elgadi ◽  
Laila Carolina Abu Esba ◽  
...  
Keyword(s):  
Health Care ◽  
National Guard ◽  
Personal Health Record ◽  
Patient Centered Care ◽  
Personal Health ◽  
Health Record ◽  
Objective Data ◽  
Patient Centered ◽  
Cross Sectional ◽  
Centered Care

Background As health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care. Objective The aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care). Methods A cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care. Results In the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001). Conclusions The results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.

Use of an online personal health record’s Track Health function to promote positive lifestyle behaviors in Veterans with prediabetes

2016 ◽  
Vol 23 (5) ◽  
pp. 681-690 ◽  
Author(s):  
Joseph Sharit ◽  
Thaer Idrees ◽  
Allen D Andrade ◽  
Ramanakumar Anam ◽  
Chandana Karanam ◽  
...  
Keyword(s):  
Physical Activity ◽  
Personal Health Record ◽  
Lifestyle Changes ◽  
Abdominal Circumference ◽  
Personal Health ◽  
Health Record ◽  
Lifestyle Behaviors ◽  
Veterans Health ◽  
Post Intervention ◽  
Health Function

This pilot 3-month clinical trial investigated the feasibility, effectiveness, and acceptability of using the Track Health function of the Veterans Health Administration’s personal health record for eliciting a more positive physical activity and dietary intake lifestyle in a sample of 38 overweight and obese Veterans with prediabetes. Comparisons between baseline and 3 months post-intervention indicated significant improvements in weight, physical activity, abdominal circumference, and blood pressure. Use of a personal health record that users can identify with and find usable and useful coupled with instruction targeting critical functionalities could potentially promote healthy behavioral lifestyle changes.

Developing a personal health record self-efficacy tool

2013 ◽  
Vol 26 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Kathleen M. Nokes ◽  
Jay Verkuilen ◽  
Dorothy E. Hickey ◽  
Judith C. James-Borga ◽  
Jing Shan
Keyword(s):  
Self Efficacy ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record

scholarly journals Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study (Preprint)

2018 ◽  
Author(s):  
Will L Tarver ◽  
Bruce W Robb ◽  
David A Haggstrom
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Personal Health Record ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Personal Health ◽  
Health Record ◽  
Survivorship Care ◽  
The Impact

BACKGROUND As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors. OBJECTIVE The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors. METHODS Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method. RESULTS CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information. CONCLUSIONS For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management.

scholarly journals Usefulness and Usability of a Personal Health Record and Survivorship Care Plan for Colorectal Cancer Survivors: Survey Study

JMIR Cancer ◽  
10.2196/10692 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e10692
Author(s):  
Will L Tarver ◽  
Bruce W Robb ◽  
David A Haggstrom
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Survivors ◽  
Personal Health Record ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Personal Health ◽  
Health Record ◽  
Survivorship Care ◽  
The Impact

Background As a result of improvements in cancer screening, treatment, and supportive care, nearly two-thirds of individuals diagnosed with colorectal cancer (CRC) live for 5 years after diagnosis. An ever-increasing population of CRC survivors creates a need for effective survivorship care to help manage and mitigate the impact of CRC and its treatment. Personal health records (PHRs) and survivorship care plans provide a means of supporting the long-term care of cancer survivors. Objective The purpose of this study is to characterize the usefulness of a CRC PHR and survivorship care plan and to describe the usability of these technologies in a population of CRC survivors. To our knowledge, this is the first study to assess a PHR and survivorship care plan specifically targeting CRC survivors. Methods Twenty-two patients with CRC were recruited from surgery clinics of an academic medical center and Veterans Affairs hospital in Indianapolis and provided access to an online Colorectal Cancer Survivor’s Personal Health Record (CRCS-PHR). Survey data were collected to characterize the usefulness of the CRCS-PHR and describe its usability in a population of CRC survivors. CRC survivors were surveyed 6 months after being provided online access. Means and proportions were used to describe the usefulness and ease of using the CRC website. Open-ended questions were qualitatively coded using the constant comparative method. Results CRC survivors perceived features related to their health care (ie, summary of cancer treatment history, follow-up care schedule, description of side effects, and list of community resources) to be more useful than communication features (ie, creating online relationships with family members or caregivers, communicating with doctor, and secure messages). CRC survivors typically described utilizing traditional channels (eg, via telephone or in person) to communicate with their health care provider. Participants had overall positive perceptions with respect to ease of use and overall satisfaction. Major challenges experienced by participants included barriers to system log-in, lack of computer literacy or experience, and difficulty entering their patient information. Conclusions For CRC, survivors may find the greater value in a PHR’s medical content than the communication functions, which they have available elsewhere. These findings regarding the usefulness and usability of a PHR for the management of CRC survivorship provide valuable insights into how best to tailor these technologies to patients’ needs. These findings can inform future design and development of PHRs for purposes of both cancer and chronic disease management.

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