1. A cross-sectional study of barriers to personal health record use among patients attending a safety-net clinic.
- Author
-
Hilton JF, Barkoff L, Chang O, Halperin L, Ratanawongsa N, Sarkar U, Leykin Y, Muñoz RF, Thom DH, and Kahn JS
- Subjects
- Consumer Health Information statistics & numerical data, Cross-Sectional Studies, Female, Health Surveys, Humans, Male, Mental Health Services statistics & numerical data, Middle Aged, Health Records, Personal psychology, Internet statistics & numerical data, Mental Disorders psychology, Substance-Related Disorders psychology
- Abstract
Background: Personal health records (PHR) may improve patients' health by providing access to and context for health information. Among patients receiving care at a safety-net HIV/AIDS clinic, we examined the hypothesis that a mental health (MH) or substance use (SU) condition represents a barrier to engagement with web-based health information, as measured by consent to participate in a trial that provided access to personal (PHR) or general (non-PHR) health information portals and by completion of baseline study surveys posted there., Methods: Participants were individually trained to access and navigate individualized online accounts and to complete study surveys. In response to need, during accrual months 4 to 12 we enhanced participant training to encourage survey completion with the help of staff. Using logistic regression models, we estimated odds ratios for study participation and for survey completion by combined MH/SU status, adjusted for levels of computer competency, on-study training, and demographics., Results: Among 2,871 clinic patients, 70% had MH/SU conditions, with depression (38%) and methamphetamine use (17%) most commonly documented. Middle-aged patients and those with a MH/SU condition were over-represented among study participants (N = 338). Survey completion was statistically independent of MH/SU status (OR, 1.85 [95% CI, 0.93-3.66]) but tended to be higher among those with MH/SU conditions. Completion rates were low among beginner computer users, regardless of training level (<50%), but adequate among advanced users (>70%)., Conclusions: Among patients attending a safety-net clinic, MH/SU conditions were not barriers to engagement with web-based health information. Instead, level of computer competency was useful for identifying individuals requiring substantial computer training in order to fully participate in the study. Intensive on-study training was insufficient to enable beginner computer users to complete study surveys.
- Published
- 2012
- Full Text
- View/download PDF