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Patient portals (PPs) are robust health IT programs that engage and empower patients in their care. Although PPs can benefit older adults who manage chronic conditions, their use of PPs have been largely overlooked and little training has been provided to them. Previously, our research team developed an older-adult-friendly Theory-based PP eLearning Program (T-PeP) and tested its impact on older adults with chronic conditions. As part of T-PeP, participants used discussion forums. The aim of this study was to explore older adults’ experiences with using PPs, perceived impact of PP on their health, and suggestions for improvement through analysis of discussion posts. A total of 205 posts were subjected to content analysis. Findings from 10 major themes explained older adults’ experiences with PPs and offered suggestions for vendors and healthcare organizations. As U.S. population is aging, older adults must be considered during the development and implementation of health IT programs.

Introduction - Cancer survivors may have physical, psychological, social, spiritual, and financial challenges that require coordinated, comprehensive care. Patient involvement programs that focus on education and health promotion help survivors to manage their symptoms and take better control of their total health. At the University of Maryland, a collaborative group developed the Cancer Survivorship Patient Engagement Toolkit (CaS-PET) which includes survivorship care plans, education on health topics, discussion boards, and ongoing communication between providers and patients using a patient portal. A study was performed to test the feasibility and preliminary impact of the CaS-PET program. Methods - After IRB approval, 30 cancer survivors at the University of Maryland Marlene and Stuart Greenebaum Comprehensive Cancer Center who were within 6 months of completion of active treatment were enrolled in a prospective pilot study of the CaS-PET that used a single group pre-post (3 month) design. The outcome measures included changes in quality of life, fear of recurrence, impact of cancer, dietary and exercise behaviors, and selected cancer symptoms. Participants’ demographic characteristics, internet/patient portal experience, and eHealth literacy was collected at baseline. Results - Among the 30 total participants, 15 (50%) were breast cancer survivors. Of the breast cancer participants, the median age was 57.2±13 years, 66.7% (n=10) were African American, and all were female. 13/15 (86%) participants completed the program and post questionnaires. After the CaS-PET program, participants had improved adherence to treatment (p=0.019), fruit and vegetable consumption (p=0.039), and trend to improved physical activity score (p=0.069). Tests related to psychosocial aspects of health did not show improvement. PrePostTest StatisticP valueAdherence to treatment25.223.2t=-2.7670.019Fruit and veg consumption9.712.4t=2.3110.039Physical Activity total MET5.16.7t=1.9950.069Global distress index0.90.9t=0.1890.853Fear of recurrence15.016.4t=0.8060.435 Discussion - The Cancer Survivorship Patient Engagement Toolkit (CaS-PET) was successfully administered to breast cancer survivors. Improvements in adherence, diet, and a trend towards improved physical activity were noted at the 3 month time point. While measured changes in fear of recurrence, impact of cancer, and symptom burden did not show significant changes, patients reported to investigators positive experiences from the program. Further longitudinal designed studies are needed with a larger sample and across different age groups. Citation Format: Paula Rosenblatt, Lindsey Hertsenberg, Hyojin Son, Mary McQuaige, Kenneth Miller, Eun Shim Nahm. Use of cancer survivorship patient engagement toolkit (CaS-PET) in breast cancer patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-13-11.

Objectives To evaluate an interactive electronic Cancer Survivorship Patient Engagement Toolkit (CaS-PET) using a single-group pre-/post-test design. Sample & setting 30 cancer survivors with a mean age of 56.5 years (SD = 13.6) were recruited from the University of Maryland Medical Center in Baltimore. Methods & variables CaS-PET was designed to deliver survivorship care plans (SCPs) with multifactorial support and comprised of SCPs, biweekly follow-up using patient portal e-messages, and online resources. Outcomes included health-related quality of life, symptom burden, impact of cancer, fear of recurrence, physical activities, dietary behavior, patient-provider communication, adherence to treatment, and e-health literacy. Results At three months, there was a significant improvement in quality of life, physical symptom burden, and total symptom burden. Implications for nursing Findings suggest an excellent potential for using CaS-PET for survivors who are in transition from treatment to survivorship.

Purpose The aim of this study was to test a modified version of the Technology Acceptance Model, which describes users' technology adoption, to examine the relations between patient portal use and potential influencing factors in adult patients who have used patient portals. The modified model posits that patient portal use can be explained by attitude and self-efficacy for using patient portals, perceived usefulness and ease of use, data privacy and security concerns, eHealth literacy, education level, and age. Design A cross-sectional anonymous online survey was conducted for adult patients who had used their patient portals in the past 12 months. Methods Participants were recruited from 20 settings selected in a large integrated health care system. Data from 743 patients were subject to structural equation modeling for model testing. Findings Sixty-eight percent were White and female, with a mean age of 53.1 years (SD = 15.34). Forty-seven percent used patient portals about monthly or more frequently. Scores for perceived usefulness and ease of use of patient portals were relatively high (as measured using the modified Perceived Health Web Site Usability Questionnaire; each item mean, 6.0-6.2; range, 1-7). The final model adequately fit the data (comparative fit index = .983, standardized root mean square residual = .064, root mean square error of approximation = .059). Patient portal self-efficacy and data privacy and security concerns had a direct impact on patient portal use. Perceived usefulness and ease of use, eHealth literacy, education level, and age indirectly influenced patient portal use. Conclusions This study contributes to expanding a theoretical understanding of adult patients' patient portal use in a real health care environment. Future studies need to include more diverse populations in various settings. Clinical relevance Knowledge gained from this study can be used by technology experts to make patient portals more user friendly and by administrators to implement patient portals more effectively.

Introduction: The high prevalence of chronic illnesses is a serious public health problem in the United States, and more than 70 million older adults have at least one chronic illness. Patient portals (PPs) have an excellent potential to assist older adults in managing chronic illnesses; however, older adults' PP adoption rates have been low. Lack of support for older adults using PPs remains a critical gap in most implementation processes. The main aim of this study was to assess the impact of an older adult friendly Theory-based Patient portal e-Learning Program (T-PeP) on PP knowledge, selected health outcomes (health decision-making self-efficacy [SE] and health communication), PP SE and use, and e-health literacy in older adults. Materials and Methods: A two-arm randomized controlled trial was conducted with older adults (N = 272) who had chronic conditions. Participants were recruited online, and data were collected at baseline, 3 weeks, and 4 months. The main intervention effects were tested using linear mixed models. Results: The average age of participants was 70.0 ± 8.5 years, and 78.3% (n = 213) were white. At 3 weeks, the intervention group showed significantly greater improvement than the control group in all outcomes except PP use. At 4 months, the intervention effects decreased, but PP SE remained significant (p = 0.015), and the intervention group showed higher frequency of PP use than the control group (p = 0.029). Conclusion: The study findings showed that the T-PeP was effective in improving selected health and PP usage outcomes. Further studies are needed to test the long-term effects of T-PeP using more diverse samples.

Patient portals can be beneficial for older adults who manage their own health. However, there is a lack of research on older adults' experience using patient portals in the community. The aim of this study was to assess older adults' perceived usability of patient portals they currently use. This was a secondary data analysis using selected baseline data from an online trial that tested the effects of a 3-week Theory-Based Patient Portal eLearning Program, and included 272 older adults recruited online. Data were analyzed using descriptive statistics and content analysis. Most participants owned patient portal accounts (n = 194 [71.3%]). Self-efficacy for using patient portals was relatively low (mean, 27.1; range, 0-40), and perceived usability of patient portals was also low (mean, 28.7; range, 6-42). The most-favored features of patient portals were review of medical information and eMessaging. The main difficulties in using patient portals were associated with login/access and specific portal functions. Managing multiple patient portals was a particular challenge for many participants. Findings from this study indicate the importance of providing proper levels of training and technical support to older adults to maximize use and improve outcomes of patient portal implementation.