Abstract
Background: Web-based technologies offer an efficient patient-centered means of educating patients and improving their chronic disease self-management skills. Our objective was to engage patients in the use of an internet-based health behavior change program.
Methods: We tested the effectiveness of a web-based behavior change application designed by HealthMedia, Inc. (HMI) in patients with cardiovascular disease, diabetes, and/or heart failure. Eligible patients were required to be registered users of MyGeisinger, a web-based patient portal used to access medical information, communicate with providers, and review test results. Patients randomized to the intervention group received multiple letters and e-mails inviting them to use HMI’s behavior change tool. Control group patients did not have access to the HMI application. Given the low initial response rate (only 11.9% enrolled in the HMI application), we conducted a phone survey of 30 non-enrollees. The survey included 35 questions about internet usage, MyGeisinger usage, and reasons for not enrolling in the HMI system.
Results: All respondents reported having access to an internet-connected computer. Ninety percent of the respondents indicated that they accessed the internet 2–7 times per week. Seventy percent of respondents reported that they were active users of MyGeisinger. The most common reasons for not using the HMI system included: not knowing the physician who signed the letter inviting them to participate in the study (67%), technical problems with the computer, website, login or pop-up windows (67%), and needing more information about the intervention (43%).
Conclusions: The target population (i.e., comfortable using a web-based patient portal) for an internet-based behavior change tool was easy to identify. Several barriers remain to get these technology-savvy users to additionally adopt a web-based behavior-change application. In a separate analysis of MyGeisinger usage, 86% of the intervention group used MyGeisinger three or more times during a 12-month period. We conclude that motivating patients to use an electronic health tool that provides a platform for exchanging information (e.g., MyGeisinger) is fundamentally different from engaging patients in electronic health tools for health behavior change. There is a need to reduce and/or eliminate the technical hurdles and to develop better ways of providing information to prospective users about the purpose and benefits of web-based behavior change tools.
- Received September 11, 2008.
