Examining the determinants of eHealth usage among elderly people with disability: The moderating role of behavioural aspects

Ali, Mohammad Afshar; Alam, Khorshed; Taylor, Brad; Ashraf, Mahmud

doi:10.1016/j.ijmedinf.2021.104411

Cited by 25 publications

(15 citation statements)

References 36 publications

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“…Younger age increased program use in our study, which is in agreement with the results of previous studies. However, in contrast to our finding that a lower level of education increased program use, earlier studies showed that a higher level of education increased program use [ 18 - 20 , 32 , 33 ]. Despite this discrepancy, these results show that age and education both influence program use, possibly because they are both related to eHealth literacy.…”

Section: Discussioncontrasting

confidence: 99%

The Influencing Contexts and Potential Mechanisms Behind the Use of Web-Based Self-management Support Interventions: Realistic Evaluation

Engelen¹,

Gaal²,

Vermeulen³

et al. 2022

JMIR Hum Factors

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Background Self-management can increase self-efficacy and quality of life and improve disease outcomes. Effective self-management may also help reduce the pressure on health care systems. However, patients need support in dealing with their disease and in developing skills to manage the consequences and changes associated with their condition. Web-based self-management support programs have helped patients with cardiovascular disease (CVD) and rheumatoid arthritis (RA), but program use has been low. Objective This study aimed to identify the patient, disease, and program characteristics that determine whether patients use web-based self-management support programs or not. Methods A realistic evaluation methodology was used to provide a comprehensive overview of context (patient and disease characteristics), mechanism (program characteristics), and outcome (program use). Secondary data of adult patients with CVD (n=101) and those with RA (n=77) were included in the study. The relationship between context (sex, age, education, employment status, living situation, self-management [measured using Patient Activation Measure-13], quality of life [measured using RAND 36-item health survey], interaction efficacy [measured using the 5-item perceived efficacy in patient-physician interactions], diagnosis, physical comorbidity, and time since diagnosis) and outcome (program use) was analyzed using logistic regression analyses. The relationship between mechanism (program design, implementation strategies, and behavior change techniques [BCTs]) and outcome was analyzed through a qualitative interview study. Results This study included 68 nonusers and 111 users of web-based self-management support programs, of which 56.4% (101/179) were diagnosed with CVD and 43.6% (78/179) with RA. Younger age and a lower level of education were associated with program use. An interaction effect was found between program use and diagnosis and 4 quality of life subscales (social functioning, physical role limitations, vitality, and bodily pain). Patients with CVD with higher self-management and quality of life scores were less likely to use the program, whereas patients with RA with higher self-management and quality of life scores were more likely to use the program. Interviews with 10 nonusers, 10 low users, and 18 high users were analyzed to provide insight into the relationship between mechanisms and outcome. Program use was encouraged by an easy-to-use, clear, and transparent design and by recommendations from professionals and email reminders. A total of 5 BCTs were identified as potential mechanisms to promote program use: tailored information, self-reporting behavior, delayed feedback, providing information on peer behavior, and modeling. Conclusions This realistic evaluation showed that certain patient, disease, and program characteristics (age, education, diagnosis, program design, type of reminder, and BCTs) are associated with the use of web-based self-management support programs. These results represent the first step in improving the tailoring of web-based self-management support programs. Future research on the interaction between patient and program characteristics should be conducted to improve the tailoring of participants to program components.

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Section: Discussioncontrasting

confidence: 99%

The Influencing Contexts and Potential Mechanisms Behind the Use of Web-Based Self-management Support Interventions: Realistic Evaluation

Engelen¹,

Gaal²,

Vermeulen³

et al. 2022

JMIR Hum Factors

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“…The use of eHealth also depends on the human–other characteristics mentioned above. For instance, the usage of eHealth significantly depends on higher educational attainment, employment, and household income [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

“…For instance, given the challenges of the aging population and pandemics such as COVID-19, eHealth services have become integral for an inclusive, effective, and robust healthcare system. A study by Ali et al suggests that with public and private efforts, there will be an increase in the availability of ICT infrastructure supporting the elderly population with disability [ 42 ]. Further, interventions are also being made in the oral healthcare system with models that target specific community organizations where the high-risk underserved geriatric population lives.…”

Section: Discussionmentioning

confidence: 99%

Access to Geriatric Disability Care in India: A Roadmap for Research

Chidambaram

Sreeganga

Sanjeev³

et al. 2022

IJERPH

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This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in India. First, the dominant research focus is on resources (human, financial, and spatial) that affect access to disability care; there is little focus on informational and technological resources. Second, functional disabilities are the dominant focus of the research, followed by cognitive, mental, and locomotor disabilities; there is little focus on speech, hearing, and visual disabilities. Third, barriers, inhibitors, and catalysts of physical access are the dominant focus, with relatively less focus on virtual access; there is very little emphasis on the drivers to access. Fourth, the primary, although not dominant, focus is on access for urban and rural populations; there is very little focus on access for underserved and indigenous populations. Future research must address these gaps systematically to improve access. This paper adds: (a) a systemic framework for the study of an important, complex, emerging problem; (b) a systematic review of the global research on the problem; and (c) a research roadmap to address the emerging problem in India.

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“…Since the beginning of the COVID-19 pandemic, many authors have addressed the challenges related to the rapid expansion of e-health and telemedicine services. Many reports have analyzed the importance of sociodemographic and economic factors [ 24 , 25 , 26 , 27 , 28 ] or potential disparities in their usage [ 29 , 30 ]. Some authors have also addressed other determinants of e-health usage.…”

Section: Introductionmentioning

confidence: 99%

A Nationwide Natural Experiment of e-Health Implementation during the COVID-19 Pandemic in Poland: User Satisfaction and the Ease-of-Use of Remote Physician’s Visits

Duplaga

2022

IJERPH

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The COVID-19 pandemic resulted in a considerable increase in the use of e-health applications. Shortly after confirmation of the first case of COVID-19 in Poland, the Ministry of Health allowed for the general use of remote physician’s visits (RPVs) as a substitute for traditional visits to the physician’s office. It was estimated that during the first year of the pandemic, as many as 80% of primary care visits were provided remotely, mainly by phone. This study’s main aim was to assess the use of e-health services in the initial phase of the COVID-19 pandemic. Furthermore, the factors related to user satisfaction and positive assessment of the ease-of-use of RPVs were analyzed. The analysis was based on data obtained from a computer-assisted web-based interviewing (CAWI) survey among 2410 adult Internet users in Poland. The questionnaire consisted of 55 items, including a 16-item European Health Literacy Questionnaire, an 8-item e-Health Literacy scale, a set of questions about the use of and experience with e-health services during the pandemic, and items exploring the sociodemographic characteristics of the respondents. Univariate logistic regression models were developed for variables reflecting user satisfaction and the assessment of the ease-of-use of RPVs. The use of RPVs increased during the pandemic by about 200%. Higher health literacy and e-health literacy, older age, higher income, a greater number of e-health services used before the pandemic, and telephone-based remote visits were significantly associated with higher user satisfaction and ease-of-use of RPVs. Respondents using RPVs for renewal of prescriptions were more favorable in assessing satisfaction and ease-of-use. A less positive assessment of satisfaction and ease-of-use was provided by students and vocationally passive persons in comparison to the employed. Finally, the perception of the threat of COVID-19 was associated with higher satisfaction and better assessment of ease-of-use. Persons declaring the intention to be vaccinated against COVID-19 were more likely to be satisfied with remote visits. User satisfaction and the feeling of ease-of-use in the case of remote advice provided by a physician depend on many factors. Significant predictors include selected sociodemographic and economic variables, determinants associated with the perception of the threat of COVID-19, the aims and tools used for the RPVs, and earlier experience with e-health services.

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Examining the determinants of eHealth usage among elderly people with disability: The moderating role of behavioural aspects

Cited by 25 publications

References 36 publications

The Influencing Contexts and Potential Mechanisms Behind the Use of Web-Based Self-management Support Interventions: Realistic Evaluation

The Influencing Contexts and Potential Mechanisms Behind the Use of Web-Based Self-management Support Interventions: Realistic Evaluation

Access to Geriatric Disability Care in India: A Roadmap for Research

A Nationwide Natural Experiment of e-Health Implementation during the COVID-19 Pandemic in Poland: User Satisfaction and the Ease-of-Use of Remote Physician’s Visits

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