Patient Portals as Highly Acceptable Tools to Support HIV Preventative Behaviors Among Adolescent and Young Sexual Minority Men

Jackman, Kevon-Mark; Latkin, Carl A.; Maksut, Jessica L.; Trent, Maria; Sanchez, Travis; Baral, Stefan

doi:10.1016/j.jadohealth.2020.03.029

Cited by 12 publications

(19 citation statements)

References 8 publications

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“…Slightly higher AMIS-PPSHI scores among participants with mental health illness support the acceptability of the patient portal use among patients with mental health disorders [ 66 ]. Together with earlier studies, findings support patient portals as a promising avenue to plan interventions around increasing health engagement among marginalized groups, including persons with HIV [ 28 , 30 , 46 ]. The overall high mean sample score on AMIS-PPSHI may also indicate that patient portal interventions may extend to other areas of health care engagement, such as achieving hepatitis A and B vaccination and screening recommendations for SMM [ 67 - 69 ].…”

Section: Discussionsupporting

confidence: 66%

“…This is important because privacy concerns and mistrust are known barriers to PHR adoption [ 13 , 14 ]. Nevertheless, among US sexual minority men (SMM), patient portals are highly acceptable for delivery of comprehensive sexual health services that support HIV preventative behaviors, such as disclosing STI PHRs with sex partners [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, little information is available on patients’ perceptions of patient portals and their potential use for the prevention and care of STIs, including HIV [ 28 - 30 ]. STIs are substantial public health problems, and they may be particularly well suited for prevention and management with patient portals.…”

Section: Introductionmentioning

confidence: 99%

“…SMM today have demonstrated high acceptability of medical and public health practice supported by mobile devices or mobile health (mHealth) in HIV interventions; however, these solutions have largely operated outside of the Health IT aegis of EHR and integrated PHR systems [ 45 ]. Previous studies examining perceptions of patient portal use for HIV care and STI prevention have demonstrated high acceptability and concern about potential breaches of privacy [ 28 , 30 , 46 ].…”

Section: Introductionmentioning

confidence: 99%

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Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study

et al. 2021

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Background Patient portal modules, including electronic personal health records, health education, and prescription refill ordering, may be leveraged to address the sexually transmitted infection (STI) burden, including HIV, among gay, bisexual, and other sexual minority men (SMM). Theoretical frameworks in the implementation sciences highlight examining constructs of innovation attributes and performance expectations as key determinants of behavioral intentions and the use of new web-based health technologies. However, behavioral intentions to use patient portals for HIV and other STI prevention and care among SMM is understudied. Objective The aim of this study is to develop a brief instrument for measuring attitudes focused on using patient portals for STI prevention and care among a nationwide sample of SMM. Methods A total of 12 items of the American Men’s Internet Survey-Patient Portal Sexual Health Instrument (AMIS-PPSHI) were adapted from a previous study. Psychometric analyses of the AMIS-PPSHI items were conducted among a randomized subset of 2018 AMIS participants reporting web-based access to their health records (N=1375). Parallel analysis and inspection of eigenvalues in a principal component analysis (PCA) informed factor retention in exploratory factor analysis (EFA). After EFA, Cronbach α was used to examine the internal consistency of the scale and its subscales. Confirmatory factor analysis (CFA) was used to assess the goodness of fit of the final factor structure. We calculated the total AMIS-PPSHI scale scores for comparisons within group categories, including age, STI diagnosis history, recency of testing, serious mental illness, and anticipated health care stigma. Results The AMIS-PPSHI scale resulting from EFA consisted of 12 items and had good internal consistency (α=.84). The EFA suggested 3 subscales: sexual health engagement and awareness (α=.87), enhancing dyadic communication (α=.87), and managing sexual health care (α=.79). CFA demonstrated good fit in the 3-factor PPSHI structure: root mean square error of approximation=0.061, comparative fit index=0.964, Tucker-Lewis index=0.953, and standardized root mean square residual=0.041. The most notable differences were lower scores on the enhanced dyadic communication subscale among people living with HIV. Conclusions PPSHI is a brief instrument with strong psychometric properties that may be adapted for use in large surveys and patient questionnaires in other settings. Scores demonstrate that patient portals are favorable web-based solutions to deliver health services focused on STI prevention and care among SMM in the United States. More attention is needed to address the privacy implications of interpersonal use of patient portals outside of traditional health settings among persons with HIV.

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study

et al. 2021

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“…Electronic personal health records (PHRs) are creating new opportunities to increase fidelity and habits around disclosing STI test histories [ 8 , 11 ]. However, little data among Black youth are available on behavioral intentions to adopt patient portals for sharing STI PHRs with sex partners.…”

Section: Introductionmentioning

confidence: 99%

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college

et al. 2020

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Patient portals are creating new opportunities for youth to disclose high-fidelity sexually transmitted infection (STI) laboratory test result histories to sex partners. Among an online survey sample, we describe latent constructs and other variables associated with perceived behavioral intentions to disclose STI test history using patient portals. Participants were co-ed students aged 18 to 25 years (N = 354) attending a southern United States Historically Black College and University in 2015. Three reliable latent constructs were identified by conducting psychometric analyses on 27 survey items. Latent constructs represent, a) STI test disclosure valuation beliefs, b) communication practices, and c) performance expectancy beliefs for disclosing with patient portals. Multivariable logistic regression was used to estimate the relationship of latent constructs to perceived behavioral intentions to disclose STI test history using patient portals. Approximately 14% (48/354) reported patient portal use prior to study and 59% (208/354) endorsed behavioral intentions to use patient portals to disclose STI test history. The latent construct reflecting performance expectancies of patient portals to improve communication and accuracy of disclosed test information was associated with behavioral intentions to disclose STI test histories using patient portals [adjusted odds ratio (AOR) = 1.15; 95% CI = 1.08 to 1.22; p <0.001]. Latent constructs representing communication valuation beliefs and practices were not associated with intentions. Self-reporting prior STI diagnosis was also associated with intentions to disclose using patient portals (AOR = 2.84; 95% CI = 1.15 to 6.96; p = 0.02). Point of care messages focused on improvements to validating test results, communication, and empowerment, may be an effective strategy to support the adoption of patient portals for STI prevention among populations of college-aged Black youth.

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Behavioral Intentions to Use Patient Portals to Disclose HIV and Other Sexually Transmitted Infection Testing Histories with Sexual Partners Among U.S. Sexual Minority Men

et al. 2020

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Disclosure of HIV and other sexually transmitted infection (HIV/STI) testing history to sexual partners is low among gay, bisexual, and other U.S. sexual minority men (SMM). Patient portals (PP) could increase HIV/STI testing history disclosure. This study estimated the predictive validity of the Enhancing Dyadic Communication (EDC) latent construct for perceived behavioral intentions to use PP for HIV/STI test disclosures. A randomized subset of SMM completed the Patient Portal Sexual Health Instrument as part of the 2018 American Men's Internet Survey. Multivariable logistic regression models estimated associations between EDC and intentions to use PP for test disclosures. Among a sample of 1,509 SMM aged 15 to 77 years, EDC was associated with intentions to use PP to disclose test history with main partners (aOR 2.17; 95% CI 1.90 to 2.47) and non-main partners (aOR 2.39; 95%CI 2.07 to 2.76). Assessing EDC could be useful in clinical settings for interventions encouraging patients to communicate with partners about testing.

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Patient Portals as Highly Acceptable Tools to Support HIV Preventative Behaviors Among Adolescent and Young Sexual Minority Men

Cited by 12 publications

References 8 publications

Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study

Using the Patient Portal Sexual Health Instrument in Surveys and Patient Questionnaires Among Sexual Minority Men in the United States: Cross-sectional Psychometric Validation Study

Digital technology to address HIV and other sexually transmitted infection disparities: Intentions to disclose online personal health records to sex partners among students at a historically Black college

Behavioral Intentions to Use Patient Portals to Disclose HIV and Other Sexually Transmitted Infection Testing Histories with Sexual Partners Among U.S. Sexual Minority Men

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