Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA, USA.
Patient Educ Couns. 2011 Nov;85(2):323-30. doi: 10.1016/j.pec.2010.11.012. Epub 2010 Dec 13.
To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities.
Selective critical review of research regarding IMCPs tailored to psychological mediators of behavior and their effects on health behavior and outcomes among socio-demographically disadvantaged patients.
Tailored IMCPs can address patient factors (e.g. language barriers, low self-efficacy) and buffer provider (e.g. cognitive bias) and health system (e.g. office visit time constraints) factors that contribute to poor provider-patient communication and, thereby, suboptimal health behaviors. Research indicates disadvantaged individuals' interactions with providers are disproportionately affected by such factors, and that their behaviors respond favorably to tailored information, thus suggesting tailored IMCPs could mitigate disparities. However, no randomized controlled trials (RCTs) have examined this question. The optimal design and deployment of tailored IMCPs for disadvantaged patients also requires further study.
Preliminary research suggests tailored IMCPs have the potential to reduce health disparities. RCTs designed expressly to examine this issue are warranted.
Many socio-demographic health disparities exist, and there is a dearth of proven disparity-reducing interventions. Thus, if tailored IMCPs were shown to lessen disparities, the public health implications would be considerable.
回顾旨在优化患者健康行为的定制交互式多媒体计算机程序（IMCP）的理论和研究证据，这些程序可能会减少社会人口健康差异。
选择性地对针对行为心理中介的 IMCP 研究进行评论，以及这些 IMCP 对社会人口劣势患者健康行为和结果的影响。
定制的 IMCP 可以解决患者因素（例如语言障碍、低自我效能感）和缓冲提供者（例如认知偏见）以及卫生系统（例如就诊时间限制）等因素，这些因素会导致提供者与患者之间的沟通不佳，从而导致健康行为不佳。研究表明，劣势个体与提供者的互动受到这些因素的不成比例的影响，他们的行为对定制信息反应良好，因此表明定制的 IMCP 可以减轻差异。但是，没有随机对照试验（RCT）研究过这个问题。还需要进一步研究为劣势患者设计和部署定制的 IMCP。
初步研究表明，定制的 IMCP 有可能减少健康差异。专门为此问题设计的 RCT 是必要的。
存在许多社会人口健康差异，而且缺乏经证实的减少差异的干预措施。因此，如果定制的 IMCP 被证明可以减少差异，那么这对公共卫生的影响将是巨大的。
