Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
J Am Med Inform Assoc. 2013 Mar-Apr;20(2):277-84. doi: 10.1136/amiajnl-2012-000876. Epub 2012 Jul 16.
The use of the internet as a source of health information and link to healthcare services has raised concerns about the ability of consumers, especially vulnerable populations such as older adults, to access these applications. This study examined the influence of training on the ability of adults (aged 45+ years) to use the Medicare.gov website to solve problems related to health management. The influence of computer experience and cognitive abilities on performance was also examined.
Seventy-one participants, aged 47-92, were randomized into a Multimedia training, Unimodal training, or Cold Start condition and completed three healthcare management problems. MEASUREMENT AND ANALYSES: Computer/internet experience was measured via questionnaire, and cognitive abilities were assessed using standard neuropsychological tests. Performance metrics included measures of navigation, accuracy and efficiency. Data were analyzed using analysis of variance, χ(2) and regression techniques.
The data indicate that there was no difference among the three conditions on measures of accuracy, efficiency, or navigation. However, results of the regression analyses showed that, overall, people who received training performed better on the tasks, as evidenced by greater accuracy and efficiency. Performance was also significantly influenced by prior computer experience and cognitive abilities. Participants with more computer experience and higher cognitive abilities performed better.
The findings indicate that training, experience, and abilities are important when using complex health websites. However, training alone is not sufficient. The complexity of web content needs to be considered to ensure successful use of these websites by those with lower abilities.
互联网作为健康信息来源和医疗服务链接的使用引起了人们对消费者（尤其是老年人等弱势群体）获取这些应用程序的能力的关注。本研究考察了培训对成年人（45 岁以上）使用 Medicare.gov 网站解决与健康管理相关问题的能力的影响。还研究了计算机经验和认知能力对绩效的影响。
71 名参与者年龄在 47-92 岁之间，随机分为多媒体培训、单模态培训或冷启动条件，并完成了三个医疗保健管理问题。
通过问卷测量计算机/互联网经验，使用标准神经心理学测试评估认知能力。绩效指标包括导航、准确性和效率的度量。使用方差分析、χ(2)和回归技术分析数据。
数据表明，在准确性、效率或导航方面，三种条件之间没有差异。然而，回归分析的结果表明，总体而言，接受培训的人在任务上表现更好，表现为更高的准确性和效率。绩效还受到先前计算机经验和认知能力的显著影响。具有更多计算机经验和更高认知能力的参与者表现更好。
研究结果表明，培训、经验和能力在使用复杂健康网站时很重要。然而，仅仅培训是不够的。需要考虑网络内容的复杂性，以确保那些能力较低的人能够成功使用这些网站。
