Aarts Johanna W M, Faber Marjan J, den Boogert Anne G, Cohlen Ben J, van der Linden Paul J Q, Kremer Jan A M, Nelen Willianne L D M
Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, Netherlands.
J Med Internet Res. 2013 Aug 30;15(8):e163. doi: 10.2196/jmir.2098.
Online health communities are becoming more popular in health care. Patients and professionals can communicate with one another online, patients can find peer support, and professionals can use it as an additional information channel to their patients. However, the implementation of online health communities into daily practice is challenging. These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected. Therefore, we aimed at answering 2 research questions: (1) what factors are associated with subscription to an online health community, and (2) which are associated with becoming an active participant within an online health community.
To identify barriers and facilitators as perceived by patients for the implementation of an online health community.
We performed a cross-sectional study. Three Dutch fertility clinics (2 IVF-licensed) offered their patients a secure online clinical health community through which clinicians can provide online information and patients can ask questions to the medical team or share experiences and find support from peers. We randomly selected and invited 278 men and women suffering from infertility and attending 1 of the participating clinics. Participants filled out a questionnaire about their background characteristics and current use of the online community. Possible barriers and facilitators were divided into 2 parts: (1) those for subscription to the community, and (2) those for active participation in the community. We performed 2 multivariate logistic regression analyses to calculate determinants for both subscription and active participation.
Subscription appeared to be associated with patients' background characteristics (eg, gender, treatment phase), intervention-related facilitators (odds ratio [OR] 2.45, 95% CI 1.14-5.27), and patient-related barriers (OR 0.20, 95% CI 0.08-0.54), such as not feeling the need for such an online health community. After subscription, determinants for participation consisted of aspects related to participant's age (OR 0.86, 95% CI 0.76-0.97), length of infertility (OR 1.48, 05% CI 1.09-2.02), and to intervention-related facilitators (OR 5.79, 95% CI 2.40-13.98), such as its reliable character and possibility to interact with the medical team and peers.
Implementing an online health community in addition to usual fertility care should be performed stepwise. At least 2 strategies are needed to increase the proportion of patient subscribers and consequently make them active participants. First, the marketing strategy should contain information tailored to different subgroups of the patient population. Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed. These results imply that involving patients and their needs into the promotion strategy, community's design, and implementation are crucial.
在线健康社区在医疗保健领域越来越受欢迎。患者和专业人员可以在线相互交流，患者可以获得同伴支持，专业人员可以将其作为向患者提供额外信息的渠道。然而，将在线健康社区应用于日常实践具有挑战性。这些挑战与以下事实有关：在期望产生任何效果之前，需要促使患者（1）成为会员（即订阅），以及（2）在社区内积极参与。因此，我们旨在回答两个研究问题：（1）与订阅在线健康社区相关的因素有哪些，以及（2）与成为在线健康社区的活跃参与者相关的因素有哪些。
确定患者所感知到的在线健康社区实施的障碍和促进因素。
我们进行了一项横断面研究。三家荷兰生育诊所（两家拥有体外受精许可证）为其患者提供了一个安全的在线临床健康社区，临床医生可以通过该社区提供在线信息，患者可以向医疗团队提问、分享经验并从同伴那里获得支持。我们随机选择并邀请了278名患有不孕症且在其中一家参与诊所就诊的男性和女性。参与者填写了一份关于他们的背景特征和当前对在线社区使用情况的问卷。可能的障碍和促进因素分为两部分：（1）与订阅社区相关的因素，以及（2）与积极参与社区相关的因素。我们进行了两项多变量逻辑回归分析，以计算订阅和积极参与的决定因素。
订阅似乎与患者的背景特征（如性别、治疗阶段）、干预相关的促进因素（比值比[OR]2.45，95%置信区间1.14 - 5.27）以及患者相关的障碍（OR 0.20，95%置信区间0.08 - 0.54）有关，例如感觉不需要这样一个在线健康社区。订阅后，参与的决定因素包括与参与者年龄相关的方面（OR 0.86，95%置信区间0.76 - 0.97）、不孕时长（OR 1.48，95%置信区间1.09 - 2.02）以及干预相关的促进因素（OR 5.79，95%置信区间2.40 - 13.98），例如其可靠性以及与医疗团队和同伴互动的可能性。
除了常规的生育护理外，逐步实施在线健康社区。至少需要两种策略来增加患者订阅者的比例，并进而使他们成为活跃参与者。首先，营销策略应包含针对患者群体不同亚组量身定制的信息。其次，对于一个有活力的在线健康社区，需要纳入互动元素以及频繁的新闻和更新。这些结果表明，将患者及其需求纳入推广策略、社区设计和实施至关重要。
