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移动健康应用在美国成年人健康寻求行为中的应用

Use of Mobile Health Applications for Health-Seeking Behavior Among US Adults.

机构信息

Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, 135 Robison Hall, Memphis, TN, 38152, USA.

Department of Health Administration, Governors State University, University Park, IL, USA.

出版信息

J Med Syst. 2016 Jun;40(6):153. doi: 10.1007/s10916-016-0492-7. Epub 2016 May 4.

Abstract

This study explores the use of mobile health applications (mHealth apps) on smartphones or tablets for health-seeking behavior among US adults. Data was obtained from cycle 4 of the 4th edition of the Health Information National Trends Survey (HINTS 4). Weighted multivariate logistic regression models examined predictors of 1) having mHealth apps, 2) usefulness of mHealth apps in achieving health behavior goals, 3) helpfulness in medical care decision-making, and 4) asking a physician new questions or seeking a second opinion. Using the Andersen Model of health services utilization, independent variables of interest were grouped under predisposing factors (age, gender, race, ethnicity, and marital status), enabling factors (education, employment, income, regular provider, health insurance, and rural/urban location of residence), and need factors (general health, confidence in their ability to take care of health, Body Mass Index, smoking status, and number of comorbidities). In a national sample of adults who had smartphones or tablets, 36 % had mHealth apps on their devices. Among those with apps, 60 % reported the usefulness of mHealth apps in achieving health behavior goals, 35 % reported their helpfulness for medical care decision-making, and 38 % reported their usefulness in asking their physicians new questions or seeking a second opinion. The multivariate models revealed that respondents were more likely to have mHealth apps if they had more education, health insurance, were confident in their ability to take good care of themselves, or had comorbidities, and were less likely to have them if they were older, had higher income, or lived in rural areas. In terms of usefulness of mHealth apps, those who were older and had higher income were less likely to report their usefulness in achieving health behavior goals. Those who were older, African American, and had confidence in their ability to take care of their health were more likely to respond that the mHealth apps were helpful in making a medical care decision and asking their physicians new questions or for a second opinion. Potentially, mHealth apps may reduce the burden on primary care, reduce costs, and improve the quality of care. However, several personal-level factors were associated with having mHealth apps and their perceived helpfulness among their users, indicating a multidimensional digital divide in the population of US adults.

摘要

本研究探讨了美国成年人在智能手机或平板电脑上使用移动健康应用程序(mHealth 应用程序)寻求健康的行为。数据来自第 4 版健康信息国家趋势调查(HINTS 4)的第 4 轮。使用加权多元逻辑回归模型,研究了以下因素的预测指标:1)拥有 mHealth 应用程序;2)mHealth 应用程序在实现健康行为目标方面的有用性;3)在医疗决策方面的帮助;4)向医生提出新问题或寻求第二意见。本研究使用健康服务利用的安德森模型,将感兴趣的自变量分为倾向因素(年龄、性别、种族、民族和婚姻状况)、促成因素(教育、就业、收入、常规提供者、健康保险和居住的城乡位置)和需求因素(一般健康、对自己照顾健康能力的信心、身体质量指数、吸烟状况和合并症数量)。在一项拥有智能手机或平板电脑的成年人全国样本中,36%的成年人在其设备上安装了 mHealth 应用程序。在有应用程序的人群中,60%的人报告 mHealth 应用程序在实现健康行为目标方面有用,35%的人报告 mHealth 应用程序在医疗决策方面有帮助,38%的人报告 mHealth 应用程序在向医生提出新问题或寻求第二意见方面有用。多元模型显示,受访者如果受教育程度更高、拥有健康保险、对自己照顾自己的能力更有信心或有合并症,更有可能拥有 mHealth 应用程序;如果年龄更大、收入更高或居住在农村地区,则不太可能拥有 mHealth 应用程序。就 mHealth 应用程序的有用性而言,年龄较大和收入较高的人不太可能报告其在实现健康行为目标方面的有用性。年龄较大、非裔美国人和对自己照顾健康的能力有信心的人更有可能表示,mHealth 应用程序在医疗决策方面有帮助,并向医生提出新问题或寻求第二意见。移动健康应用程序可能会减轻初级保健的负担,降低成本,并提高医疗质量。然而,一些个人层面的因素与成年人拥有 mHealth 应用程序及其用户对其的感知有用性有关,这表明美国成年人中存在多维数字鸿沟。

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