Zieve Garret G, Richardson Laura P, Katzman Katherine, Spielvogle Heather, Whitehouse Sandy, McCarty Carolyn A
Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, United States.
Department of Psychology, University of California, Berkeley, Berkeley, CA, United States.
J Med Internet Res. 2017 Jul 20;19(7):e261. doi: 10.2196/jmir.7474.
Electronic health screening tools for primary care present an opportunity to go beyond data collection to provide education and feedback to adolescents in order to motivate behavior change. However, there is limited research to guide feedback message development.
The aim of this study was to explore youth perceptions of and preferences for receiving personalized feedback for multiple health risk behaviors and reinforcement for health promoting behaviors from an electronic health screening tool for primary care settings, using qualitative methodology.
In total, 31 adolescents aged 13-18 years completed the screening tool, received the electronic feedback, and subsequently participated in individual, semistructured, qualitative interviews lasting approximately 60 min. Participants were queried about their overall impressions of the tool, perceptions regarding various types of feedback messages, and additional features that would help motivate health behavior change. Using thematic analysis, interview transcripts were coded to identify common themes expressed across participants.
Overall, the tool was well-received by participants who perceived it as a way to enhance-but not replace-their interactions with providers. They appreciated receiving nonjudgmental feedback from the tool and responded positively to information regarding the consequences of behaviors, comparisons with peer norms and health guidelines, tips for behavior change, and reinforcement of healthy choices. A small but noteworthy minority of participants dismissed the peer norms as not real or relevant and national guidelines as not valid or reasonable. When prompted for possible adaptations to the tool, adolescents expressed interest in receiving follow-up information, setting health-related goals, tracking their behaviors over time, and communicating with providers electronically between appointments.
Adolescents in this qualitative study desired feedback that validates their healthy behavior choices and supports them as independent decision makers by neutrally presenting health information, facilitating goal setting, and offering ongoing technological supports.
基层医疗的电子健康筛查工具为超越数据收集提供了契机，可向青少年提供教育和反馈，以促进行为改变。然而，指导反馈信息开发的研究有限。
本研究旨在采用定性方法，探索青少年对基层医疗电子健康筛查工具针对多种健康风险行为提供个性化反馈以及对健康促进行为给予强化的看法和偏好。
共有31名13 - 18岁的青少年完成了筛查工具，收到了电子反馈，随后参加了时长约60分钟的个人半结构化定性访谈。询问参与者对该工具的总体印象、对各类反馈信息的看法以及有助于促进行为改变的其他功能。通过主题分析，对访谈记录进行编码，以识别参与者表达的共同主题。
总体而言，该工具受到参与者的好评，他们认为这是一种增强而非取代与医疗服务提供者互动的方式。他们赞赏从该工具中获得无评判性的反馈，并对有关行为后果、与同龄人规范和健康指南的比较、行为改变提示以及健康选择强化的信息做出了积极回应。一小部分但值得注意的参与者认为同龄人规范不真实或不相关，国家指南无效或不合理而不予理会。当被问及对该工具可能的改进时，青少年表示有兴趣接收后续信息、设定与健康相关的目标、长期跟踪自己的行为以及在预约之间通过电子方式与医疗服务提供者沟通。
在这项定性研究中，青少年希望获得的反馈能认可他们的健康行为选择，并通过中立地呈现健康信息、促进目标设定和提供持续的技术支持，将他们作为独立决策者给予支持。
