Han Jeong Yeob, Hawkins Robert, Baker Timothy, Shah Dhavan V, Pingree Suzanne, Gustafson David H
a Department of Advertising and Public Relations , Grady College of Journalism and Mass Communication, University of Georgia , Athens , Georgia , USA.
b Center for Health Enhancement Systems Studies , University of Wisconsin-Madison , Madison , Wisconsin , USA.
J Health Commun. 2017 Oct;22(10):792-799. doi: 10.1080/10810730.2017.1360413. Epub 2017 Sep 18.
Despite the mounting evidence of efficacy of eHealth interventions, their mechanisms of action remain unknown. The current study analyzed patient log data as each patient engaged in an eHealth system called the Comprehensive Health Enhancement Support System (CHESS) and reports on how patients engage with different combinations of eHealth services over time. Newly diagnosed breast cancer patients (N = 443) were given access for 6 months to one of four different configurations of CHESS: (1) Information, (2) Information and Support, (3) Information, Support, and Coaching (Full CHESS), and (4) Full CHESS and Mentor. Besides a baseline survey, three follow-up posttests were administered. Action log data on how patients engaged with the CHESS were also collected and merged with surveys to examine how patients benefit during the cancer experience. The findings suggest that usage patterns were not competitive, implying that cancer patients' access to more complex tools generates more use with their time spreading out over the diverse services. Despite overall decline in usage rates, it was less severe in Full CHESS and Mentor condition, suggesting that communication functions drive long-term engagement with the system. Notably, the strongest relation between use and cancer information competence appeared late in the follow-up period.
尽管有越来越多的证据表明电子健康干预措施具有疗效，但其作用机制仍然未知。本研究分析了患者在使用一个名为综合健康强化支持系统（CHESS）的电子健康系统时的日志数据，并报告了患者如何随着时间的推移与不同组合的电子健康服务进行互动。新诊断出的乳腺癌患者（N = 443）被给予6个月的时间使用CHESS的四种不同配置之一：（1）信息，（2）信息与支持，（3）信息、支持与指导（完整CHESS），以及（4）完整CHESS与导师。除了基线调查外，还进行了三次随访后测。还收集了患者使用CHESS的行动日志数据，并与调查数据合并，以研究患者在癌症经历期间如何受益。研究结果表明，使用模式并非相互竞争，这意味着癌症患者使用更复杂的工具会带来更多使用，且他们的时间会分散在各种服务上。尽管使用率总体呈下降趋势，但在完整CHESS与导师配置的情况下下降幅度较小，这表明沟通功能推动了患者与系统的长期互动。值得注意的是，使用与癌症信息能力之间最强的关系出现在随访后期。
