Bosak Kelly, Park Shin Hye
School of Nursing, University of Kansas Medical Center, Kansas City, KS, United States.
JMIR Hum Factors. 2017 Dec 21;4(4):e33. doi: 10.2196/humanfactors.8246.
Mobile health technology is rapidly evolving with the potential to transform health care. Self-management of health facilitated by mobile technology can maximize long-term health trajectories of adults. Little is known about the characteristics of adults seeking Web-based support from health care providers facilitated by mobile technology.
This study aimed to examine the following: (1) the characteristics of adults who seek human support from health care providers for health concerns using mobile technology rather than from family members and friends or others with similar health conditions and (2) the use of mobile health technology among adults with chronic health conditions. Findings of this study were interpreted in the context of the Efficiency Model of Support.
We first described characteristics of adults seeking Web-based support from health care providers. Using chi-square tests for categorical variables and t test for the continuous variable of age, we compared adults seeking Web-based and conventional support by demographics. The primary aim was analyzed using multivariate logistic regression to examine whether chronic health conditions and demographic factors (eg, sex, income, employment status, race, ethnicity, education, and age) were associated with seeking Web-based support from health care providers.
The sample included adults (N=1453), the majority of whom were female 57.60% (837/1453), white 75.02% (1090/1453), and non-Hispanic 89.13% (1295/1453). The age of the participants ranged from 18 to 92 years (mean 48.6, standard deviation [SD] 16.8). The majority 76.05% (1105/1453) of participants reported college or higher level of education. A disparity was found in access to health care providers via mobile technology based on socioeconomic status. Adults with annual income of US $30,000 to US $100,000 were 1.72 times more likely to use Web-based methods to contact a health care provider, and adults with an annual income above US $100,000 were 2.41 to 2.46 times more likely to access health care provider support on the Web, compared with those with an annual income below US $30,000. After adjusting for other demographic covariates and chronic conditions, age was not a significant factor in Web-based support seeking.
In this study, the likelihood of seeking Web-based support increased when adults had any or multiple chronic health conditions. A higher level of income and education than the general population was found to be related to the use of mobile health technology among adults in this survey. Future study is needed to better understand the disparity in Web-based support seeking for health issues and the clinicians' role in promoting access to and use of mobile health technology.
移动健康技术正在迅速发展，具有变革医疗保健的潜力。移动技术促进的健康自我管理可以使成年人的长期健康轨迹最大化。对于通过移动技术寻求医疗保健提供者基于网络的支持的成年人的特征，人们知之甚少。
本研究旨在探讨以下内容：（1）使用移动技术而非向家庭成员、朋友或其他健康状况相似的人寻求医疗保健提供者人力支持以解决健康问题的成年人的特征，以及（2）患有慢性健康状况的成年人对移动健康技术的使用情况。本研究的结果在支持效率模型的背景下进行了解释。
我们首先描述了寻求医疗保健提供者基于网络支持的成年人的特征。对于分类变量使用卡方检验，对于年龄这一连续变量使用t检验，我们通过人口统计学特征比较了寻求基于网络支持和传统支持的成年人。主要目标通过多变量逻辑回归进行分析，以检查慢性健康状况和人口统计学因素（如性别、收入、就业状况、种族、族裔、教育程度和年龄）是否与寻求医疗保健提供者基于网络的支持相关。
样本包括成年人（N = 1453），其中大多数为女性，占57.60%（837/1453），白人占75.02%（1090/1453），非西班牙裔占89.13%（1295/1453）。参与者的年龄范围为18至92岁（平均48.6岁，标准差[SD] 16.8）。大多数参与者（76.05%，1105/1453）报告具有大学或更高教育水平。基于社会经济地位，在通过移动技术获得医疗保健提供者的支持方面发现了差异。与年收入低于30,000美元的成年人相比，年收入在30,000美元至100,000美元之间的成年人使用基于网络的方法联系医疗保健提供者的可能性高1.72倍，年收入超过100,000美元的成年人在网络上获得医疗保健提供者支持的可能性高2.41至2.46倍。在调整其他人口统计学协变量和慢性疾病后，年龄不是寻求基于网络支持的重要因素。
在本研究中，当成年人患有任何一种或多种慢性健康状况时，寻求基于网络支持的可能性会增加。在本次调查中，发现收入和教育水平高于一般人群与成年人使用移动健康技术有关。需要进一步研究以更好地理解在寻求健康问题基于网络支持方面的差异以及临床医生在促进获取和使用移动健康技术方面的作用。
