让老年人参与心血管风险自我管理的互联网平台：对荷兰HATICE参与者的定性研究。
Engaging older people in an internet platform for cardiovascular risk self-management: a qualitative study among Dutch HATICE participants.
作者信息
van Middelaar Tessa, Beishuizen Cathrien R L, Guillemont Juliette, Barbera Mariagnese, Richard Edo, Moll van Charante Eric P
机构信息
Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
出版信息
BMJ Open. 2018 Jan 21;8(1):e019683. doi: 10.1136/bmjopen-2017-019683.
OBJECTIVES
To study older peoples' experiences with an interactive internet platform for cardiovascular self-management, to assess which factors influence initial and sustained engagement. To assess their views on future use within primary care.
DESIGN
Qualitative semistructured interview study, with thematic analysis.
SETTING
Primary care in the Netherlands.
PARTICIPANTS
People ≥65 years with an increased risk of cardiovascular disease who used the 'Healthy Ageing Through Internet Counselling in the Elderly' internet platform with remote support of a coach. Participants were selected using a purposive sampling method based on gender, age, level of education, cardiovascular history, diabetes, duration of participation and login frequency.
RESULTS
We performed 17 interviews with 20 participants, including three couples. In the initial phase, platform engagement was influenced by perceived computer literacy of the participants, user-friendliness, acceptability and appropriateness of the intervention and the initial interaction with the coach. Sustained platform use was mainly facilitated by a relationship of trust with the coach. Other facilitating factors were regular automatic and personal reminders, clear expectations of the platform, incorporation into daily routine, social support and a loyal and persistent attitude. Perceived lack of change in content of the platform could work both stimulating and discouraging. Participants supported the idea of embedding the platform into the primary care setting.
CONCLUSIONS
Human support is crucial to initial and sustained engagement of older people in using an interactive internet platform for cardiovascular self-management. Regular reminders further facilitate sustained use, and increased tailoring to personal preference is recommended. Embedding the platform in primary healthcare may enhance future adoption.
TRIAL REGISTRATION NUMBER
ISRCTN48151589; Pre-results.
目的
研究老年人在用于心血管自我管理的交互式互联网平台上的体验，评估哪些因素影响初始参与度和持续参与度。评估他们对在初级保健中未来使用该平台的看法。
设计
定性半结构化访谈研究，并进行主题分析。
地点
荷兰的初级保健机构。
参与者
年龄≥65岁、心血管疾病风险增加且在教练远程支持下使用“老年人互联网咨询促进健康老龄化”互联网平台的人群。基于性别、年龄、教育程度、心血管病史、糖尿病、参与时长和登录频率，采用目的抽样法选取参与者。
结果
我们对20名参与者进行了17次访谈，其中包括三对夫妇。在初始阶段，平台参与度受参与者的计算机素养认知、干预措施的用户友好性、可接受性和适宜性以及与教练的初次互动影响。持续使用平台主要得益于与教练的信任关系。其他促进因素包括定期自动和个性化提醒、对平台的明确期望、融入日常生活、社会支持以及忠诚和坚持的态度。认为平台内容缺乏变化可能既起到激励作用也起到阻碍作用。参与者支持将该平台嵌入初级保健机构的想法。
结论
人力支持对于老年人初始和持续参与使用交互式互联网平台进行心血管自我管理至关重要。定期提醒进一步促进持续使用，建议根据个人偏好进行更多定制。将该平台嵌入初级医疗保健可能会提高未来的采用率。
试验注册号
ISRCTN4815158；预结果。
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