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体重指数处于超重或肥胖范畴的癌症幸存者的电子健康实践:潜在类别分析研究

eHealth Practices in Cancer Survivors With BMI in Overweight or Obese Categories: Latent Class Analysis Study.

作者信息

Lin Annie Wen, Baik Sharon H, Aaby David, Tello Leslie, Linville Twila, Alshurafa Nabil, Spring Bonnie

机构信息

Department of Nutrition, Benedictine University, Lisle, IL, United States.

Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.

出版信息

JMIR Cancer. 2020 Dec 3;6(2):e24137. doi: 10.2196/24137.

Abstract

BACKGROUND

eHealth technologies have been found to facilitate health-promoting practices among cancer survivors with BMI in overweight or obese categories; however, little is known about their engagement with eHealth to promote weight management and facilitate patient-clinician communication.

OBJECTIVE

The objective of this study was to determine whether eHealth use was associated with sociodemographic characteristics, as well as medical history and experiences (ie, patient-related factors) among cancer survivors with BMI in overweight or obese categories.

METHODS

Data were analyzed from a nationally representative cross-sectional survey (National Cancer Institute's Health Information National Trends Survey). Latent class analysis was used to derive distinct classes among cancer survivors based on sociodemographic characteristics, medical attributes, and medical experiences. Logistic regression was used to examine whether class membership was associated with different eHealth practices.

RESULTS

Three distinct classes of cancer survivors with BMI in overweight or obese categories emerged: younger with no comorbidities, younger with comorbidities, and older with comorbidities. Compared to the other classes, the younger with comorbidities class had the highest probability of identifying as female (73%) and Hispanic (46%) and feeling that clinicians did not address their concerns (75%). The older with comorbidities class was 6.5 times more likely than the younger with comorbidities class to share eHealth data with a clinician (odds ratio [OR] 6.53, 95% CI 1.08-39.43). In contrast, the younger with no comorbidities class had a higher likelihood of using a computer to look for health information (OR 1.93, 95% CI 1.10-3.38), using an electronic device to track progress toward a health-related goal (OR 2.02, 95% CI 1.08-3.79), and using the internet to watch health-related YouTube videos (OR 2.70, 95% CI 1.52-4.81) than the older with comorbidities class.

CONCLUSIONS

Class membership was associated with different patterns of eHealth engagement, indicating the importance of tailored digital strategies for delivering effective care. Future eHealth weight loss interventions should investigate strategies to engage younger cancer survivors with comorbidities and address racial and ethnic disparities in eHealth use.

摘要

背景

已发现电子健康技术有助于超重或肥胖类别的癌症幸存者采取促进健康的行为;然而,对于他们使用电子健康促进体重管理及促进医患沟通的情况却知之甚少。

目的

本研究的目的是确定电子健康的使用是否与超重或肥胖类别的癌症幸存者的社会人口学特征以及病史和经历(即患者相关因素)有关。

方法

对一项具有全国代表性的横断面调查(美国国家癌症研究所的健康信息国家趋势调查)的数据进行了分析。潜在类别分析用于根据社会人口学特征、医学属性和医学经历在癌症幸存者中划分出不同类别。逻辑回归用于检验类别归属是否与不同的电子健康行为相关。

结果

出现了三类超重或肥胖类别的癌症幸存者:无合并症的年轻患者、有合并症的年轻患者和有合并症的老年患者。与其他类别相比,有合并症的年轻患者类别中女性(73%)和西班牙裔(46%)的比例最高,且感觉临床医生未解决其担忧的比例(75%)也最高。有合并症的老年患者类别与有合并症的年轻患者类别相比,与临床医生分享电子健康数据的可能性高6.5倍(优势比[OR]6.53,95%置信区间1.08 - 39.43)。相比之下,无合并症的年轻患者类别使用计算机查找健康信息(OR 1.93,95%置信区间1.10 - 3.38)、使用电子设备跟踪与健康相关目标的进展情况(OR 2.02,95%置信区间1.08 - 3.79)以及使用互联网观看与健康相关的YouTube视频(OR 2.70,95%置信区间1.52 - 4.81)的可能性高于有合并症的老年患者类别。

结论

类别归属与电子健康参与的不同模式相关,这表明定制数字策略以提供有效护理的重要性。未来的电子健康减肥干预措施应研究吸引有合并症的年轻癌症幸存者参与的策略,并解决电子健康使用方面的种族和族裔差异问题。

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