移动健康应用程序与健康管理行为：成本效益建模分析
Mobile Health Apps and Health Management Behaviors: Cost-Benefit Modeling Analysis.
作者信息
Mano Rita
机构信息
Department of Human Services, University of Haifa, Haifa, Israel.
出版信息
JMIR Hum Factors. 2021 Apr 22;8(2):e21251. doi: 10.2196/21251.
BACKGROUND
Rising criticism about the risks associated with the use of mobile health apps necessitates a critical perspective to assess the use of these apps. A cost-benefit approach involving several moderating factors can be used to detect technology effects and individual-level push and pull factors related to health attitudes, lifestyle, and health management behaviors.
OBJECTIVE
We introduce a cost-benefit perspective to examine how health attitudes related to mobile health apps and health situational factors (health crises, health changes, and hospitalization) affect the likelihood of adopting lifestyle and health management behaviors among app users.
METHODS
The analysis is based on individuals' reported use of mobile health apps. The sample included 1495 US adults aged over 18 years who were contacted by landline or cellphone. A total of 50.96% (762/1495) of the participants were women. A set of logistic regression models was used to predict lifestyle and health management behaviors among users considering variations in the extent of use, health attitudes, health situation, and socioeconomic characteristics.
RESULTS
The findings indicate that the proposed models were reasonably adequate. In all, 88.76% (1327/1495) of the cases were correctly classified regarding lifestyle behaviors, but only 71.97% (1076/1495) of the cases were correctly classified regarding health management behaviors. Although a large percentage of individuals changed their attitudes following the use of mobile health apps, only a small proportion adopted health management behaviors. The use of mobile health apps affected up to 67.95% (1016/1495) of the users for consultation and 71.97% (1076/1495) of the users for decision making. The model was effective for 88.76% (1327/1495) of the cases regarding lifestyle behaviors but only 71.97% (1076/1495) regarding health management behaviors. The moderating effect of regular use of mobile health apps significantly affects lifestyle (Wald=61.795; B=2.099; P<.005) but not health management behaviors (Wald=12.532; B=0.513; P=.01). These results collectively indicate that the use of mobile health apps for health management is partially effective.
CONCLUSIONS
The use of mobile health apps is a main route to instigate the process of health empowerment and shape health attitudes. However, an accurate assessment of the effectiveness of mobile health apps necessitates distinguishing between lifestyle and health management behaviors and adopting a cost-benefit approach because individuals facing health concerns, such as a chronic disease, health emergency, health crisis, or health change, consider their affordances and situational effects. These moderators generate a push and pull framework in the decision-making process that balances the costs and benefits of use.
背景
对移动健康应用程序使用风险的批评日益增加，因此有必要以批判性视角评估这些应用程序的使用情况。一种涉及多个调节因素的成本效益方法可用于检测技术效果以及与健康态度、生活方式和健康管理行为相关的个体层面的推拉因素。
目的
我们引入成本效益视角，以研究与移动健康应用程序相关的健康态度以及健康情境因素（健康危机、健康变化和住院情况）如何影响应用程序用户采取生活方式和健康管理行为的可能性。
方法
该分析基于个人报告的移动健康应用程序使用情况。样本包括1495名年龄在18岁以上的美国成年人，他们通过固定电话或手机接受了调查。共有50.96%（762/1495）的参与者为女性。使用一组逻辑回归模型来预测用户的生活方式和健康管理行为，同时考虑使用程度、健康态度、健康状况和社会经济特征的差异。
结果
研究结果表明所提出的模型具有合理的充分性。总体而言，在生活方式行为方面，88.76%（1327/1495）的案例被正确分类，但在健康管理行为方面，只有71.97%（1076/1495）的案例被正确分类。尽管很大一部分人在使用移动健康应用程序后改变了态度，但只有一小部分人采取了健康管理行为。移动健康应用程序的使用对高达67.95%（1016/1495）的用户用于咨询，对71.97%（1076/1495）的用户用于决策。该模型在生活方式行为方面对88.76%（1327/1495）的案例有效，但在健康管理行为方面仅对71.97%（1076/1495）的案例有效。经常使用移动健康应用程序的调节作用对生活方式有显著影响（Wald = 61.795；B = 2.099；P <.005），但对健康管理行为没有影响（Wald = 12.532；B = 0.513；P =.01）。这些结果共同表明，使用移动健康应用程序进行健康管理部分有效。
结论
使用移动健康应用程序是促进健康赋权过程和塑造健康态度的主要途径。然而，要准确评估移动健康应用程序的有效性，需要区分生活方式和健康管理行为，并采用成本效益方法，因为面临健康问题（如慢性病、健康紧急情况、健康危机或健康变化）的个人会考虑自身的承受能力和情境影响。这些调节因素在决策过程中产生一个推拉框架，以平衡使用的成本和收益。
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