Portz Jennifer Dickman, Miller Amy, Foster Brittany, Laudeman Lindsey
School of Social Work, Colorado State University, 1586 Campus Delivery, Education Building Room 131, Fort Collins, CO 80523-1586, USA.
Health Technol (Berl). 2016 Jul;6(2):89-99. doi: 10.1007/s12553-016-0130-x. Epub 2016 Mar 23.
Although health information technology (HIT) is essential in improving health outcomes and health care quality in the United States, current research lacks information regarding persuasive features (technology features designed to promote behavioral change) in HIT interventions for managing chronic diseases among older adults (aged 50 and older). To provide an overview of the persuasive features within current HIT interventions for managing chronic diseases among older adults, we conducted a systematic review to examine the use and efficacy of web-based chronic disease self-management for older adults. Persuasive system features included in HIT interventions were examined. Interventions presented in the final 24 studies were designed to improve health outcomes such as self-efficacy, self-care, and physical activity among participants with a chronic health condition. Examples of health conditions include diabetes, COPD, and arthritis. Among the 24 studies, several persuasive features were commonly used to support positive outcomes; 12 reported success in all measured outcomes and 10 reported a mix of both positive and unsuccessful outcomes pertaining to improvements in healthier lifestyles, self-management, chronic disease knowledge, blood pressure, and daily functioning. Only two of the studies included in our systematic review found no improvement in health outcomes and experienced high attrition rates after implementation of the persuasive systems intervention. It is important to identify specific persuasive features within interventions. Further research is needed in specifying persuasive features within technology-based interventions to help healthcare professionals modify interventions to improve chronic disease outcomes for older populations.
尽管健康信息技术(HIT)在美国改善健康状况和医疗质量方面至关重要,但目前的研究缺乏关于HIT干预措施中说服性特征(旨在促进行为改变的技术特征)在管理老年人(50岁及以上)慢性病方面的信息。为了概述当前HIT干预措施中用于管理老年人慢性病的说服性特征,我们进行了一项系统综述,以研究基于网络的慢性病自我管理对老年人的使用情况和效果。研究了HIT干预措施中包含的说服性系统特征。最后24项研究中提出的干预措施旨在改善患有慢性健康状况的参与者的健康结果,如自我效能感、自我护理和身体活动。健康状况的例子包括糖尿病、慢性阻塞性肺疾病和关节炎。在这24项研究中,几种说服性特征被普遍用于支持积极结果;12项研究报告在所有测量结果中都取得了成功,10项研究报告在更健康的生活方式、自我管理、慢性病知识、血压和日常功能改善方面既有积极结果也有未成功的结果。在我们的系统综述中纳入的研究中,只有两项研究发现健康结果没有改善,并且在实施说服性系统干预后出现了高流失率。确定干预措施中的特定说服性特征很重要。需要进一步研究确定基于技术的干预措施中的说服性特征,以帮助医疗保健专业人员修改干预措施,改善老年人群的慢性病结果。