Shaveet Eden, Urquhart Catherine, Gallegos Marissa, Dammann Olaf, Corlin Laura
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, United States.
Department of Community Health, Tufts University School of Arts and Sciences, Medford, MA, United States.
JMIR Form Res. 2022 Nov 30;6(11):e42126. doi: 10.2196/42126.
The use of web-based methods to seek health information is increasing in popularity. As web-based health information (WHI)-seeking affects health-related decision support and chronic symptom self-management, WHI-seeking from online sources may impact health care decisions and outcomes, including care-seeking decisions. Patients who are routinely connected to physicians are more likely to receive better and more consistent care. Little is known about whether WHI-seeking impacts the frequency at which patients engage with health care providers.
Our primary objective was to describe the associations between the use of web-based methods to seek information about one's own health and the time since last engaging with a health care provider about one's own health. Additionally, we aimed to assess participants' trust in health care organizations to contextualize our findings.
We analyzed data from US adults participating in the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Survey (N=1034). Bivariate associations between demographic characteristics and health information-seeking methods were assessed with Pearson chi-squared tests. Bivariate associations of Medical Mistrust Index (MMI) scores with each health information-seeking method and time since provider engagement were assessed with F tests and adjusted Wald tests. We fit a multivariable logistic regression model to assess the association between WHI-seeking within the 12 months prior to survey (alone or in combination with provider-based methods versus provider only) and engagement with a provider more than 1 year prior to the time of survey, adjusting for age, race and ethnicity, sex, education, insurance coverage, and MMI.
Age, race and ethnicity, educational attainment, health insurance source, MMI, and time since provider engagement were each significantly associated with the health information-seeking method in bivariate analyses. Compared to using only provider-based health information seeking methods, WHI-based methods alone or in combination with provider-based methods were associated with a 51% lower likelihood (odds ratio 0.49, 95% CI 0.27-0.87) of engaging with a provider within the previous year. Participants who used WHI-seeking methods alone and those who had not engaged with a health care provider within the previous year demonstrated a higher mean MMI score; however, MMI was not a significant predictor of time since engagement with a provider in the multivariable analysis.
Our findings from a nationally representative survey suggest that for those who use WHI-seeking methods (alone or in combination with provider-based information-seeking methods), there is a statistically significant lower likelihood of engaging with a provider in a year compared to those who only use provider-based methods. Future research should consider the intent of a person's visit with a provider, trust in health care systems, methods of provider engagement, and specific web-based platforms for health information.
使用基于网络的方法来寻求健康信息正日益流行。由于基于网络的健康信息寻求行为会影响与健康相关的决策支持和慢性症状自我管理,从在线来源寻求基于网络的健康信息可能会影响医疗保健决策和结果,包括就医决策。经常与医生联系的患者更有可能获得更好且更一致的护理。对于寻求基于网络的健康信息是否会影响患者与医疗保健提供者接触的频率,我们知之甚少。
我们的主要目的是描述使用基于网络的方法来寻求关于自身健康的信息与上次就自身健康与医疗保健提供者接触以来的时间之间的关联。此外,我们旨在评估参与者对医疗保健机构的信任,以便将我们的研究结果置于具体情境中。
我们分析了参与具有全国代表性的塔夫茨健康、财富与公民参与公平性调查的美国成年人的数据(N = 1034)。使用Pearson卡方检验评估人口统计学特征与健康信息寻求方法之间的双变量关联。使用F检验和调整后的Wald检验评估医疗不信任指数(MMI)得分与每种健康信息寻求方法以及自与提供者接触以来的时间之间的双变量关联。我们拟合了一个多变量逻辑回归模型,以评估在调查前12个月内寻求基于网络的健康信息(单独或与基于提供者的方法结合使用与仅使用基于提供者的方法相比)与在调查时间前1年以上与提供者接触之间的关联,并对年龄、种族和族裔、性别、教育程度、保险覆盖范围和MMI进行了调整。
在双变量分析中,年龄、种族和族裔、教育程度、健康保险来源、MMI以及自与提供者接触以来的时间均与健康信息寻求方法显著相关。与仅使用基于提供者的健康信息寻求方法相比,单独使用基于网络的健康信息寻求方法或与基于提供者的方法结合使用,在前一年与提供者接触的可能性降低了51%(优势比0.49,95%可信区间0.27 - 0.87)。单独使用基于网络的健康信息寻求方法的参与者以及在前一年未与医疗保健提供者接触的参与者的MMI平均得分较高;然而,在多变量分析中,MMI并不是自与提供者接触以来时间的显著预测因素。
我们从一项具有全国代表性的调查中得出的结果表明,对于那些使用基于网络的健康信息寻求方法(单独或与基于提供者的信息寻求方法结合使用)的人来说,与仅使用基于提供者的方法的人相比,在一年内与提供者接触的可能性在统计学上显著较低。未来的研究应考虑一个人就医的意图、对医疗保健系统的信任、与提供者接触的方法以及特定的基于网络的健康信息平台。