Fridman Ilona, Smalls Ahmaya, Fleming Patrice, Elston Lafata Jennifer
Cancer Care Quality Program, Lineberger Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, United States.
JMIR Form Res. 2023 May 24;7:e40709. doi: 10.2196/40709.
Health information delivered via daily modes of communication such as email, text, or telephone reportedly supports improved health behavior and outcomes. While different modes of communication beyond clinical visits have proven successful for patient outcomes, preferences for communication modes have not been comprehensively studied among older primary care patients. We addressed this gap by assessing patient preferences for receiving cancer screening and other information from their doctors' offices.
We explored stated preferences by communication modes through the lens of social determinants of health (SDOH) to gauge acceptability and equity implications for future interventions.
A cross-sectional survey was mailed to primary care patients aged 45-75 years, in 2020-2021, which assessed respondents' use of telephones, computers, or tablets in daily life and their preferred modes of communication for different types of health information, including educational materials about cancer screening, tips for taking prescription medication, and protection from respiratory diseases from their doctors' offices. Respondents indicated their willingness to receive messages from their doctors' offices via each of the provided modes of communication, including telephone, text, email, patient portals, websites, and social media, on a 5-point Likert scale ranging from "unwilling" to "willing." We present the percentage of respondents who indicated that they were "willing" to receive information via specific electronic mode. Chi-square tests were used to compare participants' willingness by social characteristics.
In total, 133 people completed the survey (response rate 27%). The average respondent age was 64 years, 82 (63%) respondents were female, 106 (83%) were White, 20 (16%) were Black, and 1 (1%) was Asian. In total, 75 (58%) respondents had a bachelor's degree or higher; 26 (20%) resided in rural areas, 37 (29%) in suburban areas, 50 (39%) in a town, and 15 (12%) in a city. The majority, 73 (57%), reported being comfortable with their income. Preferences of respondents for electronic communication about cancer screening were distributed as follows: 100 (75%) respondents were willing to receive information from their doctor's office via their patient portal, 98 (74%) via email, 75 (56%) via text, 60 (45%) via the hospital website, 50 (38%) via telephone, and 14 (11%) via social media. About 6 (5%) respondents were unwilling to receive any communication via electronic modes. Preferences were distributed similarly for other types of information. Respondents reporting lesser income and education consistently preferred receiving telephone calls relative to other communication modes.
To optimize health communication and reach a socioeconomically diverse population, telephone calls should be added to electronic communication, especially for people with less income and education. Further research needs to identify the underlying reasons for the observed differences and how best to ensure that socioeconomically diverse groups of older adults can access reliable health information and health care services.
据报道，通过电子邮件、短信或电话等日常通信方式传递的健康信息有助于改善健康行为和健康结果。虽然临床就诊以外的不同通信方式已被证明对患者治疗效果有积极作用，但对于老年初级保健患者对通信方式的偏好尚未进行全面研究。我们通过评估患者对从医生办公室接收癌症筛查及其他信息的偏好来填补这一空白。
我们从健康的社会决定因素（SDOH）角度探讨了不同通信方式下的既定偏好，以评估未来干预措施的可接受性和平等性影响。
2020年至2021年，我们向45 - 75岁的初级保健患者邮寄了一份横断面调查问卷，该问卷评估了受访者在日常生活中对电话、电脑或平板电脑的使用情况，以及他们对于不同类型健康信息（包括癌症筛查教育材料、处方药服用小贴士以及来自医生办公室的呼吸道疾病防护信息）的首选通信方式。受访者通过从“不愿意”到“愿意”的5点李克特量表，表明他们愿意通过提供的每种通信方式（包括电话、短信、电子邮件、患者门户网站、网站和社交媒体）接收医生办公室的信息。我们给出了表示“愿意”通过特定电子方式接收信息的受访者百分比。使用卡方检验按社会特征比较参与者的意愿。
共有133人完成了调查（回复率27%）。受访者的平均年龄为64岁，82名（63%）受访者为女性，106名（83%）为白人，20名（16%）为黑人，1名（1%）为亚洲人。共有75名（58%）受访者拥有学士学位或更高学历；26名（20%）居住在农村地区，37名（29%）居住在郊区，50名（39%）居住在城镇，15名（12%）居住在城市。大多数人，即73名（57%），表示对自己的收入感到满意。受访者对癌症筛查电子通信的偏好分布如下：100名（75%）受访者愿意通过患者门户网站接收医生办公室的信息，98名（74%）愿意通过电子邮件接收，75名（56%）愿意通过短信接收，60名（45%）愿意通过医院网站接收，50名（38%）愿意通过电话接收，14名（11%）愿意通过社交媒体接收。约6名（5%）受访者不愿意通过电子方式接收任何通信。对于其他类型的信息，偏好分布类似。报告收入和教育水平较低的受访者相对于其他通信方式，一直更倾向于接收电话。
为了优化健康通信并覆盖社会经济背景多样的人群，应在电子通信之外增加电话通信方式，特别是对于收入和教育水平较低的人群。进一步的研究需要确定观察到的差异的潜在原因，以及如何最好地确保社会经济背景多样的老年人群体能够获取可靠的健康信息和医疗服务。
