Division of Hematology/Oncology, Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.
Bioethics Research Center, Department of Medicine, Washington University School of Medicine, St Louis, Missouri.
JAMA Netw Open. 2023 Aug 1;6(8):e2330483. doi: 10.1001/jamanetworkopen.2023.30483.
Many health care systems offer adolescents access to health information through online patient portals, but few studies have explored how to engage adolescents in using and benefiting from online portals.
To determine how US children's hospitals have attempted to encourage adolescent portal use, barriers to engaging adolescents, and ideal future goals for engagement.
DESIGN, SETTING, AND PARTICIPANTS: This qualitative study performed structured qualitative interviews with informatics administrators from children's hospitals across the US between February and July 2022. Informatics administrators were employed by US health care systems that managed a children's hospital with at least 50 dedicated pediatrics beds. Data analysis was performed from November 2022 to January 2023.
This study used thematic analysis of (1) current steps that health care systems had taken to engage adolescents in using their online patient portals and (2) barriers to engaging adolescents and ideal future goals and outcomes of engagement.
Among 58 total interviews with 65 informatics administrators who represented 63 hospitals across 58 health care systems, 6 themes of approaches to engaging adolescents in portal use were identified: (1) promoting and educating adolescents about portal enrollment, (2) establishing workflows to support enrollment, (3) seeking and incorporating feedback, (4) creating a culture or environment supporting engagement, (5) increasing portal utility, and (6) limited efforts. Barriers to engaging adolescents in portal use related to either (1) stakeholder investment, interest, and capabilities or (2) intersecting technical, ethical, and legal factors. Participants identified 4 ideal future efforts to engage adolescents: (1) develop adaptable private means of communication with adolescents, (2) use adolescent-centric user design, (3) enhance promotion and education about portal use, and (4) simplify and adapt workflows to encourage enrollment. Participants described 3 ideal outcomes of this future engagement: (1) provide education about current health, (2) prepare for transition to adulthood, and (3) improve digital health education of adolescents.
In this qualitative study of informatics administrators, children's hospitals across the US were found to have varying degrees of efforts to engage adolescents in using their portals. Most of these efforts focused on supporting adolescent enrollment, but fewer efforts focused on making the portal useful and interesting to adolescents.
许多医疗保健系统通过在线患者门户为青少年提供获取健康信息的途径，但很少有研究探讨如何鼓励青少年使用和受益于在线门户。
确定美国儿童医院如何尝试鼓励青少年使用门户，以及参与青少年的障碍和理想的未来参与目标。
设计、地点和参与者：这项定性研究对美国各地儿童医院的信息管理员进行了结构化的定性访谈，时间为 2022 年 2 月至 7 月。信息管理员受雇于管理至少有 50 张专用儿科床位的美国医疗保健系统的儿童医院。数据分析于 2022 年 11 月至 2023 年 1 月进行。
本研究使用主题分析（1）医疗保健系统为鼓励青少年使用其在线患者门户而采取的当前步骤，以及（2）参与青少年的障碍以及理想的未来目标和参与结果。
在对代表 58 个医疗保健系统的 63 家医院的 65 名信息管理员进行的 58 次总访谈中，确定了 6 个吸引青少年使用门户的方法主题：（1）宣传和教育青少年有关门户注册，（2）建立支持注册的工作流程，（3）寻求和纳入反馈，（4）创建支持参与的文化或环境，（5）增加门户实用性，以及（6）有限的努力。阻碍青少年使用门户的因素与（1）利益相关者的投资、兴趣和能力，或（2）交叉的技术、道德和法律因素有关。参与者确定了 4 项未来吸引青少年的理想努力：（1）开发与青少年进行沟通的适应性私人方式，（2）使用以青少年为中心的用户设计，（3）加强关于门户使用的宣传和教育，以及（4）简化和调整工作流程以鼓励注册。参与者描述了这种未来参与的 3 个理想结果：（1）提供有关当前健康的教育，（2）为成年过渡做准备，以及（3）提高青少年的数字健康素养。
在这项对信息管理员的定性研究中，发现美国各地的儿童医院在鼓励青少年使用其门户方面都有不同程度的努力。这些努力大多集中在支持青少年注册上，但很少有努力使门户对青少年有用和有趣。
