影响多发性硬化症患者非正式照料者访问和使用一个精心策划的干预网站方式的因素：一项随机对照试验的分析

Factors influencing how informal caregivers of people with multiple sclerosis access and use a curated intervention website: Analysis from an RCT.

作者信息

Packer Tanya, Austin Nichole, Lehman Michelle, Douglas Sara L, Plow Matthew

机构信息

Schools of Health Administration and Occupational Therapy, Dalhousie University, Halifax, Nova Scotia, Canada.

School of Health Administration, Dalhousie University, Halifax, Nova Scotia, Canada.

出版信息

Digit Health. 2024 Feb 8;10:20552076241228403. doi: 10.1177/20552076241228403. eCollection 2024 Jan-Dec.

DOI:10.1177/20552076241228403

PMID:38343587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10858664/

Abstract

OBJECTIVE

Healthcare consumers and providers are increasingly turning to digital solutions, such as curated websites. Knowing who accesses/benefits from these may improve design and development. This study investigated website usage of informal caregivers of people with multiple sclerosis and shifts in outcome plausibly associated with usage.

METHODS

Secondary analysis of data from a randomized clinical trial of 148 caregivers compared effectiveness of a website + tele-coaching to a website only intervention for caregivers. Groupwise differences in means/proportions were tested using t-tests and chi-square. Modified Poisson regression with a robust variance estimator and ordinal logistic regression tested the relationship between group and likelihood of website log-in. Ordinal logistic regression models examined whether caregiver characteristics were associated with website use. Generalized estimating equations (GEE) with an autoregressive correlation structure modeled the relationship between website usage and outcomes.

RESULTS

Females were more likely to access the website than males (60% vs. 43%; p = 0.05). Though not statistically significant, a possible association (POR: .85, 95% CI: .69, 1.03) between caregiver burden and website access emerged; caregivers experiencing highest levels of burden appeared less likely to engage. Usage patterns differed by treatment arm: the website-only group accessed the topic significantly more (61.67% vs. 38.33%: p = .04) with similar, but insignificant, trends for other topics.

CONCLUSIONS

Clinicians can be confident referring females with moderate levels of burden to website-based interventions. By contrast, male caregivers and those experiencing high levels of burden may be less likely to access these resources, pointing to the need for alternative interventions.

TRIAL REGISTRATION

Clinicaltrials.gov, registration number: NCT0466208.

摘要

目的

医疗保健消费者和提供者越来越多地转向数字解决方案，如精选网站。了解哪些人访问这些网站并从中受益，可能会改进其设计和开发。本研究调查了多发性硬化症患者非正式护理人员对网站的使用情况，以及与使用情况可能相关的结果变化。

方法

对一项针对148名护理人员的随机临床试验数据进行二次分析，比较网站+电话辅导与仅网站干预对护理人员的效果。使用t检验和卡方检验均值/比例的组间差异。采用稳健方差估计器的修正泊松回归和有序逻辑回归检验组与网站登录可能性之间的关系。有序逻辑回归模型检验护理人员特征是否与网站使用相关。具有自回归相关结构的广义估计方程（GEE）模拟网站使用与结果之间的关系。

结果

女性比男性更有可能访问该网站（60%对43%；p = 0.05）。护理人员负担与网站访问之间出现了一种可能的关联（比值比：0.85，95%置信区间：0.69，1.03），尽管无统计学意义；负担水平最高的护理人员参与度似乎较低。不同治疗组的使用模式不同：仅网站组访问该主题的比例显著更高（61.67%对38.33%：p = 0.04），其他主题的趋势相似但不显著。