Dataset Information

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study.

ABSTRACT:

Background

Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization.

Objective

The primary objective for this analysis was to use a conceptual framework to determine potentially modifiable factors affecting patient portal utilization by older adults (aged 55 years and older) who receive care at clinics that serve low income and ethnically diverse communities. The secondary objective was to delineate how patient portal utilization is associated with perceived usefulness and usability.

Methods

Patients from one urban and two rural clinics serving low income patients were recruited and completed interviewer-administered questionnaires on patient portal utilization.

Results

A total of 200 ethnically diverse patients completed questionnaires, of which 41 (20.5%) patients reported utilizing portals. Education, social support, and frequent Internet utilization improve the odds of patient portal utilization; receiving health care at a rural clinic decreases the odds of portal utilization.

Conclusions

Leverage points to address disparities in patient portal utilization include providing training for older adults in patient portal utilization, involving spouses or other care partners in this training, and making information technology access available at public places in rural and urban communities.

SUBMITTER: Arcury TA

PROVIDER: S-EPMC5705857 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Publications

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study.

Arcury Thomas A TA Quandt Sara A SA Sandberg Joanne C JC Miller David P DP Latulipe Celine C Leng Xiaoyan X Talton Jenifer W JW Melius Kathryn P KP Smith Alden A Bertoni Alain G AG

JMIR medical informatics 20171114 4

<h4>Background</h4>Patient portals can improve patient communication with providers, provide patients with greater health information access, and help improve patient decision making, if they are used. Because research on factors facilitating and limiting patient portal utilization has not been conceptually based, no leverage points have been indicated for improving utilization.<h4>Objective</h4>The primary objective for this analysis was to use a conceptual framework to determine potentially mo ...[more]

PMID: 29138129

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Project description:Computer-tailored written nutrition interventions have been shown to be more effective than non-tailored materials in changing diet, but continued research is needed. Your Healthy Life/Su Vida Saludable (YHL-SVS) was an intervention study with low income, ethnically diverse, English and Spanish-speaking participants to determine which methods of delivering tailored written nutrition materials were most effective in lowering fat and increasing fruit and vegetable (F&V) intake.YHL-SVS was a randomized controlled trial with four experimental conditions: 1) Nontailored (NT) comparison group; 2) Single Tailored (ST) packet; 3) Multiple Tailored (MT) packet mailed in four installments; 4) Multiple Re-Tailored (MRT) MT packets re-tailored between mailings via brief phone surveys. A baseline telephone survey collected information for tailoring as well as evaluation. Follow-up evaluation surveys were collected 4- and 7-months later. Primary outcomes included F&V intake and fat related behaviors. Descriptive statistics, paired t-test and ANOVA were used to examine the effectiveness of different methods of delivering tailored nutrition information.Both the ST and MT groups reported significantly higher F&V intake at 4-months than the NT and MRT groups. At 7 months, only the MT group still had significantly higher F&V intake compared to the NT group. For changes in fat-related behaviors, both the MT and MRT groups showed more change than NT at 4 months, but at 7 months, while these differences persisted, they were no longer statistically significant. There was a significant interaction of experimental group by education for change in F&V intake (P = .0085) with the lowest educational group demonstrating the most change.In this study, tailored interventions were more effective than non-tailored interventions in improving the short-term dietary behaviors of low income, ethnically diverse participants. Delivery of information in multiple smaller doses over time appeared to improve effectiveness. Future studies should determine which variables are mediators of dietary change and whether these differ by participant demographics. Moreover, future research should differentiate the effects of tailoring vs. cultural adaptation in ethnically diverse populations and study the dissemination of tailored interventions into community-based settings.Current Controlled Trials # NCT00301691.

Project description:OBJECTIVES:Cross-sectional and longitudinal evidence from largely non-Hispanic White cohorts suggests that positive psychosocial factors, particularly self-efficacy and social support, may protect against late-life cognitive decline. Identifying potentially protective factors in racial/ethnic minority elders is of high importance due to their increased risk of Alzheimer's disease. The overall goal of this study was to characterize cross-sectional associations between positive psychosocial factors and cognitive domains among Black, Hispanic, and White older adults. METHODS:A total of 548 older adults (41% Black, 28% Hispanic, 31% White) in the Washington Heights-Inwood Columbia Aging Project completed cognitive and psychosocial measures from the NIH Toolbox and standard neuropsychological tests. Multiple-group regressions were used to compare cross-sectional associations between positive psychosocial factors and cognition across racial/ethnic groups, independent of demographics, depressive symptoms, and physical health. RESULTS:Positive associations between self-efficacy and language did not significantly differ across race/ethnicity, although the bivariate association between self-efficacy and language was not significant among Hispanics. Additional positive associations were observed for Whites and Blacks, but not Hispanics. Negative associations between emotional support and purpose in life and working memory were seen only in Hispanics. CONCLUSIONS:Results confirm and extend the link between self-efficacy and cognition in late life, particularly for White and Black older adults. Previous studies on positive psychosocial factors in cognitive aging may not be generalizable to Hispanics. Longitudinal follow-up is needed to determine whether negative relationships between certain psychosocial factors and cognition in Hispanics reflect reverse causation, threshold effects, and/or negative aspects of having a strong social network. (JINS, 2018, 24, 294-304).

Project description:BACKGROUND:The older adult population (65 years or older) in the United States is growing, and it is important for communities to consider ways to support the aging population. Patient portals and electronic personal health records (ePHRs) are technologies that could better serve populations with the highest health care needs, such as older adults. OBJECTIVE:The aim of this study was to assess the existing research landscape related to patient portal and ePHR use and experience among older adults and to understand the benefits and barriers to older adults' use and adoption of patient portals and ePHRs. METHODS:We searched six pertinent bibliographic databases for papers, published from 2006 to 2016 and written in English, that focused on adults 60 years or older and their use of or experience with patient portals or ePHRs. We adapted preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to review papers based on exclusion and inclusion criteria. We then applied thematic analysis to identify key themes around use, experience, and adoption. RESULTS:We retrieved 199 papers after an initial screening and removal of duplicate papers. Then we applied an inclusion and exclusion criteria, resulting in a final set of 17 papers that focused on 15 separate projects. The majority of papers described studies involving qualitative research, including interviews and focus groups. They looked at the experience and use of ePHRs and patient portals. Overall, we found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet. We found 2 facilitators: (1) technical assistance and (2) family and provider advice. We also reported on older adults' experience, including satisfaction with the system and improvement of the quality of their health care. Several studies captured features that older adults wanted from these systems such as further assistance managing health-related tasks and contextual health advice and tips. CONCLUSIONS:More research is needed to better understand the patient portal experience among older adults from initial use to adoption. There are also opportunities to explore the role of design in addressing barriers and supporting facilitators to patient portal and ePHR use. Finally, the future use of these systems by older adults should be anticipated and considered in the design process.

Dataset Information

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study.

Background

Objective

Methods

Results

Conclusions

Publications

Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study.

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