@Article{info:doi/10.2196/jmir.2682,
author="Lau, Annie YS
and Dunn, Adam G
and Mortimer, Nathan
and Gallagher, Aideen
and Proudfoot, Judith
and Andrews, Annie
and Liaw, Siaw-Teng
and Crimmins, Jacinta
and Arguel, Ama{\"e}l
and Coiera, Enrico",
title="Social and Self-Reflective Use of a Web-Based Personally Controlled Health Management System",
journal="J Med Internet Res",
year="2013",
month="Sep",
day="23",
volume="15",
number="9",
pages="e211",
keywords="personal health record; social networks; Internet intervention; health service; help-seeking; emotional well-being; physical well-being; preventative health; eHealth; consumer; university",
abstract="Background: Personally controlled health management systems (PCHMSs) contain a bundle of features to help patients and consumers manage their health. However, it is unclear how consumers actually use a PCHMS in their everyday settings. Objective: To conduct an empirical analysis of how consumers used the social (forum and poll) and self-reflective (diary and personal health record [PHR]) features of a Web-based PCHMS designed to support their physical and emotional well-being. Methods: A single-group pre/post-test online prospective study was conducted to measure use of a Web-based PCHMS for physical and emotional well-being needs during a university academic semester. The PCHMS integrated an untethered PHR with social forums, polls, a diary, and online messaging links with a health service provider. Well-being journeys additionally provided information to encourage engagement with clinicians and health services. A total of 1985 students and staff aged 18 and above with access to the Internet were recruited online, of which 709 were eligible for analysis. Participants' self-reported well-being, health status, health service utilization, and help-seeking behaviors were compared using chi-square, McNemar's test, and Student's t test. Social networks were constructed to examine the online forum communication patterns among consumers and clinicians. Results: The two PCHMS features that were used most frequently and considered most useful and engaging were the social features (ie, the poll and forum). More than 30{\%} (213/709) of participants who sought well-being assistance during the study indicated that other people had influenced their decision to seek help (54.4{\%}, 386/709 sought assistance for physical well-being; 31.7{\%}, 225/709 for emotional well-being). Although the prevalence of using a self-reflective feature (diary or PHR) was not as high (diary: 8.6{\%}, 61/709; PHR: 15.0{\%}, 106/709), the proportion of participants who visited a health care professional during the study was more than 20{\%} greater in the group that did use a self-reflective feature (diary: P=.03; PHR: P<.001). Conclusions: There was variation in the degree to which consumers used social and self-reflective PCHMS features but both were significantly associated with increased help-seeking behaviors and health service utilization. A PCHMS should combine both self-reflective as well as socially driven components to most effectively influence consumers' help-seeking behaviors. ",
issn="14388871",
doi="10.2196/jmir.2682",
url="http://www.jmir.org/2013/9/e211/",
url="https://doi.org/10.2196/jmir.2682",
url="http://www.ncbi.nlm.nih.gov/pubmed/24064188"
}