TY  - JOUR
AU  - Lau, Annie YS
AU  - Dunn, Adam G
AU  - Mortimer, Nathan
AU  - Gallagher, Aideen
AU  - Proudfoot, Judith
AU  - Andrews, Annie
AU  - Liaw, Siaw-Teng
AU  - Crimmins, Jacinta
AU  - Arguel, Amaël
AU  - Coiera, Enrico
PY  - 2013
DA  - 2013/09/23
TI  - Social and Self-Reflective Use of a Web-Based Personally Controlled Health Management System
JO  - J Med Internet Res
SP  - e211
VL  - 15
IS  - 9
KW  - personal health record
KW  - social networks
KW  - Internet intervention
KW  - health service
KW  - help-seeking
KW  - emotional well-being
KW  - physical well-being
KW  - preventative health
KW  - eHealth
KW  - consumer
KW  - university
AB  - 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. 
SN  - 14388871
UR  - http://www.jmir.org/2013/9/e211/
UR  - https://doi.org/10.2196/jmir.2682
UR  - http://www.ncbi.nlm.nih.gov/pubmed/24064188
DO  - 10.2196/jmir.2682
ID  - info:doi/10.2196/jmir.2682
ER  -