1
|
François J, Audrain-Pontevia AF, Boudhraâ S, Vial S. Assessing the Influence of Patient Empowerment Gained Through Mental Health Apps on Patient Trust in the Health Care Provider and Patient Compliance With the Recommended Treatment: Cross-sectional Study. J Med Internet Res 2024; 26:e48182. [PMID: 38345851 PMCID: PMC10897799 DOI: 10.2196/48182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/12/2023] [Accepted: 12/18/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In chronic mental illness, noncompliance with treatment significantly worsens the illness course and outcomes for patients. Considering that nearly 1 billion people worldwide experience mental health issues, including 1 of 5 Canadians in any given year, finding tools to lower noncompliance in these populations is critical for health care systems. A promising avenue is apps that make mental health services more accessible to patients. However, little is known regarding the impact of the empowerment gained from mental health apps on patient compliance with recommended treatment. OBJECTIVE This study aimed to investigate the impact of patient empowerment gained through mental health apps on patient trust in the health care provider and patient compliance with the recommended treatment. METHODS A cross-sectional web-based survey was conducted in Canada. Eligible participants were Canadian adults diagnosed with chronic mental health disorders who were using at least one of the following apps: Dialogue, MindBeacon, Deprexis, Ginger, Talkspace, BetterHelp, MindStrong, Mindshift, Bloom, Headspace, and Calm. A total of 347 valid questionnaires were collected and analyzed using partial least-squares structural equation modeling. Trust in the health care provider and patient compliance were measured with multiple-item scales adapted from existing scales. Patient empowerment was conceived and measured as a higher-order construct encompassing the following 2 dimensions: patient process and patient outcome. All the items contributing to the constructs in the model were measured with 7-point Likert scales. The reliability and validity of the measurement model were assessed, and the path coefficients of the structural model were estimated. RESULTS The results clearly show that patient empowerment gained through mental health apps positively influenced patient trust in the health care provider (β=.306; P<.001). Patient trust in the health care provider had a positive effect on patient compliance (β=.725; P<.001). The direct relationship between patient empowerment and patient compliance was not significant (β=.061, P=.23). Interestingly, the data highlight that the effect of patient empowerment on patient compliance was fully mediated by trust in the health care provider (β=.222; P<.001). The results show that patient empowerment gained through the mental health app involves 2 dimensions: a process and an outcome. CONCLUSIONS This study shows that for individuals living with mental health disorders, empowerment gained through mental health apps enhances trust in the health care provider. It reveals that patient empowerment impacts patient compliance but only through the full mediating effect of patient trust in the health care provider, indicating that patient trust is a critical variable to enhance patient compliance. Hence, our results confirm that health care systems could encourage the use of mental health apps to favor a climate that facilitates patients' trust in health care provider recommendations, possibly leading to better compliance with the recommended treatment.
Collapse
Affiliation(s)
- Julien François
- École des Sciences de la Gestion, Université du Québec à Montréal, Montréal, QC, Canada
| | | | - Sana Boudhraâ
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- École de Design, Université du Québec à Montréal, Montréal, QC, Canada
| | - Stéphane Vial
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- École de Design, Université du Québec à Montréal, Montréal, QC, Canada
| |
Collapse
|
2
|
Karampatakis GD, Wood HE, Griffiths CJ, Lea NC, Ashcroft RE, Day B, Walker N, Coulson NS, De Simoni A. Ethical and Information Governance Considerations for Promoting Digital Social Interventions in Primary Care. J Med Internet Res 2023; 25:e44886. [PMID: 37756051 PMCID: PMC10568391 DOI: 10.2196/44886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/28/2023] [Accepted: 07/31/2023] [Indexed: 09/28/2023] Open
Abstract
Promoting online peer support beyond the informal sector to statutory health services requires ethical considerations and evidence-based knowledge about its impact on patients, health care professionals, and the wider health care system. Evidence on the effectiveness of digital interventions in primary care is sparse, and definitive guidance is lacking on the ethical concerns arising from the use of social media as a means for health-related interventions and research. Existing literature examining ethical issues with digital interventions in health care mainly focuses on apps, electronic health records, wearables, and telephone or video consultations, without necessarily covering digital social interventions, and does not always account for primary care settings specifically. Here we address the ethical and information governance aspects of undertaking research on the promotion of online peer support to patients by primary care clinicians, related to medical and public health ethics.
Collapse
Affiliation(s)
- Georgios Dimitrios Karampatakis
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Helen E Wood
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Chris J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Nathan C Lea
- Department of Medical Informatics & Statistics, The European Institute for Innovation through Health Data, Ghent University Hospital, Ghent, Belgium
| | | | - Bill Day
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil S Coulson
- Medical School, Nottingham City Hospital, Nottingham, United Kingdom
| | - Anna De Simoni
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
3
|
Karampatakis GD, Wood HE, Griffiths CJ, Taylor SJC, Toffolutti V, Bird VJ, Lea NC, Ashcroft RE, Day B, Coulson NS, Panzarasa P, Li X, Sheikh A, Relton C, Sastry N, Watson JS, Marsh V, Mant J, Mihaylova B, Walker N, De Simoni A. Non-randomised feasibility study testing a primary care intervention to promote engagement in an online health community for adults with troublesome asthma: protocol. BMJ Open 2023; 13:e073503. [PMID: 37433727 DOI: 10.1136/bmjopen-2023-073503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
INTRODUCTION In the UK, approximately 4.3 million adults have asthma, with one-third experiencing poor asthma control, affecting their quality of life, and increasing their healthcare use. Interventions promoting emotional/behavioural self-management can improve asthma control and reduce comorbidities and mortality. Integration of online peer support into primary care services to foster self-management is a novel strategy. We aim to co-design and evaluate an intervention for primary care clinicians to promote engagement with an asthma online health community (OHC). Our protocol describes a 'survey leading to a trial' design as part of a mixed-methods, non-randomised feasibility study to test the feasibility and acceptability of the intervention. METHODS AND ANALYSIS Adults on the asthma registers of six London general practices (~3000 patients) will be invited to an online survey, via text messages. The survey will collect data on attitudes towards seeking online peer support, asthma control, anxiety, depression, quality of life, information on the network of people providing support with asthma and demographics. Regression analyses of the survey data will identify correlates/predictors of attitudes/receptiveness towards online peer support. Patients with troublesome asthma, who (in the survey) expressed interest in online peer support, will be invited to receive the intervention, aiming to reach a recruitment target of 50 patients. Intervention will involve a one-off, face-to-face consultation with a practice clinician to introduce online peer support, sign patients up to an established asthma OHC, and encourage OHC engagement. Outcome measures will be collected at baseline and 3 months post intervention and analysed with primary care and OHC engagement data. Recruitment, intervention uptake, retention, collection of outcomes, and OHC engagement will be assessed. Interviews with clinicians and patients will explore experiences of the intervention. ETHICS AND DISSEMINATION Ethical approval was obtained from a National Health Service Research Ethics Committee (reference: 22/NE/0182). Written consent will be obtained before intervention receipt and interview participation. Findings will be shared via dissemination to general practices, conference presentations and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT05829265.
Collapse
Affiliation(s)
- Georgios Dimitrios Karampatakis
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Helen E Wood
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Chris J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Stephanie J C Taylor
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Veronica Toffolutti
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Victoria J Bird
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Nathan C Lea
- Department of Medical Informatics and Statistics, The European Institute for Innovation through Health Data, Ghent University Hospital, Gent, Belgium
| | | | - Bill Day
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Neil S Coulson
- Nottingham City Hospital, University of Nottingham School of Medicine, Nottingham, UK
| | - Pietro Panzarasa
- School of Business and Management, Queen Mary University of London, London, UK
| | - Xiancheng Li
- School of Business and Management, Queen Mary University of London, London, UK
| | - Aziz Sheikh
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Clare Relton
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Nishanth Sastry
- Department of Computer Science, University of Surrey, Guildford, UK
| | - Jane S Watson
- Respiratory Department, St George's Healthcare NHS Trust, London, UK
| | - Viv Marsh
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Jonathan Mant
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Borislava Mihaylova
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Anna De Simoni
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| |
Collapse
|
4
|
Jin X, Yuan Z, Zhou Z. Understanding the Antecedents and Effects of mHealth App Use in Pandemics: A Sequential Mixed-Method Investigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20010834. [PMID: 36613156 PMCID: PMC9819572 DOI: 10.3390/ijerph20010834] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 05/27/2023]
Abstract
Pandemics such as COVID-19 pose serious threats to public health and disrupt the established systems for obtaining healthcare services. Mobile health (mHealth) apps serve the general public as a potential method for coping with these exogenous challenges. However, prior research has rarely discussed the antecedents and effects of mHealth apps and their use as a coping method during pandemics. Based on the technology acceptance model, empowerment theory, and event theory, we developed a research model to examine the antecedents (technology characteristics and event strength) and effects (psychological empowerment) of mHealth apps and their use. We tested this research model through a sequential mixed-method investigation. First, a quantitative study based on 402 Chinese mHealth users who used the apps during the COVID-19 pandemic was conducted to validate the theoretical model. A follow-up qualitative study of 191 online articles and reviews on mHealth during the COVID-19 pandemic was conducted to cross-validate the results and explain the unsupported findings of the quantitative study. The results show that (1) the mHealth app characteristics (perceived usefulness and perceived ease of use) positively affect mHealth app use; (2) mHealth app use positively affects the psychological empowerment of mHealth users; and (3) the characteristics of pandemic events (event criticality and event disruption) have positive moderating effects on the relationship between mHealth app characteristics and mHealth app use. This study explains the role of mHealth apps in the COVID-19 pandemic on the micro-level, which has implications for the ways in which mHealth apps are used in response to public pandemics.
Collapse
Affiliation(s)
- Xiaoling Jin
- Management School, Shanghai University, Shanghai 200444, China
| | - Zhangshuai Yuan
- Management School, Shanghai University, Shanghai 200444, China
| | - Zhongyun Zhou
- School of Economics and Management, Tongji University, Shanghai 200092, China
| |
Collapse
|
5
|
Helou S, Khalil N, Daou M, El Helou E. Virtual reality for healthcare: A scoping review of commercially available applications for head-mounted displays. Digit Health 2023; 9:20552076231178619. [PMID: 37312952 PMCID: PMC10259138 DOI: 10.1177/20552076231178619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 05/11/2023] [Indexed: 06/15/2023] Open
Abstract
Objective This scoping review aimed to describe the scope of commercially available virtual reality (VR) healthcare applications for mainstream head-mounted displays (HMD)s. Methods A search was conducted during late April and early May 2022 over five major VR app stores using "health," "healthcare," "medicine," and "medical" as keywords. Apps were screened based on their title and description sections. Metadata collected included: title, description, release date, price (free or paid), multilingual support, VR app store availability, and HMD support. Results The search yielded 1995 apps, out of which 60 met the inclusion criteria. The analysis showed that the number of healthcare VR apps has been steadily increasing since 2016, but no developer has released more than two apps so far. Most of the reviewed apps can run on HTC Vive, Oculus Quest, and Valve Index. Thirty-four (56.7%) apps had a free version, and 12 (20%) apps were multilingual, i.e., supported languages other than English. The reviewed apps fell into eight major themes: life science education (3D anatomy, physiology and pathology, biochemistry, and genetics); rehabilitation (physical, mental, and phobia therapy); public health training (safety, life-saving skills, and management); medical training (surgical and patient simulators); role-playing as a patient; 3D medical imagery viewing; children's health; and online health communities. Conclusions Although commercial healthcare VR is still in its early phases, end-users can already access a broad range of healthcare VR apps on mainstream HMDs. Further research is needed to assess the usefulness and usability of existing apps.
Collapse
Affiliation(s)
- Samar Helou
- Global Center for Medical Engineering and Informatics, Osaka University, Suita, Japan
| | - Nour Khalil
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Melissa Daou
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Elie El Helou
- Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| |
Collapse
|
6
|
Guetz B, Bidmon S. The Impact of Social Influence on the Intention to Use Physician Rating Websites: Moderated Mediation Analysis Using a Mixed Methods Approach. J Med Internet Res 2022; 24:e37505. [PMID: 36374547 PMCID: PMC9706386 DOI: 10.2196/37505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/23/2022] [Accepted: 10/11/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physician rating websites (PRWs) have become increasingly important in the cross-section between health and digitalization. Social influence plays a crucial role in human behavior in many domains of life, as can be demonstrated by the increase in high-profile influential individuals such as social media influencers (SMIs). Particularly in the health-specific environment, the opinion of family and friends has a significant influence on health-related decisions. However, so far, there has been little discussion about the role of social influence as an antecedent of behavioral intention to use PRWs. OBJECTIVE On the basis of theories of social psychology and technology acceptance and theories from the economic perspective, this study aimed to evaluate the impact of social influence on the behavioral intention to use PRWs. METHODS We conducted 2 studies by applying a mixed methods approach including a total of 712 participants from the Austrian population. The impact of social influence on the behavioral intention to use PRWs was investigated through linear regression and mediation and moderated mediation analysis using the PROCESS macro 4.0 in SPSS 27 (IBM Corp). RESULTS The 2 studies show similar results. In study 1, an experiment, no direct effect of social influence on the behavioral intention to use PRWs could be detected. However, an indirect effect of social influence on the behavioral intention to use PRWs via credibility (b=0.572; P=.005) and performance expectancy (b=0.340; P<.001) could be confirmed. The results of study 2, a cross-sectional study, demonstrate that social influence seems to have a direct impact on the behavioral intention to use PRWs (b=0.410; P<.001). However, when calculating the proposed mediation model, it becomes clear that this impact may partly be explained through the 2 mediator variables-credibility (b=0.208; P<.001) and performance expectancy (b=0.312; P<.001). In contrast to the observed direct and indirect effect, neither demographic nor psychographic variables have a significant moderating impact on the influencing chain in study 2. CONCLUSIONS This study provides an indication that social influence has at least an indirect impact on the behavioral intention to use PRWs. It was observed that this impact is exerted through credibility and performance expectancy. According to the findings of both studies, social influence has the potential to boost the use of PRWs. As a result, these web-based networks might be a promising future interface between health care and digitalization, allowing health care practitioners to gain a beneficial external impact while also learning from feedback. Social influence nowadays is not just limited to friends and family but can also be exerted by SMIs in the domain of PRW use. Thus, from a marketing perspective, PRW providers could think of collaborating with SMIs, and our results could contribute to stimulating discussion in this vein.
Collapse
Affiliation(s)
- Bernhard Guetz
- Department of Marketing and International Management, Alpen-Adria-Universitaet Klagenfurt, Klagenfurt am Woerthersee, Austria
| | - Sonja Bidmon
- Department of Marketing and International Management, Alpen-Adria-Universitaet Klagenfurt, Klagenfurt am Woerthersee, Austria
| |
Collapse
|
7
|
Shah AM, Muhammad W, Lee K, Naqvi RA. Examining Different Factors in Web-Based Patients' Decision-Making Process: Systematic Review on Digital Platforms for Clinical Decision Support System. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111226. [PMID: 34769745 PMCID: PMC8582809 DOI: 10.3390/ijerph182111226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 01/22/2023]
Abstract
(1) Background: The appearance of physician rating websites (PRWs) has raised researchers’ interest in the online healthcare field, particularly how users consume information available on PRWs in terms of online physician reviews and providers’ information in their decision-making process. The aim of this study is to consistently review the early scientific literature related to digital healthcare platforms, summarize key findings and study features, identify literature deficiencies, and suggest digital solutions for future research. (2) Methods: A systematic literature review using key databases was conducted to search published articles between 2010 and 2020 and identified 52 papers that focused on PRWs, different signals in the form of PRWs’ features, the findings of these studies, and peer-reviewed articles. The research features and main findings are reported in tables and figures. (3) Results: The review of 52 papers identified 22 articles for online reputation, 15 for service popularity, 16 for linguistic features, 15 for doctor–patient concordance, 7 for offline reputation, and 11 for trustworthiness signals. Out of 52 studies, 75% used quantitative techniques, 12% employed qualitative techniques, and 13% were mixed-methods investigations. The majority of studies retrieved larger datasets using machine learning techniques (44/52). These studies were mostly conducted in China (38), the United States (9), and Europe (3). The majority of signals were positively related to the clinical outcomes. Few studies used conventional surveys of patient treatment experience (5, 9.61%), and few used panel data (9, 17%). These studies found a high degree of correlation between these signals with clinical outcomes. (4) Conclusions: PRWs contain valuable signals that provide insights into the service quality and patient treatment choice, yet it has not been extensively used for evaluating the quality of care. This study offers implications for researchers to consider digital solutions such as advanced machine learning and data mining techniques to test hypotheses regarding a variety of signals on PRWs for clinical decision-making.
Collapse
Affiliation(s)
- Adnan Muhammad Shah
- Department of Computing Engineering, Gachon University, Seoul 13120, Korea
- Department of Physics, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL 33431-0991, USA; (A.M.S.); (W.M.)
- Department of Management Sciences, Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Islamabad 44320, Pakistan
| | - Wazir Muhammad
- Department of Physics, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, FL 33431-0991, USA; (A.M.S.); (W.M.)
| | - Kangyoon Lee
- Department of Computing Engineering, Gachon University, Seoul 13120, Korea
- Correspondence:
| | - Rizwan Ali Naqvi
- Department of Unmanned Vehicle Engineering, Sejong University, Seoul 05006, Korea;
| |
Collapse
|
8
|
Chew AMK, Gunasekeran DV. Social Media Big Data: The Good, The Bad, and the Ugly (Un)truths. Front Big Data 2021; 4:623794. [PMID: 34142082 PMCID: PMC8204107 DOI: 10.3389/fdata.2021.623794] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alton M K Chew
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore, Singapore.,UCL Medical School, University College London (UCL), London, United Kingdom
| | | |
Collapse
|
9
|
De Simoni A, Shah AT, Fulton O, Parkinson J, Sheikh A, Panzarasa P, Pagliari C, Coulson NS, Griffiths CJ. Superusers' Engagement in Asthma Online Communities: Asynchronous Web-Based Interview Study. J Med Internet Res 2020; 22:e18185. [PMID: 32573463 PMCID: PMC7381072 DOI: 10.2196/18185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/23/2020] [Accepted: 05/13/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Superusers, defined as the 1% of users who write a large number of posts, play critical roles in online health communities (OHCs), catalyzing engagement and influencing other users' self-care. Their unique online behavior is key to sustaining activity in OHCs and making them flourish. Our previous work showed the presence of 20 to 30 superusers active on a weekly basis among 3345 users in the nationwide Asthma UK OHC and that the community would disintegrate if superusers were removed. Recruiting these highly skilled individuals for research purposes can be challenging, and little is known about superusers. OBJECTIVE This study aimed to explore superusers' motivation to actively engage in OHCs, the difficulties they may face, and their interactions with health care professionals (HCPs). METHODS An asynchronous web-based structured interview study was conducted. Superusers of the Asthma UK OHC and Facebook groups were recruited through Asthma UK staff to pilot and subsequently complete the questionnaire. Open-ended questions were analyzed using content analysis. RESULTS There were 17 superusers recruited for the study (14 patients with asthma and 3 carers); the majority were female (15/17). The age range of participants was 18 to 75 years. They were active in OHCs for 1 to 6 years and spent between 1 and 20 hours per week reading and 1 and 3 hours per week writing posts. Superusers' participation in OHCs was prompted by curiosity about asthma and its medical treatment and by the availability of spare time when they were off work due to asthma exacerbations or retired. Their engagement increased over time as participants furthered their familiarity with the OHCs and their knowledge of asthma and its self-management. Financial or social recognition of the superuser role was not important; their reward came from helping and interacting with others. According to the replies provided, they showed careful judgment to distinguish what can be dealt with through peer advice and what needs input from HCPs. Difficulties were encountered when dealing with misunderstandings about asthma and its treatment, patients not seeking advice from HCPs when needed, and miracle cures or dangerous ideas. Out of 17 participants, only 3 stated that their HCPs were aware of their engagement with OHCs. All superusers thought that HCPs should direct patients to OHCs, provided they are trusted and moderated. In addition, 9 users felt that HCPs themselves should take part in OHCs. CONCLUSIONS Superusers from a UK-wide online community are highly motivated, altruistic, and mostly female individuals who exhibit judgment about the complexity of coping with asthma and the limits of their advice. Engagement with OHCs satisfies their psychosocial needs. Future research should explore how to address their unmet needs, their interactions with HCPs, and the potential integration of OHCs in traditional healthcare.
Collapse
Affiliation(s)
- Anna De Simoni
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
| | | | - Olivia Fulton
- Asthma UK Centre for Applied Research, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Pietro Panzarasa
- School of Business and Management, Queen Mary University of London, London, United Kingdom
| | - Claudia Pagliari
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Neil S Coulson
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Chris J Griffiths
- Asthma UK Centre for Applied Research, Institute of Population Health Sciences, Queen Mary University of London, London, United Kingdom
| |
Collapse
|
10
|
van Eenbergen MC, Vromans RD, Tick LW, Vreugdenhil G, Krahmer EJ, Mols F, van de Poll-Franse LV. Comparing cancer survivors in population-based samples with those in online cancer communities: Identifying differences in internet use and information needs (Preprint). JMIR Cancer 2020; 8:e19379. [PMID: 35258460 PMCID: PMC8941444 DOI: 10.2196/19379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/07/2020] [Accepted: 01/25/2022] [Indexed: 01/23/2023] Open
Abstract
Background Most Western countries have websites that provide information on cancer and the opportunity to participate in online cancer communities (OCCs). The number of patients with cancer that participate in these OCCs is growing. These patients are relatively easy to approach for research purposes. Objective The objective of this study is to determine the differences and similarities between survivors of cancer in population-based samples and survivors participating in OCCs who use the internet in relation to their illness. Methods In 2017, we drew a sample of 539 population-based patients and 531 OCC patients. The population-based patients were sent a paper-based questionnaire, and the OCC patients were sent the same questionnaire on the web. In the questionnaire, we asked patients about their sociodemographics, internet use, sources of information, media use, and wishes regarding future internet use for health care–related purposes, and the effect of internet use on their health care consumption. Results The response rate of population-based internet users was 47% (233/496), and that of the OCC group was 40.3% (214/531). The OCC group had a significantly higher education level (P<.001), was younger (P<.001), had more survivors that were employed (P<.001), and attached greater importance to the internet (171/214, 79.9% vs 126/233, 54.1%; P<.001) and fellow survivors (107/214, 50% vs 60/233, 25.8%; P<.001). Compared with the population-based group, the OCC group reported more intensive internet use immediately after diagnosis, during treatment, and during follow-up (P<.001 in each case). There were similarities in terms of the relative importance that survivors attach to the various sources of information, the topics on which they seek information, and their wishes for future eHealth possibilities. The OCC group reported a greater need to participate in a web-based class or chat with others (92/214, 43% vs 44/233, 18.9%). Conclusions We conclude that survivors who are members of an OCC are not representative of survivors of cancer in general. There are significant differences in sociodemographic characteristics, internet use during their treatment journey, internet search frequency during their cancer journey, and participation wishes. Using web-based information and communication can support shared decision-making and may facilitate the active participation of patients during their treatment. For research purposes, it is important to take the bias in OCC groups into account.
Collapse
Affiliation(s)
- Mies C van Eenbergen
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Ruben D Vromans
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Lidwine W Tick
- Department of Medical Oncology, Maxima Medical Center, Veldhoven, Netherlands
| | - Gerard Vreugdenhil
- Department of Medical Oncology, Maxima Medical Center, Veldhoven, Netherlands
| | - Emiel J Krahmer
- Department of Communication and Cognition, Tilburg University, Tilburg, Netherlands
| | - Floortje Mols
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| |
Collapse
|