Maximizing the Impact of ePHIM in Low-Income, Multiethnic Populations

最大限度地发挥 ePHIM 对低收入、多种族人群的影响

• 批准号: 9107795
• 负责人: Thomas A. Arcury
• 金额: $ 25.79万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9107795
• 关键词: Maximizing; Impact; ePHIM; Low; Income

DESCRIPTION (provided by applicant): The ability to access, manage, and understand personal health information enables individuals to become better consumers and participate more fully in making health care decisions. The development of electronic health records and the availability of patient portals for accessing personal health records, coupled with myriad health information via the internet (eHealth), have provided the potential for electronic personal health information management (ePHIM). However, great variability exists in access to eHealth information for components of the US population. Despite continuing efforts, this "digital divide" remains for rural, minority and low-income communities. Limited access for ePHIM contributes to the health disparities experienced by these populations. The goal of this project is to improve the ability of low-income African American, American Indian, Latino, and white older adults living in rural and urban communities to use information technology applications for ePHIM. The project's conceptual framework combines the Technology Acceptance Model and the person- environmental interaction model. It uses a community-based participatory partnership of Wake Forest School of Medicine and its Outpatient Department Medicine Clinic, with Community Partners HealthNet, a network of 18 clinics serving 25 rural North Carolina counties, to achieve 3 specific aims: (1) document the ePHIM experience, knowledge, perceived needs, and perceived risks of low-income African American, American Indian, Latino, and white older adults living in rural and urban communities~ (2) delineate the actual use of ePHIM by low-income African American, American Indian, Latino, and white older adults living in rural and urban communities~ and (3) delineate differences in perception, belief and experience in using ePHIM between patients and caregivers who use versus those who do not use ePHIM. This project is significant because it will delineate disparities in ePHIM by working with two networks of clinics (Community Partners HealthNet~ Outpatient Department Medicine Clinic/Wake Forest Baptist Health) that provides care to rural and urban, low- income, and minority patients. Working with these networks, this project will implement in-depth and longitudinal research that will delineate the factors affecting ePHIM use among vulnerable elders. This project is innovative. (1) It will use qualitative data collection techniques within a community-based participatory research framework to assess the motives and barriers to patients' and caregivers' ePHIM among rural as well as urban, low-income, older adult, and minority communities. (2) It emphasizes the importance of including caregivers, particularly for older adults, in understanding the use of ePHIM. (3) It will use these qualitative methods to assess the perceptions of health care providers and IT providers about the potential use of ePHIM. (4) It will use these qualitative methods to determine the factors that facilitated and limited the use of ePHIM by comparing high / expert, medium, and low users. (5) It will document the actual pattern of ePHIM use among older adults and their caregivers over a one-year period. (6) It will explore the association of ePHIM use and chronic disease management among older adults.

描述（由申请人提供）：访问，管理和理解个人健康信息的能力使个人能够成为更好的消费者并更充分地参与做出医疗保健决策。 电子健康记录的开发以及用于访问个人健康记录的患者门户网站的可用性，再加上通过互联网（EHealth）的无数健康信息，为电子个人健康信息管理（EPHIM）提供了潜力。 但是，对于美国人口组成部分的eHealth信息，存在很大的可变性。尽管持续努力，但这种“数字鸿沟”仍然是农村，少数群体和低收入社区。 Ephim的访问有限会导致这些人群所经历的健康差异。 该项目的目的是改善 居住在农村和城市社区中的低收入非裔美国人，美洲印第安人，拉丁美洲裔和白人老年人的能力，将信息技术应用用于Ephim。 该项目的概念框架结合了技术接受模型和人体环境互动模型。 It uses a community-based participatory partnership of Wake Forest School of Medicine and its Outpatient Department Medicine Clinic, with Community Partners HealthNet, a network of 18 clinics serving 25 rural North Carolina counties, to achieve 3 specific aims: (1) document the ePHIM experience, knowledge, perceived needs, and perceived risks of low-income African American, American Indian, Latino, and white older adults living in rural and urban communities~ (2)描述了低收入的非裔美国人，美洲印第安人，拉丁美洲裔和白人老年人的实际使用，居住在农村和城市社区中〜和（3）描述在使用Ephim和使用Ephim的患者和不使用Ephim的患者和护理人员之间使用Ephim的看法，信念和经验。 该项目之所以重要，是因为它将通过与两个诊所网络（社区合作伙伴Healthnet〜门诊医学诊所/韦克森林浸信会健康）合作来描述Ephim的差异，从而为农村和城市，低收入和少数族裔患者提供护理。 该项目将与这些网络合作，将实施深入和纵向研究，以描述影响Ephim在脆弱长者中使用的因素。 这个项目是创新的。 （1）它将在基于社区的参与研究框架内使用定性数据收集技术，以评估农村以及城市，低收入，老年人和少数民族社区中患者和照料者Ephim的动机和障碍。 （2）它强调包括护理人员，尤其是对于老年人的重要性，以理解Ephim的使用。 （3）它将使用这些定性方法来评估医疗保健提供者的看法及其对Ephim潜在使用的提供者的看法。 （4）它将使用这些定性方法来确定促进和限制使用的因素 通过比较高 /专家，中等和低用户，以菲姆。 （5）它将在一年的时间内记录老年人及其护理人员中Ephim使用的实际使用方式。 （6）它将探讨老年人的Ephim使用和慢性疾病管理的关联。