JMIR Publications

ABSTRACT

Background:

Health information, patient education, and self-management (HIA) tools are increasingly being made available to adults with chronic health conditions through eHealth and mHealth modalities. However, there is limited information about patient preferences for using specific types of ehealth and mHealth resources and how this differs by age and education.

Objective:

The objective of this study was to examine how current use of digital information technologies (DITs) and preferred methods for obtaining HIA varies by age and education among middle-aged and older adults with chronic health conditions.

Methods:

The study used cross-sectional survey data for 9,005 Kaiser Permanente Northern California members aged 45-85 who responded to a mailed/online health survey conducted 2014-2015 and indicated having ≥1 chronic health condition. Bivariate analyses and logistic regression models with weighted data were used to estimate and compare prevalence of DIT use, past-year use of online HIA resources, and preferences for using ehealth, mHealth, and traditional HIA modalities for adults aged 45-65, 66-75, and 76-85.

Results:

The percentages of adults who used DITs (computers, smartphones, internet, email, apps), had obtained HIA from an online resource in the past year, and who were interested in using eHealth and mHealth modalities for obtaining HIA declined with age group. Within age group, prevalence of DIT use and interest in ehealth and mHealth modalities was lower among adults who had not attended any college compared to college graduates. Differences between the oldest and younger groups and those with lower versus higher education in preferences for eHIA modalities were substantially diminished when we restricted analyses to internet users.

Conclusions:

Healthcare providers and other organizations serving middle-aged and older adults with chronic health conditions should not assume that patients will want to engage with ehealth and mHealth resources. This is especially true among those who are older and less educated. Since these groups are also less likely to be using digital devices and the internet, increasing their engagement with online HIA and health apps may require both instrumental (e.g., providing DIT devices, internet, and skills training) and social support. As part of patient-centered care, it is important for providers to ascertain their patients’ use of digital technologies and preferences for obtaining health information and patient education rather than routinely referring them to online resources. It is also important for healthcare providers and consumer health organizations to user-test their online resources to make sure they are easy for older and less educated adults to use and to make sure that it remains easy for adults with chronic conditions to obtain health information and patient education using off-line resources.