JMIR Publications

ABSTRACT

Background:

Despite the role of Health Information Technology (HIT) in patient engagement processes and government incentives for HIT development, research regarding HIT is lacking among older adults, where the burden of cancer is high. This study examines the role of HIT in patient engagement in their treatment decision-making (TDM) related to cancer care in adults 65 years of age or older.

Objective:

This study is guided by the Patient Engagement model. It investigates the role of HIT in patient engagement (PE) in older adults in cancer care by integrating sociodemographic factors of race, education, poverty index, and psychosocial factor of fatalistic beliefs. Primarily, this study determines the role of sociodemographic factors and fatalistic beliefs in accessing and utilizing patient portals in older adults. These differences are compared among two groups of older adults, those diagnosed with cancer and those who have not. The secondary aim is to examine the relationship between access to and utilization of HIT in the self-management domain of patient activation measure that serves as a precursor to PE.

Methods:

This is a secondary data analysis of a subset of the Health Information National Trend Survey (HINTS 4, Cycle 3). The subset includes individuals 65 years old and above. The relationships between access to and utilization of HIT (for those with and without a cancer diagnosis) to several sociodemographic variables and psychosocial factor of fatalistic beliefs were analyzed. Chi-square, logistic regression, and linear regression models were fit to study these associations.

Results:

The total number of individuals over 65 years of age with a cancer diagnosis in this study was 180 and without a diagnosis was 398. This analysis indicated that having less than a college education level, being nonwhite, and living in poverty were significantly associated with decreased access to HIT. The decreased utilization of HIT was associated with less than a college education level and poverty. This analysis also indicated that cancer fatalistic beliefs were significantly associated with lower HIT utilization. Specifically, a one-point increase in cancer fatalistic belief score is associated with a 59% decrease in HIT utilization. The self-management domain of patient activation (a precursor of the engagement process) was significantly associated with access to and utilization of HIT.

Conclusions:

HIT is one of the important tools for enhancing the patient engagement process in older adults. This is vital information for providers and policy researchers to consider for future implementation strategies of HIT in cancer care.