JMIR Publications

ABSTRACT

Background:

Chronic disease risk factors including smoking/vaping, poor nutrition, alcohol misuse and physical inactivity, as well as falls (SNAPF), have a significant impact on population health. Delivering preventive care using evidence-based models (eg, Ask, Advise, Help (AAH) model) during clinical consultations is recommended and can reduce SNAPF risks. Rates of preventive care delivery within clinical consultations are variable, with barriers including limited time and competing priorities. One solution to increase preventive care delivery is using hybrid approaches that combine digital and clinician-delivered care.

Objective:

We aimed to test the use and acceptability of an online preventive care tool based on the AAH model and delivered through a hybrid care approach from the perspective of Community Health clients and clinicians.

Methods:

A convenience sample of adult clients with an upcoming appointment at two Australian Community Health services were sent an SMS containing a link to the online tool. The tool ‘Asked’ about SNAPF risk factors, and provided ‘Advice’ and ‘Help' via a summary message and information sheets. Data on use and acceptability was collected via analytics, semi-structured telephone interviews with clients, and semi-structured online interviews and focus groups with clinicians. Data analysis was conducted using descriptive statistics for quantitative data and thematic analysis for qualitative data.

Results:

Forty-three participants (56% female, mean age 55.0) completed the tool, out of 76 who received it (57%). Fifty-two participants who received the tool completed a semi-structured telephone interview (68%). Most participants found it acceptable to receive the tool via SMS (87%) and for the tool to provide ‘Advice’ and ‘Help’ (91%), although a smaller proportion of participants who completed the tool recalled the summary message (66%) or engaged with the information sheets (20%-53%). The main reasons reported for not completing the tool included receiving it at an inconvenient time, not being good with online forms, and being wary of opening links. Clinician feedback (n=7) highlighted client use barriers (eg, concerns about scams) and enablers (eg, assistance from family), as well as positive feedback on the tool itself (eg, clients receiving enhanced advice).

Conclusions:

The online preventive care tool was used by over half of the clients to whom it was sent, and was acceptable to Community Health clients and clinicians. There is an opportunity to use digital tools to help enhance preventive care within clinical care.