@Article{信息:doi 10.2196 / / jmir。1603年，作者=“Nijland, Nicol和van Gemert-Pijnen, Julia EWC和Kelders, Saskia M和Brandenburg, Bart J和Seydel, Erwin R”，标题=“影响使用基于web的应用程序支持2型糖尿病患者自我护理的因素:纵向研究”，期刊=“J医学互联网研究”，年=“2011”，月=“Sep”，日=“30”，卷=“13”，数=“3”，页=“e71”，关键词=“互联网;技术;电子健康;电子邮件;沟通;初级保健;自理;背景:电子健康应用程序的使用率总体上仍然相当低，用户流失率通常很高。关于特定患者群体使用电子保健技术的信息有限。 Objective: The aim of this study was to explore the factors that influence the initial and long-term use of a Web-based application (DiabetesCoach) for supporting the self-care of patients with type 2 diabetes. Methods: A mixed-methods research design was used for a process analysis of the actual usage of the Web application over a 2-year period and to identify user profiles. Research instruments included log files, interviews, usability tests, and a survey. Results: The DiabetesCoach was predominantly used for interactive features like online monitoring, personal data, and patient--nurse email contact. It was the continuous, personal feedback that particularly appealed to the patients; they felt more closely monitored by their nurse and encouraged to play a more active role in self-managing their disease. Despite the positive outcomes, usage of the Web application was hindered by low enrollment and nonusage attrition. The main barrier to enrollment had to do with a lack of access to the Internet (146/226, 65{\%}). Although 68{\%} (34/50) of the enrollees were continuous users, of whom 32{\%} (16/50) could be defined as hardcore users (highly active), the remaining 32{\%} (16/50) did not continue using the Web application for the full duration of the study period. Barriers to long-term use were primarily due to poor user-friendliness of the Web application (the absence of ``push'' factors or reminders) and selection of the ``wrong'' users; the well-regulated patients were not the ones who could benefit the most from system use because of a ceiling effect. Patients with a greater need for care seemed to be more engaged in long-term use; highly active users were significantly more often medication users than low/inactive users (P = .005) and had a longer diabetes duration (P = .03). Conclusion: Innovations in health care will diffuse more rapidly when technology is employed that is simple to use and has applicable components for interactivity. This would foresee the patients' need for continuous and personalized feedback, in particular for patients with a greater need for care. From this study several factors appear to influence increased use of eHealth technologies: (1) avoiding selective enrollment, (2) making use of participatory design methods, and (3) developing push factors for persistence. Further research should focus on the causal relationship between using the system's features and actual usage, as such a view would provide important evidence on how specific technology features can engage and captivate users. ", issn="1438-8871", doi="10.2196/jmir.1603", url="//www.mybigtv.com/2011/3/e71/", url="https://doi.org/10.2196/jmir.1603", url="http://www.ncbi.nlm.nih.gov/pubmed/21959968" }