@文章{信息:doi/10.2196/13477，作者=“Costello, Ruth E和Anand, Amrutha和Jameson Evans, Matt和Dixon, William G”，标题=“参与在线健康社区与患者激活和医疗保健利用变化之间的关系:纵向基于web的调查”，期刊=“J医学互联网研究”，年=“2019”，月=“8”，日=“29”，卷=“21”，数=“8”，页=“e13477”，关键词=“自我管理;慢性疾病;卫生信息交流;数字健康;同伴支持;点对点的支持;在线支持小组;背景:参与在线健康社区(OHCs)在英国是一种流行趋势。然而，到目前为止，尚无证据表明参与OHCs与改善健康结果之间存在关联。目的:本研究旨在(1)确定OHC新用户在3个月内的患者激活变化，(2)描述OHC的参与模式，(3)检查患者基线时的特征是否与后续的参与模式相关，以及(4)确定3个月期间的参与模式是否与患者激活、医疗保健利用和健康状况的变化相关。 Methods: Active new OHC users on HealthUnlocked (HU) were surveyed to measure demographics, levels of patient activation (describing a person's confidence in managing their own health; scale 0-100 with 4 categories), health care utilization, and health status using a Web-based survey at baseline and 3 months. Patient activation at baseline and 3 months was compared (aim 1). Alongside, for a sample of HU users and survey responders, daily OHC website usage data were automatically captured. This was used to identify clusters of engagement with HU (aim 2). For survey responders, baseline characteristics, patient activation, health care utilization, and health status were compared at baseline and 3 months, overall, and between engagement clusters using t tests and chi-square tests (aims 3 and 4). Results: In 329 people who completed both surveys, baseline activation was most frequently level 3, described as taking action but still lacking confidence. At follow-up, a change of 2.6 points was seen, with the greatest change seen in those at lowest baseline activation levels. In addition, 4 clusters of engagement were identified: low, medium, high, and very high, who were active on HU for a mean of 4, 12, 29, and 59 days, respectively. Survey responders were more commonly high or very high engagers. Baseline activation was highest in low and very high engagers. Overall activation increased over time in all engagement groups. Very high engagers had the greatest improvement in activation (5 points), although the average change was not above what is considered clinically meaningful for any group. Fewer accident and emergency visits were seen at follow-up in those with higher engagement, although this trend was not seen for other health care utilization measures. There was no change in health status at 3 months. Conclusions: This observational study provides some insight into how patterns of engagement with OHCs are associated with changes in patient activation, health care utilization, and health status. Over 3 months, overall, the change in activation was not clinically significant, and there were some indications that OHCs may be of benefit to particular groups. However, the study limitations prevent firm conclusions about causal relationships. ", issn="1438-8871", doi="10.2196/13477", url="//www.mybigtv.com/2019/8/e13477/", url="https://doi.org/10.2196/13477", url="http://www.ncbi.nlm.nih.gov/pubmed/31469082" }