TY - JOUR AU - Costello, Ruth E AU - Anand, Amrutha AU - Jameson Evans, Matt AU - Dixon, William G PY - 2019 DA - 2019/08/29 TI -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联:基于web的纵向调查JO - J Med Internet Res SP - e13477 VL - 21 IS - 8kw -自我管理KW -慢性疾病KW -健康信息交换KW -数字健康KW -对等支持KW -点对点支持KW -在线支持团体KW -互联网AB -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。方法:对HealthUnlocked (HU)上活跃的新OHC用户进行了调查，以测量人口统计数据、患者激活水平(描述一个人对管理自己健康的信心;0-100量表(4类)，医疗保健利用和健康状况，使用基于网络的调查，基线和3个月。比较了患者在基线和3个月时的激活情况(目标1)。此外，对于HU用户和调查应答者的样本，还自动捕获了每日OHC网站使用数据。这用于确定参与HU的群体(目标2)。对于调查应答者，基线特征、患者激活、医疗保健利用和健康状况在基线和3个月进行了总体比较，并在参与群体之间使用t检验和卡方检验(目标3和4)。结果:在完成两项调查的329人中，基线激活最常见的是3级，描述为采取行动但仍缺乏信心。在随访中，观察到2.6分的变化，其中基线激活水平最低的患者变化最大。此外，还确定了4组参与度:低、中、高和非常高，他们在HU上的活跃时间平均分别为4、12、29和59天。 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. SN - 1438-8871 UR - //www.mybigtv.com/2019/8/e13477/ UR - https://doi.org/10.2196/13477 UR - http://www.ncbi.nlm.nih.gov/pubmed/31469082 DO - 10.2196/13477 ID - info:doi/10.2196/13477 ER -