The Acceptance and Use of the e-Health Instrument \u2018The Personal Health Check\u2019 in Four Dutch Municipalities: Lessons Learned

M Rombouts,T J M Kuunders,L G M Raaijmakers,H Van Donkersgoed,R Van Steijn-Martens,L A M Van De Goor,T De Vuijst

doi:10.1007/s10935-021-00651-2

Abstract

This pilot study assessed the acceptance and use of the e-Health instrument “the Personal Health Check” (PHC) among clients and professionals in primary care settings. By filling in the online PHC instrument, participants were provided insights into their health and lifestyle. When results revealed an increased health risk, participants were advised to undertake additional lab tests measuring blood pressure and haemaglobin levels. Based on the online questionnaire and optional lab tests, participants then received a report that included individually-tailored feedback from the e-Health application about personal health risks and suggestions for health interventions. The PHC was implemented in 2016 in four Dutch municipalities that determined which neighbourhood(s) the PHC targeted and how participants were invited. The Unified Theory of Acceptance and Use of Technology was used as a theoretical framework to address our research questions. Methods used to assess acceptance were: PHC instrument data, data from additional questionnaires completed by PHC participants, focus groups with PHC participants and professionals in primary care, and telephone interviews with non-responders to the invitation to participate in the online PHC. Of the 21,735 invited, 12% participated. Our results showed that participants and professionals in this pilot were predominantly positive about the PHC. Participants reported that they made an effort to apply the PHC lifestyle advice they received. Almost all had the knowledge and resources needed to use the PHC online instrument. Invitations from general practitioners almost doubled participation relative to invitations from the sponsoring municipalities. The overall low response rate, however, suggests that the PHC is unsuitable as a foundation on which to develop local public health policy.

Highlights

An ageing population, lifestyle impairments, and an increasing number of patients with multiple morbidities are considered to constitute major social and economic challenges (Cassell et al, 2018; Reeves et al, 2018)
About a quarter of the participants said they critically evaluated the advice provided in their personal health report
Only a few new patients were diagnosed with chronic conditions, and the Personal Health Check” (PHC) did not lead to an increased workload through an increase in patients visiting general practitioners with questions or concerns

Summary

Introduction

Lifestyle impairments, and an increasing number of patients with multiple morbidities are considered to constitute major social and economic challenges (Cassell et al, 2018; Reeves et al, 2018). Chronic diseases, including heart disease, stroke, cancer, diabetes, and chronic lung disease, are collectively responsible for 71% of all deaths worldwide and impose the greatest burden on global health (World Health Organization, 2018). Research has shown that health care costs for chronic diseases in the Netherlands doubled between 2011 and 2016 (Nibud, 2016). According to the World Health Organization (2018), these chronic diseases would be mitigated by reducing four modifiable risk factors, namely smoking, excess weight, physical inactivity, and unhealthy diets. In 2017, 23% of the Dutch adult population 18 years and older smoked and 17% smoked daily (Rijksinstituut voor Volksgezondheid en Milieu, 2021). In 2017 only 47% of Dutch adults met national physical activity guidelines. With regard to fruit and vegetable intake, 30% and 18% of adults, respectively, met established guidelines (Rijksinstituut voor Volksgezondheid en Milieu, 2021)

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Results

Conclusion