Health Self-management Research Articles

The relationship between hope level and self-management behaviors in Chinese patients with type 2 diabetes mellitus: a chain-mediated role of social support and disease perception

BackgroundType 2 diabetes mellitus is a chronic disease and one of the fastest- growing global health emergencies of the 21st century. The relationships between hope level, social support, disease perception, and self-management behaviors are still unclear. Therefore, this study aimed to create a structural equation model to investigate the underlying mechanisms of self-management behaviors in patients with type 2 diabetes mellitus and provide a theoretical basis for future interventions.MethodsBy using cross-sectional studies and convenience sampling methods. A survey was conducted from June 2023 to April 2024 on 404 patients with type 2 diabetes mellitus at the First and Third Hospitals of Jinzhou Medical University. Data were collected using scales, including the General Information Questionnaire, the Herth Hope Scale, the Social Support Rating Scale, the Brief Disease Perception Questionnaire, and the Diabetes Self-Management Behavior Scale. Data were analyzed using descriptive analysis, Harman’s one-way analysis of variance, Pearson’s correlation test, structural equation modeling, and the bootstrap method to verify mediating effects.ResultsCorrelation analyses showed that all four variables were significantly correlated with each other (p < 0.01). Social support had the strongest correlation with self-management behavior (β = 0.554, p < 0.01), followed by hope level (β = 0.543, p < 0.01), and disease perception (β = -0.505, p < 0.01). The structural equation model indicated a strong overall fit (χ2/df = 3.378, GFI = 0.926, CFI = 0.924, IFI = 0.925, TLI = 0.903, RMSEA = 0.077).ConclusionOverall, the chain mediation of social support and disease perception was significant. In developing targeted intervention strategies, future research should prioritize enhancing hope, optimizing social support, and reducing negative perceptions of disease by patients as key areas of focus. At the same time, strengthening self-management abilities and health behaviors in patients with type 2 diabetes should not be neglected.

Promoting Resilience in Stress Management for Adolescents With Type 1 Diabetes

Type 1 diabetes (T1D) requires demanding self-management health behaviors, and adolescents with T1D are at risk for poor psychosocial and medical outcomes. Developing resilience skills may help adolescents with T1D and elevated distress navigate common stressors and achieve positive outcomes. To test the efficacy of the Promoting Resilience in Stress Management (PRISM) intervention on levels of hemoglobin A1c (HbA1c), diabetes distress, self-management behaviors, resilience, and quality of life among adolescents. This phase 3, parallel, 1:1 randomized clinical trial that followed up 172 participants for 12 months was conducted from January 1, 2020, to November 30, 2022, at each of 2 children's hospitals, in Seattle, Washington, and Houston, Texas. Participants were ages 13 to 18 years with T1D for at least 12 months and elevated diabetes distress. PRISM, a manualized, skills-based, individual intervention program that teaches stress management, goal setting, reframing, and meaning-making, facilitated by a coach and accompanied by a digital app, was delivered in three 30- to 60-minute sessions approximately 2 weeks apart. The 2 primary outcomes, diabetes distress and HbA1c levels, and 3 secondary outcomes, resilience, quality of life, and engagement in self-management behaviors, were assessed at baseline and 6 and 12 months after baseline. Linear mixed-effects regression models were used to evaluate associations between PRISM or usual care (UC) and these outcomes at both time points for the intention-to-treat population. Among 172 adolescents (mean [SD] age, 15.7 [1.6] years), 96 were female (56%), and their baseline mean (SD) HbA1c level was 8.7% (2.0%). No differences were evident between PRISM and UC recipients in HbA1c levels (β, -0.21 [95% CI, -0.65 to 0.22]; P = .33) or diabetes distress (β, -2.71 [95% CI, -6.31 to 0.90]; P = .14) or any participant-reported outcome (eg, β, 2.25 [95% CI, -0.30 to 4.80]; P = .08 for self-management behaviors) at 6 months. At 12 months, there was no statistically significant difference between arms in HbA1c levels (β, -0.26 [95% CI, -0.72 to 0.19]; P = .25); however, PRISM recipients reported significantly greater amelioration of diabetes distress (β, -4.59 [95% CI, -8.25 to -0.94]; P = .01) and improvement in self-management behaviors (β, 3.4 [95% CI, 0.9 to 5.9]; P = .01) compared with UC recipients. The findings in this randomized clinical trial of psychosocial and behavioral improvements associated with PRISM at 12 months illustrate the value of a strengths-based intervention. Integrating resilience skills-building with traditional diabetes care may be a promising approach for improving outcomes among adolescents with T1D and elevated diabetes distress. ClinicalTrials.gov number: NCT03847194.

A Qualitative Study of Aboriginal Peoples' Health Care Experiences With Chronic Obstructive Pulmonary Disease.

Aboriginal Australians experience a high prevalence of chronic obstructive pulmonary disease (COPD), with high rates of potentially preventable hospitalisations. However, little is known about Aboriginal peoples' experiences of living with COPD and how they navigate health care systems. This study used thematic analysis and Aboriginal methodology to explore Aboriginal peoples' lived experiences of COPD, their health care journey from receiving a diagnosis of COPD to the clinical management, and the impact of COPD on their daily lives. We conducted in-depth semi-structured interviews over a 6-month period with 18 Aboriginal adults diagnosed with COPD from four Aboriginal Community Controlled Health Services (ACCHS) in New South Wales, Australia. Reflexive thematic analysis was employed to ensure rigour. The findings revealed deeply personal and reflective stories shaped by historical, social, and cultural realities of Aboriginal peoples living with COPD. Four themes were identified characterising their experiences. Based on the findings, the following guidance is provided on future COPD care for Aboriginal peoples: Better alignment of existing COPD management with Aboriginal peoples' cultural contexts and perspectives to improve access to culturally safe care; Increased funding for ACCHS to enhance COPD management, such as early detection through case finding and access to ACCHS-led pulmonary rehabilitation; Engaging family members in COPD management and providing culturally centred COPD education that facilitates discussions and builds health literacy and self-management skills; Implementing health promotion initiatives to increase awareness and counteract fear and shame to improve early COPD detection.

Using an Empathetic Approach to Explore Technology Readiness and Needs for Digital Services to Assist People with Dementia.

This qualitative study investigates technology readiness, i.e., self-management, social support, and digital health literacy, in people with dementia (PwD). PwD are difficult to recruit; therefore, we used an empathic approach to recruit and conduct interviews. The interviews with seven participants with dementia and two informal caregivers, guided by the READHY framework, reveal nuanced insights into their experiences. Participants demonstrate varying degrees of self-management, with informal caregivers playing pivotal roles in facilitating activities and supporting overall well-being. Cognitive challenges, such as concentration and communication difficulties, are prevalent, highlighting the importance of robust support systems. Internal and external support networks significantly influence social integration, yet societal misconceptions impede inclusion, exacerbating feelings of isolation for both participants and caregivers. Limited interaction with technology is observed, primarily reliant on caregivers for assistance. Technology may hold potential for enhancing independence and alleviating caregiver burden. As an empathetic approach eased recruitment and communication with PwD, we recommend using this approach for future studies to include participants who otherwise would not be recruited. Given that the number of participants in this study is limited to only seven PwD with moderate to severe cognitive impairment, further investigation using mixed methods, including the READHY framework, and a larger number of participants is needed to examine the generalizability of the findings.

An OT Health Self-Management Program for Cancer Survivors Improves Health Behavior Occupational Performance Scores: A Pilot Study

Abstract Date Presented 03/22/24 Cancer survivors (n = 7) completed a 12-week occupation-based health self-management program. Postintervention, participants showed clinically significant improvements in occupational performance per the Canadian Occupational Performance Measure. Primary Author and Speaker: Alix G. Sleight Additional Authors and Speakers: Alexandra E. Feldman Contributing Authors: Pamela S. Roberts, Kathleen Lyons, LJ Amaral

Comparisons of Medication Adherence in Adult Stroke &amp; Hypertension: Implications for Applying the Health Self-Management Evidence in Disability

Abstract Date Presented 03/22/24 We explore the similarities and differences of people with stroke and hypertension in medication management. Findings are used to better guide the translation of the chronic disease self-management evidence for use with people with disabilities. Primary Author and Speaker: Jaclyn K. Schwartz Additional Authors and Speakers: Katherine Aylmer, Sami Tayeb, Samy Hamdan

HUBUNGAN TUGAS KESEHATAN KELUARGA DENGAN MANAJEMEN DIRI KLIEN HIPERTENSI DI PUSKESMAS SILO 1 KABUPATEN JEMBER

The role of the family is very important in carrying out family health duties for family members who carry out hypertension self-management. Apart from the family, the role of health workers is to carry out strategies for pharmacological and non-pharmacological treatment. The Health Promotion model is a non-pharmacological strategy that must be implemented by health workers. This research is to determine the relationship between family health tasks and self-management of hypertensive clients at the Silo 1 Health Center, Jember Regency. This research design uses a correlational cross sectional approach, the population is 454 hypertensive clients, the size used is 213 hypertensive clients, the sampling technique uses simple random sampling, data analysis uses the Spearman Rank test. Tested using the family health task questionnaire and HSMBQ. Based on the research results, most of the family health tasks were in the quite good category, numbering 159 people (74.7%) while hypertensive clients who had quite good self-management were 172 respondents (80%). Analysis of the relationship between family health tasks and self-management resulted in a p value = 0.012 with r = 0.172 so that H0 was rejected, which means there is a significant relationship between family health tasks and self-management of hypertensive clients. The results of this study can be a basis for health workers, especially those who focus on hypertension health problems, to make efforts to improve health promotion.

AI Hesitancy and Acceptability-Perceptions of AI Chatbots for Chronic Health Management and Long COVID Support: Survey Study.

Artificial intelligence (AI) chatbots have the potential to assist individuals with chronic health conditions by providing tailored information, monitoring symptoms, and offering mental health support. Despite their potential benefits, research on public attitudes toward health care chatbots is still limited. To effectively support individuals with long-term health conditions like long COVID (or post-COVID-19 condition), it is crucial to understand their perspectives and preferences regarding the use of AI chatbots. This study has two main objectives: (1) provide insights into AI chatbot acceptance among people with chronic health conditions, particularly adults older than 55 years and (2) explore the perceptions of using AI chatbots for health self-management and long COVID support. A web-based survey study was conducted between January and March 2023, specifically targeting individuals with diabetes and other chronic conditions. This particular population was chosen due to their potential awareness and ability to self-manage their condition. The survey aimed to capture data at multiple intervals, taking into consideration the public launch of ChatGPT, which could have potentially impacted public opinions during the project timeline. The survey received 1310 clicks and garnered 900 responses, resulting in a total of 888 usable data points. Although past experience with chatbots (P<.001, 95% CI .110-.302) and online information seeking (P<.001, 95% CI .039-.084) are strong indicators of respondents' future adoption of health chatbots, they are in general skeptical or unsure about the use of AI chatbots for health care purposes. Less than one-third of the respondents (n=203, 30.1%) indicated that they were likely to use a health chatbot in the next 12 months if available. Most were uncertain about a chatbot's capability to provide accurate medical advice. However, people seemed more receptive to using voice-based chatbots for mental well-being, health data collection, and analysis. Half of the respondents with long COVID showed interest in using emotionally intelligent chatbots. AI hesitancy is not uniform across all health domains and user groups. Despite persistent AI hesitancy, there are promising opportunities for chatbots to offer support for chronic conditions in areas of lifestyle enhancement and mental well-being, potentially through voice-based user interfaces.

User Engagement in an Online Digital Health Intervention to Promote Problem Solving

Abstract Digital health interventions (DHIs) can facilitate positive health outcomes. User engagement (UE) plays an important role in DHI efficacy. Yet, DHIs vary in functionality, design and intended outcomes, underscoring the importance of incremental, user-centred design to understand engagement in specific settings. This study explores the relationship between user engagement and DHI implementation in three design iterations, or rounds, of a unique, multi-week asynchronous intervention that leverages online discussion and problem-solving therapy (PST). The intervention seeks to engage older adults to improve problem solving skills relating to the intervention focus, health aging (two rounds) and Lewy Body Dementias (LBD) caregiving (one round). The PST component drew upon personas, a common user-centered design method, in a novel way. Exit interviews were conducted at the end of each round to understand participants' experiences. Using thematic analysis, we identified factors that contributed to social engagement (‘engaging with others’) and learning engagement (‘engaging with content’) with the DHI. The findings demonstrate how iterative changes in the design and delivery of a DHI can contribute to user engagement, increasing the likelihood of knowledge acquisition and developing problem-solving skills as part of health self-management.

A protocol for a multidisciplinary early intervention during chemotherapy to improve dietary management behavior in breast cancer patients: a two-arm, single-center randomized controlled trial

BackgroundAdverse reactions are prone to occur in the early stage of chemotherapy and can negatively affect the dietary intake and nutritional status of breast cancer (BC) patients. Consequently, they need to participate in health self-management and lifestyle promotion programs. Early multidisciplinary interventions aim to enhance dietary management behavior and quality of life in chemotherapy-treated BC patients.MethodsThis single-blinded, single-center, randomized controlled trial will include 88 females who have not yet started the early or middle stage of the chemotherapy cycle. A random number table will be used randomly assign females to the intervention group or usual group at a 1:1 ratio. The intervention elements are based on the theoretical guidance of the Integrated Theory of Health Behavior Change (ITHBC). A multidisciplinary team (MDT) comprising oncologists, dietitians, nurses, traditional Chinese medicine (TCM) practitioners, and psychologists will provide the intervention. Intervention sessions will be conducted once a week for 8 weeks, beginning in the early or middle stage of the chemotherapy cycle and continuing through admission and a home-based interval chemotherapy period. The intervention includes face-to-face discussions, online meetings, WeChat messaging, and telephone calls. The themes target adverse reactions, dietary information and habits, self-care self-efficacy, treatment self-regulation, dietary supplement and TCM use, social support, weight management, and outcome expectations. The primary outcome is dietary management behavior measured by the Dietary Management Behavior Questionnaire (DMBQ). Secondary outcomes are self-care self-efficacy assessed by the Strategies Used by People to Promote Health (SUPPH); quality of life measured by the Functional Assessment of Cancer Therapy-Breast (FACT-B); and body mass index (BMI) measured by an electronic meter. All participants will be assessed at baseline and immediately, 1 month, 3 months, 6 months, and 12 months after the intervention.DiscussionEarly dietary intervention is needed, as diet is one of the most common health self-management behaviors influenced by chemotherapy. Early multidisciplinary interventions may provide a foundation for dietary self-management and improve nutritional status in the survival period.Trial registrationThis intervention protocol was registered with the Chinese Clinical Trials Registry (ChiCTR2300076503, October 10, 2023).

Cultural and Contextual Adaptation of Digital Health Interventions: Narrative Review.

Emerging evidence suggests that positive impacts can be generated when digital health interventions are designed to be responsive to the cultural and socioeconomic context of their intended audiences. This narrative review aims to synthesize the literature about the cultural adaptation of digital health interventions. It examines how concepts of culture and context feature in design and development processes, including the methods, models, and content of these interventions, with the aim of helping researchers to make informed decisions about how to approach cultural adaptation in digital health. Literature searches for this narrative review were conducted across 4 databases. Following full-text article screening by 2 authors, 16 studies of interventions predominantly focused on the self-management of health were selected based on their detailed focus on the process of cultural adaptation. Key considerations for cultural adaptation were identified and synthesized through a qualitative narrative approach, enabling an integrative and in-depth understanding of cultural adaptation. The literature demonstrates varying approaches and levels of cultural adaptation across stages of intervention development, involving considerations such as the research ethos orienting researchers, the methodologies and models used, and the resultant content adaptations. In relation to the latter, culturally appropriate and accessible user interface design and translation can be seen as particularly important in shaping the level of adaptation. Optimizing cultural adaptation involves linking culture with other contextual factors such as economic conditions and social systems to ensure accessibility and the sustained use of digital health interventions. Culturally humble approaches that use the involvement of a broad range of participants, experts, and other stakeholders are demonstrated to spark vital insights for content development, implementation, and evaluation.

Assessment of electronic health literacy and its association with self-management among gout patients: A cross-sectional study.

This study aimed to assess electronic health (eHealth) literacy and self-management ability among gout patients in China and analyze their correlation. A cross-sectional study was conducted on 168 male gout patients (mean age: 44.5±13.8 years, range, 22 to 76 years) using a gout patient self-management assessment scale and the Chinese version of eHealth Literacy Scale between August 2020 and February 2021. The correlation between eHealth literacy and gout self-management was examined. Multivariate regression analysis was conducted to identify the predictors of gout patients' self-management ability. The scores of eHealth literacy and self-management were 28.56±1.72 and 3.59±0.78, respectively, which were both in the medium level, with the lowest score in the lifestyle management dimension. Pearson's correlation analysis showed that eHealth literacy was significantly and positively associated with the total score of gout self-management and its four dimensions. Literacy in eHealth (β=0.399, p<0.001, 95% confidence interval [CI]: 0.023-0.069), living with family members (β=0.336, p=0.001, 95% CI: 0.313-1.234), living in an urban area (β=0.312, p=0.005, 95% CI: 0.191- 1.022), and having college or a higher level of education (β=0.268, p=0.016, 95% CI: 0.032-0.302) were the significant predictors of gout patients' self-management ability, explained 30.6% of the total variance. Literacy in eHealth was the most significant predictor of gout self-management ability. Gout patients had the lowest score in the perceived ability of searching and applying online health-related information, indicating that both the quantity and quality of gout-specific information needs to be enlarged in electronic resources. Healthcare providers could design and implement eHealth literacy interventions to strengthen patients' gout self-management ability.

Development and validation of gestational diabetes mellitus health literacy scale

ObjectiveWhile there are various health literacy scales that exist, none of health literacy scale suitable for pregnant women with gestational diabetes mellitus (GDM). To address this gap, this study aimed to develop GDM health literacy scale and evaluate its psychometric properties. MethodsBased on the Delphi expert consultation, we developed the initial GDM health literacy scale. Item analysis was taken using a sample (n = 299) recruited in China to form formal scale. Additional participants (n = 395) completed survey to assess the internal consistency reliability, test-retest reliability, content validity, construct validity and criterion correlation validity of scale. ResultsThe scale performed well in terms of internal consistency reliability, content validity, construct validity and criterion correlation validity. Test-retest reliability indicated that the instrument was effective at measuring health literacy of GDM over time. ConclusionThe scale is a reliable and valid measure of six domains of health literacy for GDM. Practice implicationsThe scale can be used to effectively evaluate the level of health literacy of pregnant women with GDM. The information can provide targeted health support for pregnant women with GDM to improve their health literacy and self-management ability.

A qualitative study of stakeholders' experiences with and acceptability of a technology-supported health coaching intervention (SHARE-S) delivered in coordination with cancer survivorship care.

Healthy cancer survivorship involves patients' active engagement with preventative health behaviors and follow-up care. While clinicians and patients have typically held dual responsibility for activating these behaviors, transitioning some clinician effort to technology and health coaches may enhance guideline implementation. This paper reports on the acceptability of the Shared Healthcare Actions & Reflections Electronic systems in survivorship (SHARE-S) program, an entirely virtual multicomponent intervention incorporating e-referrals, remotely-delivered health coaching, and automated text messages to enhance patient self-management and promote healthy survivorship. SHARE-S was evaluated in single group hybrid implementation-effectiveness pilot study. Patients were e-referred from the clinical team to health coaches for three health self-management coaching calls and received text messages to enhance coaching. Semi-structured qualitative interviews were conducted with 21 patient participants, 2 referring clinicians, and 2 health coaches to determine intervention acceptability (attitudes, appropriateness, suitability, convenience, and perceived effectiveness) and to identify important elements of the program and potential mechanisms of action to guide future implementation. SHARE-S was described as impactful and convenient. The nondirective, patient-centered health coaching and mindfulness exercises were deemed most acceptable; text messages were less acceptable. Stakeholders suggested increased flexibility in format, frequency, timing, and length of participation, and additional tailored educational materials. Patients reported tangible health behavior changes, improved mood, and increased accountability and self-efficacy. SHARE-S is overall an acceptable and potentially effective intervention that may enhance survivors' self-management and well-being. Alterations to tailored content, timing, and dose should be tested to determine impact on acceptability and outcomes.

Experiences of women with gestational diabetes in using social media for self-care: A qualitative study in Northern Vietnam

Aims: The present study aimed to explore the use and experience of social media to improve self-managed health care of women with GDM in Northern Vietnam. Materials and methods: A qualitative study was carried out among 21 pregnant women with GDM aged between 20 and 47 years in Thai Binh province, Northern Vietnam. We conducted in- depth open-ended interviews from April to May 2023. Data were simultaneously analyzed as they were being collected, using the content analysis approach. Results: Five types of social media support were used by women with GDM in self-care includ- ing Facebook, TikTok, Zalo, Google searches, and mobile health apps. These social media were used by the pregnant women with GDM to search for information, to receive advice, or to share knowledge about diet, exercise, and control blood sugar. Conclusions: This study found that women with GDM were eager users of social media, relying strongly on social media information for pregnancy self-care. This points to the need for access to high-quality social media-based information about GDM among women in northern Vietnam.

Nursing interventions to promote healthy lifestyles in older adults with high blood pressure

This study sought to describe and summarize the effects of nursing interventions for the promotion of healthy lifestyles in the elderly with arterial hypertension. The scope of the use of these interventions makes it possible to appreciate the related problems in neurological, cardiovascular, and renal complications. The current situation is a problem without achieving criteria, which need to be clarified through systematic reviews with livelihoods. For this review, a bibliographic search was carried out using an electronic database manager that includes searches at: Scopus, Wiley Online Library, Magiran, Sid, Cochran, Embase, Pubmed (Medline), Web of Science, Embase, Ovid, Cinahl, and Google Scholar, according to the Prism guidelines. The result has been 47 articles with temporary relevance between 2019 and March 2024. As a search criteria, keywords were used: (I) nursing intervention; (II) healthy lifestyles; (III) older adults; (IV) arterial hypertension. The systematic analysis highlights that age, gender, ethnicity, and family history have been associated with the factors that cause arterial hypertension. In conclusion, four clinical factors have been determined that must influence the adoption of healthy lifestyles in older adults with arterial hypertension. These factors tend to impact their consciousness of the disease: the need to control blood pressure, the management of related diseases, and the prevention of complications. It can be intervened with patient education protocols, drug administration with the respective physical care and care in older adults with arterial hypertension, individually and in groups, in order to promote self-management in your health for modification in lifestyles, helping to avoid or reduce high blood pressure.

Repertoires of action and collective memory: the re-emergence of feminist self-managed health centers in Italy

ABSTRACT This article analyzes the relationship between repertoires of action and collective memory by exploring the re-emergence of feminist self-managed health centers in Italy. These were a key form of action of 1970s feminism in the country, which rapidly disappeared after the institution of state-based Family Health Centers. In the last decades, feminist and transfeminist self-managed health centers have resurfaced in several Italian cities. The present article investigates the mnemonic dynamics underpinning the re-adoption of a form of action from the past in subsequent cycles of mobilization. Social movement scholars have stressed the relatively stable and repetitive character of the repertoire of collective action over time, considering it as part of an implicit memory. The article examines a case in which the discontinuous adoption of a form of action makes its retrieval by subsequent activists the result of active memory work. While the study of social movements and collective memory has grown considerably in the last decades, the study of repertoires remains largely under-researched in this field. Filling this gap, this study shows how, by adopting a symbolically and historically meaningful repertoire, activists re-elaborate their collective identity in the present and establish a relationship with previous cycles. It suggests that further research should investigate the relationship between collective memory and repertoires of action.

Effective provider communication for personal agency in mental health recovery: A cross-sectional study on Japanese users' perspectives.

INTRODUCTION: Recovery-oriented practice in community-based mental health services is crucial for individuals with mental illness, with communication with familiar individuals being important for recovery in Japanese and Asian cultures. This study aimed to examine effective communication factors for personal agency in recovery by investigating the association between perceived support provided through communication and personal agency of individuals with mental illness. A cross-sectional study was conducted among community-dwelling Japanese mental health service users, assessing subjective agency, decisional conflict, staff support for personal recovery, activation for mental health self-management, demographic variables and living difficulties. Multiple linear regression analysis identified factors predicting subjective agency, revealing characteristics of effective provider communication for recovery. Data from 222 users were analysed, revealing negative correlations between uncertainty about treatment choices and ineffective decision-making with higher subjective agency, while staff support for personal recovery positively correlated with higher subjective agency. In recovery-oriented practice, prioritizing users' emotional experiences during decision-making and supporting their self-determination in their unique recovery journeys is crucial. Providers should approach dialogue as carefully as medication prescriptions, prioritizing therapeutic partnerships with users. The findings extend beyond nursing to all mental health service providers, advancing the theory of recovery-oriented practice.

PCR104 The Self-Management Activities, Health Literacy and Health-Related Quality of Life of Patients with Type 2 Diabetes: A Structural Equation Modelling in Vietnam

PCR104 The Self-Management Activities, Health Literacy and Health-Related Quality of Life of Patients with Type 2 Diabetes: A Structural Equation Modelling in Vietnam

Understanding older adults’ motivations to use digital health portals

ObjectiveTo understand how older adults perceive digital health portals (DHPs), what motivates them to use them, and how their experience can be improved. BackgroundThe number of people over age 60 will continue to increase over the following decades. Many older adults have chronic health conditions such as high blood pressure or diabetes. Digital health technology, specifically DHPs, could be helpful in wellness management, healthcare provider communication, and health record management. MethodWe interviewed 26 older adults aged 60–85 who logged into their DHP at least twice a year to learn more about their usage and motivations to adopt DHPs. We integrated the Self Determination Theory (SDT) and the Unified Theory of Acceptance of Use of Technology (UTAUT) model to assess factors that were intrinsic motivators and what facilitated the use of DHPs. We coded the transcribed data into these categories to evaluate the factors that were reportedly important to the older adults’ use of their health portal. ResultsAll the older adults shared that they were willing to communicate with their healthcare provider, and 25 of the 26 reported that their DHP supported their healthcare needs. The older adults were primarily influenced by family members or healthcare providers to support their wellness. Our integration of the SDT theory and UTAUT model provides insights into motivational factors that guide use of DHPs. ConclusionSocial support from friends and family supported general usage and provided additional guidance for DHP features. The findings of this study provide recommendations on how to redesign navigation within future health portals, how older adults are encouraged to use their DHP, and how they are provided support when using their DHP. PrécisHow do we help older adults with health self-management? Digital health portals, including features such as electronic health records and clinician communication have potential but are underutilized. Understanding motivational influences can guide design and support for digital health portals.