Abstract:
BACKGROUND:The prevalence of chronic diseases such as type 2 diabetes and chronic low back pain is rising. Patient empowerment is a key strategy in the management of chronic diseases. Patient empowerment can be fostered by Web-based interactive health communication applications (IHCAs) that combine health information with decision support, social support, and/or behavioral change support. Tailoring the content and tone of IHCAs to the needs of individual patients might improve their effectiveness. OBJECTIVE:The main objective was to test the effectiveness of a Web-based, tailored, fully automated IHCA for patients with type 2 diabetes or chronic low back pain against a standard website with identical content without tailoring (control condition) on patients' knowledge and empowerment. METHODS:We performed a blinded randomized trial with a parallel design. In the intervention group, the content was delivered in dialogue form, tailored to relevant patient characteristics. In the control group, the sections of the text were presented in a content tree without any tailoring. Participants were recruited online and offline and were blinded to their group assignments. Measurements were taken at baseline (t0), directly after the first visit (t1), and at 3-month follow-up (t2). The primary hypothesis was that the tailored IHCA would have larger effects on knowledge and patient empowerment (primary outcomes) than the control website. The secondary outcomes were decisional conflict and preparation for decision making. All measurements were conducted by online self-report questionnaires. Intention-to-treat (ITT) and available cases (AC) analyses were performed for all outcomes. RESULTS:A total of 561 users agreed to participate in the study. Of these, 179 (31.9%) had type 2 diabetes and 382 (68.1%) had chronic low back pain. Usage was significantly higher in the tailored system (mean 51.2 minutes) than in the control system (mean 37.6 minutes; P<.001). Three months after system use, 52.4% of the sample was retained. There was no significant intervention effect in the ITT analysis. In the AC analysis, participants using the tailored system displayed significantly more knowledge at t1 (P=.02) and more emotional well-being (subscale of empowerment) at t2 (P=.009). The estimated mean difference between the groups was 3.9 (95% CI 0.5-7.3) points for knowledge and 25.4 (95% CI 6.3-44.5) points for emotional well-being on a 0-100 points scale. CONCLUSIONS:The primary analysis did not support the study hypothesis. However, content tailoring and interactivity may increase knowledge and reduce health-related negative effects in persons who use IHCAs. There were no main effects of the intervention on other dimensions of patient empowerment or decision-related outcomes. This might be due to our tailored IHCA being, at its core, an educational intervention offering health information in a personalized, empathic fashion that merely additionally provides decision support. Tailoring and interactivity may not make a difference with regard to these outcomes. TRIAL REGISTRATION:International Clinical Trials Registry: DRKS00003322; http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00003322 (Archived by WebCite at http://www.webcitation.org/6WPO0lJwE).
journal_name
J Med Internet Resjournal_title
Journal of medical Internet researchauthors
Weymann N,Dirmaier J,von Wolff A,Kriston L,Härter Mdoi
10.2196/jmir.3904subject
Has Abstractpub_date
2015-03-03 00:00:00pages
e53issue
3eissn
1439-4456issn
1438-8871pii
v17i3e53journal_volume
17pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Health behavior interventions using periodic prompts have utilized technology, such as the Internet, that allows messages to be sent to participants in cost-effective ways. To our knowledge, no comprehensive evidence review has been performed specifically to evaluate the effectiveness of communicating regula...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
doi:10.2196/jmir.1138
更新日期:2009-05-14 00:00:00
abstract:BACKGROUND:Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention ("ikherstel" intervention or "I recover" intervention) was developed to empower gyn...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.9938
更新日期:2019-02-06 00:00:00
abstract:BACKGROUND:Digital health is poised to transform health care and redefine personalized health. As Internet and mobile phone usage increases, as technology develops new ways to collect data, and as clinical guidelines change, all areas of medicine face new challenges and opportunities. Inflammatory bowel disease (IBD) i...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2019-08-19 00:00:00
abstract:BACKGROUND:Digital health has become an advancing phenomenon in the health care systems of modern societies. Over the past two decades, various digital health options, technologies, and innovations have been introduced; many of them are still being investigated and evaluated by researchers all around the globe. However...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2019-12-19 00:00:00
abstract:BACKGROUND:Most smokers attempt to quit on their own even though cessation aids can substantially increase their chances of success. Millions of smokers seek cessation advice on the Internet, so using it to promote cessation products and services is one strategy for increasing demand for treatments. Little is known, ho...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2011-08-26 00:00:00
abstract:BACKGROUND:Health care systems increasingly rely on patients' data entry efforts to organize and assist in care delivery through health information exchange. OBJECTIVES:We sought to determine (1) the variation in burden imposed on parents by data entry efforts across paper-based and computer-based environments, and (2...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
doi:10.2196/jmir.1612
更新日期:2011-01-26 00:00:00
abstract:BACKGROUND:Exposure to risk behavior on social media is associated with risk behavior tendencies among adolescents, but research on the mechanisms underlying the effects of social media exposure is sparse. OBJECTIVE:This study aimed to investigate the motivations of social media use and the mediating and moderating me...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2019-06-27 00:00:00
abstract::A growing number of investigators have commented on the lack of models to inform the design of behavioral intervention technologies (BITs). BITs, which include a subset of mHealth and eHealth interventions, employ a broad range of technologies, such as mobile phones, the Web, and sensors, to support users in changing ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2014-06-05 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2020-05-13 00:00:00
abstract:BACKGROUND:eHealth is widely used as a tool for improving health care delivery and information. However, distinct policies and strategies are required for its proper implementation and integration at national and international levels. OBJECTIVE:To determine the scope of policy issues faced by individuals, institutions...
journal_title:Journal of medical Internet research
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更新日期:2012-02-17 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2017-02-13 00:00:00
abstract:BACKGROUND:Digital tools provide a unique opportunity to increase access to eye care. We developed a Web-based test that measures visual acuity and both spherical and cylindrical refractive errors. This test is Conformité Européenne marked and available on the Easee website. The purpose of this study was to compare the...
journal_title:Journal of medical Internet research
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更新日期:2019-11-08 00:00:00
abstract:BACKGROUND:Statistical shape models are widely used in biomedical research. They are routinely implemented for automatic image segmentation or object identification in medical images. In these fields, however, the acquisition of the large training datasets, required to develop these models, is usually a time-consuming ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2013-11-12 00:00:00
abstract:BACKGROUND:Internet-based health resources can support informal caregivers who are caring for children or adolescents with health care needs. However, few studies discriminate informal caregivers' needs from those of their care recipients or those of people caring for adults. OBJECTIVE:This study reviews the literatur...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2016-03-03 00:00:00
abstract:BACKGROUND:A clinical algorithm (Algo) in paper form is used in Quebec, Canada, to allow health care workers other than occupational therapists (OTs) to make bathroom adaptation recommendations for older adults. An integrated knowledge transfer process around Algo suggested an electronic version of this decision suppor...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
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更新日期:2020-08-10 00:00:00
abstract:BACKGROUND:Mobile phone use and the adoption of healthy lifestyle software apps ("health apps") are rapidly proliferating. There is limited information on the users of health apps in terms of their social demographic and health characteristics, intentions to change, and actual health behaviors. OBJECTIVE:The objective...
journal_title:Journal of medical Internet research
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更新日期:2017-04-19 00:00:00
abstract:BACKGROUND:Pollen forecasts are highly valuable for allergen avoidance and thus raising the quality of life of persons concerned by pollen allergies. They are considered as valuable free services for the public. Careful scientific evaluation of pollen forecasts in terms of accurateness and reliability has not been avai...
journal_title:Journal of medical Internet research
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更新日期:2017-05-08 00:00:00
abstract:BACKGROUND:For the last decade, mHealth has constantly expanded as a part of eHealth. Mobile applications for health have the potential to target heterogeneous audiences and address specific needs in different situations, with diverse outcomes, and to complement highly developed health care technologies. The market is ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2013-05-21 00:00:00
abstract:BACKGROUND:Prevention of depression is important due to the substantial burden of disease associated with it. To this end, we developed a novel, brief, and low-threshold Web-based self-help approach for depressive complaints called complaint-directed mini-interventions (CDMIs). These CDMIs focus on highly prevalent com...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
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更新日期:2017-01-04 00:00:00
abstract:BACKGROUND:Patients who suffer from different diseases may use different electronic health (eHealth) resources. Thus, those who plan eHealth interventions should take into account which eHealth resources are used most frequently by patients that suffer from different diseases. OBJECTIVE:The aim of this study was to un...
journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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更新日期:2019-08-29 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2019-04-01 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2017-11-06 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2012-11-14 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2018-06-26 00:00:00
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journal_title:Journal of medical Internet research
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更新日期:2009-08-26 00:00:00
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