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Radvan D, Wiggers J,
Hazell T. HEALTH C.H.I.P.S.: opportunistic community
use of computerized health information programs. Health
Education Research 2004;19:581-90. [Overview, Access]
1: 386 people age 18-83, mean age 42.9; 70.2% female. Study
2: 55.3% male, age range of users from <12 to >60
with the greatest proportion (31.4%) of users children
under age 12
information: community-based touch screen computer in free-standing
CHIPS (Computerized Health Information Programs): health
education modules (smoking, blood pressure, cervical cancer)
available on a touch-screen computer kiosk. Modules include
information, personal risk assessment with tailored feedback,
and quizzes. Modules also include text, photos, diagrams,
animations, sound, and video.
Intercept: a kiosk loaded with three modules (blood pressure,
cervical cancer, and smoking) was in a shopping center
for 7 months. Then, trained interviewers approached subjects
every 15 minutes for intercept-interviews. Utilization
study: kiosks established at 17 venues over 12 months with
17 modules on many health topics. Program database collected
Intercept: exposure, attention, and use; usefulness and
information; barriers to use 2. Utilization
Intercept: a total of 99.7% of participants were in the
vicinity of the kiosk (exposure); 77.4% of these noticed
it, and 20.8% of these used it. Program acceptability was
high. Most common barriers to use were time constraints,
disinterest, kiosk already in use, not comfortable using
kiosk in public. 2. Utilization: there were 57,064 uses
in 2,943 days (19.4 uses per kiosk per day). Most used
the following topics: sexual health, smoking, and drunk
driving. Most often submodules used were quizzes and self-assessments.
Also had a comparison of use across different community
Reeves, PM. Coping
in cyberspace: the impact of Internet use on the ability
of HIV-positive individuals to deal with their illness.
Journal of Health Communication 2000;5(Suppl):47-59.
adults with HIV; 60% male, 80% Caucasian, all at least
with some college
home computer with Internet
interviews about Internet use and coping
of Internet use, how they use the Internet, and coping
use promotes empowerment, augments social support, and
facilitates helping others.
Rozmovits L, Ziebland
S. What do patients with prostate or breast cancer
want from an Internet site? A qualitative study of information
needs. Patient Education and Counseling 2004;53:57-64.
adults with breast or prostate cancer for focus groups;
8 adults with breast or prostate cancer for individual
home computer with Internet
Web site: presents video, audio, and written clips from
interview studies with people about their experiences of
health and illness. Modules available for breast and prostate
cancer; hypertension; and cancer of the testis, cervix,
and focus groups with members of the target audience
needs, sources of information, review of Web site content
patients have information needs that change over time,
and some information needs are unmet. Sample seems aware
of issues with getting information from the Internet. Interviewees
liked DIPEx site, but site could be improved to provide
other needed information, such as financial help and benefits,
practical advice, non-Internet resources.
Ryan R, Kobb R, Hilsen
P. Making the right connection: matching patients to
technology. Telemedicine Journal and e-Health
2003;9:81-8. [Overview, Access, Acceptability]
veterans with chronic medical or mental health problems
interaction: home with traditional telehealth technology;
Web-based messaging devices; disease management tool; cameras,
PC with Internet for supervised chat rooms
an algorithm to match patients to technology based on education,
vision, manual dexterity, willingness to use technology,
and compliance to medical regimen.
ease of use, self-reported functional status (physical
function, bodily pain, general health, vitality, mental
health, and role function)
satisfied with their primary technology device at 12 months;
93% found the technology easy to understand, 95% easy to
use, 87% device generally reliable; 90% felt the Community
Care Coordination Service program helped educate them about
their chronic disease, 88% helped them manage their health
better; 82% improved communication with providers, 95%
would recommend participation to other veterans. Initial
medication compliance at 63%, increased to over 93% during
the study. Self-reported functional status either improved
or remained unchanged for all but one parameter (physical
Shaw BR, McTavish F,
Hawkins R, Gustafson DH, Pingree S. Experiences of
women with breast cancer: exchanging social support over
the CHESS computer network. Journal of Health Communication
women participating in the Comprehensive Health Enhancement
Support System (CHESS). Mean age 51, all at least high
school educated, one-half college educated
home computer connected to central server
contains 11 tools that provide information, decisionmaking,
and support services.
with breast cancer who used CHESS were interviewed to examine
the experience of giving and receiving support in a computer-mediated
they used CHESS, how do CHESS support groups compare with
other support groups, how could CHESS work better
findings include: equalized participation important; no
social cues to bias. Could not see others’ reactions,
so not discouraged from venting painful feelings. Online
support can compensate when participants do not feel good
about appearance, do not feel well enough to go out. Asynchronous
nature had pros and cons (could use any time, might not
get response in timely manner). Other advantages: do not
have to travel, good for those who are geographically isolated.
In CHESS, groups are size-limited, so people can create
more intimate ties. Even with size limitations, still get
an abundance of messages, membership requires a serious
time commitment. Motivations: CHESS groups provide support
especially when family members do not understand the stresses
of living with breast cancer, may change over time—start
out needing support/information then become a provider
of support/information. Benefits: realizing that others
have similar problems—helps to feel less isolated;
reducing uncertainty; knowing what to expect from noxious
treatments, altruism, and showing caring to others in group
help take focus from preoccupation with self to others;
social comparison (“maybe what you have isn’t
so bad compared to someone else”).
Shaw LH, Gant LM.
In defense of the Internet: the relationship between Internet
communication and depression, loneliness, self-esteem,
and perceived social support. Cyberpsychology and Behavior
support: home computer with Internet
site with chat rooms, requiring login name and password
engaged in five structured chats with an anonymous partner
from the study.
loneliness, social support, self-esteem
on depression and loneliness scales decreased, and scores
on social support and self-esteem scales increased, indicating
positive effects over time.
Tang PC, Black W, Buchanan
J, Young CY, Hooper D, Lane SR. PAMFOnline: integrating
ehealth with an electronic medical record system. Proceedings
of the American Medical Informatics Association Symposium
2003:649-53. [Acceptability, Applicability]
adults recruited from the Palo Alto Medical Foundation;
gender equally split, mean age 52
interaction/electronic medical record: home computer with
provides access to summary data from medical records: users
can view test results, make appointments, refill prescriptions,
update demographics, view doctor-approved health information,
get advice from doctors and nurses. All services were available
free, except messaging service, which required a nominal
users of PAMFOnline, conducted focus groups to determine
who would be the most likely users.
findings: 73% satisfied with existing functionality. Majority
of users ranked viewing lab test results as most important
benefit. Online messaging with clinicians also rated highly,
even though this was available only with an extra charge.
Patients wanted more of the medical record available to
them, especially old lab results.
Weis R, Stamm K, Smith
C, Nilan M, Clark F, Weis J, et al. Communities of
care and caring: the case of MSWatch.com. Journal of
Health Psychology 2003;8:135-48. [Acceptability]
adults; 76% female, mean age 43.7
sclerosis (MS): home computer with Internet
a Web site designed for patients with MS. Site provides
information (community news, humor, ask-an-expert, personal
stories, tips, library, newsletter, diary, and MS news)
and support (chat rooms, discussion groups, instant messaging,
e-mail, and postcards).
of MSWatch were surveyed.
usefulness of information and support functions
functions showed greater perceived usefulness than support
features. Only between 10% and 30% of users found the support
features useful. Usefulness of the Web site was greater
for those in the early stages of the disease and then again
in the third year of the disease. Use of support features
did not relate to disease progression. Those using the
Web site to answer general questions rated the information
as useful, while those who were referred to the site by
other MS patients found the support features useful. Women
rated the information function of greater importance than
males. Adults with children rated both support and information
functions higher than those without children. Younger people
rated the support functions more highly than older people
did. The highest rating of the site overall came from those
who found it useful for information and support.
Wilkie D, Huang H,
Berry D, Schwartz A, Lin Y, Ko N, et al. Cancer symptom
control: feasibility of a tailored, interactive computerized
program for patients. Family and Community Health 2001;24:48-62.
outpatients with cancer; age 18 or older; all participants
were white except for one Asian; 26% had never used computer
management: clinic-based computer program with touch screen
is a software program that asks questions about pain and
fatigue. SymptomConsult provides tailored management strategies.
groups of patients: all used SymptomReport, saw doctor,
then randomly interacted with SymptomConsult or computer
games; 4 weeks later completed SymptomReport again.
completion time for SymptomReport was less than 40 minutes,
for SymptomConsult 20 minutes. High acceptability scores
for SymptomReport; some felt SymptomConsult was not targeted
to their needs or provided no new information. Some reported
they had increased understanding, awareness, and medical
Wilkie D, Judge M,
Berry D, Dell J, Zong S, Gilespie R. Usability of a
computerized PAINReportIt in the general public with pain
and people with cancer pain. Journal of Pain and Symptom
Management 2003;25:213-24. [Acceptability]
patients with pain. Outpatients: N=10, all white, 40% male
and 60% female; Inpatients N=106, 46% male and 64% female,
86% white and 14% people of color; general public N=97,
58% male and 42% female, 73% white and 27% people of color
management: clinic-based computer program with touch screen
is a computerized version of the McGill Pain Questionnaire.
different groups of participants interacted with PAINReportIt.
time, completeness of pain data, acceptability
completion time 15.8 minutes. All gave responses to at
least 3/4 domains (location, intensity, quality, pattern).
High acceptability overall, with highest acceptability
among participants of color.
Woodruff SI, Edward
CC, Conway TL, Elliott SP. Pilot test of an Internet
virtual world chat room for rural teen smokers. Journal
of Adolescent Health 2001;29:239-43. [Acceptability]
high-risk youth recruited from 6 small alternative schools;
mean age 15, 66% male; 55% Caucasian, 28% Hispanic, 17%
cessation: school computer with Internet
Room: Internet-based virtual “world” in which
young smokers interact with a trained cessation facilitator
and with each other; primarily offered chat, also created
billboards to address teens’ reasons to quit smoking
and coping strategies. Also had access to links, shopping,
and other features.
interacted with facilitator and other teens in chat room
for seven 1-hour sessions.
attitudes about quitting, quitting, intentions
in an average of 5.3 out of 7 sessions, 95% would recommend
this to another teen smoker. Positive but not significant
changes in “abstinence in the past week” from
pretest to posttest. 39% called themselves former smokers
at posttest, maintained at 1-month followup. Reduction
in number of cigarettes smoked, intention to quit greater,
attitudes toward quitting more positive.
Blanco M, Boyer JF. Unweaving the Web: an exploratory
study of low-literate adults’ navigation skills on
the World Wide Web. Journal of Health Communication
adults with low-literacy, low incomes; 17 Hispanic, 3 African
American, 2 Asian, 2 white; recruited from literacy or
computer classes at community-based organizations; 10 reported
owning computers, 15 had used the Internet before.
information: lab computer with Internet
Web sites on the World Wide Web
were asked to assess the content and information available
on specific Web sites as well as perform specific tasks.
Methods used included observation, contextual inquiry,
and a think-aloud protocol.
excited to use Internet. 23/24 thought they would use Internet
more in next few years. Navigation difficulties: scrolling,
using back arrow, typing/spelling to enter Web address,
using graphic links. 11/24 thought people should not trust
everything on Web, 9/24 thought they should trust everything,
4/24 not sure. None could identify how to determine what
Zimmerman DE, Akerelrea
CA, Buller DB, Hau B, Leblanc M. Integrating usability
testing into the development of a 5 a day nutrition Website
for at-risk populations in the American Southwest. Journal
of Health Psychology 2003;8:119-34. [Appropriateness]
1: 43 adults; mean age 42.8, 32% income <$15,000, 61%
Hispanic/Latino, 15% Native American, 24% Caucasian; 91%
had computer experience. Study 2: 35 participants; mean
age 43.7, 74% women, 25% income <$15,000, 47% Hispanic/Latino,
26% Native American, 27% other (8 white, 1 Asian); 66%
with more than 1 year computer experience, 34% with less
than 1 year experience. Study 3: 31 adults; mean age 43,
60% female; 35% income <$15,000, 42% Hispanic/Latino,
35% Native Americans, 23% Caucasians
lab computer with Internet
a Day, the Rio Grande Way”: a nutrition education
Web site for multicultural adults living in southern Colorado
and northern New Mexico
1: card-sorting task used to identify how target population
categorized nutrition concepts. Study 2: talk aloud protocol
and observation as users interacted with a prototype Web
site. Study 3: same protocol as study 2, but with a larger
and near-final version of the Web site
of nutritional concepts; satisfaction and ease of use
task results were used to create the site map for the Web
site. Study 2 found that most users (86%) were satisfied
with the Web site, 85% found it easy to use. Observation
showed some areas of difficulty including: assumption of
user content knowledge that was lacking, text type too
small, unclear titles, participants reluctant to use page
links, some difficulty initially locating information,
need for additional visuals. Study 3 found that 83% found
site interesting, 74% useful, 55% easy to read. Observation
showed problems with navigation and locating information.
Of the study participants, about 33% had never used computers,
and they had difficulty with the hand-eye coordination
required for navigating the site, recognizing navigational
aids, and understanding the Web site organization and structure.
Mouse skills were difficult for users with physical impairments.
Only 23% completed all 12 tasks in the protocol. This version
was less well-received than previous prototype. Those with
more computer experience reported that the site was easier