NUR 711 WA 1 Consumer Assessment Data Part 1: Interview and Data Collection

The survey I conducted of 10 family and friends included the following questions based on the data in the Campbell (2005) article: 

1.      Age: adults only. 18-29, 30-49, 50-64, 65 and older

2.      Race (mark all that apply): White (non-Hispanic), Hispanic, African-American, Asian, American Indian

3.  Household income: <15, 000, 15,001-30,000, 30,001-45,000, 45,001-60,000, 60,001- 75,000, 75,0001 and above.

4.    Employment status: Full Time, Part Time, Retired, Not Employed, Homemaker, Student (may include intermittent employment)

5.  Education Level: High School Graduate, Technical School, 2 Years College (Associate, Diploma), 4 Years College (Bachelor, Baccalaureate), Graduate School (Masters, Doctorate).

6.      Do you have health insurance coverage? Yes, No

7.      Are you a caregiver? : Yes, No

8.      Do you (or your family member you care for) have health problems? Yes, current health issue. Yes, chronic health issue, No

9.      Do you have a computer at home? Yes, No

a.       If no, do you have access to  computer? Yes, public computer (library, internet café), Yes, at a friend or family member’s home, No

10.  How often do you use a computer? Daily, >3days a week, weekly, > 3 times a month, monthly, less often than monthly, never

11.  How do you use the computer? To search the internet, to locate health information, to use email, to participate in an online support group, n/a

12.  Do you think that the internet can help you manage your health? Yes, No

13.  Do you use the internet to locate health information? Yes, No

a.       If yes, how often? Daily, weekly, monthly , when needed

b.      If yes, what kind of information were you seeking? General information (back surgery, wellness, general disease information i.e. Diabetes, symptoms), Medication information (side effects, uses of medication, contraindications), Specific information (treatments for a specific disease, prognosis) 

14.  Have you visited a health care provider in the last six months?  Yes,No

a.       If yes, did you search for information prior to your appointment? Yes, No

b.      Did you use the information you found to prepare a list of questions for the health care provider? Yes, No, N/A

15.  During your health care visit who made decisions regarding treatment?

                 Health care provider made all the decisions, I made the decisions and asked health care provider                   for opinions, the health care provider and I made the decisions together

16.  How many questions did you ask at you last healthcare provider visit? None, one, two or three, four or five, six or more.

17.  How did your healthcare provider react to your questions based on internet information? Positively: answered questions to my satisfaction, Negatively, did not answer my questions or I was not satisfied with provider’s answers, neither positively nor negatively

18.  After you last healthcare provider visit, did you use the internet to locate further information? Yes, No

a.       If yes, why? I wanted to see if my healthcare provider was giving me accurate information, I wanted to learn more about my health issue, I wanted to check on the medications my provider prescribed, other

19.  Do you have a set of specific websites that you use to locate health information? Yes, No

a.       If so, please name the websites you use. 

Half of the respondents were in the 18 to 29 year age group, while there were 2 each in the 30-49 and 50-64 year age groups. Only one was older than 65. All were white non-Hispanic, had health insurance coverage and owned a computer. Twenty percent earned more than $60,000 per year and 40 percent earned more than $75,000 per year. Only one respondent earned less than $15,000 per year. More than half were employed full time (6), two were retired, and there were one student and one homemaker among the respondents.  Education completed was fairly evenly distributed with 30 % each having a high school diploma, bachelor’s degree or graduate degree while only one of the respondents had an associate degree. None had attended a technical school. There were two caregivers among the sample. Caregiving was defined as assisting in any way to manage health care. Two respondents reported they or the family member they cared for had a chronic health issue, one reported a current, non-chronic health issue. 

The vast majority (80%) used the internet daily with 100% using it to search the internet. Other reasons for using the internet given by four of the participants were social media, banking, political information and contacting representatives, searching for scientific research, playing games, and for work reasons. Eighty percent used the internet to seek health information, although the majority (80%) also answered that they seek health information on the internet on an as needed basis.  Nine respondents believed that the internet could help to manage healthcare. Eighty percent had searched the internet for all of the answer options (general health issues, medication information, and specific health information), while one had used it for latest research. 

Nine of the ten respondents had visited a health care provider in the last six months, with 60% of those searching for information prior to the appointment and using the information to help prepare a list of questions for the provider. The single respondent who had not had a healthcare appointment in the past six months was 22 years old and healthy. 

Six of the participants reported that they made health care decisions jointly with their providers while two stated their provider made all of the decisions. Only one reported making a healthcare decision and asking for the provider’s opinion. Four reported asking six or more questions during the appointment, none reported asking zero questions. Seventy percent reported their providers responded positively to the information they had obtained for the appointment and answered their questions to their satisfaction (including all of the younger respondents and the oldest); only one reported a provider reacting negatively. Seventy percent also reported using the internet to locate information after the appointment with their provider, with 60% using it to check the accuracy of the information their provider gave during the appointment. All 70% who reported using the internet after the appointment also used it to check on medications prescribed and to learn more about the health issue they had sought care for.Three of the respondents reported using a specific website or set of websites for locating information. The websites listed were all sources of reliable information, including WebMD, NIH, Medline, and Mayoclinic. 

The majority of those interviewed were proactive in their own health care, with only one who was not interested in using the internet for health information.  The data collected showed a mostly younger, internet-savvy sample, while the older respondents were capable of using the internet for a variety of reasons, including healthcare information seeking. As a relatively affluent, well-educated group with health insurance coverage, they do not have access to care issues. Their education levels may have influenced their ability to navigate the healthcare system; they seek information before, during and after their appointments through the use of reliable internet resources and by asking questions of their providers. Most have had positive experiences do so and are satisfied with the providers’ answers, but they will still check up on their providers on the internet to be sure the information they are receiving is correct. As savvy healthcare consumers, they regularly collaborate with their providers.

The convenience sample was likely skewed by it being  made up of this student’s family and friends, the majority of whom are well-educated, relatively affluent, and all of the same race. Half of the respondents were also young and more than half answered by email, which assumes the use of a computer. 

 Despite these limitations, the survey data is consistent with Campbell’s (2005) findings that those who are most likely to use the internet to locate health information are also white and fairly well off.  The data is also consistent with Lewis et al (2005) in their assertion that the internet can be an empowering tool for healthcare consumers when used by those who can navigate the vast amounts of information available and use it to collaborate with their health care provider. 

References

Campbell, R. J. (2005). Consumer informatics: Elderly persons and the internet. .Perspectives in Health Information Management, 2(2), 1-16. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

Lewis, D., Eysenbach, G., Kukafka, R., Stavri, P. Z., & Jimison, H. (Eds.). (2005). Consumer health informatics. Informing consumers and improving health care. New York, NY: Springer.

Välimäki, M., Nenonen, H., Koivunen, M., & Suhonen, R. (2007). Patients’ perceptions of Internet usage and their opportunity to obtain health information. Medical Informatics & the Internet in Medicine, 32(4), 304-315. http://dx.doi.org/10.1080/14639230701819792