Limits...
Barriers and facilitators for the implementation of an online clinical health community in addition to usual fertility care: a cross-sectional study.

Aarts JW, Faber MJ, den Boogert AG, Cohlen BJ, van der Linden PJ, Kremer JA, Nelen WL - J. Med. Internet Res. (2013)

Bottom Line: These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected.Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed.These results imply that involving patients and their needs into the promotion strategy, community's design, and implementation are crucial.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, Netherlands. a.aarts@obgyn.umcn.nl

ABSTRACT

Background: Online health communities are becoming more popular in health care. Patients and professionals can communicate with one another online, patients can find peer support, and professionals can use it as an additional information channel to their patients. However, the implementation of online health communities into daily practice is challenging. These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected. Therefore, we aimed at answering 2 research questions: (1) what factors are associated with subscription to an online health community, and (2) which are associated with becoming an active participant within an online health community.

Objective: To identify barriers and facilitators as perceived by patients for the implementation of an online health community.

Methods: We performed a cross-sectional study. Three Dutch fertility clinics (2 IVF-licensed) offered their patients a secure online clinical health community through which clinicians can provide online information and patients can ask questions to the medical team or share experiences and find support from peers. We randomly selected and invited 278 men and women suffering from infertility and attending 1 of the participating clinics. Participants filled out a questionnaire about their background characteristics and current use of the online community. Possible barriers and facilitators were divided into 2 parts: (1) those for subscription to the community, and (2) those for active participation in the community. We performed 2 multivariate logistic regression analyses to calculate determinants for both subscription and active participation.

Results: Subscription appeared to be associated with patients' background characteristics (eg, gender, treatment phase), intervention-related facilitators (odds ratio [OR] 2.45, 95% CI 1.14-5.27), and patient-related barriers (OR 0.20, 95% CI 0.08-0.54), such as not feeling the need for such an online health community. After subscription, determinants for participation consisted of aspects related to participant's age (OR 0.86, 95% CI 0.76-0.97), length of infertility (OR 1.48, 05% CI 1.09-2.02), and to intervention-related facilitators (OR 5.79, 95% CI 2.40-13.98), such as its reliable character and possibility to interact with the medical team and peers.

Conclusions: Implementing an online health community in addition to usual fertility care should be performed stepwise. At least 2 strategies are needed to increase the proportion of patient subscribers and consequently make them active participants. First, the marketing strategy should contain information tailored to different subgroups of the patient population. Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed. These results imply that involving patients and their needs into the promotion strategy, community's design, and implementation are crucial.

Show MeSH

Related in: MedlinePlus

Overview of inclusion procedure participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3815434&req=5

figure1: Overview of inclusion procedure participants.

Mentions: We invited patients who attended 1 of the 3 fertility clinics that participated in this study. We aimed at inviting both patients who were a member of the online health community and patients who were informed about the startup of the online infertility community, but did not subscribe to the community. From the online infertility communities’ members databases, the main researcher randomly selected half of the patients (n=141) to participate in the study. To identify patients who had not subscribed to the online infertility community, the community managers listed all patients that visited the clinic in the previous 2 weeks for an intake consultation, diagnostic assessments, or a fertility treatment. We deleted patients from the lists who already subscribed to the online infertility community. Thereafter, we randomly selected patients from these lists and invited both partners of a couple separately to participate in this study. The proportion of subscribed versus nonsubscribed patients was 1:2, foreseeing a lower response rate of nonsubscribed patients. All participants received a questionnaire package by mail 6 months after the setup of the online infertility community. The questionnaire package was accompanied by instructions, a refusal form, and a stamped return envelope. Participation in the study was voluntary and anonymous. In the Netherlands, institutional ethics committee approval was not required for this study. Participants were sent a reminder at 3 and 5 weeks following the initial mailing, respectively. Figure 1 presents an overview of the data collection and analysis procedure.


Barriers and facilitators for the implementation of an online clinical health community in addition to usual fertility care: a cross-sectional study.

Aarts JW, Faber MJ, den Boogert AG, Cohlen BJ, van der Linden PJ, Kremer JA, Nelen WL - J. Med. Internet Res. (2013)

Overview of inclusion procedure participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3815434&req=5

figure1: Overview of inclusion procedure participants.
Mentions: We invited patients who attended 1 of the 3 fertility clinics that participated in this study. We aimed at inviting both patients who were a member of the online health community and patients who were informed about the startup of the online infertility community, but did not subscribe to the community. From the online infertility communities’ members databases, the main researcher randomly selected half of the patients (n=141) to participate in the study. To identify patients who had not subscribed to the online infertility community, the community managers listed all patients that visited the clinic in the previous 2 weeks for an intake consultation, diagnostic assessments, or a fertility treatment. We deleted patients from the lists who already subscribed to the online infertility community. Thereafter, we randomly selected patients from these lists and invited both partners of a couple separately to participate in this study. The proportion of subscribed versus nonsubscribed patients was 1:2, foreseeing a lower response rate of nonsubscribed patients. All participants received a questionnaire package by mail 6 months after the setup of the online infertility community. The questionnaire package was accompanied by instructions, a refusal form, and a stamped return envelope. Participation in the study was voluntary and anonymous. In the Netherlands, institutional ethics committee approval was not required for this study. Participants were sent a reminder at 3 and 5 weeks following the initial mailing, respectively. Figure 1 presents an overview of the data collection and analysis procedure.

Bottom Line: These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected.Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed.These results imply that involving patients and their needs into the promotion strategy, community's design, and implementation are crucial.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Center, Radboud University, Nijmegen, Netherlands. a.aarts@obgyn.umcn.nl

ABSTRACT

Background: Online health communities are becoming more popular in health care. Patients and professionals can communicate with one another online, patients can find peer support, and professionals can use it as an additional information channel to their patients. However, the implementation of online health communities into daily practice is challenging. These challenges relate to the fact that patients need to be activated to (1) become a member (ie, subscription) and (2) participate actively within the community before any effect can be expected. Therefore, we aimed at answering 2 research questions: (1) what factors are associated with subscription to an online health community, and (2) which are associated with becoming an active participant within an online health community.

Objective: To identify barriers and facilitators as perceived by patients for the implementation of an online health community.

Methods: We performed a cross-sectional study. Three Dutch fertility clinics (2 IVF-licensed) offered their patients a secure online clinical health community through which clinicians can provide online information and patients can ask questions to the medical team or share experiences and find support from peers. We randomly selected and invited 278 men and women suffering from infertility and attending 1 of the participating clinics. Participants filled out a questionnaire about their background characteristics and current use of the online community. Possible barriers and facilitators were divided into 2 parts: (1) those for subscription to the community, and (2) those for active participation in the community. We performed 2 multivariate logistic regression analyses to calculate determinants for both subscription and active participation.

Results: Subscription appeared to be associated with patients' background characteristics (eg, gender, treatment phase), intervention-related facilitators (odds ratio [OR] 2.45, 95% CI 1.14-5.27), and patient-related barriers (OR 0.20, 95% CI 0.08-0.54), such as not feeling the need for such an online health community. After subscription, determinants for participation consisted of aspects related to participant's age (OR 0.86, 95% CI 0.76-0.97), length of infertility (OR 1.48, 05% CI 1.09-2.02), and to intervention-related facilitators (OR 5.79, 95% CI 2.40-13.98), such as its reliable character and possibility to interact with the medical team and peers.

Conclusions: Implementing an online health community in addition to usual fertility care should be performed stepwise. At least 2 strategies are needed to increase the proportion of patient subscribers and consequently make them active participants. First, the marketing strategy should contain information tailored to different subgroups of the patient population. Second, for a living online health community, incorporation of interactive elements, as well as frequent news and updates are needed. These results imply that involving patients and their needs into the promotion strategy, community's design, and implementation are crucial.

Show MeSH
Related in: MedlinePlus