|The Health Record Review
by Jeff Rowe, Editor
Posted on Fri, Nov 02, 2012 - 10:47 am
Many health IT stakeholders are keen on patient engagement as one road to reaping the benefits of new technologies.
But a new Danish study suggests that road may constitute a steep, uphill trip.
To be clear, the study didn’t look specifically at EHRs, so there’s certainly room for discussing the applicability. Rather, it gauged the effectiveness of web-site intervention as a tool to get people more physically active.
As the authors put it in an article in the Journal of Internet Medical Research (JMIR), “the aim of this study was to examine whether an automated Web-based intervention would lead to increased (physical activity) PA among inactive persons in a large population. More specifically, we aimed to determine whether access to a website with individually tailored feedback on PA level and suggestions to increase PA would result in improvements in self-reported PA, anthropometrics, and physiological measurements in an intervention group compared with a no-information control group.”
As described in the JMIR piece, the researchers went to considerable lengths to make the website user friendly and at least potentially productive. “The website was structured as three major parts: (1) a personal page, which included individually tailored PA advice and a personal profile, (2) a page with training programs and general recommendations, and (3) a forum and discussion page for questions from participants.”
But despite their efforts, the results were less than overwhelming. “Less than 22.0% of the participants logged on to the website once and only 7.0% on frequently. We found no difference in PA level between the website and control groups at 3- and 6-month follow-ups. . . . The follow-up health examination showed no significant reductions in body mass index, waist circumference, body fat percentage, and blood pressure, or improvements in arm strength and aerobic fitness in the website group.”
For advocates and policymakers, the most useful part of the study may be in the observations the researchers make toward the end.
“A review of PA interventions,” they note, “found that studies with more supervision and contact through texting and email with participants were more successful and more often reported positive outcomes on PA than did studies with few contacts. Research has shown that forming a new habit (ie, automaticity for the behavior) requires a large number of repetitions. A single-time intervention may raise awareness and interest but, to progress further, additional intervention interactions are needed.”
In short, you can lead a horse to water, but it’ll take some time and effort to get that horse to drink.
Again, there’s an element of apples and oranges in the comparison with the discussion over engaging patients in managing their health information via EHRs and PHRs. But if nothing else it doesn’t hurt to remember that old habits do indeed die hard.
Photo courtesy of RubyGoes via Creative Commons