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Evaluation of a web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial

Evaluation of a web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial
Evaluation of a web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial
Background: There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions.

Objective: This study was designed as an evaluation of the usage and effects of the “Internet Doctor” website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change.

Methods: Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use.

Results: The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline in intentions to consult the doctor between baseline and follow-up was predicted by age (beta = .10, P= .003), believing before accessing the website that consultation was necessary for recovery (beta = .19, P < .001), poor understanding of illness (beta = .11, P = .004), emotional reactions to illness (beta = .15, P <.001), and use of the Diagnostic section of the Internet Doctor website (beta = .09, P = .007).

Conclusions: Our findings provide initial evidence that tailored web-based advice could help patients self-manage minor symptoms to a greater extent. These findings constitute a sound foundation and rationale for future research. In particular, our study provides the evidence required to justify carrying out much larger trials in representative population samples comparing tailored web-based advice with routine care, to obtain a definitive evaluation of the impact on self-management and health service use.
internet, self-care, consumer health information, communication, common cold, influenza
1438-8871
e66
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Joseph, Judith
d6b0dcec-cd05-4776-97e9-1d702d7f617b
Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
Weal, Mark
e8fd30a6-c060-41c5-b388-ca52c81032a4
Wills, Gary
3a594558-6921-4e82-8098-38cd8d4e8aa0
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Joseph, Judith
d6b0dcec-cd05-4776-97e9-1d702d7f617b
Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
Weal, Mark
e8fd30a6-c060-41c5-b388-ca52c81032a4
Wills, Gary
3a594558-6921-4e82-8098-38cd8d4e8aa0
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Yardley, Lucy, Joseph, Judith, Michie, Susan, Weal, Mark, Wills, Gary and Little, Paul (2010) Evaluation of a web-based intervention providing tailored advice for self-management of minor respiratory symptoms: exploratory randomized controlled trial Journal of Medical Internet Research, 12, (4), e66. (PMID:21159599).

Record type: Article

Abstract

Background: There has been relatively little research on the role of web-based support for self-care in the management of minor, acute symptoms, in contrast to the wealth of recent research into Internet interventions to support self-management of long-term conditions.

Objective: This study was designed as an evaluation of the usage and effects of the “Internet Doctor” website providing tailored advice on self-management of minor respiratory symptoms (eg, cough, sore throat, fever, runny nose), in preparation for a definitive trial of clinical effectiveness. The first aim was to evaluate the effects of using the Internet Doctor webpages on patient enablement and use of health services, to test whether the tailored, theory-based advice provided by the Internet Doctor was superior to providing a static webpage providing the best existing patient information (the control condition). The second aim was to gain an understanding of the processes that might mediate any change in intentions to consult the doctor, by comparing changes in relevant beliefs and illness perceptions in the intervention and control groups, and by analyzing usage of the Internet Doctor webpages and predictors of intention change.

Methods: Participants (N = 714) completed baseline measures of beliefs about their symptoms and self-care online, and were then automatically randomized to the Internet Doctor or control group. These measures were completed again by 332 participants after 48 hours. Four weeks later, 214 participants completed measures of enablement and health service use.

Results: The Internet Doctor resulted in higher levels of satisfaction than the control information (mean 6.58 and 5.86, respectively; P = .002) and resulted in higher levels of enablement a month later (median 3 and 2, respectively; P = .03). Understanding of illness improved in the 48 hours following use of the Internet Doctor webpages, whereas it did not improve in the control group (mean change from baseline 0.21 and -0.06, respectively, P = .05). Decline in intentions to consult the doctor between baseline and follow-up was predicted by age (beta = .10, P= .003), believing before accessing the website that consultation was necessary for recovery (beta = .19, P < .001), poor understanding of illness (beta = .11, P = .004), emotional reactions to illness (beta = .15, P <.001), and use of the Diagnostic section of the Internet Doctor website (beta = .09, P = .007).

Conclusions: Our findings provide initial evidence that tailored web-based advice could help patients self-manage minor symptoms to a greater extent. These findings constitute a sound foundation and rationale for future research. In particular, our study provides the evidence required to justify carrying out much larger trials in representative population samples comparing tailored web-based advice with routine care, to obtain a definitive evaluation of the impact on self-management and health service use.

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More information

Published date: 15 December 2010
Keywords: internet, self-care, consumer health information, communication, common cold, influenza
Organisations: Community Clinical Sciences, Electronics & Computer Science, Psychology

Identifiers

Local EPrints ID: 178415
URI: http://eprints.soton.ac.uk/id/eprint/178415
ISSN: 1438-8871
PURE UUID: 122e1a82-8f4c-41ea-8022-affbc4ad3b9d
ORCID for Mark Weal: ORCID iD orcid.org/0000-0001-6251-8786
ORCID for Gary Wills: ORCID iD orcid.org/0000-0001-5771-4088

Catalogue record

Date deposited: 29 Mar 2011 15:57
Last modified: 08 Nov 2017 13:52

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