Year

2013

Degree Name

Doctor of Philosophy

Department

School of Information Systems and Technology

Abstract

Although Online Patient Education (OPE) is becoming increasingly common in many countries, research on the design features of the sites and the perceived benefits of OPE remains sparse. Specifically, this study extends upon extant research, proposing a model in which the design features OPE influence the users’ perceptions regarding the benefits of OPE. This study formulates hypotheses regarding the effect of: (1) the OPE design features on the perceived benefits derived from health outcomes; and (2) the OPE design features on the perceived benefits derived from social outcomes. This study was undertaken in three phases. First, a conceptual phase was conducted in order to investigate and analyse the existing literature on the key dimension of OPE design features; and also on the key dimensions of the perceived benefits of OPE. The conceptual phase resulted in the development of a research model and relevant hypotheses. Second, in the exploratory phase, two separate questionnaire surveys were formulated and distributed. The exploratory phase enabled the development and testing of all instruments that were subsequently used in the study. The result of the exploratory phase was the production of a reliable and valid set of instruments to be used within the final phase – the confirmatory phase. In the confirmatory phase, an online survey was conducted in order to test the research model and the proposed hypotheses. This phase provided a broader understanding of the OPE design features and their effect on the perceived benefits of OPE, as well as on the significance of the patients’ stages of change. The results of this study indicate that: (1) a positive effect exists between the OPE design features and the perceived benefits derived from the health outcomes; (2) there is a positive effect existing between OPE design features and perceived benefits derived from social outcomes; (3) there is a significant difference in patients’ perceptions of the way that content features are presented, according to the patients’ stages of change; and (4) there is a significant difference in the patients’ perceptions of interpretability features, according to the patients’ stage of change. However, the results of this study show no significant difference for fourteen of the hypothesized relationships. These included: (1) a significant difference in patients’ perceptions toward the perceived benefits derived from health outcomes, according to the patients’ stages of change; and (2) a significant difference in patients’ perceptions of the benefits derived from social outcomes, according to the patients’ stages of change. These results also suggest that SOC has no significant effect on the OPE design features and the perceived benefits derived from health and social outcomes. Whilst preceding studies on design features have focused upon online health information and online health interventions, this study is the first to investigate OPE design features and their relation to the perceived benefits of OPE, as influenced by the patients’ stages of change. Specifically, this research was conducted within the research field of OPE for chronic diseases. The main contribution of this study is in the form of a conceptual framework that includes OPE design feature-dimensions and two dimensions of OPE perceivedbenefits from the perspectives of both health professionals and patients/carers. This study also explains the effect of OPE design features and the perceived benefits of OPE whilst taking each patient’s stage of change into consideration. Finally, this study contributes to extant theory by using the two-factor theory and the persuasive system development (PSD) model. In doing so, this study may have important implications for developing Websites that are intended for use within health promotion research and practice, with attention focused upon the final Transtheoretical Model (TTM) theory. This study entailed several methodological improvements suggested within previous studies; these included: (1) the use of new instrument items to measure the OPE design features construct; (2) the use of a new two-dimensional perceived-benefits construct, according to health outcomes and social outcomes (respectively); and (3) the assessment of the content validity and reliability of instrument-items prior to the actual data collection. This study provides healthcare providers and system developers with a better understanding of the OPE design features and the perceived benefits of OPE, as drawn from the health professionals and patients/carers that used the system. This study also provides healthcare providers and system developers with an explanation of the different perceptions held toward OPE design features and the benefits of OPE, according to the patients’ stages of change.

FoR codes (2008)

0806 INFORMATION SYSTEMS, 0899 OTHER INFORMATION AND COMPUTING SCIENCES, 1199 OTHER MEDICAL AND HEALTH SCIENCES, 1399 OTHER EDUCATION

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Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.