Skip to main content
Top
Published in: BMC Primary Care 1/2014

Open Access 01-12-2014 | Research article

Development of the PRE-HIT instrument: patient readiness to engage in health information technology

Authors: Richelle J Koopman, Gregory F Petroski, Shannon M Canfield, Julie A Stuppy, David R Mehr

Published in: BMC Primary Care | Issue 1/2014

Login to get access

Abstract

Background

Technology-based aids for lifestyle change are becoming more prevalent for chronic conditions. Important “digital divides” remain, as well as concerns about privacy, data security, and lack of motivation. Researchers need a way to characterize participants’ readiness to use health technologies. To address this need, we created an instrument to measure patient readiness to engage with health technologies among adult patients with chronic conditions.

Methods

Initial focus groups to determine domains, followed by item development and refinement, and exploratory factor analysis to determine final items and factor structure. The development sample included 200 patients with chronic conditions from 6 family medicine clinics. From 98 potential items, 53 best candidate items were examined using exploratory factor analysis. Pearson’s Correlation for Test/Retest reliability at 3 months.

Results

The final instrument had 28 items that sorted into 8 factors with associated Cronbach’s alpha: 1) Health Information Need (0.84), 2) Computer/Internet Experience (0.87), 3) Computer Anxiety (0.82), 4) Preferred Mode of Interaction (0.73), 5) Relationship with Doctor (0.65), 6) Cell Phone Expertise (0.75), 7) Internet Privacy (0.71), and 8) No News is Good News (0.57). Test-retest reliability for the 8 subscales ranged from (0.60 to 0.85).

Conclusion

The Patient Readiness to Engage in Health Internet Technology (PRE-HIT) instrument has good psychometric properties and will be an aid to researchers investigating technology-based health interventions. Future work will examine predictive validity.
Appendix
Available only for authorised users
Literature
2.
go back to reference McMahon GT, Gomes HE, Hickson HS, Hu TM, Levine BA, Conlin PR: Web-based care management in patients with poorly controlled diabetes. Diabetes Care. 2005, 28: 1624-1629. 10.2337/diacare.28.7.1624.CrossRefPubMedPubMedCentral McMahon GT, Gomes HE, Hickson HS, Hu TM, Levine BA, Conlin PR: Web-based care management in patients with poorly controlled diabetes. Diabetes Care. 2005, 28: 1624-1629. 10.2337/diacare.28.7.1624.CrossRefPubMedPubMedCentral
3.
go back to reference Allen M, Iezzoni LI, Huang A, Huang L, Leveille SG: Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention. Nurs Res. 2008, 57: 107-112. 10.1097/01.NNR.0000313478.47379.98.CrossRefPubMed Allen M, Iezzoni LI, Huang A, Huang L, Leveille SG: Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention. Nurs Res. 2008, 57: 107-112. 10.1097/01.NNR.0000313478.47379.98.CrossRefPubMed
4.
go back to reference Lorig KR, Ritter PL, Laurent DD, Plant K: Internet-based chronic disease self-management: a randomized trial. Med Care. 2006, 44: 964-971. 10.1097/01.mlr.0000233678.80203.c1.CrossRefPubMed Lorig KR, Ritter PL, Laurent DD, Plant K: Internet-based chronic disease self-management: a randomized trial. Med Care. 2006, 44: 964-971. 10.1097/01.mlr.0000233678.80203.c1.CrossRefPubMed
5.
go back to reference Kruse RL, Koopman RJ, Wakefield BJ, Wakefield DS, Keplinger LE, Mehr DR: Internet use by primary care patients: where is the digital divide?. Fam Med. 2012, 44: 342-347.PubMed Kruse RL, Koopman RJ, Wakefield BJ, Wakefield DS, Keplinger LE, Mehr DR: Internet use by primary care patients: where is the digital divide?. Fam Med. 2012, 44: 342-347.PubMed
6.
go back to reference Malhotra NK, Kim SS, Agarwal J: Internet users’ information privacy concerns (IUIPC): the construct, the scale, and a causal model. Inf Syst Res. 2004, 15: 336-355. 10.1287/isre.1040.0032.CrossRef Malhotra NK, Kim SS, Agarwal J: Internet users’ information privacy concerns (IUIPC): the construct, the scale, and a causal model. Inf Syst Res. 2004, 15: 336-355. 10.1287/isre.1040.0032.CrossRef
8.
go back to reference Norman CD, Skinner HA: eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006, 8: e9-10.2196/jmir.8.2.e9.CrossRefPubMedPubMedCentral Norman CD, Skinner HA: eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006, 8: e9-10.2196/jmir.8.2.e9.CrossRefPubMedPubMedCentral
9.
go back to reference van der Vaart R, Van Deursen AJ, Drossaert CH, Taal E, Van Dijk JA, van de Laar MA: Does the eHealth Literacy Scale (eHEALS) measure what it intends to measure? Validation of a Dutch version of the eHEALS in two adult populations. J Med Internet Res. 2011, 13: e86-10.2196/jmir.1840.CrossRefPubMedPubMedCentral van der Vaart R, Van Deursen AJ, Drossaert CH, Taal E, Van Dijk JA, van de Laar MA: Does the eHealth Literacy Scale (eHEALS) measure what it intends to measure? Validation of a Dutch version of the eHEALS in two adult populations. J Med Internet Res. 2011, 13: e86-10.2196/jmir.1840.CrossRefPubMedPubMedCentral
10.
go back to reference Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A: Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001, 20: 64-78. 10.1377/hlthaff.20.6.64.CrossRef Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A: Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001, 20: 64-78. 10.1377/hlthaff.20.6.64.CrossRef
11.
go back to reference Czaja SJ, Charness N, Fisk AD, Hertzog C, Nair SN, Rogers WA, Sharit J: Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE). Psychol Aging. 2006, 21: 333-352.CrossRefPubMedPubMedCentral Czaja SJ, Charness N, Fisk AD, Hertzog C, Nair SN, Rogers WA, Sharit J: Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE). Psychol Aging. 2006, 21: 333-352.CrossRefPubMedPubMedCentral
12.
go back to reference Brodie M, Flournoy RE, Altman DE, Blendon RJ, Benson JM, Rosenbaum MD: Health information, the Internet, and the digital divide. Health Aff (Millwood). 2000, 19: 255-265. 10.1377/hlthaff.19.6.255.CrossRef Brodie M, Flournoy RE, Altman DE, Blendon RJ, Benson JM, Rosenbaum MD: Health information, the Internet, and the digital divide. Health Aff (Millwood). 2000, 19: 255-265. 10.1377/hlthaff.19.6.255.CrossRef
13.
go back to reference Pelletier AL, Sutton GR, Walker RR: Are your patients ready for electronic communication?. Fam Pract Manag. 2007, 14: 25-26.PubMed Pelletier AL, Sutton GR, Walker RR: Are your patients ready for electronic communication?. Fam Pract Manag. 2007, 14: 25-26.PubMed
14.
go back to reference Harrison AW, Rainer RK: An examination of the factor structures and concurrent validities for the computer attitude scale, the computer anxiety rating scale, and the computer-self-efficacy scale. Educ Psychol Meas. 1992, 52: 735-745. 10.1177/0013164492052003024.CrossRef Harrison AW, Rainer RK: An examination of the factor structures and concurrent validities for the computer attitude scale, the computer anxiety rating scale, and the computer-self-efficacy scale. Educ Psychol Meas. 1992, 52: 735-745. 10.1177/0013164492052003024.CrossRef
15.
go back to reference Bunz U, Curry C, Voon W: Perceived versus actual computer-email-web fluency. Comput Human Behav. 2007, 23: 2321-2344. 10.1016/j.chb.2006.03.008.CrossRef Bunz U, Curry C, Voon W: Perceived versus actual computer-email-web fluency. Comput Human Behav. 2007, 23: 2321-2344. 10.1016/j.chb.2006.03.008.CrossRef
16.
go back to reference Smith B, Caputi P, Rawstorne P: The development of a measure of subjective computer experience. Comput Human Behav. 2007, 23: 127-145. 10.1016/j.chb.2004.04.001.CrossRef Smith B, Caputi P, Rawstorne P: The development of a measure of subjective computer experience. Comput Human Behav. 2007, 23: 127-145. 10.1016/j.chb.2004.04.001.CrossRef
17.
go back to reference Bunz U: The Computer-Email-Web (CEW) Fluency Scale–development and validation. Int J Hum Comput Interact. 2004, 17: 479-506. 10.1207/s15327590ijhc1704_3.CrossRef Bunz U: The Computer-Email-Web (CEW) Fluency Scale–development and validation. Int J Hum Comput Interact. 2004, 17: 479-506. 10.1207/s15327590ijhc1704_3.CrossRef
18.
go back to reference Yaghmaie F: Development of a scale for measuring user computer experience. J Res Nurs. 2007, 12: 185-190. 10.1177/1744987106068353.CrossRef Yaghmaie F: Development of a scale for measuring user computer experience. J Res Nurs. 2007, 12: 185-190. 10.1177/1744987106068353.CrossRef
19.
go back to reference Gardner DG, Discenza R, Dukes RL: The measurement of computer attitudes: an empirical comparison of available scales. J Educ Comput Res. 1993, 9: 487-507. 10.2190/DXLM-5J80-FNKH-PP2L.CrossRef Gardner DG, Discenza R, Dukes RL: The measurement of computer attitudes: an empirical comparison of available scales. J Educ Comput Res. 1993, 9: 487-507. 10.2190/DXLM-5J80-FNKH-PP2L.CrossRef
20.
go back to reference Woodrow JE: A comparison of four computer attitude scales. J Educ Comput Res. 1991, 7: 165-187. 10.2190/WLAM-P42V-12A3-4LLQ.CrossRef Woodrow JE: A comparison of four computer attitude scales. J Educ Comput Res. 1991, 7: 165-187. 10.2190/WLAM-P42V-12A3-4LLQ.CrossRef
21.
go back to reference Murphy CA, Coover D, Owen SV: Development and validation of the computer self-efficacy scale. Educ Psychol Meas. 1989, 49: 893-899. 10.1177/001316448904900412.CrossRef Murphy CA, Coover D, Owen SV: Development and validation of the computer self-efficacy scale. Educ Psychol Meas. 1989, 49: 893-899. 10.1177/001316448904900412.CrossRef
22.
go back to reference Swift JA, Glazebrook C, Macdonald I: Validation of a brief, reliable scale to measure knowledge about the health risks associated with obesity. Int J Obes (Lond). 2006, 30: 661-668. 10.1038/sj.ijo.0803165.CrossRef Swift JA, Glazebrook C, Macdonald I: Validation of a brief, reliable scale to measure knowledge about the health risks associated with obesity. Int J Obes (Lond). 2006, 30: 661-668. 10.1038/sj.ijo.0803165.CrossRef
23.
go back to reference Hudon C, Fortin M, Vanasse A: Cumulative Illness Rating Scale was a reliable and valid index in a family practice context. J Clin Epidemiol. 2005, 58: 603-608. 10.1016/j.jclinepi.2004.10.017.CrossRefPubMed Hudon C, Fortin M, Vanasse A: Cumulative Illness Rating Scale was a reliable and valid index in a family practice context. J Clin Epidemiol. 2005, 58: 603-608. 10.1016/j.jclinepi.2004.10.017.CrossRefPubMed
24.
go back to reference Parmelee PA, Thuras PD, Katz IR, Lawton MP: Validation of the cumulative illness rating scale in a geriatric residential population. J Am Geriatr Soc. 1995, 43: 130-137.CrossRefPubMed Parmelee PA, Thuras PD, Katz IR, Lawton MP: Validation of the cumulative illness rating scale in a geriatric residential population. J Am Geriatr Soc. 1995, 43: 130-137.CrossRefPubMed
25.
go back to reference Parkerson GR, Broadhead WE, Tse CK: The Duke Severity of Illness Checklist (DUSOI) for measurement of severity and comorbidity. J Clin Epidemiol. 1993, 46: 379-393. 10.1016/0895-4356(93)90153-R.CrossRefPubMed Parkerson GR, Broadhead WE, Tse CK: The Duke Severity of Illness Checklist (DUSOI) for measurement of severity and comorbidity. J Clin Epidemiol. 1993, 46: 379-393. 10.1016/0895-4356(93)90153-R.CrossRefPubMed
26.
go back to reference Moss-Morris R, Weinman J, Petrie KJ, Horne R, Cameron LD, Buick D: The revised illness perception questionnaire (IPQ-R). Psychol Health. 2002, 17: 1-16. 10.1080/08870440290001494.CrossRef Moss-Morris R, Weinman J, Petrie KJ, Horne R, Cameron LD, Buick D: The revised illness perception questionnaire (IPQ-R). Psychol Health. 2002, 17: 1-16. 10.1080/08870440290001494.CrossRef
27.
go back to reference Weinman J, Petrie KJ, Moss-Morris R, Horne R: The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health. 1996, 11: 431-445. 10.1080/08870449608400270.CrossRef Weinman J, Petrie KJ, Moss-Morris R, Horne R: The illness perception questionnaire: a new method for assessing the cognitive representation of illness. Psychol Health. 1996, 11: 431-445. 10.1080/08870449608400270.CrossRef
28.
go back to reference Wrench JS: The influence of perceived risk knowledge on risk communication. Commun Res Rep. 2007, 24: 63-70. 10.1080/08824090601128182.CrossRef Wrench JS: The influence of perceived risk knowledge on risk communication. Commun Res Rep. 2007, 24: 63-70. 10.1080/08824090601128182.CrossRef
29.
go back to reference Parker RM, Baker DW, Williams MV, Nurss JR: The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995, 10: 537-541. 10.1007/BF02640361.CrossRefPubMed Parker RM, Baker DW, Williams MV, Nurss JR: The test of functional health literacy in adults: a new instrument for measuring patients’ literacy skills. J Gen Intern Med. 1995, 10: 537-541. 10.1007/BF02640361.CrossRefPubMed
30.
go back to reference Wallace LS, Rogers ES, Roskos SE, Holiday DB, Weiss BD: Brief report: screening items to identify patients with limited health literacy skills. J Gen Intern Med. 2006, 21: 874-877. 10.1111/j.1525-1497.2006.00532.x.CrossRefPubMedPubMedCentral Wallace LS, Rogers ES, Roskos SE, Holiday DB, Weiss BD: Brief report: screening items to identify patients with limited health literacy skills. J Gen Intern Med. 2006, 21: 874-877. 10.1111/j.1525-1497.2006.00532.x.CrossRefPubMedPubMedCentral
31.
go back to reference Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA: Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993, 25: 391-395.PubMed Davis TC, Long SW, Jackson RH, Mayeaux EJ, George RB, Murphy PW, Crouch MA: Rapid estimate of adult literacy in medicine: a shortened screening instrument. Fam Med. 1993, 25: 391-395.PubMed
32.
go back to reference Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, Bairnsfather LE: Rapid assessment of literacy levels of adult primary care patients. Fam Med. 1991, 23: 433-435.PubMed Davis TC, Crouch MA, Long SW, Jackson RH, Bates P, George RB, Bairnsfather LE: Rapid assessment of literacy levels of adult primary care patients. Fam Med. 1991, 23: 433-435.PubMed
33.
go back to reference Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983, 51: 390-395.CrossRefPubMed Prochaska JO, DiClemente CC: Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol. 1983, 51: 390-395.CrossRefPubMed
34.
go back to reference Biener L, Abrams DB: The contemplation ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991, 10: 360-365.CrossRefPubMed Biener L, Abrams DB: The contemplation ladder: validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991, 10: 360-365.CrossRefPubMed
35.
go back to reference Streiner DL, Norman GR: Selecting the items. Health measurement scales: a practical guide to their development and use. 1995, New York: Oxford University Press, 54-68. 2 Streiner DL, Norman GR: Selecting the items. Health measurement scales: a practical guide to their development and use. 1995, New York: Oxford University Press, 54-68. 2
36.
go back to reference Holden RR, Fekken GC, Jackson DN: Structured personality test item characteristics and validity. J Res Pers. 1985, 19: 386-394. 10.1016/0092-6566(85)90007-8.CrossRef Holden RR, Fekken GC, Jackson DN: Structured personality test item characteristics and validity. J Res Pers. 1985, 19: 386-394. 10.1016/0092-6566(85)90007-8.CrossRef
37.
go back to reference Likert R: A technique for the measurement of attitudes. Arch Psychol. 1932, 22: 1-55. Likert R: A technique for the measurement of attitudes. Arch Psychol. 1932, 22: 1-55.
38.
go back to reference Streiner DL, Norman GR: Biases in responding. Health measurement scales: a practical guide to their development and use. 1995, New York: Oxford University Press, 69-84. 2 Streiner DL, Norman GR: Biases in responding. Health measurement scales: a practical guide to their development and use. 1995, New York: Oxford University Press, 69-84. 2
39.
go back to reference Mundfrom DJ, Shaw DG, Tian LK: Minimum sample size recommendations for conducting factor analyses. Int J Test. 2005, 5: 159-168. 10.1207/s15327574ijt0502_4.CrossRef Mundfrom DJ, Shaw DG, Tian LK: Minimum sample size recommendations for conducting factor analyses. Int J Test. 2005, 5: 159-168. 10.1207/s15327574ijt0502_4.CrossRef
40.
go back to reference Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ: Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999, 4: 272-299.CrossRef Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ: Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999, 4: 272-299.CrossRef
41.
go back to reference Cronbach LJ, Warrington WG: Time-limit tests: estimating their reliability and degree of speeding. Psychometrika. 1951, 16: 167-188. 10.1007/BF02289113.CrossRefPubMed Cronbach LJ, Warrington WG: Time-limit tests: estimating their reliability and degree of speeding. Psychometrika. 1951, 16: 167-188. 10.1007/BF02289113.CrossRefPubMed
42.
go back to reference Rice RE: Influences, usage, and outcomes of Internet health information searching: multivariate results from the Pew surveys. Int J Med Inform. 2006, 75: 8-28. 10.1016/j.ijmedinf.2005.07.032.CrossRefPubMed Rice RE: Influences, usage, and outcomes of Internet health information searching: multivariate results from the Pew surveys. Int J Med Inform. 2006, 75: 8-28. 10.1016/j.ijmedinf.2005.07.032.CrossRefPubMed
44.
Metadata
Title
Development of the PRE-HIT instrument: patient readiness to engage in health information technology
Authors
Richelle J Koopman
Gregory F Petroski
Shannon M Canfield
Julie A Stuppy
David R Mehr
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-15-18

Other articles of this Issue 1/2014

BMC Primary Care 1/2014 Go to the issue