Transcript Web Research Challenges

Interactive Health Communication
and Work Site Health Promotion
Robin G. Molella, MD, Candace K. Kolars, PhD, MPH, Neil R.
Sullivan, MPH, and Philip T. Hagen, MD
There has been significant interest on the part of
employers in using the Internet as a tool for
promoting employee health. This interest has
been fueled by the realization that improved
employee health correlates with both
increased worker productivity and decreased
health care expenditures.
A health promotion web site has been designed
to improve the health status of employees. It
includes health information, a health risk
assessment, self-care information and
modules focused on healthy behaviors and
disease management. The site is based on
behavioral theory and uses tailored e-mail
messages to motivate and re-engage site
users in the behavior change process.
Additional messages address barriers to
behavior change.
Over the course of 2 years the site has been
available to employees of a number of large
corporations. Usage trends were followed by
collection of data from the Internet site. The
results were reviewed and adjusted for issues
such as double registration. Forty-three
percent of the registrants were female. The
average age was 42.6 years.
Usage by gender
use by age
18-29
30-39
40-49
50-59
>=60
Female:
43%
Male:
57%
USE BY AGE AND GENDER
35.00%
30.00%
25.00%
20.00%
Male
female
15.00%
10.00%
5.00%
0.00%
18-29
30-39
40-49
50-59
>=60
Comment: In the above data, men are well
represented and often outnumber women.
This is somewhat at odds with data presented
by the Pew Internet and American Life Project
which reports women seek Internet information
more commonly than men. If this observed
difference is true and not merely related to
denominator issues, then the question is why.
Are men more likely to seek health promotion
information in the work place? Can we utilize
work place interventions to encourage use of
Internet health promotion programming?
PERCENT OF VISITS BY SESSION LENGTH IN MINUTES
20+ minutes
22%
<10 minutes
56%
10 - 19.9 Minutes
22%
Peak Usage: 8am-6pm CST (usage starts at 7am and is high until 8pm reflecting the other time zones)
Average session length: 12.5 minutes
Average page-views/session: 12
Note: Session length is timed from the first page viewed to the last page viewed and so underestimates
the amount of time spent on the site.
The health risk appraisal was completed by 26
percent of registered users revealing that 15
percent were at high risk. The most popular
areas of the site are exercise, healthy weight,
self-care, nutrition and depression.
Life-style Planner usage by Gender
70%
60%
50%
40%
Male
Female
30%
20%
10%
0%
Smoking
Exercise
Weight
Stress
Nutrition
Disease Self Manager Usage by Gender
70%
60%
50%
40%
Male
Female
30%
20%
10%
0%
Asthma
Headache
Back Pain
Depression
Relative Popularity of Lifesyle Planners
Nutrition
18%
Exercise
34%
Stress
9%
Weight
39%
Relative popularity of Disease Self Managers
Smoking
12%
Asthma
22%
Depression
20%
Headache
19%
Back Pain
27%
Substance Use
35.0%
29.7%
30.0%
25.0%
20.0%
17.1%
15.0%
10.0%
5.1%
5.0%
3.1%
3.6%
2.1%
0.0%
Percent who use
tobacco
Percent of
tobacco users
who use
smokeless
tobacco
Percent of
women drinkers
who report
excess Alcohol
Use
Percent of male
drinkers who
report excess
Alcohol Use
Percent of
drinkers who
report risky
behavior while
using Alcohol
Percent of
drinkers who
report alcohol
related problems
Nutrition and Exercise
100.0%
92.8%
90.0%
80.7%
80.0%
70.0%
60.0%
65.9%
55.6%
55.2%
50.0%
40.0%
30.0%
23.6%
20.0%
10.0%
0.0%
Percent who report Percent who report Percent who report
less than 30 minutes consuming less than consuming less than
exercise 3 times per the recommended
the recommended
week
servings of fruit
servings of
vegetables
Percent who report
consuming more
than the
recommended
servings of meat
Percent who report
consuming more
than the
recommended
servings of fat
Percent who fail to
meet all dietary
recommendations
Preventive Health Issues
60.0%
50.0%
40.0%
30.0%
20.0%
10.0%
0.0%
Percent who report failure Percent who report failure
to use safety belts.
to use safe sex practices.
Percent of women over
Percent of respondents
Percent of respondents
50 who have not had a over 50 who have not had who report stress often
mammogram in past two colon cancer screening in having a negative impact
years (includes never)
the past 5 years
on their life
Web Research Challenges
While web site databases
collect profuse amounts of data,
finding meaningful data from
site usage logs is not always
simple.
Things such as multiple
registrations by the same user
may contaminate data.
Web Research
Challenges
Site logs and data points are
created as a result of the
conveniences of engineering unless
researchers and developers give
specific guidance at the time of
design. Data obtained after the fact
may not provide answers to key
questions.
Web Research
Challenges
A body of research regarding
usability, accessibility, graphic
design and program design needs
to be compiled as part of efficacy
and outcomes research.
Web Research Challenges
Site usage data gives important hints to how
individuals are using web based health
promotion information but fails to answer
important questions regarding those who do
not use the programs who might be at highest
risk of the conditions we seek to prevent.
In addition site usage data does not answer
questions regarding usability issues which
might have caused individuals to leave the site
or fail to return.
Web Research Challenges
 Future research in Web based health
promotion, in addition to focusing on
outcomes, needs to focus on how to
integrate Web based programs into the
existing health promotion infrastructure.
How can these programs be used to
complement more traditional interventions?
Conclusions
Individuals regardless of age and gender are
willing to seek out health promotion
information on the Internet. Studies are
needed to define the web designs, which
maximize program participation and behavior
change. Research goals should be
incorporated at the time of web design to
facilitate further investigation of these issues
Robin G. Molella, MD1, Candace K. Kolars, PhD,
MPH2, Neil R. Sullivan, MPH3, and Philip T.
Hagen, MD1
(1) Preventive and Occupational Medicine, Mayo Clinic, 200 1st St. SW, Rochester,
MN 55905, 284-2560, [email protected], (2) Mayo Foundation, Mayo
Medical Ventures, 200 1st St. SW, Rochester, MN 55905, (3) Mayo Clinic Health
Management Resources, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905