Browsing by Author "Hess AC"

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    A Typology of Patients Based on Decision-Making Styles: Cross-Sectional Survey Study
    (JMIR Publications, 20/11/2019) FitzPatrick MA; Hess AC; Sudbury-Riley L; Schulz PJ
    Background: Although previous research shows broad differences in the impact of online health information on patient-practitioner decision making, specific research is required to identify and conceptualize patient decision-making styles related to the use of online health information and to differentiate segments according to the influence of online information on patient decision making and interactions with health professionals. Objective: This study aimed to investigate patients’ decision making in relation to online health information and interactions with health care practitioners. We also aimed to present a typology of patients based on significant differences in their decision making. Methods: We applied a large-scale cross-sectional research design using a survey. Data, generated using a questionnaire that was administered by companies specializing in providing online panels, were collected from random samples of baby boomers in the United Kingdom, the United States, and New Zealand. The total sample comprised 996 baby boomers born between 1946 and 1964, who had used the internet in the previous 6 months to search for and share health-related information. Data were analyzed using hierarchical cluster analysis and confirmatory factor analysis, as well as one-way analysis of variance, chi-square tests, and paired sample t tests. Results: Analyses identified 3 key decision-making styles that served as the base for 4 unique and stable segments of patients with distinctive decision-making styles: the Collaborators (229/996, 23.0%), the Autonomous-Collaborators (385/996, 38.7%), the Assertive-Collaborators (111/996, 11.1%), and the Passives (271/996, 27.2%). Profiles were further developed for these segments according to key differences in the online health information behavior, demographics, and interactional behaviors of patients. The typology demonstrates that collaborative decision making is dominant among patients either in its pure form or in combination with autonomous or assertive decision making. In other words, most patients (725/996, 72.8%) show significant collaboration in their decision making with health care professionals. However, at times, patients in the combination Autonomous-Collaborative segment prefer to exercise individual autonomy in their decision making, and those in the combination Assertive-Collaborative segment prefer to be assertive with health professionals. Finally, this study shows that a substantial number of patients adopt a distinctly passive decision-making style (271/996, 27.2%). Conclusions: The patient typology provides a framework for distinguishing practice-relevant and addressable segments with important implications for health care practitioners, including better-targeted communication programs for patients and more successful outcomes for health care services in the long term.
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    Adapting research methodology during COVID-19: Lessons for transformative service research
    (Emerald Publishing Limited, 8/02/2021) Dodds S; Hess AC
    Purpose Coronavirus disease 2019 (COVID-19) has created a challenging, yet opportunistic, environment in which to conduct transformative service research (TSR) and assess research methodology. The purpose of this paper is to evaluate and gain important new insights of a group interviewing method with vulnerable people and their support group, adapted and transferred online during COVID-19. Design/methodology/approach This research examines the experiences of 35 participants (nine family groups composed of parents and young people), involved in a research project that explores a sensitive topic, youth alcohol consumption and family communication, that was moved online during lockdown. Researcher reflections on running group interviews face-to-face prior to COVID- 19 and online during lockdown are included in the data. Findings Thematic analysis of participant interviews and researcher reflections reveals four key benefits and three limitations of online group interviews with vulnerable people and their support group. The benefits include being comfortable, non-intrusive and safe; engaging and convenient; online communication ease and easy set-up. The limitations relate to lack of non-verbal communication, poor set-up, and privacy and access issues. Practical implications The global environment is uncertain and being able to implement effective qualitative research online is essential for TSR and service research in the future. This paper provides a step by step procedure for an innovative online group interviewing technique that can be used by TSR and qualitative service researchers. Originality/value Conducting research during a pandemic has provided unprecedented insights into qualitative research approaches and methodology. This paper contributes to literature on service and TSR methodology by providing a framework for researchers to investigate vulnerable groups online in an effective, safe and non-intrusive way. The framework also has the potential to be applied to other service contexts.
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    Effects of eHealth literacy on general practitioner consultations: A mediation analysis
    (JMIR Publications, 16/05/2017) Schulz PJ; Fitzpatrick MA; Hess AC; Sudbury-Riley L; Hartung U
    Objective: We propose and test two potential mediators of the negative effect of eHealth literacy on health care utilization: (1) health information seeking and (2) gain in empowerment by information seeking. Methods: Data were collected in New Zealand, the United Kingdom, and the United States using a Web-based survey administered by a company specialized on providing online panels. Combined, the three samples resulted in a total of 996 baby boomers born between 1946 and 1965 who had used the Internet to search for and share health information in the previous 6 months. Measured variables include eHealth literacy, Internet health information seeking, the self-perceived gain in empowerment by that information, and the number of consultations with one’s general practitioner (GP). Path analysis was employed for data analysis. Results: We found a bundle of indirect effect paths showing a positive relationship between health literacy and health care utilization: via health information seeking (Path 1), via gain in empowerment (Path 2), and via both (Path 3). In addition to the emergence of these indirect effects, the direct effect of health literacy on health care utilization disappeared. Conclusions: The indirect paths from health literacy via information seeking and empowerment to GP consultations can be interpreted as a dynamic process and an expression of the ability to find, process, and understand relevant information when that is necessary.