Evaluation of influenza prevention in the workplace using a personally controlled health record: randomized controlled trial.

Publisher: JMIR Publications Country of Publication: Canada NLM ID: 100959882 Publication Model: Electronic Cited Medium: Internet ISSN: 1438-8871 (Electronic) Linking ISSN: 14388871 NLM ISO Abbreviation: J Med Internet Res Subsets: MEDLINE

Publication: <2011- > : Toronto : JMIR Publications
Original Publication: [Pittsburgh, PA? : s.n., 1999-

Health Knowledge, Attitudes, Practice*; Health Promotion/*methods ; Influenza, Human/*prevention & control ; Internet/*statistics & numerical data ; Medical Records Systems, Computerized/*statistics & numerical data ; Patient Access to Records/*statistics & numerical data; Adult ; Computer-Assisted Instruction ; Female ; Health Behavior ; Health Promotion/statistics & numerical data ; Humans ; Logistic Models ; Male ; Middle Aged ; Occupational Health Services/organization & administration ; Patient Education as Topic ; United States ; Workplace

Background: Personally controlled health records (PCHRs) are accessible over the Internet and allow individuals to maintain and manage a secure copy of their medical data. These records provide a new opportunity to provide customized health recommendations to individuals based on their record content. Health promotion programs using PCHRs can potentially be used in a variety of settings and target a large range of health issues.
Objectives: The aim was to assess the value of a PCHR in an employee health promotion program for improving knowledge, beliefs, and behavior around influenza prevention.
Methods: We evaluated a PCHR-based employee health promotion program using a randomized controlled trial design. Employees at Hewlett Packard work sites who reported reliable Internet access and email use at least once every 2 days were recruited for participation. PCHRs were provided to all participants for survey administration, and tailored, targeted health messages on influenza illness and prevention were delivered to participants in the intervention group. Participants in the control group received messages addressing cardiovascular health and sun protection. The main outcome measure was improvement in knowledge, beliefs, and behavior around influenza prevention. Secondary outcomes were influenza vaccine rates among household members, the impact of cardiovascular health and sun protection messages on the control group, and the usability and utility of the PCHR-based program for employees.
Results: The intervention did not have a statistically significant effect on the influenza knowledge elements we assessed but did impact certain beliefs surrounding influenza. Participants in the intervention group were more likely to believe that the influenza vaccine was effective (OR = 5.6; 95% CI = 1.7-18.5), that there were actions they could take to prevent the flu (OR = 3.2; 95% CI = 1.1-9.2), and that the influenza vaccine was unlikely to cause a severe reaction (OR = 4.4; 95% CI = 1.3-15.3). Immunization rates did not differ between the intervention and control groups. However, participants in the intervention group were more likely to stay home during an infectious respiratory illness compared with participants in the control group (39% [16/41] vs 14% [5/35], respectively; P = .02). The program also succeeded in improving recognition of the signs of heart attack and stroke among participants in the control group. Overall, 78% of participants rated the PCHR as "extremely/very" easy to use, and 73% responded that they would be "extremely/very" likely to participate again in a PCHR-based health promotion system such as this one.
Conclusions: With a small sample size, this study identified a modest impact of a PCHR-based employee health program on influenza prevention and control. Employees found the PCHR acceptable and easy to use, suggesting that it should be explored as a common medium for health promotion in the workplace.
Trial Registration: ClinicalTrials.gov NCT00142077.

J Gen Intern Med. 1998 Jul;13(7):469-75. (PMID: 9686713)
J Am Med Inform Assoc. 2005 Jan-Feb;12(1):47-54. (PMID: 15492031)
J Med Internet Res. 2007 Sep 30;9(3):e28. (PMID: 17942390)
MMWR Recomm Rep. 2006 Jul 28;55(RR-10):1-42. (PMID: 16874296)
MMWR Recomm Rep. 2005 Jul 29;54(RR-8):1-40. (PMID: 16086456)
J Med Internet Res. 2006 Mar 30;8(1):e3. (PMID: 16585028)
N Engl J Med. 2007 Oct 11;357(15):1465-9. (PMID: 17928592)
BMC Med Inform Decis Mak. 2007 Sep 12;7:25. (PMID: 17850667)
BMJ. 2001 Feb 3;322(7281):283-7. (PMID: 11157533)
J Med Internet Res. 2007 Jun 19;9(2):e17. (PMID: 17581811)
J Am Med Inform Assoc. 2004 Jul-Aug;11(4):332-8. (PMID: 15187075)
N Engl J Med. 1995 Oct 5;333(14):889-93. (PMID: 7666874)
Int J Med Inform. 2001 Jun;62(1):27-40. (PMID: 11340004)
J AHIMA. 2007 Apr;78(4):44-6; quiz 49-50. (PMID: 17455846)
Vital Health Stat 10. 1999 Oct;(200):1-203. (PMID: 15782448)
J Am Med Inform Assoc. 2006 Mar-Apr;13(2):121-6. (PMID: 16357345)
J Med Internet Res. 2007 May 08;9(2):e10. (PMID: 17513281)

P01 CD000260 United States CD ODCDC CDC HHS; T32 HD40128-04 United States HD NICHD NIH HHS; 8 R01 CD000286-03 United States CD ODCDC CDC HHS; T32 HD040128 United States HD NICHD NIH HHS; T32 HD40128-03 United States HD NICHD NIH HHS; R01 CD000286 United States CD ODCDC CDC HHS; 5 P01 CD000260-02 United States CD ODCDC CDC HHS

ClinicalTrials.gov NCT00142077

Date Created: 20080318 Date Completed: 20080411 Latest Revision: 20220309

20231215

PMC2483848

10.2196/jmir.984

18343794