How an internet intervention works to achieve benefit for patients with coronary heart disease.
Doctoral thesis, UCL (University College London).
Internet interventions have the potential to support patient self-management of long term conditions. However, their mechanisms of action are unclear. There is also a concern that lack of equity of internet access may limit their benefits. The aim of this thesis was to develop a greater understanding of the potential of internet interventions for patients with a long term condition, in this case coronary heart disease (CHD), and their mechanisms for supporting patient self-management. Mechanisms of action were explored using constructs from psychological theories. Literature reviews of internet and CHD self-management interventions identified illness perceptions, self-efficacy and social support as psychological constructs that may explain mechanisms of action of internet interventions for patients with CHD. These constructs were evaluated in a prospective study with 168 patients with CHD. Participants, with or without home internet access or prior internet experience, had unlimited access to a CHD internet intervention over 9 months. Use of the intervention and changes in psychological constructs, behavioural, emotional and quality of life outcomes were evaluated using a mixed quantitative and qualitative design. Only a small proportion of eligible patients with CHD participated. Participants were predominantly male, highly educated and had better internet access and/or internet experience than was likely in the wider CHD population. Few had experienced recent problems with their condition. Overall use of the intervention was low compared to other internet interventions. Participants who were older, had more recently experienced a cardiac event or diagnosis, had home internet access and prior internet experience made greater use of the intervention. Most participants were positive about the intervention but no significant changes in psychological constructs or health outcomes were found. This implementation of an internet intervention to support CHD self-management appears to have limited potential, particularly for those without home internet access or confidence using computers.
|Title:||How an internet intervention works to achieve benefit for patients with coronary heart disease|
|Open access status:||An open access version is available from UCL Discovery|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Primary Care and Population Health|
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