Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

3014 — Diabetic Veterans’ Access to and Use of the Internet: Implications for My HealtheVet Adoption

Cho AH (Durham VAMC) , Hartwell P (Durham VAMC), Edelman D (Durham VAMC), Yancy, Jr WS (Durham VAMC)

Objectives:
VHA’s My HealtheVet (MHV) Internet portal could deliver self-management support to chronically ill VA users, but it is unknown how many can access it. Our goal was to describe the access to, use of, and attitudes toward the Internet of VA users at Durham VAMC with uncontrolled diabetes.

Methods:
Our study population included veterans assigned to any of five Durham VAMC primary care practices. Eligible veterans had diabetes mellitus with last HgbA1c >8.0, correct contact information, no psychotic mental illness, and were physically able to complete the survey. All were mailed a survey modeled (with permission) after a Kaiser Family Foundation national survey of older adults’ use of the Internet for health reasons. Summary statistics were generated, and Chi-square analysis was used to identify factors associated with Internet access and ‘strong interest’ in MHV.

Results:
382 veterans were eligible; 195 completed surveys (response rate=51%). Average age was 59.5 years; 92% were male; 34% were African American, 58% white; 37% reported schooling up to high school graduation or less; 58% had incomes of $30,000 or less. 150 (77%) reported already monitoring their blood sugars and other vitals at home. 117 (60%) had Internet access at home. An additional 36 (18%) said they could go online at a friend’s or family member’s. Only 14 (7%) reported having no access. 145 (74%) reported knowing someone they trusted who went online regularly and 105 (54%) said it was ‘likely’ this person could help them use the Internet on a regular basis. 93 (48%) reported having looked for information online about diabetes. 30 (15%) had heard of MHV. 78 (40%) reported a ‘strong interest’ in using a website like MHV to help track their home blood glucose measurements, including 20 who did not have a computer at home. In bivariate analyses, predictors of having a home Internet connection included income (p=0.004) and education (p=0.016). Race was not a significant predictor. Having a computer at home was associated with ‘strong interest’ in using MHV (p=0.009).

Implications:
Many veterans with diabetes at Durham VAMC have access to the Internet, and many have looked for information about their illness online. Predictors of not having access include lower income and educational attainment; these barriers will have to be addressed if all VA users are to benefit from MHV implementation.

Impacts:
These results will be used to identify VA users at Durham VAMC for possible inclusion in a pilot study of a MHV-based intervention to improve diabetes outcomes.