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2015 HSR&D/QUERI National Conference Abstract

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3151 — A Community Engagement Strategy to Increase Veterans' Use of My HealtheVet, a Computerized Patient Portal and Self-Management Tool

Whittle J, Milwaukee VA Medical Center and the Medical College of Wisconsin; Fletcher , Milwaukee VA Medical Center and the Medical College of Wisconsin; Patterson , Medical College of Wisconsin; Ertl , Milwaukee VA Medical Center and the Medical College of Wisconsin;

Objectives:
To evaluate a peer-based educational mechanism to help Veterans register for and use My HealtheVet (MHV).

Methods:
We collaborated with American Legion leadership to identify 12 volunteer posts. We trained 1-6 "super-user" (SU) members of each post how to enroll in and use My HealtheVet. We asked these SU to deliver 10-minute lessons encouraging and facilitating MHV use at each of 4 monthly post meetings. We evaluated intervention impact using a step-wedge design, randomly assigning 3 groups of 4 posts to receive the 4-month interventions beginning during months 1, 5, and 9, respectively. We collected survey data from post members at baseline, after intervention period 1, and after intervention period 2. We used direct observation, focus groups, tracking software, and SU interviews to provide qualitative insights.

Results:
Survey respondents in participating posts were older (mean age 67.1 years old) men (100%). Intervention post members increased self-reported awareness of MHV (29.3%, 58.5%, 79.3% over 3 survey rounds), registration for advanced access (6.9%, 14.9%, 24.0%), and use of MHV (10.3%, 17.0%, 29.8%); in each case, statistically significant increases occurred after the intervention period. Observation visits confirmed the reliable delivery of the monthly lessons by SU in 7 of 8 intervention posts. Focus groups revealed that while post members appreciated the opportunity to learn about the resource, many do not use computers and think "the old way" works just fine. Family members were sometimes engaged to overcome resistance to computer use. SU were often frustrated by this issue, but valued the opportunity to serve their comrades. They thought that the loaner laptops were valuable, but often used their own equipment if they worked with individual post members. Review of tracking software on loaner laptops showed that laptops were seldom used except to access MHV during in-post presentations.

Implications:
Our community-based, peer-delivered educational intervention increased use of MHV by VA users in participating Legion posts; anecdotes suggest greater family involvement could facilitate non-computer using Veterans access to MHV.

Impacts:
Peer support from American Legion post members can increase MHV use and may be an important resource to improve Veterans' health.