An exploratory analysis of factors associated with use of the Internet and a continuity of care document for persons living with HIV/AIDS in New York City

Background. Healthy People 2020 identified as a Focus Area the need for improved interactive Health Communication and Health IT in disparate populations. Attainment of this goal includes: (1) increasing access to the Internet as essential for obtaining health information and health promotion efforts; and (2) increasing the use of electronic personal health management tools (EPHMTs) as essential for keeping track of personal health information.;Statement of the problem. For these objectives to be achieved, a more comprehensive perspective on the predictors of Internet and EPHMT use in special needs, chronically ill populations must be identified. There is currently a lack of definitive research that: (1) Explores predictors of Internet use; (2) Identifies contributing factors to use of EPHMTs; (3) Examines the acceptance of and satisfaction with EPHMTs [e.g. Continuity of Care Document (CCD)] in disparate populations of People Living with HIV/AIDS (PLWH). With a special needs population of PLWH, the current study sought to assess technology experience by the examination of potential predictors of Internet use, to explore the perceptions of PLWH, their Healthcare Providers and Care Site Mangers regarding the implementation of a CCD and to evaluate the extent to which PLWH believe a CCD to be useful and simple to use.;Procedures and methods. PLWH enrolled in a Medicaid/Managed Care plan, completed a survey that assessed predictors of health outcomes and Internet use. Pre-CCD implementation focus groups and interviews were conducted to identify factors that may potentially impact system use. CCD users completed a survey that gathered perceptions of the system's effectiveness.;Results. PLWH that were younger, higher educated, with favorable perceptions of personal health, were significantly more likely to use the Internet. Qualitative results identified potential barriers to CCD use and strategies to facilitate use. CCD users believed the system to be useful in managing healthcare needs and enhancing care.;Conclusions. Study results contribute to the identification of factors associated with use of the Internet and EPHMTs in a special needs population of PLWH. Results can be used to inform population-level strategies to overcome disparities, inform enhancements and modifications of existing EPHMTs, and guide future Health IT efforts.