Needs Assessment And Application Mode Research Of Community Chronic Disease Health Management APP

Objective:To figure out the utilization and and its associates of health management APP in China,and to understand users’ perception,attitude and functional needs of health management APP for chronic disease,thus to provide a basis for the development of community health management APP,and to form an application mode of community chronic disease health management APP based on mobile health technology.Methods:With the principle and procedures of informed consent,1 506 chronic disease patients with stroke,hypertension or diabetes,30 family members of patients with chronic disease,460 community health workers,12 specialists,and 12 staff members in Beilun District of Ningbo City and Pingyin County of Jinan City were recruited as the objects in the study.Based on Technology Acceptance Model theory,we used a combination of quantitative questionnaire surveys and focus group discussions to investigate subjects’demographic data,as well as subjects’cognition,attitudes,usage and functional needs of health management APP.Epidata3.1 was used to establish a database for quantitative data in this study.SAS 9.4,SPSS 22.0 and SPSSAU were used for statistical analysis.χ2 test was used to compare the utilization rate of health management APP,unconditional logistic regression was used to analyze the influencing factors of health management APP use,and the Structural Equation Modeling was used to fit the model of cognition,attitudes,and functional needs.Content analysis was used to analyze and interpret the interview results.Results:1.The utilization rate of health management APP:the utilization rate of health management APP in chronic disease patients and community health workers was 16.60%and 46.30%respectively.2.Influencing factors for the use of health management APP:higher education level(OR=3.25,95%CI:1.63～6.49),higher family income(OR=4.11,95%CI:210～8.05),currently smoking(OR=1.83,95%CI:1.14～2.93)and more medical advertisements in health management APP(OR=1.85,95%CI:1.35-2.53)were related to higher usage rate of health management APP for chronic disease patients,while older(OR=0.20,95%CI:0.10～0.38),lack of exercise(OR=0.40,95%CI:0.28～0.57)and unbalanced diet(OR=0.67,95%CI:0.49～0.92)were related to lower usage rate of health management APP.Male(OR=2.07,95%CI:1.36～3.17),general practitioners(OR=2.36,95%CI:1.35～4.15),regular exercise(OR=2.32,95%CI:1.59-3.37),higher willingness to use health management APP for patients(OR=5.57,95%CI:1.60～19.40)were correlated with higher usage rate of health management APP in community health workers.3.Needs assessment:external variables had an impact on users’ perceived usefulness,perceived usefulness affected users’ attitude towards the use of health management APP,which in turn had an impact on users’ use needs,including health monitoring,health assessment and health intervention needs.Among the functional needs for health management APP,the most needed was health monitoring,followed by health education,other functions included health reminders and warning,mutual assistance between doctors and patients,health intervention and other functions.For the design of health management APP,simplicity and practicality was the most important,other requirements included incentive mechanism,connectivity with local health system,strong operability,etc.Conclusions:1.The utilization rate of health management APP for chronic disease patients and community health workers was low,the integrated development of mHealth technology and traditional chronic disease health management should be promoted to improve the quality and efficiency of health management.2.Education level,family income,lifestyle,and the characteristics of health management APP,such as whether there were plenty of medical advertisements were correlated with the use of health management APP.3.The design of community health management APP should be user-oriented.We should develop a simple,practical and easy-to-operate APP,and focus on health monitoring and health education,and set up incentive mechanism,thus to improve the compliance of patients with chronic diseases and community health workers.