Published online November 1, 2005
PEDIATRICS Vol. 116 No. 5 November 2005, pp. e643-e647 (doi:10.1542/peds.2005-0404)
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ELECTRONIC ARTICLE

Using the Internet to Provide Information Prescriptions

Lee M. Ritterband, PhD*, Stephen Borowitz, MD{ddagger}, Daniel J. Cox, PhD*, Boris Kovatchev, PhD*, Lynn S. Walker, PhD*,§, Vanessa Lucas, MA* and James Sutphen, MD, PhD{ddagger}

* Departments of Psychiatric Medicine
{ddagger} Pediatrics, University of Virginia Health System, Charlottesville, Virginia
§ Department of Pediatrics, Vanderbilt University, Nashville, Tennessee

Introduction. An information prescription is the provision of specific information to a patient on how to help manage a health problem. The Internet is being used increasingly as a source for information prescriptions, with clinicians directing patients to specific Web sites. As with any health care intervention, patients' lack of compliance is a barrier to the effectiveness of Web-based information prescriptions (WebIPs). WebIPs cannot be helpful if patients do not review the information prescribed for them.

Objective. The main objective of this study was to quantify the percentage of families who visit a Web site that was specifically prescribed by their physician. In addition, the use of an e-mail reminder was used to determine if it increases the likelihood that families will visit the prescribed Web site. Finally, barriers to accessing the prescribed Web site were identified.

Methods. Children were eligible if they presented to the pediatric gastroenterology clinic with chronic constipation and/or encopresis and their family had an active e-mail account and access to the Internet in their home. During their clinic visit, physicians instructed families to visit a Web site that provided educational information pertinent to their child's problem. Families were given a form with the Web-site address and a log-in identification number. Two days after their clinic visit, half of the families received an e-mail reminding them to visit the Web site. Families were contacted 1 week after their clinic visit to identify barriers to accessing the Web site.

Results. Eighty-three families participated in the study. Of the 83 families, 54 (65%) visited the prescribed Web site within 1 week of their clinic visit. Families who received e-mail reminders were significantly more likely to visit the Web site than families who did not receive an e-mail reminder (77% vs 53%). This difference could not be explained by the type or speed of Internet connection or how frequently they accessed the Internet or e-mail. The most common reasons that families cited for not accessing the Web site were "I forgot" and "I didn't have time." Few families cited technical reasons for not accessing the Web site.

Conclusions. Almost two thirds of the families given a WebIP logged on to the prescribed Web site. The probability that families would access the site was increased by 45% with an e-mail reminder. Clearly, e-mail prompts improve compliance to WebIPs. As content and treatment programs continue to proliferate on the Web, it is important to identify barriers and solutions to them to improve overall compliance.

Key Words: information prescriptions • Internet • World Wide Web • encopresis • behavior change • compliance

Abbreviations: WebIP, Web-based information prescription

Accepted May 19, 2005.


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