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Citizens and ICT for Health in 14 EU countries: results from an online panel survey (14,000 responses)

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Citizens and ICT for Health in 14 EU countries: results from an online panel survey (14,000 responses)

Citizens and ICT for Health in 14 EU countries: results from an online panel survey (14,000 responses)

  1. 1. The views expressed in this presentation are those of the author and do not (necessarily) reflect the position of the European Commission. Neither the Commission nor any person acting on behalf of the Commission can be hold responsible for the use which is made of this presentation Citizens and ICT for Health in 14 EU countries: results from an online panel survey SIMPHS 2 - Validation Workshop 30/01/2012 (Brussels) Survey results presentation
  2. 2. <ul><li>From eEurope to Digital Agenda for Europe: towards Europe 2020 </li></ul>The Digital Agenda stresses how &quot;by harnessing the full potential of ICT, Europe could much better address some of its most acute societal challenges: climate change and other pressures on our environment, an ageing population and rising health costs &quot; ICT for Social Challenges: reducing health inequalities; promoting active and healthy ageing; and increasing empowerment - Action 75: Give Europeans secure online access to their medical health data - Action 76: Propose a recommendation to define a minimum common set of patient data - Action 77: Foster EU-wide standards, interoperability testing and certification of eHealth - Action 78: Reinforce the Ambient Assisted Living (AAL) Joint Programme European Innovation Partnerships on Active and Healthy Ageing (chronic patients; the elderly; RMT) - Prevention - Care and cure - Independent living Policy context
  3. 3. Objectives Analysing the demand side - To develop typologies of digital healthcare users and measure the impact of ICT and the Internet on health status, health care demand and health management. - To identify factors that can enhance or inhibit the role and use of Personal Health Systems from citizens' perspective with special emphasis on mHealth, RMT, disease management, Telecare, Telemedicine, Wellness
  4. 4. From theoretical framework and empirical evidence to policy-making <ul><li>1. Define and contextualise the theoretical framework for policy- Making </li></ul><ul><li>Design and gather relevant information grounded within robust and consolidate theoretical framework to support policy-making </li></ul><ul><li>Multivariate statistical analysis to find underlying dimensions: from questionnaire items to concept </li></ul><ul><li>Identify key relationships between concepts to understand ICT for Health as a complex ecosystem </li></ul><ul><li>Policy lessons </li></ul>
  5. 5. <ul><li>Define and contextualise the theoretical framework for policy-making </li></ul>
  6. 6. Social determinants of Health World Health Organization., A conceptual framework for action on the social determinants of health. Discussion Paper Series on Social Determinants of Health,. 2010, Geneva: World Health Organization. 76 p.
  7. 7. Social determinants of ICT Divides Motivational Material Skills Usage Social determinants of Health
  8. 8. Social determinants of ICT for Health Social determinants of Health + Social determinants of ICT = Social determinants of ICT for Health
  9. 9. Technological properties of ICT (hardware, software, content) Social determinants of ICT for Health SOCIOECONOMIC AND POLITICAL CONTEXT Health Information Sources Trust Awareness Material Skills Usage ICT for Health READINESS Evaluation Usefulness Learning Social life ICT for Health ASSESSMENT Health care Demand Health Management Health care Quality ICT for Health IMPACT Individual uses Social uses BARRIERS EMPOWERMENT TRIGGERS ICT for Health MOTIVATION Motivation Material Skills Usage ICT ACCESS Social cohesion & Social capital Distribution of Health and well-being Material circumstances Social Cohesion Psychosocial factors Behaviour Biological factors Intermediary determinants Health System <ul><li>Personal categories </li></ul><ul><li>Age/generation </li></ul><ul><li>Sex/gender </li></ul><ul><li>Race/ethnicity </li></ul><ul><li>Intelligence </li></ul><ul><li>Personality </li></ul><ul><li>HEALTH/ABILITY </li></ul><ul><li>Positional categories </li></ul><ul><li>Labor </li></ul><ul><li>Education </li></ul><ul><li>Household </li></ul><ul><li>Nation </li></ul>Structural determinants Willingness to use ICT for Health ICT FOR HEALTH ACCESS PARTICIPATORY HEALTH
  10. 10. Health care Demand Health Management Health care Quality Health Information Sources Trust Motivation Material Skills Usage ICT ACCESS Evaluation Usefulness Learning Social life ICT for Health IMPACT Individual uses Social uses PARTICIPATORY HEALTH Awareness Material Skills Usage BARRIERS EMPOWERMENT TRIGGERS Willingness to use ICT for Health ICT for Health MOTIVATION ICT for Health ASSESSMENT ICT for Health READINESS Material circumstances Social Cohesion Psychosocial factors Behaviour Biological factors Distribution of Health and well-being Intermediary determinants Health System Social cohesion & Social capital ICT FOR HEALTH ACCESS Technological properties of ICT (hardware, software, content) Social determinants of ICT for Health <ul><li>Personal categories </li></ul><ul><li>Age/generation </li></ul><ul><li>Sex/gender </li></ul><ul><li>Race/ethnicity </li></ul><ul><li>Intelligence </li></ul><ul><li>Personality </li></ul><ul><li>HEALTH/ABILITY </li></ul><ul><li>Positional categories </li></ul><ul><li>Labor </li></ul><ul><li>Education </li></ul><ul><li>Household </li></ul><ul><li>Nation </li></ul>SOCIOECONOMIC AND POLITICAL CONTEXT Structural determinants
  11. 11. <ul><li>Design and gather relevant information grounded within robust and consolidate theoretical framework to support policy-making </li></ul><ul><li>METHODS </li></ul>
  12. 12. Methods Questionnaire design • Block A: Health status and health care and social care services use • Block B: ICT for Health Motivation and Health Information sources • Block C: ICT Access • Block D: ICT for Health Readiness and Evaluation • Block E: Socio demographic profile of participants
  13. 13. Methods Online survey technical information Population Citizens aged from 16 to 74 years old who have used the Internet in the last three months. Scope of countries Austria, Belgium, Germany, Denmark, Estonia, Finland, France, Italy, Netherlands, Sweden, Slovenia, Slovakia, Spain, United Kingdom Type of survey Online Sample size 1,000 interviews per country. 14,000 interviews in total. Quotas Country Gender (Female/Male) Age Group (16-24/ 25-54/ 55-74) Sampling error + 0.85% for overall data and + 3.16% for country-specific data. In all cases, a maximum indeterminate probability (p=q=50), for a confidence level of 95.5% is applicable for each one of the reference populations Weighting Proportional allocation for each country. Weighting by country to be able to interpret the overall data. Sampling Individuals have been sampled in a completely random manner.
  14. 14. Methods <ul><li>Data analysis – Multivariate statistics </li></ul><ul><li>Frequencies and socio-demographics characterisation </li></ul><ul><li>To confirm the several internal complementarities of grouped items, the means and their significant correlation were checked </li></ul><ul><li>Factor analysis was used to assess item correlations and identify common relationships between similar items, allowing the items to be categorized into various themes or factors </li></ul><ul><li>Correlations (ANOVA – MANOVA) test results showed that dimensions’ mean differ significantly across categories </li></ul><ul><li>Structural Equation Modeling ( SEM ) </li></ul>
  15. 15. <ul><li>Multivariate statistical analysis to find underlying dimensions: from questionnaire items to concept </li></ul><ul><li>RESULTS </li></ul>
  16. 16. ICT ACCESS
  17. 17. ICT ACCESS Basic uses Individual uses - eComm Tech uses Social – Web 2.0 uses
  18. 18. ICT ACCESS & AGE
  19. 19. ICT FOR HEALTH ACCESS MOTIVATION
  20. 20. TRIGGERS Social & Services oriented Individual-oriented
  21. 21. EMPOWERMENT <ul><li>Empowerment, broadly understood as the </li></ul><ul><li>development of personal involvement and responsibility </li></ul><ul><ul><li>Assuming responsibility is a more active form of control </li></ul></ul><ul><ul><li>“ Competence ” refers to aptitudes or qualities that make it possible to be more autonomous and take a role in decision-making </li></ul></ul><ul><ul><li>One of the goals of prevention, promotion and protection in health campaigns across the world for several years </li></ul></ul><ul><ul><li>Perspectives of personal empowerment seem to coexist with respect to </li></ul></ul><ul><ul><li>Health </li></ul></ul><ul><ul><li>an aptitude to comply with expert advice ( professional perspective) </li></ul></ul><ul><ul><li>self-reliance through individual choice ( consumer perspective) </li></ul></ul><ul><ul><li>social inclusion through the development of collective support ( community perspective) </li></ul></ul>
  22. 22. ICT for Health MOTIVATION - Empowerment Control oriented Competence oriented Competence oriented
  23. 23. MOTIVATION - Empowerment Control oriented
  24. 24. MOTIVATION - Empowerment Competence oriented Control oriented
  25. 25. BARRIERS Lack of confidence Lack of readiness
  26. 26. ICT FOR HEALTH ACCESS READINESS
  27. 27. ICT for Health READINESS Information and Communication Usage Awareness Skills Willingness
  28. 28. ICT for Health READINESS Services and Devices Usage Awareness Skills Willingness
  29. 29. Services and Devices usage % At least once Accessed or uploaded your information or health record through an Internet application provided by your healthcare organization Used a game console to play games related with your health or your wellness Used a health/wellness application on your mobile phone Used devices to transmit vital signs or other clinical information and/or received alarms or follow-up about your health Received any message about health promotion and/or health prevention Gender Male 20* 26* 23* 26* 41* Female 12 19 14 16 33 Age group 16-24 26* 38* 33* 30* 47* 25-54 15 22 17 20 36 55-74 7 5 4 16 29 Level of education completed Primary or lower secondary education 15 20 16 22 33 Upper secondary education 17 23 19 22* 37 Tertiary education 15 22 19 19 39* Type of locality Densely-populated area 18* 25* 21* 22* 41* Intermediate area 15 22 18 20 36 Thinly-populated area 11 18 13 20 32 Health status Bad 12 14 12 22 36 Neither good or bad 15 18 16 21 36 Good 16 24* 19* 21 38 Long standing illness Yes 14 18 15 22* 37* No 17* 25* 20* 20 37
  30. 30. ICT FOR HEALTH WILLINGNESS
  31. 31. ICT for Health WILLINGNESS Web 2.0 uses Internet Health Information Assuming that you were provided the possibility, state how likely it is that you would do the following during the next year?
  32. 32. ICT for Health READINESS Services and Devices Assuming that you were provided the possibility, state how likely it is that you would do the following during the next year?
  33. 33. ICT FOR HEALTH IMPACT
  34. 34. ICT for Health IMPACT Quality of care and Healthy behaviors Health care access
  35. 35. Health Information sources & Trust
  36. 36. Traditional media Health professionals Health Information sources & Trust Social media sources Institutional Trust Companies Trust
  37. 37. <ul><li>Identify key relationships between concepts to understand ICT for Health as a complex ecosystem </li></ul>
  38. 38. Health care Demand Health Management Health care Quality Health Information Sources Trust Tech uses Social uses - Web 2.0 Individual uses - eCom Basic uses ICT USAGE Usefulness - Learning Social life ICT for Health IMPACT PARTICIPATORY HEALTH Information & Communication Services & Devices Willingness to use ICT for Health ICT for Health MOTIVATION ICT for Health ASSESSMENT <ul><li>Personal categories </li></ul><ul><li>Age/generation </li></ul><ul><li>Sex/gender </li></ul><ul><li>Race/ethnicity </li></ul><ul><li>Intelligence </li></ul><ul><li>Personality </li></ul><ul><li>HEALTH/ABILITY </li></ul><ul><li>Positional categories </li></ul><ul><li>Labor </li></ul><ul><li>Education </li></ul><ul><li>Household </li></ul><ul><li>Nation </li></ul>Material circumstances Social Cohesion Psychosocial factors Behaviour Biological factors SOCIOECONOMIC AND POLITICAL CONTEXT Distribution of Health and well-being Intermediary determinants Structural determinants Health System ICT FOR HEALTH ACCESS Social cohesion & Social capital Technological properties of ICT (hardware, software, content) A1 – A2 – A3 A4 – A5 – A6 – A7 – A8 A11-A12 E1 E2 E5 E7 E9,E10,E11,E12 Traditional sources Health professionals Social media sources Institutional Companies Information and professional Interaction and organisation Triggers Individual oriented Social & Services oriented Empowerment Competences Control Barriers Lack of confidence Lack of readiness Internet Health information use Services & devices use Web 2.0 uses Quality of care & healthy behaviours Health care access Individual uses Social uses ICT for Health USAGE
  39. 39. Social determinants of ICT for Health Tech uses Web 2.0 Basic uses Individual uses ICT Readiness ICT for Health Usage Services & devices Information & Communication ++ + ++ + + + + ++ ++ + Quality & Healthy behavior Healthcare access ICT for Health Impact - ICT for Health Triggers Social & Services oriented Individual oriented Competence oriented Control oriented Empowerment MOTIVATION Confidence Readiness Barriers + + + + Structural determinants Intermediary determinants Health System ++ Health problems
  40. 40. Social determinants of ICT for Health Tech uses Web 2.0 Basic uses Individual uses ICT Readiness ICT for Health Usage Services & devices Information & Communication ++ + ++ + + + + ++ ++ + Quality & Healthy behavior Healthcare access ICT for Health Impact - ICT for Health Triggers Social & Services oriented Individual oriented Competence oriented Control oriented Empowerment MOTIVATION Confidence Readiness Barriers + + + + Structural determinants Intermediary determinants Health System ++ Health problems
  41. 41. ICT for Health Willingness and Age SOCIAL ENGAGEMENT BEYOND INFORMATION FOSTERING ADVANCE USES
  42. 42. ICT for Health Impact and Age CURE, CARE AND INDEPENDENT LIVING HEALTH PREVENTION AND PROMOTION AS SERVICES
  43. 43. Health is social ICT for Health is also social Social engagement Household participation Peers
  44. 44. Correlation ICT usages / # Health problems ICT for Health Usage and Chronic Yes – No / Chronic illness reported
  45. 45. ICT for Health Skills and Age # ICT for Health activities (mean)
  46. 46. <ul><li>POLICY LESSONS </li></ul>
  47. 47. Conclusions <ul><li>High potential of ICT for Health to promote active and healthy individuals and increase empowerment. </li></ul><ul><li>Even though our findings are related with Internet users, it is worth pointing out that new health inequalities are emerging due to the impact of the &quot;traditional determinants of heath&quot; on ICT readiness. </li></ul><ul><li>These ICT for Health divides specially impact on the elderly. This also could be an opportunity to engage them within Information Society through ICT for Health </li></ul><ul><li>eInclusion policies related with ICT for Health are needed to ensure that individuals with low socio-economic status and worse health status are able to benefit from these types of technologies. </li></ul>
  48. 48. <ul><li>The different typologies of ICT Access and ICT for Health Motivation, Readiness and Impact (life events) </li></ul><ul><li>Young individuals are already using this type of technologies mostly in relation with wellness and healthy live style . These uses enable an entire world of possibilities related with health promotion and prevention as a services , specially considering that young individuals are heavy Web 2.0 users. </li></ul><ul><li>Middle age individuals are also active users of ICT for Health acting as gatekeepers of this type of technologies within the household. Therefore these individuals could act as enablers for others , both the elderly and the youth within the households </li></ul><ul><li>The elderly are basically using ICT for Health for information and communication purposes. There is a gap between this type of uses and services and devices uses with could be more effective in relation with cure and chronic conditions . </li></ul>Conclusions
  49. 49. Conclusions <ul><li>Chronic conditions </li></ul><ul><li>Young and middle age individuals with chronic conditions; undergoing long-term treat and with more than one health problem are more likely to use ICT for Health than individuals without these type of health problems. Health status as a driver for these periods of life . </li></ul><ul><li>Healthier elderly are more likely to utilise ICT for Health, specially Information and Communication, than non healthy elderly. </li></ul><ul><ul><li>This group of individuals will be pushing in the short term health systems to provide them with new solutions ( services and devices ) when they will tackle a health problem. </li></ul></ul><ul><ul><li>This pressure will be increased during the next decade when middle age individuals will become elderly. </li></ul></ul>
  50. 50. Challenges <ul><li>Ready for new users’ typologies? Short and middle term? </li></ul><ul><ul><li>Organisations </li></ul></ul><ul><ul><li>Professionals </li></ul></ul><ul><ul><li>Health policy and planning </li></ul></ul><ul><li>New ICT for Health inequalities? Opportunity to include the elderly within Information Society? </li></ul><ul><li>ICT for Health along life? </li></ul><ul><ul><li>Prevention and Promotion </li></ul></ul><ul><ul><li>Care and Cure </li></ul></ul><ul><ul><li>Independent living </li></ul></ul>
  51. 51. Thank you very much for your attention Francisco Lupiáñez-Villanueva, PhD @flupianez http://www.ictconsequences.net [email_address] Information Society Unit European Commission, DG JRC Institute for Prospective Technological Studies (IPTS) Edificio Expo - Calle Inca Garcilaso, s/n E-41092 Seville - Spain http://ipts.jrc.ec.europa.eu Phone +34 954 488 206 (direct) Fax +34 954 488 208

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