The document presents the Plymouth E-health Readiness Questionnaire (PERQ) developed by Professor Ray Jones to measure e-health readiness and inequality, which assesses individuals' ability to use the internet for health on scales of provision, personal skills, support, and economic access. The PERQ has undergone piloting and can be used to evaluate the impact of interventions on e-health readiness and inequality.

1. A questionnaire and measure of
‘e-health readiness’
and
‘e-health inequalities’
for use in intervention studies
Ray Jones
Professor Health Informatics
Plymouth University

2. What is the impact of……

3. What is the impact of……
Superfast Cornwall?
Is it going to mean
the young and
connected will start
doing ever more
things on the
Internet leaving the
old and
disconnected ever
further behind and
disadvantaged?

4. How do we measure digital inequality?
Binary: have or haven’t
Typically
•Number with home Internet
•Number used Internet in last 3 months

5. How do we measure digital inequality?
Binary: have or haven’t
Or perhaps
•Have been able to do X on Internet
(access+skill)

6. Can assess inequality by looking at spread

7. Other more sophisticated ways..

8. Other more sophisticated ways..
Lorenz curve
Mr Gini Gini coefficient

9. e-health readiness:
ability to use Internet for health
e-health inequality:
spread (SD) of distribution of e-health readiness

10. e-health readiness:
ability to use Internet for health
e-health inequality:
spread (SD) of distribution of e-health readiness
Interventions are ‘good’ if they improve e-health
readiness and at least do not increase e-health
inequality, preferably decrease it:

11. e-health readiness:
ability to use Internet for health
e-health inequality:
spread (SD) of distribution of e-health readiness
Interventions are ‘good’ if they improve e-health
readiness but at least do not increase e-health
inequality, preferably decrease it:
Why? (i) fairness, (ii) efficiency of health services

12. Things you know about
• Differences in use of Internet: about 80% of people had
used Internet in last 3 months
• Differences by age (personal skill and interest)
• Differences by urban/rural (physical availability)
• Some people have support to help, others don’t
• Some people will consider Internet expensive

13. E-health inequalities you may not have
thought about
• 35% of GPs in Southend had a website compared to
94% in Harrogate
• Many US practices use pre-consultation computer-
interviews but these are rarely used in the UK.
• Most UK renal patients have access to their renal
medical record online but few if any stroke patients have
such facility.
• Use of a globally available online cognitive behavioural
therapy site for depression, varied 30-fold by postcode
area across UK

14. Plymouth E-health Readiness
Questionnaire (PERQ)
• 3 stage process of piloting
• Self-completed questionnaire
• Used in population survey to check validity
• Produces an e-health readiness score (0-9)
• From four subscores:
– Provision
– Personal
– Support
– Economic

15. Distribution of e-health readiness (PERQ) scores on possible
scale 0-9 showing Internet-users and non-Internet-users

16. Assumed changes Difference in Paired t- Overall Paired t-
readiness test on mean test on
score for sub (SD) whole
sub group group readiness population
Baseline: 344 respondents 4.24
(1.73)
20 people who previously used computer From t=12.6 4.32 t=4.34
at home and at work got mobile access 4.9 to 6.2 P<0.001 (1.79) P<0.001
and became aware of GP services for these 20
including patient access to records.
20 non-Internet-users are supported in From t=18.6 4.44 t=4.48
getting online. They have not looked at the 1.8 to 5.0 p<0.001 (1.61) p<0.001
GP website but have found other health for these 20
information online

17. • If you would like to use PERQ and its scoring
system, or would like to collaborate on its
further development, please get in touch
• Ray.jones@plymouth.ac.uk