title: Web-based tailoring and its effect on self-efficacy: results from the MI-HEART randomized controlled trial.
abstract: This paper reports the effects of a tailored Web-based delivery system on self-efficacy as it relates to a patients' response to acute myocardial information (AMI) symptoms. The data reported are from MI-HEART, a randomized trial examining ways in which a clinical information system can favorably influence the appropriateness and rapidity of decision-making in patients suffering from symptoms of acute myocardial infarction. Participants were randomized into one of three groups: tailored Web-based, non-tailored Web-based and non-tailored paper based. A theoretically based behavioral-cognitive model was used to identify key variables upon which to tailor education material. A key variable in the model is self-efficacy, operationalized with a three-dimensional scaling. Results show trends in improved self-efficacy scores for all groups at 1-month follow up, with sustained significant increases in baseline to 3-month scores only in the tailored Web-based group. One possible explanation could be related to "hit-count", which was significantly higher in the tailored group. This study is a first step in quantifying the contribution of Web-based tailoring over non-tailoring in changing key determinants of patient delay to AMI symptoms.
authors.affiliation: Department of Medical Informatics, Columbia University, New York, NY, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Kukafka
authors.forename: Yves A
authors.initials: YA
authors.lastname: Lussier
authors.forename: P
authors.initials: P
authors.lastname: Eng
authors.forename: Vimla L
authors.initials: VL
authors.lastname: Patel
authors.forename: James J
authors.initials: JJ
authors.lastname: Cimino
mesh_terms: D000465:Algorithms; D000704:Analysis of Variance; D003657:Decision Making; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods*; D020377:Self Efficacy; D011795:Surveys and Questionnaires