title: Determinants of use and non-use of a web-based communication system in cerebral palsy care: evaluating the association between professionals' system use and their a priori expectancies and background.
abstract: BACKGROUND
  Previously we described parents' and professionals' experiences with a web-based communication system in a 6-month pilot in three Dutch cerebral palsy care settings. We found that half of the participating professionals had not used the system, and of those who had used the system one third had used it only once. The present study aimed to evaluate whether professionals' system use was associated with their a priori expectancies and background.
  
  
  METHODS
  Professionals who had not used the system (n = 54) were compared with professionals who had used the system more than once (n = 46) on the basis of their questionnaire responses before the pilot, their affiliation and the number of patients which they represented in the study. The questionnaire items comprised professionals' expectancies regarding the system's performance and ease of use, as well as the expected time availability and integration into daily care practice.
  
  
  RESULTS
  Overall, users had higher a priori expectancies than non-users. System use was associated with expected ease of use (p = .046) and time availability (p = .005): 50% of the users (vs. 31% of the non-users) expected that the system would be easy to use and 93% of the users (vs. 72% of the non-users) expected that they would be able to reserve a time slot each week for responding to submitted questions. With respect to professionals' affiliation, system use was associated with professionals' institution (p = .003) and discipline (p = .001), with more (para-) medical professionals among users (93% vs. 63% among non-users), and more education professionals among non-users (37% vs. 7% among users). In addition, users represented more patients (mean 2, range 1-8) than non-users (mean 1.1, range 1-2) (p = .000).
  
  
  CONCLUSIONS
  Professionals' system use was associated with expected ease of use and time availability, professionals' affiliation and the number of represented patients, while no association was found with expected performance of the system. To achieve higher adoption rates in the future, it is important to further develop the technology by optimizing the system's ease of use and interoperability and including advanced consultation options. In addition, better identified end users should be more extensively informed about the system's possibilities through tailored education.
authors.affiliation: Roessingh Research & Development, Research Institute for Rehabilitation and Technology, PO Box 310, 7500 AH Enschede, The Netherlands. j.gulmans@rrd.nl
authors.forename: Jitske
authors.initials: J
authors.lastname: Gulmans
authors.forename: Miriam Mr
authors.initials: MM
authors.lastname: Vollenbroek-Hutten
authors.forename: Lisette Jewc
authors.initials: LJ
authors.lastname: van Gemert-Pijnen
authors.forename: Wim H
authors.initials: WH
authors.lastname: van Harten
mesh_terms: D001291:Attitude of Health Personnel; D002547:Cerebral Palsy / Q000628:therapy*; D003142:Communication; D006801:Humans; D020407:Internet; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D013663:Teaching