title: Emergency department patients' preferences for technology-based behavioral interventions.
abstract: OBJECTIVE
  To assess emergency department (ED) patients' preferences for technology-based behavioral interventions, and the demographic factors associated with these preferences.
  
  
  METHODS
  A cross-sectional survey of a random sample of urban ED patients (≥13 years) from a representative sample of shifts, with oversampling of adolescents/young adults (aged 13 to 24 years). Participants self-administered the survey about baseline technology use, concerns about technology-based interventions, and preferred intervention format for 7 behavioral health topics. We performed descriptive statistics and multivariate logistic regression (controlling for demographics and then additionally for baseline technology use) to identify factors differentially associated with technology preference for each behavioral topic.
  
  
  RESULTS
  Of patients presenting during research assistant shifts, 1,429 (≈59%) were screened and 664 (68.2% of eligible) consented to participate. Mean age was 31 years (SD 0.69); 54.5% were female, 64.1% were white, 23.2% were Hispanic, and 46.6% reported low income. Baseline use of computers (91.2%), Internet (70.7%), social networking (66.9%), mobile phones (95.0%), and text messaging (73.8%) was high. Participants reported interest in receiving interventions on each behavioral topic. Ninety percent preferred a technology-based intervention for at least 1 topic. Patients expressed greatest concerns about Internet (51.5%) and social networking (57.6%), particularly about confidentiality. Adjusting for sex, race, ethnicity, and income, younger age associated with preference for technology-based interventions for unintentional injuries (odds ratio 0.63 for technology preference if adult versus youth; 95% confidence interval 0.45 to 0.89) and peer violence (odds ratio 0.63 if adult; 95% confidence interval 0.43 to 0.92). Additionally adjusting for baseline technology usage, only baseline usage was associated with preference for technology-based interventions.
  
  
  CONCLUSIONS
  ED patients reported high baseline technology use, high interest in behavioral health interventions, and varying preferences for technology-based interventions. Future studies should address actual feasibility and acceptability of technology-based interventions in a more generalized population and ways to alleviate concerns about these interventions.
authors.affiliation: Injury Prevention Center of Rhode Island Hospital, Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA. mranney@lifespan.org
authors.forename: Megan L
authors.initials: ML
authors.lastname: Ranney
authors.forename: Esther K
authors.initials: EK
authors.lastname: Choo
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Wang
authors.forename: Andrew
authors.initials: A
authors.lastname: Baum
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Clark
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mello
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D037001:Directive Counseling / Q000379:methods*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008490:Medical Informatics; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods; D057240:Patient Preference / Q000706:statistics & numerical data; D014754:Violence / Q000517:prevention & control; D014947:Wounds and Injuries / Q000517:prevention & control; D055815:Young Adult