title: Evaluation of the Compliance, Acceptance, and Usability of a Web-Based eHealth Intervention for Parents of Children With Infantile Hemangiomas: Usability Study.
abstract: BACKGROUND
  Infantile hemangiomas (IH) are common benign vascular tumors in children. Recognition and timely referral of high risk IH to specialized centers is important. This might be achieved by involving parents in the care for IH by means of an eHealth intervention.
  
  
  OBJECTIVE
  The objective of our study was to evaluate parent compliance, acceptance, and usability of an open access, Web-based eHealth intervention (including e-learning and e-consult) designed to increase parents' knowledge and (risk) evaluation of IH.
  
  
  METHODS
  A cross-sectional study of parents who completed the eHealth intervention between October 2010 and November 2012 was carried out. All parents were sent a study questionnaire. Questions to evaluate compliance (to the advice given by a dermatologist during e-consultation) were asked. Acceptance and usability were evaluated by using the modified Technology Acceptance Model.
  
  
  RESULTS
  A total of 224 parents completed the eHealth intervention and received the questionnaire, 135/224 parents responded (response rate was 60.3%). There were 128/135 questionnaires that were completed and included. A total of 110/128 (85.9%) parents were compliant to the advice of the dermatologist. There were 116.8/128 (91.3%) that perceived the eHealth intervention as useful and almost all parents (98.4%, 126/128) found the information in the e-learning clear. There were 29/128 (22.7%) that experienced technical problems. The majority of the parents (94.5%, 121/128) found the eHealth intervention reliable and most of them (98.4%, 126/128) would recommend the eHealth intervention to other parents. Noncompliant parents judged the eHealth intervention significantly less reliable compared to compliant parents (71%, 10/14 versus 97.3%, 107/110; P=.003).
  
  
  CONCLUSIONS
  Parents of children with an IH showed a high compliance (85.9%, 110/128) to the advice of the dermatologist given via our Web-based eHealth intervention. This high compliance might be positively influenced by the good acceptance and usability of the eHealth intervention and might result in timely presentation and treatment of children with high risk IH in specialized centers.
authors.affiliation: Wilhelmina Children's Hospital, Department of Pediatric Dermatology and Allergology, University Medical Center Utrecht, Utrecht, Netherlands. m.degraaf-10@umcutrecht.nl.
authors.forename: Marlies
authors.initials: M
authors.lastname: de Graaf
authors.forename: Joan
authors.initials: J
authors.lastname: Totte
authors.forename: Corstiaan
authors.initials: C
authors.lastname: Breugem
authors.forename: Harmieke
authors.initials: H
authors.lastname: van Os-Medendorp
authors.forename: Suzanne
authors.initials: S
authors.lastname: Pasmans
keywords: Internet; acceptance; child; compliance; dermatology; e-learning; eHealth; infantile hemangioma; optimizing care; usability