title: Using Digital Technology to Engage and Communicate with Patients: A Survey of Patient Attitudes.
abstract: BACKGROUND
  As primary care moves toward a system of population health management, providers will need to engage patients outside traditional office-based interactions.
  
  
  OBJECTIVE
  We assessed patient attitudes regarding technology use to communicate with their primary care team or to engage with other patients outside typical office settings. Design/Participants/Main Measures We conducted a national survey using GfK KnowledgePanel(®) to examine attitudes on the use of digital technology (email, text messaging, and social media such as Facebook and Twitter) to communicate with primary care teams about health behavior goals and test results. We also assessed attitudes toward the use of digital technologies to engage with other patients in activities such as peer coaching.
  
  
  RESULTS
  Of the 5119 panel members invited to participate, 3336 completed the survey (response rate, 65.2 %). Among respondents, more than half (58 %) reported using Facebook, and nearly two-thirds (64.1 %) used text messaging. Overall, few participants were willing to communicate about health goals via social media (3.1 %) or text messaging (13.3 %), compared to email (48.8 %) or phone (75.5 %) (results were similar for communication about test results). Among those that used text messaging, race/ethnicity was the only factor independently associated with greater support for text messaging [African American (OR 1.44; 95 % CI, 1.01-2.06) and Hispanic (OR 1.8; 95 % CI, 1.25-2.59)] in multivariate models. Participants interested in engaging in peer coaching through Facebook (11.7 %) were more likely to be younger (p < 0.0001), female (p < 0.001), and a racial/ethnic minority (African American, non-Hispanic or Hispanic, p < 0.0004).
  
  
  CONCLUSIONS
  Despite regular use of new digital technology such as text messaging and social media, few participants supported using these tools for communicating with their physicians' practice. Participants were most supportive of using email for communication. Contrary to previous studies, among users of technology, low socioeconomic status and racial/ethnic minorities were equally or more likely to support use.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, 1310 Blockley Hall, 423 Guardian Drive, Philadelphia, PA, 19104, USA. jenssenb@email.chop.edu.|Division of General Pediatrics, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. jenssenb@email.chop.edu.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Jenssen
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Nandita
authors.initials: N
authors.lastname: Mitra
authors.affiliation: PCCI, Dallas, TX, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Shah
authors.affiliation: Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Fei
authors.initials: F
authors.lastname: Wan
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.|Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Grande
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003142:Communication; D003195:Computer Communication Networks / Q000706:statistics & numerical data*; D005260:Female; D015438:Health Behavior; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: email; patient engagement; social media; technology use; text messaging