title: The Use of eHealth and Provider-Based Health Services by Patients with Diabetes Mellitus: Protocol for a Cross-Sectional Study.
abstract: BACKGROUND
  The prevalence of diabetes and the use of electronic health (eHealth) resources are increasing. People with diabetes need frequent monitoring and follow-up of health parameters, and eHealth services can be of great significance in this regard. However, little is known about the extent to which different kinds of eHealth tools are used, and how the use of eHealth is associated with the use of provider-based health care services among people with diabetes.
  
  
  OBJECTIVE
  The primary objective of this study is to investigate the use of eHealth and its association with the use of provider-based health care services. The secondary objectives include investigating which eHealth services are used (apps, search engines, video services, social media), the relationship between socioeconomic status and the use of different eHealth tools, whether the use of eHealth is discussed in the clinical encounter, and whether such tools might lead to (or prevent) doctor visits and referrals.
  
  
  METHODS
  We will conduct cross-sectional studies based on self-reported questionnaire data from the population-based seventh Tromsø Study. Participants will be diabetic patients aged 40 years and older. According to our estimates, approximately 1050 participants will be eligible for inclusion. Data will be analyzed using descriptive statistics, chi-square tests, and univariable and multivariable logistic regressions.
  
  
  RESULTS
  The grant proposal for this study was approved by the Northern Norway Regional Health Authority on November 23, 2015 (HST 1306-16). Recruitment of participants for the Tromsø Study started in 2015 and will continue throughout 2016. This particular project started on July 1, 2016.
  
  
  CONCLUSIONS
  This project may yield benefits for patients, health care providers, hospitals, and society as a whole. Benefits are related to improved prevention services, health, experience of care services, self-management tools and services, organizational structures, efficiency of specialist care use, allocation of resources, and understanding of how to meet the challenges from the increasing prevalence of diabetes. This project has potential for generalization to other groups with chronic disease.
authors: University Hospital of North Norway, Tromsø, Norway.|Department of Community Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
authors: Anne Helen
authors: http://orcid.org/0000-0002-2731-6916
authors: AH
authors: Hansen
authors: Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.
authors: Meghan
authors: http://orcid.org/0000-0003-4540-225X
authors: M
authors: Bradway
authors: Department of Internal Medicine, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Jan
authors: http://orcid.org/0000-0003-2465-7333
authors: J
authors: Broz
authors: Medical Centre, Nordland Hospital, Bodø, Norway.
authors: Tor
authors: http://orcid.org/0000-0002-0076-169X
authors: T
authors: Claudi
authors: Faculty of Social Sciences, Nord University, Bodø, Norway.
authors: Øystein
authors: http://orcid.org/0000-0002-4127-2905
authors: Ø
authors: Henriksen
authors: Department of Substance Use and Mental Health, University Hospital of North Norway, Narvik, Norway.|Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Narvik, Norway.
authors: Silje C
authors: http://orcid.org/0000-0001-9501-0989
authors: SC
authors: Wangberg
authors: Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway.|Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.
authors: Eirik
authors: http://orcid.org/0000-0002-9520-1408
authors: E
authors: Årsand
keywords: Norway; cross-sectional study; diabetes mellitus; health care utilization; socioeconomic status; use of eHealth