Background: Identifying effective means of communication between patients and their health care providers has a positive impact on patients’ satisfaction, adherence, and health-related outcomes. Objective: This study aimed to identify the impact of patients’ age on their communication and technology preferences when managing their health. We hypothesize that a patient’s age affects their communication and technology preferences when interacting with clinicians and managing their health. Methods: A mixed methods study was conducted to identify the preferences of patients with cardiovascular diseases. Results were analyzed based on the patients’ age. Grounded theory was used to analyze the qualitative data. Patients were recruited based on age, gender, ethnicity, and zip code. Results: A total of 104 patients were recruited: 34 young adults (19-39 years), 33 middle aged (40-64), and 37 senior citizens (>65). Young adults (mean 8.29, SD 1.66) reported higher computer self-efficacy than middle-aged participants (mean 5.56, SD 3.43; P<.05) and senior citizens (mean 47.55, SD 31.23; P<.05). Qualitative analysis identified the following three themes: (1) patient engagement (young adults favored mobile technologies and text messaging, middle-aged patients preferred phone calls, and senior citizens preferred direct interactions with the health care provider); (2) patient safety (young adults preferred electronic after-visit summaries [AVS] and medication reconciliation over the internet; middle-aged patients preferred paper-based or emailed AVS and medication reconciliation in person; senior citizens preferred paper-based summaries and in-person medication reconciliation); (3) technology (young adults preferred smartphones and middle-aged patients and senior citizens preferred tablets or PCs). Middle-aged patients were more concerned about computer security than any other group. A unique finding among senior citizens was the desire for caregivers to have access to their personal health record (PHR). Conclusions: Patients of different ages have different communication and technology preferences and different preferences with respect to how they would like information presented to them and how they wish to interact with their provider. The PHR is one approach to improving patient engagement, but nontechnological options need to be sustained to support all patients.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: In the era of precision medicine, it is critical for health communication efforts to prioritize personal health record (PHR) adoption. Objective: To describe the characteristics of patients with heart disease that choose to adopt a PHR. Methods: Seventy-nine with chronic cardiovascular disease patients participated in this study: 48 PHR users and 31 non-users. They completed five surveys related to their choice to use or not use the PHR: demographics, patient activation, medication adherence, health literacy, and computer self-efficacy (CSE). Results: There is a significant difference between users and non-users in sociodemographic measure education (P=0.046). There is no significant difference between users and non-users in sociodemographic measures: age (P=0.20), sex (P=0.35), education (P=0.046), ethnicity (P=0.43), race (P=0.42), and employment (P=0.6360). There is a significant difference between PHR users and PHR non-users in CSE (P=0.0061). Conclusions: In this study, we demonstrate that sociodemographic characteristics were not an important factor in patients’ use of their PHR except for education. This study had a small sample size and may not have been large enough to detect differences between groups. Our results did demonstrate that there is a difference between PHR users and non-users related to their CSE. This work suggests that incorporating CSE into the design of PHRs is critical. The design of patient facing tools must take into account patients’ preferences and abilities when developing effective user-friendly health information technologies (HIT).

Background: This study explores heart failure (HF) dyadic contextual factors and caregiver burden during acute exacerbation hospitalization and discharge. Methods: It employed a mixed-methods approach, with HF dyads completing questionnaires and semi-structured interviews at a one-week post-discharge outpatient visit. Quantitative tools included the SF-12 Quality of Life, Zarit Burden Interview (ZBI), Bakas Caregiving Outcomes Scale (BCOS), and Self-Care of Heart Failure Index v. 6 (SCHFI). Thematic analysis was conducted on interview data to assess caregiver burden, disease trajectory, comorbidities, caregiving time, and employment status. Results: Twelve HF dyads participated, with caregivers (six female, six male) averaging 65.76 years. The ZBI indicated a low caregiver burden (median score of 15), but qualitative data revealed a higher perceived burden related to social isolation, future fears, and caregiver dependence. Male caregivers reported a lower burden than females. Positive goal congruence was noted in caregiving hours and HF management compliance. HF patients had a 10-year survival prediction of 22.75% per the Charlson Comorbidity Index, with 69% in NYHA class III and an average ejection fraction of 37.7%. Caregivers working full-time and caring for higher NYHA-class patients showed higher ZBI and BCOS scores. Conclusions: The study highlights the need for mixed methods and longitudinal research to understand HF disease trajectory and caregiver burden, emphasizing the importance of including caregivers in HF education and screening for perceived burden to improve outcomes and reduce re-hospitalizations.

Background: Hospital-acquired pressure injuries (HAPIs) remain a costly yet preventable threat to patient safety and quality of care. Evidence-based prevention strategies are essential to reduce incidence and support institutional goals. Objective: The purpose of this review was to synthesize evidence-based quality improvement interventions to prevent nondevice-related HAPIs in US hospital settings. Methods: Using the Whittemore and Knafl integrative review framework, a systematic search of 4 databases identified studies published between 2015 and 2023. Of 178 records screened, 10 studies met the inclusion criteria. Methodological quality was appraised using the Quality Improvement Minimum Quality Criteria Set. Results: Interventions were clustered into 4 categories: turn teams, documentation enhancements, protocol strategies, and interdisciplinary collaborations. Conclusion: HAPI prevention requires coordinated, system-level, interprofessional interventions with engaged leadership, and future research should emphasize sustainability, scalability, and fidelity using standardized quality improvement reporting frameworks.