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Essays on the Design and Evaluation of Information Technology-Enabled Interventions for Chronic Disease Risk Assessment and Communication
Any type of content formally published in an academic journal, usually following a peer-review process.
posted on 30.06.2009by Christopher Harle
This dissertation contains four essays that address the design and evaluation of health information
technology for improving clinician and consumer decision making related to chronic disease risk.
A basic question that summarizes the problems in these essays is: How should information
technology-enabled interventions be designed and evaluated in order to effectively deliver expert
information about health risks to non-expert users? Chapter 1, An Information Visualization
Approach to Classification and Assessment of Diabetes Risk in Primary Care, describes the
development and evaluation of a novel approach to organizing, classifying and displaying patient
data according to risk of diabetes and heart disease. Chapter 2, The Impact of Web-Based Risk
Calculators on Health Risk Perceptions and Information Processing evaluated the response of
middle-aged adults to personalized risk calculator websites, like those commonly available on the
Internet, versus non-personalized diabetes risk information. Results showed that the nonpersonalized
website led users to seek significantly more health information, to be more engaged,
and to process information more systematically. Chapter 3, Evaluating Consumer E-Health
Services for Risk Communication: An Organizational Field Experiment, built on the second essay
to test the effectiveness of online risk calculators using a larger participant sample and a realistic
health promotion setting. Most striking was that participants who underestimated their prediabetes
risk showed little propensity to adopt more accurate risk beliefs, but participants who
overestimated their risk significantly reduced their risk perceptions after using a personalized risk
calculator. This suggested an avoidance of negative risk information and may mean that the
primary effect of risk calculators is to risk perceptions, a troubling result since these diseases are
already known to raise relatively little concern among the public. Chapter 4, Designing
Individualized Risk Communication that Avoids Information Avoidance looks at prior
psychology, decision making and health behavior research to explain the empirical results presented in earlier chapters and point to future work that may improve the design and evaluation
of technology-mediated risk communication services.