Explaining Health-Related Internet Use for Three Patient Engagement Activities in Rural Pacific Northwest.

Background and objective: Internet-based patient engagement (PE) can empower rural individuals in essential health services. This study investigated predisposing, need, and enabling factors associated with major online PE activities in the rural populations of the United States Pacific Northwest region.

Method: A cross-sectional survey of 250 adults aged 45 to 75 residing in rural parts of Alaska, Idaho, Oregon, and Washington was conducted. Three domains of predictors (predisposing, need, and enabling factors) were assessed. The outcomes were 3 major online PE activities (online access to care, information seeking and sharing, and self-management support).

Result: Online health engagement was associated with multiple chronic diseases, perceived need for colorectal cancer screening, difficulty finding providers, and lower mistrust. Younger age, higher awareness of colorectal cancer risk, better health status, difficulty finding providers, frequent internet use, and misunderstanding between patients and providers were associated with increased online information seeking and sharing. Female gender, more cancer knowledge, lower income, and higher information search difficulty were associated with increased online self-management support. Health information literacy was associated with all PE activities.

Conclusion: Different factors influence online PE activities among rural populations. Optimizing diverse PE activities should assess different predisposing, need, and enabling factors in rural health care.