Veterans Experiences Using Secure Messaging

• Usability of Secure Messaging [ Time Frame: November 2011 - April 2012 ] [ Designated as safety issue: No ]
  To determine user ability of secure messaging at baseline (ex. Navigate to Secure Messaging Log-in site; Secure Messaging Log-in; Set user preferences; Check Inbox; Open Secure Message; Open and read attachment; Send Secure Message)
  
  

• Secure Messaging use and content patterns [ Time Frame: November 2011 - August 2012 ] [ Designated as safety issue: No ]
  To longitudinally examine the quantity and quality of content, exchange patterns, and timing of inbound and outbound SM between participants and their healthcare teams.
  
  
• User experiences with Secure Messaging [ Time Frame: January - August 2012 ] [ Designated as safety issue: No ]
  These interviews will assess usability, barriers, facilitators and satisfaction of Secure Messaging at 3 months post-testing.
  
  

The primary aim of this project is to describe Veterans' experiences when using the SM feature on MyHealtheVet (MHV):

Objective 1: Describe Veterans' beliefs, attitudes, and perceptions toward using SM.

RQ1.1: Are there differences in beliefs, attitudes, and perceptions for adopters of SM (high volume, active users); and non-adopters of SM (low volume, not active users, or opted out)? RQ1.2: How do beliefs, attitudes, and perceptions toward using SM differ based on Veteran characteristics, including socio-demographic factors, health literacy, and computer literacy? Objective 2: Describe the user patterns and trends of Veterans when using SM. RQ2.1: How do user patterns and trends differ for adopters of SM and non-adopters of SM? RQ2.2: How do user patterns and trends differ based on Veteran characteristics, including socio-demographic factors, health literacy, and computer literacy? Objective 3: Identify the barriers to and facilitators for using SM. RQ3.1: How do barriers and facilitators differ for adopters of SM and non-adopters of SM? RQ3.2: How do barriers and facilitators differ based on Veteran characteristics, including socio-demographic factors, health literacy, and computer literacy? Objective 4: Identify strategies for overcoming barriers to using the Secure Messaging feature on My HealtheVet? RESEARCH DESIGN: This mixed-methods descriptive study will utilize in-person qualitative interviews, usability testing of the SM feature on MHV; SM secondary data analysis and 3-month follow-up interviews. Purposive sampling will be used to identify a sample of 30-40 Veterans who have been Personally Authenticated for the SM feature on MHV. Fifteen participants will be recruited from each site (Tampa, Boston). Two types of participants will be recruited at each site: (1) high volume users; and (2) low volume- or non- users. High volume user is defined by the quantity of SM use since opting in the SM program. Low volume user is defined by minimal or no use of SM since opting in the SM program. Data Collection Procedures: (1) In-person interviews; (2) usability testing; (3) SM secondary data collection; and (4) three-month follow-up telephone interviews will be conducted to complete study objectives.

ANALYSIS: Content analysis methods will be used to manage transcript data to identify domains and taxonomies related to Veteran experiences using SM. Data will be categorized and interpreted, and barriers and facilitators will be identified. Quantitative data will be summarized with descriptive statistics to describe sample characteristics. We will examine frequency counts and proportions to provide a descriptive picture of the usability. Using Morae software, a usability analysis will be conducted to analyze and interpret the patterns and trends of veteran testing data. Descriptive statistics will be used to examine group differences and effect sizes will be calculated to provide data for planning future studies. These data sources will be triangulated to increase the knowledge base of Veteran experiences when using SM.