Abstract
OBJECTIVE: To determine whether access to health information via in-home Internet technology can positively influence empowerment among residents of a low-income urban community.
DESIGN: In-home Internet access and training were provided to volunteers, who, along with a comparison group, were interviewed prior to and 1 year after initiation of the program. Community-based participatory research methods were used to design and implement the intervention.
SETTING: A 57-block area on the West Side of Chicago.
PATIENTS/PARTICIPANTS: Twenty-five community residents completed all phases of the technology intervention. Thirty-five randomly selected neighbors of these residents served as the comparison group.
INTERVENTIONS: Members of the intervention group received Internet access via WebTV, training, technical support, and access to a community specific health-oriented web page during the course of the study.
MEASUREMENTS AND MAIN RESULTS: Intervention group members were similar to comparison group members in terms of empowerment at baseline. After receiving Internet access and training, empowerment related to health decision-making improved significantly in the intervention group. Similar changes did not occur in the comparison group. Affinity for and appreciation of information technology also increased in the intervention group but not in the comparison group. As a result, differences in attitudes toward technology increased between the 2 groups over time.
CONCLUSIONS: Using community-based participatory research methods, we found that Internet access to community-specific and general health information can lead to increased empowerment and appreciation of information technology. These benefits accrued among the intervention group but not among a random group of their neighbors.
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References
United States Department of Health and Human Services. Healthy People 2010, 2nd edition. Washington, DC: U.S. Government Printing Office; 2000.
Israel BA, Checkoway B, Schulz A, Zimmerman M. Health education and community empowerment: Conceptualizing and measuring perceptions of individual, organizational, and community control. Health Educ Q. 1994;21:149–70.
Conger JA, Kanungo RN. The empowerment process: integrating theory and practice. Acad Manage Rev. 1988;13:471–82.
Thomas KW, Velhouse BA. Cognitive elements of empowerment: an “interpretive” model of intrinsic task motivation. Acad Manage Rev. 1990;15:666–81.
Menon ST. Psychological empowerment: definition, measurement, and validation. Can J Behav Sci. 1999;31:161–4.
Zimmerman MA. Empowerment theory: psychological, organizational and community levels of analysis. In: Rappaport J, Seidman E, ed. Handbook of Community Psychology. New York, NY: Plenum Press; 1994.
Longo DR, Patrick TB, Kruse RL. The natural history of the use of healthcare information by women with breast cancer: a conceptual model. Proc AMIA Symp. 2001;Jan:413–7.
D’Alessandro DM, Dosa NP. Empowering children and families with information technology. Arch Pediatr Adolesc Med. 2001;155:1131–6.
Levin-Zamir D, Peterburg Y. Health literacy in health systems: perspectives on patient self-management in Israel. Health Promot Internation. 2001;16:87–94.
Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002;288:2469–75.
Rogers EM. Diffusion of Innovations. New York, NY: Free Press; 1983:5–7.
Rogers EM. Lessons for guidelines from the diffusion of innovation. Jt Comm J Qual Improv. 1995;21:324–8.
City of Chicago. Department of Public Health, Epidemiology Program Report, Community Area Health Inventory, 1989 & 1999, Volume I: Demographic and Health Profiles. Chicago, Ill: Department of Public Health; 2003.
Cassey MZ, Masi CM, Every block a village online: a strategy transfer guide. Bureau of Primary Health Care 2000. Available at: http://bphc.hrsa.gov/mtw/STGs.htm. Accessed June 1, 2003.
Suarez-Balcazar Y, Kinney L, Masi C, Cassey M, Muhammad B. Implementing a WebTV intervention in an African American neighborhood. Journal of Prevention & Intervention in the Community. In press.
Israel BA, Schulz AJ, Parker EA, Becker A. A review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.
Park PL, Lee WL. A theoretical framework for participatory evaluation research. Sociological Practice. 1999;2:89–100.
Selener D. Participatory Action Research and Social Change. Ithaca, NY: The Cornell Participatory Action Research Network; 1997.
Suarez-Balcazar Y, Balcazar F, Fawcett SB. Problem identification in applied social research. In: Bryant F, Edwards J, Tindale RS, et al., eds. Social Psychological Methods Applied to Social Issues. New York, NY: Plenum Press; 1992:25–42.
Whyte WF. Participatory Action Research. London, UK: Sage Publications; 1991.
Balcazar F, Keys C, Kaplan D, Suarez-Balcazar Y. Participatory action research and people with disabilities: principles and challenges. Can J Rehab. 1999;12:105–12.
Fetterman DM, Kaftarian SJ, Wandersman A. Empowerment Evaluation: Knowledge and Tools for Self-Assessment and Accountability. Thousand Oaks, Calif: Sage Publications; 1996.
Fawcett SB, Paine-Andrews A, Francisco VT, et al. Empowering community health initiatives through evaluation. In: Fetterman DM, Kaftarian SJ, Wandersman A, eds. Empowerment Evaluation. London, UK: Sage Publications; 1996:161–87.
Suarez-Balcazar Y, Orellana-Damacela L. A university-community partnership for empowerment evaluation in a community housing organization. Sociological Practice. 1999;1:115–32.
Linney JA, Wandersman A. Empowering community groups with evaluation skills: The Prevention Plus III Model. In: Fetterman DM, Kaftarian SJ, Wandersman A, eds. Empowerment Evaluation. London, UK: Sage Publications; 1996:259–76.
American Psychological Association. Publication Manual of the American Psychological Association, 4th ed. Washington, DC: American Psychological Association; 1994.
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Financial support was provided by the U.S. Department of Commerce’s Technology Opportunities Program and West Suburban Health Care, Oak Park, III.
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Masi, C.M., Suarez-Balcazar, Y., Cassey, M.Z. et al. Internet access and empowerment. J GEN INTERN MED 18, 525–530 (2003). https://doi.org/10.1046/j.1525-1497.2003.20344.x
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DOI: https://doi.org/10.1046/j.1525-1497.2003.20344.x