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Meta-Analysis
. 2012 Nov 14;11(11):CD007982.
doi: 10.1002/14651858.CD007982.pub2.

Email for the provision of information on disease prevention and health promotion

Prescilla Sawmynaden  1 , Helen Atherton, Azeem Majeed, Josip Car
Affiliations
Meta-Analysis

Email for the provision of information on disease prevention and health promotion

Prescilla Sawmynaden et al. Cochrane Database Syst Rev. .

Abstract

Background: Email is a popular and commonly used method of communication, but its use in health care is not routine. Its application in health care has included the provision of information on disease prevention and health promotion, but the effects of using email in this way are not known. This review assesses the use of email for the provision of information on disease prevention and health promotion.

Objectives: To assess the effects of email for the provision of information on disease prevention and health promotion, compared to standard mail or usual care, on outcomes for healthcare professionals, patients and caregivers, and health services, including harms.

Search methods: We searched: the Cochrane Consumers and Communication Review Group Specialised Register (January 2010), the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1 2010), MEDLINE (1950 to January 2010), EMBASE (1980 to January 2010), CINAHL (1982 to February 2010), ERIC (1965 to January 2010) and PsycINFO (1967 to January 2010). We searched grey literature: theses/dissertation repositories, trials registers and Google Scholar (searched July 2010). We used additional search methods: examining reference lists, contacting authors.

Selection criteria: Randomised controlled trials, quasi-randomised trials, controlled before and after studies and interrupted time series studies examining interventions where email is used by healthcare professionals to provide information to patients on disease prevention and health promotion, and taking the form of 1) unsecured email 2) secure email or 3) web messaging. We considered healthcare professionals or associated administrative staff as participants originating the email communication, and patients and caregivers as participants receiving the email communication, in all settings. Email communication was one-way from healthcare professionals or associated administrative staff originating the email communication, to patients or caregivers receiving the email communication.

Data collection and analysis: Two authors independently assessed the risk of bias of included studies and extracted data. We contacted study authors for additional information. We assessed risk of bias according to the Cochrane Handbook for Systematic Reviews of Interventions. For continuous outcome measures, we report effect sizes as mean differences (MDs). For dichotomous outcome measures, we report effect sizes as odds ratios (ORs). We conducted a meta-analysis for one primary health service outcome, comparing email communication to standard mail, and report this result as an OR.

Main results: We included six randomised controlled trials involving 8372 people. All trials were judged to be at high risk of bias for at least one domain. Four trials compared email communication to standard mail and two compared email communication to usual care. For the primary health service outcome of uptake of preventive screening, there was no difference between email and standard mail (OR 0.93; 95% CI 0.69 to 1.24). For both comparisons (email versus standard mail and email versus usual care) there was no difference between the groups for patient or caregiver understanding and support. Results were inconclusive for patient or caregiver behaviours and actions. For email versus usual care only, there was no significant difference between groups for the primary outcome of patient health status and well-being. No data were reported relating to healthcare professionals or harms.

Authors' conclusions: The evidence on the use of email for the provision of information on disease prevention and health promotion was weak, and therefore inadequate to inform clinical practice. The available trials mostly provide inconclusive, or no evidence for the outcomes of interest in this review. Future research needs to use high-quality study designs that take advantage of the most recent developments in information technology, with consideration of the complexity of email as an intervention.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
4
4
Forest plot of comparison: 3 Email compared to standard mail: Health service outcome, uptake of preventive screening, outcome: 3.1 No. of participants having colorectal screening (completing either a FOBT, sigmoidoscopy or colonoscopy).
5
5
Funnel plot of comparison: 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, outcome: 3.1 No. of participants having colorectal screening (completing either a FOBT, sigmoidoscopy or colonoscopy).
1.1
1.1. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 1 During study, communicated with doctor by email (private access arm only).
1.2
1.2. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 2 Information requested from doctor by email about a disease or condition (private access arm only).
1.3
1.3. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 3 Information requested from doctor by email about appointments, test results or prescriptions (private access arm only).
1.4
1.4. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 4 Information requested from doctor by email about 'other' topic (private access arm only).
1.5
1.5. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 5 Discussed CRCS with no‐one (private access arm only).
1.6
1.6. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 6 Discussed CRCS with doctor (private access arm only).
1.7
1.7. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 7 Discussed CRCS with 'other' (private access arm only).
1.8
1.8. Analysis
Comparison 1 Email versus standard mail: Primary outcome, Patient or caregiver behaviours/actions, Outcome 8 % Programme attendance.
2.1
2.1. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 1 Transformed scores for MOS Social Support: emotional/informational support.
2.2
2.2. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 2 Transformed scores for MOS Social Support: tangible support.
2.3
2.3. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 3 Transformed scores for MOS Social Support: Affectionate support.
2.4
2.4. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 4 Transformed scores for MOS Social Support: Positive social interaction.
2.5
2.5. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 5 Transformed scores for MOS Social Support: Overall support index.
2.6
2.6. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 6 Sallis Social Support and Exercise Survey Scores: participation: friends.
2.7
2.7. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 7 Sallis Social Support and Exercise Survey Scores: participation: family.
2.8
2.8. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 8 Sallis Social Support and Exercise Survey Scores: participation: others.
2.9
2.9. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 9 Sallis Social Support and Exercise Survey Scores: rewards and punishment: family.
2.10
2.10. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 10 Sallis Social Support and Exercise Survey Scores: rewards and punishment: others.
2.11
2.11. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 11 Likert‐type scale: participatory intention scores: 6 months.
2.12
2.12. Analysis
Comparison 2 Email versus standard mail: Primary outcome, Patient or caregiver understanding and support, Outcome 12 Likert‐type scale: participatory intention scores: 12 months.
3.1
3.1. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 1 No. of participants having colorectal screening (completing either a FOBT, sigmoidoscopy or colonoscopy).
3.2
3.2. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 2 No. of participants who had an mammography (Mayo Clinic employees).
3.3
3.3. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 3 No. of participants who had a Papanicalaou smear (Mayo Clinic employees).
3.4
3.4. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 4 No. of participants having colorectal screening (Mayo Clinic employees).
3.5
3.5. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 5 No. of participants having influenza vaccine (Mayo Clinic employees).
3.6
3.6. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 6 No. of participants having tetanus vaccine (Mayo Clinic employees).
3.7
3.7. Analysis
Comparison 3 Email versus standard mail: Primary outcome, Health service, uptake of preventive screening, Outcome 7 No. of participants having lipid screening (Mayo Clinic employees).
4.1
4.1. Analysis
Comparison 4 Email versus usual care: Primary outcome, patient or caregiver behaviours/actions, Outcome 1 No. of visits to prescribed website within 1 week of clinic visit.
4.2
4.2. Analysis
Comparison 4 Email versus usual care: Primary outcome, patient or caregiver behaviours/actions, Outcome 2 Eating breakfast daily.
4.3
4.3. Analysis
Comparison 4 Email versus usual care: Primary outcome, patient or caregiver behaviours/actions, Outcome 3 Drinking alcohol in last month.
4.4
4.4. Analysis
Comparison 4 Email versus usual care: Primary outcome, patient or caregiver behaviours/actions, Outcome 4 Eating low fat food regularly.
4.5
4.5. Analysis
Comparison 4 Email versus usual care: Primary outcome, patient or caregiver behaviours/actions, Outcome 5 Eating low sugar items regularly.
5.1
5.1. Analysis
Comparison 5 Email versus usual care: Primary outcome, patient health status and well‐being, Outcome 1 Below weight maintenance band.
5.2
5.2. Analysis
Comparison 5 Email versus usual care: Primary outcome, patient health status and well‐being, Outcome 2 In weight maintenance band.
5.3
5.3. Analysis
Comparison 5 Email versus usual care: Primary outcome, patient health status and well‐being, Outcome 3 Above weight maintenance band.
5.4
5.4. Analysis
Comparison 5 Email versus usual care: Primary outcome, patient health status and well‐being, Outcome 4 Mean % weight loss maintained at 6 months.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD007982

References

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Burgard 2006 {published data only}
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References to ongoing studies

Catz NCT00923624 {unpublished data only}
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Morgan ACTRN1260900092524 {unpublished data only}
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Atherton 2009b
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