Date of Award

May 2017

Degree Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Nursing

First Advisor

Jennifer Doering

Committee Members

Amy Coenen, Susan McRoy, Carol Klingbeil

Abstract

Background: The prevalence of gestational diabetes mellitus (GDM) continues to increase. Research suggests that adverse maternal and newborn outcomes increase in relation to the mother’s elevated blood glucose levels. Diabetes researchers discuss that utilizing information technology for self-management, particularly Internet-based modes of delivery, may result in individual improvements in diabetes outcomes. Scant research exists on the use of Internet-based tools such as patient web portals (PWPs) for GDM self-management and outcomes.

Purpose: The purpose of this study was to examine PWP use in women with GDM. Specific aims of this study included: 1) compare the characteristics of nonusers and users of a patient web portal (PWP) for self-management including relationships between characteristics and PWP use, 2) in users of the PWP, describe the frequency and patterns of PWP use, and 3) compare glycemic control between PWP users and nonusers.

Methods: A retrospective study was conducted using electronic health record (EHR) review of PWP users (n=91) and nonusers (n=67) who sought care in a diabetes and pregnancy clinic for GDM management.

Results: PWP users were more likely to be employed fulltime than nonusers (p= .011). There were no statistically significant differences between users and nonusers for the other patient characteristics. Most users accessed the PWP each month in the third trimester but the number of days accessed varied greatly. The AVS [24.31 (SD 25.05)] and appointment reminders [15.44 (SD 17.00)] were accessed most frequently. Glycemic control did not differ significantly between users and nonusers (F (1.520, 191.474) = 184.428, p=.559).

Discussion: This research provides insight into the patient characteristics of users and nonusers of a PWP for a non-chronic condition (GDM) and outlines the features of the PWP used. Patient web portals should be further stringently evaluated for their usability in this population of patients including facilitators and barriers to its use as well as dosage of utilization.

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