Health knowledge acquisition by rural women with chronic health conditions: A tale of two Web approaches

OBJECTIVES: To determine the differences in health knowledge acquisition and the perceived impact on self-management of chronic illness provided by two approaches to providing Web-based information. DESIGN: Repeated-measure questionnaire administered at four time points: baseline, 11, 23 and 53 weeks; a post-computer intervention survey. SETTING AND PARTICIPANTS: One hundred and seventy-six chronically ill women (aged 32-68 years) living in rural areas. MAIN OUTCOME MEASURES: Scores on knowledge questions within repeated measures; participant ratings on perceptions of abilities to self-manage. INTERVENTION: The 22-week computer-based intervention provided online support and health information. Women were randomly assigned to an intense intervention (n = 54), less-intense intervention (n = 58) or control group (n = 64). RESULTS: Both computer intervention groups gained significantly in health knowledge with little differential effect at intervention conclusion or after 6 months, when there was a drop-off in health knowledge retention of about one-third (intense - baseline mean = 0.54, week 23 = 0.69, week 53 = 0.65; less intense - 0.58, 0.68, 0.65). Control remained about the same (0.51, 0.51, 0.53). Using an anova analysis, there was no appreciable difference between intervention groups in perceptions of ability to self-manage illness (intense - mean = 4.02 (on a scale of 1-6), standard deviation = 0.99); less intense - (mean = 3.85, standard deviation = 1.00), t(107) = 0.90, P = 0.37). CONCLUSIONS: A less-intense intervention can be as effective as a more complex, labour-intensive and costly intervention in assisting chronically ill rural women to acquire health knowledge they consider to be moderately helpful in managing their chronic conditions.