Rural providers’ access to online resources: a randomized controlled trial
Keywords:Clinical Decision Support Systems, Computer- Assisted Decision Making, Decision Making, Evidence-Based Library and Information Practice, Evidence-Based Practice, Health Status Disparities, Health Care Disparities, Information Divide
Objective: The research determined the usage and satisfaction levels with one of two point-of-care (PoC) resources among health care providers in a rural state.
Methods: In this randomized controlled trial, twenty-eight health care providers in rural areas were stratified by occupation and region, then randomized into either the DynaMed or the AccessMedicine study arm. Study participants were physicians, physician assistants, and nurses. A pre- and post-study survey measured participants’ attitudes toward different information resources and their information-seeking activities. Medical student investigators provided training and technical support for participants. Data analyses consisted of analysis of variance (ANOVA), paired t tests, and Cohen’s d statistic to compare pre- and post-study effects sizes.
Results: Participants in both the DynaMed and the AccessMedicine arms of the study reported increased satisfaction with their respective PoC resource, as expected. Participants in both arms also reported that they saved time in finding needed information. At baseline, both arms reported too little information available, which increased to ‘‘about right amounts of information’’ at the completion of the study. DynaMed users reported a Cohen’s d increase of þ1.50 compared to AccessMedicine users’ reported use of 0.82. DynaMed users reported d2 satisfaction increases of 9.48 versus AccessMedicine satisfaction increases of 0.59 using a Cohen’s d.
- Figure 4: Rated mean satisfaction with 13 health information resources by providers given gratis access to AccessMedicine for 3 months
- APPENDIX A: Email text and phone script for prospective participants
- Figure 1: Reported mean frequency of use of 13 health information resources by providers given gratis access to DynaMed for 3 months
- Figure 3: Rated mean satisfaction with 13 health information resources by providers given gratis access to DynaMed for 3 months
- Figure 2: Reported mean frequency of use of 13 health information resources by providers given gratis access to AccessMedicine for 3 months
- APPENDIX B: Health information resource post-survey for state practitioners