Student Survey – Teens, Technology, and Transforming Healthcare: Findings from a Student Survey

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September / October 2006

Student Survey

Teens, Technology, and Transforming Healthcare: Findings from a Student Survey

By George Leonard Ettel, III;

Michael Anthony Cerio, Jr., M.Ed.; Megan Thuy Vu; Kehsi Iman Wilson; William Jamal Johnson

Despite a national push toward the use of health information technology and increasing use of the Internet for medical information, not much is known about the knowledge and use of these applications by high school students (Thoenes, et al., 2006). Literature provides many examples that show adolescents want to discuss issues with health professionals but often do not. One national study in the United States sampled adolescent boys and girls and found that the majority (70.9%) report at least 1 of 8 potential health risks, but few (37%) actually spoke to their doctors about them (Klein & Wilson, 2002). Typical adolescents are early adopters of new technology applications and are increasingly utilizing the Internet to find health-related information since traditional sources do not meet their needs. The Internet provides innovative opportunities for engaging youths who may avoid traditional health education methods (Borzekowski & Rickert, 2001).

This is the first data-driven article of its kind; it delineates specific demographic and utilization patterns of high school students currently using this technology and discusses barriers for those who are not.

Methods
This study specifically focused on high school students’ knowledge and utilization of health information technology applications and compared them across grade levels. Students at Saint Petersburg Catholic High School in Florida partnered with academic researchers at the University of South Florida and organized a multidisciplinary team to simultaneously clarify how students procure healthcare information and to further determine what types of information they seek.

Using a multifactorial approach, team members and content experts conducted a literature review to identify gaps in HIT knowledge and use in the high school setting. This was followed by the development of a set of questions built on published work. Students drafted the instrument, which was developed for and ultimately administered to a large sample of high school students (n=705). The survey questions focused on the following criteria:

 

  • Internet use at home
  • Broadband use at home
  • Comfort/ease with navigating the Internet
  • Internet use at school
  • Email communication with physicians
  • Ability to search general health information
  • Ability to use the Web for specific topics
  • Ability to search the Web for specific medical conditions or diagnoses
  • Behavior changes related to information obtained.

 

Individuals with expertise in medical informatics and/or health policy reviewed the content and offered recommendations for revision, which were integrated into the document.

The questionnaire and cover letter, which described the purpose of the study and encouraged participation, were hand delivered to all 705 students (359 males and 346 females; seniors, juniors, sophomores, and freshmen) at Saint Petersburg Catholic High School by their teachers. The majority of students were Caucasian (89%) and from Catholic families (88%), and of the 705 students, 133 came from single-parent households. The approximate amount of time to complete the survey was 30 minutes. Students who did not complete the survey in its entirety or chose not to participate were excluded from the study. All questionnaires were tracked by a 6-digit identifying code. Data were entered by a researcher and confirmed by a second researcher for accuracy. The protocol was approved by the university’s Institutional Review Board.

Findings
There were a total of 497 returned surveys representing a response rate of 71%. The freshman class returned 98 surveys (20% response rate); the sophomore class returned 227 surveys (46% response rate); the junior class returned 80 surveys (16% response rate); and the senior class returned 92 surveys (19% response rate). Ninety-two percent of the students reported that their health ranged from good to excellent, while the remaining students felt that their health ranged from fair to poor. Overall there were four statistically significant findings and one celebration. The remaining two provide opportunities for educational interventions.

Educational Celebration
Internet access at school refers to the proportion of students who use the Internet at school. Overall findings show that 80% of the students access the Internet at school: 67% of the freshmen, 81% of the sophomores, 75% of the juniors, and 98% of the seniors.

Educational Opportunities
Search health information refers to the proportion of students who use the Internet to search for any type of health information. Overall findings show that 42% of the students search for health-related information via the Internet: 32% of the freshmen, 41% of the sophomores, 53% of the juniors, and 48% of the seniors.

Medical condition refers to the proportion of students who access the Web to research a specific disease state or medical diagnosis. Overall findings show that 51% of the students researched a specific disease state on the Internet: 38% of the freshmen, 48% of the sophomores, 59% of the juniors, and 63% of the seniors.

Discussion
Information technologies promise to enhance the ability of students to actively understand and influence their health status (Breugal, 1998). The personal computer, Internet, and the World Wide Web have dramatically increased students’ ease of access to health information. Specifically, students may enhance their decision-making abilities through learning the research process, accessing health information, being introduced to medical terminology, and looking at specific diagnosis-related information.

The current study suggests that a majority of students regularly utilize the Internet via broadband access at school to research health information. This trend may be explained by the availability of the school’s computer laboratory and media center accessibility. Additionally, the students report high comfort levels and ease with this technology due to instruction initiated at the primary level. Educators reinforce use of this technology through school assignments, and students become savvier as they progress through their educational career.

This study identified that approximately half of the student body researched health information at one time or another. Upper classman are more likely to research health information on the Internet. This trend may be explained by age and maturity level. As students become more responsible and face healthcare decisions, they are more likely to utilize these applications prior to making informed decisions.

Finally, this study suggested that the majority of students sought information regarding a specific medical condition or disease state. Some of these conditions include asthma, ADHD, kidney failure, diabetes, cancer, and skin conditions. Of note, many students also inquired about pregnancy, sexually transmitted diseases (STDs), alcoholism, depression, and eating disorders. Many students wrote notes on the survey about specific health topics that concerned them. Seven themes were identified, including nutrition, physical activity, skin conditions, injury prevention, birth control, HIV/AIDS, and STDs.

Conclusion
Today, there is little question that teens are familiar and comfortable with using the Internet. However, simply being able to access the Web does not necessarily mean that the medical information teens are obtaining is accurate. Half of the surveyed students were searching for specific medical conditions such as alcoholism, depression, and eating disorders. In contrast, many students searched for specific topics such as nutrition, physical activity, pregnancy, and STDs. This information will be instrumental in assisting key stakeholders to identify, design, and implement strategies to promote HIT utilization among students while simultaneously supporting family-centered care for adolescents.

Dedication
This manuscript is dedicated to our principal Fr. John Serio, SDB.
Highly respected, Student advocate, Results oriented

Acknowledgements
We would like to express our appreciation to Mrs. Mary Vigue, assistant principal, for her continuous academic support and encouragement, Mrs. Susan McGough for her survey expertise, and finally to the members of the St. Petersburg Catholic High School Family.

The authors are students and a teacher at St. Petersburg Catholic High School (SPHS). The students are dually enrolled in the University of South Florida Honors College. George Leonard Ettel, III is a junior and has been inducted into the National Honor Society. He has made numerous national presentations and is an Eagle Scout Candidate. Michael Anthony Cerio, Jr. currently chairs the Science Department at SPHS. He holds a master’s degree in science education and is a licensed paramedic. Kehsi Iman Wilson is a 16-year-old senior and is in the top 10% of her class. She is president of the Spanish Honor Society, treasurer of Mu Alpha Theta, and an active member of both the National Honor Society and Science National Honor Society. William Jamal Johnson is a senior AP and Honors student. He currently serves as the student body president and captain of the football team. Recently, he was invited to participate in the Georgetown University summer medical program as part of the Lead America initiative. Megan Thuy Vu is a proud volunteer with the Vietnamese American Mutual Association of Tampa Bay and the Pinellas Vietnamese Church. In addition to being in the top 5% of her class, she holds executive board positions in several honor societies and founded the school newspaper.

References

Borzekowski, D., & Rickert, V. (2001). Adolescent cybersurfing for health information: A new resource that crosses barriers. Pediatric Adolescent Medicine, 155(7), 813-817.

Bruegal, R. (1998). Patient empowerment: A trend that matters. Journal of the American Health Information Management Association 69(3), 30-33.

Johnson, K., Ravert, R., & Hopkins E. A. (2001). Teen central: Assessment of an Internet-based support system for children with cystic fibrosis. Pediatrics, 107(2e24).

Klein, J., & Wilson, K. (2002). Delivering quality care: Adolescents’ discussion of health risks with their providers. Journal of Adolescent Health, 3, 190-195.

Kraushal, R., et. al. (2000). Medication errors and adverse drug events. Pediatrics, 47, 201.

Thoenes, M., et al. (2006). Teens, technology and transforming healthcare. Patient Safety and Quality Healthcare, 3(1), 6.