The Health Planning Context and Its Effect on a User's Perceptions of Software Usefulness

Article excerpt

ABSTRACT

This article reports a health planner's experience in using program planning software and the contextual factors that influenced her perceptions. The software examined (EMPOWER) is designed to support program planning for prevention of breast cancer through mammography screening. Use by a health professional in an urban hospital was examined through a case study approach. The user was interviewed at 3, 6, and 12 months following initial use. Transcripts were coded using Roger's characteristics of an innovation as a framework for categorizing the user's perceptions. Contextual factors identified as important in influencing her perceptions were open-coded and themes identified. The user referred to three contextual factors in describing characteristics of the innovation: implementation factors, user background, and work and community environment. The successful dissemination of software will depend not only on characteristics of the innovation, but also on situational circumstances that must be changed by, or accommodated in the technology.

ABREGE

Cet article rend compte de 1'experience d'une planificatrice en sante qui a utilise un logiciel de planification de programmes, et des facteurs contextuels qui ont influence sa perception. EMPOWER, le logiciel en question, est concu pour aider a planifier des programmes de prevention du cancer du sein par depistage mammographique. On a fait une etude de cas pour examiner son utilisation par une professionnelle de la sante dans un hopital urbain. On a interviewe l'utilisatrice a des intervalles de 3, 6 et 12 mois apres le debut de son utilisation. On s'est servi des cinq caracteristiques d'innovation de Roger comme cadre pour coder les perceptions de l'utilisatrice. Les facteurs contextuels consideres comme ayant une importante influence sur ses perceptions ont ete codes et des themes identifies. L'utilisatrice a fait reference a trois facteurs contextuels pour decrire les caracteristiques d'innovation: conditions de mise en oeuvre, antecedents de l'utilisatrice et environnement au travail et au sein de la communaute. L'adoption du logiciel va non seulement dependre de ses caracteristiques d'innovation mais aussi des conditions qui doivent etre modifies ou prises en compte par la technologie.

Research findings related to the effectiveness of health promotion and disease prevention activities have burgeoned in recent years. As a result, some researchers believe that many public health issues could be solved through better application of current research evidence.1

Difficulty accessing and applying this knowledge, however, has the potential to stifle progress in achieving many public health goals. To support the diffusion and application of research in health planning, health professionals require an effective and accessible medium for planning health programs. Information technology and computers have the potential to address the diffusion, collection and application of research and community knowledge. The computer has been identified as an "enabler" for integrating prevention and health promotion into ongoing clinical and community care.2,3 Computers have been used in health promotion programming to: 2) simulate estimates or outcomes applying different theoretical assumptions, 2) practice new skills; 3) access information from data bases, literature, and experts, and users; and 4) present selected information in a time, speed, and format controlled by the user.4-7

Although a number of studies have begun to address the issue of software and information technology (IT) planning, development, adoption and use in health assessment and health planning,7-12 a number of important issues remain. These include: 1) institutional barriers affecting the dissemination and adoption of new technology for relaying health information,2 2) use of information technology and electronic media in disseminating research information,13 3) effects of practice context on using information technology,14,15 and 4) the capability of information technology to support application of health promotion theory. …