Background/Rationale: At present, many veterans are living with and taking steps to manage multiple chronic health conditions simultaneously. Compared to the onset of a single disease, the experience of co-morbid chronic conditions can present pressing challenges to self-management, including the need to manage diverse kinds of health information. The expression 'personal health information management' refers to the range of activities that support individuals' access, integration, organization, and use of information pertaining to their own health situation. Although there is a growing evidence-base regarding the management of personal health information, the challenges confronted by individuals who must manage personal health information for multiple, co-existing conditions has been largely ignored. Objectives: The objectives of this pilot study are to 1) describe the management of personal health information among veterans with co-morbid chronic health conditions; 2) examine the relationships between the management of personal health information and chronic disease self-management in the context of co-morbid conditions; and 3) explore the role that 'veteran-centric informatics' applications play in the management of personal health information and in the self-management activities of veterans with co-morbid chronic conditions. Methods: We have designed a two-component study employing primarily qualitative approaches to data collection and analysis. In an effort to assemble an in-depth picture of the resources, strategies, and challenges associated with personal health information management among veterans with co-morbid chronic conditions, we will first conduct one-on-one, audio-recorded, semi-structured interviews and administer a brief background questionnaire to 30 veterans, all of whom will be recruited from a single VA facility. We will then pursue targeted follow-up work with 3 to 5 of these veterans to further explore how veteran-centric informatics applications are used to support self-management efforts. In addition to a second interview, we will also interview and collect background questionnaire data from one of the veteran's informal caregivers and one of his/her VA healthcare providers. Questionnaire data will be analyzed using basic descriptive statistics. Audio- recordings of the interviews will be transcribed into text and analysis will proceed through coding and the constant comparative method, the essence of which involves deriving basic concepts from data and comparing them with other data to facilitate meaningful categorization.
Impact Statement: Recently, the VA identified veteran-centric informatics and the care of complex, chronic health conditions as priority research areas. This pilot study represents a critical first step in an emerging research program that will enhance the capacity of veteran-centric informatics applications to support self- management and ultimately improve health outcomes among veterans with co-morbid chronic diseases. It will also provide foundation for a larger study focused on the development of theoretically-based interventions to facilitate personal health information management in the context of co-morbid chronic conditions.
