ttitudes for tailoring self - management

Healthcare providers are moving towards tailoring self-management interventions to include the communication nology and involvement in managing chronic conditions will be critical for informing effective self-management strategies. The race, and education level that have been shown to negatively affect care. To inform the design and tailoring of selfmanagement interventions, we elicited attitudes toward technology use and participation in care of 40 participants in a maximum variation sample. The analysis revealed three participant clusters that represent varying attitudes toward health behaviors and technologies that were independent of race, education level, and age. Our approach provides insight into how people prioritize important values related to health participation and technology. Introduction Self-management of chronic conditions, such as diabetes and asthma, creates considerable burden for patients. Effective self-management requires patients to be active participants in treatment by taking medications, making lifestyle changes, and regulating emotions1,2. The day-to-day skills involved in self-management include identifying problems, selecting solutions, using information sources, collaborating with providers, changing behavior, and evaluating results2. This dynamic process goes well beyond adhering to treatment plans, and considers the patient holistically in the context of the attitudes and values that influence their everyday behaviors. Self-management interventions are designed to alleviate some of the burden of chronic illness care. Selfmanagement support through the internet, over the phone, and in person have proven effective, and the delivery of programs via SMS and other mobile platforms are promising3 8. However, tailoring and personalization of selfmanagement interventions is limited by the lack of methods for understanding how patients prioritize health information and tools to accomplish self-care goals. Moreover, implicit biases of providers, such as ascribing preferences for health information and treatments on the basis of age, race, literacy, and gender, can differentially affect provision of chronic care for underrepresented minorities9 16. Therefore, understanding toward health and technology is especially important for informing unbiased and patient-centered interventions that augment patients health self-management strategies in everyday life. To address the lack of understanding of information and technology, we studied how patients prioritize tools (e.g. email, cell phones, paper tools) to strengthen their accountability for health selftechnology, accountability, and goalapproaches to health selfattitudes and values were more influential than demographic characteristics especially race, age, and education level on defining health self-management behaviors. We contribute a description of a method for eliciting preferences for self-management support, including attitudes toward adopting technology to attain health goals. Our empirical evidence from this study can inform new approaches to clustering patients and tailoring appropriate self-care support based on the tools, information, and goals they perceive to be essential to managing their health. Related Work Previous research on self-management, disparities in use of e-health services, and patterns of technology adoption inform our work. Below, we briefly summarize this literature and describe how our approach to clustering patients based on health and technology attitudes contributes new insights for supporting self-management.