{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:34:26Z","timestamp":1780076066986,"version":"3.54.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Although depression is one of the most common mental health disorders outpacing other diseases and conditions, poor access to care and limited resources leave many untreated. Secure messaging (SM) offers patients an online means to bridge this gap by communicating nonurgent medical questions. We focused on self-care health management behaviors and delved into\n                      <jats:italic toggle=\"yes\">SM initiation<\/jats:italic>\n                      as the initial act of engagement and\n                      <jats:italic toggle=\"yes\">SM exchanges<\/jats:italic>\n                      as continuous engagement patterns. This study examined whether those with depression might be using SM more than those without depression.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Patient portal data were obtained from a large academic medical center\u2019s electronic health records spanning 5 years, from January 2018 to December 2022. We organized and analyzed SM\n                      <jats:italic toggle=\"yes\">initiations<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">exchanges<\/jats:italic>\n                      using the linear mixed-effects modeling technique.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Our predictors correlated with SM initiations, accounting for 25.1% of variance explained. In parallel, 24.9% of SM exchanges were attributable to these predictors. Overall, our predictors demonstrate stronger associations with SM exchanges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>We examined patients with and without depression across 2,629 zip codes over five years. Our findings reveal that the predictors affecting SM initiations and exchanges are multifaceted, with certain predictors enhancing its utilization and others impeding it.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SM telehealth service provided support to patients with mental health needs to a greater extent than those without. By increasing access, fostering better communication, and efficiently allocating resources, telehealth services not only encourage patients to begin using SM but also promote sustained interaction through ongoing SM exchanges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2024.0171","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T11:14:01Z","timestamp":1719314041000},"page":"2157-2164","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Secure Messaging Use Among Patients with Depression: An Analysis Using Real-World Data"],"prefix":"10.1177","volume":"30","author":[{"given":"Seung-Min A.","family":"Ko","sequence":"first","affiliation":[{"name":"Keck School of Medicine, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J.","family":"Warm","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Schauer","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-0333","authenticated-orcid":false,"given":"Dong-Gil","family":"Ko","sequence":"additional","affiliation":[{"name":"Carl H. Lindner College of Business, University of Cincinnati, Cincinnati, Ohio, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,9]]},"reference":[{"key":"e_1_3_5_2_2","unstructured":"Anonymous. Mental Health | NIH COVID-19 Research. n.d. Available from: https:\/\/covid19.nih.gov\/covid-19-topics\/mental-health [Last accessed: January27 2024]."},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.3826"},{"key":"e_1_3_5_4_2","unstructured":"Anonymous. Healthcare dive trendline on telehealth. n.d. Available from: https:\/\/www.healthcaredive.com\/trendline\/telehealth\/94\/ [Last accessed: September18 2023]."},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2021.100847"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-02721-x"},{"key":"e_1_3_5_7_2","unstructured":"CDC. Ambulatory care use and physician office visits. 2022. Available from: https:\/\/www.cdc.gov\/nchs\/fastats\/physician-visits.htm [Last accessed March16 2022]."},{"key":"e_1_3_5_8_2","unstructured":"Anonymous. ONC tech forum: Insights into API use to enable data sharing between EHRs and Apps | HealthIT.Gov. n.d. Available from: https:\/\/www.healthit.gov\/news\/events\/onc-tech-forum-insights-api-use-enable-data-sharing-between-ehrs-and-apps [Last accessed: May6 2023]."},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocab268"},{"key":"e_1_3_5_10_2","unstructured":"Raths D. Health systems begin charging for some portal message responses. 2022. Available from: https:\/\/www.hcinnovationgroup.com\/clinical-it\/patient-portals\/article\/21287423\/health-systems-begin-charging-for-some-portal-message-responses [Last accessed: May6 2023]."},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1771"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.30953\/thmt.v8.435"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.2196\/19477"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2013.05.065"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1044\/2019_JSLHR-S-19-0112"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.2196\/44981"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pdig.0000219"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20525"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.4794"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/19.177"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.3109\/02703181.2014.946640"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-023-03856-8"},{"key":"e_1_3_5_23_2","unstructured":"Anonymous. Depression and older adults. n.d. Available from: https:\/\/www.nia.nih.gov\/health\/mental-and-emotional-health\/depression-and-older-adults [Last accessed: March20 2024]."},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/1557988320949322"},{"key":"e_1_3_5_25_2","unstructured":"Anonymous. Infographic: Mental health for men. n.d. Available from: https:\/\/www.mhanational.org\/infographic-mental-health-men [Last accessed: January27 2024]."},{"key":"e_1_3_5_26_2","volume-title":"Results from the 2016 National Survey on Drug Use and Health: Detailed Tables","author":"Center for Behavioral Health Statistics and Quality","year":"2017","unstructured":"Center for Behavioral Health Statistics and Quality. Results from the 2016 National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration; 2017."},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2019.01.006"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1080\/07370016.2018.1404832"},{"key":"e_1_3_5_29_2","unstructured":"Marte J Mutikani L. Share of U.S. workers holding multiple jobs is rising New Census Report Shows. 2021. Available from: https:\/\/www.reuters.com\/article\/idUSKBN2AH2PH\/ [Last accessed: February21 2024]."},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.2196\/formative.5322"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","unstructured":"Hostetter M Klein S. 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