{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:50:47Z","timestamp":1777668647147,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T00:00:00Z","timestamp":1409875200000},"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":["Hum Factors"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The goals of this study were to identify the demands associated with using electronic personal health records (PHRs) and to evaluate the ability of adults of lower socioeconomic status and low health literacy to use PHRs to perform health management activities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>PHRs are proliferating in clinical practices and health care organizations. These systems offer the potential of increasing the active involvement of patients in health self-management. However, little is known about the actual usability of these tools for health consumers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>We used task analysis and health literacy load analysis to identify the cognitive and literacy demands inherent in the use of PHRs and evaluated the usability of three currently available PHR systems with a sample of 54 adults. Participants used the systems to perform tasks related to medication management, interpretation of lab\/test results, and health maintenance. Data were also gathered on the participants\u2019 perception of the potential value of using a PHR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The results indicated that a majority of the participants had difficulty completing the tasks and needed assistance. There was some variability according to task and PHR system. However, most participants perceived the use of PHRs as valuable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although considered a valuable tool by consumers, the use of PHR systems may be challenging for many people. Strategies are needed to enhance the usability of these systems, especially for people with low literacy, low health literacy, or limited technology skills.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Application:<\/jats:title>\n                    <jats:p>The data from this study have implications for the design of PHRs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0018720814549238","type":"journal-article","created":{"date-parts":[[2014,9,6]],"date-time":"2014-09-06T01:19:34Z","timestamp":1409966374000},"page":"491-506","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":79,"title":["The Usability of Electronic Personal Health Record Systems for an Underserved Adult Population"],"prefix":"10.1177","volume":"57","author":[{"given":"Sara J.","family":"Czaja","sequence":"first","affiliation":[{"name":"University of Miami, Miami, Florida"}]},{"given":"Christina","family":"Zarcadoolas","sequence":"additional","affiliation":[{"name":"Hunter College, New York, New York"}]},{"given":"Wendy L.","family":"Vaughon","sequence":"additional","affiliation":[{"name":"Hunter College, New York, New York"}]},{"given":"Chin Chin","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Miami, Miami, Florida"}]},{"given":"Maxine L.","family":"Rockoff","sequence":"additional","affiliation":[{"name":"Columbia University, New York, New York"}]},{"given":"Joslyn","family":"Levy","sequence":"additional","affiliation":[{"name":"Joslyn Levy and Associates, New York, New York"}]}],"member":"179","published-online":{"date-parts":[[2014,9,5]]},"reference":[{"key":"bibr1-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2011-000105"},{"key":"bibr2-0018720814549238","unstructured":"athenahealth. (2009). Summary of the HITECH Act. Retrieved from http:\/\/www.athenahealth.com\/_doc\/pdf\/HITECH_Fact_Sheet_Whitepaper.pdf"},{"key":"bibr3-0018720814549238","unstructured":"Centers for Disease Control and Prevention. (2013). Heart disease and stroke. Retrieved from http:\/\/www.cdc.gov\/phlp\/publications\/topic\/heart.html"},{"key":"bibr4-0018720814549238","unstructured":"Centers for Medicare and Medicaid Services. (2011). National health expenditure projections 2011\u20132021. Retrieved from http:\/\/www.cms.gov\/Research-Statistics-Data-and-Systems\/Statistics-Trends-and-Reports\/NationalHealthExpendData\/Downloads\/Proj2011PDF.pdf"},{"key":"bibr5-0018720814549238","unstructured":"Connecting for Health. (2003). Connecting for health. Retrieved from http:\/\/www.connectingforhealth.org\/resources\/final_phwg_report1.pdf"},{"key":"bibr6-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(83)90215-6"},{"key":"bibr7-0018720814549238","first-page":"1","volume":"100","author":"Freid V. M.","year":"2012","journal-title":"NCHS Data Brief"},{"key":"bibr8-0018720814549238","volume":"8","author":"Gibbons M. C.","year":"2011","journal-title":"Perspectives in Health Information Management"},{"key":"bibr9-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2005.06.012"},{"key":"bibr10-0018720814549238","unstructured":"Goodman M., Finnegan R., Mohadjer L., Krenzke T., Hogan J. (2013). Literacy, numeracy, and problem solving in technology-rich environments among U.S. adults: Results for the Program for the International Assessment of Adult Competencies 2012. First look (NCES 2014-008). Washington, DC: U.S. Department of Education, National Center for Education Statistics. Retrieved from http:\/\/nces.ed.gov\/pubsearch"},{"key":"bibr11-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.24.285"},{"key":"bibr12-0018720814549238","unstructured":"Health Resources and Services Administration. (2014). Medically underserved areas\/populations. Retrieved from http:\/\/www.hrsa.gov\/shortage\/mua\/index.html"},{"key":"bibr13-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0031888"},{"key":"bibr14-0018720814549238","volume-title":"Health literacy: A prescription to end confusion","author":"Institute of Medicine","year":"2004"},{"key":"bibr15-0018720814549238","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1256"},{"key":"bibr16-0018720814549238","volume-title":"Adult literacy in America: A first look at the results of the National Adult Literacy Survey (NALS)","author":"Kirsch I. S.","year":"1993"},{"key":"bibr17-0018720814549238","volume-title":"The health literacy of America\u2019s adults: Results from the 2003 National Assessment of Adult Literacy","author":"Kutner M.","year":"2006"},{"key":"bibr18-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1145\/1940761.1940811"},{"key":"bibr19-0018720814549238","doi-asserted-by":"publisher","DOI":"10.2196\/resprot.2302"},{"key":"bibr20-0018720814549238","unstructured":"Markle Foundation. (2011). The public and doctors largely agree patients should be able to view, download and share their health info. Retrieved from http:\/\/www.markle.org\/publications\/1460-public-and-doctors-largely-agree-patients-should-be-able-view-download-and-share-t"},{"key":"bibr21-0018720814549238","unstructured":"National Network of Libraries of Medicine. (2013). Health literacy. Retrieved from http:\/\/nnlm.gov\/outreach\/consumer\/hlthlit.html"},{"key":"bibr22-0018720814549238","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1220"},{"key":"bibr23-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1136\/jamia.2010.006015"},{"key":"bibr24-0018720814549238","first-page":"1233","volume-title":"AMIA Annual Symposium Proceedings","volume":"2011","author":"Segall N.","year":"2011"},{"key":"bibr25-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-011-1679-8"},{"key":"bibr26-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1037\/a0033911"},{"key":"bibr27-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1197\/jamia.M2025"},{"key":"bibr28-0018720814549238","volume-title":"Consumers and health information technology: A national survey","author":"Undem T.","year":"2010"},{"key":"bibr29-0018720814549238","volume-title":"Expanding the reach and impact of consumer e-health tools","author":"U.S. Department of Health and Human Services","year":"2006"},{"key":"bibr30-0018720814549238","unstructured":"U.S. Department of Health and Human Services. (2014). Quick guide to healthy literacy. Retrieved from http:\/\/www.health.gov\/communication\/literacy\/quickguide\/factsliteracy.htm"},{"key":"bibr31-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1370\/afm.405"},{"key":"bibr32-0018720814549238","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/daq075"},{"key":"bibr33-0018720814549238","volume-title":"Advancing health literacy: A framework for understanding and action","author":"Zarcadoolas C.","year":"2006"},{"key":"bibr34-0018720814549238","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2507"}],"container-title":["Human Factors: The Journal of the Human Factors and Ergonomics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018720814549238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0018720814549238","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0018720814549238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:50:45Z","timestamp":1777449045000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0018720814549238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9,5]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,5]]}},"alternative-id":["10.1177\/0018720814549238"],"URL":"https:\/\/doi.org\/10.1177\/0018720814549238","relation":{},"ISSN":["0018-7208","1547-8181"],"issn-type":[{"value":"0018-7208","type":"print"},{"value":"1547-8181","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9,5]]}}}