Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Challenges and Opportunities with Empowering Baby Boomers for Personal Health Information Management Using Consumer Health Information Technologies: an Ecological Perspective

1 College for Public Health and Social Justice, Department of Health Management and Policy, Saint Louis University, Saint Louis, MO 63104, USA;
2 Medical Center Library, Saint Louis University, Saint Louis, MO 63104, USA;
3 College of Arts and Sciences, Department of Communication, Saint Louis University, Saint Louis, MO 63104, USA;
4 School of Nursing, Saint Louis University, Saint Louis, MO 63104, USA;
5 Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA

Special Issues: Addressing Understudied and Vulnerable Populations and Health Systems

“Baby Boomers” (adults born between the years of 1946 and 1964) make up the largest segment of the population in many countries, including the United States (about 78 million Americans) [1]. As Baby Boomers reach retirement age and beyond, many will have increasing medical needs and thus demand more health care resources that will challenge the healthcare system. Baby Boomers will likely accelerate the movement toward patient self-management and prevention efforts. Consumer Health Information Technologies (CHIT) hold promise for empowering health consumers to take an active role in health maintenance and disease management, and thus, have the potential to address Baby Boomers' health needs. Such innovations require changes in health care practice and processes that take into account Baby Boomers' personal health needs, preferences, health culture, and abilities to use these technologies. Without foundational knowledge of barriers and opportunities, Baby Boomers may not realize the potential of these innovations for improving self-management of health and health outcomes. However, research to date has not adequately explored the degree to which Baby Boomers are ready to embrace consumer health information technology and how their unique subcultures affect adoption and diffusion. This position paper describes an ecological conceptual framework for understanding and studying CHIT aimed at satisfying the personal health needs of Baby Boomers. We explore existing literature to provide a detailed depiction of our proposed conceptual framework, which focuses characteristics influencing Baby Boomers and their Personal Health Information Management (PHIM) and potential information problems. Using our ecological framework as a backdrop, we provide insight and implications for future research based on literature and underlying theories represented in our model.
  Article Metrics


2. Institute of Medicine. (2008) Retooling for an aging American: Building the healthcare workforce. Washington, DC: Academies Press.

3. Fisher E, Brownson C, O'Toole M, et al. (2005) Ecological approaches to self-management: The case of diabetes. Am J Public Health 95: 1523-1535.    

4. Battersby M, Von Korff M, Schaefer J, et al. (2010) Twelve evidence-based principles for implementing self-management support in primary care. Joint Commis J Quality Patient Safety 36: 561-570.

5. Mercer S, Green L, Rosenthal A, et al. (2003) Possible lessons from the tobacco experience for obesity control. Am J Clin Nutr 77: 1073S-1082S.

6. Bodenheimer T, Lorig K, Holman H, et al. (2002) Patient self-management of chronic disease in primary care. J Am Med Assoc 288: 2469-2475.    

7. Goldzweig C, Orshansky G, Paige N, et al. (2013) Electronic patient portals: Evidence on health outcomes, satisfaction, efficiency, and attitudes: A systematic review. Ann Int Med 159: 677-687.    

8. Coughlin J, Pope J, Leedle B. (2006) Old age, new technology, and future innovations in disease management and home health care. Home Health Care Manag 18: 196-207.    

9. National Academy of Sciences. (2005) Facilitating interdisciplinary research. Washington, DC: National Academies Press.

10. Frey W. (2010) Baby boomers and the new demographics of America's seniors Generations 34: 28-37.

11. Robinson K, Reinhard S. (2009) Looking ahead in long-term care: The next 50 years. Nurs Clin North Am 44 (2): 253-262.

12. Stokols D. (1992) Establishing and maintaining healthy environments. Toward a social ecology of health promotion. Am Psychol 47: 6-22.

13. Hopkins D, Fielding J, Task Force on Community Preventive Services. (2001) The guide to community preventive services: Tobacco use prevention and control: Reviews, recommendations, and expert commentary. Am J Prev Med 20: S1-S88.

14. Patrick K, Intille S, Zabinski M. (2005) An ecological framework for cancer communication: Implications for research. J Med Int Res 7: e23.

15. Wagner E, Austin B, Von Korff M. (1996) Organizing care for patients with chronic illness. Milbank Quart 74: 511-544.    

16. Coleman K, Austin B, Brach C, et al. (2009) Evidence on the Chronic Care Model in the new millennium. Health Affairs 28: 75-85.    

17. Vincent G, Velkoff V. (2010) The next four decades: The older population in the United States, 2010 to 2050. Washington, DC: US Census Bureau.

18. Pruchno R. (2012) Not your mother's old age: Baby boomers at age 65. Gerontol 52: 149-152.    

19. Frey W. (2010) Baby boomers and the new demographics of American's seniors. Generations 34: 28-37.

20. Gassoumis Z, Wilber K, Baker L, et al. (2010) Who are the Latino baby boomers? Demographic and economic characteristics of a hidden population. J Aging Soc Policy 22: 53-68.

21. Lipschultz J, Hilt M, Reilly H. (2007) Organizing the baby boomer construct: An exploration of marketing, social systems, and culture. Educ Gerontol 33: 759-773.    

22. Knickman JR, Snell EK. (2002) The 2030 problem: caring for aging baby boomers. Health Services Res 37: 849-884.    

23. Mochris G, Mathur A. (2007) Baby boomers and their parents: Surprising findings about their lifestyles, mindsets and well-being. Amarillo: Paramount Publishing.

24. Koch S. (2010) Healthy ageing supported by technology—a cross-disciplinary research challenge. Inform Health Soc Care 35: 81-91.    

25. Barns P, Blooom B, Nihin R. (2008) Complementary and alternative use among adults and children: United States 2007.

26. Robinson K, Reinhard S. (2009) Looking ahead in long-term care: The next 50 years. Nurs Clin North Am 44: 253-262.    

27. Zwijsen SA, Niemeijer AR, Hertogh CM. (2011) Ethics of using assistive technology in the care for community-dwelling elderly people: an overview of the literature. Aging Ment Health 15: 419-427.    

28. Steel DM, Gray MA. (2009) Baby boomers' use and perception of recommended assistive technology. International J Ther Rehab 16: 546-556.    

29. Mihailidis A, Cockburn A, Longley C, et al. (2008) The acceptability of home monitoring technology among community-dwelling older adults and baby boomers. Assist Technol 20: 1-12.    

30. Smith SP, Barefield AC. (2007) Patients meet technology. Health Care Manag 26: 354-362.

31. Zickuhr K. (2011) Generations and their gadgets. Washington: Pew Research Center's Internet & American Life Project, 1-20

32. Andreassen H, Bujnowska-Fedak M, Chronaki C, et al. (2007) European citizens' use of e-health services: A study of seven countries. BMC Public Health 7: 53.    

33. Tang PC, Lee HT. (2009) Your doctor's office or the internet? two paths to personal health records. New Engl J Med 360: 1276-1278.

34. Health on the Net Foundation. (1999) HON's fourth survey on the use of internet for medical and health purposes. .

35. Reisenwitz T, Iyer R. (2007) A comparison of younger and older baby boomers: investigating the viability of cohort segmentation. J Consum Marketing 24: 202-212.    

36. Sinden D, Wister AV. (2008) E-health promotion for aging baby boomers in north america. Gerontech J 7: 271-278.

37. Arora N, Hesse B, Rimer B, et al. (2007) Frustrated and confused: The American pubic rates it's cancer-related information-seeking experience J Gener Int Med 23: 223-228.

38. Tripp C, Straub L. (2008) Search for drug information: technology implications for rural consumers and pharmacies. Health Market Quart 18: 103-117.

39. Koch S. (2010) Healthy ageing supported by technology, a cross-disciplinary research challenge. Inform Health Soc Care 35: 81-91.    

40. Chatterjee S, Price A. (2009) Health living with persuasive technologies: framework, issues and challenges. J Am Med Inform Assoc 16: 171-178.    

41. Civan A, Skeels M, Stolyar A, et al. (2006) Personal health information management: Consumers' perspectives. AMIA Annual Symposium Proceedings: 156-160.

42. Agarwal R, Khuntia J. (2009) Personal health information and the design of consumer health information technology: Background report. Rockville: Agency for Healthcare Research and Quality.

43. Wilson C, Peterson A. (2010) Managing personal health information: An action agenda Rockville, MD: Insight Policy Research AHRQ Publication No. 10-0048-

44. Noh H-I, Lee JM, Yun YH, et al. (2009) Cervical cancer patient information-seeking behaviors, information needs, and information sources in South Korea. Supp Care Cancer 17: 1277-1283.    

45. Caiata-Zufferey M, Abraham A, Sommerhalder K, et al. (2010) Online health information seeking in the context of the medical consultation in Switzerland. Qualit Health Res 20: 1050-1061.    

46. Manafo E, Wong S. (2012) Exploring older adults' health information seeking behaviors. J Nutr Educ Behav 44: 85-89.    

47. Kim K, Kwon N. (2010) Profile of e-patients: analysis of their cancer information-seeking from a national survey. J Health Commun 15: 712-733.    

48. Higgins O, Sixsmith J, Barry M, et al. (2011) A literature review on healht information seeking behaviour on teh web: A health consumer and health professional perspective. Stockholm: European Center for Disease Prevention and Control.

49. Eheman CR, Berkowitz Z, Lee J, et al. (2009) Information-seeking styles among cancer patients before and after treatment by demographics and use of information sources. J Health Commun 14: 487-502.    

50. Kelly KM, Sturm AC, Kemp K, et al. (2009) How can we reach them? Information seeking and preferences for a cancer family history campaign in underserved communities. J Health Commun 14: 573-589.

51. Kelly B, Hornik R, Romantan A, et al. (2010) Cancer information scanning and seeking in the general population. J Health Commun 15: 734-753.    

52. Galarce EM, Ramanadhan S, Weeks J, et al. (2011) Class, race, ethnicity and information needs in post-treatment cancer patients. Patient Educ Counsel 85: 432-439.    

53. Sung VW, Raker CA, Myers DL, et al. (2010) Treatment decision-making and information-seeking preferences in women with pelvic floor disorders. Int Urogynecol J 21: 1071-1078.    

54. Fox S. (2007) E-patients with disability or chronic disease. Washington, DC: Pew Internet & American Life Project.

55. Fox S, Jones S. (2009) The social lifew of health information. Washington, DC: Pew Internet & American Life Project.

56. Radina ME, Ginter AC, Brandt J, et al. (2011) Breast cancer patients' use of health information in decision making and coping. Cancer Nurs 34: E1-12.

57. Smith SK, Dixon A, Trevena L, et al. (2009) Exploring patient involvement in healthcare decision making across different education and functional health literacy groups. Soc Sci Med 69: 1805-1812.    

58. Weaver J 3rd, Mays D, Weaver S, et al. (2010) Health information-seeking behaviors, health indicators, and health risks. American J Public Health 100: 1520-1525.    

59. Agarwal R, Angst C. (2006) Technology-enabled transformations in health care: Early findings on personal health records and invidual use In: Galletta D, Zhang P, editors. Human-computer interaction and management information systems: Application. Armonk, NY: M. E. Sharp, 357-378.

60. Tawara S, Yonemochi Y, Kosaka T, et al. (2013) Use of patients' mobile phones to store and share personal health information: Results of a questionnaire survey. Int Med 52: 751-756.    

61. Siek K, Khan D, Ross S, et al. (2011) Designing a personal health application for older adults to manage medications: a comprehensive case study. J Med Syst 35: 1099-1121.    

62. Moen A, Brennan PF. (2005) Health@Home: the work of health information management in the household (HIMH): implications for consumer health informatics (CHI) innovations. J Am Me Inform Assoc 12: 648-656.    

63. Marchionini G, Rimer B, Wildemuth B. (2007) Evidence base for personal health record usability: final report to the National Cancer Institute. Chapel Hill: University of North Carolina Chapel Hill.

64. Maiorana A, Steward W, Koester K, et al. (2012) Trust, confidentiality, and the acceptability of sharing HIV-related patient data: lessons learned from a mixed methods study about health information exchanges. Implem Sci 7: 34.    

65. Avtgis T, Polack E, Staggers S, et al. (2011) Health provider-recipient interactions: Is “online interaction” the next best thing to “being there?” In: Wright K, Webb L, editors. Computer-medicated communication in interpersonal relationships London: Peter Lang.

66. Grande N, Mitra N, Shah A, et al. (2013) Public preferences about secondary uses of electronic health information. J Am Med Assoc Int Med 173: 1798-1806.

67. Hunter I, Whiddett R, Norris A, et al. (2009) New Zealanders' attitudes towards access to their electronic health records: Preliminary results from a national study using vignettes. Health Inform J 15: 212-228.    

68. King T, Brankovic L, Gillard P. (2012) Perspectives of Australian adults about protecting the privacy of their health information in statistical databases. Int J Med Inform 81: 279-289.    

69. Page S, Mitchell I. (2006) Patients' opinions on privacy, consent and the disclosure of health information for medical research. Chron Dis Canada 27: 60-67.

70. Caine K, Hanania R. (2013) Patients want granular privacy control over health information in electronic medical records. J Am Med Inform Assoc AMIA 20: 7-15.    

71. Reason J. (1990) Human Error. New York: Cambridge University Press.

72. Street R Jr. (2007) Aiding medical decision making: A communication perspective. Med Dec Making 27: 550-553.    

73. Gochman DS. (1997) Handbook of health behavior research. New York: Plenum Press.

74. Glanz K, Rimer B, Viswanath K. (2008) Health behavior and health education: Theory, research, and practice. San Francisco: Jossey-Bass.

75. Agency for Healthcare Research and Quality. (2000) Outcomes research fact sheet. Agency for Healthcare Research and Quality, 0-11.

76. Attias-Confut C, Wolff F. (2000) The redistributive effects of generational transfers. In: Arbur S, Attias-Confut C, editors. The myth of generational conflict: The family and state in ageing societies. New York: Routledge, 22-46.

77. Lin I. (2008) Consequences of parental divorce for adult children's support of their frail parents J Marr Family 70: 113-128.

79. Centers for Disease Control and Prevention. (2013) The state of aging and health in America 2013. Atlanta: U. S. Department of Health and Human Services.

80. Ahn S, Smith M, Dicerhson J, et al. (2012) Health and health care utilization among obese and diabetic baby boomers and older adults Am J Health Prom 27: 123-132.

81. Martin L, Freedman V, Schoeni R, et al. (2009) Health and functioning of the Baby Boom approaching 60. J Gerontol Soc Sci 63: 369-377.

82. King D, Matheson E, Chirina S, et al. (2013) The status of Baby Boomers' health in the United States: The healthiest generation? J Am Med Assoc Int Med 173: 385-386.

83. Wagner E, Austin B, Von Korff M. (1996) Organizing care for patients with chronic illness. Milbank Quart 74: 511-544.    

84. Civan A, Skeels M, Stolyar A, et al. (2006) Personal health information management: Consumers' perspectives. AMIA Annual Symposium Proceedings, 156-160.

85. Miller N, Berra K, Long J. (2010) Hypertension 2008--awareness, understanding, and treatment of previously diagnosed hypertension in baby boomers and seniors: A survey conducted by Harris interactive on behalf of the Preventive Cardiovascular Nurses Association. J Clin Hypert 12: 328-334.    

86. Koh H, Baur C, Brach C, et al. (2013) Toward a systems approach to health literacy research. J Health Commun 18: 1-5.

87. Rudd R. (2010) Improving Americans' health literacy. New Engl J Med 363: 2283-2285.    

88. Bell RA, Hu X, Orrange SE, et al. (2011) Lingering questions and doubts: online information-seeking of support forum members following their medical visits. Patient Educ Counsel 85: 525-528.    

89. Tustin N. (2010) The role of patient satisfaction in online health information seeking. J Health Commun 15: 3-17.

90. Court D, Farrell D, Forsyth J. (2007) Serving aging baby boomers. McKinsey Quart 104: 102-113.

91. Ganong L, Coleman M. (1999) Changing families, changing responsibilities: Family obligations following divorce and remarriage. Mahwah, NJ: Lawrence Erlbaum.

92. Fingerman K, Pillemer K, Silverstein M, et al. (2012) The Baby Boomers' intergenerational relationships. Gerontologist 52: 199-209.    

93. Nussbaum J (1994) Friendship in older adulthood. In: Hummert M, Weimann J, Nussbaum J, editors. Interpersonal communication in older adulthood. Thousand Oaks, CA: Sage, 209-225.

94. Brennan P, Safran C. (2005) Empowered consumers. In: Lewis D, Eysenbach G, Kukafka R, et al. , editors. Consumer health informatics: Informing consumers and improving health care New York: Springer, 8-21.

95. Longo DR, Schubert SL, Wright BA, et al. (2010) Health information seeking, receipt, and use in diabetes self-management. Ann Family Med 8: 334-340.    

96. Kreuter M, Alcaraz K, Pfeiffer D, et al. (2008) Using dissemination research to identify optimal community settings for tailored breast cancer information kiosks. J Public Health Manag Pract 14: 160-169.    

97. Fogg B. (2003) Persuasive technology, using computers to change what we think and do. San Francisco, CA: Morgan Kaufmann.

Copyright Info: © 2014, Cynthia M. LeRouge, et al., licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved