A Web-Based Social Network Tool (GENIE) for Supporting Self-management Among High Users of the Health Care System: Feasibility and Usability Study

Abstract

Background Primary care providers are well positioned to foster self-management through linking patients to community-based health and social services (HSSs). This study evaluated a web-based tool—GENIE (Generating Engagement in Network Involvement)—to support the self-management of adults. GENIE empowers patients to leverage their personal social networks and increase their access to HSSs. GENIE maps patients’ personal social networks, elicits preferences, and filters local HSSs from a community service directory based on patient’s interests. Trained volunteers (an extension of the primary care team) conducted home visits and conducted surveys related to life and health goals in the context of the Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) program, in which the GENIE tool was implemented. GENIE reports were uploaded to an electronic medical record for care planning by the team. Objective This study aims to explore patients’, volunteers’, and clinicians’ perceptions of the feasibility, usability, and perceived outcomes of GENIE—a tool for community-dwelling adults who are high users of the health care system. Methods This study involved 2 primary care clinician focus groups and 1 clinician interview (n=15), 1 volunteer focus group (n=3), patient telephone interviews (n=8), field observations that captured goal-action sequences to complete GENIE, and GENIE utilization statistics. The patients were enrolled in a primary care program—Health TAPESTRY—and Ontario’s Health Links Program, which coordinates care for the highest users of the health care system. NVivo 11 (QSR International) was used to support qualitative data analyses related to feasibility and perceived outcomes, and descriptive statistics were used for quantitative data. Results Most participants reported positive overall perceptions of GENIE. However, feasibility testing showed that participants had a partial understanding of the tool; volunteer facilitation was critical to support the implementation of GENIE; clinicians perceived their navigation ability as superior to that of GENIE supported by volunteers; and tool completion took 39 minutes, which made the home visit too long for some. Usability challenges included difficulties completing some sections of the tool related to medical terminology and unclear instructions, limitations in the quality and quantity of HSSs results, and minor technological challenges. Almost all patients identified a community program or activity of interest. Half of the patients (4/8, 50%) followed up on HSSs and added new members to their network, whereas 1 participant lost a member. Clinicians’ strengthened their understanding of patients’ personal social networks and needs, and patients felt less social isolation. Conclusions This study demonstrated the potential of GENIE, when supported by volunteers, to expand patients’ social networks and link them to relevant HSSs. Volunteers require training to implement GENIE for self-management support, which may help overcome the time limitations faced by primary care clinicians. Refining the filtering capability of GENIE to address adults’ needs may improve primary care providers’ confidence in using such tools.

The influence of social relationships and activities on the health of adults with obesity: A qualitative study

“… 52 Also, it could be useful to increase awareness of local community health resources and how the people who participate in them could influence change practice. Different innovative interventions 53 , 54 are being tested, facilitating health services addressing these issues through social prescription. The use of network mapping could be used as a reflective process by the general population.…”

“…52 Also, it could be useful to increase awareness of local community health resources and how the people who participate in them could influence change practice. Different innovative interventions 53,54 The visualization and the narratives of our participants' network diagrams in different moments in life presented the involvement of varied types of relationships, showing the importance of considering historical life perspectives to understand the process of gaining and losing weight and the role of networks, understanding them as dynamic entities rather than static. 55 For future research, the use of biographic narratives (to understand more in-depth the content of meaningful relationships over time) with the exploration of the structure of social relationships using network metrics could provide an upgraded tool to explore their impact on health over time.…”

Implementing a digital tool to support meaningful engagement with socially isolated or lonely older adults

“…Sustainability of GENIE implementation is dependent upon access to updated resources (Valaitis et al, 2021 ). Student involvement was advantageous as they assumed the role of administrators, and both found and updated the resource database.…”

“…The identified database challenges enabled insights into strategies to tailor finding, uploading and maintaining of resources to the organisations' advantage. Within the GENIE database, the steps to successfully input resources needs to be streamlined and filters should be introduced (Valaitis et al, 2021 ) so that it is user‐friendly and time‐efficient (Ross et al, 2016 ). Training materials and interaction with the GENIE developer (Safi et al, 2018 ) coupled with peer learning and practice opportunities (Tai et al, 2016 ) were highly valued and critical in becoming familiar with the GENIE platform.…”

“…As GENIE has been successfully applied in Canada and the United Kingdom, it merits research to assess its feasibility in an Australian setting. GENIE has been primarily implemented as a self‐management support tool to empower individuals with long‐term conditions (Bloom et al, 2020 ; Kennedy et al, 2016 ; Valaitis et al, 2021 ; Welch et al, 2020 ). However, further research is needed to understand GENIE's potential in supporting the social engagement and well‐being of older adults.…”