Term of Award

Spring 2023

Degree Name

Doctor of Public Health in Health Policy and Management (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Health Policy and Management (COPH)

Committee Chair

Gulzar Shah

Committee Member 1

Hani Samawi

Committee Member 2

Ana Palacios

Committee Member 3

Kristie Waterfield

Committee Member 3 Email



Background: Nearly 60% of adults in the United States are estimated to have one or more chronic conditions, necessitating strategies to improve the health status of persons with chronic disease. Given that health information technology (HIT) is considered highly valuable for superior disease management, it is imperative to examine how HIT use can improve health behaviors, which can in turn improve health status. This study aimed to examine if there was an association between patient portal utilization and the use of preventive services & health-promoting behaviors. Also, this study examined the influence of self-efficacy on preventive health behaviors among adults in the United States.

Methods: This study analyzed secondary data from the nationally representative Health Information National Trends Survey 5 combined dataset from 2017 to 2020. Data analysis was restricted to respondents who had used their patient portals in the past year and the sample size was 14,103. Binomial & multinomial logistic regression models were conducted for this study.

Results: Patient portal utilization was significantly associated with preventive health behaviors such as pap smear testing, mammogram screening, non-smoking, levels of participation in physical activities, and muscle-strengthening activities. Self-efficacy was significantly associated with mammogram screening and the levels of participation in physical and muscle-strengthening activities.

Conclusion: The study provides information that suggests that stakeholders need to encourage the population to use their patient portals. Also, optimizing the patient portals for not just clinical care but preventive care may reduce the incidence and cost of chronic diseases.

Research Data and Supplementary Material