Masters in Information Systems

Tomorrow's leaders in health promotion are being educated at American University today.

APPENDIX 3

NARRATIVE DESCRIPTION OF THE RESULTS

SECTION I: YOUR COMPUTING HABITS

Table 3. Perceived Worth of Computers at Work

Item # 1 Perceived Worth of Computers at Work

Rating	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	34	25.4	25.8	25.8
Unimportant	0	0	0	25.8
Average Importance	2	1.5	1.5	27.3
Important	22	16.4	16.7	43.9
Very Important	74	55.2	56.1	100.0
Total Responses	132	98.5	100.0
Missing values	2	1.5
Total Respondents	134	100.0

The first item is an assessment item to address research question one. It was designed to assess the respondents attitudes toward the perceived worth of computers at work. Almost three quarters of the respondents (72.8%) rated the worth of computers positively, with over half (56.1%) indicating that they were 'very important' while others (16.7%) chose 'important'. These high ratings indicate that the respondents perceive computers to be important tools in their work. Interestingly, 25.8% of those surveyed responded that computers were 'very unimportant' in their work. The large cluster of respondents (81.9%) at the extreme ends of the continuum is an intriguing phenomenon. In item 11 (Table 22) this data has been compared with the perceived worth ratings of computers in health promotion activities with clients.

Table 4. Computer Use Required at Work

Item # 2 Required to Use a Computer at Work

Required	Number	Percent	Valid Percent	Cumulative Percent
Yes	126	94.0	94.0	94.0
No	8	6.0	6.0	100.0
Total Respondents	134	100.0	100.0

The first research question was addressed by several items (2, 3, 4, 7, 8, 10, 12, and 14) that were designed to assess the respondent's patterns of use with computers. When asked if they were required to use a computer at work, 94% of those surveyed indicated that computers were required. This extremely high rating indicates how pervasive computers are in the working environment for this population.

Table 5. Years Using a Computer

Item # 3 Total Number of Years Using a Computer

Number of Years	Number	Percent	Valid Percent	Cumulative Percent
Never	0	0	0	0
0-2 Years	3	2.2	2.2	2.2
3-4 Years	8	6.0	6.0	8.2
5-9 Years	57	42.5	42.5	50.7
10 or more Years	66	49.2	49.2	100.0
Total Respondents	134	100.0	100.0

A very high number of respondents indicated that they were very experienced computer users. Over ninety percent (91.7%) of those surveyed indicated that they had used computers for five-or-more years, while almost half (49.2%) said they had used computers for 10-or-more years. Clearly, this group is very familiar and experienced with computers.

The respondents indicated that they were heavy users of computers during the workday, which is consistent with the computer experience data from item number three.

Table 6. Hours per Day Using a Computer

Item # 4 Average Number of Hours Using a Computer Per Day

Time per day	Number	Percent	Valid Percent	Cumulative Percent
Never	0	0	0	0
Less than 1 hour	5	3.7	3.8	3.8
1-2 Hours	20	14.9	15.0	18.8
3-4 Hours	48	35.8	36.1	54.9
5-6 Hours	40	29.9	30.1	85.0
7 or More Hours	20	14.9	15.0	100.0
Total Responses	133	99.3	100.0
Missing value	1	.7
Total Respondents	134	100.0

Over eighty percent (81.2%) answered that they used their computers for three-or-more hours, while 66.2% used them for five-or-more hours, and 15% used computers for seven-or-more hours per day. This population would be described as moderate-to-heavy users in terms of hours of use per workday.

Table 7. Access to Computers

Item #5 How Much Access You Have

Type of Access	Number	Percent	Valid Percent	Cumulative Percent
No Access	2	1.5	1.5	1.5
Unrestricted	122	91.0	91.7	93.2
Share with others	9	6.7	6.8	100.0
Total Responses	133	99.3	100.0
Missing value	1	.7
Total Respondents	134	100.0

Over ninety percent of the respondents (91.0%) had unrestricted access to a computer at work. Only 6.8% had to share a computer with others. This data is consistent with what would be expected given the responses to item two. Clearly, access to computers does not appear to be a significant barrier for this group.

In item six, two forms of computer training accounted for over eighty percent (80.3%) of the responses. Over forty percent (46.2%) of the respondents stated that they were self-taught, while 34.1% received training at work. Interestingly, very few (6.1%) of those surveyed received computer training through a college course. These data have far-reaching implications for a variety of entities and especially educational institutions. There are significant connotations for health promotion professionals that are related to the development of computer literacy and skills as well as for the adoption of computer and technology-based applications, programs, and systems at work and in their dealings with their clients.

Table 8. Types of Training

Item #6 Your Most Important Form of Computer Training

Type of Training	Number	Percent	Valid Percent	Cumulative Percent
Self-taught	61	45.5	46.2	46.2
College Course	8	6.0	6.1	52.3
Training at work	45	33.6	34.1	86.4
Colleague at work	11	8.2	8.3	94.7
Friend	4	3.0	3.0	97.7
Other	3	2.2	2.3	100.0
Total Responses	132	98.5	100.0
Missing value	2	1.5
Total Respondents	134	100.0

The Internet has become a very popular and important tool for many computer users in a short period of time. However, 80% of the respondents in this survey were relatively new to the Internet in that they had been on-line less than five years. Moreover, almost half of the users (49.2%) were in the zero-to-two year category. Of the longer-term users, 31.8% were in the three-to-four year group, 12.1% were in the five-to-six year group, and 3.8% were users for seven-or-more years. The proliferation of the Internet is an important phenomenon now and it will be an interesting trend to monitor in the future.

Table 9. Years on the Internet

Item #7 Number of Years on the Internet

Number of Years	Number	Percent	Valid Percent	Cumulative Percent
Never	4	3.0	3.0	3.0
0-2 Years	65	48.5	49.2	52.3
3-4 Years	42	31.3	31.8	84.1
5-6 Years	16	11.9	12.1	96.2
7 or more Years	5	3.7	3.8	100.0
Total Responses	132	98.5	100.0
Missing value	2	1.5
Total Respondents	134	100.0

Table 10. Hours Per Day on the Internet

Item #8 Average Number of Hours Per Day on the Internet

Number of Hours	Number	Percent	Valid Percent	Cumulative Percent
Never	8	6.0	6.1	6.1
Less than 1	70	52.2	53.4	59.5
1-2 Hours	44	32.8	33.6	93.1
3-4 Hours	6	4.5	4.6	97.7
5-6 Hours	2	1.5	1.5	99.2
7 or more Hours	1	.7	.8	100.0
Total Responses	131	97.8	100.0
Missing Value	3	2.2
Total Respondents	134	100.0

When asked how many hours per day they were on the Internet, only 6.1% of the respondents answered 'never'. Over half (53.4%) of the respondents stated that they were on-line less-than-one hour, while 33.6% were on-line one-to-two hours, and only 6.1% were on-line three-or-more hours. Although it was clear from item four that the respondents were moderate-to-heavy computer users, when compared to some other information-intensive occupations, this population spends a relatively small portion of their time on-line.

Table 11. Company Website

Item #9 Does Your Company Host a Website

Host	Number	Percent	Valid Percent	Cumulative Percent
Yes	120	89.6	90.3	90.2
No	7	5.2	5.3	95.5
Don't Know	6	4.5	4.5	100.0
Total	133	99.3	100.0
Missing Value	1	.7
Total Respondents	134	100.0

The Internet has become much more valued and important for many organizations and companies in the last few years. The fact that 90.2% of the respondents indicated that their companies had a Website the respondents validated this statement.

Table 12. Years with a Company Website

Item #9B Number of Years Hosting a Website

Number of Years	Number	Percent	Valid Percent	Cumulative Percent
0-1 Years	28	20.9	24.3	24.3
2-3 Years	53	39.6	46.1	70.4
4 or more Years	19	14.2	16.5	87.0
Don't Know	15	11.2	13.0	100.0
Total Responses	115	85.8	100.0
Missing value	19	14.2
Total Respondents	134	100.0

Hosting Websites is a relatively new phenomenon for most healthcare entities. Of those companies that had a Website, only 16.5% had one for four-or-more years. Seventy percent of the respondents indicated that their company Website had been operational for less-than-four years, with 24.3% of them being in operation for less-than a year, and 46.1% were operating for two-to-three years.

Item 10: Software Applications

In item 10 the respondents were asked about their patterns of use for the most common types of software applications. The frequency data was summarized and valid percents were calculated for each part of the main item. In addition to the general observations from each of the individual cells, in many instances, interesting patterns emerged by combining the data from the two positive and two negative responses on the continuum. The three most frequently used applications were e-mail (95.5%), word processing (93.2%), and Web browsers (64.2%). Graphics packages (65.4%), desktop publishing (62.8%), and database software (55.8%) were the least often used applications in that the respondents said they 'never' or 'rarely' used them.

Table 13. Applications Used - Word Processing

Item #10A Applications Used - Word Processing

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	1	.7	.8	.8
Rarely	4	3.0	3.0	3.8
Sometimes	4	3.0	3.0	6.8
Often	19	14.2	14.3	21.1
Regularly	105	78.4	78.9	100.0
Total Responses	133	99.3	100.0
Missing value	1	.7
Total Respondents	134	100.0

Of the software applications listed on the survey, word processing was among the most frequently used. Over ninety percent (93.2%) of the respondents indicated that they used word processing 'often' (14.3%) or 'regularly' (78.9%).

More than half of the respondents (55.8%) indicated that they used 'never' (34.1%) or 'rarely' (21.7%) used database software. Only about one quarter of those surveyed said they used it 'often' (9.3%) or 'regularly' (17.8%). Clearly, there is relatively little database-related activity among this population, which is contrary to the trend in many other data intensive industries.

Table 14. Applications Used - Databases

Item #10B Applications Used - Databases

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	44	32.8	34.1	34 .1
Rarely	28	20.9	21.7	55.8
Sometimes	22	16.4	17.1	72.9
Often	12	9.0	9.3	82.2
Regularly	23	17.2	17.8	100.0
Total Responses	129	96.3	100.0
Missing value	5	3.7
Total Respondents	134	100.0

Table 15. Applications Used - E-mail

Item #10C Applications Used - E-mail

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	4	3.0	3.0	3.0
Rarely	1	.7	.8	3.8
Sometimes	1	.7	.8	4.5
Often	11	8.2	8.3	12.8
Regularly	116	86.6	87.2	100.0
Total Responses	133	99.3	100.0
Missing value	1	.7
Total Respondents	134	100.0

E-mailing emerged as the most popular software application in the survey with 95.5% of the users indicating that they used it 'regularly' (87.2%) or 'often' (8.3%).

Web browsers, the other widespread Internet-based software application, were popular, but were not used as often as e-mailing. Almost two thirds of the respondents (64.2%) said that they used browsers 'regularly' (40.5%) or (23.7%) 'often'.

From the data it appears that presentation software is well known. Over half (52.0%) of the respondents said they used it 'often' (29.5%) or 'regularly' (22.5%). An additional 22.5% indicated that they used it 'sometimes'.

Table 16. Applications Used - Web browser

Item #10D Applications Used - Web browser

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	4	3.0	3.1	3.1
Rarely	12	9.0	9.2	12.2
Sometimes	31	23.1	23.7	35.9
Often	31	23.1	23.7	59.5
Regularly	53	39.6	40.5	100.0
Total Responses	131	97.8	100.0
Missing value	3	2.2
Total Respondents	134	100.0

Table 17. Applications Used - Presentation Software

Item #10E Applications Used - Presentation Software

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	17	12.7	13.2	13.2
Rarely	16	11.9	12.4	25.6
Sometimes	29	21.6	22.5	48.1
Often	38	28.4	29.5	77.5
Regularly	29	21.6	22.5	100.0
Total Responses	129	96.3	100.0
Missing value	5	3.7
Total Respondents	134	100.0

Table 18. Applications Used - Search Engines

Item #10F Applications Used - Search Engine

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	8	6.0	6.0	6.0
Rarely	15	11.2	11.3	17.3
Sometimes	42	31.3	31.6	48.9
Often	32	23.9	24.1	72.9
Regularly	36	26.9	27.1	100.0
Total Responses	133	99.3	100.0
Missing value	1	.7
Total Respondents	134	100.0

Search engines are a class of software applications that are well know by Internet users. The data indicates that over half (51.2%) of those in the survey said they used it 'often' (24.1%) or 'regularly' (27.1%). Almost one third of the respondents (31.6%) said they used them 'sometimes'.

Table 19. Applications Used - Desktop Publishing

Item #10G Applications Used - Desktop Publishing

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	50	37.3	38.8	38.8
Rarely	31	23.1	24.0	62.8
Sometimes	22	16.4	17.1	79.8
Often	17	12.7	13.2	93.0
Regularly	9	6.7	7.0	100.0
Total Responses	129	96.3	100.0
Missing value	5	3.7
Total Respondents	134	100.0

Almost two thirds of the respondents, (62.8%) said they 'never' or 'rarely' used desktop publishing applications in their work. Desktop publishing of materials or documents does not appear to be an important task for computers in this sample as only 7.0% said they used it 'regularly'.

Table 20. Applications Used - Graphics Software

Item #10H Applications Used - Graphics Package

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	52	38.8	40.0	40.0
Rarely	33	24.6	25.4	65.4
Sometimes	21	15.7	16.2	81.5
Often	17	12.7	13.1	94.6
Regularly	7	5.2	5.4	100.0
Total Responses	130	97.0	100.0
Missing value	4	3.0
Total Respondents	134	100.0

Almost two thirds of the respondents (65.4%) of those surveyed indicated that they 'never' or 'rarely' used graphics software. Duties requiring the production or manipulation of graphics does not appear to be an important task for the respondents in this sample as only 5.4% said they used it 'regularly'.

Table 21. Applications Used - Other

Item #10I Applications Used - Other

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	17	12.7	15.3	15.3
Rarely	19	14.2	17.1	32.4
Sometimes	39	29.1	35.1	67.6
Often	17	12.7	15.3	82.9
Regularly	19	14.2	17.1	100.0
Total Responses	111	82.8	100.0
Missing value	23	17.2
Total Respondents	134	100.0

A mixture of responses were provided about other software applications that were used by this population, however, they were too numerous and diverse to report or categorize for this study.

SECTION II: COMPUTER USE IN HEALTH PROMOTION ACTIVITIES

Table 22. Perceived Worth of Computers in Health Promotion Services for Clients

Item #11 Perceived Worth of Computers in Health

Rating	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	16	11.9	12.0	12.0
Unimportant	3	2.2	2.3	14.3
Average Importance	29	21.6	21.8	36.1
Important	38	28.4	28.6	64.7
Very Important	47	35.1	35.3	100.0
Total Responses	133	99.3	100.0
Missing value	1	.7
Total Respondents	134	100.0

Item 11 addresses research question number one. Almost two thirds of the respondents (63.9%) indicated that they perceived that computers were either 'important' (28.6%) or 'very important' (35.3%) in their work with their clients. It is worth noting that a significant number of respondents (12.0%) stated that they perceived computers as being very unimportant in working with clients while less than one quarter (21.8%) listed computers as of 'average' importance.

Several intriguing perceived worth observations emerged from the data by comparing the responses from item one (at work) with item 11 (working with clients). When the 'important' and 'very important' scores were combined, the respondents gave lower perceived worth ratings (63.9% to 72.8%) in item 11. They also gave lower ratings (35.3% to 56.1%) in the 'very important' category. However, the ratings for 'very unimportant' (25.8% to 12.0%) were much higher for item one

Table 23. Frequency of Use in Health Promotion Services

Item # 12 How Often Computers Are Used in Health Promotion Services

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	9	6.7	6.8	6.8
Rarely	17	12.7	12.9	19.7
Sometimes	42	31.3	31.8	51.5
Often	31	23.1	23.5	75.0
Very Often	33	24.6	25.0	100.0
Total Responses	132	98.5	100.0
Missing value	2	1.5
Total Respondents	134	100.0

Almost half of the respondents (48.5%) said they used computers 'often' (23.5%) or 'very often' (25.5%) in the process of providing health promotion services to their clients. Fewer than twenty percent (19.7%) said they 'rarely' (12.9%) or 'never' (6.8%) used them in that capacity.

Table 24. Management Support for the Use of Computers in Health Promotion with Clients

Item #13 What Level of Support for Use of Computers in Health Promotion with Clients

How Much	Number	Percent	Valid Percent	Cumulative Percent
No support	7	5.2	5.4	5.4
Little	13	9.7	10.0	15.4
Some	20	14.9	15.4	30.8
Neither Strong/Weak	7	5.2	5.4	36.2
Strong	34	25.4	26.2	62.3
Very Strong	40	29.9	30.8	93.1
Not Applicable	9	6.7	6.9	100.0
Total Responses	130	97.0	100.0
Missing value	4	3.0
Total Respondents	134	100.0

The data shows that over half of the respondents (57.0%) had either 'strong' (26.2%) or 'very strong' (30.8%) support from management for the use of computers in providing health promotion services to their clients.

Item 14: Use of Computers in Health Promotion by Task

In item 14 the respondents were asked how much of the time they used computers for a variety of tasks and health promotion services for their clients. The frequency data was summarized and valid percents were calculated for each part of the item. In addition to the general observations from each of the individual cells, in many instances, interesting patterns emerged by combining the data from the two positive and two negative responses on the continuum. Of the tasks listed, the combined score for the most prevalent use of computers was for business or management tasks (86.9%), producing materials (83.8%), and communicating with clients (75.8%). Database tasks (50.8%) and research for clients (58.0%) were the most infrequently mentioned tasks by the respondents. Although producing materials was rated highly, from item 10 it is probable that desktop publishing and graphics packagers were most likely not the applications of choice.

Table 25. Computer Use - Business or Management Tasks

Item #14A Computer Use for Health Promotion - Business or Management Tasks

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	7	5.2	5.4	5.4
Rarely	3	2.2	2.3	7.7
Sometimes	7	5.2	5.4	13.1
Often	25	18.7	19.2	32.3
Regularly	88	65.7	67.7	100.0
Total Responses	130	97.0	100.0
Missing value	4	3.0
Total Respondents	134	100.0

A total of 86.9% of the respondents said they used computers in health promotion for business or management tasks 'regularly' (67.7%) or 'often' (19.2%). This was the highest rated task for the use of computers in health promotion.

Table 26. Computer Use - Communication with Clients

Item #14B Computer Use for Health Promotion - Communicate with My Clients

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	8	6.0	6.1	6.1
Rarely	12	9.0	9.1	15.2
Sometimes	12	9.0	9.1	24.2
Often	26	19.4	19.7	43.9
Regularly	74	55.2	56.1	100.0
Total Responses	132	98.5	100.0
Missing value	2	1.5
Total Respondents	134	100.0

When asked if they used computers to communicate with their clients, 75.8% said they used them 'often' (19.7%) or 'regularly' (56.1%). It is interesting to note that in item 10C (use of e-mail) 95.5% of the respondents indicated that used e-mail ('regularly' 87.2% or 'often' 8.3%) while only 75.8% of the respondents in this item used it with their clients ('regularly' 56.1% or 19.7% 'often').

It is assumed that the form of communication that respondents were referring to was e-mail, however it is recognized that a portion of them could have been thinking of alternative forms of computer-based communication such as video conferencing, chat, list serves, or instant messaging.

Table 27. Computer Use - Personal Research

Item #14C Computer Use for Health Promotion - Research for Myself

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	2	1.5	1.5	1.5
Rarely	3	2.2	2.3	3.8
Sometimes	33	24.6	25.2	29.0
Often	34	25.4	26.0	55.0
Regularly	59	44.0	45.0	100.0
Total Responses	131	97.8	100.0
Missing value	3	2.2
Total Respondents	134	100.0

A total of 71% of the respondents indicated that they used computers for health promotion purposes for themselves with 45% of them replying 'regularly' and 26.0% stating 'often'.

Over half (58.0%) of the respondents said they used computers to do research for their clients 'regularly' (29.8%) or (28.2%) 'often'. This is a significant drop in use, mostly in the 'regularly' category, when compared to item 14C. Clearly, this is another area where computers are being used less often for health promotion activities for clients than for general or personal computer tasks.

Table 28. Computer Use - Research for Clients

Item #14D Computer Use for Health Promotion - Research for My Clients

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	10	7.5	7.6	7.6
Rarely	12	9.0	9.2	16.8
Sometimes	33	24.6	25.2	42.0
Often	37	27.6	28.2	70.2
Regularly	39	29.1	29.8	100.0
Total Responses	131	97.8	100.0
Missing value	3	2.2
Total Respondents	134	100.0

Table 29. Computer Use - Data Gathering or Management

Item #14E Computer Use for Health Promotion - Gather/Manage Data about My Clients

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	19	14.2	14.6	14.6
Rarely	21	15.7	16.2	30.8
Sometimes	24	17.9	18.5	49.2
Often	30	22.4	23.1	72.3
Regularly	36	26.9	27.7	100.0
Total Responses	130	97.0	100.0
Missing value	4	3.0
Total Respondents	134	100.0

When asked if they used computers for data gathering and management health promotion tasks, over half (50.8%) said they used them 'regularly' (27.7%) or 'often' (23.1%).

The second most popular use of computers in health promotion was for producing materials for clients. A total of 83.8% said they used computers for this purpose with 59.2% stating 'regularly' and 24.6% stating 'often'. Although producing materials was ratedhighly, from item 10 it is probable that desktop publishing and graphics packagers were most likely not the applications of choice.

Table 30. Computer Use - Producing Materials

Item #14F Computer Use for Health Promotion - Produce Materials for My Clients

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	5	3.7	3.8	3.8
Rarely	9	6.7	6.9	10.8
Sometimes	7	5.2	5.4	16.2
Often	32	23.9	24.6	40.8
Regularly	77	57.5	59.2	100.0
Total Responses	130	97.0	100.0
Missing value	4	3.0
Total Respondents	134	100.0

Table 31. Computer Use - Other Purposes

Item #14G Computer Use for Health Promotion - Other Purposes

How Often	Number	Percent	Valid Percent	Cumulative Percent
Never	4	3.0	5.5	5.5
Rarely	4	3.0	5.5	11.0
Sometimes	18	13.4	24.7	35.6
Often	17	12.7	23.3	58.9
Regularly	30	22.4	41.1	100.0
Total Responses	73	54.5	100.0
Missing value	61	45.5
Total Respondents	134	100.0

A total of 64.4% of those surveyed indicated that they used computers for other health promotion purposes with 41.1% saying 'regularly' and 23.3% answering 'often'. However, the responses were too diverse to categorize and present for this paper.

Item 15: Barriers to the Use of Computers in Health Promotion

Item 15 was used to address research question three. In item 15 the respondents were asked for their opinion of the impact of a set of barriers to using computers in health promotion. The frequency data was summarized and valid percents were calculated for each part of the item. In addition to the general observations from each of the individual cells, in many instances, interesting patterns emerged by combining the data from the two positive and two negative responses on the continuum. Although the split between the greatest and least important barriers was not as dramatic as in item 10 and 14, the respondents rated competing priorities (55.7%), lack of technical support (53.6%), cost (53.6%), and lack of training (50.8%) as the major obstacles to the use of computers in health promotion. Lack of access (42.8.%), low priority in the organization, (42.7%), and lack of leadership, (36.9%) were the three barriers that had the highest ratings on the 'unimportant' side of the continuum.

Table 32. Barriers - Low Skills

Item #15A Barriers to Use of Computers in Health Promotion - Low skills

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	12	9.0	9.7	9.7
Unimportant	21	15.7	16.9	26.6
Average	38	28.4	30.6	57.3
Important	27	20.1	21.8	79.0
Very Important	26	19.4	21.0	100.0
Total Responses	124	92.5	100.0
Missing value	10	7.5
Total Respondents	134	100.0

When asked what barriers affected them, the pattern of responses for this item was fairly typical of a standard curve. However more, of the respondents (42.8%) answered 'important' (21.8%) or 'very important' (21.0%) than 'unimportant' (16.9%) or 'very unimportant' (9.7%).

Cost was another factor where the pattern of responses was fairly well distributed. However, a combined 53.6% said it was 'important' (34.1%) or 'very important' (19.5%), while 25.2% said it was 'unimportant' (21.1%) or 'very unimportant' (4.1%).

Table 33. Barriers - High Cost

Item #15B Barriers to Use of Computers in Health Promotion - High Cost

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	5	3.7	4.1	4.1
Unimportant	26	19.4	21.1	25.2
Average	26	19.4	21.1	46.3
Important	42	31.3	34.1	80.5
Very Important	24	17.9	19.5	100.0
Total Responses	123	91.8	100.0
Missing value	11	8.2
Total Respondents	134	100.0

Table 34. Barriers - Lack of Technical Support

Item #15C Barriers to Use of Computers in Health Promotion - Lack of Technical Support

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	9	6.7	7.3	7.3
Unimportant	20	14.9	16.3	23.6
Average	28	20.9	22.8	46.3
Important	42	31.3	34.1	80.5
Very Important	24	17.9	19.5	100.0
Total Responses	123	91.8	100.0
Missing value	11	8.2
Total Respondents	134	100.0

Technical support was another area where no strong pattern emerged, although a combined 53.6% of the respondents answered 'important' (34.1%) or 'very important' (19.5%), while only 23.6% responded 'unimportant' (16.3%) or 'very unimportant' (7.3%).

The respondents ratings for item 15D show that they do not feel lack of access is a significant issue. Less than forty percent (37.8%) of the respondents rated lack of access as 'important' (19.4%) or 'very important' while (18.5%)% while 42.8% indicated that it was 'unimportant' (20.2%) or 'very unimportant' (22.6%). These responses are consistent with the data from item #2 (required to use a computer), and #5 (access to a computer).

Table 35. Barriers - Lack of Access

Item #15D - Barriers to Use of Computers in Health Promotion - Lack of Access

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	28	20.9	22.6	22.6
Unimportant	25	18.7	20.2	42.7
Average	24	17.9	19.4	62.1
Important	24	17.9	19.4	81.5
Very Important	23	17.2	18.5	100.0
Total Responses	124	92.5	100.0
Missing value	10	7.5
Total Respondents	134	100.0

Table 36. Barriers - Lack of Time

Item #15E Barriers to Use of Computers in Health Promotion - Lack of Time

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	18	13.4	14.4	14.4
Unimportant	18	13.4	14.4	28.8
Average	40	29.9	32.0	60.8
Important	33	24.6	26.4	87.2
Very Important	16	11.9	12.8	100.0
Total Responses	125	93.3	100.0
Missing value	9	6.7
Total Respondents	134	100.0

The replies to the lack of time item were well distributed, however slightly more responses (39.2%) were toward the 'important' side from the mean. It appears that lack of time is not a significant issue for this group.

More than half (55.7%) of the respondents indicated that competing priorities were a significant barrier. For example, 34.7% said that it was 'important' and another 21.0% said it was 'very important', while only 16.7% rated it as 'unimportant' (9.7%) or 'very unimportant' (4.0%). Although the issue of competing priorities did not appear to be overwhelming, it is non-the-less rated as significant.

Table 37. Barriers - Competing Priorities

Item #15F Barriers to Use of Computers in Health Promotion - Competing Priorities

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	5	3.7	4.0	4.0
Unimportant	12	9.0	9.7	13.7
Average	38	28.4	30.6	44.4
Important	43	32.1	34.7	79.0
Very Important	26	19.4	21.0	100.0
Total Responses	124	92.5	100.0
Missing value	10	7.5
Total Respondents	134	100.0

Table 38. Barriers - Lack of Training

Item #15G Barriers to Use of Computers in Health Promotion - Lack Training

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	7	5.2	5.7	5.7
Unimportant	16	11.9	13.1	18.9
Average	37	27.6	30.3	49.2
Important	40	29.9	32.8	82.0
Very Important	22	16.4	18.0	100.0
Total Responses	122	91.0	100.0
Missing value	12	9.0
Total Respondents	134	100.0

The data for the lack of training item was well dispersed. However, the largest ratings were given to the 'important' side of the mean where 50.8% of the respondents answered either 'important' (32.8%) or 'very important' (18.0%). This item has implications to research question four.

Table 39. Barriers - Lack of Leadership

Item #15H Barriers to Use of Computers in Health Promotion - Lack of Leadership

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	17	12.7	13.9	13.9
Unimportant	28	20.9	23.0	36.9
Average	29	21.6	23.8	60.7
Important	29	21.6	23.8	84.4
Very Important	19	14.2	15.6	100.0
Total Responses	122	91.0	100.0
Missing value	12	9.0
Total Respondents	134	100.0

The data for the lack of leadership was closely grouped around the mean with ratings of 23% for the 'unimportant', 'average', and 'important' choices. The barrier data for this item is consistent with the responses from item 13. This item has implications to research question four.

Table 40. Barriers - Low Priority

Item #15I Barriers to Use of Computers in Health Promotion - Low Priority

How Often	Number	Percent	Valid Percent	Cumulative Percent
Very Unimportant	23	17.2	18.9	18.9
Unimportant	29	21.6	23.8	42.6
Average	27	20.1	22.1	64.8
Important	26	19.4	21.3	86.1
Very Important	17	12.7	13.9	100.0
Total Responses	122	91.0	100.0
Missing value	12	9.0
Total Respondents	134	100.0

The replies for the low priority as a barrier item were closely grouped around the mean with a range 21% to 23% for the 'unimportant', 'average', and 'important' response categories. There were more responses (42.7%) were on the 'unimportant' side of the mean than the 'important' (35.2%) side.

SECTION III: DEMOGRAPHICS

The demographic information was collected to answer research question five.

Table 41. Demographics - Age

Item #16 Demographics - Age

Age	Number	Percent	Valid Percent	Cumulative Percent
Under 30	15	11.2	11.5	11.5
31-40	41	30.6	31.5	43.1
41-50	47	35.1	36.2	79.2
51 and older	27	20.1	20.8	100.0
Total Responses	130	97.0	100.0
Missing value	4	3.0
Total Respondents	134	100.0

The age range of the respondents is summarized in Table 41. The distribution is typical of conference attendees for this profession.

Table 42. Demographics - Gender

Item #17 Demographics - Gender

Gender	Number	Percent	Valid Percent	Cumulative Percent
Male	14	10.4	15.1	15.1
Female	79	59.0	84.9	100.0
Total Responses	93	69.4	100.0
Missing value	41	30.6
Total Respondents	134	100.0

The gender of those surveyed is presented in Table 42. Females comprise 84.9% of the respondents. The distribution of those attending the conference is typical, however the actual breakdown of those who completed the form may be significantly skewed because of the large number of missing values. According to the roster of preregistrants for the conference, 153 or 30% of the 509 total preregistered attendees were male. There is a discrepancy in the percentage of males on the conference roster (30%) with those who chose male for item number 17.

Item #18 Demographics - Zip Code

The zip code data was not reported because analysis of it is beyond the scope of this study.

Table 43. Demographics - Educational Level

Item #19 Demographics - Educational Level

Level	Number	Percent	Valid Percent	Cumulative Percent
High School	1	.7	.8	.8
Associate Arts	8	6.0	6.3	7.0
Bachelors	22	16.4	17.2	24.2
Professional License	13	9.7	10.2	34.4
Masters	71	53.0	55.5	89.8
Ph. D.	13	9.7	10.2	100.0
Total Responses	128	95.5	100.0
Missing value	6	4.5
Total Respondents	134	100.0

The educational level for the respondents is summarized in Table 43. The relatively high number of advanced degrees is typical for the leaders of this profession.

The primary domain of health that the respondents reported working in is displayed in Table 44. This distribution is considered typical of health promotion professionals working in this sector of the healthcare industry.

The years of experience in health promotion for the respondents are displayed in

Table 44. Demographics - Health Sector

Item #20 Demographics - Health Sector

Sector	Number	Percent	Valid Percent	Cumulative Percent
Medical/Hospital	22	16.4	17.9	17.9
Academic	22	16.4	17.9	35.8
Business	19	14.2	15.4	51.2
Corporate Health	22	16.4	17.9	69.1
Consultant	8	6.0	6.5	75.6
Other	30	22.4	24.4	100.0
Total Responses	123	91.8	100.0
Missing value	11	8.2
Total Respondents	134	100.0

Table 45. From the data it is evident that, as a group, the respondents have been involved in health promotion for several years, as would be expected for a population who are the leadership roles of their profession.

Table 45. Demographics - Years in Industry

Item #21 Demographics - Years in the Industry

Years	Number	Percent	Valid Percent	Cumulative Percent
Less than 5 Years	30	22.4	24.2	24.2
6-10 Years	28	20.9	22.6	46.8
11-20 Years	44	32.8	35.5	82.3
21 or more Years	22	16.4	17.7	100.0
Total Responses	124	92.5	100.0
Missing value	10	7.5
Total Respondents	134	100.0

Table 46. Demographics - Size of Organization

Item #22 Demographics - Size of Organization

How Many	Number	Percent	Valid Percent	Cumulative Percent
Less than 100	19	14.2	15.0	15.0
101-500 People	12	9.0	9.4	24.4
501-1000 People	11	8.2	8.7	33.1
1001 or more	85	63.4	66.9	100.0
Total Responses	127	94.8	100.0
Missing value	7	5.2
Total Respondents	134	100.0

The data about the size of the organization in which the respondents work is summarized in Table 46. It is noteworthy that a large portion (64.6%) of them work in large organizations with 1000 or more employees. It may be that organizations of this size are necessary to support health promotion efforts.

Table 47. Demographics - Job Title

Item #23 Demographics - Job Title

Type of Job	Number	Percent	Valid Percent	Cumulative Percent
Executive/Manager	31	23.1	24.2	24.2
Middle Manager	30	22.4	23.4	47.7
Professor/educator	25	18.7	19.5	67.2
Professional/practitioner	19	14.2	14.8	82.0
Consultant	6	4.5	4.7	86.7
Other	17	12.7	13.3	100.0
Total Responses	128	95.5	100.0
Missing value	6	4.5
Total Respondents	134	100.0

The job title of the respondent is displayed in Table 47. It is worth noting that there is a relatively high percentage of managers and other professional types in this population.

APPENDIX 4

THE EXPERT PANEL

The following individuals agreed to assist in this study by serving as members of an expert panel. The individuals helped: to provide input and select the most important topics areas for the research questions; to select the highest priority items from the initial pool of items; to refine and develop the most appropriate wording for the items; to establish content validity for the items; and to review the administrative procedures and protocol for the study. Each individual on the panel had completed or was currently enrolled in an advanced degree program in a health promotion-related area and they were selected because of their awareness of, knowledge about, or expertise with the issues in this area of research.

Table 48. Expert Panel

Expert	Organization	Education or Area of Expertise
Mr. Mike Casey	MayoClinic.com	MBA, Marketing, Loyola University
Dr. Carlos Crespo	American University	Assistant Professor in Department of the Health and Fitness
Mr. Harold Denlow	Welltech	Online Health Market
Ms. Margaret Hawkins	American Heart Association	MS in Health and Fitness Management
Dr. Bill Hettler	University of Wisconsin-Stevens Point	M.D. University of Cincinnati College of Medicine
Dr. Robert Karch	American University	Professor in the Department of Health and Fitness
Mr. Wolf Kirsten American University	International Institute for Health Promotion	MS in Health and Fitness Management
Ms. Sue Liebenow	Liebenow and Torok	MS in Health and Fitness Management

Table 40. (Continued)

Expert Panel

Dr. Daniel Newton	The Newsoft Group	Ph.D. in Education, MS in Health and Fitness Management
Dr. Michael O’Donnell	American Journal of Health Promotion	PhD in Health Behavior and Health Education, University of Michigan, MBA in Entrepreneurship and General Management and MPH in Hospital Administration, University of California, Berkeley
Dr. Marc Schaeffer	American University	Adjunct Faculty Member in the Department of Health and Fitness and Biostatistican
Dr. Anastasia Snelling	American University	Assistant Professor in the Department of Health and Fitness
Dr. David Stevenson	Sewickley Valley YMCA	Ph.D. in Education, MS in Health and Fitness Management
Mrs. Holly Hollister-Morganti	HM Consulting	MS in Health and Fitness Management
Mrs. Jennifer Posa-Flynn	Mayo Online	MS in Health and Fitness Management
Ms. Monica Riggi American University	Student	MS in Health and Fitness Management
Ms. Shannon Swift-Hines	Kaiser Permante	MS in Health and Fitness Management
Mrs. Jeanne Studach	Alexandria City School District	Pediatric Nurse Practitioner
Mr. Shea VanHorn	IQ Solutions	MS in Health and Fitness Management

APPENDIX 5

COMPARISON DATA FOR COMPUTER USE AND GENDER

Several relevant bits of data that are germane to this study were collected from other studies and sources from the literature. The data has been organized into the tables below. The purpose of developing the tables is to allow for some basic trends analysis, approximations, and very rough comparisons between this study and other research and data collection efforts.

The United States Census Bureau and the National Telecommunication and Information Administration are the primary sources of the longitudinal data. These agencies have been collecting data on computer-related indices s since the 1980s as part of an effort to track economic development trends in America (United States Census Bureau, 1999; United States Department of Commerce, 1999). Several key patterns of growth that are of interest to this study are reflected in the data. However, it is not possible to make clear comparisons or to draw definitive conclusions from the data because the rates of adoption of computer technologies is very rapid and unfortunately the Current Population Survey data for the 2000 census have not been released and the last release of data from the Computer Use Survey was in 1997. Moreover, the categories that are used for the classification of the occupational and industry data, the age groupings, and the operational definitions for some of the survey items differ from those that were developed for this study. Finally, in many cases, there was not sufficient data or there was no single category for employees in the health sector in either of the two primary sources that would allow for comparisons to this study. Data from two recent studies of health educators have also been included in the tables to provide additional comparison data.

Table 49. Computer-Related Data by Gender

	All Employed(97)		AJHP (1999)
	Female	Male	Female	Male
Use a computer at work	56.5	44.1	94.4	92.3
Use the Internet at work	15.5	17.5	94.8	100
Application used at work - word processing	59.8	53.9	93.5	100
Application used at work - E-mail	43.1	51.3	94.6	100
Application used at work - graphics	24.3	17.0	83.9	97.8
Application used at work - databases	31.6	36.8	57.3	42.8
Managers who use a computer at work	74.0	75.2
Financial industry who use computers at work	87.6	72.4
Public administrators who use computers at work	82.4	68.6

There are three sources of data included in Table 50. The Census data is from 1997 on all employed individuals. The Hanks and Ellery data is from studies with sample populations of health educators in 1999 (Ellery, 2001; Hanks, 2000). The AJHP data is from this 1999 study of health promotion professionals.

Table 50. Application, Computer, and Internet Use in the General Population and Health Domain

	Census	Hanks	Ellery	AJHP
Application used at work - word processing	57.0	92.9		96.2
Application used at work - E-mail	47.0	85.0	97.0	96.2
Application used at work - graphics	20.4			36.4
Application used at work - databases	34.1	39.4		44.2
Application used at work - desktop publishing	15.3	52.7		37.2
Application used at work - Presentation software		60.2		74.4
Application used at work - Web browser		78.3		84.7
Application used at work - Search engine			87.0	76.7
Computer access - work (Census - use of computer)	49.8		88.0	98.5
Internet access - work	16.6		84.0	97.0

The Aspden data is from a sample population of physicians form New Jersey in 1998 (Aspden, 1998). The AJHP data is from a sample of health promotion professionals in 1999.

Table 51. Use of Internet and E-Mail by Physicians and Health Promotion Professionals

	Aspen	AJHP
Use of Internet	61.6	97.0
Used E-mail	55	96.2
Used E-mail with clients	18	84.8

Narrative Description of the Gender Difference for Selected Items

Because other studies have found significant differences in the way men and women use computers, several of the items in this study were selected for further analysis by gender. A description of the data for several of the key items has been included below.

Item #5 Computer access

There is little difference between women and men (94.4% to 92.3%) in terms of unrestricted access to computers. However, a greater percentage of men share a computer than women (7.7% to 5.1%).

Item #6 Training

Almost twice as many men than women (71.4% to 38.5%) indicated that their 'most important' form of training was self-taught. More women than men (37.2% to 21.4%) indicated that their 'most important' form of training was a course at work. Equal numbers of men and women (7.1% to 7.7%) received training from a colleague at work. The two most popular and roughly equal forms of training for women are self-taught and training at work 38.5% and 37.2%. Almost three times as many men than women (71.4% to 21.4) report that they are self-taught as opposed to receiving training at work.

Item #7 Years on the Internet vs. Never on the Internet

94.8% of women and 100% of men reported being on the Internet. Men have greater percentages for use of the Internet in every category except for 0-2 years where there were twice as many women (50.6% to 21.4%). Almost three times as many men report being on the Internet for 5 or more years than women 42.8% to 14.3%.

Item #10A Applications used - word processing

100% of the men and 93.5% of the women reported using word processing 'often' or 'regularly'. Men reported using word processing regularly more often than women (92.9% to 78.5%).

Item #10B Applications used - data bases

More women than men responded that they 'never' or 'rarely' used database software (57.3% to 42.8%). More than three times more men than women (28.6% to 8.0%) responded that they used databases 'often' but slightly more women indicated that they used it 'regularly' (18.7% to 14.3%).

Item #10C Applications used - E-mail

100% of men and 94.6% of women report using E-mail 'often' or 'regularly'. Four times as many men than women (21.4% to 5.1%) responded that they used it 'often'.

Item #10F Applications used - Search Engines

97.8% of the men and 83.9% of the women indicated that they used search engines. More than twice as many women than men (31.6% to 14.3%) responded that used search engines 'sometimes'. However, almost twice as many men than women (50.0% to 26.6%) indicated that they used search engines 'regularly'.

Item #10H Applications used - Graphics

91.1% of the men, but only 41.1% of the women, indicated that they used graphics software. In the 'often' category men indicated that they used graphics applications almost two times as often as women (15.45 to 7.8%).

Item #14B Applications used - Communication with clients

97.8% of the men and 85.9% of the women responded that they communicate at least some of the time with their clients. 71.5% of the men and 78.2% of the women indicated that they communicate 'often' or 'regularly'. However, more women than men (62.8% to 42.9%) indicated that they used it 'regularly'.

Item #10E Applications used - Data with clients

Men and women are almost equal (28.5% to 30.7%) in terms of reporting that they 'never' or 'rarely' use databases for their clients. However, more than twice as many women than men (19.2% to 7.1%) stated that they 'never' use databases for their clients.

Bibliography

Last Updated: December 10, 2001