- •Participants living with multiple sclerosis (MS) enroled in an online course about MS reported being satisfied with their perceived healthcare quality and accessibility.
- •The number of healthcare visits, MS knowledge, health literacy, self-efficacy, and quality of life were all positively associated with perceived healthcare quality and accessibility in this cohort.
- •Participation in the understanding MS massive open online course had no effect on healthcare utilization or perceived healthcare quality and accessibility.
People living with multiple sclerosis (MS) need access to high quality healthcare and support services. However, many people with MS do not have access to the services that they need.
To survey healthcare utilisation and perceived quality and accessibility amongst people living with MS who enroled in a free online course about MS (the Understanding MS massive open online course (MOOC)) and to evaluate the impact of course completion on these outcomes.
This longitudinal cohort study evaluated participants before they began the course, immediately following completion, and six months following completion. We describe baseline healthcare utilisation and perceived accessibility and quality (N = 813) and identify factors associated with satisfaction using chi-square and t-tests. We evaluate the impact of course completion amongst a sub-group (N = 123) of participants who both completed the course and completed all three assessments using paired t-tests. We determined effect size using Cohen's D.
Most participants accessed at least one healthcare service in the month before beginning the course and were satisfied with their healthcare accessibility and quality. Participants who reported being satisfied with their healthcare quality and accessibility had more healthcare visits, and greater MS knowledge, health literacy, quality of life and self-efficacy. Completing the Understanding MS MOOC had no effect on perceived healthcare accessibility or quality.
Our study suggests that people with MS who access online educational resources are likely to be well resourced in other areas as well. Our findings also suggest that a more targeted intervention may be necessary to improve healthcare accessibility and quality outcomes in people with MS.
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- Measuring the health-related quality of life in Australians with multiple sclerosis using the assessment of quality of ilfe-8-dimension (AQoL-8D) multi-attribute utility instrument.Mult. Scler. Rel. Dis. 2020; 44102358
- All-cause health care utilization and costs associated with newly diagnosed multiple sclerosis in the United States.J. Manag. Care Pharm. 2010; 16: 703-712
- Self-efficacy: toward a unifying theory of behavioral change.Psychol. Rev. 1977; 84: 191-215
- Low health literacy and health outcomes: an updated systematic review.Ann. Intern. Med. 2011; 155: 97-107
- Development and psychometric properties of the multiple sclerosis knowledge assessment scale: rasch analysis of a novel tool for evaluating MS knowledge.Mult. Scler. 2020; https://doi.org/10.1177/1352458520929626
- Evaluating the impact of the Understanding Multiple Sclerosis online course on participant MS knowledge, health literacy, resilience, self-efficacy, quality of life, and MS symptom severity.MSARD. 2022; https://doi.org/10.1016/j.msard.2022.103717
- An investigation of the psychometric properties of the Personal Wellbeing Index.Bachelor (Honours). School of Psychology, Deakin University, VIC, Australia2014
- Barriers to the accessibility and continuity of health-care services in people with multiple sclerosis.Int. J. MS Care. 2017; 19: 313-321
- Assessing the impact of online health education interventions from 2010 to 2020: a systematic review of the evidence.Am. J. Health Promot. 2022; 36: 201-224
- Association between MS-related knowledge, health literacy, self-efficacy, and quality of life in a large cohort of MS community members: a cross-sectional study.MSARD. 2021; 54103158
- Building a successful massive open online course (MOOC): a description of our process and lessons learned.J. Med. Int. Res. 2020; 22: e16687
- Statistical Power Analysis For the Behavioral Sciences.Routledge Academic, New York, NY1988
- Multiple sclerosis – a review.Eur. J. Neurol. 2019; 26: 27-40
- Observational study assessing demographic, economic, and clinical factors associated with access and utilization of health care services of patients with multiple sclerosis under treatment with interferon beta-1b (EXTAVIA).PLoS One. 2014; 9e113933
International Society for Quality of Life Research (ISOQOL). What is Quality of life [Internet]. Accessed 3 May 2021. Available from: http://www.isoqol.org/about-isoqol/what-is-health-related-quality-of-life-research.
- Barriers to health care access for low income families: a review of the literature.J. Community Health Nurs. 2018; 35: 28-37
- Sex and gender: modifiers of health, disease, and medicine.Lancet. 2020; 396: 565-582
- Identifying barriers to and facilitators of health services access encountred by individuals with multiple sclerosis.Int. J. MS Care. 2021; 1: 39-44
- Access to health care for people with multiple sclerosis.Mult. Scler. 2007; 13: 547-558
- The grounded psychometric development and initial validation of the Health Literacy Questionnaire (HLQ).BMC Public Health. 2013; 13: 658
- Is it worth it?: the experiences of person with multiple sclerosis as they access health care to manage their condition.Health Expect. 2020; 23: 1269-1279
- The English and Spanish self-efficacy to manage chronic disease Scale measures were validated using multiple studies.J. Clin. Epidemiol. 2014; 67: 1265-1273
- Inequalities in access to health and social care among adults with multiple sclerosis: a scoping review of the literature.Mult. Scler. Relat. Disord. 2019; 28: 290-304
- Health literacy and public health: a systematic review and integration of definitions and models.BMC Public Health. 2012; 12: 80
Published online: March 12, 2023
Accepted: March 11, 2023
Received in revised form: February 27, 2023
Received: September 21, 2022
© 2023 Published by Elsevier B.V.