Motivating, influencing, and persuading patients through personal health records: a scoping review

The manuscript is an evaluative review of the literature pertaining to personal health records (PHRs). The primary focus was on revealing their potential to function as persuasive tools and their efficiency in this role. We demonstrated the ways in which PHRs could motivate, influence, and persuade patients in their adoption of target health behaviors associated with disease and medication management. We based this review on the theoretical framework of captology by B. J. Fogg and colleagues (1998) and the York methodological framework by Arksey and O'Malley (2005). The final sample of studies for review included 22 articles that met eligibility criteria and were retrieved from the SciVerse Scopus database (1999-present). Findings of this review were mixed. Some studies provided evidence that patients found PHRs easy to use and useful. The patients' self-efficacy and motivation in managing health conditions increased as a result of receiving personalized recommendations, guidance, and decision support generated in PHRs. Other studies, however, demonstrated the PHRs' lack of efficiency associated with the target behavior change. We explain the mixed findings by access to an unbalanced pool of study designs as well as the breadth of the applied theoretical framework of captology. We suggest future research in a more targeted direction, for example, focusing on the evidence of the efficiency of reminders as means for motivation, influence, and persuasion.