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O'Shea AMJ, Mulligan K, Carlson P, Haraldsson B, Augustine MR, Kaboli PJ, Shimada SL. Healthcare Utilization Differences Among Primary Care Patients Using Telemedicine in the Veterans Health Administration: a Retrospective Cohort Study. J Gen Intern Med 2024; 39:109-117. [PMID: 38252240 PMCID: PMC10937860 DOI: 10.1007/s11606-023-08472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/10/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND The COVID-19 pandemic encouraged telemedicine expansion. Research regarding follow-up healthcare utilization and primary care (PC) telemedicine is lacking. OBJECTIVE To evaluate whether healthcare utilization differed across PC populations using telemedicine. DESIGN Retrospective observational cohort study using administrative data from veterans with minimally one PC visit before the COVID-19 pandemic (March 1, 2019-February 28, 2020) and after in-person restrictions were lifted (October 1, 2020-September 30, 2021). PARTICIPANTS All veterans receiving VHA PC services during study period. MAIN MEASURES Veterans' exposure to telemedicine was categorized as (1) in-person only, (2) telephone telemedicine (≥ 1 telephone visit with or without in-person visits), or (3) video telemedicine (≥ 1 video visit with or without telephone and/or in-person visits). Healthcare utilization 7 days after index PC visit were compared. Generalized estimating equations estimated odds ratios for telephone or video telemedicine versus in-person only use adjusted for patient characteristics (e.g., age, gender, race, residential rurality, ethnicity), area deprivation index, comorbidity risk, and intermediate PC visits within the follow-up window. KEY RESULTS Over the 2-year study, 3.4 million veterans had 12.9 million PC visits, where 1.7 million (50.7%), 1.0 million (30.3%), and 649,936 (19.0%) veterans were categorized as in-person only, telephone telemedicine, or video telemedicine. Compared to in-person only users, video telemedicine users experienced higher rates per 1000 patients of emergent care (15.1 vs 11.2; p < 0.001) and inpatient admissions (4.2 vs 3.3; p < 0.001). In adjusted analyses, video versus in-person only users experienced greater odds of emergent care (OR [95% CI]:1.18 [1.16, 1.19]) inpatient (OR [95% CI]: 1.29 [1.25, 1.32]), and ambulatory care sensitive condition admission (OR [95% CI]: 1.30 [1.27, 1.34]). CONCLUSIONS Telemedicine potentially in combination with in-person care was associated with higher follow-up healthcare utilization rates compared to in-person only PC. Factors contributing to utilization differences between groups need further evaluation.
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Affiliation(s)
- Amy M J O'Shea
- VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA.
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA.
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA.
| | - Kailey Mulligan
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, 52241, USA
| | - Paige Carlson
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Bjarni Haraldsson
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA
| | - Matthew R Augustine
- Geriatric Research Education and Clinical Center, James J Peters VA Medical Center, Bronx, NY, USA
- Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter J Kaboli
- VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, 52246-2208, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Stephanie L Shimada
- Center for Healthcare Organization and Implementation Research (CHOIR) at the Bedford VA Medical Center, Bedford, MA, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA, USA
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
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Long SE, Lama Y, D'Angelo H. Digital Communication Inequalities Among U.S. Adults Reporting Current Cigarette Use. Am J Prev Med 2024; 66:307-314. [PMID: 37793558 PMCID: PMC10842098 DOI: 10.1016/j.amepre.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/26/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION To reduce tobacco-related health problems, it is critical to reach people who smoke with smoking cessation information and treatment. However, digital communication inequalities may limit access to online information sources. METHODS Digital device ownership, high-speed internet access, and online health information-seeking were examined among adults reporting current smoking in the Health Information National Trends Survey (n=847). Data were collected in 2019 and 2020 and analyzed in 2022. Multivariable logistic regression models examined associations between demographics, digital technology access, and online health information-seeking. RESULTS Only 47.6% (95% CI 39.0%, 56.3%) of adults aged 65+, 54.2% of Black/African American adults (95% CI 37.8%, 69.8%), and 59.6% with high school or less education (95% CI 51.5%, 67.1%) reported high-speed internet access (vs. 74.0% overall, 95% CI 68.9%, 78.6%). Inequalities in device ownership, high-speed internet access, and online health information-seeking were found by education and income. Adults with high school or less education (vs. college or more) had 78% lower odds of digital device ownership (aOR 0.22, 95% CI 0.08, 0.59) and 75% lower odds of high-speed internet access (aOR 0.25, 95% CI 0.09, 0.71). High-speed internet access (vs. no digital device or high-speed internet) was associated with 4.9 times greater odds of online health information-seeking (95% CI 1.81, 13.4). CONCLUSIONS Digital communication inequalities among adults who smoke exist. Understanding digital technology access among lower income populations could inform the development and delivery of interventions and health communication strategies to improve health outcomes among this population.
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Affiliation(s)
| | - Yuki Lama
- National Cancer Institute, Rockville, Maryland
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Osae SP, Chastain DB, Young HN. Access to Media and Emerging Technologies: An Evolving Opportunity for Pharmacists to Contribute to Improving Health Outcomes. J Pharm Pract 2024; 37:9-10. [PMID: 36602310 DOI: 10.1177/08971900221149159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Sharmon P Osae
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, GA, USA
| | - Daniel B Chastain
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, GA, USA
| | - Henry N Young
- Kroger Professor Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy Athens, GA, USA
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Grant MJ. COVID-19, health librarianship and the wider context. Health Info Libr J 2023; 40:341-342. [PMID: 37994580 DOI: 10.1111/hir.12513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
In this second special collection of COVID-19-related manuscripts, our focus moves from health information within academia to health librarianship in the wider context. Although COVID-19 manuscripts may still occasionally appear in the Health Information and Libraries Journal, the World Health Organisation's declaration earlier this year of an end to the global health emergency marks an intentional editorial shift to adopting a broader perspective in publishing this type of work, a focus on public health information challenges and emergency preparedness, and a return to publishing a more familiar range of health library and information contexts and practice.
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Affiliation(s)
- Maria J Grant
- Editor-in-Chief, Health Information and Libraries Journal, Manchester, UK
- Trainer/Researcher, Maria J. Grant Consulting, Manchester, UK
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Samadbeik M, Bastani P, Fatehi F. Bibliometric analysis of COVID-19 publications shows the importance of telemedicine and equitable access to the internet during the pandemic and beyond. Health Info Libr J 2023; 40:390-399. [PMID: 36373187 PMCID: PMC9877810 DOI: 10.1111/hir.12465] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/09/2022] [Accepted: 10/19/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Pandemics highlight the increasing role of information and communications technology for improving access to health care. This study aimed to present a bibliometric analysis of the concept of digital divide reported in the published articles concerning the coronavirus disease 2019 (COVID-19) pandemic. METHODS To conduct this bibliometric analysis of research topics and trends, we used VOSviewer software. We developed a search strategy to retrieve peer-reviewed publications related to 'digital divide in the COVID-19 era' from the Scopus database. RESULTS In total, 241 publications on the topic of digital divide and COVID-19 were retrieved from Scopus database between 2020 and 2021. The analysis of keywords co-occurrence of research topics revealed four main clusters including: 'telemedicine', 'Internet access and Internet use', 'e-learning' and 'epidemiology'. Seven characteristic categories were examined in these research topics, including: sociodemographic, economic, social, cultural, personal, material and motivational. CONCLUSION 'Telemedicine' and 'Internet access and Internet use' as the largest clusters are connected to topics addressing inequalities in online health care access. Thus, policymakers should develop or modify policies in more egalitarian Internet access for all community members not only during a pandemic like the COVID-19 but also at regular times.
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Affiliation(s)
- Mahnaz Samadbeik
- Social Determinants of Health Research CenterLorestan University of Medical SciencesKhorramabadIran
- School of Allied Medical SciencesLorestan University of Medical SciencesKhorramabadIran
| | - Peivand Bastani
- School of Dentistry, UQ Oral Health CentreThe University of QueenslandBrisbaneAustralia
| | - Farhad Fatehi
- School of Psychological SciencesMonash UniversityMelbourneAustralia
- Centre for Health Services ResearchThe University of QueenslandBrisbaneAustralia
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O'Shea AMJ, Gibson M, Merchant J, Rewerts K, Miell K, Kaboli PJ, Shimada SL. Understanding rural-urban differences in veterans' internet access, use and patient preferences for telemedicine. J Rural Health 2023. [PMID: 37935649 DOI: 10.1111/jrh.12805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/25/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND The expansion of telemedicine (e.g., telephone or video) in the Veterans Health Administration (VA) raises concerns for health care disparities between rural and urban veterans. Factors impeding telemedicine use (e.g., broadband, digital literacy, age) disproportionally affect rural veterans. PURPOSE To examine veteran-reported broadband access, internet use, familiarity with, and preferences for telemedicine stratified by residential rurality. METHODS Three hundred fifty veterans with a VA primary care visit in March 2022 completed a 30-min computer-assisted telephone interview. The sampling design stratified veterans by residential rurality (i.e., rural or urban) and how primary care was delivered (i.e., in-person or by video). Counts and weighted percentages are reported. FINDINGS After accounting for survey weights, 96.2% of respondents had in-home internet access and 89.5% reported functional connection speeds. However, rural- compared to urban-residing veterans were less likely to experience a telemedicine visit in the past year (74.1% vs. 85.2%; p = 0.02). When comparing telemedicine to in-person visits, rural versus urban-residing veterans rated them not as good (45.3% vs. 36.8%), just as good (51.1% vs. 53.1%), or better (3.5% vs. 10.0%) (p = 0.05). To make telemedicine visits easier, veterans, regardless of where they lived, recommended technology training (46.4%), help accessing the internet (26.1%), or provision of an internet-enabled device (25.9%). CONCLUSIONS Though rural-residing veterans were less likely to experience a telemedicine visit, the same actionable facilitators to improve telemedicine access were reported regardless of residential rurality. Importantly, technology training was most often recommended. Policy makers, patient advocates, and other stakeholders should consider novel initiatives to provide training resources.
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Affiliation(s)
- Amy M J O'Shea
- VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, Iowa City, Iowa, USA
- Center for Access and Delivery Research and Evaluation (CADRE), The Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Mikayla Gibson
- Department of Human Physiology, University of Iowa College of Liberal Arts and Sciences, Iowa City, Iowa, USA
| | - James Merchant
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | - Kelby Rewerts
- Center for Access and Delivery Research and Evaluation (CADRE), The Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Kelly Miell
- Center for Access and Delivery Research and Evaluation (CADRE), The Iowa City VA Healthcare System, Iowa City, Iowa, USA
| | - Peter J Kaboli
- VA Office of Rural Health, Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City Veterans Affairs Health Care System, Iowa City, Iowa, USA
- Center for Access and Delivery Research and Evaluation (CADRE), The Iowa City VA Healthcare System, Iowa City, Iowa, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Stephanie L Shimada
- Center for Healthcare Organization and Implementation Research (CHOIR), The Bedford VA Medical Center, Bedford, Massachusetts, USA
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
- Division of Health Informatics and Implementation Science, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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Masterson Creber R, Dodson JA, Bidwell J, Breathett K, Lyles C, Harmon Still C, Ooi SY, Yancy C, Kitsiou S. Telehealth and Health Equity in Older Adults With Heart Failure: A Scientific Statement From the American Heart Association. Circ Cardiovasc Qual Outcomes 2023; 16:e000123. [PMID: 37909212 DOI: 10.1161/hcq.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Enhancing access to care using telehealth is a priority for improving outcomes among older adults with heart failure, increasing quality of care, and decreasing costs. Telehealth has the potential to increase access to care for patients who live in underresourced geographic regions, have physical disabilities or poor access to transportation, and may not otherwise have access to cardiologists with expertise in heart failure. During the COVID-19 pandemic, access to telehealth expanded, and yet barriers to access, including broadband inequality, low digital literacy, and structural barriers, prevented many of the disadvantaged patients from getting equitable access. Using a health equity lens, this scientific statement reviews the literature on telehealth for older adults with heart failure; provides an overview of structural, organizational, and personal barriers to telehealth; and presents novel interventions that pair telemedicine with in-person services to mitigate existing barriers and structural inequities.
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Standley K, Mashinchi GM, Greiman L, Sage R. "Just trying to adjust to the new reality that seems to be changing every hour": Lessons learned from nation-wide peer meetings on COVID-19 with rural disability service providers. Community Dev (Columb) 2023; 55:271-288. [PMID: 38530863 PMCID: PMC10961924 DOI: 10.1080/15575330.2023.2244573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 07/24/2023] [Indexed: 03/28/2024]
Abstract
At the onset of the COVID-19 pandemic, providers of independent living services for rural disabled people were forced to adapt how they conducted their operations. This study is a primary analysis of data based on transcripts from eight meetings of a nationwide network of service providers, who met virtually to provide peer support during the unfolding pandemic. We used qualitative thematic analysis to understand the ways these service providers adapted to address the needs of rural disabled people during the pandemic. Each meeting was attended by Center for Independent Living (CIL) staff members (n = 40 to 150 participants per meeting). We identified four main themes describing organizational adaptations: 1) Providing core services remotely, 2) Regular check-ins, 3) Virtual group meetings became a mainstay of service provision, and 4) Barriers and solutions to virtual connectivity in rural areas. Although this was a predominantly challenging time, CIL staff identified ways their adaptations were beneficial. These included creating new ways to connect, reaching more people with disabilities, and cutting down on commuting time to provide services. CIL staff intended to continue using their adapted strategies and platforms for providing services, and thus projected these benefits would be long-lasting.
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Affiliation(s)
- Krys Standley
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, Montana 59812, USA
| | - Genna M. Mashinchi
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, Montana 59812, USA
| | - Lillie Greiman
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, Montana 59812, USA
| | - Rayna Sage
- The Rural Institute for Inclusive Communities, University of Montana, Missoula, Montana 59812, USA
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Nakayama LF, Binotti WW, Link Woite N, Fernandes CO, Alfonso PG, Celi LA, Regatieri CV. The Digital Divide in Brazil and Barriers to Telehealth and Equal Digital Health Care: Analysis of Internet Access Using Publicly Available Data. J Med Internet Res 2023; 25:e42483. [PMID: 37477958 PMCID: PMC10403759 DOI: 10.2196/42483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/09/2022] [Accepted: 03/30/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has increased the use of digital solutions in medical care, especially for patients in remote areas and those requiring regular medical care. However, internet access is essential for the implementation of digital health care. The digital divide is the unequal distribution of access to digital technology, and the first level digital divide encompasses structural barriers. Brazil, a country with economic inequality and uneven population distribution, faces challenges in achieving internet access for all. OBJECTIVE This study aims to provide a comprehensive overview of the first-level digital divide in Brazil, estimate the relationship between variables, and identify the challenges and opportunities for digital health care implementation. METHODS Data were retrieved from the Brazilian Institute of Geography and Statistics National Continuous House survey database, including demographic, health, and internet-related variables. Statistical analysis included 2-tailed t tests, chi-square, and multivariate logistic regression to assess associations between variables. RESULTS Our analysis included 279,382 interviews throughout Brazil. The sample included more houses from the northeast (n=99,553) and fewer houses from the central west (n=30,804). A total of 223,386 (80.13%) of the interviewed population used the internet, with urban areas having higher internet access (187,671/212,109, 88.48%) than rural areas (35,715/67,077, 53.24%). Among the internet users, those interviewed who lived in urban houses, were women, were younger, and had higher income had a statistically higher prevalence (P<.001). Cell phones were the most common device used to access the internet (141,874/143,836, 98.63%). Reasons for not using the internet included lack of interest, knowledge, availability, and cost, with regional variations. The prevalence of internet access also varied among races, with 84,747 of 98,968 (85.63%) White respondents having access, compared to 22,234 of 28,272 (78.64%) Black respondents, 113,518 of 148,191 (76.6%) multiracial respondents, and 2887 of 3755 (76.88%) other respondents. In the southeast, central west, and south regions, the numbers of people with internet access were 49,790 of 56,298 (88.44%), 27,209 of 30,782 (88.39%), and 27,035 of 31,226 (86.58%), respectively, and in the north and northeast, 45,038 of 61,404 (73.35%) and 74,314 of 99,476 (74.7%). The income of internet users was twice the income of internet nonusers. Among those with diabetes-related limitations in daily activities, 945 of 2377 (39.75%) did not have internet access, and among those with daily activity restrictions, 1381 of 3644 (37.89%) did not have access. In a multivariate logistic regression analysis, women (odds ratio [OR] 1.147, 95% CI 0.118-0.156; P<.001), urban households (OR 6.743, 95% CI 1.888-1.929; P<.001), and those earning more than the minimum wage (OR 2.087, 95% CI 0.716-0.756; P<.01) had a positive association with internet access. CONCLUSIONS Brazil's diverse regions have different demographic distributions, house characteristics, and internet access levels, requiring targeted measures to address the first-level digital divide in rural areas and reduce inequalities in digital health solutions. Older people, poor, and rural populations face the greatest challenges in the first level digital divide in Brazil, highlighting the need to tackle the digital divide in order to promote equitable access to digital health care.
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Affiliation(s)
- Luis Filipe Nakayama
- Department of Ophthalmology, São Paulo Federal University, Sao Paulo, Brazil
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - William Warr Binotti
- Department of Ophthalmology, New England Eye Center, Tufts Medical Center, Boston, MA, United States
| | | | - Chrystinne Oliveira Fernandes
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Informatics, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Leo Anthony Celi
- Laboratory for Computational Physiology, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Biostatistics, School of Public Health, Harvard TH Chan, Boston, MA, United States
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
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Fung KK, Hung SSL, Lai DWL, Shum MHY, Fung HW, He L. Access to Information and Communication Technology, Digital Skills, and Perceived Well-Being among Older Adults in Hong Kong. Int J Environ Res Public Health 2023; 20:6208. [PMID: 37444058 PMCID: PMC10340767 DOI: 10.3390/ijerph20136208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
Population aging is a major concern worldwide. Active aging should be promoted by increasing the social participation of older adults and enabling them to remain involved in the community. Research has demonstrated the utility of digital resources for addressing the needs of older adults, which include networking, entertaining, and seeking health-related information. However, the digital divide among older adults (i.e., the "gray digital divide") is increasingly being recognized as a social problem that may be related to poor well-being. To obtain updated local data on the prevalence of Internet access and usage and their relationship with perceived well-being, we conducted telephone interviews with a random sample of 1018 older adults in Hong Kong from January to July 2021 (This research has received funding support from the Interdisciplinary Research Matching Scheme, Hong Kong Baptist University). We found that only 76.5% of the participants had Internet access at home, a mobile phone data plan, or both, whereas 36.3% had never used Internet services and 18.2% had no digital devices. A younger age, male gender, higher education level, living with others, and higher self-perceived social class were associated with material access to digital devices and everyday use of Internet services. Participants who accessed the Internet every day had higher levels of life satisfaction and self-rated physical and mental health than those who rarely or never used the Internet. Hierarchical multiple regression analysis revealed that digital skills were significantly associated with self-rated mental health even when controlling for demographic variables (including age, gender, education level, and self-perceived social class). This study contributes to the limited body of literature on the relationship between Internet use, digital skills, and perceived well-being. Our findings highlight the importance of addressing the digital divide even in cities with high penetration of information and communication technology, such as Hong Kong. We also discuss our insights into the use of timely interventions for older adults to address the gray digital divide.
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Affiliation(s)
- Kwok-kin Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China; (K.-k.F.)
| | - Shirley Suet-lin Hung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China; (K.-k.F.)
| | - Daniel W. L. Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China
| | - Michelle H. Y. Shum
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China; (K.-k.F.)
| | - Hong-wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China; (K.-k.F.)
| | - Langjie He
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China; (K.-k.F.)
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O'Shea AMJ, Howren MB, Mulligan K, Haraldsson B, Shahnazi A, Kaboli PJ. Quantifying the Digital Divide: Associations of Broadband Internet with Tele-mental Health Access Before and During the COVID-19 Pandemic. J Gen Intern Med 2023:10.1007/s11606-023-08120-8. [PMID: 37340258 DOI: 10.1007/s11606-023-08120-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 02/24/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, telemedicine quickly expanded. Broadband speeds may impact equitable access to video-based mental health (MH) services. OBJECTIVE To identify access disparities in Veterans Health Administration (VHA) MH services based on broadband speed availability. DESIGN Instrumental variable difference-in-differences study using administrative data to identify MH visits prior to (October 1, 2015-February 28, 2020) and after COVID-19 pandemic onset (March 1, 2020-December 31, 2021) among 1176 VHA MH clinics. The exposure is broadband download and upload speeds categorized as inadequate (download ≤25 Megabits per second - Mbps; upload ≤3 Mbps), adequate (download ≥25 Mbps and <100 Mbps; upload ≥5 Mbps and <100 Mbps), or optimal (download and upload ≥100/100 Mbps) based on data reported to the Federal Communications Commission at the census block and spatially merged to each veteran's residential address. PARTICIPANTS All veterans receiving VHA MH services during study period. MAIN MEASURES MH visits were categorized as in-person or virtual (i.e., telephone or video). By patient, MH visits were counted quarterly by broadband category. Poisson models with Huber-White robust errors clustered at the census block estimated the association between a patient's broadband speed category and quarterly MH visit count by visit type, adjusted for patient demographics, residential rurality, and area deprivation index. KEY RESULTS Over the 6-year study period, 3,659,699 unique veterans were seen. Adjusted regression analyses estimated the change after pandemic onset versus pre-pandemic in patients' quarterly MH visit count; patients living in census blocks with optimal versus inadequate broadband increased video visit use (incidence rate ratio (IRR) = 1.52, 95% CI = 1.45-1.59; P < 0.001) and decreased in-person visits (IRR = 0.92, 95% CI = 0.90-0.94; P < 0.001). CONCLUSIONS This study found patients with optimal versus inadequate broadband availability had more video-based and fewer in-person MH visits after pandemic onset, suggesting broadband availability is an important determinant of access-to-care during public health emergencies requiring remote care.
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Affiliation(s)
- Amy M J O'Shea
- Veterans Rural Health Resource Center-Iowa City, VA Office of Rural Health, Iowa City VA Healthcare System, Iowa City, IA, USA.
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA.
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - M Bryant Howren
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, FL, USA
- Florida Blue Center for Rural Health Research & Policy, Florida State University College of Medicine, Tallahassee, FL, USA
| | - Kailey Mulligan
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Bjarni Haraldsson
- Veterans Rural Health Resource Center-Iowa City, VA Office of Rural Health, Iowa City VA Healthcare System, Iowa City, IA, USA
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA
| | - Ariana Shahnazi
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA
| | - Peter J Kaboli
- Veterans Rural Health Resource Center-Iowa City, VA Office of Rural Health, Iowa City VA Healthcare System, Iowa City, IA, USA
- Center for Access and Delivery Research and Evaluation (CADRE), Iowa City VA Healthcare System, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA
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12
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Kaval ME, Sarsar F, Buduneli N, Güneri P. A sustainable, self-sufficient peer review algorithm for health-related YouTube videos: A proposal. Oral Dis 2023. [PMID: 36840381 DOI: 10.1111/odi.14555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 02/26/2023]
Abstract
YouTube has recently become one of the major sources of information in the field of health. Not only healthcare professionals but also laypersons can upload videos to YouTube and this fact creates a significant heterogeneity in the content, viewpoint, and accuracy of the available videos. Particularly, those videos presenting personal experiences and inferences on health problems may not rely on scientific evidence thus create inaccurate information. This commentary aims to propose an algorithm to improve the accuracy and reliability of health-related YouTube videos.
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Affiliation(s)
- Mehmet Emin Kaval
- Department of Endodontics, School of Dentistry, Ege University, Izmir, Turkey
| | - Fırat Sarsar
- Department of Computer Education and Instructional Technologies, Faculty of Education, Ege University, Izmir, Turkey
| | - Nurcan Buduneli
- Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey
| | - Pelin Güneri
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Ege University, Izmir, Turkey
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13
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van Deursen AJAM. General Health Statuses as Indicators of Digital Inequality and the Moderating Effects of Age and Education: Cross-sectional Study. J Med Internet Res 2022; 24:e37845. [PMID: 36269664 DOI: 10.2196/37845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/14/2022] [Accepted: 10/08/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Considerable effort has been directed to offering online health information and services aimed at the general population. Such efforts potentially support people to obtain improved health outcomes. However, when health information and services are moved online, issues of equality need to be considered. In this study, we focus on the general population and take as a point of departure how health statuses (physical functioning, social functioning, mental health, perceived health, and physical pain) are linked to internet access (spanning internet attitude, material access, internet skills, and health-related internet use). OBJECTIVE This study aims to reveal to what extent (1) internet access is important for online health outcomes, (2) different health statuses are important for obtaining internet access and outcomes, and (3) age and education moderate the contribution of health statuses to internet access. METHODS A sequence of 2 online surveys drawing upon a sample collected in the Netherlands was used, and a data set with 1730 respondents over the age of 18 years was obtained. RESULTS Internet attitude contributes positively to material access, internet skills, and health outcomes and negatively to health-related internet use. Material access contributes positively to internet skills and health-related internet use and outcomes. Internet skills contribute positively to health-related internet use and outcomes. Physical functioning contributes positively to internet attitude, material access, and internet skills but negatively to internet health use. Social functioning contributes negatively to internet attitude and positively to internet skills and internet health use. Mental health contributes positively to internet attitude and negatively to material access and internet health use. Perceived health positively contributes to material access, internet skills, and internet health use. Physical pain contributes positively to internet attitude and material access and indirectly to internet skills and internet health use. Finally, most contributions are moderated by age (<65 and ≥65 years) and education (low and high). CONCLUSIONS To make online health care attainable for the general population, interventions should focus simultaneously on internet attitude, material access, internet skills, and internet health use. However, issues of equality need to be considered. In this respect, digital inequality research benefits from considering health as a predictor of all 4 access stages. Furthermore, studies should go beyond single self-reported measures of health. Physical functioning, social functioning, mental health, perceived health, and physical pain all show unique contributions to the different internet access stages. Further complicating this issue, online health-related interventions for people with different health statuses should also consider age and the educational level of attainment.
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14
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McCall T, Asuzu K, Oladele CR, Leung TI, Wang KH. A Socio-Ecological Approach to Addressing Digital Redlining in the United States: A Call to Action for Health Equity. Front Digit Health 2022; 4:897250. [PMID: 35924138 PMCID: PMC9339607 DOI: 10.3389/fdgth.2022.897250] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Physical distancing requirements due to the coronavirus (COVID-19) pandemic has increased the need for broadband internet access. The World Health Organization defines social determinants of health as non-medical factors that impact health outcomes by affecting the conditions in which people are born, grow, work, live, and age. By this definition broadband internet access is a social determinant of health. Digital redlining-the systematic process by which specific groups are deprived of equal access to digital tools such as the internet-creates inequities in access to educational and employment opportunities, as well as healthcare and health information. Although it is known that internet service providers systematically exclude low-income communities from broadband service, little has been done to stop this discriminatory practice. In this paper, we seek to amplify the call to action against the practice of digital redlining in the United States, describe how it contributes to health disparities broadly and within the context of the COVID-19 pandemic, and use a socio-ecological framework to propose short- and long-term actions to address this inequity.
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Affiliation(s)
- Terika McCall
- Division of Health Informatics, Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States.,Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States
| | - Kammarauche Asuzu
- Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States
| | - Carol R Oladele
- Equity Research and Innovation Center, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Tiffany I Leung
- Care and Public Health Research Institute/Maastricht University Medical Center, Maastricht, Netherlands.,Department of Internal Medicine (Adjunct), Southern Illinois University School of Medicine, Springfield, IL, United States
| | - Karen H Wang
- Center for Medical Informatics, Yale School of Medicine, New Haven, CT, United States.,Equity Research and Innovation Center, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States
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15
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Affiliation(s)
- Leslie Eiland
- Division of Diabetes, Endocrinology and Metabolism, University of Nebraska Medical Center, Omaha
| | - Andjela Drincic
- Division of Diabetes, Endocrinology and Metabolism, University of Nebraska Medical Center, Omaha
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16
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Li Y, Han WJ, Hu M. Does internet access make a difference for older adults' cognition in urban China? The moderating role of living arrangements. Health Soc Care Community 2022; 30:e909-e920. [PMID: 34245201 DOI: 10.1111/hsc.13493] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 05/29/2021] [Accepted: 06/19/2021] [Indexed: 06/13/2023]
Abstract
Since the mid-1990s, information technology, particularly the diffusion of the internet, has brought tremendous changes to communication and social participation for people in China, including older adults. At the same time, modernisation and urbanisation have transformed the way many people in China live. The traditional multigenerational household-older adults living with adult children and grandchildren-is giving way to other living arrangements, such as living alone or with a spouse only. Using wave 1 of the World Health Organization Study on Global AGEing and Adult Health collected between 2007 and 2010, we examined the extent to which home internet access might be associated with cognitive function in older adults aged 50 or over in urban China (N = 5,898), paying attention to the moderating role of living arrangements. We found that home internet access was associated with better cognitive function, and living arrangements played an essential role in such an association for different age groups. Specifically, older adults living alone benefited cognitively from internet access, particularly among those aged 50-64 and 65-74. Those living with a spouse only and those in two-generation households benefited cognitively from internet access, particularly among those aged 50-64 and 75+. Older adults age 75+ in skip-generation households benefited cognitively from internet access. Considering the trend of older adults living apart from their children, our research suggests that providing internet access to older adults in urban China, especially those living alone, could help protect their cognitive function.
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Affiliation(s)
- Ying Li
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Wen-Jui Han
- Silver School of Social Work, New York University, New York, NY, USA
| | - Miao Hu
- School of Labor and Human Resources, Renmin University of China, Beijing, China
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17
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Humphreys BL. The multiple dimensions of expanded access to health information: Don Lindberg and the U.S. National Library of Medicine. Inf Serv Use 2022; 42:139-150. [PMID: 35720423 PMCID: PMC9196099 DOI: 10.3233/isu-220146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
When Donald A. B. Lindberg M.D. became Director of the U.S. National Library of Medicine in 1984, trained searchers, primarily librarians, conducted less than three million searches of NLM databases. They paid for their fair share of the commercial telecommunications costs to reach NLM's computer system. In 2015 when Lindberg retired, millions of scientists, health professionals, patients, members of the public, and librarians conducted billions of free searches of NLM's greatly expanded electronic resources via the Internet. Lindberg came to NLM intending to expand access to biomedical and health information along multiple dimensions: reaching more users, providing more types and volumes of information and data; and improving the conceptual, technical, and organizational connections needed to provide information to users when and where it is needed. By any measure he and NLM were spectacularly successful. This chapter discusses some key decisions and developments that contributed to that success.
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18
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Medero K, Merrill K, Ross MQ. Modeling Access Across the Digital Divide for Intersectional Groups Seeking Web-Based Health Information: National Survey. J Med Internet Res 2022; 24:e32678. [PMID: 35289761 PMCID: PMC8965683 DOI: 10.2196/32678] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/31/2021] [Accepted: 11/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background The digital divide refers to technological disparities based on demographic characteristics (eg, race and ethnicity). Lack of physical access to the internet inhibits online health information seeking (OHIS) and exacerbates health disparities. Research on the digital divide examines where and how people access the internet, whereas research on OHIS investigates how intersectional identities influence OHIS. We combine these perspectives to explicate how unique context–device access pairings operate differently across intersectional identities—particularly racial and ethnic groups—in the domain of OHIS. Objective This study aims to examine how different types of internet access relate to OHIS for different racial and ethnic groups. We investigate relationships among predisposing characteristics (ie, age, sex, education, and income), internet access (home computer, public computer, work computer, and mobile), health needs, and OHIS. Methods Analysis was conducted using data from the 2019 Health Information National Trends Survey. Our theoretical model of OHIS explicates the roles of internet access and health needs for racial and ethnic minority groups’ OHIS. Participant responses were analyzed using structural equation modeling. Three separate group structural equation modeling models were specified based on Black, Latine, and White self-categorizations. Results Overall, predisposing characteristics (ie, age, sex, education, and income) were associated with internet access, health needs, and OHIS; internet access was associated with OHIS; and health needs were associated with OHIS. Home computer and mobile access were most consistently associated with OHIS. Several notable linkages between predisposing characteristics and internet access differed for Black and Latine individuals. Older racial and ethnic minorities tended to access the internet on home and public computers less frequently; home computer access was a stronger predictor of OHIS for White individuals, and mobile access was a stronger predictor of OHIS for non-White individuals. Conclusions Our findings necessitate a deeper unpacking of how physical internet access, the foundational and multifaceted level of the digital divide, affects specific racial and ethnic groups and their OHIS. We not only find support for prior work on the digital divide but also surface new insights, including distinct impacts of context–device access pairings for OHIS and several relationships that differ between racial and ethnic groups. As such, we propose interventions with an intersectional approach to access to ameliorate the impact of the digital divide.
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Affiliation(s)
- Kristina Medero
- School of Communication, Ohio State University, Columbus, OH, United States
| | - Kelly Merrill
- School of Communication, Ohio State University, Columbus, OH, United States
| | - Morgan Quinn Ross
- School of Communication, Ohio State University, Columbus, OH, United States
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19
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Mc Carthy A, Bossut C. A Comprehensive Evaluation of the Readability of Online Healthcare Materials Regarding Distal Radius Fractures. Cureus 2021; 13:e18188. [PMID: 34707959 PMCID: PMC8532190 DOI: 10.7759/cureus.18188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Distal radius fractures (DRFs) are among the most common upper limb fractures reviewed in the emergency and orthopaedic departments. Approximately 40% of these fractures are unstable and require fixation to improve limb function. Confronted with an impending operation, many patients will access the internet, looking for information and reassurance. Previous studies have suggested that orthopaedic healthcare websites are beyond the comprehension of their target audience. Objective To assess the readability of healthcare websites regarding DRFs. Methods The terms distal radius fracture, broken wrist and wrist fracture were searched on Google and Bing. Of 101 websites initially considered, 52 unique websites underwent evaluation using readability software. Websites were assessed using two common methods for assessing readabilty; the Reading Grade Level (RGL) and the Flesch Reading Ease Score (FRES). In line with recommended guidelines and previous studies, an RGL of sixth grade and under and a FRES score above 65 was considered acceptable. Results The mean score for the FRES index was 56.67 (SD: ± 19.6), which resulted in the majority of pieces assessed being classified as ‘fairly difficult to read'. The mean RGL was 8.61 (SD: ± 2.86); 17.3% of the websites assessed fulfilled the criteria of having an RGL of six or less. One way T-tests comparing the FRES and RGL mean scores against the acceptable standards showed that they failed to meet the acceptable indexes (FRES: P<0.004; 95% CI: -13.8 to -2.8; RGL: P<0.0001; CI: 1.8-3.4). ANOVA testing showed no significant difference based on category (FRES: P=0.791; RGL: P=0.101). Conclusion The level of comprehension required for online healthcare education materials related to distal radius fractures exceeds the recommended guidelines. Improving the readability content of these websites would enhance the internet’s usability as an educational tool as well as improve patient post-operative outcomes.
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20
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Dolcini MM, Canchola JA, Catania JA, Song Mayeda MM, Dietz EL, Cotto-Negrón C, Narayanan V. National-Level Disparities in Internet Access Among Low-Income and Black and Hispanic Youth: Current Population Survey. J Med Internet Res 2021; 23:e27723. [PMID: 34636728 PMCID: PMC8548978 DOI: 10.2196/27723] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/18/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background Internet access is increasingly critical for adolescents with regard to obtaining health information and resources, participating in web-based health promotion, and communicating with health practitioners. However, past work demonstrates that access is not uniform among youth in the United States, with lower access found among groups with higher health-related needs. Population-level data yield important insights about access and internet use in the United States. Objective The aim of this study is to examine internet access and mode of access by social class and race and ethnicity among youth (aged 14-17 years) in the United States. Methods Using the Current Population Survey, we examined internet access, cell phone or smartphone access, and modes of connecting to the internet for adolescents in 2015 (unweighted N=6950; expanded weights N=17,103,547) and 2017 (unweighted N=6761; expanded weights N=17,379,728). Results Internet access increased from 2015 to 2017, but socioeconomic status (SES) and racial and ethnic disparities remained. In 2017, the greatest disparities were found for youth in low-income households (no home access=23%) and for Black youth (no home access=18%) and Hispanic youth (no home access=14%). Low-income Black and Hispanic youth were the most likely to lack home internet access (no home access, low SES Black youth=29%; low SES Hispanic youth=21%). The mode of access (eg, from home and smartphone) and smartphone-only analyses also revealed disparities. Conclusions Without internet access, web-based dissemination of information, health promotion, and health care will not reach a significant segment of youth. Currently, SES and racial and ethnic disparities in access prolong health inequalities. Moreover, the economic impact of COVID-19 on Black, Hispanic, and low-income communities may lead to losses in internet access for youth that will further exacerbate disparities.
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Affiliation(s)
- M Margaret Dolcini
- Hallie Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | | | - Joseph A Catania
- Hallie Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Marissa M Song Mayeda
- Hallie Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Erin L Dietz
- Hallie Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Coral Cotto-Negrón
- Hallie Ford Center for Healthy Children and Families, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
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21
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DeGuzman PB, Abooali S, Jain N, Scicchitano A, Siegfried ZC. Improving equitable access to care via telemedicine in rural public libraries. Public Health Nurs 2021; 39:431-437. [PMID: 34614251 DOI: 10.1111/phn.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/11/2021] [Accepted: 09/14/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Rural public libraries have been proposed as ideal locations from which individuals can access a telemedicine visit, but limited adoption of this practice suggests significant barriers remain. The purpose of this study was to determine rural public librarians' perspectives on the benefits and barriers to offering patrons the ability to use their public library for a telemedicine video visit, and to suggest strategies for moving this practice forward. DESIGN Qualitative content analysis. SAMPLE Fifteen rural US librarians and library directors. MEASUREMENTS Individual interviews were conducted to determine perspectives on the benefits of and barriers to implementing telemedicine in public libraries. RESULTS We identified four themes from the data: rural public libraries increase healthcare access in a trustworthy location, librarians are supportive of telemedicine, but have concerns, limited resources drive barriers to telemedicine implementation in rural libraries, and small rural libraries continued in-person service during the COVID-19 pandemic. CONCLUSION Rural public libraries can be an important part of achieving equitable access to care, particularly with regard to chronic disease management in rural populations. Rural public health nurses can be instrumental in promoting collaborations between local libraries and regional health systems that may help libraries overcome financial barriers to this practice.
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Affiliation(s)
| | - Setareh Abooali
- University of Virginia College of Liberal Arts and Sciences, Charlottesville, Virginia
| | - Neha Jain
- University of Virginia School of Nursing, Charlottesville, Virginia
| | - Alec Scicchitano
- University of Virginia Batten School of Public Policy, Charlottesville, Virginia
| | - Zachary C Siegfried
- University of Virginia College of Liberal Arts and Sciences, Charlottesville, Virginia
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22
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Xue P, Han X, Elahi E, Zhao Y, Wang X. Internet Access and Nutritional Intake: Evidence from Rural China. Nutrients 2021; 13:nu13062015. [PMID: 34208201 PMCID: PMC8230947 DOI: 10.3390/nu13062015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/29/2021] [Accepted: 06/10/2021] [Indexed: 12/22/2022] Open
Abstract
Over the past 4 decades, China has experienced a nutritional transition and has developed the largest population of internet users. In this study, we evaluated the impacts of internet access on the nutritional intake in Chinese rural residents. An IV-Probit-based propensity score matching method was used to determine the impact of internet access on nutritional intake. The data were collected from 10,042 rural households in six Chinese provinces. The results reveal that rural residents with internet access have significantly higher energy, protein, and fat intake than those without. Chinese rural residents with internet access consumed 1.35% (28.62 kcal), 5.02% (2.61 g), and 4.33% (3.30 g) more energy, protein, and fat, respectively. There was heterogeneity in regard to the intake of energy, protein, and fat among those in different income groups. Moreover, non-staple food consumption is the main channel through which internet access affects nutritional intake. The results demonstrate that the local population uses the internet to improve their nutritional status. Further studies are required to investigate the impact of internet use on food consumed away from home and micronutrient intake.
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Affiliation(s)
- Ping Xue
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (P.X.); (X.W.)
| | - Xinru Han
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (P.X.); (X.W.)
- Correspondence:
| | - Ehsan Elahi
- School of Economics, Shandong University of Technology, Zibo 255049, China;
| | - Yinyu Zhao
- College of Economics and Management, Northwest A&F University, Yangling 712100, China;
| | - Xiudong Wang
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (P.X.); (X.W.)
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Rigot SK, Worobey LA, Boninger ML, Robinson-Whelen S, Roach MJ, Heinemann AW, McKernan G. Changes in Internet Use Over Time Among Individuals with Traumatic Spinal Cord Injury. Arch Phys Med Rehabil 2021; 103:832-839.e2. [PMID: 34062118 DOI: 10.1016/j.apmr.2021.04.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/12/2021] [Accepted: 04/25/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To investigate the changes in total internet and mobile internet use over time and determine how demographic characteristics are related to changes in internet and mobile internet use among individuals with spinal cord injury (SCI). DESIGN Cross-sectional analysis of multicenter cohort study. SETTING National SCI Database. PARTICIPANTS Persons with traumatic SCI with follow-up data collected between 2012 and 2018 (n=13,622). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Proportion of sample reporting internet use at all or through a mobile device over time and specifically in 2018. RESULTS The proportion of internet users increased from 77.7% in 2012 to 88.1% in 2018. Older participants (p<0.001), those with lower annual income (p<0.001), less education (p<0.001), non-White race or Hispanic ethnicity (p<0.001), motor incomplete tetraplegia (p=0.004), or males (p=0.035) were less likely to use internet from 2012 to 2018. By 2018, there were no longer differences in internet use based upon race/ethnicity (p=0.290) or sex (p=0.066). Mobile internet use increased each year (52.4% to 87.7% of internet users from 2012 to 2018), with a participant being 13.7 times more likely to use mobile internet in 2018 than 2012. Older age (p<0.001), income less than $50,000 (p<0.001), high school diploma or less (p=0.011), or non-Hispanic White race/ethnicity (p=0.001) were associated with less mobile internet use over time. By 2018 there were no differences in mobile internet use by education (p=0.430) and only participants with incomes greater than $75,000/year had greater odds of mobile internet use (p=0.016). CONCLUSIONS Disparities associated with internet access are decreasing likely due to mobile device use. Increased internet access offers an important opportunity to provide educational and training materials to frequently overlooked groups of individuals with SCI.
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Affiliation(s)
- Stephanie K Rigot
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA
| | - Lynn A Worobey
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA.
| | - Michael L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA
| | | | | | - Allen W Heinemann
- Shirley Ryan AbilityLab and Northwestern University Feinberg School of Medicine
| | - Gina McKernan
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
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de Barcelos TDN, Muniz LN, Dantas DM, Cotrim Junior DF, Cavalcante JR, Faerstein E. [Analysis of fake news disseminated during the COVID-19 pandemic in BrazilAnálisis de las noticias falsas divulgadas durante la pandemia de COVID-19 en Brasil]. Rev Panam Salud Publica 2021; 45:e65. [PMID: 34007263 PMCID: PMC8118089 DOI: 10.26633/rpsp.2021.65] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/15/2021] [Indexed: 12/24/2022] Open
Abstract
Objetivo. Caracterizar as fake news sobre COVID-19 que circularam no Brasil de janeiro a junho de 2020. Métodos. As fake news registradas até 30 de junho de 2020 em dois sites (G1, da corporação Globo, e Ministério da Saúde) foram coletadas e categorizadas de acordo com o seu conteúdo. Para cada notícia enganosa, foram extraídos os seguintes dados: data de circulação, título, canal de divulgação (por exemplo, WhatsApp), formato da divulgação (por exemplo, texto, foto ou vídeo) e portal de registro. Os termos encontrados nos títulos das notícias falsas foram analisados no Google Trends para determinar se houve aumento de buscas no Google com utilização desses termos após a disseminação de uma determinada notícia enganosa. Foram também identificadas as macrorregiões brasileiras com maior porcentagem de aumento nas buscas utilizando os termos analisados. Resultados. Foram identificadas 329 fake news relacionadas à pandemia de COVID-19 nos sites estudados (253 no G1 e 76 no Ministério da Saúde). As fake news foram disseminadas principalmente através de WhatsApp e Facebook. As categorias temáticas mais frequentes foram: política (por exemplo, governantes falsificando a vacinação contra a COVID-19, com 20,1%), epidemiologia e estatística (proporção dos casos e óbitos, 19,5%) e prevenção (16,1%). Conforme o Google Trends, houve um aumento de 34,3% nas buscas que utilizavam termos presentes nas fake news. O maior aumento nas buscas ocorreu no Sudeste (45,1%) e Nordeste (27,8%). Conclusões. As fake news divulgadas durante os primeiros 6 meses da pandemia de COVID-19 no Brasil se caracterizaram por conteúdos de posicionamento político e desinformação sobre número de casos e óbitos e medidas de prevenção e de tratamento. Os principais veículos de divulgação foram o WhatsApp e o Facebook, com utilização de mensagens, imagens e vídeos, tendo maior alcance nas regiões Sudeste e Nordeste do país.
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Affiliation(s)
- Thainá do Nascimento de Barcelos
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Nutrição Rio de Janeiro (RJ) Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Nutrição, Rio de Janeiro (RJ), Brasil
| | - Luíza Nepomuceno Muniz
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Ciências Sociais Rio de Janeiro (RJ) Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Ciências Sociais, Rio de Janeiro (RJ), Brasil
| | - Deborah Marinho Dantas
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Ciências Sociais Rio de Janeiro (RJ) Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Ciências Sociais, Rio de Janeiro (RJ), Brasil
| | - Dorival Fagundes Cotrim Junior
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social Rio de Janeiro (RJ) Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social, Rio de Janeiro (RJ), Brasil
| | - João Roberto Cavalcante
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social Rio de Janeiro (RJ) Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social, Rio de Janeiro (RJ), Brasil
| | - Eduardo Faerstein
- Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social Rio de Janeiro (RJ) Brasil Universidade do Estado do Rio de Janeiro (UERJ), Instituto de Medicina Social, Rio de Janeiro (RJ), Brasil
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Naqvi IA, Montiel TC, Bittar Y, Hunter N, Okpala M, Johnson C, Weiner MG, Savitz S, Sharrief A, Beauchamp JES. Internet Access and Usage Among Stroke Survivors and Their Informal Caregivers: Cross-sectional Study. JMIR Form Res 2021; 5:e25123. [PMID: 33683206 PMCID: PMC7985796 DOI: 10.2196/25123] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/05/2021] [Accepted: 01/17/2021] [Indexed: 12/12/2022] Open
Abstract
Background Web-based interventions have shown promise for chronic disease management but have not been widely applied to populations with stroke. Existing barriers may inhibit the adoption of web-based interventions among stroke survivors and necessitate the involvement of informal caregivers. However, limited information is available on internet accessibility and usability among stroke survivors and their caregivers. Objective This study aims to investigate internet access and usage in a cohort of stroke survivors and their caregivers. Methods A cross-sectional survey was conducted with 375 participants (248 stroke survivors and 127 caregivers). Descriptive statistics were generated using cross-tabulation. Comparisons with categorical data were conducted using the chi-square test, whereas the Mann-Whitney U test was used for comparisons involving ordinal variables. Results Overall, 86.1% (323/375) of the participants reported having internet access. Caregivers were more likely than stroke survivors to access the internet (N=375, χ21=18.5, P<.001) and used text messaging (n=321, χ21=14.7, P<.001). Stroke survivors and caregivers with internet access were younger than stroke survivors and caregivers without internet access. The highest number of participants who reported internet access were non-Hispanic White. Smartphones were the most common devices used to access the internet. Email was the most common type of internet usage reported. Patients who survived for >12 months after a stroke reported higher internet access than those who survived <3 months (P<.001). The number of hours per week spent using the internet was higher for caregivers than for stroke survivors (P<.001). Conclusions Future feasibility and acceptability studies should consider the role of the informal caregiver, participant age, race and ethnicity, the use of smartphone apps, email and text correspondence, and the amount of time elapsed since the stroke event in the design and implementation of web-based interventions for populations with stroke.
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Affiliation(s)
- Imama Ali Naqvi
- Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Columbia University Irving Medical Center, New York, NY, United States
| | - Tahani Casameni Montiel
- Department of Nursing Research, Cizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Yazan Bittar
- Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Norma Hunter
- Department of Neurology, Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Munachi Okpala
- Department of Neurology, Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Constance Johnson
- Department of Nursing Research, Cizik School of Nursing and School of Bioinformatics, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Mark G Weiner
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States
| | - Sean Savitz
- Department of Neurology, Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Anjail Sharrief
- Department of Neurology, Institute for Stroke and Cerebrovascular Disease, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jennifer Elizabeth Sanner Beauchamp
- Department of Nursing Research, Cizik School of Nursing, Institute for Stroke and Cerebrovascular Disease, The University of Texas Health Science Center at Houston, Houston, TX, United States
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Daniel Garrote Sanchez, Nicolas Gomez Parra, Caglar Ozden, Bob Rijkers, Mariana Viollaz, Hernan Winkler. Who on Earth Can Work from Home? World Bank Res Obs 2021:lkab002. [ DOI: 10.1093/wbro/lkab002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This paper reviews the emerging literature on which jobs can be performed from home and presents new estimates of the prevalence of such jobs based on the task content of occupations, their technology requirements and the availability of internet access by country and income groupings. Globally, one of every five jobs can be performed from home. In low-income countries, this ratio drops to one of every 26 jobs. Failing to account for internet access yields upward biased estimates of the resilience of poor countries, lagging regions, and poor workers. Since better paid workers are more likely to be able to work from home, COVID-19 is likely to exacerbate inequality, especially in richer countries where better paid and educated workers are insulated from the shock. The overall labor market burden of COVID-19 is bound to be larger in poor countries, where only a small share of workers can work from home and social protection systems are weaker. Across the globe, young, poorly educated workers and those on temporary contracts are least likely to be able to work from home and more vulnerable to the labor market shocks from COVID-19.
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Yang X, Yang N, Lewis D, Parton J, Hudnall M. Patterns and Influencing Factors of eHealth Tools Adoption Among Medicaid and Non-Medicaid Populations From the Health Information National Trends Survey (HINTS) 2017-2019: Questionnaire Study. J Med Internet Res 2021; 23:e25809. [PMID: 33599619 PMCID: PMC7932842 DOI: 10.2196/25809] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/22/2020] [Accepted: 01/20/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Evidence suggests that eHealth tools adoption is associated with better health outcomes among various populations. The patterns and factors influencing eHealth adoption among the US Medicaid population remain obscure. OBJECTIVE The objective of this study is to explore patterns of eHealth tools adoption among the Medicaid population and examine factors associated with eHealth adoption. METHODS Data from the Health Information National Trends Survey from 2017 to 2019 were used to estimate the patterns of eHealth tools adoption among Medicaid and non-Medicaid populations. The effects of Medicaid insurance status and other influencing factors were assessed with logistic regression models. RESULTS Compared with the non-Medicaid population, the Medicaid beneficiaries had significantly lower eHealth tools adoption rates for health information management (11.2% to 17.5% less) and mobile health for self-regulation (0.8% to 9.7% less). Conversely, the Medicaid population had significantly higher adoption rates for using social media for health information than their counterpart (8% higher in 2018, P=.01; 10.1% higher in 2019, P=.01). Internet access diversity, education, and cardiovascular diseases were positively associated with health information management and mobile health for self-regulation among the Medicaid population. Internet access diversity is the only factor significantly associated with social media adoption for acquisition of health information (OR 1.98, 95% CI 1.26-3.11). CONCLUSIONS Our results suggest digital disparities in eHealth tools adoption between the Medicaid and non-Medicaid populations. Future research should investigate behavioral correlates and develop interventions to improve eHealth adoption and use among underserved communities.
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Affiliation(s)
- Xin Yang
- Institute of Data and Analytics, The University of Alabama, Tuscaloosa, AL, United States
| | - Ning Yang
- Department of Information Systems, Statistics, and Management Science, Culverhouse College of Business, The University of Alabama, Tuscaloosa, AL, United States
| | - Dwight Lewis
- Institute of Data and Analytics, The University of Alabama, Tuscaloosa, AL, United States.,Department of Management, Culverhouse College of Business, The University of Alabama, Tuscaloosa, AL, United States
| | - Jason Parton
- Institute of Data and Analytics, The University of Alabama, Tuscaloosa, AL, United States.,Department of Information Systems, Statistics, and Management Science, Culverhouse College of Business, The University of Alabama, Tuscaloosa, AL, United States
| | - Matthew Hudnall
- Institute of Data and Analytics, The University of Alabama, Tuscaloosa, AL, United States.,Department of Information Systems, Statistics, and Management Science, Culverhouse College of Business, The University of Alabama, Tuscaloosa, AL, United States
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Yeong JL, Thomas P, Buller J, Moosajee M. A Newly Developed Web-Based Resource on Genetic Eye Disorders for Users With Visual Impairment (Gene.Vision): Usability Study. J Med Internet Res 2021; 23:e19151. [PMID: 33470932 PMCID: PMC7857953 DOI: 10.2196/19151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/17/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
Background Despite the introduction of the Web Content Accessibility Guidelines and legislations, many websites remain poorly accessible to users with disability, especially those with visual impairment, as the internet has become a more visually complex environment. With increasing reliance on the internet and almost 2 million people in the United Kingdom being affected by vision loss, it is important that they are not overlooked when developing web-based materials. A significant proportion of those affected have irreversible vision loss due to rare genetic eye disorders, and many of them use the internet as a primary source of information for their conditions. However, access to high-quality web-based health information with an inclusive design remains a challenge for many. We have developed a new web-based resource for genetic eye disorders called Gene.Vision that aims to provide a holistic guide for patients, relatives, and health care professionals. Objective Through a usability testing session of our website prototype, this study aims to identify key web-based accessibility features for internet users with vision impairment and to explore whether the contents provided in Gene.Vision are relevant and comprehensible. Methods A face-to-face testing session with 8 participants (5 patients, 2 family members, and 1 member of the public) and 8 facilitators was conducted on a prototype website. Remote testing was performed with another patient due to COVID-19 restrictions. Home page design, navigation, content layout and quality, language, and readability were explored through direct observation and task completion using the think-aloud method. A patient focus group was organized to elicit further feedback. Qualitative data were gathered and analyzed to identify core themes through open and axial coding. Results All participants had good computer literacy; 6 patients with visual impairment used visual aid software including iOS VoiceOver and Speak Screen, iOS Classic Invert, ZoomText 2020, Job Access With Speech, and Nonvisual Desktop Access. The features identified by the participants that will enhance accessibility and usability for users with visual impairment were a consistent website layout, a structured information hierarchy with a clear description of links, good chromatic and luminance contrast, a simple home page with predictable and easy navigation, adaptability to various assistive software, and readable and relevant content. They reported that dynamic content (such as carousels) and large empty spaces reduced accessibility. Information on research, support available, practical advice, and links to charities were incentives for repeated website visits. Conclusions We demonstrated the importance of developing a website with a user-based approach. Through end user testing, we identified several key web-based accessibility features for people with visual impairment. Target end users should always be involved early and throughout the design process to ensure their needs are met. Many of these steps can be implemented easily and will aid in search engine optimization.
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Affiliation(s)
- Jian Lee Yeong
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Peter Thomas
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | - Mariya Moosajee
- Institute of Ophthalmology, University College London, London, United Kingdom.,Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.,Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
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Gunnlaugsson G, Whitehead TA, Baboudóttir FN, Baldé A, Jandi Z, Boiro H, Einarsdóttir J. Use of Digital Technology among Adolescents Attending Schools in Bissau, Guinea-Bissau. Int J Environ Res Public Health 2020; 17:ijerph17238937. [PMID: 33271847 PMCID: PMC7729758 DOI: 10.3390/ijerph17238937] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 12/14/2022]
Abstract
Digital technology plays an important role in achieving many of the Sustainable Development Goals. However, access is uneven, with 80% of those in high-income countries being online compared to 20% of those in the 47 least developed countries. This study aimed to describe and analyse adolescents’ access to and usage of digital technology in Guinea-Bissau and its implications. In June 2017, a survey with a locally adapted Planet Youth questionnaire was implemented in the capital, Bissau, whereby classes in 16 secondary schools were surveyed on a variety of issues. In total, 2039 randomly selected students participated; the survey included ten questions specifically on the access to and use of digital technology. Half of the respondents had access to desktop/laptops, and one-third used mobile internet daily; about two-thirds had an experience of social media. Explanatory variables included educational institution, parental education, economic situation, and gender. Furthermore, students’ experience of social media was significantly linked to bullying, anxiety, depression, smoking and alcohol consumption. Many adolescents in Bissau have no experience of using digital technology, including for schoolwork. Access improvements are necessary so that young Bissau-Guineans are not to be left behind in developing their capabilities and can benefit from proficiency in the use of digital technologies. At the same time, potential harmful usage of the media requires the implementation of preventive measures.
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Affiliation(s)
- Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavík, Iceland; (T.A.W.); (F.N.B.); (H.B.); (J.E.)
- Correspondence:
| | - Thomas Andrew Whitehead
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavík, Iceland; (T.A.W.); (F.N.B.); (H.B.); (J.E.)
| | - Fatou N’dure Baboudóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavík, Iceland; (T.A.W.); (F.N.B.); (H.B.); (J.E.)
| | - Aladje Baldé
- University Campus, Jean Piaget University of Guinea-Bissau, Bissau 5100, Guinea-Bissau;
| | - Zeca Jandi
- Instituto Nacional de Estudos e Pesquisa (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau C.P. 112, Guinea-Bissau;
| | - Hamadou Boiro
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavík, Iceland; (T.A.W.); (F.N.B.); (H.B.); (J.E.)
- Instituto Nacional de Estudos e Pesquisa (INEP), Avenida dos Combatentes da Liberdade da Pátria, Complexo Escolar 14 de Novembro, Bissau C.P. 112, Guinea-Bissau;
| | - Jónína Einarsdóttir
- Faculty of Sociology, Anthropology and Folkloristics, University of Iceland, IS-102 Reykjavík, Iceland; (T.A.W.); (F.N.B.); (H.B.); (J.E.)
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Min Q, Wang X, Huang B, Xu L. Web-Based Technology for Remote Viewing of Radiological Images: App Validation. J Med Internet Res 2020; 22:e16224. [PMID: 32975520 PMCID: PMC7547396 DOI: 10.2196/16224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 07/21/2020] [Accepted: 08/11/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Internet technologies can create advanced and rich web-based apps that allow radiologists to easily access teleradiology systems and remotely view medical images. However, each technology has its own drawbacks. It is difficult to balance the advantages and disadvantages of these internet technologies and identify an optimal solution for the development of medical imaging apps. OBJECTIVE This study aimed to compare different internet platform technologies for remotely viewing radiological images and analyze their advantages and disadvantages. METHODS Oracle Java, Adobe Flash, and HTML5 were each used to develop a comprehensive web-based medical imaging app that connected to a medical image server and provided several required functions for radiological interpretation (eg, navigation, magnification, windowing, and fly-through). Java-, Flash-, and HTML5-based medical imaging apps were tested on different operating systems over a local area network and a wide area network. Three computed tomography colonography data sets and 2 ordinary personal computers were used in the experiment. RESULTS The experimental results demonstrated that Java-, Flash-, and HTML5-based apps had the ability to provide real-time 2D functions. However, for 3D, performances differed between the 3 apps. The Java-based app had the highest frame rate of volume rendering. However, it required the longest time for surface rendering and failed to run surface rendering in macOS. The HTML5-based app had the fastest surface rendering and the highest speed for fly-through without platform dependence. Volume rendering, surface rendering, and fly-through performances of the Flash-based app were significantly worse than those of the other 2 apps. CONCLUSIONS Oracle Java, Adobe Flash, and HTML5 have individual strengths in the development of remote access medical imaging apps. However, HTML5 is a promising technology for remote viewing of radiological images and can provide excellent performance without requiring any plug-ins.
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Affiliation(s)
- Qiusha Min
- School of Educational Information Technology, Central China Normal University, Wuhan, Hubei, China
| | - Xin Wang
- School of Educational Information Technology, Central China Normal University, Wuhan, Hubei, China
| | - Bo Huang
- Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Liangzhou Xu
- Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, China
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Kanmaz B, Buduneli N. Evaluation of information quality on the internet for periodontal disease patients. Oral Dis 2020; 27:348-356. [PMID: 32671923 DOI: 10.1111/odi.13546] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/22/2020] [Accepted: 07/02/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To evaluate the quality of accessible information on periodontal diseases on the Internet using different scales. MATERIALS AND METHODS A search was performed using the Google search engine with questions about periodontal disease symptoms. The first 30 web sites obtained after searching for each question were evaluated. Duplicate web sites, advertisements, discussion groups, links to research articles, videos, and images were excluded. A total of 90 web sites were included and evaluated with Health on the Net Code of Conduct Certification (HONCode) presence, Journal of American Medical Association (JAMA) benchmarks, and the quality criteria for consumer health information (DISCERN) toolkit. RESULTS Only 27.8% of the analyzed web sites contain HONCode certificates. No webpages fulfilled all JAMA criteria, whereas 32.2% of the web sites did not provide any of them. Majority of the web sites' (44.4%) overall rating score was 2 with the DISCERN instrument. In the DISCERN Section Scores comparison between various types of web sites, information web site scores were higher than Dental Health Center Web sites in Section 1 and Section 3 scores (p = .000 and p = .001, respectively). CONCLUSION Overall quality of periodontal information based on patients' questions on the Internet has serious shortcomings especially in terms of attribution and the quality of information on treatment choices.
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Affiliation(s)
- Burcu Kanmaz
- Department of Periodontology, Faculty of Dentistry, İzmir Demokrasi University, Izmir, Turkey
| | - Nurcan Buduneli
- Department of Periodontology, Faculty of Dentistry, Ege University, Izmir, Turkey
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Joshi A, Malhotra B, Amadi C, Loomba M, Misra A, Sharma S, Arora A, Amatya J. Gender and the Digital Divide Across Urban Slums of New Delhi, India: Cross-Sectional Study. J Med Internet Res 2020; 22:e14714. [PMID: 32343670 PMCID: PMC7338923 DOI: 10.2196/14714] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/18/2019] [Accepted: 12/16/2019] [Indexed: 01/20/2023] Open
Abstract
Background Disparities in access to specific technologies within gender groups have not been investigated. Slum settings provide an ideal population to investigate the contributing factors to these disparities. Objective This study aimed to examine gender differences in mobile phone ownership, internet access, and knowledge of SMS text messaging among males and females living in urban slum settings. Methods A convenience sampling approach was used in sample selection from 675 unnotified slums. A total of 38 slum sites were then selected across four geographic zones. Of these, 10% of the households in each slum site was selected from each zone. One household member was interviewed based on their availability and fulfillment of the eligibility criteria. Eligible individuals included those aged 18 years and above, residing in these slums, and who provided voluntary consent to participate in the study. Individuals with mental or physical challenges were excluded from the study. Results Our results showed that females were half as likely to own mobile phones compared with males (odds ratio [OR] 0.53, 95% CI 0.37-0.76), less likely to have internet access (OR 0.79, 95% CI 0.56-1.11), or know how to send text messages (OR 0.93, 95% CI 0.66-1.31). The predictors of mobile phone ownership, internet access, and text messaging between males and females included age, individual education, housing type, and the number of earning members in a household in the adjusted analysis. Among males, the number of earning members was a predictor of both mobile phone ownership and text messaging, whereas household education was a predictor of both internet access and text messaging. Age and individual education only predicted internet access, whereas housing type only predicted text messaging. Among females, household education was a predictor of all the technology outcomes. Age and type of toilet facility only predicted mobile phone ownership; housing type only predicted internet access whereas television ownership with satellite service and smoking behavior only predicted text messaging. Conclusions Our study findings showing disparate access to technology within gender groups lend support for further research to examine the causal mechanisms promoting these differences to proffer significant solutions. Specifically, our study findings suggest that improving household education is crucial to address the disparate access and usage of mobile phones, the internet, and text messaging among women in slum settings. This suggestion is due to the consistency in household educational level as a predictor across all these technology indicators. In addition, the mechanisms by which the number of household earning members influences the disparate access to technology among men call for further exploration.
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Affiliation(s)
- Ashish Joshi
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Bhavya Malhotra
- Foundation of Health care Technologies Society, Delhi, India
| | - Chioma Amadi
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
| | - Menka Loomba
- Foundation of Health care Technologies Society, Delhi, India
| | - Archa Misra
- Foundation of Health care Technologies Society, Delhi, India
| | - Shruti Sharma
- Foundation of Health care Technologies Society, Delhi, India
| | - Arushi Arora
- Foundation of Health care Technologies Society, Delhi, India
| | - Jaya Amatya
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, United States
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Too LS, Leach L, Butterworth P. Mental Health Problems and Internet Access: Results From an Australian National Household Survey. JMIR Ment Health 2020; 7:e14825. [PMID: 32410731 PMCID: PMC7260658 DOI: 10.2196/14825] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/09/2019] [Accepted: 02/10/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Mental health support and interventions are increasingly delivered on the web, and stepped care systems of mental health services are embracing the notion of a digital gateway through which individuals can have access to information, assessment, and services and can be connected with more intensive services if needed. Although concerns have been raised over whether people with mental health problems are disadvantaged in terms of their access to the internet, there is a lack of representative data on this topic. OBJECTIVE This study aimed to examine the relationship between mental health and internet access, particularly lack of access because of affordability issues. METHODS Data from wave 14 of the Household, Income, and Labour Dynamics in Australia survey were used (n=15,596) in the analyses. Sample weights available in the survey were used to calculate the proportion of those with or without internet access for those with and without mental health problems and more severe long-term mental health conditions. These proportions were also calculated for those with and without internet access due, specifically, to affordability issues. Multinomial logistic regression analyses assessed the relationship between mental health status and internet access/affordability issues, adjusting for a range of covariates. RESULTS Access to the internet was poorer for those with mental health problems (87.8%) than those without mental health problems (92.2%), and the difference was greater when a measure of more severe mental health conditions was used (81.3% vs 92.2%). The regression models showed that even after adjusting for a broad range of covariates, people with mental ill health were significantly more likely to have no internet access because of unaffordability than those without mental ill health (mental health problems: relative risk ratio [RRR] 1.68; 95% CI 1.11-2.53 and severe mental health conditions: RRR 1.92; 95% CI 1.16-3.19). CONCLUSIONS As Australia and other nations increasingly deliver mental health services on the web, issues of equity and affordability need to be considered to ensure that those who most need support and assistance are not further disadvantaged.
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Affiliation(s)
- Lay San Too
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia
| | - Liana Leach
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australia National University, Canberra, Australia
| | - Peter Butterworth
- Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Parkville, Australia.,Centre for Research on Ageing, Health & Wellbeing, Research School of Population Health, The Australia National University, Canberra, Australia
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Kobayashi R, Ishizaki M. Examining the Interaction Between Medical Information Seeking Online and Understanding: Exploratory Study. JMIR Cancer 2019; 5:e13240. [PMID: 31586366 PMCID: PMC6783696 DOI: 10.2196/13240] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/23/2019] [Accepted: 08/19/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Online information seeking on medical topics by patients can have beneficial effects by helping them decide on treatment options and fostering better relationships with doctors. The quality of websites and processes of seeking information online have mostly been studied, with a focus on the accuracy and reliability of websites; however, few studies have examined the relationship between other aspects of quality and the processes of seeking medical information online. OBJECTIVE This exploratory study aimed to shed light on the quality of websites used for information seeking from the perspective of understanding medical information in combination with seeking it online. METHODS The study participants were 15 Japanese university students with no problem using the internet. A questionnaire survey about health literacy (47 items on a 4-point Likert scale) and information navigation skills on the internet (8 items on a 5-point Likert scale) was conducted before participants engaged in online information seeking and qualitative interviews. The students searched for information on a disease and its treatment. The websites viewed were gathered from search behavior recorded by software and browser logs. Follow-up interviews were conducted to elicit explanations from the participants about the assignments and their views of online information seeking. The explanations were evaluated by 55 health care professionals on a 3-point Likert scale and then assessed based on their comments and the participant interviews. RESULTS The mean age of the participants was 20.6 years (median 21; SD 1.06). All participants were able to access reliable websites with information relevant to the assignments. The mean ratings of the students' explanations were 108.6 (median 109; range=83-134) for the disease and 105.6 (median 104; range=87-117) for its treatment. The inter-rater reliability were 0.84 (95% CI 0.77-0.90) and 0.95 (95% CI 0.93-0.97), indicating good and excellent, respectively. The mean of the sum of the health literacy skills was 115.1 (median 115; range=80-166) and the mean for information navigation skills was 25.9 (median 26; range=17-36), respectively. Health literacy and information navigation skills were moderately correlated (r=0.54; 95% CI 0.033-0.822; P=.04). Among the four stages of health literacy, understanding and appraising (r=0.53; 95% CI 0.025-0.820; P=.04) were moderately correlated with information navigation skills (r=0.52; 95% CI 0.013-0.816; P=.046). The participants had no difficulties operating and browsing the internet and considered medical and public institution websites to be reliable; however, due to unfamiliarity with medical terms, they had difficulties choosing a site from the results obtained and comparing and synthesizing information provided by different sites. They also looked for sites providing orderly information in plain language but provided explanations from sites that gave inadequate interpretations of information. CONCLUSIONS This study revealed interactions between searching the internet for, and understanding, medical information by analyzing the processes of information seeking online, physicians' evaluations and comments about the participants' explanations, and the participants' perceptions.
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Affiliation(s)
- Rei Kobayashi
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
| | - Masato Ishizaki
- Interfaculty Initiative in Information Studies, The University of Tokyo, Tokyo, Japan
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Nzabonimana E, Isyagi MM, Njunwa KJ, Hackley DM, Razzaque MS. Use of an online medical database for clinical decision-making processes: assessment of knowledge, attitude, and practice of oral health care providers. Adv Med Educ Pract 2019; 10:461-467. [PMID: 31417332 PMCID: PMC6600754 DOI: 10.2147/amep.s146451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 07/16/2018] [Indexed: 06/10/2023]
Abstract
Purpose: This study was conducted to determine the level of knowledge, attitude, and practice of oral health care providers toward the use of online medical databases for clinical decision-making processes. Subjects and methods: The study population included all the licensed oral health care providers living in Rwanda, registered either with the Rwanda Allied Health Professional Council (RAHPC) or Rwanda Medical and Dental Council (RMDC). A self-administered questionnaire was used to collect demographic data as well as data regarding knowledge, attitude, and practice of oral health care providers regarding the use of online medical databases for making clinical decisions. A pilot study with 12 oral health care providers was done before the main study to pretest the questionnaire. Results: The study results show that among the 201 respondents, 80% (N=160) reported using internet-based resources to support their clinical decisions, while 20% (N=41) of oral health care providers do not use online resources when making their clinical decisions. In general, there was a positive attitude towards internet-based resources among the participants, as 92% (N=184) respondents believe that internet-based resources are helpful in clinical decision-making processes. Of clinical importance, 68% respondents (N=136) believe that by using current internet-based information, better clinical care can be offered to their patients. Conclusion: Educating oral health care providers on the useful and appropriate online resources available for supporting clinical decision-making processes might increase the efficiency of patient care.
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Affiliation(s)
- Emmanuel Nzabonimana
- Department of Preventive & Community Dentistry, University of Rwanda School of Dentistry, Kigali, Rwanda
| | - Moses M Isyagi
- Department of Oral Maxillofacial Surgery & Pathology, University of Rwanda School of Dentistry, Kigali, Rwanda
| | - Kato J Njunwa
- Research, Innovation & Postgraduate Studies, University of Rwanda, Kigali, Rwanda
| | - Donna M Hackley
- Department of Preventive & Community Dentistry, University of Rwanda School of Dentistry, Kigali, Rwanda
- Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Mohammed S Razzaque
- Department of Preventive & Community Dentistry, University of Rwanda School of Dentistry, Kigali, Rwanda
- Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
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Shum AK, Lai ES, Leung WG, Cheng MN, Wong HK, So SW, Law YW, Yip PS. A Digital Game and School-Based Intervention for Students in Hong Kong: Quasi-Experimental Design. J Med Internet Res 2019; 21:e12003. [PMID: 30950795 PMCID: PMC6473212 DOI: 10.2196/12003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/28/2018] [Accepted: 02/03/2019] [Indexed: 12/16/2022] Open
Abstract
Background In Hong Kong, with an increasing number of children experiencing mental health issues, there is a need to not only develop innovative interventions but also develop comprehensive prevention interventions so as to reduce their anxiety symptoms and enhance their emotional management and interpersonal relationships. Objective The aim of this study was to determine the effectiveness of The Adventures of DoReMiFa, an integration model of the cognitive-behavioral approach and positive psychology by using digital game–based and school-based mental health enhancement intervention to magnify the social and emotional health and well-being of the school children in Hong Kong aged 9 to 11 years. Methods A quasi-experimental design method was used to evaluate this digital game and school-based intervention. The Adventures of DoReMiFa was piloted in 4 primary schools where students were allocated to either an intervention or a control group. The participants were assessed at pre- and postintervention with a 6-month follow-up measuring their mental health knowledge, levels of anxiety symptoms, positive and negative thinking, perspective-taking, and self-esteem. Results A total of 459 primary school students from 4 primary schools participated in the study. The response rate on the questionnaires answered on the Web was up to 85.1% (391/459). Compared with the control group, the intervention group was found to have significant association with improved mental health knowledge at the time immediately after the intervention (beta=.46; P=.01) and in the 6-month postintervention period (beta=.66; P<.001); for perspective-taking, the intervention group had exhibited a significant improvement 6 months after the completion of the universal program (beta=1.50; P=.03). The intervention, however, was found not to be effective in reducing the rates of anxiety symptoms and negative thinking among the participating students. Conclusions The Adventures of DoReMiFa, an integration of a digital game–based and school-based mental health enhancement intervention, was shown to be effective in elevating the knowledge of mental health and promoting perspective-taking in the primary school students of Hong Kong. Although there was insufficient evidence to support a reduction in symptoms of anxiety and negative automatic thoughts, the overall results were still encouraging in that a preventive effect was found, indicating that the program has the potential to enhance the mental well-being of schoolchildren. It also suggests that knowledge enhancement may not necessarily lead to behavior change, and more focused effort may be needed to achieve the translation. The implications and limitations of this study and suggestions for future research were also discussed.
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Affiliation(s)
- Angie Ky Shum
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Eliza Sy Lai
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wing Gi Leung
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Mabel Ns Cheng
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Ho Kit Wong
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Sam Wk So
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Paul Sf Yip
- The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Hong Kong, China (Hong Kong)
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Cruickshank C, MacIntyre DJ. Digital Access in Working-Age and Older Adults and Their Caregivers Attending Psychiatry Outpatient Clinics: Quantitative Survey. JMIR Aging 2018; 1:e4. [PMID: 31518247 PMCID: PMC6715401 DOI: 10.2196/aging.9130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/21/2018] [Accepted: 09/05/2018] [Indexed: 11/13/2022] Open
Abstract
Background It has been suggested that improving access to mental health services, supporting self-management, and increasing clinical productivity can be achieved through the delivery of technology-enabled care by personal mobile-based and internet-based services. There is little evidence available about whether working-age and older adults with mental health problems or their caregivers have access to these technologies or their confidence with these technologies. Objective This study aimed to ascertain the prevalence and range of devices used to access the internet in patients and caregivers attending general and older adult psychiatry outpatient services and their confidence in using these technologies. Methods We conducted an anonymous survey of 77 patients and caregivers from a general psychiatry and old age psychiatry clinic to determine rates of internet access and device ownership, and attitudes to technology-enabled care. Results We found high levels of internet access and confidence in using the internet in working-age adults, their caregivers, and older adult caregivers but not in older adult patients. The smartphone usage predominated in working-age adults and their caregivers. Older adult caregivers were more likely to use desktop or laptop computers. In our sample, tablets were the least popular form factor. Conclusions Access rates and uptake of internet-based services have the potential to be high in working-age adults and their caregivers but are likely to be markedly lower among older adult patients attending psychiatry clinics. Applications designed for tablets are likely to have low uptake. All groups identified appointment reminders as likely to be beneficial.
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Affiliation(s)
- Callum Cruickshank
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Donald J MacIntyre
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
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Jamwal R, Callaway L, Farnworth L, Winkler D. Electronic assistive technology use in Australian shared supported accommodation: rates and user characteristics. Disabil Rehabil Assist Technol 2017; 13:634-640. [PMID: 28774211 DOI: 10.1080/17483107.2017.1360948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals.
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Affiliation(s)
- Rebecca Jamwal
- a Department of Occupational Therapy , Monash University , Frankston , VIC , Australia.,b Royal Talbot Rehabilitation Centre, Austin Health , Kew , VIC , Australia
| | - Libby Callaway
- a Department of Occupational Therapy , Monash University , Frankston , VIC , Australia.,c Neuroskills Pty Ltd , Sandringham , VIC , Australia
| | - Louise Farnworth
- a Department of Occupational Therapy , Monash University , Frankston , VIC , Australia
| | - Di Winkler
- d Summer Foundation Ltd , Blackburn , VIC , Australia
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Jabson JM, Patterson JG, Kamen C. Understanding Health Information Seeking on the Internet Among Sexual Minority People: Cross-Sectional Analysis From the Health Information National Trends Survey. JMIR Public Health Surveill 2017. [PMID: 28630036 PMCID: PMC5495969 DOI: 10.2196/publichealth.7526] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Individuals who face barriers to health care are more likely to access the Internet to seek health information. Pervasive stigma and heterosexism in the health care setting are barriers to health care for sexual minority people (SMP, ie, lesbian, gay, and bisexual people); therefore, SMP may be more likely to use the Internet as a source of health information compared to heterosexual people. Objective Currently, there is a dearth of published empirical evidence concerning health information seeking on the Internet among SMP; the current project addresses this gap. Methods Data from the 2015 Health Information National Trends Survey Food and Drug Administration Cycle were used to describe and summarize health information seeking among SMP (n=105) and heterosexual people (n=3405). Results Almost all of the SMP in this sample reported having access to the Internet (92.4%, 97/105). SMP were equally as likely as heterosexual people to seek health information on the Internet (adjusted odds ratio [aOR] 0.94, 95% CI 0.56-1.66) and to report incidental exposure to health information online (aOR 1.02, 95% CI 0.66-1.60). SMP were 58% more likely to watch a health-related video on YouTube than heterosexual people (aOR 1.58, 95% CI 1.00-2.47). Incidental exposure to health information was associated with seeking health information for oneself (aOR 3.87, 95% CI 1.16-14.13) and for someone else (aOR 6.30, 95% CI 2.40-17.82) among SMP. Conclusions SMP access the Internet at high rates and seek out health information online. Their incidental exposure could be associated with seeking information for self or others. This suggests that online interventions could be valuable for delivering or promoting health information for SMP.
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Affiliation(s)
- Jennifer M Jabson
- University of TennesseeDepartment of Public HealthKnoxville, TNUnited States
| | - Joanne G Patterson
- University of TennesseeDepartment of Public HealthKnoxville, TNUnited States
| | - Charles Kamen
- University of RochesterCancer Control UnitDepartment of SurgeryRochester, NYUnited States
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Yepes M, Maurer J, Viswanathan B, Gedeon J, Bovet P. Potential Reach of mHealth Versus Traditional Mass Media for Prevention of Chronic Diseases: Evidence From a Nationally Representative Survey in a Middle-Income Country in Africa. J Med Internet Res 2016; 18:e114. [PMID: 27207074 PMCID: PMC4893150 DOI: 10.2196/jmir.5592] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/15/2016] [Accepted: 03/28/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Public radio and television announcements have a long tradition in public health education. With the global rise of computer and mobile device ownership, short message service (SMS) and email-based health services (mHealth) are promising new tools for health promotion. OBJECTIVE Our objectives were to examine 1) self-reported exposure to programs related to noncommunicable diseases (NCDs) on national public television and radio during the 12 months preceding the survey (2013-2014), 2) current ownership of a mobile phone, smartphone, computer, or tablet, and use of the Internet, and 3) willingness of individuals to receive SMS or emails with information on health, with a focus on distribution of these variables across different demographic, socioeconomic status (SES), and NCD risk groups. METHODS We obtained data in a population survey of 1240 participants aged 25-64 years conducted in 2013-2014 in the Seychelles, a rapidly developing small island state in the African region. We administered a structured questionnaire and measured NCD risk factors. Univariate and multivariate analyses explored the relationships between outcomes and sociodemographic variables. RESULTS Of 1240 participants, 1037 (83.62%) reported exposure to NCD-related programs on public television, while a lower proportion of 740 adults (59.67%), reported exposure via public radio (P<.001). Exposure to NCD-related programs on public television was associated with older age (P<.001) and female sex (P<.001), but not with SES, while exposure to NCD-related programs on public radio was associated with older age (P<.001) and lower SES (P<.001). A total of 1156 (93.22%) owned a mobile phone and ownership was positively associated with female sex (P<.001), younger age (P<.001), and higher SES (P<.001). Only 396 adults (31.93%) owned a smartphone and 244 adults (19.67%) used their smartphone to access the Internet. A total of 1048 adults (84.51%) reported willingness to receive health-related SMS, which was positively associated with female sex (P<.001), younger age (P<.001), and higher SES (P<.001). Controlling for SES, exposure to NCD-related programs on public television or radio and willingness to receive health-related SMS were not independently associated with a person's NCD risk. CONCLUSIONS Broadcasting health programs through traditional mass media (national public radio and television) reached the majority of the population under study, including older adults and those in lower socioeconomic groups. With a high penetration of mobile phones and willingness to receive health-related SMS, mHealth presents an opportunity for health programs, especially when targeted SMS messages are intended for younger adults and those in higher socioeconomic groups. By contrast, due to reduced Internet access, email-based programs had a more limited reach for health promotion programs. These findings emphasize the different reach of interventions using SMS or email versus traditional mass media, according to demographic and socioeconomic categories, for health education programs in a developing country.
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Affiliation(s)
- Maryam Yepes
- University Institute of Social and Preventive Medicine (IUMSP), Department of Biology and Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Dijksterhuis MGK, Jozwiak I, Braat DDM, Scheele F. An exploratory study into the effect of time-restricted internet access on face-validity, construct validity and reliability of postgraduate knowledge progress testing. BMC Med Educ 2013; 13:147. [PMID: 24195696 PMCID: PMC4228367 DOI: 10.1186/1472-6920-13-147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 10/31/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Yearly formative knowledge testing (also known as progress testing) was shown to have a limited construct-validity and reliability in postgraduate medical education. One way to improve construct-validity and reliability is to improve the authenticity of a test. As easily accessible internet has become inseparably linked to daily clinical practice, we hypothesized that allowing internet access for a limited amount of time during the progress test would improve the perception of authenticity (face-validity) of the test, which would in turn improve the construct-validity and reliability of postgraduate progress testing. METHODS Postgraduate trainees taking the yearly knowledge progress test were asked to participate in a study where they could access the internet for 30 minutes at the end of a traditional pen and paper test. Before and after the test they were asked to complete a short questionnaire regarding the face-validity of the test. RESULTS Mean test scores increased significantly for all training years. Trainees indicated that the face-validity of the test improved with internet access and that they would like to continue to have internet access during future testing. Internet access did not improve the construct-validity or reliability of the test. CONCLUSION Improving the face-validity of postgraduate progress testing, by adding the possibility to search the internet for a limited amount of time, positively influences test performance and face-validity. However, it did not change the reliability or the construct-validity of the test.
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Affiliation(s)
- Marja GK Dijksterhuis
- Department of Obstetrics and Gynecology, Amphia Ziekenhuis, Langendijk 75, 4819 EV, Breda, The Netherlands
| | - Izabela Jozwiak
- Management of Learning, Maastricht University School of Business and Economics, Tongersestraat 53, 6211 LM, Maastricht, The Netherlands
| | - Didi DM Braat
- Department of Obstetrics and Gynecology, University Medical Center Nijmegen, Geert Groteplein 10, 6525 GA, Nijmegen, The Netherlands
| | - Fedde Scheele
- School of Medical Sciences, Department of Health Systems Innovation and Education, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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Ettienne-Gittens R, Boushey CJ, Au D, Murphy SP, Lim U, Wilkens L. Evaluating the feasibility of utilizing the Automated Self-administered 24-hour (ASA24) dietary recall in a sample of multiethnic older adults. ACTA ACUST UNITED AC 2013; 2:134-144. [PMID: 28149712 DOI: 10.1016/j.profoo.2013.04.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The ASA24 is a web application which enables the collection of self-administered dietary recalls thus utilizing technology to overcome some of the limitations of traditional assessment methodologies. Older adults, particularly those from certain ethnic groups may have less access to and may be less receptive to technology. This research sought to determine the level of access to the internet as well as evaluate the feasibility of using a web-based alternative dietary data collection method in older, multiethnic adults. Participants completed three telephone administered diet recalls (n=347), and were asked to complete a one day recall via the ASA24. They were also asked to evaluate their experience with using the ASA24 system. Almost 60% of the participants reported no access to a computer or internet access, with African Americans and Latinos less likely than non-Hispanic Whites and Japanese-Americans to have access. Of those with access to the internet (n=100), 44% of the participants accessed the ASA24 system and 37% successfully launched the ASA24 program. However, most respondents preferred the traditional diet recall methodology over the ASA24. Further research is needed to investigate recruitment and use of electronic data collection methodologies in older adults.
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Affiliation(s)
| | - Carol J Boushey
- University of Hawai'i Cancer Center, Epidemiology Program, Honolulu, HI, 96813, USA
| | - Donna Au
- University of Hawai'i Cancer Center, Epidemiology Program, Honolulu, HI, 96813, USA
| | - Suzanne P Murphy
- University of Hawai'i Cancer Center, Epidemiology Program, Honolulu, HI, 96813, USA
| | - Unhee Lim
- University of Hawai'i Cancer Center, Epidemiology Program, Honolulu, HI, 96813, USA
| | - Lynne Wilkens
- University of Hawai'i Cancer Center, Epidemiology Program, Honolulu, HI, 96813, USA
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Cunningham JA. Access and interest: two important issues in considering the feasibility of web-assisted tobacco interventions. J Med Internet Res 2008; 10:e37. [PMID: 18984558 PMCID: PMC2630837 DOI: 10.2196/jmir.1000] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2007] [Revised: 01/02/2008] [Accepted: 08/19/2008] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous research has found that current smokers are less likely to have access to the Internet than nonsmokers. As access to the Internet continues to expand, does this finding remain true? Also, how many smokers are interested in Web-assisted tobacco interventions (WATIs)? These questions are important to determine the potential role that WATIs might play in promoting tobacco cessation. OBJECTIVES The aims of the study were to determine whether smokers are less likely than nonsmokers to have access to the Internet and to establish the level of interest in WATIs among a representative sample of smokers. METHODS A random digit dialing telephone survey was conducted of 8467 adult respondents, 18 years and older, in Ontario, Canada from September 2006 to August 2007. All respondents were asked their smoking status and whether they used the Internet (at home or work in the past 12 months; where; how often in the past 12 months). To assess the level of interest in WATIs, current daily smokers were asked whether they would be interested in a confidential program that they could access on the Internet, free of charge, that would allow them to check their smoking and compare it to other Canadians. RESULTS Smokers were marginally less likely to have used the Internet than nonsmokers (74% vs 81% in the last year), and, of those who had access to the Internet, smokers used the Internet less often than nonsmokers. Overall, 40% of smokers said they would be interested in a WATI. The number of cigarettes smoked per day was unrelated to level of interest in the WATI, but time to first cigarette after waking was. Smokers who used the Internet were more interested in the WATI than smokers who did not use the Internet (46% vs 20%). CONCLUSIONS While the difference in level of Internet use between smokers and nonsmokers was greatly reduced compared to 2002 and 2004 data, smokers still remain marginally less likely to use the Internet than nonsmokers. Overall, there was a substantial level of interest in the WATI among smokers, in particular among smokers who currently use the Internet. These results indicate that WATIs have a substantial potential audience among smokers, and, given the growing body of evidence regarding their efficacy, there is growing support that WATIs have a significant role to play in promoting tobacco cessation.
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