Dataset Information

Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003-2018.

ABSTRACT: PURPOSE:Prior research on the use of the internet among cancer survivors indicates a digital divide. The online landscape and patterns of information consumption, however, have notably changed over the past decade necessitating an updated examination of health-related internet use (HRIU) among cancer survivors. METHODS:Using survey data from 2003, 2005, 2007, 2011, 2013, 2017, and 2018 Health Information National Trends Survey (HINTS) iterations, the objectives of this study were to report prevalence, trends, and user profiles in HRIU in terms of emailing doctors, buying medicine online, and support group participation. Descriptive analyses and weighted multivariate logistic regression analyses were performed. RESULTS:Cancer survivors who reported not using the internet were more likely to be older, belong to ethnic minorities, be less educated, and reside in rural areas as compared with those who reported using the internet. Except for participation in online support groups, all other types of HRIU increased in prevalence across the years. CONCLUSIONS:Consistent with the increased penetration of the internet and the altered online health communication landscape, we found increased prevalence of HRIU among cancer survivors. However, the digital divide persists in terms of internet access. These findings can inform initiatives to bridge the gap among survivors of varying profiles in using the internet for their health needs. IMPLICATIONS FOR CANCER SURVIVORS:There is increased reliance on online platforms to obtain and communicate health-related information. The risk with this approach is potential oversight of ensuring equity in terms of internet access and technology literacy among survivors.

SUBMITTER: Fareed N

PROVIDER: S-EPMC7360998 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003-2018.

Fareed Naleef N Swoboda Christine M CM Jonnalagadda Pallavi P Huerta Timothy R TR

Journal of cancer survivorship : research and practice 20200715 1

<h4>Purpose</h4>Prior research on the use of the internet among cancer survivors indicates a digital divide. The online landscape and patterns of information consumption, however, have notably changed over the past decade necessitating an updated examination of health-related internet use (HRIU) among cancer survivors.<h4>Methods</h4>Using survey data from 2003, 2005, 2007, 2011, 2013, 2017, and 2018 Health Information National Trends Survey (HINTS) iterations, the objectives of this study were ...[more]

PMID: 32671557

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Project description:BACKGROUND:Communication is key in chronic disease management, and the internet has altered the manner in which patients and providers can exchange information. Adoption of secure messaging differs among patients due to the digital divide that keeps some populations from having effective access to online resources. OBJECTIVE:This study aimed to examine the current state of online patient-provider communication, exploring trends over time in the use of online patient-provider communication tools. METHODS:A 3-part analytic process was used to study the following: (1) reanalysis, (2) close replication across years, and (3) trend analysis extension. During the reanalysis stage, the publicly available Health Information National Trends Survey (HINTS) 1 and 2 data were used with the goal of identifying the precise analytic methodology used in a prior study, published in 2007. The original analysis was extended to add 3 additional data years (ie, 2008, 2011, and 2013) using the original analytical approach with the purpose of identifying trends over time. Multivariate logistic regression was used to analyze pooled data across all years, with year as an added predictor, in addition to a model for each individual data year. RESULTS:The odds of internet users to communicate online with health care providers was significantly and increasingly higher year-over-year, starting in 2003 (2005: odds ratio [OR] 1.31, 95% CI 1.03-1.68; 2008: OR 2.14, 95% CI 1.76-2.59; 2011: OR 2.92, 95% CI 2.33-3.66; and 2013: OR 5.77; 95% CI 4.62-7.20). Statistically significant socio-economic factors found to be associated with internet users communicating online with providers included age, having health insurance, having a history of cancer, and living in an urban area of residence. CONCLUSIONS:The proportion of internet users communicating online with their health care providers has significantly increased since 2003. Although these trends are encouraging, access challenges still exist for some groups, potentially giving rise to a new set of health disparities related to communication.

Project description:Introduction: Advances in information and communication technology (ICT) and post-COVID-19 tectonic changes in healthcare delivery have made it possible for cancer survivors to obtain disease-related information for remote management online rather than through healthcare providers. To comprehend and evaluate health information, digital literacy is crucial. Objectives: This study examined cancer survivors’ information-seeking behaviour, information sources, digital health literacy, and digital trends, as well as potential determinants of e-health information receptivity and online resource use. Methods: A national 30-item cross-sectional survey using a representative random sample of cancer survivors from Jordan’s cancer registry was conducted. Chi-square tests established categorical variable relationships. Using the mean and standard deviation, we calculated the Likert scale’s ordinal data average. A p-value < 0.05 was statistically significant. Logistic regression identified predictors of interest in late-trajectory information acquisition and use of e-health platforms (apps, portals) for cancer self-management. Results: Lower digital literacy and electronic searching were associated with older age and lower income, education, and employment status (p ≤ 0.001). Digital literacy independently predicted m-health app use for remote management and interest in cancer supportive care information. Digitally literate survivors preferred the use of digital platforms (p ≤ 0.001). Information acquisition barriers included “reliability” (26%, n = 25) and “health information trustworthiness” (16.2%, n = 25). Following treatment completion, Internet-seeking behaviour decreased significantly when compared to the early cancer trajectory. Conclusion: Our findings imply that Jordanian cancer survivors’ low digital literacy may hinder information acquisition and technology-enabled cancer care. Digital interventions for cancer survivors should be adaptable to varying levels of digital health literacy. Healthcare policymakers should recognise digital inequities and devise focused initiatives to bridge the digital divide while responding to the urgent need to digitalise cancer care delivery.

Project description:ImportanceTime trends and population disparities in nutritional quality of foods from major US sources, including grocery stores, restaurants, schools, worksites, and other sources, are not well established.ObjectiveTo investigate patterns and trends in diet quality by food sources among US children and adults overall and in sociodemographic subgroups.Design, setting, and participantsThis serial, cross-sectional survey study included respondents from 8 National Health and Nutrition Examination Survey cycles (2003-2018) with valid dietary recalls. Data were analyzed from April 16, 2020, to July 20, 2020.ExposuresSurvey cycle, food source, and key sociodemographic subgroups.Main outcomes and measuresMean diet quality of foods (meals, snacks, and beverages) consumed per person, characterized by the American Heart Association diet score (range, 0-80, with higher scores indicating healthier diets), the Healthy Eating Index 2015 (range, 0-100, with higher scores indicating healthier diets), and their components. For the American Heart Association diet score, poor diet was defined as less than 40.0% adherence (score, <32.0), intermediate diet as 40.0% to 79.9% adherence (score, 32.0-63.9), and ideal as 80.0% or greater adherence (score, ≥64.0).ResultsThe study included 20 905 children 5 to 19 years of age (mean [SD] age, 12.1 [5.24] years; 51.0% male) and 39 757 adults 20 years or older (mean [SD] age, 47.3 [15.1] years; 51.9% female). Diet quality of foods consumed from grocery stores increased modestly in children (53.2% to 45.1% with poor diet quality; P = .006 for trend) and adults (40.1% to 32.9% with poor diet quality; P = .001 for trend), with smaller changes for restaurants among children (84.8% to 79.6% with poor diet quality; P = .003 for trend). Changes for restaurants among adults were not statistically significant (65.4% to 65.2% with poor diet quality; P = .07 with poor diet quality); the same was true of worksites (adults: 55.6% to 50.7% with poor diet quality; P = .25 for trend). Food quality from other sources worsened (children: 40.0% to 51.7% with poor diet quality; adults: 33.8% to 43.8% with poor diet quality; P < .001 for trend each). The largest improvement in diet quality was in schools, with the percentage with poor diet quality decreasing from 55.6% to 24.4% (P < .001 for trend), mostly after 2010, and with equitable improvements across population subgroups. Findings were similar for Healthy Eating Index 2015. Significant disparities in diet quality trends were seen by sex, race/ethnicity, educational level, and household income for food consumed from grocery stores. For example, the proportion of foods consumed from grocery stores that were of poor diet quality decreased among high-income adults (from 36.9% to 26.5%; P = .001 for trend) but not among low-income adults (from 45.8% to 41.3%; P = .09 for trend).Conclusions and relevanceBy 2017-2018, foods consumed at schools improved significantly and provided the best mean diet quality of major US food sources, without population disparities. Additional improvements are needed from all major US food sources, with particular attention on equity.

Dataset Information

Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003-2018.

Publications

Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003-2018.

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