Who actually uses eHealth once they are online?
In HINTS 2012 (N=3959; 2358 Internet users), online eHealth use showed no racial/ethnic divide, but lower education predicted much lower odds of finding a clinician online (OR 0.50) or emailing a doctor (OR 0.46); women used eHealth more.
Source
Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012
Study at a glance
- Design
- Cross-sectional — HINTS 4 Cycle 1 (Oct 2011–Feb 2012) mailed survey; multivariable logistic models of 11 eHealth tasks among online US adults
- N
- N=3959 · 3,959 HINTS respondents; eHealth models among 2,358 adult Internet users; response rate 36.7%
- Population
- US noninstitutionalized adults in a nationally representative HINTS sample; Internet users for eHealth-use models
- Outcome
- Odds of eHealth tasks across health care, information-seeking, and user-generated/sharing domains by SES, age, sex, and race/ethnicity
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Who actually uses eHealth once they are online?
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HINTS 2012 N=3959; eHealth models used N=2358 Internet users.
adult Internet users (N=2358) across 3 health communication domains
High school or less: OR 0.50 (0.33–0.76) for looking online for a provider.
Patients with lower levels of education had significantly lower odds of going online to look for a health care provider (high school or less: OR 0.50, 95% CI 0.33-0.76)
What they did
Analyzed nationally representative HINTS 4 Cycle 1 mailed data (36.7% response) and ran multivariable logistic regressions on 11 eHealth tasks in three domains among adult Internet users.
What they found
No digital-use divide by race/ethnicity among the online. SES gaps were large for care and information-seeking. Female sex predicted care and sharing uses; age mainly affected information-seeking. Lower-SES, older, and male online adults were less engaged.
The limits
What it doesn't show
2011–12 mailed HINTS cannot describe today’s app landscape; access-to-Internet divides are excluded by restricting to users, and cross-sectional ORs are not intervention effects.
Key terms
- HINTS
- NCI Health Information National Trends Survey; 2012 Cycle 1 N=3959.
- eHealth
- Online tasks for care, information-seeking, and sharing/user-generated health content.
- Digital divide
- Here, differences in eHealth use among people who are already online, not only access.
- SES
- Socioeconomic status; education showed the most consistent eHealth gaps.
- OR 0.50
- High-school-or-less odds of looking online for a health-care provider vs higher education.
- Communication inequality
- Unequal ability to use health information channels, which can widen outcome disparities.
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HINTS 2012 total N was about:
Common questions
Survey N?
3,959 HINTS respondents; 2,358 Internet users in eHealth models.
Race/ethnicity divide among the online?
No evidence of a digital-use divide by race/ethnicity.
Education OR to find a provider online?
0.50 (95% CI 0.33–0.76) for high school or less.
Who used eHealth more?
Women, across care and sharing domains.
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