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Who actually uses eHealth once they are online?

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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

Kontos E, Blake KD, Chou WY, et al. · Journal of medical Internet research · 2014

doi.org/10.2196/jmir.3117Read the full paper ↗633 citationscc by

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

Structured fields used in claim comparison tables when every cited study has a complete layer.

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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