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Park S, Kim B. Predictors of Internet Use Among Older Adults With Diabetes in South Korea: Survey Study. JMIR Med Inform 2020; 8:e19061. [PMID: 33277232 PMCID: PMC7787888 DOI: 10.2196/19061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/06/2020] [Accepted: 11/24/2020] [Indexed: 01/16/2023] Open
Abstract
Background Internet access in Korea has grown dramatically over the past two decades. However, disparities in internet use, referred to as the second level of the digital divide, persist. Objective This study aims to examine opportunity, motivation, and health variables that indicate internet use among older adults with diabetes. Methods Data were sourced from a nationally representative sample of people 65 years and older with diabetes (N=1919). Logistic regression was used to explore potential differences in predictor variables between internet users and nonusers. Results Only 306 of the 1919 (15.95%) participants in the sample used the internet. They were more likely to be younger (odds ratio [OR] 0.89, 95% CI 0.87-0.92), well-educated (OR 1.20, 95% CI 1.16-1.26), and able to afford leisure expenditures (OR 1.02, 95% CI 1.01-1.04). Additionally, they had more information and communications technology (ICT) training experience, were motivated to learn, volunteered, and reported good physical and cognitive function. Participation in ICT education and better health more positively correlated with a higher rate of internet use than did years of education or economic standing in older adults with diabetes. Conclusions To support older adults with diabetes in the internet age, policies and health care providers should focus on digital competency training as well as physical and cognitive function.
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Affiliation(s)
- Sunhee Park
- Barun ICT Research Center, Yonsei University, Seoul, Republic of Korea
| | - Beomsoo Kim
- Graduate School of Information, Yonsei University, Seoul, Republic of Korea
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Cherrez-Ojeda I, Felix M, Mata VL, Vanegas E, Gavilanes AWD, Chedraui P, Simancas-Racines D, Calderon JC, Ortiz F, Blum G, Plua A, Gonzalez G, Moscoso G, Morquecho W. Preferences of ICT among Patients with Chronic Kidney Disease Undergoing Hemodialysis: An Ecuadorian Cross-Sectional Study. Healthc Inform Res 2018; 24:292-299. [PMID: 30443417 PMCID: PMC6230525 DOI: 10.4258/hir.2018.24.4.292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 10/18/2018] [Accepted: 10/23/2018] [Indexed: 11/25/2022] Open
Abstract
Objectives The aim of the present study was to assess the frequency of use, and preferences regarding information and communication technologies (ICTs) among Ecuadorian patients with chronic kidney disease (CKD) undergoing hemodialysis. Methods We conducted an anonymous cross-sectional survey-based study from January 2016 to April 2017, involving 393 patients with end-stage renal disease from 9 hemodialysis centers, in which they rated their use and preferences of various ICTs through a modified version of the Michigan Questionnaire. The questionnaire collected information regarding demographics, patients' interest in obtaining health-related information through ICTs, and interest in using ICTs as a potential way to communicate with their healthcare providers. A chi-square test for association and adjusted regression analyses were performed. Results Among all patients who participated, 64.3% reported owning a cellphone, with less than a third reporting active Internet connection. The most used ICT for obtaining information about CKD and/or hemodialysis was web-based Internet, followed by YouTube. SMS was rated the highest to receive and seek health-related information, followed by Facebook. Younger age and higher levels of education were associated with a higher overall usage of ICTs. Finally, more than half of the patients reported interest in using WhatsApp for communicating with their healthcare providers. Conclusions Understanding the preferences of ICTs among patients with CKD undergoing hemodialysis could help to improve their outcomes through the potential uses and benefits of ICTs. Further research is needed to assess their role in improving the care of patients with chronic diseases.
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Affiliation(s)
- Ivan Cherrez-Ojeda
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | - Miguel Felix
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | - Valeria L Mata
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | - Emanuel Vanegas
- Universidad Espíritu Santo, Samborondón, Ecuador.,Respiralab Research Group, Guayaquil, Ecuador
| | - Antonio W D Gavilanes
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands.,School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Peter Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, Ecuador
| | | | - Fabian Ortiz
- Instituto Ecuatoriano de Diálisis y Trasplantes (IEDYT), Guayaquil, Ecuador.,Unidad de Diálisis del Norte (UNIDIAL), Guayaquil, Ecuador
| | - Guillermina Blum
- Centro de Diálisis de la Fundación Renal del Ecuador "Iñigo Alvarez de Toledo", Guayaquil, Ecuador
| | - Angela Plua
- Instituto del Riñón y Diálisis, MEDICDIAL S.A., Guayaquil, Ecuador
| | | | - Grace Moscoso
- Universidad Espíritu Santo, Samborondón, Ecuador.,Hospital Dr. Abel Gilbert Pontón, Guayaquil, Ecuador
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Use of Web-Based Parent-Adolescent Health Promotion Program Among Puerto Ricans. Nurs Res 2018; 67:473-484. [PMID: 30067581 DOI: 10.1097/nnr.0000000000000306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Despite positive attitudes of Latinos using the Internet and the increased availability of health information resources, few studies have been conducted that examine actual use and barriers to web-based health information. OBJECTIVE The aim of this study was to examine whether select sociodemographic factors and technology factors (e.g., computer and Internet access) predicted use of a web-based, parent-adolescent sexual communication program or a physical activity program, entitled Cuídalos, among Puerto Rican parents. METHODS This study uses data from a randomized controlled trial designed to examine the long-term effectiveness of Cuídalos. Parents were recruited from community-based and school sites throughout Puerto Rico and randomly assigned to a web-based, parent-adolescent sexual communication (n = 245) or a physical activity (n = 247) program. Parents were instructed to complete the two-session program within 1 week and had access to the program for a period of 3 months. Outcomes in this secondary analysis were the number of log-ins and self-reported access during the 3-month period. Reasons for not accessing the program after the 3-month period were assessed. RESULTS Self-reported access after completion of the Cuídalos program and the actual number of log-ins over the intervention period were low. There were no statistically significant differences in the number of log-ins between parents who accessed Cuídalos during the 3-month time frame and those who did not (p = .28). Logistic regression analyses demonstrated that the odds of accessing Cuídalos during the 3-month period was 72% higher (OR = 1.72, 95% CI [1.08, 2.75]) among parents with a high school education or less, as compared to parents with a college education (p = .02). Similarly, Poisson regression model results indicated that, with every year increase in age, the expected number of log-ins increased by 1% (RR = 1.01, 95% CI [1.00, 1.02]); compared to those who accessed the program at home, the expected number of log-ins ranged from 10% to 27% lower for parents accessing elsewhere. Reasons for not accessing the program during the 3-month period included not having easy access to a computer (n = 134, 48.6%), or they did not know how to access the program again (n = 56, 20.3%). DISCUSSION Despite the availability of web-based and e-health resources, further research is needed to identify how to facilitate greater access and actual use of digital health resources by Latinos. This is an important effort in order to prevent a widening health equity gap caused by a lack of access and use of digital health resources.
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Lockwood MB, Dunn-Lopez K, Pauls H, Burke L, Shah SD, Saunders MA. If you build it, they may not come: modifiable barriers to patient portal use among pre- and post-kidney transplant patients. JAMIA Open 2018; 1:255-264. [PMID: 31984337 PMCID: PMC6951926 DOI: 10.1093/jamiaopen/ooy024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 05/11/2018] [Accepted: 06/05/2018] [Indexed: 12/19/2022] Open
Abstract
Background Patient access to health information using electronic patient portals is increasingly common. Portal use has the potential to improve patients’ engagement with their health and is particularly important for patients with chronic illness; however, patients’ abilities, attitudes, and use of portals are poorly understood. Methods A single-center, cross-sectional survey was conducted of 240 consecutive pre- and post-kidney transplant patients of all levels of technological proficiency who presented to an urban transplant center in the United States. The investigator-developed Patient Information and Technology Assessment-Patient Portal was used to assess patients’ attitudes towards the use of patient portals. Results Most patients surveyed did not use the patient portal (n = 176, 73%). Patients were more likely to use the patient portal if they were White, highly educated, in the post-transplant period, more comfortable with technology, and reported being a frequent internet user (P < .05). The most common reasons for not using the patient portal included: (1) preference for traditional communication, (2) not being aware of the portal, (3) low technological proficiency, and (4) poor interoperability between the portal at the transplant center and the patient’s primary care center. Conclusions We identified several modifiable barriers to patient portal use. Some barriers can be addressed by patient education and training on portal use, and federal initiatives are underway to improve interoperability; however, a preference for traditional communications represents the most prominent barrier. Additional strategies are needed to improve portal adoption by encouraging acceptance of technologies as a way of clinical communication.
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Affiliation(s)
- Mark B Lockwood
- Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois, USA
| | - Karen Dunn-Lopez
- Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois, USA
| | - Heather Pauls
- Office of Research Facilitation, University of Illinois at Chicago College of Nursing, Chicago, Illinois, USA
| | - Larisa Burke
- Department of Biobehavioral Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois, USA
| | - Sachin D Shah
- Departments of Medicine and Pediatrics, University of Chicago Medicine, Chicago, Illinois, USA
| | - Milda A Saunders
- General Internal Medicine, Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA
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Bonner A, Gillespie K, Campbell KL, Corones-Watkins K, Hayes B, Harvie B, Kelly JT, Havas K. Evaluating the prevalence and opportunity for technology use in chronic kidney disease patients: a cross-sectional study. BMC Nephrol 2018; 19:28. [PMID: 29394930 PMCID: PMC5797344 DOI: 10.1186/s12882-018-0830-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/22/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is increasing worldwide and early education to improve adherence to self-management is a key strategy to slow CKD progression. The use of the internet and mobile phone technologies (mHealth) to support patients is considered an effective tool in many other chronic disease populations. While a number of mHealth platforms for CKD exist, few studies have investigated if and how this population use technology to engage in self-management. METHODS Using a cross-sectional design across five health districts in Queensland (Australia), a 38-item self-report survey was distributed to adults with CKD attending outpatient clinics or dialysis units to measure current use and type of engagement with mHealth, perceived barriers to use, and opportunities to support CKD self-management. Odds ratio (OR) were calculated to identify associations between demographic characteristic and mHealth use. RESULTS Of the 708 participants surveyed, the majority had computer access (89.2%) and owned a mobile phone (83.5%). The most likely users of the internet were those aged ≤ 60 years (OR: 7.35, 95% confidence interval [CI]: 4.25-12.75, p < 0.001), employed (OR: 7.67, 95% CI: 2.58-22.78, p < 0.001), from non-indigenous background (OR: 6.98, 95% CI: 3.50-13.93, p < 0.001), or having completed higher levels of education (OR: 3.69, CI: 2.38-5.73, p < 0.001). Those using a mobile phone for complex communication were also younger (OR: 6.01, 95% CI: 3.55-10.19, p < 0.001), more educated (OR: 1.99, 95% CI: 1.29-3.18, p < 0.01), or from non-indigenous background (OR: 3.22, 95% CI: 1.58-6.55, p < 0.001). Overall, less than 25% were aware of websites to obtain information about renal healthcare. The mHealth technologies most preferred for communication with their renal healthcare teams were by telephone (56.5%), internet (50%), email (48.3%) and text messages (46%). CONCLUSION In the CKD cohort, younger patients are more likely than older patients to use mHealth intensively and interactively although all patients' technology literacy ought to be thoroughly assessed by renal teams before implementing in practice. Further research testing mHealth interventions to improve self-management in a range of patient cohorts is warranted.
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Affiliation(s)
- Ann Bonner
- School of Nursing, Queensland University of Technology, Brisbane, Australia
- Kidney Health Service, Royal Brisbane and Women’s Hospital, Herston, Australia
- NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Herston, Australia
| | - Kerri Gillespie
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Katrina L. Campbell
- Renal Service, Princess Alexandra Hospital, Woolloongabba, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | | | | | | | - Jaimon T. Kelly
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Kathryn Havas
- School of Nursing, Queensland University of Technology, Brisbane, Australia
- NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Herston, Australia
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Frequency of In-Home Internet Use Among Prekidney and Postkidney Transplant Patients-Facilitators and Barriers to Use and Trends Over Time. Transplant Direct 2017; 3:e216. [PMID: 29184905 PMCID: PMC5682761 DOI: 10.1097/txd.0000000000000735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/11/2017] [Indexed: 12/04/2022] Open
Abstract
Background As health-related communications become digitized, strategies to increase adoption of these Web-based platforms are needed. The purpose of this study was to assess facilitators and barriers to in-home Internet use among prekidney and postkidney transplant patients. Methods A single center, cross-sectional survey of 240 consecutive patients of all levels of technological proficiency who presented to an urban transplant center in the United States. The Patient Information and Technology Assessment consists of 6 demographic questions, 3 disease-related questions, and 8 technology-related questions. Results Much of the sample was African American, male with a mean age of 51 years, and median income of $53 800/year. Logistic regression analysis was undertaken, and after adjusting for covariates, we found Smartphone ownership (odds ratio [OR], 4.94; 95% confidence interval [CI], 2.32-10.52), a higher number of Internet users in the home (OR, 2.00; 95% CI, 1.11-3.62), and having college education and beyond (OR, 4.88; 95% CI, 2.03-11.74) increased the likelihood of being a frequent Internet user. African American or Hispanic/Latino patients were less likely to be frequent Internet users compared with white patients (OR, 0.26 and 0.24, respectively, compared with whites, all P < 0.05). As the total number of people in the household increased, frequent Internet use decreased (OR, 0.52; 95% CI, 0.29-0.92). As age increased, reports of frequent Internet use decreased. Conclusions Lower rates of Internet use among African Americans and Hispanic/Latinos in urban areas in the United States remains a problem despite a significant increase in access to the Internet and Smartphone ownership. The finding that Internet use increases as the number of Internet users in the household increases indicates that leveraging the patient’s social support network and/or the development of patient information champion programs may aid with patient’s adoption of health technology and patient engagement in self-care.
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