Background Studies have previously shown that rural cancer patients are diagnosed at later stages of disease. This delay is felt throughout treatment and follow-up, reflected in the fact that rural patients often have poorer clinical outcomes compared with their urban counterparts. Objective Few studies have explored whether there is a difference in cancer patients’ current use of health information technology tools by residential location. Methods Data from 7 cycles of the Health Information National Trends Survey (HINTS, 2003-2017) were merged and analyzed to examine whether differences exist in managing electronic personal health information (ePHI) and emailing health care providers among rural and urban cancer patients. Geographic location was categorized using Rural-Urban Continuum Codes (RUCCs). Bivariate analyses and multivariable logistic regression were used to determine whether associations existed between rural/urban residency and use of health information technology among cancer patients. Results Of the 3031 cancer patients/survivors who responded across the 7 cycles of HINTS, 797 (26.9%) resided in rural areas. No difference was found between rural and urban cancer patients in having managed ePHI in the past 12 months (OR 0.78, 95% CI 0.43-1.40). Rural cancer patients were significantly less likely to email health care providers than their urban counterparts (OR 0.52, 95% CI 0.32-0.84). Conclusions The digital divide between rural and urban cancer residents does not extend to general ePHI management; however, electronic communication with providers is significantly lower among rural cancer patients than urban cancer patients. Further research is needed to determine whether such disparities extend to other health information technology tools that might benefit rural cancer patients as well as other chronic conditions.

BACKGROUND tudies have previously shown that rural cancer patients are diagnosed at later stages of disease. This delay is felt throughout treatment and follow-up, which is reflected in the fact that rural patients often have poorer clinical outcomes as compared to their urban counterparts. Few studies have explored whether there is a difference in cancer patients’ current utilization of health information technology (HIT) tools by residential location. OBJECTIVE In this present study, we sought to 1) determine the overall use of ePHI tools among cancer patients in urban and rural regions, and 2) assess the rate of email communication between cancer patients in urban and rural regions with their health care provider. METHODS Data from 7 cycles of the Health Information National Trends Survey (HINTS, 2003-2017) were merged and analyzed to examine whether differences exist in managing personal health information (PHI) online and e-mailing healthcare providers among rural and urban cancer patients. Geographic location was categorized using Rural-Urban Continuum Codes (RUCCs). Bivariate analyses and multivariable logistic regression were used to determine whether associations existed between rural/urban residency and use of HIT among cancer patients. RESULTS Of the 4163 cancer patients/survivors who responded across the 7 cycles of HINTS, 797 (26.9%) resided in rural areas. No difference was found between rural and urban cancer patients in having managed PHI electronically in the past 12 months (OR = 0.78, 95% CI = 0.43-1.40). Rural cancer patients were significantly less likely to e-mail health care providers than their urban counterparts (OR = 0.52, 95% CI = 0.32-0.84). CONCLUSIONS The digital divide between rural and urban cancer residents does not extend to general electronic PHI management; however, electronic communication with providers is significantly lower among rural cancer patients than urban cancer patients. Further research is needed to determine whether such disparities extend to other HIT tools that might benefit rural cancer patients as well as other chronic conditions.

BACKGROUND There is a need to address the factors associated with underrepresentation of socioeconomically disadvantaged groups in research participation. The growth of social networking sites over the past decade provides an opportunity to engage and educate patients from underrepresented populations about health information and research. OBJECTIVE To use the National Cancer Institute’s Health Information National Trends Survey (HINTS) to determine if there is an association between social networking site use and interest in patient engagement in research, and to identify sociodemographic disparities between social networking site use and interest in patient engagement in research. METHODS Data from the 2013 administration of HINTS were analyzed. Descriptive statistics were generated for all items, and bivariate analyses were conducted between sociodemographic variables and interest in participating in patient engaged research. Multivariate logistic regression modeling was used to examine the effects of each independent variable on respondent interest in patient-engaged research. RESULTS There was a statistically significant association between social networking site use for reading/sharing a medical topic (P< .001) and being interested in patient engagement in research, after adjusting for relevant covariates (OR=3.17; 95% CI: 2.04, 4.90). Respondents who had some college education (OR=3.13; 95% CI: 1.56, 6.27) or were college graduates (OR=3.98; 95% CI: 2.19, 7.24) had higher odds of interest in patient engagement in research, as compared to respondents with less than a high school education (P=.002). Among respondents who indicated using social networking sites for medical topics, males (P=.006) showed increased interest in patient engagement in research, as compared to females (OR=1.56; 95% CI: 1.13, 2.17). Interest in patient engagement in research did not differ significantly between different races/ethnicities, irrespective of their social networking site use (P<.001). CONCLUSIONS The relationship found between social networking site use and increased interest in patient engagement in research gives researchers an avenue to overcome barriers that have limited participation among different groups. Our study found no significant difference in this association among race/ethnicity, suggesting that social networking could be a tool to address the underrepresentation of certain groups regarding participation in research.

BACKGROUND More and more, people are using internet resources, such as YouTube, as a primary source of health-related information. While evidence exists of how this behavior affects the patient-physician relationship and the clinician perspective, it is still uncertain how it affects patient engagement in research. OBJECTIVE The aims of this study were to (1) determine if an association exists between watching health-related YouTube videos and being interested in patient engagement in research and (2) explore if any associations exist between sociodemographic characteristics, health-related YouTube use, and interest in patient engagement in research. METHODS We analyzed data from the 2013 Health Information National Trends Survey (n = 3039). Our independent variable of interest was whether individuals had watched health-related videos in the las 12 months; our dependent variable of interest was whether respondents were interested in patient engagement in research. Analysis included bivariate analyses and multivariate logistic regression modeling between sociodemographic characteristics, YouTube viewing, and being interested in patient engagement in research. RESULTS Interest in patient engagement in research was significantly associated with watching a health-related video on YouTube, after adjustment for relevant covariates. Individuals who watched a health-related video on YouTube, had a 2.11-fold increased odds ratio of being interested in patient engagement in research, compared to those who did not watch health-related videos (OR = 2.11, 95% CI = 1.40, 3.18, P <.001). We did not find any statistically significant associations between being interested in patient engagement in research and gender, age, race/ethnicity, or education. CONCLUSIONS YouTube has the potential to be used as a tool to increase interest in patient engagement in research. Future studies could use YouTube to evaluate its effectivity promoting participation in research of underrepresented communities.