Cell phone disconnection disrupts access to healthcare and health resources: A technology maintenance perspective

Gonzales, Amy L.; Ems, Lindsay; Suri, Venkata Ratnadeep

doi:10.1177/1461444814558670

Cited by 61 publications

(77 citation statements)

References 42 publications

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“…Gonzales et al [ 42 ] indicate that access to technologies for disadvantaged groups is unstable, and can be regularly disrupted, suggesting that simply measuring access to technology adoption across socioeconomic groups ignores the possibility that unstable access–or unequal use–can have large consequences on social inequalities in health. Perez et al [ 43 ] support these results, further demonstrating that purely having access to a particular technology does not guarantee equal use.…”

Section: Resultsmentioning

confidence: 99%

“…The technologies addressed by studies included in our results focus predominantly on technologies designed and used in health care services. Included in this collection of technologies is a growing focus on the internet and internet-based tools, as the use of these technologies also become an integrated resource in health care services [ 3 , 4 , 42 , 44 – 46 ]. However, as various researchers have highlighted in recent years, technologies that have the potential to greatly influence health and social inequalities in health are not limited to those found in health care services [ 3 , 6 , 7 , 11 ].…”

Section: Resultsmentioning

confidence: 99%

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Innovative technologies and social inequalities in health: A scoping review of the literature

et al. 2018

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The aim of this study was to systematically review the range, nature, and extent of current research activity exploring the influence of innovative health-related technologies on social inequalities in health, with specific focus on a deeper understanding of the variables used to measure this connection and the pathways leading to the (re)production of inequalities. A review process was conducted, based on scoping review techniques, searching literature published from January 1, 1996 to November 25, 2016 using MEDLINE, Scopus, and ISI web of science. Search, sorting, and data extraction processes were conducted by a team of researchers and experts using a dynamic, reflexive examination process. Of 4139 studies collected from the search process, a total of 33 were included in the final analysis. Results of this study include the classification of technologies based on how these technologies are accessed and used by end users. In addition to the factors and mechanisms that influence unequal access to technologies, the results of this study highlight the importance of variations in use that importantly shape social inequalities in health. Additionally, focus on health care services technologies must be accompanied by investigating emerging technologies influencing healthy lifestyle, genomics, and personalized devices in health. Findings also suggest that choosing one measure of social position over another has important implications for the interpretation of research results. Furthermore, understanding the pathways through which various innovative health technologies reduce or (re)produce social inequalities in health is context dependent. In order to better understand social inequalities in health, these contextual variations draw attention to the need for critical distinctions between technologies based on how these various technologies are accessed and used. The results of this study provide a comprehensive starting point for future research to further investigate how innovative technologies may influence the unequal distribution of health as a human right.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Innovative technologies and social inequalities in health: A scoping review of the literature

et al. 2018

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“…Technology maintenance predicts that, 'as the poor increasingly have initial in-home and public access to technology, the digital divide will begin to center on differences in the ability to maintain that access' (Gonzales, 2014;Gonzales, Ems, & Suri, 2014). Previously applied only to barriers to cell phone access, technology maintenance would also suggest that Internet access in low-income communities must be continuously maintained, often at substantial ongoing economic and social cost (e.g.…”

mentioning

confidence: 99%

The contemporary US digital divide: from initial access to technology maintenance

Gonzales

2015

Information, Communication & Society

267

166

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As US Internet penetration rates have climbed, digital divide researchers have largely shifted attention to differences in Internet skills. Interviews with 72 low-income US residents from both a large metropolitan city and a medium-sized Midwestern town, however, reveal that many people still struggle to maintain physical access, supporting technology maintenance theory. Technology maintenance theory argues that although most of the US poor now use digital technology, access is unstable and characterized by frequent periods of disconnection. As a result, low-income users must work to maintain access, often experiencing cycles of dependable instability. In these interviews, nearly all used the Internet, but technology maintenance practices were widespread, including negotiation of temporarily disconnected service, broken hardware, and logistic limitations on public access. As a result, participants had limited access to health information and employment, and biased attitudes toward technology. That is, in some cases, negative attitudes toward Internet adoption reflected a rational response to disconnection rather than cultural norms or fears of the Internet, as suggested by previous research. Findings support and extend the theory of technology maintenance by emphasizing a shift in the US digital divide from issues of ownership to issues of sustainability; they also provide insight into the interrelated nature of access and attitudes toward technology. This new theoretical approach complements other theoretical approaches to the digital divide that foreground a contextualized understanding of digital disparities as embedded within a history of broad social disparities.

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“…Among low income smokers, cell phones are often the only form of telephone service (43,44). Gonzales et al found that temporary phone disconnection among low-income patients was frequent, and often caused disruption in access to healthcare (45). Others have suggested that limited minutes among low income cell phone users could impose a burden on calling plans and therefore deter use of the QL (20,44), although this was not reported in this study.…”

Section: Discussionmentioning

confidence: 68%

Quitting the quitline: a qualitative study of patient experience of electronic referrals to quitlines

Albert

Rose

Gill

et al. 2020

Preprint

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Background: The use of electronic referrals (eReferrals) to state quitlines (QLs) for tobacco-using patients is a promising approach for addressing smoking cessation on a large scale. However, QL contact, enrollment, and completion rates are low. The purpose of this study was to examine the eReferral to QL process from the patient’s perspective in order to inform strategies for improving QL engagement.Methods: We conducted interviews with 55 patients who agreed to an eReferral at a primary care visit to 1 of 8 safety-net community health centers in Cuyahoga County, Ohio (September 2017-August 2018). Interviews were designed to explore the experiences of three subgroups of patients who subsequently: 1) declined participation in the QL; 2) were unreachable by the QL; or 3) were enrolled in or had completed the QL program. Analysis was guided by a phenomenological approach designed to identify emergent themes.Results: Reasons for QL program non-completion included changing life circumstances and events making cessation unviable; misunderstandings about the QL; discomfort with telephonic counseling; perceived lack of time for counseling; cell phone barriers; and having already quit smoking. We found that some individuals who were no longer receiving QL support because they had been classified as program complete, unreachable, or declined - desired continued support from the QL.Conclusions: Integrating QL care with community-based resources that address the socio-economic mediators of tobacco use, and/or incorporating culturally adapted interventions could be promising strategies. Follow up by the referring primary care provider to encourage engagement and offer support is recommended.

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Cell phone disconnection disrupts access to healthcare and health resources: A technology maintenance perspective

Cited by 61 publications

References 42 publications

Innovative technologies and social inequalities in health: A scoping review of the literature

Innovative technologies and social inequalities in health: A scoping review of the literature

The contemporary US digital divide: from initial access to technology maintenance

Quitting the quitline: a qualitative study of patient experience of electronic referrals to quitlines

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