Digital Divide: Variation in Internet and Cellular Phone Use among Women Attending an Urban Sexually Transmitted Infections Clinic

Abstract

We sought to describe: (1) the prevalence of internet, cellular phone, and text message use among women attending an urban sexually transmitted infections (STI) clinic, (2) the acceptability of health advice by each mode of information and communication technology (ICT), and (3) demographic characteristics associated with ICT use. This study is a cross-sectional survey of 200 English-speaking women presenting to a Baltimore City STI clinic with STI complaints. Participants completed a self-administered survey querying ICT use and demographic characteristics. Three separate questions asked about interest in receiving health advice delivered by the three modalities: internet, cellular phone, and text message. We performed logistic regression to examine how demographic factors (age, race, and education) are associated with likelihood of using each modality. The median age of respondents was 27 years; 87% were African American, and 71% had a high school diploma. The rate of any internet use was 80%; 31% reported daily use; 16% reported weekly use; and 32% reported less frequent use. Almost all respondents (93%) reported cellular phone use, and 79% used text messaging. Acceptability of health advice by each of the three modalities was about 60%. In multivariate analysis, higher education and younger age were associated with internet use, text messaging, and cellular phone use. Overall rate of internet use was high, but there was an educational disparity in internet use. Cellular phone use was almost universal in this sample. All three modalities were equally acceptable forms of health communication. Describing baseline ICT access and the acceptability of health advice via ICT, as we have done, is one step toward determining the feasibility of ICTdelivered health interventions in urban populations.

Text Messaging for Enhancement of Testing and Treatment for Tuberculosis, Human Immunodeficiency Virus, and Syphilis: A Survey of Attitudes Toward Cellular Phones and Healthcare

“…15 However, a 2008 study of primarily African-American women attending an urban sexually transmitted infection clinic reported very high rates of cell phone ownership (93%) and text messaging (79%). 4 Our data confirm that the demographic reach of cell phones has expanded, and further we found that minority groups (African-Americans and Hispanics) surveyed were more amenable to receiving information from healthcare providers via text messaging than White patients. There are some drawbacks to using text messaging for healthcare-related communication.…”

“…3 In one study of women attending an urban sexually transmitted infections clinic, 93% reported owning a cellular phone and 79% used text messaging to communicate. 4 Not surprisingly, text messaging is an increasingly common method of communicating between medical providers and patients. Text message reminders of clinic appointments are being used in a number of healthcare settings.…”

Characteristics of patients with epilepsy who use a website providing healthcare information about epilepsy in South Korea

“…This can be explained in terms of the 'digital divide,' since health-seeking behavior using the internet seems to be related to the general internet activities of epilepsy patients [37]. In previous studies, there were major differences between online and offline health seekers in terms of age, income, and education [42][43][44]. However, only higher education differed between the two groups in our sample, while age and income did not.…”

Pediatric Caregiver Attitudes and Technologic Readiness Toward Electronic Follow-Up Communication in an Urban Community Emergency Department

“…7 These findings run contrary to reports concerning Internet use among lower socioeconomic groups and ethnic minorities published only a few years ago, mitigating concerns that expanding the use of electronic communication between patients and providers would widen healthcare disparities. The majority of caregivers have access to one or both of these technologies, and a significant number want to be able to use e-mail or text messaging to communicate with their provider.…”