Pediatric Caregiver Attitudes Toward Email Communication: Survey in an Urban Primary Care Setting

Abstract

BackgroundOverall usage of email communication between patients and physicians continues to increase, due in part to expanding the adoption of electronic health records and patient portals. Unequal access and acceptance of these technologies has the potential to exacerbate disparities in care. Little is known about the attitudes of pediatric caregivers with regard to their acceptance of email as a means to communicate with their health care providers.ObjectiveWe conducted a survey to assess pediatric caregiver access to and attitudes toward the use of electronic communication modalities to communicate with health care providers in an urban pediatric primary care clinic.MethodsParticipants were pediatric caregivers recruited from an urban pediatric primary care clinic in Baltimore, Maryland, who completed a 35-item questionnaire in this cross-sectional study.ResultsOf the 229 caregivers who completed the survey (91.2% response rate), 171 (74.6%) reported that they use email to communicate with others. Of the email users, 145 respondents (86.3%) stated that they would like to email doctors, although only 18 (10.7%) actually do so. Among email users, African-American caregivers were much less likely to support the expanded use of email communication with health care providers (adjusted OR 0.34, 95% CI 0.14-0.82) as were those with annual incomes less than US $30,000 (adjusted OR 0.26, 95% CI 0.09-0.74).ConclusionsCaregivers of children have access to email and many would be interested in communicating with health care providers. However, African-Americans and those in lower socioeconomic groups were much less likely to have positive attitudes toward email.

Evaluating Secure Messaging From the Veteran Perspective: Informing the Adoption and Sustained Use of a Patient‐driven Communication Platform

“…However, it should be noted that in general educational and income levels as well as eHealth and health literacy levels were higher than usually found in the general Veteran population. This is consistent with existing literature suggesting that eHealth users tend to have higher levels of education, income, and eHealth and health literacy, than the general population (Archer et al, ; Cutrona et al, ; Dudas and Crocetti ; Kim and Nahm ). Perceptions of these two groups, sometimes shared, provide clear indications of changes needed to remove barriers and align expectations.…”

Large-Scale Survey Findings Inform Patients’ Experiences in Using Secure Messaging to Engage in Patient-Provider Communication and Self-Care Management: A Quantitative Assessment

“…Our findings are consistent with a previously published research outside the VA, which found that older age was negatively associated with frequency of use to contact health care providers using email (ie, secure messaging) [ 16 ]. Consistent with previous findings, income was positively correlated with preferences to use email (ie, secure messaging) to communicate with health care providers [ 15 ]. Previous research has shown mixed findings about minority groups’ preferences for using email-type services to communicate with health care providers [ 15 , 16 ].…”

“…Consistent with previous findings, income was positively correlated with preferences to use email (ie, secure messaging) to communicate with health care providers [ 15 ]. Previous research has shown mixed findings about minority groups’ preferences for using email-type services to communicate with health care providers [ 15 , 16 ]. However, in our sample, minority status was consistent with findings that suggest a positive association between minority status and use of electronic email communication with health care providers [ 16 ].…”

“…Key findings from this cross-sectional survey suggest that in a random sample (N=819) of patients receiving care within the VA who opted in to use secure messaging, a majority reported using secure messaging at least once a year, with less than 15% reporting never using the communication tool. Our VA sample had a higher percentage of participants reporting use of secure messaging than previous survey studies outside the VA, in which about 10-37% of respondents reported using email to contact their physician [ 15 - 17 ]. However, our percentage is likely higher due to our sampling methods that identified veteran patients who opted in to use secure messaging.…”

Health-Related Internet Use by Informal Caregivers of Children and Adolescents: An Integrative Literature Review

“…The majority of studies were limited to parents or legal guardians (14/17, 82%); the remaining studies were of relatives as caregivers (3/17, 18%). The majority of participants were female, usually mothers [ 17 , 23 , 24 , 27 - 29 , 33 ]. A high proportion of racial and ethnic minorities were found in only 4 studies; African Americans were the largest group in these studies, with proportions ranging from 32% [ 21 ] to 83% [ 32 ].…”