The Sociodemographic Digital Divide in Mobile Health App Use Among Clients at Outpatient Departments in Inner Mongolia, China: Cross-sectional Survey Study

Abstract

Background Mobile health (mHealth) apps have become part of the infrastructure for access to health care in hospitals, especially during the COVID-19 pandemic. However, little is known about the effects of sociodemographic characteristics on the digital divide regarding the use of hospital-based mHealth apps and their benefits to patients and caregivers. Objective The aim of this study was to document the cascade of potential influences from digital access to digital use and then to mHealth use, as well as the potential influence of sociodemographic variables on elements of the cascade. Methods A cross-sectional survey was conducted from January to February 2021 among adult clients at outpatient departments in 12 tertiary hospitals of Inner Mongolia, China. Structural equation modeling was conducted after the construct comprising digital access, digital use, and mHealth use was validated. Results Of 2115 participants, the β coefficients (95% CI) of potential influence of digital access on digital use, and potential influence of digital use on mHealth use, were 0.28 (95% CI 0.22-0.34) and 0.51 (95% CI 0.38-0.64), respectively. Older adults were disadvantaged with regard to mHealth access and use (β=–0.38 and β=–0.41), as were less educated subgroups (β=–0.24 and β=–0.27), and these two factors had nonsignificant direct effects on mHealth use. Conclusions To overcome the mHealth use divide, it is important to improve digital access and digital use among older adults and less educated groups.

Use Patterns of Smartphone Apps and Wearable Devices Supporting Physical Activity and Exercise: Large-Scale Cross-Sectional Survey

“…Age is also an important predictor of app use-in general, older people do not use mHealth services [46]. Our results overall replicated this tendency, which may point to digital divides among an older population.…”

Functions of Smartphone Apps and Wearable Devices Promoting Physical Activity: Six-Month Longitudinal Study on Japanese-Speaking Adults (Preprint)

“…In general, women are dominant users of healthcare apps (for diet, nutrition, and self-care), but fitness apps are an exception as they are more preferred by men [46]. Older people typically avoid new technology and mHealth services [49]. In contrast, our results indicated that older users were more likely to continue using apps.…”

Large-data contextualizations of social determinant associations in pediatric head and neck cancers

“…Despite these advances in methodology, the datasets available initially were only applicable to the state of Indiana, making its application limited. Addressing these shortcomings, our group developed the Digital Inequity Index (DII) that utilized similar methodologies and data sources of the Digital Divide Index while expanding the coverage to the entirety of the United States at the county level [50 ▪ ].While many recent works on digital inequity have encompassed literature reviews and small-scaled implementation studies on diseases such as breast cancer, brain tumors, and COVID-19 [51 ▪▪ ,52 ▪▪ ,53–57], modern large-data analyses on digital inequity have only been performed on cancers of the esophagus and gastrointestinal system by our group [50 ▪ ]. In short, this study observed that, after adjusting for the impact of traditional SDoH, such as education level, income, disability status, and others, poorer digital resource access contributed to upwards of 20% differences in postoperative surveillance and 16% differences in survival time for patients diagnosed with esophageal and other types of gastrointestinal malignancies.…”