Trends in Health Information Technology Use Among the US Population With and Without Cardiovascular Risk Factors, 2012-2018: Evidence From the National Health Interview Survey

Abstract

Background The COVID-19 pandemic has required clinicians to pivot to offering services via telehealth; however, it is unclear which patients (users of care) are equipped to use digital health. This is especially pertinent for adults managing chronic diseases, such as obesity, hypertension, and diabetes, which require regular follow-up, medication management, and self-monitoring. Objective The aim of this study is to measure the trends and assess factors affecting health information technology (HIT) use among members of the US population with and without cardiovascular risk factors. Methods We used serial cross-sectional data from the National Health Interview Survey for the years 2012-2018 to assess trends in HIT use among adults, stratified by age and cardiovascular risk factor status. We developed multivariate logistic regression models adjusted for age, sex, race, insurance status, marital status, geographic region, and perceived health status to assess the likelihood of HIT use among patients with and without cardiovascular disease risk factors. Results A total of 14,304 (44.6%) and 14,644 (58.7%) participants reported using HIT in 2012 and 2018, respectively. When comparing the rates of HIT use for the years 2012 and 2018, among participants without cardiovascular risk factors, the HIT use proportion increased from 51.1% to 65.8%; among those with one risk factor, it increased from 43.9% to 59%; and among those with more than one risk factor, it increased from 41.3% to 54.7%. Increasing trends in HIT use were highest among adults aged >65 years (annual percentage change [APC] 8.3%), who had more than one cardiovascular risk factor (APC 5%) and among those who did not graduate from high school (APC 8.8%). Likelihood of HIT use was significantly higher in individuals who were younger, female, and non-Hispanic White; had higher education and income; were married; and reported very good or excellent health status. In 2018, college graduates were 7.18 (95% CI 5.86-8.79), 6.25 (95% CI 5.02-7.78), or 7.80 (95% CI 5.87-10.36) times more likely to use HIT compared to adults without high school education among people with multiple cardiovascular risk factors, one cardiovascular risk factor, or no cardiovascular risk factors, respectively. Conclusions Over 2012-2018, HIT use increased nationally, with greater use noted among younger and higher educated US adults. Targeted strategies are needed to engage wider age, racial, education, and socioeconomic groups by lowering barriers to HIT access and use.

An e–Mental Health Resource for COVID-19–Associated Stress Reduction: Mixed Methods Study of Reach, Usability, and User Perceptions

“…Demographic data indicated that the majority of website users were white women with higher education aged between 20 and 59 years. This is consistent with the findings of other studies that females and adults aged 18-64 years, with high levels of socioeconomic status, are more engaged, than males and other age groups, in using health content-related websites [39,[48][49][50][51][52][53][54]. The website's reach may be a reflection of recent evidence showing that women perceived a decline in their mental health in 2020 during the second wave of the pandemic and experienced worse mental health outcomes in comparison with men [1,25,40,55].…”

Latent class analysis of eHealth behaviors among adults with epilepsy

“…Female sex was associated with increased eHealth usage. The uptake of eHealth tools among females is concordant with a large body of research showing they have higher eHealth usage 28,34,46 . This may be due to higher levels of health care engagement and management among female patients, who tend to be more involved not only in self‐care but also in the care of their family members 28 .…”

“…The uptake of eHealth tools among females is concordant with a large body of research showing they have higher eHealth usage. 28,34,46 This may be due to higher levels of health care engagement and management among female patients, who tend to be more involved not only in self-care but also in the care of their family members. 28 Increasing age, higher education, and ability to use the internet independently were positively associated with patient portal and eHealth use.…”

The Impact of COVID-19 on the Cardiovascular Health of Emerging Adults Aged 18-25: Findings From a Scoping Review

“…In a national longitudinal study by Clark et al 200 , the average 30-year risk of developing CVD for young adults (mean age=29) ranged from 4.4-18%. Health literacy and education initiatives 199 , 201 , 202 that emphasize CVD prevention (e.g. healthy diets, physical activity, avoiding substance use) and the recognition of cardiovascular events need to be developed and targeted at emerging adults and parents/guardians.…”