Access to and Use of Internet and Social Media by Low-Morbidity Stroke Survivors Participating in a National Web-Based Secondary Stroke Prevention Trial: Cross-sectional Survey

Abstract

Background eHealth applications for stroke are a growing area of research that has yielded promising results. However, little is known about how stroke survivors engage with the internet, social media, and other digital technologies on a day-to-day basis. Objective This study had three main objectives: to describe the type, frequency, and purpose of technology use among a cohort of low-morbidity stroke survivors; to investigate associations between social media use and participant factors, including sociodemographics, physical function, and independence in activities of daily living; and to investigate associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Methods This study is a secondary analysis of data obtained during a national randomized controlled trial—Prevent 2nd Stroke. The participants were stroke survivors recruited from 2 Australian stroke registries who completed 2 telephone-administered surveys to collect data on demographics and stroke characteristics; health risk factors (diet quality, physical activity, blood pressure medication, alcohol intake, anxiety and depression, and smoking status); physical functioning; independence in activities of daily living; and questions about what technology they had access to, how often they used it, and for what purposes. Participants were eligible if they had no more than a moderate level of disability (modified Rankin score ≤3) and had access to the internet. Multivariable logistic regression was used to assess the associations between social media use and sociodemographics, physical function, and independence in activities of daily living as well as associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Results Data from 354 participants were included in the analysis. Approximately 79.1% (280/354) of participants used the internet at least daily, 40.8% (118/289) accessed social media on their phone or tablet daily, and 46.4% (134/289) looked up health and medical information at least monthly. Women were 2.7 times more likely to use social media (adjusted odds ratio 2.65, 95% CI 1.51-4.72), and people aged >75 years were significantly less likely to use social media compared with those aged <55 years (adjusted odds ratio 0.17, 95% CI 0.07-0.44). Health risk factors were not found to be associated with searching for health- or medical-related information. Conclusions The internet appears to be a viable platform to engage with stroke survivors who may not be high-morbidity to conduct research and provide information and health interventions. This is important given that they are at high risk of recurrent stroke regardless of their level of disability. Exploring the technology use behaviors and the possibility of eHealth among survivors who experience higher levels of morbidity or disability because of their stroke is an area of research that warrants further study.

Digital Therapy: Alleviating Anxiety and Depression in Adolescent Students During COVID-19 Online Learning - A Scoping Review

“…70 In line with previous studies showing that digital therapy is effective in reducing anxiety symptoms in adolescents who experience mental health problems. 71,72 Other studies also show that there is a decrease in anxiety and depression in students after receiving digital therapy. 53,73 Digital therapy is given to students with comprehensive attention to physical and psychological aspects.…”

Wellbeing After Stroke (WAterS): Feasibility Testing of a Co-developed Acceptance and Commitment Therapy Intervention to Support Psychological Adjustment After Stroke

“…27 It can increase reach to certain communities, including those likely to opt into an online intervention, but is threatened by digital poverty and may result in a sample that is skewed towards lower stroke morbidity and higher social economic status, which may limit findings. 28,29 We recruited a predominantly white (83%), well-educated, mild-to-moderate morbidity sample. This racial profile is similar to existing studies in stroke but reflects issues with equity of access, considering the well-documented health inequalities in stroke.…”

Wellbeing After Stroke (WAterS): feasibility testing of a co-developed Acceptance and Commitment Therapy (ACT) intervention, to support psychological adjustment after stroke

“…However, study recruitment using social media and digital platforms, including for trials, is becoming more common [37]. It can increase reach to certain communities, including those likely to opt into an online intervention, but is threatened by digital poverty and may result in a sample that is skewed towards lower stroke morbidity and higher social economic status [38, 39]. We recruited a predominantly white (83%), well-educated, mild-to-moderate morbidity sample.…”