Internet Access and Usage Among Stroke Survivors and Their Informal Caregivers: Cross-sectional Study

Abstract

Background Web-based interventions have shown promise for chronic disease management but have not been widely applied to populations with stroke. Existing barriers may inhibit the adoption of web-based interventions among stroke survivors and necessitate the involvement of informal caregivers. However, limited information is available on internet accessibility and usability among stroke survivors and their caregivers. Objective This study aims to investigate internet access and usage in a cohort of stroke survivors and their caregivers. Methods A cross-sectional survey was conducted with 375 participants (248 stroke survivors and 127 caregivers). Descriptive statistics were generated using cross-tabulation. Comparisons with categorical data were conducted using the chi-square test, whereas the Mann-Whitney U test was used for comparisons involving ordinal variables. Results Overall, 86.1% (323/375) of the participants reported having internet access. Caregivers were more likely than stroke survivors to access the internet (N=375, χ21=18.5, P<.001) and used text messaging (n=321, χ21=14.7, P<.001). Stroke survivors and caregivers with internet access were younger than stroke survivors and caregivers without internet access. The highest number of participants who reported internet access were non-Hispanic White. Smartphones were the most common devices used to access the internet. Email was the most common type of internet usage reported. Patients who survived for >12 months after a stroke reported higher internet access than those who survived <3 months (P<.001). The number of hours per week spent using the internet was higher for caregivers than for stroke survivors (P<.001). Conclusions Future feasibility and acceptability studies should consider the role of the informal caregiver, participant age, race and ethnicity, the use of smartphone apps, email and text correspondence, and the amount of time elapsed since the stroke event in the design and implementation of web-based interventions for populations with stroke.

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

“…We found that stroke survivors, including those in older age groups, frequently use the internet for a number of purposes. A previous US study of stroke survivors with a similar average age (64 years) reported that 81% had access to the internet, with most accessing it for >5 hours per week [ 25 ], whereas a Danish study of 100 people who were patients in a stroke unit found that 87% reported having access to an internet-enabled device at home [ 40 ]. In 2016-2017 in Australia, 55% of the general population aged >65 years had used the internet in the last 3 months, an increase on the 46% from 2012 to 2013, and two-thirds had accessed it for health services [ 19 ].…”

“…Despite the increasing popularity of eHealth use in this group, little is known about how stroke survivors engage with technology. A recent cross-sectional survey of stroke survivors (n=248) and carers (n=127) in the United States found that 81% of stroke survivors and 97% of carers had internet access and that smartphones were the most common device used to access the internet [ 25 ]. Beyond this, although information and communication technology interventions aimed at stroke survivors and their carers are likely to provide benefits, there is little information available about how stroke survivors use technology in their day-to-day lives [ 15 ].…”

Factors impacting the access and use of formal health and social services by caregivers of stroke survivors: an interpretive description study

“…Digital applications such as smartphone apps, email and internet-based tools have the potential to facilitate service delivery to caregivers and stroke survivors. However, more research is needed to better understand feasibility and acceptability of these tools across a range of socioeconomic, cultural and geographic parameters [ 73 , 74 ].Inherent in such tools is also the recognition that caregivers must have access to technology as well as support and training to optimize use of such services. Past research suggests that caregivers have diverse abilities and preferences for supportive telehealth technologies, emphasizing the need for a variety of options to support and foster service use by this population [ 75 ].…”

Utilization of social media communities for caregiver information support in stroke recovery: An analysis of content and interactions

“…As a result, the trend towards internet use for health information purposes has been significantly rising [ 16 ]. A cross-sectional study by Naqvi, Montiel [ 17 ] reported over 96.8% of caregivers having access to the internet to generally browse web pages (84.6%) and access their emails (89.4%).…”