Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003–2018

Abstract

Purpose Prior research on the use of the internet among cancer survivors indicates a digital divide. The online landscape and patterns of information consumption, however, have notably changed over the past decade necessitating an updated examination of health-related internet use (HRIU) among cancer survivors.

Social and Demographic Patterns of Health-Related Internet Use Among Adults in the United States: A Secondary Data Analysis of the Health Information National Trends Survey

“…These differences may be attributable to differences in health literacy, difficulties and frustration in accessing online information, or trust in health information from online sources [ 23 , 24 , 27 , 45 , 46 , 47 , 48 , 49 , 50 ]. Consistent with previous studies, we observed that older adults were also less likely to use the internet to locate health-related information for themselves or others [ 13 , 20 , 23 , 27 , 46 ]. Prior studies have observed that older individuals are more likely to access and trust health information from other sources, including friends and families and religious organizations [ 20 , 27 , 49 ].…”

“…Each observation with missing data was imputed 20 times and the imputed weight was recalibrated to preserve the national representative survey weight. Given previous HINTS studies examining differences in eHealth use among smokers and cancer survivors, all models were adjusted for smoking status, personal cancer history, and family cancer history [ 13 , 25 , 35 , 36 , 37 , 38 , 39 , 40 ]. To measure the change in eHealth usage in different HINTS release, a dummy variable was used to represent the survey year.…”

“…Despite the evidence documenting the effectiveness of internet-based interventions in improving chronic disease outcomes and the wealth of health information available, access and uptake of health information remains a challenge, thus potentially increasing health disparities across race/ethnicity, socioeconomic status, and language [ 12 , 13 , 14 , 15 , 16 ]. In particular, studies have observed gaps in internet use for specific health outcomes (e.g., cancer, cardiovascular disease) across race/ethnicity, age, and gender [ 17 , 18 , 19 , 20 , 21 , 22 ].…”

“…A secondary analysis of data from the Pew Research Center observed that racial and ethnic minority groups were more likely to contribute to COVID-19 content on social media [ 14 ]. A previous analysis of health-related internet use among cancer survivors documented lower rates of use among older adults, racial and ethnic minorities, adults with lower levels of education, and adults living in rural areas [ 13 ]. Additional studies examining potential explanations for lower rates of eHealth use among particular demographic groups have documented lower rates of trust in health information from internet sources among older adults, racial and ethnic minorities, smokers, and men [ 20 , 23 , 24 , 25 ].…”

Disparities in access to mobile devices and e-health literacy among breast cancer survivors

“…These access issues are likely to have a substantial impact on the uptake of e-health interventions. Furthermore, studies have shown that older adults are less likely to use the Internet, to be users of mobile health apps, and to seek cancer information online [ 9 , 17 , 18 ]. This suggests there are also likely to be issues with long-term engagement in this age group, as they may be less familiar or comfortable with using e-health interventions or accessing information online.…”