Internet Accessibility and Perceptions for Possible Online Interventions




Fulda, Kimberly
Franks, Susan


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Internet Accessibility and Perceptions for Possible Online Interventions Tam Cung, DO1; Kimberly Fulda, DRPH1,2; Susan Franks, PHD1,2 1Plaza Medical Center; 2Department of Family Medicine, University of North Texas Health Science Center Fort Worth, TX 76107 BACKGROUND: Healthcare costs are a serious escalating burden, especially within Medicare/Medicaid populations. The Internet and social media have made the flow of information cheaper and more efficient. Previous studies have shown increasing internet penetration into lower social economic households creating a potential opportunity to improve health outcomes. HYPOTHESIS: The primary aim was to evaluate internet accessibility of patients of an urban clinic with large Medicare/Medicaid populations. The secondary aim was to evaluate racial/ethnic differences in preferences for using various formats with healthcare information. METHODS: Patients in a family medicine clinic completed a 25-item survey. Logistic regression was performed to assess the association between race/ethnicity (Caucasian, Hispanic, African American, and Other) and likeliness to use selected formats for healthcare information (very unlikely/unlikely, likely/very likely) while controlling for gender, age, and income. A regression model was run for the following formats: online video, 3-4 page handout, and online chat/forum. Odds ratios and 95% confidence intervals were calculated. RESULTS: A total 107 participants with the mean age of 45 (SD=16) completed the survey. Approximately 67% were females, 85% had internet access, 61% were on Medicare/Medicaid. Racial/ethnic distributions were 32% Hispanic, 33% Caucasian, 25% African-American, and 10% Other. All racial/ethnic groups connected to the internet using a phone more than a laptop, desktop, or tablet. Caucasians (70.0%) and Hispanics (59.3%) selected online video more often than other formats. African-Americans (57.1%) and Others (66.7%) were more likely to select handout than other formats. Adjusted analyses showed racial/ethnic differences in the likelihood of using selected formats to receive healthcare information. African-Americans were less likely than Caucasians to select online video (OR=0.18: 95% CI:0.05-0.69). Hispanics were less likely than Caucasians to select handout (OR=0.15: 95% CI:0.04-0.56) and online chat/forum (OR=0.14; 95% CI:0.03-0.61). CONCLUSIONS: Medicaid/Medicare patients are interested in online interventions, but it is best individualized towards each patient in consideration of culturally related preferences. Future studies should further explore sociocultural differences in format preference given equal accessibility, and compare online interventions directly to traditional resources. ACKNOWLEDGEMENTS: Material cost of the survey was funded by UNTHSC. This study was approved by the IRB at UNTHSC. IRB # 2015-125