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Source publication
Background:
Despite the growing penetration of the Internet, little is known about the usage and browsing patterns of those in poverty. We report on a randomized controlled trial that sheds light on the Internet use and browsing patterns among the urban poor.
Methods:
The data come from 312 participants in Boston, Massachusetts, from Click to Co...
Context in source publication
Similar publications
Background
Given the major changes in internet use for health communication, the objective of the current study was to compare the internet use and wishes of cancer survivors between 2005 and 2017.
Methods
The authors drew a sample of 390 patients in 2005 and 539 patients in 2017 who were diagnosed with breast (128 patients in 2005 and 143 patient...
There has been no study that has allowed clear conclusions about the impact of suicide-related or mental health consultation-related internet use.
To investigate the impacts of suicide-related or mental health consultation-related internet use.
We conducted prospective observational longitudinal study with data collection at baseline screening (T0)...
Citations
... Twenty-four studies included other populations (e.g. African American breast cancer survivors [95], members of public libraries [143], women in Tanzania [126] a rural community [127], students in an ESOL class [17,28,34,41,47,60,62,67,70,80,83,93,95,106,110,112,113,117,120,123,124,126,127,145]. Eighteen studies were a sample of the general population [16,19,24,43,48,49,56,58,68,73,77,79,81,92,108,121,128,144] and sixteen studies did not identify the population [15,20,21,30,36,71,76,89,98,103,116,118,136,138,140,141]. ...
... General health information 11 [19,23,39,44,48,55,58,72,83,93,128] A specific disease / condition including its -symptoms -diagnosis -prognosis - To make health decisions, including whether to seek professional help 8 [19,38,53,68,72,95,117,128] To avoid going to a HC provider 1 [105] To make own diagnosis, prevent or cure or manage disease / condition or maintain health 9 [19,20,45,47,68,72,104,105,145] To verify/confirm/clarify or add to information received from another given source including: ...
Background
Making high-quality health and care information available to members of the general public is crucial to support populations with self-care and improve health outcomes. While attention has been paid to how the public accesses and uses health information generally (including personal records, commercial product information or reviews on healthcare practitioners and organisations) and how practitioners and policy-makers access health research evidence, no overview exists of the way that the public accesses and uses high quality health and care information.
Purpose
This scoping review aimed to map research evidence on how the public accesses and uses a specific type of health information, namely health research and information that does not include personal, product and organisational information.
Methods
Electronic database searches [CINAHL Plus, MEDLINE, PsycInfo, Social Sciences Full Text, Web of Science and SCOPUS] for English language studies of any research design published between 2010–2022 on the public’s access and use of health research or information (as defined above). Data extraction and analysis was informed by the Joanna Briggs Institute protocol for scoping reviews, and reported in accordance with the PRISMA extension for scoping reviews.
Results
The search identified 4410 records. Following screening of 234 full text studies, 130 studies were included. One-hundred-and-twenty-nine studies reported on the public’s sources of health-research or information; 56 reported the reasons for accessing health research or information and 14 reported on the use of this research and information. The scoping exercise identified a substantial literature on the broader concept of ‘health information’ but a lack of reporting of the general public’s access to and use of health research. It found that ‘traditional’ sources of information are still relevant alongside newer sources; knowledge of barriers to accessing information focused on personal barriers and on independent searching, while less attention had been paid to barriers to access through other people and settings, people’s lived experiences, and the cultural knowledge required.
Conclusions
The review identified areas where future primary and secondary research would enhance current understanding of how the public accesses and utilises health research or information, and contribute to emerging areas of research.
... Third, because data were collected in 2013-14, public opinion towards these policies could have changed. However, this study uses data from people of low SEP, groups whose data tend to be limited and inadequate in health organizations datasets (i.e., data absenteeism) (Lee and Viswanath, 2020;Viswanath et al., 2013). Despite these limitations, this study can help inform policymakers and public health officials about who they may target in communicating the advantages of supporting these types of population-based interventions and highlights the need to study people from low SEP. ...
People from low socioeconomic positions (SEP) are at a higher risk of smoking, face greater barriers to smoking cessation, and have lower access to health information. To improve tobacco-related health outcomes, policies requiring altering labeling on cigarette packs could be implemented. However, public support is needed to influence the policymaking process. We assessed factors associated with supporting tobacco-control communication policies. We analyzed data from Project CLEAR, a study conducted in Massachusetts. The analytic sample included participants who answered questions on their support for three policies: 1) graphic health warnings (GHWs), 2) Quitline number, and 3) smoking cessation information on cigarette packs (n = 357). Binomial logistic regression modeling was conducted by policy. Independent variables included demographic characteristics and smoking status. We found that younger vs. older individuals (aOR = 0.41, 95 %CI:0.23-0.72), males vs. females (aOR = 0.58, 95 %CI:0.35-0.96), and people who smoke vs. those who don't smoke (aOR = 0.41, 95 %CI:0.24-0.70) were less likely to support a law requiring GHWs. Participants with a low vs. higher level of education (aOR = 0.55, 95 %CI:0.32-0.95) were less likely to support a law requiring a Quitline number. Younger (18-39) vs. older individuals (aOR = 0.53, 95 %CI:0.29-0.94), males vs. females (aOR = 0.57, 95 %CI:0.34-0.96), and participants with a low vs. higher level of education (aOR = 0.56, 95 %CI:0.32-0.98) were less likely to support a law requiring cessation information on cigarette packs. Findings suggest that targeted theory-based public health and communication strategies should be developed to increase awareness and support towards policies that would help reduce cigarette smoking among people from low SEP to eliminate tobacco-related health inequities in the US.
... Beyond individual factors, external factors, such as individuals' social networks, the type of hospitals in the community, and community-based organizations (CBOs) play a crucial role in boosting health literacy [27][28][29][30][31][32]. Thus, it will be strategic to gain insights into CBOs and social networks of the underserved groups, as they would have the experience in identifying the type of interventions that would best suit the needs of the underserved populations and those that would simply not work [33,34]. Without the input of the community, designers of eHealth interventions may fall into the trap of having solutions in search of a problem [35] and forcing innovations that simply do not work in the community. ...
... Project C2C was a randomized controlled trial that aimed to improve eHealth literacy among people from lower socioeconomic positions (SEPs). To achieve the objective of empowering people from lower SEP groups by taking advantage of web-based health portals to seek information and gain health knowledge, we designed an intervention that involved the (1) development of a web-based health portal ( Figure 2) from scratch that was customized for novice or less experienced users to easily navigate and access the internet, specifically health information; (2) purchase and provision of computer and broadband internet access for the entire length of study; (3) training classes where participants were taught digital skills such as how to use computers and the internet; and (4) ongoing technical support if participants had any questions on the health web portal or connectivity issues [34]. The trial was conducted in three waves from 2007 to 2009, and for each wave, participants attended 9 monthly training classes at community colleges located in Boston. ...
Despite the proliferation of eHealth interventions, such as web portals, for health information dissemination or the use of mobile apps and wearables for health monitoring, research has shown that underserved groups do not benefit proportionately from these eHealth interventions. This is largely because of usability issues and the lack of attention to the broader structural, physical, and psychosocial barriers to technology adoption and use. The objective of this paper is to draw lessons from a decade of experience in designing different user-centered eHealth interventions (eg, web portals and health apps) to inform future work in leveraging technology to address health disparities. We draw these lessons from a series of interventions from the work we have done over 15 years in the Viswanath laboratory at the Dana-Farber Cancer Institute and Harvard TH Chan School of Public Health, focusing on three projects that used web portals and health apps targeted toward underserved groups. The projects were the following: Click to Connect, which was a community-based eHealth intervention that aimed to improve internet skills and health literacy among underserved groups by providing home access to high-speed internet, computer, and internet training classes, as well as a dedicated health web portal with ongoing technical support; PLANET MassCONECT, which was a knowledge translation project that built capacity among community-based organizations in Boston, Lawrence, and Worcester in Massachusetts to adopt evidence-based health promotion programs; and Smartphone App for Public Health, which was a mobile health research that facilitated both participatory (eg, surveys) and passive data (eg, geolocations and web-browsing behaviors) collection for the purpose of understanding tobacco message exposure in individuals’ built environment. Through our work, we distilled five key principles for researchers aiming to design eHealth interventions for underserved groups. They are as follows: develop a strategic road map to address communication inequalities (ie, a concrete action plan to identify the barriers faced by underserved groups and customize specific solutions to each of them), engage multiple stakeholders from the beginning for the long haul, design with usability—readability and navigability—in mind, build privacy safeguards into eHealth interventions and communicate privacy–utility tradeoffs in simplicity, and strive for an optimal balance between open science aspirations and protection of underserved groups.
... However, a swift pace of development in communication technologies-including text messaging, social media, smartphones, and artificial intelligence (AI) -has dramatically changed the landscape in which we can exchange our ideas with one another, express our needs in society, and utilize interventions to better meet our needs to control the growing cancer burden. While these technologies do enable us to become more interconnected than ever before, there exists a clear digital divide between those who have better access to information and communication resources, and those who do not [2,3]. The digital era presents us with new opportunities and challenges for cancer communication research, and the field of behavioral medicine is exceptionally well-poised to meet them. ...
Communicating risk and other health information in a clear, understandable, and actionable manner is critical for the prevention and control of cancer, as well as the care of affected individuals and their family members. However, the swift pace of development in communication technologies has dramatically changed the health communication landscape. This digital era presents new opportunities and challenges for cancer communication research and its impact on practice and policy. In this article, we examine the science of health communication focused on cancer and highlight important areas of research for the coming decade. Specifically, we discuss three domains in which cancer communication may occur: (a) among patients and their healthcare providers; (b) within and among families and social networks; and (c) across communities, populations, and the public more broadly. We underscore findings from the prior decade of cancer communication research, provide illustrative examples of future directions for cancer communication science, and conclude with considerations for diverse populations. Health informatics studies will be necessary to fully understand the growing and complex communication settings related to cancer: such works have the potential to change the face of information exchanges about cancer and elevate our collective discourse about this area as newer clinical and public health priorities emerge. Researchers from a wide array of specialties are interested in examining and improving cancer communication. These interdisciplinary perspectives can rapidly advance and help translate findings of cancer communication in the field of behavioral medicine.
... eHealth can exacerbate SHIs due to the digital divide [2]. The term digital divide evokes the separation between those who have access to technologies, such as computers, mobile phones, or the internet, and those with no such access, especially low-income individuals [3][4][5]. This concept also highlights the knowledge gap between users. ...
... These professionals included nurses, nursing assistants, client care attendants, home care workers, occupational therapists, physiotherapists, physicians, social workers, and psychologists. 4. Research team members: The research team of the QADA project initially consisted of 8 coresearchers, whose participation varied based on their availability and their expertise. ...
Background
eHealth can help reduce social health inequalities (SHIs); at the same time, it also has the potential to increase them. Several conversion factors can be integrated into the development of an eHealth tool to make it inclusive: (1) providing physical, technical, and financial access to eHealth; (2) enabling the integration of people at risk of SHIs into the research and development of digital projects targeting such populations (co-design or participatory research); (3) promoting consistency between the digital health literacy level of future users (FUs) and the eHealth tool; (4) developing an eHealth tool that is consistent with the technological skills of FUs; (5) ensuring that the eHealth tool is consistent with the help-seeking process of FUs; (6) respecting the learning capacities of FUs; and (7) being sensitive to FUs’ cultural context. However, only little empirical evidence pointing out how these conversion factors can be integrated into an effective eHealth tool is available.
Objective
On the basis of Amartya Sen’s theoretical framework of social justice, the objective of this study was to explore how these 7 conversion factors can be integrated into an eHealth tool for caregivers of functionally dependent older persons.
Methods
This study was based on a social justice design and participant observation as part of a large-scale research project funded by the Ministère de la Famille through the Quebec Ami des Aînés Program. Data were collected by recording the preparation sessions, the co-design and advisory committee sessions, as well as the debriefing sessions. The results were analyzed using Miles and Huberman’s method.
Results
A total of 78 co-designers participated in 11 co-design sessions, 24 preparation sessions, and 11 debriefing sessions. Of the 7 conversion factors, 5 could be explored in this experiment. The integration of conversion factors has been uneven. The participation of FUs in the development of the tool supports other conversion factors. Respecting the eHealth literacy level of FUs means that their learning abilities and technological skills are also respected because they are closely related to one another and are therefore practically difficult to be distinguished.
Conclusions
Conversion factors can be integrated into the development of eHealth tools that are intended to be inclusive and contribute to curbing SHIs by integrating FU participation into the tool design process.
... Digital Divide) zu nennen. Zum anderen können individuelle, soziale und kulturelle Barrieren, die beispielsweise die Selbstwirksamkeit, die Gesundheitskompetenz (Health Literacy) oder die kulturelle und sprachliche Angemessenheit betreffen, die Nutzung beeinträchtigen [30]. Daher gibt es trotz der zunehmenden Verbreitung des (auch mobilen) Internets immer noch Anzeichen für Ungleichheiten in drei Dimensionen: Zugang zu und Nutzung von Kommunikationsmedien, Verarbeitung von Gesundheitsinformationen und Auswirkungen auf das Gesundheitsverhalten [31]. ...
Digital Public Health verspricht neben einer umfänglicheren medizinischen Versorgung auch eine individuelle Gesundheitsförderung und Unterstützung für positive Veränderungen im Lebensstil. Mobilen digitalen Gesundheitsgeräten und -diensten, auch Mobile Health (M-Health) genannt, kommt dabei eine Schlüsselrolle zu. Sie umfassen gesundheitsspezifische Hardware- und Softwareapplikationen wie Smartphone-Apps und Wearables zur Aufzeichnung, Überwachung und Auswertung spezifischer Gesundheitsparameter. Obwohl es wissenschaftliche Nachweise für die Effektivität einzelner Anwendungen gibt, bleibt die praktische Nutzung meist von verhältnismäßig kurzer Dauer. Um eine höhere Akzeptanz- und Nutzungsrate zu erreichen, wird Evidenz benötigt, die stärker an der Praxis orientiert ist.
... Data absenteeism describes an ironic phenomenon of data scarcity in a data-rich society, where data from underprivileged groups are not represented-or severely underrepresented-in the databases of health organizations [13]. For instance, a study on the diversity and representation of racial groups across 51 biobanks in the United States found that compared with the US census, there were statistically significantly lower enrollment numbers for Hispanics and Latinos (US census: 18%; selected biobanks: 7%), as well as Hawaiian and Pacific Islanders (US census: 0.2%; selected biobanks: 0.01%) [14]. ...
... To alleviate these latent costs, researchers should be mindful to factor in an additional budget to reduce the connection maintenance costs borne by the underprivileged groups, such as covering their cell phone bills for health app interventions. For instance, in a study examining health information seeking habits among the underprivileged groups, the researchers conducted a randomized controlled trial to examine if provision of home computers, broadband internet access, training in computer use, and a Web portal designed for low-literacy populations would significantly improve internet use [13]. The results showed that participants in the intervention group (ie, those who received computers, internet access, computer training, and a Web portal) were more likely to use the internet compared with the control group. ...
Recent advances in the collection and processing of health data from multiple sources at scale—known as big data—have become appealing across public health domains. However, present discussions often do not thoroughly consider the implications of big data or health informatics in the context of continuing health disparities. The 2 key objectives of this paper were as follows: first, it introduced 2 main problems of health big data in the context of health disparities—data absenteeism (lack of representation from underprivileged groups) and data chauvinism (faith in the size of data without considerations for quality and contexts). Second, this paper suggested that health organizations should strive to go beyond the current fad and seek to understand and coordinate efforts across the surrounding societal-, organizational-, individual-, and data-level contexts in a realistic manner to leverage big data to address health disparities.
... Employing features of mobile phones that are unfamiliar may exclude populations from the benefit of these interventions and thereby worsen the "digital divide." The term "digital divide" describes disparities in technology use [3][4]. Adapting the 1 2 3 4 5 definition of health literacy from Selden et al., we propose the term mobile phone literacy to describe the ability to access, process, understand, and use the features on mobile phones (e.g., sending text messages, taking photos/videos, using apps) [5]. ...
Purpose:
Mobile health (mHealth) has promise to improve patient access to disease prevention and health promotion services; however, historically underserved populations may have poor access to mobile phones or may not be aware of or comfortable using phone features. Our objectives were to assess mobile phone ownership and mobile phone literacy among low-income, predominately racial and ethnic minority patients.
Materials and methods:
We conducted a cross-sectional survey of a convenience sample of primary care patients in a publicly-funded clinic in Houston, TX.
Results:
Of 285 participants, 240 owned a mobile phone and 129 owned a smartphone. The most common uses of phones were talk (89%) and text messaging (65%). Only 28% of smartphone owners had health apps. Younger age was significantly associated with smartphone ownership and use of smartphones for Internet browsing, social media, and apps.
Conclusion:
Our findings from a safety-net patient population represent trends in mobile phone ownership and literacy. Despite the single-site location of our study, the findings could be helpful to health promotion practitioners working with similar underserved populations. mHealth interventions should employ phone features that are accessible and familiar to the target audience to avoid denying intervention benefits to those with low mobile phone literacy and therefore widen health disparities.
... There are often barriers to gathering data on vulnerable groups in adequate numbers, and reaching them may require specialized strategies for their inclusion in adequate numbers to power subgroup analyses. First, members of so-called hard-to-reach groups, such as low SEP or homeless individuals, may not participate in, or be reached by, large-scale phone-or internetbased survey strategies due to lack of reliable connectivity to phone or internet (8). Second, members of certain groups may historically distrust research institutions, making them less likely to participate in health-related studies (9). ...
Background:
NCI-Designated Cancer Centers provide key cancer research, prevention, and treatment services to members of their catchment area. Characterization of these areas may be complex given the diverse needs of the populations within, particularly those from low socioeconomic position (SEP). The purpose of this paper is to describe the characterization of the Dana-Farber/Harvard Cancer Center (DF/HCC) catchment area through using a two-pronged approach.
Methods:
Participants (n = 1,511) were recruited through (i) an online, probability-based survey (n = 1,013) and (ii) a supplementary, in-person survey from priority groups (African Americans, Latinos, blue-collar workers, low SEP, homeless; n = 498) within Massachusetts. Study staff worked closely with community partners across the state to reach individuals who may not usually be included in online surveys.
Results:
There were several differences across samples, with the community-based sample having a higher percentage of low SEP, low education, African Americans, and Latinos compared with the online sample. Differences were also noted in the cancer-related behaviors of the samples, with the community-based sample having higher rates of smoking, particularly within those who were homeless or make less than $20,000 per year. Fewer community-based subgroups were current with cancer screenings, and more showed more indication of potential communication inequalities compared with statewide estimates.
Conclusions:
The sampling strategy used to characterization of the DF/HCC catchment area provided broad, statewide estimates and additional focus on vulnerable populations, highlighting several potential areas for intervention.
Impact:
This study provides data to highlight the value of using multiple sampling strategies when characterizing cancer center catchment areas.
... Lack of access as a barrier to technology uptake has been described in the academic literature [52][53][54] . It is possible that there is poor communication between GP surgeries and patients on what areas of the online system patients do have access to. ...
This mixed methods research uses data from a survey conducted in 2016 aimed at understanding which GP online services were actively being used, how easy it was access these services, and what were perceived to be the disadvantages of GP online services. The focus of this research is on the perceived disadvantages of GP online services presented in contrast with responses to the survey. The top five major themes discussed as perceived disadvantages were:
1. unmet expectations;
2. lack of access;
3. perceived irrelevance;
4. awareness; and
5. lack of social contact.
