Literacy disparities in patient access and health-related use of Internet and mobile technologies
Literacy disparities in patient access and health-related use of Internet and mobile technologies
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DOI：
10.1111/hex.12294
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发表时间：
2015-12-01
影响因子：
3.2
通讯作者：
Wolf, Michael S.
中科院分区：
文献类型：
--
作者：
Bailey, Stacy C.;O'Conor, Rachel;Wolf, Michael S.
背景技术使用中与年龄和种族相关的差异已被充分记录，但对健康素养如何影响技术的获取和使用知之甚少。目的评估患者的素养技能与移动的电话拥有率、短信使用、互联网接入、和使用互联网的健康相关的目的。方法二次分析利用数据从1077初级保健患者参加了两个，2011-2013年的多站点研究。结果与健康素养较低或较低的患者相比，健康素养较高的患者更有可能拥有移动的手机或智能手机（移动的手机拥有率：分别为96.8% vs. 95.2% vs. 90.1%，P < 0.001;智能手机拥有率：70.6 vs. 62.5 vs. 40.1%，P < 0.001）和报告短信（78.6 vs. 75.2 vs. 53.1%，P < 0.001）。他们也更有可能从家里上网（92.1 vs. 74.7 vs. 44.9%，P < 0.001），并使用互联网报告电子邮件（93.0vs. 75.7vs. 38.5%，P < 0.001），浏览网页（93.9vs.80.2vs.44.5%，P < 0.001），获取健康信息（86.3 vs. 75.5 vs. 40.8%，P < 0.001），与提供者沟通（54.2 vs. 29.8 vs. 13.0%，P < 0.001）。在多变量分析中，控制相关协变量的关系仍然显着。结论结果显示，识字相关的差距在技术的获取和使用是普遍的，识字率较低的患者不太可能拥有智能手机或访问和使用互联网，特别是出于健康原因。未来的干预措施应考虑到这些差距，并确保健康促进活动不会进一步加剧差距。
Background Age and race-related disparities in technology use have been well documented, but less is known about how health literacy influences technology access and use.Objective To assess the association between patients' literacy skills and mobile phone ownership, use of text messaging, Internet access, and use of the Internet for health-related purposes.Methods A secondary analysis utilizing data from 1077 primary care patients enrolled in two, multisite studies from 2011-2013. Patients were administered an in-person, structured interview.Results Patients with adequate health literacy were more likely to own a mobile phone or smartphone in comparison with patients having marginal or low literacy (mobile phone ownership: 96.8 vs. 95.2 vs. 90.1%, respectively, P < 0.001; smartphone ownership: 70.6 vs. 62.5 vs. 40.1%, P < 0.001) and to report text messaging (78.6 vs. 75.2 vs. 53.1%, P < 0.001). They were also more likely to have access to the Internet from their home (92.1 vs. 74.7 vs. 44.9%, P < 0.001) and to report using the Internet for email (93.0 vs. 75.7 vs. 38.5%, P < 0.001), browsing the web (93.9 vs. 80.2 vs. 44.5%, P < 0.001), accessing health information (86.3 vs. 75.5 vs. 40.8%, P < 0.001), and communicating with providers (54.2 vs. 29.8 vs. 13.0%, P < 0.001). Relationships remained significant in multivariable analyses controlling for relevant covariates.Conclusions Results reveal that literacy-related disparities in technology access and use are widespread, with lower literate patients being less likely to own smartphones or to access and use the Internet, particularly for health reasons. Future interventions should consider these disparities and ensure that health promotion activities do not further exacerbate disparities.