Internet-Based Developmental Screening: A Digital Divide Between English- and Spanish-Speaking Parents
Internet-Based Developmental Screening: A Digital Divide Between English- and Spanish-Speaking Parents
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DOI：
10.1542/peds.2010-0111
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发表时间：
2011-10-01
期刊：
影响因子：
8
通讯作者：
Bergman, David Aaron
中科院分区：
文献类型：
--
作者：
Hambidge, Simon J.;Phibbs, Stephanie;Bergman, David Aaron
背景：基于互联网的发育筛查正在全美的儿科实践中实施。我们对这项技术在城市贫困人口中的应用知之甚少。目的：我们描述了焦点小组、调查和家访期间对由城市安全网组织服务的家庭的深入访谈的结果，以解决在一个以西班牙裔为主、社会经济地位较低且有许多非英语家庭的人口中，是否有可能使用互联网或电子邮件通信进行就诊前参与的问题。方法：这项研究包括安全网卫生保健系统中4个诊所的家庭。研究设计包括(1)对其子女在诊所接受初级保健的父母进行方便抽样的父母调查(n=200)，(2)与父母的焦点小组(n=7组)，以及(3)在家访期间对4个家庭进行深入访谈。我们使用chi(2)和多变量分析来比较说英语和说西班牙语的家庭的互联网接入情况。结果：在多变量分析中，与计算机使用相关的独立因素是英语和西班牙语(优势比：3.2[95%可信区间：1.4-6.9])和至少高中教育(优势比：4.7[95%可信区间：2.3-9.7])。在焦点小组中，父母探视前工作的概念，如发育筛查测试，受到所有小组的好评。然而，许多家长对使用互联网或电子邮件进行这项工作持保留态度，并表示倾向于使用纸质或电话方式。许多说西班牙语的家庭讨论了缺乏电脑和打印机的问题。结论：在这个经济困难的人口中，语言和母亲教育与互联网的接入有关。鉴于访问前工作的潜在力量，即根据个别家庭的需要量身定做健康儿童访问，应为没有可靠互联网接入的人群探索使用互联网的替代战略。儿科2011；128：e939-e946
BACKGROUND: Internet-based developmental screening is being implemented in pediatric practices across the United States. Little is known about the application of this technology in poor urban populations.OBJECTIVE: We describe here the results of focus groups, surveys, and in-depth interviews during home visits with families served by an urban safety-net organization to address the question of whether it is possible to use Internet or e-mail communication for medical previsit engagement in a population that is majority Hispanic, of low socioeconomic status, and has many non-English-speaking families.METHODS: This study included families in 4 clinics within a safety-net health care system. The study design included the use of (1) parental surveys (n = 200) of a convenience sample of parents whose children received primary care in the clinics, (2) focus groups (n = 7 groups) with parents, and (3) in-depth interviews during home visits with 4 families. We used chi(2) and multivariate analyses to compare Internet access in English-and Spanish-speaking families. Standard qualitative methods were used to code focus-group texts and identify convergent themes.RESULTS: In multivariate analysis, independent factors associated with computer use were English versus Spanish language (odds ratio: 3.2 [95% confidence interval: 1.4-6.9]) and education through at least high school (odds ratio: 4.7 [95% confidence interval: 2.3-9.7]). In focus groups, the concept of parental previsit work, such as developmental screening tests, was viewed favorably by all groups. However, many parents expressed reservations about doing this work by using the Internet or e-mail and stated a preference for either paper or telephone options. Many Spanish-speaking families discussed lack of access to computers and printers.CONCLUSIONS: In this economically disadvantaged population, language and maternal education were associated with access to the Internet. Given the potential power of previsit work to tailor well-child visits to the needs of individual families, alternative strategies to using the Internet should be explored for populations without reliable Internet access. Pediatrics 2011;128:e939-e946