The digital divide among low-income homebound older adults: Internet use patterns, eHealth literacy, and attitudes toward computer/Internet use.
The digital divide among low-income homebound older adults: Internet use patterns, eHealth literacy, and attitudes toward computer/Internet use.
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DOI：
10.2196/jmir.2645
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发表时间：
2013-05-02
影响因子：
7.4
通讯作者：
Dinitto DM
中科院分区：
文献类型：
--
作者：
Choi NG;Dinitto DM
互联网技术可以为低收入残疾人和居家老年人提供多样化的在线资源，以管理他们的健康和心理健康问题并维持社会联系。尽管之前有许多关于老年人互联网使用情况的研究，但没有一项研究关注这些最脆弱的老年人。这项研究调查了 60 岁及以上低收入居家人士与年轻同龄人（60 岁以下居家成年人）的互联网使用模式、停止使用的原因、电子健康素养以及对计算机/互联网使用的态度。对德克萨斯州中部 980 名送餐上门的接受者进行了面对面或电话调查（78% 为 60 岁及以上，22% 为 60 岁以下）。使用电子健康素养量表 (eHEALS) 以及对计算机/互联网态度问卷 (ATC/IQ) 的功效和兴趣分量表来衡量各自的结构。年龄组的比较采用卡方检验和 t 检验。使用多项逻辑回归分析互联网使用的相关性，并使用 OLS 回归模型分析 eHEALS 和 ATC/IQ 评分的相关性。目前，只有 34% 的 60 岁以下群体和 17% 的 60 岁及以上群体使用互联网，并且各群体成员中有 35% 和 16% 表示由于费用和残疾而停止使用互联网。除了年龄较大之外，从未使用过的人更有可能是黑人（OR 4.41；95% CI 2.82-6.91，P<.001）或西班牙裔（OR 4.69；95% CI 2.61-8.44，P<.001），并且收入较低（OR 0.36；95% CI 0.27-0.49， P<.001)。停止使用的用户也更有可能是黑人或西班牙裔，且收入较低。在这两个年龄段中，大约四分之三的当前用户每天或每隔几天使用互联网，他们的 eHEALS 分数与年龄呈负相关，与使用频率呈正相关。在 60 岁及以上人群中，抑郁症诊断也与 eHEALS 评分呈负相关。在所有年龄段的从未使用过的人和老年人中，ATC/IQ 的功效与独居、收入和医疗状况的数量呈正相关，与年龄、西班牙裔和西班牙语作为主要语言呈负相关。尽管老年人对 ATC/IQ 的兴趣也与年龄成反比，但与西班牙裔和西班牙语作为主要语言无关。这项研究首次详细描述了低收入残疾人、居家成年人和老年人的互联网使用情况。与美国人口相比，互联网使用率非常低，这要么是由于缺乏接触计算机/互联网技术的原因；要么是由于缺乏对计算机/互联网技术的接触；缺乏获得计算机和技术的财政资源；或限制使用的医疗状况、残疾和相关疼痛。提供了缩小这些人之间数字鸿沟的建议。
Internet technology can provide a diverse array of online resources for low-income disabled and homebound older adults to manage their health and mental health problems and maintain social connections. Despite many previous studies of older adults’ Internet use, none focused on these most vulnerable older adults. This study examined Internet use patterns, reasons for discontinued use, eHealth literacy, and attitudes toward computer/Internet use among low-income homebound individuals aged 60 and older in comparison to their younger counterparts—homebound adults under age 60. Face-to-face or telephone surveys were conducted with 980 recipients of home-delivered meals in central Texas (78% were age 60 years and older and 22% under age 60). The eHealth Literacy Scale (eHEALS) and the efficacy and interest subscales of the Attitudes Toward Computer/Internet Questionnaire (ATC/IQ) were used to measure the respective constructs. Age groups were compared with chi-square tests and t tests. Correlates of Internet use were analyzed with multinomial logistic regression, and correlates of eHEALS and ATC/IQ scores were analyzed with OLS regression models. Only 34% of the under-60 group and 17% of the 60 years and older group currently used the Internet, and 35% and 16% of the respective group members reported discontinuing Internet use due to cost and disability. In addition to being older, never users were more likely to be black (OR 4.41; 95% CI 2.82-6.91, P<.001) or Hispanic (OR 4.69; 95% CI 2.61-8.44, P<.001), and to have lower incomes (OR 0.36; 95% CI 0.27-0.49, P<.001). Discontinued users were also more likely to be black or Hispanic and to have lower incomes. Among both age groups, approximately three-fourths of the current users used the Internet every day or every few days, and their eHEALS scores were negatively associated with age and positively associated with frequency of use. Among the 60 and older group, a depression diagnosis was also negatively associated with eHEALS scores. ATC/IQ efficacy among never users of all ages and among older adults was positively associated with living alone, income, and the number of medical conditions and inversely associated with age, Hispanic ethnicity, and Spanish as the primary language. Although ATC/IQ interest among older adults was also inversely associated with age, it was not associated with Hispanic ethnicity and Spanish as the primary language. This study is the first to describe in detail low-income disabled and homebound adults’ and older adults’ Internet use. It shows very low rates of Internet use compared to the US population, either due to lack of exposure to computer/Internet technology; lack of financial resources to obtain computers and technology; or medical conditions, disabilities, and associated pain that restrict use. Recommendations to reduce the digital divide among these individuals are provided.
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