TY - JOUR
T1 - Differences in electronic personal health information tool use between rural and urban cancer patients in the United States
T2 - Secondary data analysis
AU - Greenberg-Worisek, Alexandra
AU - Ferede, Liaa
AU - Balls-Berry, Joyce
AU - Marigi, Ian
AU - Mendez, Emily Valentin
AU - Bajwa, Numra
AU - Ouk, Melody
AU - Orellana, Minerva
AU - Enders, Felicity
N1 - Funding Information:
HINTS is funded by the National Cancer Institute’s Division of Cancer Control and Population Sciences with contract support to Westat, Inc.
PY - 2020/7
Y1 - 2020/7
N2 - Background: Studies have previously shown that rural cancer patients are diagnosed at later stages of disease. This delay is felt throughout treatment and follow-up, reflected in the fact that rural patients often have poorer clinical outcomes compared with their urban counterparts. Objective: Few studies have explored whether there is a difference in cancer patients’ current use of health information technology tools by residential location. Methods: Data from 7 cycles of the Health Information National Trends Survey (HINTS, 2003-2017) were merged and analyzed to examine whether differences exist in managing electronic personal health information (ePHI) and emailing health care providers among rural and urban cancer patients. Geographic location was categorized using Rural-Urban Continuum Codes (RUCCs). Bivariate analyses and multivariable logistic regression were used to determine whether associations existed between rural/urban residency and use of health information technology among cancer patients. Results: Of the 3031 cancer patients/survivors who responded across the 7 cycles of HINTS, 797 (26.9%) resided in rural areas. No difference was found between rural and urban cancer patients in having managed ePHI in the past 12 months (OR 0.78, 95% CI 0.43-1.40). Rural cancer patients were significantly less likely to email health care providers than their urban counterparts (OR 0.52, 95% CI 0.32-0.84). Conclusions: The digital divide between rural and urban cancer residents does not extend to general ePHI management; however, electronic communication with providers is significantly lower among rural cancer patients than urban cancer patients. Further research is needed to determine whether such disparities extend to other health information technology tools that might benefit rural cancer patients as well as other chronic conditions.
AB - Background: Studies have previously shown that rural cancer patients are diagnosed at later stages of disease. This delay is felt throughout treatment and follow-up, reflected in the fact that rural patients often have poorer clinical outcomes compared with their urban counterparts. Objective: Few studies have explored whether there is a difference in cancer patients’ current use of health information technology tools by residential location. Methods: Data from 7 cycles of the Health Information National Trends Survey (HINTS, 2003-2017) were merged and analyzed to examine whether differences exist in managing electronic personal health information (ePHI) and emailing health care providers among rural and urban cancer patients. Geographic location was categorized using Rural-Urban Continuum Codes (RUCCs). Bivariate analyses and multivariable logistic regression were used to determine whether associations existed between rural/urban residency and use of health information technology among cancer patients. Results: Of the 3031 cancer patients/survivors who responded across the 7 cycles of HINTS, 797 (26.9%) resided in rural areas. No difference was found between rural and urban cancer patients in having managed ePHI in the past 12 months (OR 0.78, 95% CI 0.43-1.40). Rural cancer patients were significantly less likely to email health care providers than their urban counterparts (OR 0.52, 95% CI 0.32-0.84). Conclusions: The digital divide between rural and urban cancer residents does not extend to general ePHI management; however, electronic communication with providers is significantly lower among rural cancer patients than urban cancer patients. Further research is needed to determine whether such disparities extend to other health information technology tools that might benefit rural cancer patients as well as other chronic conditions.
KW - Cancer
KW - Digital divide
KW - Disparities
KW - Health research
KW - Patient engagement
UR - http://www.scopus.com/inward/record.url?scp=85097869808&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85097869808&partnerID=8YFLogxK
U2 - 10.2196/17352
DO - 10.2196/17352
M3 - Article
AN - SCOPUS:85097869808
VL - 6
JO - JMIR Cancer
JF - JMIR Cancer
SN - 2369-1999
IS - 2
M1 - e17352
ER -