Open AccessLiteracy disparities in patient access and health‐related use of I nternet and mobile technologies
Author(s) -
Bailey Stacy C.,
O'Conor Rachel,
Bojarski Elizabeth A.,
Mullen Rebecca,
Patzer Rachel E.,
Vicencio Daniel,
Jacobson Kara L.,
Parker Ruth M.,
Wolf Michael S.
Publication year - 2015
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/hex.12294
Subject(s) - mobile phone , health literacy , medicine , literacy , the internet , phone , health equity , internet access , african american , family medicine , health care , psychology , public health , world wide web , nursing , computer science , political science , telecommunications , pedagogy , linguistics , philosophy , law , ethnology , history
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, I nternet access, and use of the I nternet 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.