JMIR Publications

ABSTRACT

Background:

Healthcare organizations are increasingly using patient portals and other web platforms to provide health information and advice (HIA) to their customers. However, there is limited information about willingness of middle-aged and older adults to use online HIA (eHIA) resources.

Objective:

The objective of this study was to examine prevalence and social determinants of Internet use, prior year use of online health information and advice resources, and interest in using online health information and advice and other digital modalities for obtaining health information and advice among middle-aged and older adults.

Methods:

The study used cross-sectional survey data for 10,920 adults aged 45-85 who responded to a mailed/online health survey conducted with Kaiser Permanente Northern California members 2014-2015. Bivariate analyses and logistic regression models with weighted data were used to study prevalence and factors associated with Internet use, past-year use of the health plan’s patient portal, past-year use of online resources for HIA, and interest in using eHIA modalities.

Results:

Access to digital technology is high, with over 90% having easy access to a computer, 61% owning a smartphone, and 86% being able to use the Internet on their own. The percentages of adults who went online, both with and without assistance, declined with age. Use of the patient portal and online HIA resources increased with levels of education and income. Interest in using web-based HIA modalities was lower among adults over the age of 70 and Hispanics and increased with level of education and income. Among the online middle-aged adults, the percentages that used or were interested in using online health resources were substantially lower than the percentages of adults who were online. Online adults were more likely to be White than Blacks, Hispanic, or Filipino, to be female, and to have higher levels of education and income. Among online adults, being female, age > 55 years and < 80 years, and having higher levels of education and income were significantly associated with being a patient portal user. Adults who had not completed high school were less likely than high school graduates to have used the portal, and Blacks, Hispanics, and other Asians were less likely than Whites to have used the portal. Interest in future use of web-based HIA resources was lower among online adults > age 75, and higher among those with post-secondary education and an income > $100,000, and lower among Hispanics as compared to Whites.

Conclusions:

Organizations serving older adults should consider user factors such as educational attainment, ability to go online without help, device access, and preferences when implementing eHIA resources. As healthcare is increasingly delivered remotely through online portals or digital formats, accessibility beyond just Internet access is needed to ensure healthcare equity. Clinical Trial: not applicable