Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 22, 2020
Date Accepted: Apr 6, 2021
Date Submitted to PubMed: Aug 16, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Health Information Technology Use among Patients with Self-Reported Atherosclerotic Cardiovascular Disease: Evidence from the 2011-2018 National Health Interview Survey
ABSTRACT
Background:
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide. Health-Information Technologies (HIT) have recently emerged as a viable intervention to mitigate the burden of ASCVD. At least 60% of United States (US) adults report searching the internet for health information; however, previous research has not examined the prevalence of general technology or HIT use between adults with and without ASCVD. In addition, social determinants in HIT use among adults with ASCVD are not well understood.
Objective:
To evaluate the prevalence and social determinants of HIT use among U.S. adults with vs without self-reported ASCVD.
Methods:
We pooled cross-sectional data from the 2011-2018 National Health Interview Survey (NHIS) to examine general technology and HIT use between adults aged ≥18 years with and without self-reported ASCVD (coronary heart disease and/or stroke). General technology use was defined as mobile phone ownership, Internet use, and computer use. HIT use was defined as looking up health information on the Internet, filling a prescription online, scheduling a medical appointment on the Internet, communicating with a healthcare provider by email, or using online group chats to learn about health topics. We evaluated sociodemographic differences in HIT use among respondents using Poisson regression. Analyses were weighted according to NHIS standards.
Results:
A total sample of N=256,534 individuals were included, 2,194 (0.9%) reported prior ASCVD. Among adults with prior ASCVD, the mean (±SD) age was 70.6 (11.5) years, and 47% were female. General technology use differed between participants with and without prior ASCVD, with 36% (657/1,826) and 76% (162,500/213,816) indicating internet usage and 25% (394/1,575) and 61% (112,580/184,557) indicating using a computer every day, respectively. Similarly, adults with ASCVD were less likely to use HIT use than those without ASCVD (25% vs. 51%, p<0.001). Among adults with prior ASCVD, social determinants that were associated with HIT use included younger age, higher education, higher income, being employed, and being married.
Conclusions:
HIT use was low among adults with a history of ASCVD, which may represent a barrier to delivering care via emerging HIT. Given the associations with social determinants such as income, education and employment, targeted strategies and policies are needed to eliminate barriers to impact HIT usage. Clinical Trial: N/A
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