JMIR Publications

ABSTRACT

Background:

The use of digital technology in pediatric asthma management has emerged as a potential tool for improving asthma management. However, the use of these tools has the potential to contribute to the inequitable delivery of asthma care because of existing social factors associated with asthma disparities. Our study focused on parent language and sociodemographic factors that might shape the use of digital technology in asthma self-management.

Objective:

To estimate and compare patient, family, and technology-related characteristics by parent language (English or Spanish) and compare a digital literacy measure by sociodemographic factors

Methods:

Survey data were collected July to December 2021 in a pediatric pulmonary clinic of patients with asthma. Questions assessed patient and family characteristics, digital technology use, and digital literacy, measured using the validated eHealth literacy scale (eHEALS). Chi-squared tests and multivariable logistic regression were used for comparisons, and Kruskal-Wallis tests were used for comparing median eHEALS scores by social characteristics.

Results:

Of the 197 parents surveyed, 38.6% of parents identified as Black, 24.4% as a race categorized as Other, and 37.1% as White; 47.2% identified as Hispanic/Latinx. Also, 79.7% of parents preferred English and 20.3% of parents preferred Spanish. English-speaking parents were more likely to report having a data plan for their smartphone (74.5%) or high-speed internet (87.9%), compared to Spanish-speaking parents (57.5% smartphone, p= 0.03; 67.5% internet, p=.002). Compared with Spanish-speaking caregivers, English-speaking parents were less likely to report having a lot or some concern paying for internet (70.0% v 52.9%, p=0.046) or about data privacy (87.5% vs 67.5%, p=0.01). Digital literacy scores differed significantly by race, income, education level, and language. In a multivariable model, language was not a significant factor for having high speed internet service (p=0.12) or concern about paying for internet at home (p=0.6); but it was significant for concerns about data privacy (p=0.04).

Conclusions:

The significant differences in technology-related characteristics suggest that digital connectivity, affordability, and data privacy may also be important factors in considering digital technology use in asthma care.