Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 26, 2024
Date Accepted: May 1, 2025
Measuring reliable internet connectivity among families seeking pediatric digital healthcare: a US national survey
ABSTRACT
Background:
Internet connectivity is crucial for family participation in pediatric digital healthcare, including telehealth. Lack of reliable internet connectivity is a barrier to pediatric telehealth access. There is limited knowledge on the national prevalence of reliable internet connectivity among diverse households with children.
Objective:
We examined the prevalence of reliable internet connectivity among US households with children, and its association with digital technology access and sociodemographic factors.
Methods:
We performed a secondary data analysis of a US national cross-sectional survey examining parents' health-seeking decisions for children <18 years old. This analysis focused on survey items related to reliable internet connectivity, digital technology access (internet plan use and device ownership), and sociodemographic characteristics (education, employment, geographic region, race and ethnicity, and disability) of parent respondents and their child. Unadjusted Rao-Scott chi-square tests and adjusted multivariable logistic regressions with sampling weights were applied.
Results:
About 81% of parent respondents (n=1,158) experienced reliable internet connectivity in the household. In adjusted analysis, reliable internet connectivity was significantly associated with owning both non-mobile and mobile internet plans combined (86%) vs. non-mobile internet plan-only (67%); postgraduate education (94%) vs. high school (75%); employment (84%) vs. unemployment (76%); racial and ethnic marginalized status (77%) vs. non-marginalized (85%); and disability (70%) vs. without disability (85%), but not with device ownership, geographic region, race and ethnicity as separate groups, or parent gender.
Conclusions:
One-fifth of families with children experienced unreliable internet connectivity, highlighting an important dimension of the digital health divide that appears distinct from internet plan use or device ownership. Because reliable internet connectivity is needed for the growing field of digital healthcare, this is a critical issue for equitable pediatric healthcare access and delivery.
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