Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 8, 2025
Date Accepted: Sep 11, 2025
Regional Disparities in the Utilization and Demand for Digital Health Services for Autism Spectrum Disorder in China: A Cross-sectional Survey of Stakeholder Perspectives
ABSTRACT
Background:
Digital health technologies offer promising solutions for improving screening, diagnosis, and rehabilitation for children with autism spectrum disorder (ASD), particularly in resource-limited settings. However, the adoption of these technologies in China remains underexplored.
Objective:
This study aimed to assess the current utilization, influencing factors, and perceived needs of digital health services among parents of children with ASD and rehabilitation therapists in two distinct provinces in China.
Methods:
A cross-sectional survey was conducted between November 2023 and February 2024 across Heilongjiang and Fujian provinces. A total of 780 parents and 745 rehabilitation therapists completed a structured questionnaire. Data were analyzed using descriptive statistics and multivariable logistic regression.
Results:
The utilization of digital health services was low among parents (5.9%) and therapists (21.6%), whereas the demand was substantially higher (79.6% and 90.0%, respectively). Parental utilization was positively associated with younger age, employment, lower income, longer caregiving duration, and delayed ASD diagnosis. Therapists with male gender, higher education, and autism-specific training reported higher usage. Demand was significantly greater in Fujian than in Heilongjiang across both groups (P = 0.031). Key benefits included enhanced understanding of ASD behavior and improved access to training resources. Cost, limited functionality, and technological complexity were the primary barriers identified. Smartphone-Wechat mini-program were the preferred platforms. Parents prioritized access to rehabilitation content and policy guidance, while therapists favored personalized plans and professional development tools.
Conclusions:
Despite strong demand, digital health services remain underutilized in ASD care across China. Regional disparities and socio-demographic factors influence adoption. To promote equitable access, strategies should prioritize digital literacy, affordability, and localized implementation, particularly in underserved regions.
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