JMIR Publications

ABSTRACT

Background:

Telehealth use expanded rapidly during the COVID‑19 pandemic, yet persistent digital inequities continue to shape who benefits from virtual and preventive health services. Community‑based digital inclusion programs address access gaps, but less is known about how device reliability, broadband conditions, and attitudes toward online health information influence health care utilization after access is provided.

Objective:

This study examined associations between digital attitudes, infrastructure conditions, and health care utilization—including telehealth use and preventive health care visits—among participants in a community‑based laptop distribution program.I analyzed cross‑sectional survey data from adults who received a refurbished laptop through a library‑led digital inclusion initiative in a large urban county. Ordered logistic regression models estimated predictors of telehealth use frequency and changes in preventive health care visits, adjusting for sociodemographic characteristics, digital access conditions, and health information attitudes.

Methods:

I analyzed cross‑sectional survey data from adults who received a refurbished laptop through a library‑led digital inclusion initiative in a large urban county. Ordered logistic regression models estimated predictors of telehealth use frequency and changes in preventive health care visits, adjusting for sociodemographic characteristics, digital access conditions, and health information attitudes.

Results:

Approximately 27% of participants reported increased preventive health care visits following receipt of a laptop, and over 60% reported using telehealth sometimes or often. Increased preventive care was associated with having a functioning device and with the combined presence of fast and affordable broadband. Telehealth use was more frequent among participants who perceived online health information as improving health and less frequent among those reporting poor health care experiences. Race, gender, and their interaction were not significant predictors after accounting for digital access conditions.

Conclusions:

Findings suggest that digital access alone is insufficient to support health care engagement. Device reliability, broadband quality and affordability, and perceived usefulness of online health information are key factors shaping telehealth and preventive care use. Public health informatics–informed digital inclusion initiatives should address infrastructure and information environments alongside access to promote equitable health service utilization.