Tracking Healthy People 2020 Internet, Broadband, and Mobile Device Access Goals: An Update Using Data From the Health Information National Trends Survey (Preprint)

BACKGROUND As the year 2020 approaches, there is a need to evaluate progress toward the United States government’s Healthy People 2020 (HP2020) health information technology and communication objectives to establish baselines upon which Healthy People 2030 objectives can be based. OBJECTIVE The aim of this study was to use the National Cancer Institute’s (NCI) Health Information National Trends Survey (HINTS) to benchmark progress toward HP2020 goals related to increasing internet access using broadband, and to assess the state of the digital divide for various sociodemographic groups. METHODS We merged and analyzed data from 8 administrations of HINTS (2003-2017). Descriptive statistics were generated, and predicted marginals were calculated using interaction terms between survey year and selected sociodemographic variables of interest, including age, sex, race and ethnicity, income, education, and geography (rural versus urban), to test for differential change over time. RESULTS The number of users having access to the internet increased between 2003 and 2014 (63.15% [3982/6358] to 83.41% [2802/3629]); it remained relatively steady from 2014 to 2017 (81.15% [2533/3283]). Broadband access increased between 2003 and 2011 (from 32.83% [1031/3352] to 77.87% [3375/4405]), but has been declining since (55.93% [1364/2487] in 2017). Access via cellular network increased between 2008 and 2017 (from 6.86% [240/4405] to 65.43% [1436/2489]). Statistically significant disparities in overall internet access were noted in the predicted marginals for age, sex, race and ethnicity, income, and education; for age, sex, income, and geography for broadband access; and for age and sex for cellular network. CONCLUSIONS The targets set forth in HP2020 were met for overall internet access and for internet access via cellular network; however, the target was not met for internet access via broadband. Furthermore, although the digital divide persisted by sociodemographic characteristics, the magnitude of many disparities in access decreased over time.

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Progress on Broadband Access to the Internet and Use of Mobile Devices in the United States

Public Health Reports ◽

10.1177/0033354916679365 ◽

2016 ◽

Vol 132 (1) ◽

pp. 27-31 ◽

Cited By ~ 11

Author(s):

Katrina J. Serrano ◽

Chan L. Thai ◽

Alexandra J. Greenberg ◽

Kelly D. Blake ◽

Richard P. Moser ◽

...

Keyword(s):

Health Information ◽

Mobile Devices ◽

Cellular Network ◽

The United States ◽

The Internet ◽

Broadband Access ◽

Improve Population Health ◽

The Us ◽

Healthy People 2020 ◽

National Trends

Healthy People 2020 (HP2020) aims to improve population health outcomes through several objectives, including health communication and health information technology. We used 7 administrations of the Health Information National Trends Survey to examine HP2020 goals toward access to the Internet through broadband and mobile devices (N = 34 080). We conducted descriptive analyses and obtained predicted marginals, also known as model-adjusted risks, to estimate the association between demographic characteristics and use of mobile devices. The HP2020 target (7.7% of the US population) for accessing the Internet through a cellular network was surpassed in 2014 (59.7%), but the HP2020 target (83.2%) for broadband access fell short (63.8%). Sex and age were associated with accessing the Internet through a cellular network throughout the years (Wald F test, P <.05). The increase in the percentage of people accessing the Internet through mobile devices presents an opportunity for technology-based health interventions that should be explored.

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Meeting the Healthy People 2020 Goals: Using the Health Information National Trends Survey to Monitor Progress on Health Communication Objectives

Journal of Health Communication ◽

10.1080/10810730.2014.954084 ◽

2014 ◽

Vol 19 (12) ◽

pp. 1497-1509 ◽

Cited By ~ 24

Author(s):

Bradford W. Hesse ◽

Anna Gaysynsky ◽

Allison Ottenbacher ◽

Richard P. Moser ◽

Kelly D. Blake ◽

...

Keyword(s):

Health Communication ◽

Health Information ◽

Healthy People ◽

Healthy People 2020 ◽

National Trends

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Tracking Healthy People 2020 Internet, Broadband, and Mobile Device Access Goals: An Update Using Data From the Health Information National Trends Survey

Journal of Medical Internet Research ◽

10.2196/13300 ◽

2019 ◽

Vol 21 (6) ◽

pp. e13300 ◽

Cited By ~ 14

Author(s):

Alexandra J Greenberg-Worisek ◽

Shaheen Kurani ◽

Lila J Finney Rutten ◽

Kelly D Blake ◽

Richard P Moser ◽

...

Keyword(s):

Health Information ◽

Mobile Device ◽

Healthy People ◽

Healthy People 2020 ◽

Using Data ◽

National Trends

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Online Health Information Seeking Among US Adults: Measuring Progress Toward a Healthy People 2020 Objective

Public Health Reports ◽

10.1177/0033354919874074 ◽

2019 ◽

Vol 134 (6) ◽

pp. 617-625 ◽

Cited By ~ 11

Author(s):

Lila J. Finney Rutten ◽

Kelly D. Blake ◽

Alexandra J. Greenberg-Worisek ◽

Summer V. Allen ◽

Richard P. Moser ◽

...

Keyword(s):

Health Information ◽

Information Source ◽

Healthy People ◽

Easy Access ◽

The Internet ◽

Online Health Information ◽

Multivariable Logistic Regression Analysis ◽

Annual Household Income ◽

Healthy People 2020 ◽

Race Ethnicity

Objective: During the past decade, the availability of health information online has increased dramatically. We assessed progress toward the Healthy People 2020 (HP2020) health communication and health information technology objective of increasing the proportion of health information seekers who easily access health information online. Methods: We used data from 4 administrations of the Health Information National Trends Survey (HINTS 2008-2017) (N = 18 103). We conducted multivariable logistic regression analysis to evaluate trends over time in experiences with accessing health information and to examine differences by sociodemographic variables (sex, age, race/ethnicity, education, income, metropolitan status) separately for those who used the internet (vs other information sources) during their most recent search for health information. Results: Among US adults who looked for health information and used the internet for their most recent search, the percentage who reported accessing health information without frustration was stable during the study period (from 37.2% in 2008 to 38.5% in 2017). Accessing information online without frustration was significantly and independently associated with age 35-49 (vs age 18-34) (odds ratio [OR] = 1.34; 95% confidence interval [CI], 1.03 -1.73), non-Hispanic black (vs non-Hispanic white) race/ethnicity (OR = 2.15; 95% CI, 1.55-2.97), and annual household income <$20 000 (vs >$75 000) (OR = 0.66; 95% CI, 0.47-0.93). The percentage of adults who used an information source other than the internet and reported accessing health information online without frustration ranged from 31.3% in 2008 to 42.7% in 2017. Survey year 2017 (vs 2008) (OR = 1.61; 95% CI, 1.09-2.35) and high school graduate education (vs college graduate) (OR = 0.69; 95% CI, 0.49-0.97) were significantly and independently associated with accessing health information without frustration from sources other than the internet. Conclusions: The percentage of online health information seekers reporting easily accessing health information did not meet the HP2020 objective. Continued efforts are needed to enable easy access to online health information among diverse populations.

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Digital Knowledge Management Artifacts and the Growing Digital Divide

Encyclopedia of Information Science and Technology, Second Edition ◽

10.4018/978-1-60566-026-4.ch180 ◽

2011 ◽

pp. 1133-1141

Author(s):

Ioannis Tarnanas ◽

Vassilios Kikis

Keyword(s):

World Wide Web ◽

Digital Divide ◽

Internet Use ◽

World Wide ◽

Internet Access ◽

College Freshman ◽

The Internet ◽

The World ◽

E Mail ◽

Over Time

That portion of the Internet known as the World Wide Web has been riding an exponential growth curve since 1994 (Network Wizards, 1999; Rutkowski, 1998), coinciding with the introduction of NCSA’s graphically based software interface Mosaic for “browsing” the World Wide Web (Hoffman, Novak, & Chatterjee 1995). Currently, over 43 million hosts are connected to the Internet worldwide (Network Wizards, 1999). In terms of individual users, somewhere between 40 to 80 million adults (eStats, 1999) in the United States alone have access to around 800 million unique pages of content (Lawrence & Giles, 1999), globally distributed on arguably one of the most important communication innovations in history. Yet even as the Internet races ambitiously toward critical mass, some social scientists have begun to examine carefully the policy implications of current demographic patterns of Internet access and usage (Hoffman & Novak, 1998; Hoffman, Kalsbeek, & Novak, 1996; Hoffman, Novak, & Venkatesh, 1997; Katz & Aspden, 1997; Wilhelm, 1998). Looming large is the concern that the Internet may not scale economically (Keller, 1996), leading to what Lloyd Morrisett, the former president of the Markle Foundation, has called a “digital divide” between the information “haves” and “have-nots.” For example, although almost 70% of the schools in this country have at least one computer connected to the Internet, less than 15% of classrooms have Internet access (Harmon, 1997). Not surprisingly, access is not distributed randomly, but correlated strongly with income and education (Coley, Cradler, & Engel 1997). A recent study of Internet use among college freshman (Sax, Astin, Korn, & Mahoney 1998) found that nearly 83% of all new college students report using the Internet for school work, and almost two-thirds use e-mail to communicate. Yet, closer examination suggests a disturbing disparity in access. While 90.2% of private college freshman use the Internet for research, only 77.6% of students entering public black colleges report doing so. Similarly, although 80.1% of private college freshman use e-mail regularly, only 41.4% of students attending black public colleges do. Further, although numerous studies (e.g., CyberAtlas, 1999; Maraganore & Morrisette, 1998) suggest that the gender gap in Internet use appears to be closing over time and that Internet users are increasingly coming from the ranks of those with lower education and income (Pew Research Center, 1998), the perception persists that the gap for race is not decreasing (Abrams, 1997). We now raise a series of points for further discussion. We believe these issues represent the most pressing unanswered questions concerning access and the impact of the digital divide on the emerging digital economy. This article is intended to stimulate discussion among scholars and policymakers interested in how differences in Internet access and use among different segments in our society affect their ability to participate and reap the rewards of that participation in the emerging digital economy. In summary, we have reviewed the most recent research investigating the relationship of race to Internet access and usage over time. Our objective is twofold: (1) to stimulate an informed discussion among scholars and policymakers interested in the issue of diversity on the Internet, and 2) to propose a research agenda that can address the many questions raised by this and related research.

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Public use of electronic personal health information: Measuring progress of the Healthy People 2020 objectives

Health Policy and Technology ◽

10.1016/j.hlpt.2016.08.003 ◽

2017 ◽

Vol 6 (1) ◽

pp. 33-39 ◽

Cited By ~ 6

Author(s):

Alexandra J. Greenberg ◽

Katrina J. Serrano ◽

Chan L. Thai ◽

Kelly D. Blake ◽

Richard P. Moser ◽

...

Keyword(s):

Health Information ◽

Healthy People ◽

Personal Health Information ◽

Personal Health ◽

Information Measuring ◽

Healthy People 2020

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Indoor Tanning Trends Among US Adults, 2007–2018

American Journal of Public Health ◽

10.2105/ajph.2020.305605 ◽

2020 ◽

Vol 110 (6) ◽

pp. 823-828 ◽

Cited By ~ 2

Author(s):

Jennifer M. Bowers ◽

Alan C. Geller ◽

Elizabeth Schofield ◽

Yuelin Li ◽

Jennifer L. Hay

Keyword(s):

United States ◽

Young Adults ◽

Health Information ◽

The United States ◽

Indoor Tanning ◽

The Past ◽

National Trends ◽

Mailed Survey ◽

Over Time

Objectives. To examine indoor tanning trends among US adults, and the relation to indoor tanning youth access legislation. Methods. This study analyzed the Health Information National Trends Survey (HINTS), a mailed survey, from the years 2007, 2011, 2013, 2014, 2017, and 2018 (combined n = 20 2019). Results. Indoor tanning prevalence decreased significantly over time among all US adults from 2007 (10%) to 2018 (4%; P < .001), among young adults aged 18 to 34 years (14% to 4%; P < .001), and among both women (14% to 4%; P < .001) and men (5% to 4%; P < .05). Indoor tanning significantly decreased in states that enacted youth access legislation by 2018, but did not significantly decrease for other states. Frequent indoor tanning was common in 2018; about one quarter of respondents who reported any indoor tanning did so 25 times or more in the past year. Conclusions. This study identifies several challenges in continuing to reduce indoor tanning in the United States. Youth access legislation may be effective for reducing tanning among the broader population of tanners; however, there remains a need for focus on highly frequent tanners, as well as men.

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Access Across the Digital Divide for Intersectional Groups Seeking Online Health Information: A National Survey (Preprint)

10.2196/preprints.32678 ◽

2021 ◽

Author(s):

Kristina Medero ◽

Kelly Merrill Jr. ◽

Morgan Quinn Ross

Keyword(s):

Digital Divide ◽

Health Information ◽

Ethnic Groups ◽

Sex Education ◽

Minority Groups ◽

Internet Access ◽

Home Computer ◽

Black African ◽

Mobile Access ◽

Health Need

BACKGROUND The digital divide refers to technological disparities based on demographic characteristics (e.g., race and ethnicity). Specifically, the lack of physical access to the Internet inhibits online health information seeking (OHIS) and exacerbates health disparities. Digital divide literature has adopted a multi-dimensional conceptualization of access by examining device and context of use, whereas OHIS literature has explored how intersectional identities influence OHIS. We combine these perspectives to explicate how unique context-device pairings operate differently across intersectional identities – particularly racial and ethnic groups – in the domain of OHIS. OBJECTIVE This study examines how different types of internet access relate to OHIS for different racial and ethnic groups. We investigate relationships between predisposing characteristics (i.e., age, sex, education, income), internet access (home-computer, public-computer, work-computer, and mobile), health need, and OHIS. METHODS Using data from the 2019 Health Information National Trends Survey (HINTS), participant responses (N = 5,247) were analyzed using structural equation modeling (SEM) of a theoretical model of OHIS to explicate the roles of internet access and health need for racial and ethnic minority groups’ OHIS. Three separate group SEM models were specified based on Black/African American, Latino/a/x or Hispanic, and White self-categorizations. RESULTS In general, predisposing characteristics (i.e., age, sex, education, income) were associated with internet access, health need, and OHIS, internet access was associated with OHIS, and health need was associated with OHIS. In exploring our research questions, we disaggregated internet access and found that home-computer and mobile access were most consistently associated with OHIS. When disaggregating by racial and ethnic minority groups, we found several notable linkages between predisposing characteristics and internet access that differed for Black/African American and Latino/a/x or Hispanic individuals. Older racial and ethnic minorities tended to access the Internet on home and public computers less frequently, home-computer access was a stronger predictor of OHIS for White individuals, and mobile access was a stronger predictor of OHIS for non-White individuals. CONCLUSIONS Our findings necessitate a deeper unpacking of how physical internet access, the foundational and multifaceted level of the digital divide, impacts specific racial and ethnic groups and their OHIS. We find support for prior work on the digital divide, but also surface new insights, including distinct impacts of context-device pairings for OHIS and several relationships that differ between racial and ethnic groups. As such, we propose interventions with an intersectional approach to access to ameliorate the impact of the digital divide.

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