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      Sources of Health Information, Technology Access, and Use Among Non–English-Speaking Immigrant Women: Descriptive Correlational Study

      research-article
      , MSN, RN 1 , , BSN, RN 1 , , PhD, RN, FAAN 1 , 2 ,
      (Reviewer), (Reviewer)
      Journal of Medical Internet Research
      JMIR Publications
      technology use, internet, text messaging, health literacy, English proficiency, immigrant, health disparities, Korean American, women, mobile phone

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          Abstract

          Background

          As the world is becoming increasingly connected by the World Wide Web, the internet is becoming the main source of health information. With the novel COVID-19 pandemic, ubiquitous use of the internet has changed the daily lives of individuals, from working from home to seeking and meeting with health care providers through web-based sites. Such heavy reliance on internet-based technologies raises concerns regarding the accessibility of the internet for minority populations who are likely to already face barriers when seeking health information.

          Objective

          This study aims to examine the level of technology access and common modes of technology used by Korean American women and to investigate how key psychosocial determinants of health such as age, education, English proficiency, and health literacy are correlated with sources of health information used by Korean American women and by their use of the internet.

          Methods

          We used data from a subsample of Korean American women (N=157) who participated in a community-based randomized trial designed to test a health literacy–focused cancer screening intervention. In addition to descriptive statistics to summarize Korean American women’s internet access and common modes of technology use, we conducted backward stepwise logistic regression analyses to substantiate the association between the psychosocial determinants of health and internet use.

          Results

          Approximately two-thirds (103/157, 65.6%) of the sample had access to the internet, and nearly all had access to a mobile phone. The internet was the most commonly used channel to obtain health information 63% (99/157), and 70% (110/157) of the sample used text messaging. Nevertheless, only approximately 38.8% (40/103) of the sample were very confident in using the internet, and only 29.9% (47/157) were very confident in using text messaging. Multivariate analyses revealed that older age (>50 years) was associated with 79% lower odds of using the internet to seek health information (adjusted odds ratio [AOR] 0.21, 95% CI 0.10-0.46). The higher health literacy group (19+ on Rapid Estimate of Adult Literacy in Medicine) had 56% lower odds of using the internet to acquire health information (AOR 0.44, 95% CI 1.13-11.18). Higher education (college+) was associated with both internet use (AOR 4.42, 95% CI 1.88-9.21) and text messaging (AOR 3.42, 95% CI 1.55-7.54). Finally, English proficiency was associated with text messaging (AOR 4.20, 95% CI 1.44-12.24).

          Conclusions

          The differences in modes of technology access, use, and confidence by some of the key psychosocial determinants, as observed in our study sample, have important implications when health care teams develop dissemination plans.

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          Most cited references49

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          Telemedicine in the Time of Coronavirus

          Within weeks, COVID-19 has transformed our practice of palliative care and clinical medicine as we know it. Telemedicine has emerged as a critical technology to bring medical care to patients while attempting to reduce the transmission of COVID-19 among patients, families, and clinicians. It is also increasingly necessary to preserve scarce resources like personal protective equipment. In this article, we share just-in-time tips to support palliative care clinicians and program leaders in providing the best care possible by telemedicine. These quick, practical tips cover telemedicine setup, patient considerations, and clinician considerations. Next steps include ensuring equitable access to affordable telemedicine technology for vulnerable populations through creative solutions and financing, and dedicated attention to telemedicine evaluation and quality improvement.
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            Health information seeking in the digital age: An analysis of health information seeking behavior among US adults

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              Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California.

              This study estimated health status by low health literacy and limited English proficiency alone and in combination for Latino, Chinese, Korean, Vietnamese, and White respondents in a population-based sample: 48,427 adults from the 2007 California Health Interview Survey, including 3,715 with limited English proficiency. Multivariate logistic models examined self-reported health by health literacy and English proficiency in the full sample and in racial/ethnic subgroups. Overall, 44.9% with limited English proficiency reported low health literacy, versus 13.8% of English speakers. Among the limited English proficient, Chinese respondents had the highest prevalence of low health literacy (68.3%), followed by Latinos (45.3%), Koreans (35.6%), Vietnamese (29.7%), and Whites (18.8%). In the full sample, respondents with both limited English proficiency/low health literacy reported the highest prevalence of poor health (45.1%), followed by limited English proficiency-only (41.1%), low health literacy-only (22.2%), and neither (13.8%), a hierarchy that remained significant in multivariate models. However, subanalyses revealed that limited English proficient Latinos, Vietnamese, and Whites had equal or greater odds of poor health compared with low health literate/limited English proficient respondents. Individuals with both limited English proficiency and low health literacy are at high risk for poor health. Limited English proficiency may carry greater health risk than low health literacy, though important racial/ethnic variations exist.
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J Med Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                October 2021
                29 October 2021
                : 23
                : 10
                : e29155
                Affiliations
                [1 ] Johns Hopkins University School of Nursing Baltimore, MD United States
                [2 ] Johns Hopkins University Bloomberg School of Public Health Baltimore, MD United States
                Author notes
                Corresponding Author: Hae-Ra Han hhan3@ 123456jhu.edu
                Author information
                https://orcid.org/0000-0002-5181-5942
                https://orcid.org/0000-0002-7115-4192
                https://orcid.org/0000-0002-9419-594X
                Article
                v23i10e29155
                10.2196/29155
                8590186
                34714249
                742c9e9a-7959-4033-976a-aa4897a6a874
                ©Steve Chae, Yoon-Jae Lee, Hae-Ra Han. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 29.10.2021.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 28 March 2021
                : 13 May 2021
                : 23 June 2021
                : 5 July 2021
                Categories
                Original Paper
                Original Paper

                Medicine
                technology use,internet,text messaging,health literacy,english proficiency,immigrant,health disparities,korean american,women,mobile phone

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