Abstract
Background: Prior studies have identified sex, age, and geographic differences in post-stroke rehabilitation use in certain US areas. Internet use is an important prerequisite to the adoption of telerehabilitation, which has shown promise in equalizing access to follow-up care among stroke patients. We aimed to assess 30-day internet use disparities between male and female stroke patients by age and within each US state. Methods: We identified US adults 18y and older with a self-reported history of stroke from the Behavioral Risk Factor Surveillance System surveys, a nationally representative dataset (2015-2017). Internet users were identified as those who responded “Yes” to the question, “Have you used the internet in the past 30 days?” Prevalence of internet use was compared between sex and age groups and by state. Survey weights were applied in all analyses. Results: Among 55260 individuals with stroke (57.5% women), 57.8% reported using the internet in the preceding 30 days. The overall prevalence of internet use was similar between women (58.2%, 95% CI: 57.0-59.4%) and men (57.4%, 95% CI: 56.1-58.8%). Female stroke patients had higher internet use than their male counterparts until age 65+y (all p<0.0001, Figure 1a ). Substantial differences in internet use by state were found for women and men with stroke, with stroke survivors in Louisiana reporting the greatest difference (women 51% vs. men 36%) ( Figure 1b ). Conclusions: Overall, less than 60% of US stroke survivors reported recent internet use, with marked variation by sex, age, and across states. Study findings may inform individual state’s actions to improve internet use among women 65+y who bear a greater stroke burden yet have lower internet use than men. Efforts to increase internet use in specific stroke patient subgroups may facilitate future telerehabilitation expansion and help to reduce sex- and age-based disparities currently present in post-stroke care.
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