Disparities and unmet need for e-mail use in cancer patients

Abstract

8254 Background: Using a medically underserved sample, we assess barriers and unmet need for e-mail use between cancer patients and healthcare providers by comparing e-mail users to non-users. Methods: Participants were recruited for this cross-sectional study from a public hospital serving a minority/underserved cancer patient population. Eligibility criteria included: cancer diagnosis, outpatient status, non-institutionalized, ability to read/understand spoken English, and > 21 years old. Participants anonymously completed a validated questionnaire that queried 1) sociodemographics, 2) access (for users) or barriers (for non-users), 3) potential uses and utility of e-mail for medical communication. Results: Thirty-two respondents returned surveys; 75% do not use e-mail. Non-users are older (mean=51 v. 44 for users), have lower incomes (<$15000 v. <$20000) and have less education (some high school v. some college). The primary usage barriers are: lack of access (79%), no peer pressure (40%) and no training (39%). Factor analysis shows that communication items load on two factors: medical communication (e.g., “use for pain management”, “use for prescription refills”; 93% variance explained), and utility (e.g.,“help meet medical needs quickly”, “improve the efficiency of my care; 63% explained). Cluster analysis revealed 4 distinct groups: 1) e-mail users willing to use e-mail for medical purposes (EmMP); 2) users not willing to use EmMP; 3) non-users willing to use EmMP; 4) non-users not willing to use EmMP.Conclusions: Cancer patients express unique desires to use (or not use) e-mail to communicate with health care providers in this population. E-mail may be a technologically appropriate form of communication to individualize patient treatment and management. Further research is warranted to investigate this aspect of the digital divide. No significant financial relationships to disclose.