In Internet we trust: intersectionality of distrust and patient non-adherence

Abstract

ABSTRACT The socio-technological context of health care wherein patient-consumer involvement is central increases the importance of examining the impact of Internet information on health-related attitudes and behavior. This paper examined the extent to which deployment of e-health information is associated with patient distrust and non-adherence. We examined the hypothesized associations in gender-stratified subsamples to uncover whether any differential patterns of associations exist among women and men. Our analyses allowed for estimation of significant covariate effects at the composite index and item level for both men and women while controlling for the moderation effect of race/ethnicity. Results indicate differential outcomes for patient distrust and non-adherence depending on socio-demographic characteristics. Findings suggest that it is not just health-related information that influences health-related behavior, but also mechanisms through which socio-demographic characteristics shape whether Internet use is associated with distrust and patient non-adherence. e-Health information consumers are overall less trustful and more likely to deviate from health care provider treatment. Non-adherence among those who consume e-health information is more pronounced for non-white women. Highly educated non-white men were more likely to diverge from their medical care provider’s treatment recommendations than White men. Given the increasing diversification of the demographic profile of the U.S. population, understanding the dynamics though which health-related Internet use becomes racialized and gendered represents a critical contribution to the literature on Internet and health.