Abstract
BackgroundWeb-based interventions have shown promise for chronic disease management but have not been widely applied to populations with stroke. Existing barriers may inhibit the adoption of web-based interventions among stroke survivors and necessitate the involvement of informal caregivers. However, limited information is available on internet accessibility and usability among stroke survivors and their caregivers.ObjectiveThis study aims to investigate internet access and usage in a cohort of stroke survivors and their caregivers.MethodsA cross-sectional survey was conducted with 375 participants (248 stroke survivors and 127 caregivers). Descriptive statistics were generated using cross-tabulation. Comparisons with categorical data were conducted using the chi-square test, whereas the Mann-Whitney U test was used for comparisons involving ordinal variables.ResultsOverall, 86.1% (323/375) of the participants reported having internet access. Caregivers were more likely than stroke survivors to access the internet (N=375, χ21=18.5, P<.001) and used text messaging (n=321, χ21=14.7, P<.001). Stroke survivors and caregivers with internet access were younger than stroke survivors and caregivers without internet access. The highest number of participants who reported internet access were non-Hispanic White. Smartphones were the most common devices used to access the internet. Email was the most common type of internet usage reported. Patients who survived for >12 months after a stroke reported higher internet access than those who survived <3 months (P<.001). The number of hours per week spent using the internet was higher for caregivers than for stroke survivors (P<.001).ConclusionsFuture feasibility and acceptability studies should consider the role of the informal caregiver, participant age, race and ethnicity, the use of smartphone apps, email and text correspondence, and the amount of time elapsed since the stroke event in the design and implementation of web-based interventions for populations with stroke.
Highlights
BackgroundIn the United States, 795,000 people experience stroke annually [1]
Caregivers were more likely than stroke survivors to access the internet (N=375, χ21=18.5, P
Stroke survivors and caregivers with internet access were younger than stroke survivors and caregivers without internet access
Summary
BackgroundIn the United States, 795,000 people experience stroke annually [1]. improvements in the acute management of stroke have led to a decline in associated mortality, stroke-related morbidity leads to chronic disability in approximately half of all stroke survivors [2]. Mobility is reduced in more than half of all stroke survivors aged ≥65 years [3]. Despite the complex needs of stroke survivors, poststroke care systems are inadequate. Stroke survivors may have limited access to outpatient care because of impaired mobility, limited access to transportation, and lack of support [10]. Most stroke survivors are discharged home from the hospital and receive care provided primarily by unprepared informal caregivers (eg, spouses and family members) [11,12]. Measures that expand access to poststroke care and comprehensively address the challenges that stroke survivors and their caregivers encounter are needed [13]. Existing barriers may inhibit the adoption of web-based interventions among stroke survivors and necessitate the involvement of informal caregivers. Limited information is available on internet accessibility and usability among stroke survivors and their caregivers
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