Characterizing the Digital Divide in African American Prostate Cancer Patients

Researchers aimed to evaluate access and use of computers and smartphones in diverse African American prostate cancer patients.

The study included 152 early-stage patients interviewed about their computer and smartphone use. Demographics were also collected, including income, education, and health literacy (categorized as ≤ Grade (Gr) 3; Gr 4-6; Gr 7-8; and high school (HS)). Fisher’s exact test and logistic regression were used to identify variables associated with computer and smartphone use.

The study findings indicated a wide age range of 44 to 81 years, varying income levels from <$10,000 to >$76,000, and education spanning from 4 to 20 years. Health literacy was observed to be low (62%) (< Grade 7-8) and 38% in the adequate category (high school). Individuals with greater access to smartphones and computers at home were more familiar with their usage than those who were less knowledgeable. Among 72 men with some college education or higher, over 90% were skilled in using smartphones and computers. This was in contrast to 67% (39/58) with a high school education and 50% (11/22) with less than a high school education who were adept at using smartphones (P< 0.001). Similarly, for computer usage, 55% (32/58) with a high school education and only 27% (6/22) with less than a high school education were knowledgeable (P< 0.001).

Nearly 90% of patients with an annual income <$25,000 had access to smartphones or computers, and proficiency varied. Specifically, 72% (46/64) knew how to use a smartphone (P= 0.016), and only 56% (36/64) were skilled in using a computer (P= 0.004). Among patients reading at a level below Grade 4-6, 62% (23/37) were familiar with smartphones (P = 0.006), while only 43% (16/37) were acquainted with computer usage (P< 0.001). In the multivariate logistic models, including education, income, health literacy, and age as factors, education remained a significant predictor of knowing how to use computers and smartphones. Men with some college education or higher were more likely than those with less than high school education to be proficient in using computers (OR 77.1, 95% CI 13.8-689, P< 0.001) and smartphones (OR 23.0, 95% CI 4.7-176, P< 0.001).

The study found that 28-50% of patients with low education, income, and health literacy cannot use a smartphone, while 44-73% cannot use a computer.

Source: https://meetings.asco.org/abstracts-presentations/223961 

Clinical Trial: https://www.clinicaltrials.gov/study/NCT03322891

Kerry L. Kilbridge, William Martin-Doyle, Christopher Paul Filson, Sierra Williams, Quoc-Dien Trinh, and Viraj A. Master. DOI: 10.1200/JCO.2023.41.16_suppl.e18571 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e18571-e18571.