Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services

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doi:10.1071/AH11042

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Digital technology use among disadvantaged Australians: implications for equitable consumer participation in digitally-mediated communication and information exchange with health services

Lareen Newman ^A ^C, Kate Biedrzycki ^B and Fran Baum ^A

^A Southgate Institute for Health Society & Equity, Level 2, Health Sciences Building, Flinders University, Bedford Park, SA 5042, Australia. Email: fran.baum@flinders.edu.au
^B South Australian Community Health Research Unit, Level 2, Health Sciences Building, Flinders University, Bedford Park, SA 5042, Australia. Email: katherine.biedrzycki@flinders.edu.au
^C Corresponding author. Email: lareen.newman@flinders.edu.au

Australian Health Review 36(2) 125-129 http://dx.doi.org/10.1071/AH11042
Submitted: 5 May 2011 Accepted: 14 September 2011 Published: 25 May 2012





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Abstract

Objective. To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information.

Methods. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories.

Results. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills.

Conclusion. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities.

1. What is known about the topic? Government and health provider use of digitally-mediated information and communication is rapidly increasing. However, national data show that ICT access is distributed unevenly across Australia’s population. Furthermore, this distribution mirrors the health gradient. There is little qualitative data on the extent to which, and ways in which, ICTs are used within lower income and disadvantaged groups - those with greater health need.

2. What does this paper add? This paper augments the scant literature to describe ICT access and use in a range of lower income and disadvantaged groups. It indicates barriers and facilitators, and highlights the need for formal supports to level up the whole population to have the skills, confidence and resources to use and benefit from ICT-mediated communication.

3. What are the implications for practitioners? As health services and governments increase the level of digitally-mediated information and communication connection with consumers/patients, it is important to understand and find ways to address differential consumer access to and use of ICTs, so that equity of access to services and information is promoted. This is particularly important as lower income and disadvantaged groups are likely to have both poorer health and lower ICT use.

References

[1] Lee L, Markotsis D, Weir T. Social impacts of the new economy. Canberra: Department of Industry, Tourism & Resources; 2002.

[2] Kvasny L, Kranich N, Schement J. Communities, learning and democracy in the digital age. The Journal of Community Informatics 2006; 2: .

[3] US Department of Commerce. A nation online: entering the broadband age. National Telecommunications & Information Administration Economics & Statistics Administration; 2004. Available at http://www.ntia.doc.gov/reports/anol/NationOnlineBroadband04.pdf [verified December 2010].

[4] Vinson T. Dropping off the edge: the distribution of disadvantage in Australia. Sydney: Jesuit Social Services and Catholic Social Services Australia; 2007.

[5] Government of South Australia. South Australian Government ICT Strategy –ask just once. Adelaide: Office of the Chief Information Officer; 2008.

[6] Australian Government Information Management Office. Australians’ use of and satisfaction with e-government services. Department of Finance and Deregulation. Canberra: Commonwealth of Australia; 2007.

[7] Australian Bureau of Statistics. Household use of information technology, Australia, 2008–09. Canberra: Commonwealth of Australia; 2009. (ABS Cat. No. 8146.0).

[8] Department of Broadband Communications & the Digital Economy. Online statistics. 2008. Available at http://www.archive.dbcde.gov.au/2008/01/statistical_benchmarking/online_statistics [verified 16 April 2010].

[9] Australian Bureau of Statistics. Children’s participation in cultural and leisure activities, Australia. Canberra: Commonwealth of Australia; 2009. (ABS Cat. No. 4901.0).

[10] Glover J, Hetzel D, Glover L, Tennant S, Page A. A social health atlas of South Australia. 3rd ed. Adelaide: Public Health Information Development Unit, University of Adelaide; 2006.

[11] Australian Health Ministers’ Conference. National e-health strategy: summary. Victoria, 2008. Available at http://www.ahmac.gov.au [verified September 2010].

[12] Tudor Hart J. The inverse care law. Lancet 1971; 297: 405–12.
| CrossRef |

[13] Crilly JF, Keefe RH, Volpe F. Use of electronic technologies to promote community and personal health for individuals unconnected to health care systems. Am J Public Health 2011; 101: 1163–7.
| CrossRef |

[14] Duffy ME, Thorsen E. Emerging trends in the new media landscape. In: Parker JC, Thorson E, editors. Health communication in the new media landscape. New York: Springer Publishing Company; 2009. pp. 93–116.

[15] Greenhalgh T, Wood GW, Bratan T, Stramer K, Hinder S. Patients’ attitudes to the summary care record and HealthSpace: qualitative study. BMJ 2008; 336: 1290.
| CrossRef |

[16] Gilbert MR, Masucci M, Homko C, Bove A. Theorizing the digital divide: information and communication technology use frameworks among poor women using a telemedicine system. Geoforum 2008; 39: 912–25.
| CrossRef |

[17] Kvasny L, Keil M. The challenges of redressing the digital divide: a tale of two U.S. cities. Inf Syst J 2006; 16: 23–53.
| CrossRef |

[18] Han JH, Sunderland N, Kendall E, Gudes O, Henniker G. Professional practice and innovation: chronic disease, geographic location and socioeconomic disadvantage as obstacles to equitable access to e-health. Health Information Management Journal 2010; 39: 30–6.

[19] Hesse BW. Enhancing consumer involvement in health care. In: Parker JC, Thorson E, editors. Health communication in the new media landscape. New York: Springer Publishing Company; 2009. pp. 119–50.

[20] Diaz JA, Griffith RA, Ng JJ, Reinert SE, Friedmann PD, Moulton AW. Patients’ use of the internet for medical information. J Gen Intern Med 2002; 17: 180–5.
| CrossRef |

[21] Fogel J, Albert SM, Schnabel F, Ditkoff BA, Neugut AI. Internet use and social support in women with breast cancer. Health Psychol 2002; 21: 398–404.
| CrossRef |

[22] O’Mara B, Babacan H, Borand H. Sending the right message: ICT access and use for communicating messages of health and wellbeing to CALD communities. Footscray Park, Victoria: Institute for Community, Ethnicity & Policy Alternatives, Victoria University; 2010.

[23] Liamputtong P. Researching the vulnerable. London: Sage Publications; 2007.

[24] Australian Bureau of Statistics. Adelaide: A social atlas – 2001 census of population & housing. Canberra: Commonwealth of Australia; 2002. (ABS Cat. No. 2030.4).

[25] Australian Communications & Media Authority. Telecommunications today: consumer attitudes to take-up and use. Belconnen ACT: Commonwealth of Australia; 2007.

[26] Blanchard M, Metcalf AB. Bridging the digital divide: creating opportunities for marginalised young people to get connected. Sydney: Inspire Foundation and ORYGEN Youth Health; 2007.

[27] Green J, Willis K, Hughes E, Small R, Welch N, Gibbs L, Daly J. Generating best evidence from qualitative research: the role of data analysis. Aust N Z J Public Health 2007; 31: 545–50.
| CrossRef |

[28] Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Analysing qualitative data. London: Routledge; 1993. pp. 173–94.

[29] Dahlgren G, Whitehead M. Levelling up (part 2): a discussion paper on European strategies for tackling social inequities in health. Copenhagen: WHO Regional Office for Europe; 2006.

[30] Newman L. Telephone survey methods: implications of the mobile-only population for public health research. Aust N Z J Public Health 2011; 35: 491–492.

[31] Wade V, Izzo J, Hamlyn J. Videophone delivery of medication management in community nursing. Electronic Journal of Health Informatics 2009; 4(1). Available at http://www.ejhi.net/ojs/index.php/ejhi/article/view/90 [verified 2 February 2010].

[32] Haider M, Ratzan S, Meltzer W. International innovations in health communication. In: Parker JC, Thorson E, editors. Health communication in the new media landscape. New York: Springer Publishing Company; 2009. pp. 373–95.

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