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1.
Stud Health Technol Inform ; 294: 811-812, 2022 May 25.
Article in English | MEDLINE | ID: covidwho-1865443

ABSTRACT

Recruitment is a bottleneck for research - especially digital health studies. Studies often focus on those who are easy to reach or already engaged in their health, leaving those who are uninterested or un-engaged, as "un-reached". This contributes to the "digital divide". COVID-19 restrictions made recruitment more difficult. During a virtual workshop of our peers, we discussed recruitment of un-reached groups for digital health studies, especially during COVID-times. All agreed; we need to go where the un-reached are by collaborating with community-based services and organizations.


Subject(s)
COVID-19 , Digital Divide , Pandemics , Patient Selection , Research Design/standards , SARS-CoV-2 , Community-Based Participatory Research/statistics & numerical data , Humans , Pandemics/prevention & control , Peer Group
2.
Stud Health Technol Inform ; 294: 545-549, 2022 May 25.
Article in English | MEDLINE | ID: covidwho-1865425

ABSTRACT

The digital divide can hinder the ability of elderly patients to fully benefit from PHRs. They are "digital immigrants", not having the life-long exposure to technology as younger generations, as well as physical and cognitive disabilities. The aim of this study was to explore the digital divide as a barrier for the use of a PHR in older adults (> 69 years of age) and describe the use of a PHR in an elderly population in Argentina. We conducted a cross sectional study which included older adults who attended the Coronavirus vaccination campaign in 2021. Data were collected through a survey encompassing digital divide factors and use of the PHR. A total of 128 participants agreed to complete the survey, 60.15% reported using the PHR. We found a statistically significant correlation of education level, having a personal computer and internet access with PHR use. Concerning PHR users, 45.45% reported needing assistance to use it. Although the elderly population represents a large portion of patients, there is not enough research done on their use experience using eHealth solutions. There is pending work in the eHealth field to integrate these elders into current PHRs and help them enjoy their benefits.


Subject(s)
Digital Divide , Health Records, Personal , Aged , Cross-Sectional Studies , Electronic Health Records , Humans , Patients
3.
J Health Care Poor Underserved ; 33(2): 1054-1068, 2022.
Article in English | MEDLINE | ID: covidwho-1846907

ABSTRACT

This project examined the preferred mode of response (internet, phone, mail) to a health services survey. Data were collected via survey responses from a subsample of Flint Water Crisis Medicaid Expansion Waiver enrollees (N=2,584). Analyses were stratified by age, residency, race, and income. Chi-square tests were used to detect categorical differences. The majority of participants responded by internet (55.5%), followed by mail (39.4%), and phone (5.2%). Of those responding by internet, 75% used smartphones for connectivity. Black and White respondents used the internet at a greater rate than Hispanic respondents (p<.01). Respondents at 200% federal poverty level (FPL) or higher used the internet mode at greater rates than those below 200% FPL (p<.01). Our findings suggest greater internet use in a vulnerable population than expected, but the digital divide persists. In the advent of COVID-19, this finding can inform future health programming using digital communication and telehealth.


Subject(s)
COVID-19 , Digital Divide , COVID-19/epidemiology , Humans , Internet , Medicaid , Surveys and Questionnaires , United States , Water
5.
Int J Environ Res Public Health ; 19(6)2022 03 12.
Article in English | MEDLINE | ID: covidwho-1742446

ABSTRACT

To determine whether or not digital inequalities exist, the frequency, duration, satisfaction, importance, and perceived competence of eighteen groups of digital tools during the COVID-19 pandemic confinement were examined. An online survey was administered to 2882 Latin American university students (49% female; M = 21.3 years). The following items are checked: (1) increased digital inequalities during the pandemic; (2) adequate reliability and validity of the Digital Technology Survey (DTS) instrument; (3) patterns of digital inequalities to the detriment of men, lower strata and unemployed people; and (4) evidence that the importance of digital activities as a causal factor on satisfaction with such digital activities as an outcome is mediated by the purpose of use and communication recipients, but not by strata or employment status, nor moderated by gender. The results are discussed in the light of previous studies, the limitations of the study and future perspectives.


Subject(s)
COVID-19 , Digital Divide , COVID-19/epidemiology , Digital Technology , Female , Humans , Latin America/epidemiology , Male , Pandemics , Reproducibility of Results , Universities
6.
Front Public Health ; 9: 796210, 2021.
Article in English | MEDLINE | ID: covidwho-1638119

ABSTRACT

Objectives: During the pandemic, quarantine has led to the lockdown of many physical educational institutions. Thus, massive open online courses (MOOCs) have become a more common choice for participants. MOOCs are often flagged as supplemental methods to educational disparities caused by regional socioeconomic distribution. However, dissenters argue that MOOCs can exacerbate the digital divide. This study aimed to compare the participants' performance before and after the outbreak of COVID-19, analyze the impact of the epidemic on online education of cosmetic dermatology from the view of the regional socioeconomic distribution, and investigate whether MOOCs exacerbate the digital divide in the COVID-19 epidemic. Methods: The study was conducted in participants of the MOOC course Appreciation and Analysis of Cosmetics from January 2018 to December 2020. Based on the platform data and official socioeconomic statistics, correlation of multivariate analysis was used to determine the factors related to the number of total participants. A panel regression model and stepwise least squares regression analysis (STEPLS) were employed to further analyze the relationship between GDP, population, number of college students and number of total participants in different years in the eastern, central and western regions of China. Results: The number of total participants in 2020 surged 82.02% compared with that in 2019. Completion rates were generally stable in 2018 and 2019 before the COVID-19 pandemic and significantly decreased in 2020 after the outbreak of the pandemic. GDP was the most important socioeconomic factor that determined the total number of participants and it was positively related to the total number of participants before and after the outbreak of the pandemic. The number of college students was unrelated to the total number of participants before the epidemic, and after the outbreak of COVID-19 in 2020, the number became positively related in all regions of China. Conclusions: This study shows that the epidemic pushes more people to choose MOOCs to study cosmetic dermatology, and online education could exacerbate rather than reduce disparities that are related to regional and socioeconomic status in the cosmetic field in the COVID-19 pandemic.


Subject(s)
COVID-19 , Cosmetics , Digital Divide , Education, Distance , Communicable Disease Control , Educational Status , Humans , Pandemics/prevention & control , SARS-CoV-2
7.
Brain Behav Immun ; 101: 211-213, 2022 03.
Article in English | MEDLINE | ID: covidwho-1631106

ABSTRACT

One of the most daunting unintended consequences of the digital revolution is the digital divide (DD), a pervasive social and information inequality. It negatively affects all sectors of society, and exerts compounding influences on other social inequities. To further complicate the situation, the COVID-19 pandemic has been intensifying the scale of DD and deepening the scope of DD barriers with the increasing but imbalanced applications of digital technologies. For instance, while digital technologies can provide support to fulfill people's mental health needs, recurring evidence shows that DD-prone people are more likely to be excluded from critical services, activities, and resources to support their health concerns and challenges. So far, studies about the mental health consequences of DD amid COVID-19 are limited. Available evidence suggests that the general mental health impacts of COVID-19 include anxiety, depression, and suicidal behaviors, while the mental health consequences of DD due to COVID-19 are mainly stress, distress, and anxiety. To shed light on the research gap, based on the social inequality roots of DD and the nexus between DD barriers and factors of social inequalities, this study highlights the alarming overlap between DD-prone communities and vulnerable populations. Furthermore, we underscore the future research directions that could help society better serve both underserved communities.


Subject(s)
COVID-19 , Digital Divide , Humans , Mental Health , Pandemics , SARS-CoV-2
8.
Int J Environ Res Public Health ; 18(23)2021 12 01.
Article in English | MEDLINE | ID: covidwho-1560749

ABSTRACT

With the rapid development of society, especially the advent of intelligent technology of life services, the ability of the elderly to adapt to modern digital life is getting weaker and weaker, the dilemma of the "digital divide" for the elderly has aroused heated public debate. In the era of aging and information superposition, in-depth study of the multi-dimensional impact of the digital divide on the elderly has become an effective content of China's active aging strategy. Based on the micro-data of the Chinese General Social Survey in 2017, this paper uses the entropy right method to construct the digital divide index system for the elderly over 60 years of age from the perspective of essential equipment, Internet utilization degree, and Basic Internet usage skills. At the same time, this paper constructs China's comprehensive index of active aging from three aspects: health, social participation, and guarantee of the elderly, to study the impact of the digital divide on China's active aging. The following conclusions have been drawn: the digital divide among the elderly significantly inhibits China's active aging. The digital divide reduces the level of physical and mental health and social participation of older persons and inhibits the level of guarantee of older persons, thus impeding their active aging. In addition, it also reduces the overall life satisfaction of the elderly. The use of the Internet, skills, and other digital technology abilities of the elderly have effectively promoted active aging. The more Internet access devices older people have, the higher their level of social participation. The higher the Internet frequency of the elderly, the healthier the body and mind. Furthermore, the greater the level of physical and mental health and social participation of older groups who use online payments. The digital divide among the elderly inhibits the process of China's active aging, and the unique course and stage characteristics of the development of the aging of the Chinese population require us to pay full attention to the relationship between the digital divide and active aging and how to construct a "digital-friendly" aging system is an essential issue for China's social development to consider.


Subject(s)
Digital Divide , Aged , Aged, 80 and over , Aging , China , Humans , Middle Aged , Social Participation , Technology
10.
Int J Environ Res Public Health ; 18(21)2021 10 27.
Article in English | MEDLINE | ID: covidwho-1488554

ABSTRACT

China has adopted a variety of digital technologies to effectively combat the unprecedented COVID-19 pandemic. The massive utilisation of digital technologies, however, to a great extent, magnifies the age-related digital divide. This paper aims to examine the impacts of the age-related digital divide on older adults in the context of the COVID-19 pandemic. Cases of three age-related digital divide scenarios, including older people taking public transportation, seeking medical care, as well as conducting digital transactions, are collected from Chinese official news outlets. The results indicate that the COVID-19 pandemic accelerates the pace of digital technology utilisation but exacerbates the age-related digital divide. Such an age-related digital divide has largely excluded older adults from both the real society and the virtual society. Older adults' personal attitudes and motivations, as well as education and income, governmental policies, and family and social supports, are all major contributors to the severe impacts of the age-related digital divide on old adults during the pandemic. More measures should be adopted to bridge the age-related digital divide and build a senior-friendly e-society.


Subject(s)
COVID-19 , Digital Divide , Aged , China/epidemiology , Humans , Pandemics , SARS-CoV-2
11.
BMJ Open ; 11(10): e053440, 2021 10 12.
Article in English | MEDLINE | ID: covidwho-1462972

ABSTRACT

OBJECTIVE: The increased reliance on digital technologies to deliver healthcare as a result of the COVID-19 pandemic has meant pre-existing disparities in digital access and utilisation of healthcare might be exacerbated in disadvantaged patient populations. The aim of this rapid review was to identify how this 'digital divide' was manifest during the first wave of the pandemic and highlight any areas which might be usefully addressed for the remainder of the pandemic and beyond. DESIGN: Rapid review and narrative synthesis. DATA SOURCES: The major medical databases including PubMed and Embase and Google Scholar were searched alongside a hand search of bibliographies. ELIGIBILITY CRITERIA: Original research papers available in English which described studies conducted during wave 1 of the COVID pandemic and reported between 1 March 2020 and 31 July 2021. RESULTS: The search was described using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and identified nine studies. The results are presented within a refined framework describing the three key domains of the digital divide: (1) digital access, within which one study described continuing issues with internet connectivity among vulnerable patients in the UK; (2) digital literacy, where seven studies described how ethnic minorities and the elderly were less likely to use digital technologies in accessing care; (3) digital assimilation, where one study described how video technologies can reduce feelings of isolation and another how elderly black males were the most likely group to share information about COVID-19 on social media platforms. CONCLUSIONS: During the early phase of the pandemic in the developed world, familiar difficulties in utilisation of digital healthcare among the elderly and ethnic minorities continued to be observed. This is a further reminder that the digital divide is a persistent challenge that needs to be urgently addressed when considering the likelihood that in many instances these digital technologies are likely to remain at the centre of healthcare delivery.


Subject(s)
COVID-19 , Digital Divide , Aged , Delivery of Health Care , Humans , Male , Pandemics , SARS-CoV-2
12.
Disabil Health J ; 15(1): 101214, 2022 01.
Article in English | MEDLINE | ID: covidwho-1401411

ABSTRACT

BACKGROUND: The COVID-19 pandemic has reinforced social inequality in marginalized groups. People with disabilities (PWD) are particularly restricted in their activities and lives due to the pandemic and experiencing more difficulties than the general population. OBJECTIVE: This study aims to explore the extent of the digital divide between PWD and people without disabilities (PWOD) during the COVID-19 pandemic in South Korea. METHODS: This study relied on the cross-sectional secondary data from the 2020 Digital Divide Survey conducted in Korea. We performed a series of bivariate analyses on the data of 5575 PWOD and 1781 PWD (18-69 years old) to compare Internet usage and various types of digital services related to the pandemic. RESULTS: We identified significant differences between PWOD and PWD in their Internet usage change during the pandemic. A higher number of PWD reported that their Internet usage with both computers and mobile devices remained similar to the pre-pandemic period while that of PWOD reported that their Internet usage via the same has increased. Significant gaps were found in the usage change of the five digital services with the largest gap in that of social networking services between PWOD and PWD. Further, PWOD were likelier to be aware of, utilize, and perceive the usefulness of digital services during the COVID-19 pandemic including application, information, delivery, and subscription services. CONCLUSION: To ensure better post-pandemic outcomes for marginalized groups including PWD, the governments and authority agencies must facilitate digital access and services with appropriate accommodations needed by those populations.


Subject(s)
COVID-19 , Digital Divide , Disabled Persons , Adolescent , Adult , Aged , Cross-Sectional Studies , Humans , Middle Aged , Pandemics , SARS-CoV-2 , Young Adult
15.
Int J Environ Res Public Health ; 18(15)2021 Jul 28.
Article in English | MEDLINE | ID: covidwho-1335049

ABSTRACT

To contain the COVID-19 pandemic, governments all over the world implemented strong lockdown measures to a large part of the population, including the closing of educational centres. Teachers were urged to transform their teaching methodology, moving from a face-to-face model to an emergency remote education (ERE) model, characterised by the use of technologies to continue with lectures and maintain the physical distance with the students. The aim of the present study was to analyse the existence of socio-digital inequalities and the educational challenges posed by the development of an ERE model, hence, contributing to the literature by proposing a systematic and holistic approach on this phenomenon. Based on the characteristics of the research problem and the objectives set, a qualitative methodology was applied. On the one hand, a semi-structured interview was conducted with 136 active teachers as the main data gathering technique. On the other hand, grounded theory was key in interpreting the results, with the aim of generating the theory in a systematic and holistic manner. It can be asserted that ERE was very useful during the lockdown of schools, and its potential to transform education was demonstrated. However, it was also shown that the development of an ERE model can cause socio-digital inequalities among students, due to the lack of access to digital devices and Internet connection, mainly due to factors, such as the socio-educational level of the family and the rural or urban context of the centre.


Subject(s)
COVID-19 , Digital Divide , Education, Distance , Communicable Disease Control , Humans , Pandemics , SARS-CoV-2
16.
J Affect Disord ; 294: 170-179, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1313193

ABSTRACT

BACKGROUND: COVID-19 outbreak has drawn out institutions to closure with several challenges for university students of undergraduate level in Dhaka city including an emergency shift from traditional learning to online learning, which associated digital divide, left several arguments in response to technological inefficiency, pedagogic inefficiency of teachers, inappropriate study environment and so on. Previous literature shows that the COVID-19 is imposing a threat to mental health all over the nation since its spread. This study intended to evaluate the emerging reasons for psychological distress among university students of undergraduate level in Dhaka, also assess the execution methods, barriers of online learning, and lastly, the attitudes of students regarding online learning throughout the pandemic. METHODS: A mixed methodology was used to conduct the research. Primary data has been collected using simple purposive sampling on 180 undergraduate students, 9 interviews were taken including 6 in-depth interviews of different university undergraduates from Dhaka city and also 3 (KIIs) from specialists of pedagogy and medical anthropology, and a high official from Bangladesh Telecommunication Regulatory Commission (BTRC). RESULTS: Based on the Kessler K-10 distress scale, the study found that the prevalence of no psychological distress (16.67%) followed by mild (40%), moderate (30.56%), and severe psychological distress (12.78%). CONCLUSION: The results concluded considering several reasons for mild to severe psychological distress. The findings suggest some recommendations to accumulate the process of online learning effectively and also strategies to regulate the preferred mode of learning in future.


Subject(s)
COVID-19 , Digital Divide , Education, Distance , Bangladesh/epidemiology , Humans , Pandemics , SARS-CoV-2 , Students
17.
J Am Med Inform Assoc ; 28(10): 2265-2268, 2021 09 18.
Article in English | MEDLINE | ID: covidwho-1303917

ABSTRACT

The collection of patient reported outcomes (PROs) allows us to incorporate the patient's voice into their care in a quantifiable, validated manner. Large-scale collection of PROs is facilitated by the electronic health record and its portal, though, historically, patients have eschewed the portal and completed patient-reported outcome measures in the clinic via tablet. Furthermore, access and use of the portal is associated with known racial inequities. Our institution oversees the largest clinical PRO program in the world, and has a long history of racially equitable PRO completion rates via tablet. However, when the COVID-19 pandemic forced us to remove tablets from clinics and rely exclusively on portal use for PRO completion, profound racial disparities resulted immediately. Our experience quantifiably demonstrates the magnitude of inequity that the portal, in its current configuration, generates and serves as a cautionary tale to other health care systems and electronic health records.


Subject(s)
COVID-19 , Electronic Health Records , Pandemics , Patient Reported Outcome Measures , Digital Divide , Healthcare Disparities , Humans , SARS-CoV-2
19.
J Med Internet Res ; 23(7): e27682, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1278297

ABSTRACT

The COVID-19 pandemic created numerous barriers to the implementation of participant-facing research. For most, the pandemic required rapid transitioning to all virtual platforms. During this pandemic, the most vulnerable populations are at highest risk of falling through the cracks of engagement in clinical care and research. Nonetheless, we argue that we should reframe the discussion to consider how this transition may create opportunities to engage extensively to reach populations. Here, we present our experience in Atlanta (Georgia, United States) in transitioning a group visit model for South Asian immigrants to a virtual platform and the pivotal role community members in the form of community health workers can play in building capacity among participants. We provide details on how this model helped address common barriers to group visit models in clinical practice and how our community health worker team innovatively addressed the digital challenges of working with an elderly population with limited English proficiency.


Subject(s)
COVID-19 , Community Health Workers , Digital Divide , Emigrants and Immigrants , Pandemics , Telemedicine , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Capacity Building , Female , Georgia/epidemiology , Humans , Male , Middle Aged , SARS-CoV-2 , Vulnerable Populations
20.
J Autism Dev Disord ; 52(5): 2300-2313, 2022 May.
Article in English | MEDLINE | ID: covidwho-1267497

ABSTRACT

Digital technologies have the potential to empower individuals with autism and their families. The COVID-19 pandemic emphasized and accelerated the drive towards technology for information, communication, training, clinical care and research, also in the autism community. However, 95% of individuals with autism live in low- and middle-income countries (LMIC) where access to electricity, internet and the ever-increasing range of digital devices may be highly limited. The World Bank coined the term 'the digital divide' to describe the disparities in access to digital technologies between high-income and LMIC contexts. Here we evaluated the feasibility of six emerging technologies for autism spectrum disorders, and reflected on key considerations for implementation in LMIC contexts to ensure that we do not inadvertently widen the pre-existing digital divide.


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , COVID-19 , Digital Divide , Autism Spectrum Disorder/therapy , Autistic Disorder/therapy , Developing Countries , Feasibility Studies , Humans , Pandemics , Technology
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