Determinants of broadband access and affordability: An analysis of a community survey on the digital divide.

Broadband access in the home is a necessity, especially since the COVID-19 pandemic. Increasingly, connectivity is of vital importance for school, work, family, and friends. Existing international research on the implementation of broadband has studied its adoption patterns with a focus on the rural/urban digital divide. This paper explores the digital divide in a case study of the seventh largest city, by population, in the United States; San Antonio is a majority-minority city where over half of the people are Hispanic. This paper focuses on the five key affordability factors that drive broadband adoption. Researchers test social exclusion theory, the structural facets of poverty and social marginality to ascertain its potential impact on broadband access. The authors conducted a survey in both English and Spanish to learn more about the affordability factors that influence the broadband digital divide. Through our analysis, we found evidence that four of the factors (geographical disparities, profit-based discrimination, technology deployment cost, and socio-economic factors) played a role in the digital divide in this case study. The results of this study demonstrate that the digital divide is not exclusively a rural/urban digital divide, but can also occur in an intra-city context. This is especially evident in low-income areas within the city because they have substantially lower broadband adoption rates. The results of this study demonstrate the importance of looking closely at issues of social exclusion of marginalized groups and the affordability of broadband access intra-city.

Operational strategies in US cancer centers of excellence that support the successful accrual of racial and ethnic minorities in clinical trials.

BACKGROUND: Study populations in clinical research must reflect US changing demographics, especially with the rise of precision medicine. However, racial and ethnic minority groups (REMGs) have low rates of participation in cancer clinical trials. METHODS: Criteria were developed to identify cancer centers able to accrue a higher than average proportion of REMGs into clinical trials. Comprehensive interviews were conducted with leaders of these cancer centers to identify operational strategies contributing to enhanced accrual of REMGs. RESULTS: Eight US cancer centers reported a REMG accrual rate range in cancer research between 10 and 50% in a 12-month reporting period and met other criteria for inclusion. Fourteen leaders participated in this assessment. Key findings were that centers: had a metric collection and reporting approach; routinely captured race and ethnicity data within databases accessible to research staff; had operational standards to support access and inclusion; developed practices to facilitate sustained patient participation during clinical trials; had strategies to decrease recruitment time and optimize clinical study design; and identified low-resource strategies for REMG accrual. There was also a clear commitment to establish processes that support the patient's provider as the key influencer of patient recruitment into clinical trials. CONCLUSION: We have identified operational practices that facilitate increased inclusion of REMGs in cancer trials. In order to establish a sustainable cancer center inclusion research strategy, it is valuable to include an operational framework that is informed by leading US cancer centers of excellence.

Information technology and emergency management: preparedness and planning in US states.

The purpose of this paper is to examine the impact of information technology (IT) on emergency preparedness and planning by analysing a survey of US state government departments of emergency management. The research results show that there has been a significant impact of IT on emergency planning. IT has proven to be effective for all phases of emergency management, but especially for the response phase. There are numerous technologies used in emergency management, ranging from the internet, Geographic Information Systems and wireless technologies to more advanced hazard analysis models. All were generally viewed as being effective. Lack of financial resources and support from elected officials is a perennial problem in public administration, and was found to be prevalent in this study of IT and emergency management. There was evidence that state governments rating high on a performance index were more likely to use IT for emergency management.

Managed health care plans in Southern United States municipalities: empirical evidence on choice of plan.

This study examines factors that influence choice of Southern municipal government health care plans in the United States. Using survey data, this article specifically examines the managed care offerings of Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO) and Point of Service (POS) plans. Some of the more interesting empirical results indicate that HMO plans are associated more with employee satisfaction; PPO plans are associated with cost containment; and POS plans are more likely to provide health care benefits to part-time employees. Empirical evidence also indicates that employee satisfaction is increased when there is a greater choice of managed care plans available to municipal governments.