TY  - JOUR
AU  - Medero, Kristina
AU  - Merrill Jr, Kelly
AU  - Ross, Morgan Quinn
PY  - 2022
DA  - 2022/3/15
TI  - Modeling Access Across the Digital Divide for Intersectional Groups Seeking Web-Based Health Information: National Survey
JO  - J Med Internet Res
SP  - e32678
VL  - 24
IS  - 3
KW  - Black
KW  - African American
KW  - first-level digital divide
KW  - health disparities
KW  - home computer
KW  - internet access
KW  - intersectionality
KW  - Latino
KW  - Latine
KW  - Hispanic
KW  - mobile
KW  - online health information seeking
KW  - public computer
KW  - structural equation modeling
KW  - work computer
KW  - mobile phone
AB  - Background: The digital divide refers to technological disparities based on demographic characteristics (eg, race and ethnicity). Lack of physical access to the internet inhibits online health information seeking (OHIS) and exacerbates health disparities. Research on the digital divide examines where and how people access the internet, whereas research on OHIS investigates how intersectional identities influence OHIS. We combine these perspectives to explicate how unique context–device access pairings operate differently across intersectional identities—particularly racial and ethnic groups—in the domain of OHIS. Objective: This study aims to examine how different types of internet access relate to OHIS for different racial and ethnic groups. We investigate relationships among predisposing characteristics (ie, age, sex, education, and income), internet access (home computer, public computer, work computer, and mobile), health needs, and OHIS. Methods: Analysis was conducted using data from the 2019 Health Information National Trends Survey. Our theoretical model of OHIS explicates the roles of internet access and health needs for racial and ethnic minority groups’ OHIS. Participant responses were analyzed using structural equation modeling. Three separate group structural equation modeling models were specified based on Black, Latine, and White self-categorizations. Results: Overall, predisposing characteristics (ie, age, sex, education, and income) were associated with internet access, health needs, and OHIS; internet access was associated with OHIS; and health needs were associated with OHIS. Home computer and mobile access were most consistently associated with OHIS. Several notable linkages between predisposing characteristics and internet access differed for Black and Latine individuals. Older racial and ethnic minorities tended to access the internet on home and public computers less frequently; home computer access was a stronger predictor of OHIS for White individuals, and mobile access was a stronger predictor of OHIS for non-White individuals. Conclusions: Our findings necessitate a deeper unpacking of how physical internet access, the foundational and multifaceted level of the digital divide, affects specific racial and ethnic groups and their OHIS. We not only find support for prior work on the digital divide but also surface new insights, including distinct impacts of context–device access pairings for OHIS and several relationships that differ between racial and ethnic groups. As such, we propose interventions with an intersectional approach to access to ameliorate the impact of the digital divide. 
SN  - 1438-8871
UR  - https://www.jmir.org/2022/3/e32678
UR  - https://doi.org/10.2196/32678
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35289761
DO  - 10.2196/32678
ID  - info:doi/10.2196/32678
ER  -