Date of Award

2017

Document Type

Open Access Dissertation

Department

Health Services and Policy Management

Sub-Department

The Norman J. Arnold School of Public Health

First Advisor

Janice C. Probst

Abstract

Background. The Internet has become pervasive in everyday life; the Pew Research Center reported over 84% of Americans use the Internet either on their phone or a computer. However, due to the methods by which the Internet was created, an Internet digital divide was created. The Internet digital divide is the disparity in access and speed of Internet of certain populations. This study looked into the disparity between urban and rural populations and their Internet access in two forms: e-prescriptions adoptions and Internet health information seeking behavior (HISB) through their mobile devices.

Methods. This study used 4 datasets, the Health Information Trends Survey, Area Health Resource Files, Surescripts, and National Broadband Map to determine if there was a disparity related to Internet use between urban and rural populations. A logistic regression was used to determine if there was a disparity between urban and rural populations in mobile Internet based health information seeking behavior (IHISB). A multivariable regression analysis was conducted to determine if Internet speed was related to positive change in e-prescription adoption.

Results. There were mixed results in the relationship of rurality to mobile IHISB use. Once community factors were accounted for, rurality was statistically insignificant. At the person level, the characteristics of income and age played a role in whether mobile IHISB occurred. Multivariable regression analysis showed that Internet speed played no role in e-prescription uptake. However, counties with higher percentage of insured patients and doctors aged under 55 are linked to positive changes in e-prescription adoption.

Conclusion. Income and age seem to play a statistically significant role in IHISB use. This suggests that there is an access and experience issue at play. In addition, Internet speed plays an insignificant role in e-prescription adoption change. However, it seems individual level factors play a larger role in e-prescription adoptions. More research is needed to determine what impacts e-prescription adoption change.

Rights

© 2017, Matthew W. Yuen

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