Internet Use to Access Health Information in Diabetics and Pre-diabetics in California
Background: Internet use has been widely used by about 2.4 billion population. It has provided limitless sources of information and wide areas of communication. This medium has facilitated the interaction between patients and their healthcare providers and with the knowledge gained, patients may have been guided in the care of their health. Little is known about the variation of the use of the internet for health information among diabetics and pre-diabetics in California.
Methods: We analyzed data from the 2011-2012 California Health Interview Survey (CHIS) which is a cross-sectional survey using telephone interview of adult sample in California. Diabetes and pre-diabetes status and internet use for health information were self-reported. We analyzed the data using the survey module in STATA 11 taking into consideration the sample design and the sample weight.
Results: of the 42,935 participants, 8.4% were diabetics and 2% were pre-diabetics. Eighty two percent reported using the internet and it was lowest among diabetics (58%) compared to pre-diabetics (66%) and non-diabetics (84%) (p<0.01). Overall, 65% of the participants used the internet last year to find health information and it varied by diabetes status where it was 60% among diabetics compared to 62% in pre-diabetics and 65% in non-diabetics (p<0.01). In the adjusted multivariate model, adjusting for socio-demographics, access to care, behavioral variables and co-morbidities, diabetics had lower odds of using the internet relative to non-diabetics (adjusted Odds Ratio [AOR]=0.80; 95% Confidence level (CI)=0.7-0.9); p<0.001). Adjusting for the confounders, diabetes status was not associated with using internet for health information (p>0.05). White, young married male, with high income and high education, who self-perceived their health as fair/poor, had co-morbidities and had regular source of care had higher odds of using the internet for health information compared to the other groups (p<0.05). Stratified analysis by urban/rural status reveal no relationship between use of internet for health information and diabetes status among the urban population (p>0.05), but for diabetics living in the rural areas, they had lower odds relative to non-diabetics ((AOR=0.60; 95% CI=0.4-0.9); p=0.03). Diabetics who had regular source of health care were more likely to use the internet for health information relative to non-diabetics (p<0.05).
Implications: Although the use of internet for health information was low among adult diabetics and pre-diabetics especially those in rural areas, those who has regular source of care had higher use of internet for health information than the other groups. Culturally appropriate health promotion involving health care providers and using internet might benefit the population with co-morbidities and those with fair/poor health status. Dissemination of information to patients can be achieved by using the internet and nurses have direct contact with the patients and are in a position to explore reasons for not using internet for health information among the diabetic/pre-diabetic population. More research is needed to determine barriers to the use of internet for health information among diabetics living in rural areas.