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Adoption and Use of Internet Technologies in Health Communication: Examining Disparities in Diffusion Patterns, Health Information Sources, and Patient-Provider Encounters


This dissertation examines the impact of internet technologies on the field of health communication. Access and use of health communication technologies has and will continue to become increasingly important to manage and treat chronic conditions and other ailments, particularly in the context of health care reform that promotes improved quality of care along with cost-saving measures. Through examining internet adoption rates, its use as a source of health information, and its influence on the patient-provider encounter, findings highlight ways in which the internet can be leveraged to help health consumers, health providers, health care organizations, and health insurance companies transition into the digital age of health care and health promotion.

Data from the 2003 and 2008 Health Information National Trends Survey (HINTS) are used to examine online technologies for health communication among U.S. adults. HINTS, a nationally representative repeated cross-sectional survey, is developed and implemented by the National Cancer Institute (NCI) to measure knowledge, attitudes, and practices related to health information and media use, reflecting the growing reliance on internet sources for health and illness information. Three studies based on HINTS incorporating diffusion models and communication theories to describe the use of online technologies for health information and communication are presented.

The first study demonstrates that the largest growing disparity in internet use is among women and men, with women significantly outpacing men between 2003 and 2008. A proposed disparities diffusion model suggests that other disparities in internet use are neither growing nor shrinking - that is, vulnerable populations remain at a disadvantage. The second study shows that internet use for health information continues to grow among both internet users as well as non-users. This suggests that non-users get online health information through surrogates, supporting a "team" approach to health information seeking. The third study demonstrates that the first source an individual uses for health information can influence the patient-provider encounter. Specifically, compared with individuals who use a health provider as a first source, those who use the internet have on average a more negative experience with their provider.

Health consumers will continue to use online technologies for health information; thus, it is imperative for health care providers and organizations to implement policies and procedures that acknowledge and incorporate online health information into the care process to improve satisfaction, quality of care, and ultimately health outcomes. As new technologies expand throughout populations and are integrated more into decisions regarding health and wellbeing, findings from this dissertation can be used to support intervention and policy development.

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