eHealth Activity Among African-American and White Cancer Survivors
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eHealth use among African-American and White cancer survivors is more strongly associated with age, socioeconomic status, and technology acceptance than race, despite persistent racial disparities in cancer survivorship care and outcomes.
Project Details -
Completed
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Grant NumberR01 HS022955
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AHRQ Funded Amount$1,833,605
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Principal Investigator(s)
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Organization
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LocationDetroitMichigan
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Project Dates09/30/2014 - 09/29/2019
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Technology
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Care Setting
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Medical Condition
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Population
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Type of Care
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Health Care Theme
Cancer survivors require intensive healthcare engagement to monitor long-term treatment effects and cancer recurrence, as well as the psychological, social, and economic effects of illness. There are persistent racial disparities in survivorship care and outcomes among African Americans compared to White Americans, such as lower reported quality of life and greater need for supportive care. Recent advancements in digital health interventions such as internet-based and mobile communication and information technologies (eHealth) hold promise in addressing such disparities, but racial differences in personal eHealth management are not fully understood.
To address this issue, the research team conducted surveys and ethnographic interviews with survivors of breast, prostate, and colorectal cancer to assess patients’ eHealth activity, technological comfort, healthcare experiences, and personal health management needs.
The specific aims of the research were as follows:
- Examine racial differences in general eHealth activity among African-American and White cancer survivors.
- Examine racial differences in specific categories of eHealth activity among African-American and White cancer survivors.
- Explore the role of eHealth activity in the broader context of personal health information management among African-American and White cancer survivors.
- Establish survivor-centered design principles that will be applied to the development of an eHealth tool for cancer survivors.
The research team recruited participants who self-identified as African American or White and were between 3 and 36 months post-treatment for breast, prostate, or colorectal cancer. In the first round of interviews, researchers verbally administered a series of survey questions to understand participants’ knowledge and use of specific eHealth activities, as well as potential predictors of eHealth activity, such as healthcare access, quality of life, technology acceptance, and healthcare experiences. In the second round of interviews, researchers conducted ethnographic interviews with a subset of participants to understand their current needs, concerns, or goals and the types of health information and strategies they use to address their needs.
The research team found no significant racial differences in eHealth activity, other than greater engagement in medication management and stress reduction activities among African-American cancer survivors. Across most eHealth activities, age, socioeconomic status, and technology acceptance were more strongly associated with eHealth activity than race. The research team developed a mobile app based on these findings; however, the app could not be user-tested and refined as proposed due to resource limitations. Future research on this topic should explore digital literacy interventions and eHealth strategies for older cancer survivors.
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