Information and Communication Technology Use Among Low-Income Pregnant and Postpartum Women by Race and Ethnicity: A Cross-Sectional Study

J Med Internet Res. 2015 Jul 3;17(7):e163. doi: 10.2196/jmir.3916.

Abstract

Background: Pregnancy and the postpartum period provide windows of opportunity to impact perinatal and lifelong preventive health behavior for women and their families, but these opportunities are often missed. Understanding racial/ethnic differences in information and communication technology (ICT) use could inform technology-based interventions in diverse populations.

Objective: The objective of the study was to evaluate differences in the use of ICT between racial and ethnic groups as well as by English language proficiency.

Methods: We conducted a cross-sectional study of 246 women who were aged 18 years or older and pregnant or within 1 year of delivery. They were recruited from 4 hospital-based outpatient clinics and completed a self-administered survey. We used multivariate regression analysis to evaluate the association between race/ethnicity and ICT (mobile phone/short message service [SMS] text message, Internet, and social network) usage by race/ethnicity and perceived English language proficiency after adjusting for age, income, marital status, and insurance status.

Results: In all, 28% (69/246) of participants were Latina, 40% (98/246) were African American, 23% (56/246) were white, and 9% (23/246) from other racial/ethnic groups. Of the Latinas, 84% (58/69) reported limited English language proficiency and 59% (41/69) were uninsured. More than 90% of all participants reported mobile phone use, but more than 25% (65/246) had changed phone numbers 2 or more times in the past year. Compared to white women, African American women were less likely to SMS text message (OR 0.07, 95% CI 0.01-0.63) and Latinas were less likely to use the Internet to find others with similar concerns (OR 0.23, 95% CI 0.08-0.73). Women with limited English language proficiency were less likely to use the Internet overall (OR 0.30, 95% CI 0.09-0.99) or use email (OR 0.22, 95% CI 0.08-0.63) compared to women with adequate English language proficiency.

Conclusions: Mobile phones are widely available for the delivery of health interventions to low-income, racially diverse pregnant and postpartum women, but disparities in Internet use and SMS text messaging exist. Interventions or programs requiring Web-based apps may have lower uptake unless alternatives are available, such as those adapted for limited English proficiency populations.

Keywords: Hispanic Americans; Internet; cell phones; health services accessibility; health status disparities; postpartum period; pregnancy; text messaging.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Cell Phone / statistics & numerical data*
  • Communication
  • Consumer Health Information / methods*
  • Cross-Sectional Studies
  • Ethnicity / statistics & numerical data
  • Female
  • Health Behavior
  • Health Status Disparities
  • Humans
  • Internet / statistics & numerical data*
  • Postpartum Period / ethnology*
  • Postpartum Period / psychology*
  • Poverty
  • Pregnancy
  • Surveys and Questionnaires
  • Young Adult