Satisfaction With Internet Access, Cancer Information-Seeking, and Digital Health Technology: Cross-Sectional Survey Assessment.
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BACKGROUND: Access to high-quality internet plays an increasingly important role in supporting care delivery and health information access. Although internet access has the potential to alleviate some inequities in health care, the digital divide negatively impacts cancer across the continuum. While subscription to high-speed internet has been previously assessed, satisfaction with home internet to meet the health needs of users is a lesser-known, important indicator of satisfactory access to internet-based health information and digital health technology use. OBJECTIVE: This study aimed to assess differences in perceptions of quality of at-home internet connection and its association to cancer health information-seeking experiences and use of digital health technologies in a nationally representative sample of US adults. METHODS: Secondary analysis of data from the National Cancer Institute's Health Information National Trends Survey (HINTS) 2022 (n=6252) was conducted. The primary predictor, "how satisfied are you with your Internet connection at home to meet health-related needs?," a novel item on HINTS 6, was dichotomized into "high" (extremely satisfied or very satisfied) and "low" (somewhat satisfied, not very satisfied, or not at all satisfied) satisfaction. Outcomes variables included 3 items assessing cancer information-seeking experiences and 2 items measuring access to telehealth and patient portals over the past 12 months. Adjusted logistic regression models (P<.05) were performed, including age, race and ethnicity, education, income, health insurance access, geography, and difficulty understanding cancer information, a proxy for health literacy, as covariates. RESULTS: Those reporting low satisfaction with their home internet had higher odds of agreeing that searching for cancer information took a lot of effort (odds ratio [OR] 1.59, 95% CI 1.16-2.19) and that they felt frustrated searching for cancer information (OR 1.46, 95% CI 1.07-1.98). Respondents with lower satisfaction with their home internet had lower odds of accessing their patient portal at least once in the past year (OR 0.54, 95% CI 0.33-0.89). While the relationship between internet satisfaction and concern over information quality was not significant, respondents aged 18-34 years reported higher odds to be concerned compared with those aged 75 years and older (OR 1.74, 95% CI 1.04-2.90), and those with lower education reported less concern over the quality of information compared with those with postbaccalaureate degrees (high school graduate: OR 0.56, 95% CI 0.31-0.99; college graduate: OR 0.67, 95% CI 0.48-0.95). Finally, while the association between satisfaction with internet and telehealth use over the past 12 months was not significant, those without health insurance were significantly less likely to have had a telehealth appointment in the last year (OR 0.39, 95% CI 0.19-0.81). CONCLUSIONS: Satisfaction with internet at home to meet health needs is correlated with cancer information-seeking experiences and usage of some available health technology. These findings underscore the value of high-quality internet services toward successful implementation of health care technology and better patient experiences in health information seeking.