title: Patterns of Internet use by persons with spinal cord injuries and relationship to health-related quality of life.
abstract: OBJECTIVE
  To examine patterns of computer and Internet use among persons with spinal cord injuries (SCI) and to assess the relationship between Internet use and health-related quality of life (HRQOL).
  
  
  METHODS
  Cross-sectional survey design.
  
  
  METHODS
  National Model Spinal Cord Injury Systems.
  
  
  METHODS
  People with SCI enrolled in a national database.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Patterns of Internet use and relationship to HRQOL indicators: self-perceived health status, health status compared with 1 year ago, severity of depression, social integration score, occupation score, contacts with friends, business contacts, and satisfaction with life.
  
  
  RESULTS
  Most subjects owned computers, had Internet access, and used the Internet regularly-primarily for email, disability and health information, and shopping. Bivariate analysis revealed significant differences in Internet access based on sociodemographics, particularly among subjects with less education and among African Americans and Hispanics. In initial univariate analysis, most HRQOL indicators were significantly better for Internet users; once sociodemographic factors were included, 4 indicators remained significant.
  
  
  CONCLUSIONS
  Complex factors contribute to Internet access among people with SCI, with more barriers among specific subgroups. A significant HRQOL benefit from Internet use is suggested. Targeted interventions and studies of usage patterns are recommended.
authors.affiliation: Boston University School of Public Health, New England Spinal Cord Injury Center, MA, USA. drainoni@bu.edu
authors.forename: Mari-Lynn
authors.initials: ML
authors.lastname: Drainoni
authors.forename: Bethlyn
authors.initials: B
authors.lastname: Houlihan
authors.forename: Steve
authors.initials: S
authors.lastname: Williams
authors.forename: Mark
authors.initials: M
authors.lastname: Vedrani
authors.forename: David
authors.initials: D
authors.lastname: Esch
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lee-Hood
authors.forename: Cheryl
authors.initials: C
authors.lastname: Weiner
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001294:Attitude to Health; D003194:Computer-Assisted Instruction / Q000379:methods; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D010353:Patient Education as Topic / Q000379:methods; D010549:Personal Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index; D012919:Social Behavior; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014481:United States