title: Access to communication technologies in a sample of cancer patients: an urban and rural survey.
abstract: BACKGROUND
  There is a growing awareness among providers of the symptom burden experienced by cancer patients. Systematic symptom screening is difficult. Our plan was to evaluate a technology-based symptom screening process using touch-tone telephone and Internet in our rural outreach cancer program in Indiana. Would rural patients have adequate access to technologies for home-based symptom reporting?
  
  
  OBJECTIVE
  1) To determine access to touch-tone telephone service and Internet for patients in urban and rural clinics; 2) to determine barriers to access; 3) to determine willingness to use technology for home-based symptom reporting.
  
  
  METHODS
  Patients from representative clinics (seven rural and three urban) in our network were surveyed. Inclusion criteria were age greater than 18, able to read, and diagnosis of malignancy.
  
  
  RESULTS
  The response rate was 97%. Of 416 patients completing the survey (230 rural, 186 urban), 95% had access to touch-tone telephone service, while 46% had Internet access (56% of urban patients, 38% of rural patients). Higher rates of Internet access were related to younger patient age, current employment, and higher education and income. The primary barrier to Internet access was lack of interest. Use of the Internet for health related activities was less than 50%. The preferred means of symptom reporting in patients with internet access were the touch-tone telephone (70%), compared to reporting by the Internet (28%).
  
  
  CONCLUSIONS
  Access to communication technologies appears adequate for home-based symptom reporting. The use of touch-tone telephone and Internet reporting, based upon patient preference, has the potential of enhancing symptom detection among cancer patients that is not dependent solely upon clinic visits and clinician inquiry.
authors.affiliation: Regenstrief Institute for Health Care, Department of Medicine, Indiana University School of Medicine and the Richard L, Roudebush VA Medical Center, Indianapolis, IN, USA. ABSZM@aol.com
authors.forename: Ma'n
authors.initials: M
authors.lastname: Abdullah
authors.forename: Dale E
authors.initials: DE
authors.lastname: Theobald
authors.forename: Donna
authors.initials: D
authors.lastname: Butler
authors.forename: Kurt
authors.initials: K
authors.lastname: Kroenke
authors.forename: Anthony
authors.initials: A
authors.lastname: Perkins
authors.forename: Sara
authors.initials: S
authors.lastname: Edgerton
authors.forename: William M
authors.initials: WM
authors.lastname: Dugan
mesh_terms: D003159:Community-Institutional Relations; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007196:Indiana; D020407:Internet / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000175:diagnosis*; D011159:Population Surveillance; D012424:Rural Population; D013689:Telephone / Q000706:statistics & numerical data*; D014505:Urban Population
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