Access to communication technologies in a sample of cancer patients: an urban and rural survey.
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.
Abdullah
Ma'n
M
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
Theobald
Dale E
DE
Butler
Donna
D
Kroenke
Kurt
K
Perkins
Anthony
A
Edgerton
Sara
S
Dugan
William M
WM
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
Am J Public Health. 1998 Sep;88(9):1392-5
9736886
Cancer Invest. 2003;21(4):564-78
14533447
CA Cancer J Clin. 2003 Nov-Dec;53(6):356-71
15224975
J Natl Cancer Inst. 2003 Aug 6;95(15):1110-7
12902440
Oncology (Williston Park). 2002 Sep;16(9 Suppl 10):64-70
12380956
Arch Intern Med. 2003 Jul 28;163(14):1727-34
12885689
J Gen Intern Med. 2003 Sep;18(9):736-44
12950483