title: Pediatric caregiver attitudes toward email communication: survey in an urban primary care setting.
abstract: BACKGROUND
  Overall usage of email communication between patients and physicians continues to increase, due in part to expanding the adoption of electronic health records and patient portals. Unequal access and acceptance of these technologies has the potential to exacerbate disparities in care. Little is known about the attitudes of pediatric caregivers with regard to their acceptance of email as a means to communicate with their health care providers.
  
  
  OBJECTIVE
  We conducted a survey to assess pediatric caregiver access to and attitudes toward the use of electronic communication modalities to communicate with health care providers in an urban pediatric primary care clinic.
  
  
  METHODS
  Participants were pediatric caregivers recruited from an urban pediatric primary care clinic in Baltimore, Maryland, who completed a 35-item questionnaire in this cross-sectional study.
  
  
  RESULTS
  Of the 229 caregivers who completed the survey (91.2% response rate), 171 (74.6%) reported that they use email to communicate with others. Of the email users, 145 respondents (86.3%) stated that they would like to email doctors, although only 18 (10.7%) actually do so. Among email users, African-American caregivers were much less likely to support the expanded use of email communication with health care providers (adjusted OR 0.34, 95% CI 0.14-0.82) as were those with annual incomes less than US $30,000 (adjusted OR 0.26, 95% CI 0.09-0.74).
  
  
  CONCLUSIONS
  Caregivers of children have access to email and many would be interested in communicating with health care providers. However, African-Americans and those in lower socioeconomic groups were much less likely to have positive attitudes toward email.
authors.affiliation: Johns Hopkins Bayview Medical Center, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States. rdudas@jhmi.edu.
authors.forename: Robert Arthur
authors.initials: RA
authors.lastname: Dudas
authors.forename: Michael
authors.initials: M
authors.lastname: Crocetti
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003625:Data Collection; D034742:Electronic Mail; D005260:Female; D006801:Humans; D009035:Mothers; D011320:Primary Health Care; D019037:Urban Health Services
keywords: communication; electronic mail; email; health care disparities; pediatrics; primary health care