title: Uptake and Acceptability of Information and Communication Technology in a Community-Based Cohort of People Who Inject Drugs: Implications for Mobile Health Interventions.
abstract: BACKGROUND
  Mobile phone and Internet-based technologies are increasingly used to disseminate health information and facilitate delivery of medical care. While these strategies hold promise for reducing barriers to care for medically-underserved populations, their acceptability among marginalized populations such as people who inject drugs is not well-understood.
  
  
  OBJECTIVE
  To understand patterns of mobile phone ownership, Internet use and willingness to receive health information via mobile devices among people who inject drugs.
  
  
  METHODS
  We surveyed current and former drug injectors participating in a longitudinal cohort study in Baltimore, Maryland, USA. Respondents completed a 12-item, interviewer-administered questionnaire during a regular semi-annual study visit that assessed their use of mobile technology and preferred modalities of receiving health information. Using data from the parent study, we used logistic regression to evaluate associations among participants' demographic and clinical characteristics and their mobile phone and Internet use.
  
  
  RESULTS
  The survey was completed by 845 individuals, who had a median age of 51 years. The sample was 89% African-American, 65% male, and 33% HIV-positive. Participants were generally of low education and income levels. Fewer than half of respondents (40%) indicated they had ever used the Internet. Mobile phones were used by 86% of respondents. Among mobile phone owners, 46% had used their phone for text messaging and 25% had accessed the Internet on their phone. A minority of respondents (42%) indicated they would be interested in receiving health information via phone or Internet. Of those receptive to receiving health information, a mobile phone call was the most favored modality (66%) followed by text messaging (58%) and Internet (51%).
  
  
  CONCLUSIONS
  Utilization of information and communication technology among this cohort of people who inject drugs was reported at a lower level than what has been estimated for the general U.S.
  
  
  METHODS
  Our findings identify a potential barrier to successful implementation of mobile health and Internet-based interventions for people who inject drugs, particularly those who are older and have lower levels of income and educational attainment. As mobile communication technology continues to expand, future studies should re-examine whether mHealth applications become more accessible and accepted by socioeconomically disadvantaged groups.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: Andrew
authors.identifier: http://orcid.org/0000-0001-5636-6827
authors.initials: A
authors.lastname: Genz
authors.forename: Gregory
authors.identifier: http://orcid.org/0000-0002-7829-1405
authors.initials: G
authors.lastname: Kirk
authors.forename: Damani
authors.identifier: http://orcid.org/0000-0003-2393-1193
authors.initials: D
authors.lastname: Piggott
authors.forename: Shruti H
authors.identifier: http://orcid.org/0000-0002-2523-0959
authors.initials: SH
authors.lastname: Mehta
authors.forename: Beth S
authors.identifier: http://orcid.org/0000-0002-0058-5147
authors.initials: BS
authors.lastname: Linas
authors.forename: Ryan P
authors.identifier: http://orcid.org/0000-0001-5701-4516
authors.initials: RP
authors.lastname: Westergaard
keywords: Internet; cellular phone; intravenous; substance abuse; telemedicine; text messaging