Changes in Internet Use Over Time Among Individuals with Traumatic Spinal Cord Injury |
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| Institution: | 1. Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh PA;2. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;3. Departments of Bioengineering;4. Physical Medicine and Rehabilitation;5. Physical Therapy, and;6. Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA;7. Baylor College of Medicine, Houston, TX;8. MetroHealth Medical Center, Cleveland, OH;9. Shirley Ryan AbilityLab and Northwestern University Feinberg School of Medicine, Chicago, IL;1. Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA;2. Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA;3. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA;5. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL;6. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA;1. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;4. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;5. Rehabilitation Science and Technology, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;6. Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, AL;7. Feinberg School of Medicine, Northwestern University, Chicago, IL;8. Shirley Ryan Ability Lab, Chicago, IL;9. Kessler Foundation, West Orange, NJ;10. Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ;1. Sociology Department, Vrije Universiteit Amsterdam, Netherlands;2. College of Health Sciences, Marquette University, Milwaukee, Wisconsin;3. Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois;4. Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois;5. Craig Hospital, Englewood, Colorado;6. University of Colorado, Denver, Colorado;7. UT Health Science Center at Houston, Houston, Texas;8. Neurorecovery Research Center, TIRR Memorial Hermann, Houston, Texas;9. Shepherd Center, Atlanta, Georgia;10. Division of Physical Therapy, Emory University School of Medicine, Atlanta, Georgia;1. Spaulding Rehabilitation Hospital, Boston, MA;2. The Miami Project to Cure Paralysis-University of Miami Miller School of Medicine, Miami, FL;3. Thomas Jefferson University Hospital and Magee Rehabilitation Hospital, Philadelphia PA;4. Belford Center for Spinal Cord Injury, The Ohio State University, Wexner Medical Center, Columbus, OH;5. Spinal Cord Injury Medicine, Department of Neurology, The Ohio State University, Wexner Medical Center, Columbus, OH;6. Department of Physical Medicine and Rehabilitation, The Ohio State University, Wexner Medical Center, Columbus, OH;7. Southern California Spinal Cord Injury Model System, Downey, CA;8. Rancho Research Institute at Rancho Los Amigos National Rehabilitation Center, Downey, CA;1. College of Health Professions, Medical University of South Carolina, Charleston, SC;2. Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA;3. Department of Psychiatry, University of California, San Diego, La Jolla, CA;1. Research Department, Craig Hospital, Englewood, CO;2. Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN;3. Department of Psychology, University of Colorado, Denver, CO;4. Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical School, Aurora, CO;5. Rocky Mountain Regional VA Medical Center, Aurora, CO;6. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA;7. CNS Medical Group, Englewood CO |
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| Abstract: | ObjectiveTo investigate the changes in total internet and mobile internet use over time and determine how demographic characteristics are related to changes in internet and mobile internet use among individuals with spinal cord injury (SCI).DesignCross-sectional analysis of a multicenter cohort study.SettingNational SCI Database.ParticipantsIndividuals with traumatic SCI with follow-up data collected between 2012 and 2018 (N=13,622).InterventionsNot applicable.Main Outcome MeasuresProportion of sample reporting internet use at all or through a mobile device over time and specifically in 2018.ResultsThe proportion of internet users increased from 77.7% in 2012 to 88.1% in 2018. Older participants (P<.001); those with lower annual income (P<.001), less education (P<.001), non-White race or Hispanic ethnicity (P<.001), or motor incomplete tetraplegia (P=.004); and men (P=.035) were less likely to use the internet from 2012-2018. By 2018, there were no longer differences in internet use based on race and ethnicity (P=.290) or sex (P=.066). Mobile internet use increased each year (52.4% to 87.7% of internet users from 2012-2018), with a participant being 13.7 times more likely to use mobile internet in 2018 than 2012. Older age (P<.001), income <$50,000 (P<.001), high school diploma or less (P=.011), or non-Hispanic White race/ethnicity (P=.001) were associated with less mobile internet use over time. By 2018, there were no differences in mobile internet use by education (P=.430), and only participants with incomes >$75,000 per year had greater odds of mobile internet use (P=.016).ConclusionsDisparities associated with internet access are decreasing likely as a result of mobile device use. Increased internet access offers an important opportunity to provide educational and training materials to frequently overlooked groups of individuals with SCI. |
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