Internet Access and Online Cancer Information Seeking Among Latino Immigrants From Safety Net Clinics

Abstract

Internet use is widespread, but little is known about Internet use for cancer information among Latinos, especially those who rely on safety net clinics. The authors investigated access to and intended use of the Internet for cancer information among low income, immigrant Latinos predominately from Central and South America. A cross-sectional study of 1,273 Latinos 21 years and older attending safety net clinics or health fairs was conducted from June 2007 to November 2008. The authors used logistic regression models to evaluate associations of age, acculturation, psychosocial factors and other covariates with Internet access and intended use of the Internet for cancer information among those with access. Of the sample, 44% reported Internet access. Higher information self-efficacy and greater trust in the Internet were independently associated with Internet access (p = .05 and p < .001, respectively). Among those with access, 53.8% reported they intended to seek cancer help online if they needed information. Those with younger age and higher acculturation, education and self-efficacy had higher odds of intended Internet use for cancer information, considering covariates. In addition, those with high (vs. low) perceived risk of cancer (OR = 1.76; 95% CI [1.14, 2.73]; p = .01) and higher levels of trust in online health information (OR = 1.47 per one-point increase; 95% [CI 1.19, 1.82]; p = .0004) were more likely to intend to seek cancer information online. These findings that Internet access is fairly high in the immigrant Latino population and that the Internet is a trusted source of cancer information suggest that the Internet may be a channel for cancer control interventions.

Acknowledgments

This research was supported by National Cancer Institute Grant #U01 CA114593, #KO5 CA96940 (to J.S.M.) and the Biostatistics and Bioinformatics Shared Resources at Lombardi Comprehensive Cancer Center under Grant #P30CA51008 (to G.L. and A.N.).

We thank our clinic partners for their participation in the study: Arlington Free Clinic, Community Clinics Inc., INOVA-Fairfax Hospital, La Clínica del Pueblo, the Preventorium at Washington Hospital Center, and the Spanish Catholic Center. We also thank our study participants from the Latino community of the Washington, D.C. area for their participation.

The Latin American Cancer Research Coalition includes: Elmer Huerta, MD, MPH; Jeanne Mandelblatt, MD MPH; Celia Byrne, PhD; Amanda Graham, PhD; Kristi D. Graves, PhD; Barbara Kreling, PhD; Claire Selsky, MA; Wenchi Liang, PhD; Christopher A. Loffredo, PhD; Maria Lopez-Class, PhD, MPH; Gheorghe Luta, PhD; Anne-Michelle Noone, MS, Yosselyn Rodríguez; Monique Perret-Gentil, MD, MS; Michael A. Sanchez, MPH, CHES; Jessika Angulo-Duarte; Vanessa Sheppard, PhD; Marc Schwartz, PhD; Enrique Cobham, MHA; Marguerite R. Duane, MD; Christine Reesor MSN, FNP; Janet M. Cañar, MD, MS; Gary L. Kreps, PhD; Michael Dalious, MA; Nancy Pallesen, MSW; Jyl Pomeroy, RN; Kirsten Edmiston, MD; Elita Christiansen, MA, MPA; Barbara Merritt, RN; Stacey Banks; Ronald Greger, MD; Donetta Padmore; Margarita Gutierrez; Larisa C. Caicedo S., MS; Cherie Spencer, MS; Jacqueline Burgess; Guadalupe Mota; Nadiyah Sulayman; Helen Hernandez; Margarita Peredes; Cynthia Renderos; Natalie Quesada; Bruno Tavasaki; Jose-Pablo Buerba; Héctor A. Colón-Rivera; Hema Datwani; Ana Maria Galvez; Anna Martignetti.

Anne-Michelle Noone is presently at the National Cancer Institute, Division of Cancer Control and Population Sciences, Surveillance Research Program. This work was completed while Ms. Noone was at Georgetown University.

Notes

*Values were computed using chi-square tests for categorical characteristics and t test for continuous characteristics. Missing/refused was not included in the calculation of the p values.

**Because numbers in specific countries were small, analysis was done at the regional level.

Self-efficacy ranges from 1 to 9 with higher scores representing higher self-efficacy.

Acculturation ranges from 1 to 5 with higher scores representing higher acculturation.

Trust in online health information ranges from 1 to 5 with higher scores representing higher trust in online health information.

*Values were computed using chi-square tests for categorical characteristics and t-test for continuous characteristics. Unknown/refused was not included in the calculation of the p values.

Self-efficacy ranges from 1 to 9 with higher scores representing higher self-efficacy.

Acculturation ranges from 1 to 5 with higher scores representing higher acculturation.

Trust in online health information ranges from 1 to 5 with higher scores representing higher trust in online health information.

*Adjusted results from a logistic regression model that included all listed predictors and country of origin (N = 1,092). Hosmer-Lemeshow goodness-of-fit test: p = .886.

**Adjusted results from a logistic regression model that included all listed predictors and country of origin (N = 428). Hosmer-Lemeshow goodness-of-fit test: p = .511.