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Cited by 12Health Literacy and Information AccessibilityTechnology Use by Older AdultsMobile Health and mHealth Applications

Access to and Use of Internet and Social Media by Low-Morbidity Stroke Survivors Participating in a National Web-Based Secondary Stroke Prevention Trial: Cross-sectional Survey

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Clancy, Brigid, Bonevski, Billie, English, Coralie, Baker, Amanda L, Turner, Alyna, Magin, Parker, Pollack, Michael, Callister, Robin +1 more·2022·Journal of Medical Internet Research
DOI 10.2196/33291PMC PMC9153916

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Abstract

Background: eHealth applications for stroke are a growing area of research that has yielded promising results. However, little is known about how stroke survivors engage with the internet, social media, and other digital technologies on a day-to-day basis. Objective: This study had three main objectives: to describe the type, frequency, and purpose of technology use among a cohort of low-morbidity stroke survivors; to investigate associations between social media use and participant factors, including sociodemographics, physical function, and independence in activities of daily living; and to investigate associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Methods: This study is a secondary analysis of data obtained during a national randomized controlled trial—Prevent 2nd Stroke. The participants were stroke survivors recruited from 2 Australian stroke registries who completed 2 telephone-administered surveys to collect data on demographics and stroke characteristics; health risk factors (diet quality, physical activity, blood pressure medication, alcohol intake, anxiety and depression, and smoking status); physical functioning; independence in activities of daily living; and questions about what technology they had access to, how often they used it, and for what purposes. Participants were eligible if they had no more than a moderate level of disability (modified Rankin score ≤3) and had access to the internet. Multivariable logistic regression was used to assess the associations between social media use and sociodemographics, physical function, and independence in activities of daily living as well as associations between stroke-related health risk factors and the use of the internet to search for health and medical information. Results: Data from 354 participants were included in the analysis. Approximately 79.1% (280/354) of participants used the internet at least daily, 40.8% (118/289) accessed social media on their phone or tablet daily, and 46.4% (134/289) looked up health and medical information at least monthly. Women were 2.7 times more likely to use social media (adjusted odds ratio 2.65, 95% CI 1.51-4.72), and people aged >75 years were significantly less likely to use social media compared with those aged <55 years (adjusted odds ratio 0.17, 95% CI 0.07-0.44). Health risk factors were not found to be associated with searching for health- or medical-related information. Conclusions: The internet appears to be a viable platform to engage with stroke survivors who may not be high-morbidity to conduct research and provide information and health interventions. This is important given that they are at high risk of recurrent stroke regardless of their level of disability. Exploring the technology use behaviors and the possibility of eHealth among survivors who experience higher levels of morbidity or disability because of their stroke is an area of research that warrants further study.

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  • Digital platform recruitment can increase reach to certain communities, including those likely to opt into an online intervention.

    “It can increase reach to certain communities, including those likely to opt into an online intervention”

    From Wellbeing After Stroke (WAterS): Feasibility Testing of a Co-developed Acceptance and Commitment Therapy Intervention to Support Psychological Adjustment After Stroke. (2024) · cites this paper as [28]

    The Discussion (Principal Findings; page not provided) says social media can reach diverse or narrow audiences and may be feasible for recruiting some groups of stroke survivors. The Conclusions say the internet may be viable for engaging low-disability stroke survivors in health interventions. The paper does not establish that digital recruitment specifically reaches people more likely to opt into an online intervention. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Digital platform recruitment is threatened by digital poverty and may result in a sample skewed towards lower stroke morbidity and higher social economic status, which may limit findings.

    “but is threatened by digital poverty and may result in a sample that is skewed towards lower stroke morbidity and higher social economic status, which may limit findings.28,29”

    From Wellbeing After Stroke (WAterS): Feasibility Testing of a Co-developed Acceptance and Commitment Therapy Intervention to Support Psychological Adjustment After Stroke. (2024) · cites this paper as [28]

    The Discussion’s Strengths and Limitations section says the web-based trial required internet access and enrolled a relatively well cohort, excluding many survivors with substantial stroke-related impairments; it cautions that the findings cannot be generalized to all Australian stroke survivors. This supports the concern about lower-morbidity recruitment and limited generalizability. Our copy does not establish that digital poverty caused this selection or that the sample was skewed toward higher socioeconomic status. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Authors
Clancy, B., Bonevski, B., English, C., Baker, A. L., Turner, A., Magin, P., Pollack, M., Callister, R., & Guillaumier, A.
Affiliations
  • Hunter Medical Research Institute (AU)
  • Flinders University (AU)
  • University of Newcastle Australia (AU)
  • Deakin University (AU)
  • Hunter New England Local Health District (AU)
Corresponding author
Clancy, Brigid
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2022-05-30
Volume
24
Issue
5
Pages
e33291
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/33291
PMC
PMC9153916
OpenAlex
W4213450626
Cited by
12
References
48
Citations by year
2026: 2 · 2025: 5 · 2024: 2 · 2023: 3
FWCI
2.87
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
  • NOVA (University of Newcastle Australia) (submittedVersion, cc-by)
Funders
  • Hunter Medical Research Institute
  • Medical Research Council
  • National Health and Medical Research Council (1125429)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
  • Social Sciences › Demography › Technology Use by Older Adults
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Keywords
stroke survivors, internet use, social media use, digital technology use, secondary stroke prevention, health information seeking, health risk factors, physical function, activities of daily living, e-health, sex differences, age differences, stroke registry, online health interventions, patient engagement, anxiety and depression, smoking, alcohol consumption, physical activity, diet quality, blood pressure medication
MeSH terms
Activities of Daily Living, Australia, Cross-Sectional Studies, Female, Humans, Morbidity, Survivors, Stroke, Social Media

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