Case Western Reserve University School of Medicine, Case Comprehensive Cancer Center, Cleveland, Ohio.
Center for Wellbeing Research, Optum, Eden Prairie, Minnesota.
Ethn Dis. 2019 Jul 18;29(3):495-504. doi: 10.18865/ed.29.3.495. eCollection 2019 Summer.
Internet-based tobacco cessation programs have increased in use and popularity in recent years. To examine evidence for racial/ethnic digital inequality in web-only tobacco cessation services offered by US tobacco quitlines, we conducted an analysis of quitline enrollees in five states. We hypothesized that racial/ethnic minorities would demonstrate lower enrollment and utilization of a web-only tobacco cessation program.
The sample includes enrollees into five state quitlines whose service options included a web-only program in 2015 (N=32,989). Outcomes included web-entry into the quitline, web-only enrollment, establishment of a web account, and the number of times users logged into the program. Regression models tested associations with race/ethnicity.
Compared with Whites, African Americans, Hispanics, American Indians/Alaska Natives, and "others" were less likely to enter the quitline via the web (Ps<.01) and enroll in a web-only (vs counseling) program (Ps<.01). Among web-only program enrollees, all racial/ethnic minority groups were significantly less likely than Whites to establish an online account (Ps<.03), and African Americans were less likely than Whites to log in to the web-only service (P<.01).
This study suggests that digital inequalities exist in web-based tobacco cessation services. Findings have implications for the development and implementation of digital tobacco interventions for racial/ethnic minority communities. The proliferation of digital tobacco interventions could increase disparities, as members of racial/ethnic minority groups may not engage in these interventions.
The proliferation of digital interventions has the potential to increase tobacco-related disparities, as members of racial/ethnic minority groups may not enroll in, or engage in, such interventions. As the field moves to digitize tobacco interventions, we must remain cognizant of persistent digital inequalities and the potential for widening racial/ethnic tobacco cessation disparities.
近年来，基于互联网的戒烟项目越来越普及。为了研究美国戒烟热线提供的仅网络戒烟服务中是否存在种族/民族数字不平等现象，我们对五个州的戒烟热线参与者进行了分析。我们假设，少数族裔的网络戒烟项目参与度和使用率会较低。
该样本包括 2015 年参加五个州戒烟热线且服务选项包括仅网络项目的参与者（N=32989）。结果包括通过网络进入戒烟热线、仅网络注册、建立网络账户以及用户登录程序的次数。回归模型检验了种族/民族与结果之间的关联。
与白人相比，非裔美国人、西班牙裔、美国印第安人/阿拉斯加原住民和“其他”人群更不可能通过网络进入戒烟热线（P<.01），也更不可能注册仅网络（而非咨询）项目（P<.01）。在仅网络项目注册者中，所有少数族裔群体比白人更不可能建立在线账户（P<.03），非裔美国人登录仅网络服务的可能性也低于白人（P<.01）。
本研究表明，基于网络的戒烟服务中存在数字不平等现象。研究结果对为少数族裔社区开发和实施数字烟草干预措施具有启示意义。数字烟草干预措施的普及可能会加剧差异，因为少数族裔群体的成员可能不会参与这些干预措施。
数字干预措施的普及有可能增加与烟草相关的差异，因为少数族裔群体的成员可能不会注册或参与此类干预措施。随着该领域转向数字化干预措施，我们必须意识到持续存在的数字不平等现象，以及扩大种族/民族戒烟差距的潜在风险。
