Mahmood Asos, Mahmood Aram, Kedia Satish, Chang Cyril F
Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, Memphis, TN.
Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN.
Med Care. 2025 Feb 1;63(2):111-116. doi: 10.1097/MLR.0000000000002092. Epub 2024 Nov 8.
Mobile health applications (mHealth apps) can provide health care and health-promoting information while contributing to improving cancer survivors' quality of life and health outcomes. However, little is known about the rural-urban distribution of mHealth app ownership and utilization. In this study, we explore the characteristics of cancer survivors who own and use mHealth apps and examine rural-urban disparities in mHealth app ownership and utilization among cancer survivors.
We utilized data from the "Health Information National Trends Survey-Surveillance, Epidemiology, and End Results" pilot study, fielded among cancer survivors from 3 U.S. cancer registries (Iowa, New Mexico, and California) in 2021. Our sample included 942 cancer survivors who reported owning a smart device (a smartphone and/or a tablet computer). The analyses included computing weighted proportions and fitting a multivariable regression model.
Overall, 60.3% of cancer survivors reported using mHealth apps, and 16.9% resided in rural areas. Approximately 45.0% of rural cancer survivors reported utilizing mHealth apps (vs 63.5% of urban survivors). Regression analysis revealed that rural cancer survivors had 46.0% lower odds of owning and using mHealth apps compared with their urban counterparts (adjusted odds ratio = 0.54; 95% CI: 0.36, 0.80).
Rural cancer survivors were less likely to own and use mHealth apps compared with urban survivors. Rural cancer survivors usually face structural and health care system-related barriers to health care access and affordability. Leveraging mHealth technology as a tool could potentially contribute to improving health care delivery for rural cancer survivors, and help address existing structural and informational barriers to access.
移动健康应用程序（mHealth应用）可以提供医疗保健和促进健康的信息，同时有助于提高癌症幸存者的生活质量和健康结局。然而，关于mHealth应用的拥有情况和使用情况在城乡之间的分布，我们知之甚少。在本研究中，我们探讨拥有并使用mHealth应用的癌症幸存者的特征，并研究癌症幸存者在mHealth应用拥有情况和使用情况方面的城乡差异。
我们利用了2021年在美国3个癌症登记处（爱荷华州、新墨西哥州和加利福尼亚州）对癌症幸存者进行的“健康信息国家趋势调查-监测、流行病学和最终结果”试点研究的数据。我们的样本包括942名报告拥有智能设备（智能手机和/或平板电脑）的癌症幸存者。分析包括计算加权比例和拟合多变量回归模型。
总体而言，60.3%的癌症幸存者报告使用mHealth应用，16.9%居住在农村地区。约45.0%的农村癌症幸存者报告使用mHealth应用（城市幸存者为63.5%）。回归分析显示，与城市癌症幸存者相比，农村癌症幸存者拥有并使用mHealth应用的几率低46.0%（调整后的优势比=0.54；95%置信区间：0.36，0.80）。
与城市幸存者相比，农村癌症幸存者拥有并使用mHealth应用的可能性较小。农村癌症幸存者在获得医疗保健和支付能力方面通常面临与结构和医疗保健系统相关的障碍。利用mHealth技术作为一种工具可能有助于改善农村癌症幸存者的医疗保健服务，并有助于消除现有的结构和信息获取障碍。
