Bridging the Digital Divide: Report on Focus Groups with Low-income Urban and Rural Residents in Pennsylvania

In recent years, the growth in technology and new media has created a communications revolution that allows people instant and equal access to previously unavailable or difficult-to-find information. Despite this proliferation,, however, there remains a gap, a "Digital Divide", between Americans who have access to technology and those who do not. According to the most recent report from the Department of Commerce', only onequarter of those making less than $15,000 a year have computers. White households are still more than twice as likely to own a computer than Black and Hispanic households. In addition, 60.2% of adults with only a high school degree and 87.2% of adults with less than a high school education currently do not have access to the Intemet. This divide in access, especially in relationship to finding health information, is a substantial barrier to underserved audiences who are already at greatest risk for poor health outcomes. Addressing this issue, however, will require a multi-dimensional approach combining innovation with proven public health approaches that tackle not just the lack oftechnology but the myriad of issues facing underserved audiences related to seeking and using health information. To elucidate how low-income minorities feel about having access to Internet information, we conducted focus groups with urban African Americans and rural Latinos who were clients ofcommunity nursing centers. In addition to the focus group a paper survey was administered to assess whether clients had any computer or Internet skills and whether they would be interested in utilizing technology if it were offered at the nursing centers. Overall, clients of these centers had similar responses, although the rural participants were more concerned with transportation issues than the urban participants. In general, nursing center clients were positive about having computers and Intemet access where they would be able to retrieve health and cancer information. Both groups conveyed that having access would help them be more confident about their health and would help them talk to their doctors. The urban group, especially, felt that the Intemet would give them the opportunity to get the "whole picture", meaning they could get all the information about a disease or condition, not just what a doctor "chose" to tell them. Comments are directly related to the theoretical constructs of self-efficacy and patient-provider communication(see Table 1). They also highlight the need to have help available for people to interpret and access health information. Both groups were apprehensive about using computers. In the two groups, only two participants had ever used computers and neither ofthem had ever used the Intemet. Participants said that they would be willing to try only if there were people who could help. Many related the fear of breaking the equipment if they touched it. Many also felt they needed someone they trusted to help interpret health information they would retrieve. In conclusion, while it is important to have access to quality Intemet health information, it is equally important to address the barriers that low-income communities have to adequately access and assess that information. Qualitative focus group research is one way to understand these issues.