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Factors Associated with Reducing Disparities in Electronic Personal Heath Records Use Among Non-Hispanic White and Hispanic Adults

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Abstract

Objectives

Personal health records (PHR) use has improved individuals’ health outcomes. The adoption of PHR remains low with documented racial disparities. We aim to determine factors associated with reducing racial and ethnic disparities among Hispanic adults in PHR use.

Methods

Participants included non-Hispanic White (NHW) and Hispanic adults (age ≥ 18 years) enrolled in Health Information National Trends Survey in 2018 and 2019. We identified PHR use as online medical record access in the last 12 months. We considered three factors (1. accessing mHealth Apps on the phone, 2. having a usual source of care, and 3. electronically communicating (e-communication) with healthcare providers) as facilitating PHR use. Multivariable logistic regressions with replicate weights were analyzed to determine factors associated with racial/ethnic disparities in PHR use after controlling for general characteristics (i.e., sex, age, education, insurance status, and income).

Results

A lower percentage of Hispanics than NHWs used PHR (42.0% vs. 53.5%, P < .001). When adjusted for individual general characteristics, the adjusted odds ratio (AOR) of e-communication with healthcare providers associated with PHR use was 1.49 (1.19–1.86, P < .001), AOR was 2.06 (1.62–2.6, P < .001) on accessing to mHealth App, and 2.60 (1.86–3.63, P < .001) on having a usual source of care. However, the racial difference was not statistically significant after adjusting three factors promoting PHR use (AOR = 0.90, 95% CI = 0.66, 1.22, P = .48).

Conclusions

Ethnic disparities were reduced when PHR use was facilitated by having a usual source of care, active e-communication, and having access to mHealth apps. Interventions focusing on these three factors may potentially reduce racial/ethnic disparities.

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Funding

This research was, in part, funded by the National Institutes of Health (NIH) Agreement No. 1OT2OD032581-01 (Usha Sambamoorthi) and the National Institute on Minority Health and Health Disparities through the Texas Center for Health Disparities (NIMHD), 5U54MD006882-10 (Hao Wang and Usha Sambamoorthi). The views and conclusions contained in this document are those of the authors and should not be interpreted as representing the official policies, either expressed or implied, of the NIH.

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Authors and Affiliations

  1. Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX, 76104, USA

    Hao Wang & Amy F. Ho

  2. Department of Pharmacotherapy, Texas Center for Health Disparity, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX, 76107, USA

    Sydney E. Manning & Usha Sambamoorthi

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  1. Hao Wang
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  2. Sydney E. Manning
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Contributions

Hao Wang: conceptualization, methodology, validation, formal analysis, investigation, data curation, writing-original draft, writing—review and editing, project administration. Sydney E. Manning: conceptualization, investigation, writing—review and editing. Amy F. Ho: conceptualization, investigation, writing—review and editing. Usha Sambamoorthi: conceptualization, investigation, methodology, validation, formal analysis, data curation, writing—review and editing, supervision.

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Correspondence to Hao Wang.

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Ethics Approval

This is an observational study. The University of North Texas Health Science Center Regional Institutional Review Board has confirmed that no ethical approval is required (IRB, No.1705528–1).

Competing Interests

Hao Wand and Usha Sambamoorthi received funding from the National Institutes of Health (NIH). Sydney Manning and Amy Ho declare they have no financial interests.

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Table 5 Detail variable descriptions used in this study
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Wang, H., Manning, S.E., Ho, A.F. et al. Factors Associated with Reducing Disparities in Electronic Personal Heath Records Use Among Non-Hispanic White and Hispanic Adults. J. Racial and Ethnic Health Disparities 10, 1201–1211 (2023). https://doi.org/10.1007/s40615-022-01307-5

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