Adults

with different insurance coverage vary in their individual, kinase inhibitors family, and medical traits, as confirmed in the survey sample. We found substantial differences in Internet and mHealth use among adults in our insurance-based groups, which were strongly associated with differences in individual and clinical traits (for additional analysis, see Supplement, Exhibits A1–A6). After adjustment, we found fewer differences in use by insurance type (e.g., Medicare beneficiaries had similar odds of specific health information behaviors), and the direction of some associations changed (e.g., reversal in the association where Medicaid beneficiaries became more likely to seek information online from a doctor than privately insured adults after adjustment). Exhibit A1. Percent Seeking Health Information from Friends and Family, Any Online Efforts vs. Offline Only, by Insurance Type (Unadjusted Percent) Exhibit A6. Attempt at Self-Diagnosis Through Online Search (Multivariate Logistic Model) Therefore,

we found that insurance type alone does not explain the variation observed in eHealth. Though insurance might be an informative predictor of eHealth use, our results suggest that any evaluations of insurance type and technology use among population subgroups cannot ignore the variation due to individual socio-demographic factors. Policy interventions often target populations according to insurance coverage, but our results suggest that future policies to facilitate technology use targeted to insurance groups alone will not address all major contributing sources to technology use variation. Our results showing that eHealth use remains limited despite access to the Internet and cell phones are

consistent with the literature implying that access alone cannot explain differences in utilization by insurance type (Fung et al., 2006; Span, 2013). Our results also reiterate that even after accounting for insurance and income, disparities in access to technology-based care Cilengitide remain. These findings suggest that more investigations are needed to explain the digital divide with respect to eHealth. The Pew Research Center survey provides valuable, impartial information about how Americans use eHealth, and this study indicates how insurance type might be associated with that use. Consistent assessment of use will provide knowledge on how to employ and target eHealth tools within the health care system. The Pew data and this study have notable limitations. The survey results are based on self-reported behaviors, which are subject to recall bias and could be correlated with other traits (e.g., level of need). Due to our cross-sectional study design, our study is limited to a descriptive analysis representing associations rather than any causal inferences.