J. Med. Internet Res. - Matrix analysis of the digital divide in eHealth services using awareness, want, and adoption gap.


{ group(2977) signific(1463) compar(1072) }
{ inform(2794) health(2639) internet(1427) }
{ method(984) reconstruct(947) comput(926) }
{ health(3367) inform(1360) care(1135) }
{ first(2504) two(1366) second(1323) }
{ imag(2675) segment(2577) method(1081) }
{ studi(1410) differ(1259) use(1210) }
{ imag(2830) propos(1344) filter(1198) }
{ use(1733) differ(960) four(931) }
{ measur(2081) correl(1212) valu(896) }
{ method(1219) similar(1157) match(930) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ age(1611) year(1155) adult(843) }
{ analysi(2126) use(1163) compon(1037) }
{ method(1969) cluster(1462) data(1082) }
{ perform(1367) use(1326) method(1137) }
{ intervent(3218) particip(2042) group(1664) }
{ method(2212) result(1239) propos(1039) }
{ studi(2440) review(1878) systemat(933) }
{ learn(2355) train(1041) set(1003) }
{ extract(1171) text(1153) clinic(932) }
{ design(1359) user(1324) use(1319) }
{ research(1085) discuss(1038) issu(1018) }
{ use(2086) technolog(871) perceiv(783) }
{ health(1844) social(1437) communiti(874) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ take(945) account(800) differ(722) }
{ clinic(1479) use(1117) guidelin(835) }
{ care(1570) inform(1187) nurs(1089) }
{ howev(809) still(633) remain(590) }
{ data(3963) clinic(1234) research(1004) }
{ perform(999) metric(946) measur(919) }
{ system(1050) medic(1026) inform(1018) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ studi(1119) effect(1106) posit(819) }
{ spatial(1525) area(1432) region(1030) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ state(1844) use(1261) util(961) }
{ patient(2837) hospit(1953) medic(668) }
{ cost(1906) reduc(1198) effect(832) }
{ sampl(1606) size(1419) use(1276) }
{ data(3008) multipl(1320) sourc(1022) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ estim(2440) model(1874) function(577) }
{ detect(2391) sensit(1101) algorithm(908) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ featur(3375) classif(2383) classifi(1994) }
{ network(2748) neural(1063) input(814) }
{ patient(2315) diseas(1263) diabet(1191) }
{ motion(1329) object(1292) video(1091) }
{ assess(1506) score(1403) qualiti(1306) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ concept(1167) ontolog(924) domain(897) }
{ algorithm(1844) comput(1787) effici(935) }
{ control(1307) perform(991) simul(935) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ search(2224) databas(1162) retriev(909) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ risk(3053) factor(974) diseas(938) }
{ import(1318) role(1303) understand(862) }
{ compound(1573) activ(1297) structur(1058) }
{ blood(1257) pressur(1144) flow(957) }
{ record(1888) medic(1808) patient(1693) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ gene(2352) biolog(1181) express(1162) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ decis(3086) make(1611) patient(1517) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }


CKGROUND: The digital divide usually refers to access or usage, but some studies have identified two other divides: awareness and demand (want). Given that the hierarchical stages of the innovation adoption process of a customer are interrelated, it is necessary and meaningful to analyze the digital divide in eHealth services through three main stages, namely, awareness, want, and adoption.OBJECTIVE: By following the three main integrated stages of the innovation diffusion theory, from the customer segment viewpoint, this study aimed to propose a new matrix analysis of the digital divide using the awareness, want, and adoption gap ratio (AWAG). I compared the digital divide among different groups. Furthermore, I conducted an empirical study on eHealth services to present the practicability of the proposed methodology.METHODS: Through a review and discussion of the literature, I proposed hypotheses and a new matrix analysis. To test the proposed method, 3074 Taiwanese respondents, aged 15 years and older, were surveyed by telephone. I used the stratified simple random sampling method, with sample size allocation proportioned by the population distribution of 23 cities and counties (strata).RESULTS: This study proposed the AWAG segment matrix to analyze the digital divide in eHealth services. First, awareness and want rates were divided into two levels at the middle point of 50%, and then the 2-dimensional cross of the awareness and want segment matrix was divided into four categories: opened group, desire-deficiency group, perception-deficiency group, and closed group. Second, according to the degrees of awareness and want, each category was further divided into four subcategories. I also defined four possible strategies, namely, hold, improve, evaluate, and leave, for different regions in the proposed matrix. An empirical test on two recently promoted eHealth services, the digital medical service (DMS) and the digital home care service (DHCS), was conducted. Results showed that for both eHealth services, the digital divides of awareness, want, and adoption existed across demographic variables, as well as between computer owners and nonowners, and between Internet users and nonusers. With respect to the analysis of the AWAG segment matrix for DMS, most of the segments, except for people with marriage status of Other or without computers, were positioned in the opened group. With respect to DHCS, segments were separately positioned in the opened, perception-deficiency, and closed groups.CONCLUSIONS: Adoption does not closely follow people's awareness or want, and a huge digital divide in adoption exists in DHS and DHCS. Thus, a strategy to promote adoption should be used for most demographic segments.

Resumo Limpo

ckground digit divid usual refer access usag studi identifi two divid awar demand want given hierarch stage innov adopt process custom interrel necessari meaning analyz digit divid ehealth servic three main stage name awar want adoptionobject follow three main integr stage innov diffus theori custom segment viewpoint studi aim propos new matrix analysi digit divid use awar want adopt gap ratio awag compar digit divid among differ group furthermor conduct empir studi ehealth servic present practic propos methodologymethod review discuss literatur propos hypothes new matrix analysi test propos method taiwanes respond age year older survey telephon use stratifi simpl random sampl method sampl size alloc proport popul distribut citi counti strataresult studi propos awag segment matrix analyz digit divid ehealth servic first awar want rate divid two level middl point dimension cross awar want segment matrix divid four categori open group desiredefici group perceptiondefici group close group second accord degre awar want categori divid four subcategori also defin four possibl strategi name hold improv evalu leav differ region propos matrix empir test two recent promot ehealth servic digit medic servic dms digit home care servic dhcs conduct result show ehealth servic digit divid awar want adopt exist across demograph variabl well comput owner nonown internet user nonus respect analysi awag segment matrix dms segment except peopl marriag status without comput posit open group respect dhcs segment separ posit open perceptiondefici close groupsconclus adopt close follow peopl awar want huge digit divid adopt exist dhs dhcs thus strategi promot adopt use demograph segment

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