Does the Use of Social Media Affect the Online Health Information-Seeking Behaviors Among Underserved African Americans in Rural Alabama?

Purpose: With widely adoption and utilization of the Internet, more and more people are using the Internet for health-seeking purposes. However, little is known about the online health information-seeking behaviors among African Americans living in rural areas. This study aimed to (1) investigate levels of technology device access & social media use among African Americans in rural Alabama, (2) examine the prevalence of online health information-seeking behaviors, and (3) identify associations between technology device access & social media use and online health information-seeking behaviors.

Methods: A convenient sample of 185 African Americans aged 18 or older were recruited from a rural county in Alabama. Data was collected through self-administered questionnaires. Online health information-seeking behaviors were measured by 11 binary questions, such as “have you ever looked for information about quitting smoking online?” (0=No, 1= Yes). The online health information seeking behaviors score was the sum of the 11 different behaviors. Technology access was measured by the technology device access and the number of frequently used social networking sites. Multi-linear regression was conducted to identify associations between technology access and online health information-seeking behaviors. Other variables, including health status, health service access, and demographic variables were also included in the regression model.

Results: More than half of participants had access to the Internet (60.0%), smartphone (58.4%), and tablets/computers (55.1%). The number of frequently used social networking sites was .82 (SD=.94). The prevalence of online health information-seeking behaviors was low. The most frequent behavior among this sample was “keeping track of personal health information such as care received, test results, or upcoming medical appointments”, which was only 36.8%. Then about one third of participants “looked for health or medical information for someone else” (34.1%) and “visited a social networking site to read and share about medical topics” (31.4%). The prevalence of all other behaviors was less than 30%. Technology device access was not associated with online health information-seeking behaviors, while more social networking sites were associated with more online health information-seeking behaviors (B=.76, p< .001). Younger age, being bothered by pain, having health insurance and primary physician were associated with more online health information-seeking behaviors.

Conclusion: The study underscores the importance of promoting internet use for health purposes among African Americans living in rural areas. Furthermore, subgroups of the sample (e.g., older and those without health insurance or primary physician) had more challenges in obtaining online health information and thus, were more likely to be excluded from the benefits of digital health. Public health interventions such as education programs for technology use should target toward these groups to narrow the access gap. At the same time, it should be noted that heavy reliance on online health has the risk of reproducing or exacerbating health inequalities. Thus, offline health information services may be provided in parallel for those who lack internet access and support.