Objective

To investigate the changes in total internet and mobile internet use over time and determine how demographic characteristics are related to changes in internet and mobile internet use among individuals with spinal cord injury (SCI).

Design

Cross-sectional analysis of a multicenter cohort study.

Setting

National SCI Database.

Participants

Individuals with traumatic SCI with follow-up data collected between 2012 and 2018 (N=13,622).

Interventions

Not applicable.

Main Outcome Measures

Proportion of sample reporting internet use at all or through a mobile device over time and specifically in 2018.

Results

The proportion of internet users increased from 77.7% in 2012 to 88.1% in 2018. Older participants (P<.001); those with lower annual income (P<.001), less education (P<.001), non-White race or Hispanic ethnicity (P<.001), or motor incomplete tetraplegia (P=.004); and men (P=.035) were less likely to use the internet from 2012-2018. By 2018, there were no longer differences in internet use based on race and ethnicity (P=.290) or sex (P=.066). Mobile internet use increased each year (52.4% to 87.7% of internet users from 2012-2018), with a participant being 13.7 times more likely to use mobile internet in 2018 than 2012. Older age (P<.001), income <$50,000 (P<.001), high school diploma or less (P=.011), or non-Hispanic White race/ethnicity (P=.001) were associated with less mobile internet use over time. By 2018, there were no differences in mobile internet use by education (P=.430), and only participants with incomes >$75,000 per year had greater odds of mobile internet use (P=.016).

Conclusions

Disparities associated with internet access are decreasing likely as a result of mobile device use. Increased internet access offers an important opportunity to provide educational and training materials to frequently overlooked groups of individuals with SCI.

中文翻译：

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创伤性脊髓损伤患者互联网使用随时间的变化

客观的

调查互联网和移动互联网使用总量随时间的变化，并确定人口特征与脊髓损伤 (SCI) 患者互联网和移动互联网使用变化的关系。

设计

多中心队列研究的横断面分析。

环境

国家 SCI 数据库。

参加者

在 2012 年至 2018 年间收集了随访数据的创伤性 SCI 患者 (N=13,622)。

干预措施

不适用。

主要观察指标

随着时间的推移，特别是在 2018 年，样本报告完全或通过移动设备使用互联网的比例。

结果

互联网用户比例从 2012 年的 77.7% 增加到 2018 年的 88.1%。年龄较大的参与者 ( P <.001)；年收入较低 ( P <.001)、受教育程度较低 ( P <.001)、非白人或西班牙裔 ( P <.001) 或运动不完全性四肢瘫痪 ( P =.004) 的人；从 2012 年到 2018 年，男性 ( P =.035) 不太可能使用互联网。到 2018 年，基于种族和族裔 ( P =.290) 或性别 ( P =.066) 的互联网使用不再存在差异。移动互联网的使用每年都在增加（从 2012 年到 2018 年占互联网用户的 52.4% 到 87.7%），参与者在 2018 年使用移动互联网的可能性是 2012 年的 13.7 倍。年龄较大（P <.001)、收入 <50,000 美元 ( P <.001)、高中文凭或以下 ( P =.011) 或非西班牙裔白人种族/民族 ( P =.001) 与移动互联网使用较少相关时间。到 2018 年，教育对移动互联网的使用没有差异 ( P =.430)，只有年收入超过 75,000 美元的参与者使用移动互联网的几率更大 ( P =.016)。

结论

由于移动设备的使用，与互联网访问相关的差异可能正在减少。增加互联网访问提供了一个重要的机会，可以为经常被忽视的脊髓损伤患者群体提供教育和培训材料。