Kidney transplant and the digital divide: is information and communication technology a barrier or a bridge to transplant for African Americans?

Prog Transplant. 2013 Dec;23(4):302-9. doi: 10.7182/pit2013869.


Context: Barriers to kidney transplant for African Americans are well documented in the literature. Little information on ownership of information and communication technology and use of such technology in transplant populations has been published.

Objective: To characterize racial differences related to ownership and use of information and communication technology in kidney transplant patients.

Design: A single-center, cross-sectional survey study.

Setting: An urban Midwestern transplant center.

Participants: 78 pretransplant patients and 177 transplant recipients.

Main outcomes measures: The survey consisted of 6 demographic questions, 3 disease-related questions, and 9 technology-related questions. Dichotomous (yes/no) and Likert-scale items were the basis for the survey.

Results: Cell phone use was high and comparable between groups (94% in African Americans, 90% in whites, P= .22). A vast majority (75% of African Americans and 74% of whites) reported being "comfortable" sending and receiving text messages. Computer ownership (94.3% vs 79.3%) and Internet access (97.7% vs 80.7%) were greater among whites than African Americans (both P< .01). Fewer African Americans were frequent users of the Internet (27.1% vs 56.3%) and e-mail (61.6% vs 79.3%) than whites (both P<.01). More African Americans than whites preferred education in a classroom setting (77% vs 60%; P< .005) and educational DVDs (66% vs 46%; P< .002).

Conclusion: The use of cell phone technology and text messaging was ubiquitous and comparable between groups, but computer and Internet access and frequency of use were not. Reaching out to the African American community may best be accomplished by using cell phone/text messaging as opposed to Internet-based platforms.

MeSH terms

  • African Americans*
  • Cell Phone / statistics & numerical data*
  • Computers, Handheld
  • Cross-Sectional Studies
  • Electronic Mail
  • Female
  • Health Services Accessibility*
  • Humans
  • Internet / statistics & numerical data*
  • Kidney Transplantation* / education
  • Kidney Transplantation* / nursing
  • Male
  • Middle Aged
  • Midwestern United States
  • Multivariate Analysis
  • Patient Education as Topic / methods*
  • Regression Analysis
  • Telenursing / methods*
  • Text Messaging
  • Videodisc Recording