The purpose of this exploratory study is to examine factors associated with frequency and type of internet and mobile technology use among illegal drug users, specifically use of internet and text-messaging to obtain health care information and engage in health care utilization. Web-based and mobile technology-based health interventions have been shown to be effective in providing health education, changing health behavior, and increasing medication adherence/retention in care. However, the potential impact of these interventions among drug-using populations has been grossly underexplored. Internet or mobile technology-based health promotion interventions for drug users has been hampered by the scarcity of data on: where, how often, and for what purpose drug users use internet and mobile technologies, especially for health-related reasons;barriers to internet and mobile use;and how use of these technologies vary by socio-demographics, sexual and drug risk behavior, health care status, and health care utilization. Herein, Aim 1 of the study is to examine demographic, health status, behavioral, technology self-efficacy and barrier correlates of: 1a) where, how often, and for what purpose drug users use internet and mobile technologies;1b) willingness to use internet or mobile technology for health-related purposes;and 1c) actual internet or cell phone app/text message use for the purposes of acquiring health information and/or engaging the health care system/providers.
Aim 2, among those who report internet use >1x/month (from Aim 1) who will be directed to visit a study-developed interactive health information website for drug users, we will pilot test: 2a) website use;2b) use of website functions (e.g. viewing health-related videos, use of searchable map of health care services);and 2c) uptake in receipt of automatic text message updates on relevant health information. To achieve these aims, we will target high drug activity neighborhoods in New York City and enroll participants recruited by pharmacy staff (i.e. injection drug users purchasing syringes through New York State Expanded Syringe Access Program) or screened eligible by calling a toll-free number on the study flyer posted in the pharmacy. All participants (n=336) will undergo an ACASI that will assess socio-demographics, health care access and utilization, sex/drug use behavior, health status, and characteristics of general and health-related internet/mobile technology use including factors that promote or hinder use. Participants identified as using the internet e 1/month (n=151) will return for a 2-week ACASI to report on use of the pilot website (which will largely display information currently available in the community in print/ pamphlet/ video form). Data will be analyzed using descriptive statistics and regression techniques for both aims, and multilevel modeling to account for clustered data. Our study results have the potential to inform the future development of web-based or mobile-based interventions to improve the health status of illegal drug users.
These findings will provide critical information on drug users'internet and mobile technology use and access that can provide the foundation for new research in the area of technology, drug abuse, and health outcomes. By identifying barriers to internet and mobile technology use, targeted individual, structural and multilevel intervention strategies can be designed and tested for a vulnerable population in need of quality healthcare and health information. Further exploration of internet and mobile technology among high-risk populations, such as illegal drug users, is highly warranted and if results confirm our preliminary data, there is high potential for public health impact given that such technologies are rapidly becoming ubiquitous, are transportable, and can reach a large population at low cost.