Year of Publication



Public Health

Date Available


Degree Name

Dr. of Public Health (Dr.P.H.)

Committee Chair

Dr. Richard Ingram

Committee Member

Dr. Martha Riddell

Committee Member

Dr. Sarah Wackerbarth


OBJECTIVE: Those living in the Appalachian regions face more significant healthcare disparities than those in the US. Patient portals can decrease disparities and increase health outcomes and health literacy. The purpose of this study was to determine if those living in the Appalachian region were offered access to and used their patient portals differently than the surrounding US Census region. Additionally, we aimed to determine if there was a difference in reported reasons for non-use of patient portals.

METHODS: This was a descriptive study using data from the National Cancer Institute’s Health Information National Trends Survey (HINTS) data (2017-2020) to determine if there is a difference in the use of patient portals in the Appalachian region compared to the surrounding US Census regions.

RESULTS: There was no statistically significant difference between the Appalachian and surrounding US Census regions in being offered access to and the use of patient portals. However, when holding race constant, there was a statistically significant difference between regions in the use of patient portals for non-Hispanic whites (p = 0.0192). Common reasons for non-use of patient portals were preferred to speak directly to the provider and perceived

CONCLUSIONS: Providers in the Appalachian region should be aware of the non-use of patient portals by non-Hispanic whites. Moreover, understanding the reported reasons for non-use may help providers tailor educational materials to increase the use of patient portals.

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