Theorizing the digital divide: Information and communication technology use frameworks among poor women using a telemedicine system

In this paper, we argue that reconceptualizing the “digital divide” from the perspective of those with the least access requires that the policy concern shift from disparities in access to computers and the Internet toward an examination of how Internet information resources are differentially accessed and used. Drawing on an archive of clinical narrative descriptions documenting training sessions related to eight African American, low-income women involved in a clinical trial of a telemedicine system intervention for monitoring cardiovascular disease risk factors implemented at Temple University; we illustrate the shortcomings of a limited conceptualization of access. Rather, we propose a model that depicts information and communication technology (ICT) access in terms of four interrelated elements: (a) information delivery approaches (how information is shared, disseminated and accessed through the use of e-communication technologies), (b) technology use contexts (what are the specific settings in which technology is accessed), (c) social networks (what is the role of social networks in shaping access to and use of ICTs) and (d) the social policies and institutional mechanisms regulating technology access (specifically targeted to ICT use as well as more generally). This model highlights the embeddedness of ICT use in the geography of people's daily lives and suggests a number of policy concerns related to how ICTs may mitigate or exacerbate economic and political inequalities in the United States.