Research for Community Advocates

Our Research Highlights

Connecting Cuyahoga: Investment in Digital Inclusion Brings Big Returns for Residents and Administration

This report will outline how investment in efforts to increase digital inclusion wouldimprove Cuyahoga County service delivery in many ways. Especially notable is by improving opportunities for and the quality of online transactions. And by interweaving digital literacy training and support into existing departmental programming, the county can extend theeffectiveness of existing initiatives while also catalyzing the creation of new offerings.

By assessing the digital skill level and connectivity status of clients during off-line (in-person orphone) interactions, case managers can direct their clients to opportunities to address digital gaps. By maintaining data on resident connectivity and communication preferences, serviceproviders can communicate in the most effective, efficient, and preferred methods for clients.The addition of digital inclusion programming and support to existing departmental community services will not only lower service delivery costs but can increase resident engagement and improve program outcomes. Increasing digital readiness will also prepare clients and service providers for emerging opportunities in social service delivery such as telehealth, remote monitoring and reporting.

Cuyahoga County and the State of Ohio have made significant recent investments in onlineplatforms to better facilitate social service delivery. This choice to increase support for online transactions should deliver substantial returns, considering that digital transactions have been found to cost between 1–23% of the cost of in-person, phone, and mail transactions. However,these returns will not be realized if the current nonconnection rates among benefitsrecipients go unmitigated.

Click here to download the full report.

RESTART: Survey Results on the Outcome of Digital C’s Basic Digital Literacy Program

“The RESTART program was successful in creating the expected outcomes we have seen from other historical programs. Time and again, we come to find that Digital inclusion is a unique field that provides measurable outcomes across a wide spectrum of social verticals. In an era where connectivity is ubiquitous, and society increasingly is leaning towards the cloud in search of smart initiatives that connect the public and private worlds with a hope for creating efficiencies and improved service delivery. Digital Inclusion organizations and programs are the super-connectors of social service sector. They are the pathways on which meaningful integrations can be built and the vehicle through which next-generation smart solutions will be equitably adopted.”

Some findings of this study were:

  • 48% of respondent seeking employment claim the RESTART program helped them to be better prepared for employment.

  • 67% of employed respondents are now using a computer for their jobs.

  • 87% of respondents found the RESTART program VERY or EXTREMELY helpful to them in attaining their stated goal.

  • 45% of respondent reporting to be in the workforce (not retired or full-time students) experience a positive workforce impact since participating in the RESTART program (about 1 year ago).

To learn more about the RESTART Program, how it was structured, and what impact it had on the community it served, Click HERE to download and read the full report.

Adoption PERSISTENCE: A longitudinal study of the digital inclusion impact of the Connect Your Community Project.

The Connect Your Community Project was a 19 million-dollar federal stimulus grant project funded through NTIA’s Broadband Technology Opportunities Program (BTOP) that served to train, equip and connect over 33,000 participants nationally (5,500 in the Cleveland area alone).  In 2012, the project leadership team (Bill Callahan and Samantha Schartman-Cycyk) conducted a program impact study of Project Participants.  This newly released report by Connected Insights describes the findings of the recent follow-up survey which recontacted 429 Cleveland-based residents/past project participants who had also responded to the 2012 survey.

The findings contained in the study not only prove that high-touch community-based digital literacy programs are successful in closing the digital divide, our study shows that the impact of such projects continue even after they are over.  These findings will provide useful insights for any digital inclusion program manager who is interested in learning of additional ways to measure community impact, stretch resources, and grow participation and engagement.

Read the full report:

Creating Opportunity Through Connectivity:
How Mobile Broadband for Anchor Institutions Impacts Communities

 The nonprofit sector nationally supports and serves millions of people and causes that better our society, the environment, and lives of individuals and families. Community anchor institutions (CAIs), including schools, universities, libraries, museums, healthcare organizations, and other nonprofits organizations, are increasingly recognized for their role as influencers and contributors to a community’s prosperity. Providing high-capacity bandwidth to CAIs enables these organizations to become catalysts for increasing their communities’ digital literacy, broadband deployment, and adoption. Given the number of individuals a CAI impacts, one broadband connection has a social, educational, and economic multiplier effect (Internet2, 2016). While it remains a national priority to connect CAIs with wired gigabit connections, mobile broadband also plays an important role in creating connected communities.

Mobile Beacon’s service is unique in that it provides $10/month, mobile, uncapped, and unthrottled service exclusively to CAIs. A ordable, anytime/anywhere connectivity gives these organizations an essential tool to ful ll their missions and maximize their philanthropic impact. Mobile Beacon’s clients are not restricted in the amount of data they can use in a given month, nor does their service slow or stop after reaching a certain data allotment. In this way, examining the online behaviors of CAIs using Mobile Beacon’s service provides rare insight into the demand for mobile broadband data since they use the data they need – not just what they can a ord. We note, however, that overall demand for mobile broadband is expected to grow by 23%, and so the documented data usage in this report should be seen as a benchmark from which these projections should be kept in mind (Cisco, 2016).

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Bridging the Gap:
What Affordable, Uncapped Internet Means for Digital Inclusion

Digital inequality is a persistent challenge in our increasingly online society. Though more content and services continue to be driven online, there are still 34 million Americans without access to the internet. While there are multiplex barriers to connectivity, the two main drivers that affect a person’s ability to participate online are the availability of service and the ability to afford it. With average broadband costs in the United States soaring to $90/month (per a 2013 study by the BBC (Geoghegan, 2013)), the price tag for internet access remains out-of-reach for many low- income Americans.1

People’s access to technology has become an important part of every effort to fight hunger, poverty, inequality, and countless other social causes. Thousands of community anchor institutions providing resources and services to help people become self-sufficient are finding innovative ways to help more families get online. One such nonprofit-led program is Bridging the Gap. Created by PCs for People and Mobile Beacon, this program provides refurbished computers and $10 – $13/month uncapped, unthrottled, high- speed mobile broadband service to individuals and families below the 200% poverty level.

Read the full report here:


Our Partner Research Network

Click  here  to download this full report.

Click here to download this full report.

Patient portals and broadband internet inequality

Patient portals have shown potential for increasing health care quality and efficiency. Internet ac- cess and other factors influencing patient portal use could worsen health disparities.
Methods: Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015. We used mixed effects logistic regression to evaluate the association between broadband internet access and (1) patient portal initiation (whether a patient logged in at least 1 time) and (2) messaging, controlling for demographic and neighborhood characteristics.

Results: There were 243 248 adults with 1 or more visits during 2012–2015 and 70 835 (29.1%) initiated portal use. Portal initiation was 34.1% for whites, 23.4% for blacks, and 23.8% for Hispanics, and was lower for Medic- aid (26.5%), Medicare (23.4%), and uninsured patients (17.4%) than commercially insured patients (39.3%). In multivariate analysis, both initiation of portal use (odds ratio [OR] 1⁄4 1.24 per quintile, 95% confidence interval [CI], 1.23–1.24, P < .0001) and sending messages to providers (OR 1⁄4 1.15, 95%CI, 1.09–1.14, P < .0001) were asso- ciated with neighborhood broadband internet access.

Conclusions: The majority of adults with outpatient visits to a large urban health care system did not use the patient portal, and initiation of use was lower for racial and ethnic minorities, persons of lower socioeconomic status, and those without neighborhood broadband internet access. These results suggest the emergence of a digital divide in patient portal use. Given the scale of investment in patient portals and other internet-dependent health information technologies, efforts are urgently needed to address this growing inequality.

Key words: internet, health disparities, digital divide, personal health record, patient portals

Click the above image to download the full white paper.

Click the above image to download the full white paper.

Addressing Digital Literacy and Internet Access as Social Determinants of Health

This research was designed with 3 goals in mind:

 1. Broadly, to demonstrate the value of a simple, replicable community digital inclusion strategy (combining trusted grassroots outreach and support and hands-on basic skills training with affordable Internet options) in overcoming barriers to low income patient take-up and meaningful use of patient portals. 

2. To achieve a MyChart initial adoption rate of at least 75% in an identified group of previously unconnected adult Medicaid patients, and to document a short-term incidence of subsequent “meaningful use” of MyChart by at least 50% of those patients. 

3. To create, road-test and document collaborative healthcare provider/community models for a) low-income patient recruitment for digital inclusion training and support; b) effective teaching of PHR readiness skills to digitally illiterate adult learners (curriculum, objectives, assessment tools, etc.); c) effective use of community outreach to reinforce actual PHR use by those learners subsequent to initial training. 

 Summary of Results 

The project was overwhelmingly successful at demonstrating the value of a community digital inclusion strategy for overcoming barriers to usage of the patient portal among low income patients. A total of 895 patients met 1-on-1 with a community health worker, and about half of these had an interest in the training program. A total of 127 provided their contact information for follow-up and 32 completed training. Although enrollment was lower than anticipated, our persistence and our willingness to adapt to challenges as a multi-sector collaboration have contributed substantial knowledge. Data analysis found that the project increased MyChart usage substantially at the primary care sites in the study. In addition, our project has achieved national recognition in paving the way for collaboration between community-based training organizations and health care systems.

Article citation:

Berg, K., Davis, W., Sheon, A., Newman, J., Daprano, J., Adebambo, I., ... & Perzynski, A. (2018). Strategies for addressing digital literacy and internet access as social determinants of health. Innovation in Aging2(suppl_1), 679-679. 


Click here to go to the full report!

Click here to go to the full report!

AT&T’s digital redlining of Cleveland

A mapping analysis of Federal Communications Commission broadband availability data, conducted by Connect Your Community and the National Digital Inclusion Alliance, strongly suggests that AT&T has systematically discriminated against lower-income Cleveland neighborhoods in its deployment of home Internet and video technologies over the past decade.

Our analysis, based on newly released FCC Form 477 Census block data for June 2016, provides clear evidence that AT&T has withheld fiber-enhanced broadband improvements from most Cleveland neighborhoods with high poverty rates – including Hough, Glenville, Central, Fairfax, South Collinwood, St. Clair-Superior, Detroit-Shoreway, Stockyards and others.

This analysis is part of a six-month effort that began when CYC and NDIA learned that residents of many Cleveland neighborhoods were being declared ineligible for AT&T’s “Access” discount rate program, solely because they couldn’t get AT&T connections at the 3 mbps download speed that was then the program’s minimum requirement.

After analyzing previous FCC Form 477 data releases, along with City construction permits and other information, we’ve come to believe that the ultra-slow AT&T Internet speeds available to those Access applicants reflect a larger problem: AT&T’s failure to invest to upgrade most of its Cleveland network to the company’s mainstream technology.

Specifically, AT&T has chosen not to extend its “Fiber To the Node” VDSL infrastructure – which is now the standard for most Cuyahoga County suburbs and other urban AT&T markets throughout the U.S. – to the majority of Cleveland Census blocks, including the overwhelming majority of blocks with individual poverty rates above 35%.

These neighborhoods have been relegated to an older, slower transmission technology called ADSL2, resulting in significantly slower Internet access speeds than AT&T provides to middle-income city neighborhoods as well as most suburbs.

As a result, their residents are left with

  • uneven, often severely limited Internet access – in many cases 3 mbps downstream or less; and

  • no access to the competitive fiber-enabled video service that AT&T promised communities in exchange for “cable franchise reform”, i.e. the elimination of municipal cable franchising, in Ohio in 2007.

Because the patterns revealed by this analysis result from a decade of deliberate infrastructure investment decisions, NDIA and CYC believe they constitute strong evidence of a policy and practice of “digital redlining” by AT&T — i.e. income-based discrimination against residents of lower-income urban neighborhoods in the types of broadband service AT&T offers, and in the company’s investment in improved service.

Click here to view the full presentation

Click here to view the full presentation

2012 CYC Participant Survey

Data from interviews with 2,300 randomly selected Connect Your Community (CYC) program participants. Topics include program satisfaction; home broadband connection status; broadband subscription choices (ISPs); employment and public service user characteristics; most frequent Internet uses; and broadband adoption outcomes for respondents as workers, parents, patients, etc.

2012 Cuyahoga County Survey of Internet Access and Use

“Baseline” survey of broadband adoption and use by adult residents of Cuyahoga County, Ohio including Cleveland. This survey of 1,266 county residents was designed and conducted for OneCommunity by Dr. Caroline Tolbert of the University of Iowa and Dr. Karen Mossberger, then of the University of Illinois (Chicago) and now at Arizona State University.

One-third of Cuyahoga County adults still do not have broadband Internet access in their homes, according to the results of an October 2012 phone survey of 1,261 county residents commissioned by the Connect Your Community Project.

The survey, conducted by a team from the University of Iowa, the University of Illinois and Rutgers University, found that majorities of the county’s senior citizens, the poor, and people with “educational attainment” of high school graduation or less are among the disconnected. It also found that African-American residents are significantly less likely to have high-speed home or mobile Internet access than County residents as a whole.

You can download a summary of these and other key findings here.

Or, download the full survey report.

In addition to Cuyahoga County residents as a whole, the survey report looks at a “subsample” of 686 respondents who live in the city of Cleveland and nine adjacent municipalities with significant levels of household poverty, indicated by Ohio Directions Card participation by 25% or more of their households.

43% of adults in these “Inner Core” communities lack home broadband service, including
71% of those with household income below $20,000,
67% of those 65 and older, and
75% of those without high school diplomas.

Combined with recent U.S. Census data, the survey’s findings indicate that about 360,000 of the county’s adult residents lack home broadband connections, including 190,000 in Cleveland and the adjacent Inner Core communities.

The study’s principal researchers, Dr. Caroline Tolbert of the University of Iowa and Dr. Karen Mossberger of Arizona State University, have collaborated on several important studies of the digital divide. (The most recent is Digital Cities: The Internet and the Geography of Opportunity.) CYC Assistant Project Director Samantha Schartman worked with them to design the Cuyahoga County survey, which was conducted by Rutgers’ Eagleton Institute.

Read the Plain Dealer’s coverage of the CYC Cuyahoga County internet survey.

Click here to read the full report!

Click here to read the full report!

2012 K-12 Parent Survey

In May of 2012, we conducted a survey of CYC participants who identified themselves as parents of school-age children. The intent of this survey was to assess the impact of our program on participants’ efforts to support their children’s education and engage with their schools and teacher.

Key findings: 65% of the newly connected parents told us they use their home broadband connection to communicate with their child’s school and teachers; 75% said having home broadband access increased the frequency of their engagement with teachers and administrators; and 80% reported that their children now complete homework, school work, or class projects using their home broadband connections.

Click here to view the full report.

Click here to view the full report.

2011 Employment Impact Survey

In October of 2011, Connect Your Community conducted a survey of program participants who had been verified as SBA’s (Sustainable Broadband Adopters). The intent of this survey was to assess the impact of CYC on participants’ efforts to improve their job situations.

Key finding: Among those who said they undertook the training mainly for employment reasons, 43% have since found new or better jobs, received promotions or raises, entered work-training programs, and/or started their own businesses.

Click here to view the full report.

Click here to view the full report.

2013 Digital Inequality and College Access Whitepaper

Research findings from a digital literacy program aimed at providing parents of Cleveland Municipal School District student (particularly those in grades 8-12) with free home computers and low-cost home broadband internet access in an effort to increase their awareness of school-related online resources and track its influence on college readiness.

Click here to view the full presentation.

Click here to view the full presentation.

2013 Presentation for Cleveland community development corporation directors meeting

Presentation highlighting general digital inclusion numbers for “inner core” residents of Cuyahoga County, with a focus on access to online banking.