Regional Disparities in the Use and Demand for Digital Health Services for Autism Spectrum Disorder in China: Cross-Sectional Survey of Stakeholder Perspectives

Abstract

Background: Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition, the prevalence of which is increasing in China and worldwide. Digital health technologies offer promising solutions for improving screening, diagnosis, and rehabilitation of children with ASD, particularly in resource-limited settings. However, digital health technologies for ASD have not been adopted in China. Understanding utilization patterns, influencing factors, and user needs is essential to inform equitable, effective digital health strategies. Objective: This study aimed to assess the current use, influencing factors, and perceived needs of digital health services among parents of children with ASD and rehabilitation therapists in 2 distinct provinces in China. Methods: A cross-sectional survey was carried out between November 2023 and February 2024 in Heilongjiang and Fujian provinces. Purposive sampling recruited a total of 780 parents and 745 rehabilitation therapists to complete a structured questionnaire. Data were analyzed using descriptive statistics, stepwise multivariable logistic regression, and multiple response analysis. Results: The use of digital health services was low among parents (46/780, 5.9%) and rehabilitation therapists (161/745, 21.6%), although the demand was substantially higher (621/780, 79.6% and 671/745, 90.0%, respectively). Among parents, higher use was positively associated with younger age (20-29 years), employment, lower income (≤CNY 3000/month [US $421.247/month]), and delayed ASD diagnosis (7-12 years old). Among rehabilitation therapists, male, special education background, and autism-specific training experience predicted higher use (all P