Mobile Technology and Promoting Health Equity for Low-Income Patients

Background/Aims: Mobile health promotion (mHealth) is health practices supported by mobile devices like smartphones and wireless technology. mHealth delivers health information to increase awareness, provides guided instructions about healthy behaviors and offers self-monitoring of health status. Approximately 58% of adults and 43% of individuals earning less than $20,000/year own smartphones; pervasiveness of mobile devices provides opportunity for patient self-care management. A majority of low-income patients access services in community health centers (CHCs), thus an opportunity exists to evaluate how mobile devices can promote continuity of care in CHCs. The objectives are as follows: 1) Assess attitudes and practices concerning mobile technology; and 2) Evaluate how mobile devices can promote equity in health care access for low-income populations. Methods: Researchers recruited a convenience sample of 103 low-income patients from CHCs in Washington State by approaching patients in waiting areas of two CHCs. After consenting, patients completed a 47-item survey in a private room and received a $10 gift certificate. Survey items queried about: 1) knowledge and practices concerning mobile technology, and 2) perception about access to care in CHCs. Results: Study population was 55.6% white, 67% women and had median household income of $21,192. In terms of health care access, 80% and 83% reported easy access to specialists and health information, respectively. Approximately 89% emphasized the importance of making healthy lifestyle choices, yet only 56% and 66% received the CDC’s recommended weekly physical activity and healthy eating guidance, respectively. In terms of technology knowledge and practices, 79% used mobile devices for health information. Barriers to information access were: 1) lack of knowledge about use (52%), and 2) preference for care providers’ advice (42%). Fifty-eight percent reported no knowledge about medical-based mobile apps (e.g. blood pressure monitoring), and 66% never used these devices. If medical-based apps were recommended, top preferred uses were: 1) prescription refills (80%), 2) medication reminders (66%), and 3) mental health monitoring (55%). Conclusion: Some gaps in preventive care information dissemination do exist for patients receiving care in CHCs. However, patients appear ready to use technology in sophisticated ways for self-care management. Mobile devices might supplement care by providing health information an