Mobile Phones May Not Bridge the Digital Divide: A Look at Mobile Phone Literacy in an Underserved Patient Population.

Disha Kumar,Vagish Hemmige,Monisha Arya,Michael A Kallen,Thomas P Giordano

doi:10.7759/cureus.4104

Disha Kumar, Vagish Hemmige + Show 3 more

Open Access

https://doi.org/10.7759/cureus.4104

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Abstract

Purpose: Mobile health (mHealth) has promise to improve patient access to disease prevention and health promotion services; however, historically underserved populations may have poor access to mobile phones or may not be aware of or comfortable using phone features. Our objectives were to assess mobile phone ownership and mobile phone literacy among low-income, predominately racial and ethnic minority patients.Materials and methods: We conducted a cross-sectional survey of a convenience sample of primary care patients in a publicly-funded clinic in Houston, TX.Results: Of 285 participants, 240 owned a mobile phone and 129 owned a smartphone. The most common uses of phones were talk (89%) and text messaging (65%). Only 28% of smartphone owners had health apps. Younger age was significantly associated with smartphone ownership and use of smartphones for Internet browsing, social media, and apps.Conclusion: Our findings from a safety-net patient population represent trends in mobile phone ownership and literacy. Despite the single-site location of our study, the findings could be helpful to health promotion practitioners working with similar underserved populations. mHealth interventions should employ phone features that are accessible and familiar to the target audience to avoid denying intervention benefits to those with low mobile phone literacy and therefore widen health disparities.

Highlights

Adapting the definition of health literacy from Selden et al, we propose the term mobile phone literacy to describe the ability to access, process, understand, and use the features on mobile phones [5]
Our findings highlight that text messaging or talk remains the best way to reach patients in urban safety-net outpatient settings. mobile health (mHealth) interventions using apps would be applicable to younger and relatively wealthier patients
It is important to remember that mHealth interventions – such as text messaging -- may not reach all members of the target population if text messaging imposes an undue financial burden or is not routinely accessible

Summary

Introduction

The use of mobile devices, including mobile phones, to improve health is termed mobile health (mHealth). Mobile phones and smartphones are widely prevalent, people with limited technology skills may be reluctant to use or unable to access technology to acquire health information on their phones [1,2]. It is critical for mHealth interventions to consider how sub-populations use mobile phones. Employing features of mobile phones that are unfamiliar may exclude populations from the benefit of these interventions and thereby worsen the “digital divide.”. The term “digital divide” describes disparities in technology use [3,4] Employing features of mobile phones that are unfamiliar may exclude populations from the benefit of these interventions and thereby worsen the “digital divide.” The term “digital divide” describes disparities in technology use [3,4]

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