RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0042-1742520
Consumer Health Informatics for Racial and Ethnic Minoritized Communities: Minor Progress, Major Opportunities
![](https://www.thieme-connect.de/media/10.1055-s-00034612/202201/lookinside/thumbnails/10-1055-s-0042-1742520_valdez-1.jpg)
Summary
Objective: By reducing barriers to accessing health services and by supporting health management, consumer health informatics has the potential to reduce health disparities. Yet, technologies are still being designed without considerations for racial and ethnic minoritized populations. This paper reviews consumer health informatics research within this population to assess for whom and how such technologies are being designed.
Methods: We searched four databases from January 2020- December 2021 for literature focused on consumer health informatics and racial and ethnic minoritized populations. We extracted information about the study population, geographic location, stage of the design lifecycle, culturally tailored approaches, community engagement strategies, and considerations for the social determinants of health.
Results: Twenty articles were included in the review. Most of the included literature were original research articles that tested health management interventions focused on one racial or ethnic minoritized population primarily within a confined geographic area within the United States. Seven studies described the extent to which an intervention was culturally tailored, including modifying the content, interface, functionality, and platform. Community engagement strategies varied, but few articles employed robust approaches. Lastly, seven studies detailed considerations for the social determinants of health, including providing hardware to access interventions and incorporating information about community-based resources within an intervention.
Conclusions: There has been moderate progress in consumer health informatics focused on racial and ethnic minoritized populations and many opportunities remain for these technologies to be used as an approach to address health disparities. Future research should utilize community engagement strategies to design interventions that are attune to multiple racial and ethnic minoritized populations across geographic regions in addition to numerous intersectional identities and multiple co-morbidities.
Publikationsverlauf
Artikel online veröffentlicht:
04. Dezember 2022
© 2022. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Holden RJ, Valdez RS. The Patient Factor: Theories and Methods for Patient Ergonomics. CRC Press; 2021.
- 2 Valdez RS, Holden RJ. The Patient Factor: Applications of Patient Ergonomics. CRC Press; 2021.
- 3 Agency for Healthcare Research and Quality. Consumer Health IT Applications [Internet]. Available from: https://digital.ahrq.gov/consumer-health-it-applications
- 4 Huh J, Koola J, Contreras A, Castillo AK, Ruiz M, Tedone KG, et al. Consumer Health Informatics Adoption among Underserved Populations: Thinking beyond the Digital Divide. Yearb Med Inform 2018 Aug;27(1):146-55.
- 5 Brewer LC, Fortuna KL, Jones C, Walker R, Hayes SN, Patten CA, et al. Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health. JMIR Mhealth Uhealth 2020 Jan 14;8(1):e14512.
- 6 Atske S, Perrin R. Home broadband adoption, computer ownership vary by race, ethnicity in the U.S. [Internet]. Pew Res Cent [cited 2022 Jan 7]. Available from: https://www.pewresearch.org/fact-tank/2021/07/16/home-broadband-adoption-computer-ownership-vary-by-race-ethnicity-in-the-u-s/
- 7 Chang E, Blondon K, Lyles CR, Jordan L, Ralston JD. Racial/ethnic variation in devices used to access patient portals. Am J Manag Care 2018 Jan 1;24(1):e1-e8.
- 8 Veinot TC, Mitchell H, Ancker JS. Good intentions are not enough: how informatics interventions can worsen inequality. J Am Med Inform Assoc 2018 Aug 1;25(8):1080-8.
- 9 Colvonen PJ, DeYoung PN, Bosompra NA, Owens RL. Limiting racial disparities and bias for wearable devices in health science research. Sleep 2020 Oct 13;43(10):zsaa159.
- 10 Valdez RS, Brennan PF. Embracing complexity: Rethinking culturally informed design in human factors/ergonomics and consumer health informatics. sInt J Hum Comput Interact 2017; 33(4):322-32.
- 11 Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health 1998;19:173-202.
- 12 Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005 Nov;15(9):1277-88.
- 13 Allicock M, Kendzor D, Sedory A, Gabriel KP, Swartz MD, Thomas P, et al. A Pilot and Feasibility Mobile Health Intervention to Support Healthy Behaviors in African American Breast Cancer Survivors. J Racial Ethn Health Disparities 2021 Feb;8(1):157-65.
- 14 Chandler R, Guillaume D, Parker AG, Carter S, Hernandez ND. Promoting Optimal Sexual and Reproductive Health with Mobile Health Tools for Black Women: Combining Technology, Culture and Context. Perspect Sex Reprod Health 2020 Dec;52(4):205-9.
- 15 Hanson JD, Weber TL, Shrestha U, Bares VJ, Seiber M, Ingersoll K. Acceptability of an eHealth Intervention to Prevent Alcohol-Exposed Pregnancy Among American Indian/Alaska Native Teens. Alcohol Clin Exp Res 2020 Jan;44(1):196-202.
- 16 Janevic MR, Shute V, Murphy SL, Piette JD. Acceptability and Effects of Commercially Available Activity Trackers for Chronic Pain Management Among Older African American Adults. Pain Med 2020 Feb 1;21(2):e68-e78.
- 17 Jordan DN, Jessen CM, Ferucci ED. Views of Patients and Providers on the Use of Telemedicine for Chronic Disease Specialty Care in the Alaska Native Population. Telemed J E Health 2021 Jan;27(1):82-9.
- 18 Khoong EC, Rivadeneira NA, Hiatt RA, Sarkar U. The Use of Technology for Communicating With Clinicians or Seeking Health Information in a Multilingual Urban Cohort: Cross-Sectional Survey. J Med Internet Res 2020 Apr 6;22(4):e16951.
- 19 Kim HS, Kim HJ, Juon HS. Racial/Ethnic Disparities in Patient-Provider Communication and the Role of E-Health Use. J Health Commun 2021 Mar 4;26(3):194-203.
- 20 Legha RK, Moore L, Ling R, Novins D, Shore J. Telepsychiatry in an Alaska Native Residential Substance Abuse Treatment Program. Telemed J E Health 2020 Jul;26(7):905-11.
- 21 Lopez C, Gilmore AK, Moreland A, Danielson CK, Acierno R. Meeting Kids Where They Are At-A Substance Use and Sexual Risk Prevention Program via Telemedicine for African American Girls: Usability and Acceptability Study. J Med Internet Res 2020 Aug 11;22(8):e16725.
- 22 MacCarthy S, Mendoza-Graf A, Wagner Z, L Barreras J, Kim A, Giguere R, et al. The acceptability and feasibility of a pilot study examining the impact of a mobile technology-based intervention informed by behavioral economics to improve HIV knowledge and testing frequency among Latinx sexual minority men and transgender women. BMC Public Health 2021 Feb 12;21(1):341.
- 23 Napolitano MA, Harrington CB, Patchen L, Ellis LP, Ma T, Chang K, et al. Feasibility of a Digital Intervention to Promote Healthy Weight Management among Postpartum African American/Black Women. Int J Environ Res Public Health 2021 Feb 23;18(4):2178.
- 24 Noar SM, Willoughby JF, Crosby R, Webb EM, Van Stee SK, Feist-Price S, et al. Acceptability of a Computer-Tailored Safer Sex Intervention for Heterosexually Active African Americans Attending an STI Clinic. J Prim Prev 2020 Jun;41(3):211-27.
- 25 Patchen L, Ellis L, Harrington CB, Ma T, Mohanraj R, Andrews V, et al. Engaging African American Parents to Develop a Mobile Health Technology for Breastfeeding: KULEA-NET. J Hum Lact 2020 Aug;36(3):448-60.
- 26 Pérez MC, Singh R, Chandra D, Ridde V, Seth A, Johri M. Development of an MHealth Behavior Change Communication Strategy: A Case-Study from Rural Uttar Pradesh in India. Proc 3rd ACM SIGCAS Conf Comput Sustain Soc [Internet]. New York, NY, USA: Association for Computing Machinery; 2020. p. 274–8. Available from: https://doi.org/10.1145/3378393.3402505
- 27 Pham Q, Gamble A, Hearn J, Cafazzo JA. The Need for Ethnoracial Equity in Artificial Intelligence for Diabetes Management: Review and Recommendations. J Med Internet Res 2021 Feb 10;23(2):e22320.
- 28 Shelton RL, Hall M, Ford S, Cosby RL. Telehealth in a Washington, DC African American Religious Community at the Onset of COVID-19: Showcasing a Virtual Health Ministry Project. Soc Work Health Care 2021;60(2):208-23.
- 29 Shiferaw KB, Tilahun BC, Endehabtu BF, Gullslett MK, Mengiste SA. E-health literacy and associated factors among chronic patients in a low-income country: a cross-sectional survey. BMC Med Inform Decis Mak 2020 Aug 6;20(1):181.
- 30 Stephens D, Peterson R, Singer M, Johnson J, Rushing SC, Kelley A. Recruiting and Engaging American Indian and Alaska Native Teens and Young Adults in a SMS Help-Seeking Intervention: Lessons Learned from the BRAVE Study. Int J Environ Res Public Health 2020 Dec 16;17(24):9437.
- 31 Verdezoto N, Carpio-Arias F, Carpio-Arias V, Mackintosh N, Eslambolchilar P, Delgado V, et al. Indigenous Women Managing Pregnancy Complications in Rural Ecuador: Barriers and Opportunities to Enhance Antenatal Care. Proc 11th Nord Conf Hum-Comput Interact Shap Exp Shap Soc [Internet]. New York, NY, USA: Association for Computing Machinery; 2020. Available from: https://doi.org/10.1145/3419249.3420141
- 32 Zha P, Qureshi R, Porter S, Chao YY, Pacquiao D, Chase S, et al. Utilizing a Mobile Health Intervention to Manage Hypertension in an Underserved Community. West J Nurs Res 2020 Mar;42(3):201-9.
- 33 Melton PA, Sims OT, Oh H, Truong DN, Atim K, Simon C. African American Ethnicity, Hypertension, Diabetes, and Arthritis Independently Predict Co-occurring Depression and Obesity among Community-dwelling Older Adult Alabamians. Soc Work Public Health 2021 Apr 3;36(3):344-53.
- 34 Ozkaynak M, Valdez R, Hannah K, Woodhouse G, Klem P. Understanding Gaps Between Daily Living and Clinical Settings in Chronic Disease Management: Qualitative Study. J Med Internet Res 2021 Feb 25;23(2):e17590.
- 35 Jager AD, Tewson A, Ludlow B, Boydell K. Embodied ways of storying the self: A systematic review of body-mapping. In: Forum Qualitative Sozialforschung/Forum: Qualitative Social Research 2016;17(2).
- 36 Buckle P, Clarkson PJ, Coleman R, Bound J, Ward J, Brown J. Systems mapping workshops and their role in understanding medication errors in healthcare. Appl Ergon 2010 Sep;41(5):645-56.
- 37 Weigl M, Catchpole K, Wehler M, Schneider A. Workflow disruptions and provider situation awareness in acute care: An observational study with emergency department physicians and nurses. Appl Ergon 2020 Oct;88:103155.
- 38 Nault Connors JD, Conley MJ, Lorenz LS. Use of Photovoice to engage stakeholders in planning for patient-centered outcomes research. Res Involv Engagem 2019 Nov 28;5:39.
- 39 Fouquet SD, Fitzmaurice L, Chan YR, Palmer EM. Doctors documenting: an ethnographic and informatics approach to understanding attending physician documentation in the pediatric emergency department. J Am Med Inform Assoc 2021 Feb 15;28(2):239-48.
- 40 Valdez RS, Guterbock TM, Fitzgibbon K, Williams IC, Wellbeloved-Stone CA, Bears JE, et al. From loquacious to reticent: understanding patient health information communication to guide consumer health IT design. J Am Med Inform Assoc 2017 Jul 1;24(4):680-96.
- 41 Valdez RS, Holden RJ, Novak LL, Veinot TC. Transforming consumer health informatics through a patient work framework: connecting patients to context. J Am Med Inform Assoc 2015 Jan;22(1):2-10.
- 42 Patient-Centered Outcomes Research Institute. PCORnet®, The National Patient-Centered Clinical Research Network [Internet]. 2014 [cited 2021 Apr 13]. Available from: https://www.pcori.org/research-results/pcornet-national-patient-centered-clinical-research-network
- 43 Unertl KM, Schaefbauer CL, Campbell TR, Senteio C, Siek KA, Bakken S, et al. Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations. J Am Med Inform Assoc 2016 Jan;23(1):60-73.
- 44 Valdez RS, Detmer DE, Bourne P, Kim KK, Austin R, McCollister A, et al. Informatics-enabled citizen science to advance health equity. J Am Med Inform Assoc 2021 Aug 13;28(9):2009-12.
- 45 Moen A, Brennan PF. Health@Home: the work of health information management in the household (HIMH): implications for consumer health informatics (CHI) innovations. J Am Med Inform Assoc 2005 Nov-Dec;12(6):648-56.