Previously submitted to: JMIR Human Factors (no longer under consideration since Dec 09, 2025)
Date Submitted: Oct 1, 2024
Open Peer Review Period: Oct 23, 2024 - Dec 18, 2024
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Facilitators and Barriers to Digital and In-Person Communication for Pregnant People of Color: A Content Analysis
ABSTRACT
Background:
Pregnant people of color often report poor communication with their healthcare providers, yet there is limited understanding of how their experiences with both face-to-face and digital communication intersect and effect their care.
Objective:
The aim of this study was to explore pregnant people of color’s perceptions of communication with their providers, both in-person and via the patient portal, to identify barriers and facilitators to quality communication with their prenatal providers.
Methods:
Qualitative directed content analysis was completed on 4 open-ended questions inquiring about the facilitators and barriers to in-person and digital communication. The questions were part of a cross-sectional descriptive research study on respectful patient-provider communication and patient portal use in pregnant people of color. After completion of content analysis, frequency of categories was compared between groups based on age, gestational age, parity, insurance type and portal use.
Results:
The analysis of 375 responses from 130 pregnant people of color revealed both facilitators and barriers to quality communication in healthcare. Facilitators included two main categories: provider behaviors and the functionality of MyChart, the patient portal. The functionality of MyChart had three subcategories: the ability to send secure messages, ease of use, and portal notifications. Three categories were identified as barriers to quality communication: the quality of responses, dealing with multiple providers, and digital access and literacy. The quality of responses had two subcategories: slow response times and responses from staff other than the primary provider. Comparative analysis showed that pregnant people over the age of 35 and those with private insurance did not identify multiple providers as a barrier to quality communication. However, digital access and literacy were significant barriers for participants who did not use the patient portal, though it was less prominent among those less than 32 weeks gestation.
Conclusions:
Study participants expressed a preference for prompt responses and direct digital communication with their prenatal providers. To ensure digital health equity in pregnancy, it's crucial for providers to set clear expectations regarding response times, identify who will be responding to messages, and assess patients' digital literacy and access.
Citation
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