JMIR Publications

ABSTRACT

Background:

Heart disease is a leading cause of death in the United States (U.S.), killing roughly 655,000 Americans each year. It also represents a disproportionate harm to minoritized people, who often face structural barriers to health including poor access to emergency medical services and treatment, insurance coverage, healthy foods, and safe environments for physical activity. Researchers and providers studying racial health disparities in cardiovascular disease treatment and outcomes use SMS text messaging to facilitate communication between providers and patients, electronic home blood pressure monitors to enable the tracking of trends in blood pressure readings over time, and wearable devices like the Fitbit and Apple Watch to monitor health metrics like heart rate, exercise, and cardiac electrical activity. This viewpoint argues that access to these technologies does not guarantee the ability to afford or sustainably use them; it is merely one precondition of technology use that providers and researchers should consider when designing technological interventions to address patient needs.

Objective:

This paper provides a model that interventionist health services researchers can follow in order to think about facilitators of and barriers to technology use among patients whose resource constraints may shape their capacity to address the modifiable cardiovascular disease risk factors that these technologies target.

Methods:

This Viewpoint offers reflections on an ongoing community-based participatory research design process in developing an mHealth intervention into hypertension management.

Results:

Results presented included a model that interventionist health services researchers can follow to improve research design.

Conclusions:

Structural barriers to mHealth technology use must be addressed at every stage of the research process, and must guide decision-making about how providers and researchers can work with community partners to ensure that patients and community partners have the capability to use technological interventions as designed.