Accepted for/Published in: JMIR Human Factors
Date Submitted: Dec 2, 2024
Open Peer Review Period: Jan 20, 2025 - Mar 17, 2025
Date Accepted: Jun 23, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluating the Needs and Characteristics of Individuals of Low Socioeconomic Status Using Digital Health Technology to Address Health-Related Social Needs: A Mixed Methods Study with Patients and Providers.
ABSTRACT
Background:
Social determinants of health (SDOH) are the conditions in which people are born, grow, live, work, and age, encompassing social and economic factors that shape health outcomes. There is an increasing call to leverage digital health technology (DHT) to address SDOH and health-related social needs and establish connections to resources and services.
Objective:
This study aimed to: 1) identify the DHT-related characteristics of DHT users with low socioeconomic status (SES), 2) determine the needs and preferences of DHT users with low SES, and 3) explore how current SDOH-DHT address these needs and preferences.
Methods:
We employed a multi-phase, mixed-method, user-centered design approach. In Phase 1, we developed a user profile based on a literature review, aggregate data, interviews with 26 low-SES individuals, and focus groups with 28 professionals. In Phase 2, we conducted a landscape analysis of 17 existing SDOH-DHT.
Results:
DHT users of low SES had diverse social and technology characteristics. Five key themes emerged regarding user needs and preferences: 1) user-centered design, including multilingual support, visual guidance, and customization; 2) efficient, solution-based assessment of social risks, assets, and needs; 3) e-caring support features; 4) user education and feedback mechanisms; and 5) trust, privacy, and security. The landscape analysis revealed that current SDOH-DHT features do not adequately meet these needs.
Conclusions:
Discrepancies between target user needs and current DHT features represent missed opportunities in developing user-centered tools for individuals of low SES. Findings underscore the importance of inclusive, empowering, and responsive design in SDOH-DHT to bridge health disparities and advance public health.
Citation
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Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.