JMIR Publications

ABSTRACT

Background:

Background. Biomedical research studies are increasingly using digital to enroll, recruit and collect data from participants. However, variability in digital literacy and technological acceptance can be challenging for recruitment from groups traditionally underrepresented in research, including those served by Federally Qualified Health Centers.

Objective:

Objective. The objectives of this study were to (1) measure participant accessibility and comfort with digital platforms, and (2) examine the interrelation of technology access, digital literacy, and support preferences during enrollment and data submission.

Methods:

Methods. A cross-sectional analysis was conducted using enrollment data from a FQHC participating in the All of Us Research Program (AoURP). Participants had the option of high-touch (staff-assisted) or low-touch (self-directed) support for enrollment and survey completion. Survey items assessed internet access and technology comfort, while support type was recorded by the research staff based on participants’ actual selection. Logistic regression models evaluated relationships between technology access, comfort, and enacted support type, while controlling for age, consent language, education, as well as race/ethnicity.

Results:

Results. The analytic sample included 605 participants. The majority reported access to the internet (89.1%) and felt comfortable with technology (74.1%). In the group requesting high-touch support (n = 346), 14.5% reported no internet access, and 31.5% felt uncomfortable with technology. In the group requesting low-touch support (n = 259), 6.2% had no access to the internet, and 3.9% reported feeling uncomfortable (p < 0.001). In the adjusted models, much greater comfort with technology was significantly correlated with reduced odds requesting high-touch support (comfortable: AOR = 0.118, 95% CI: 0.055–0.255; neutral: AOR = 0.212, 95% CI: 0.077–0.587), but internet access was not significantly correlated.

Conclusions:

Conclusions The strongest predictor for support preference for digital enrollment among the participants was their comfort with technology rather than access alone. These findings illustrate the significance of participant-centric design methods coupling adaptive support paths, mixed enrollment strategies, and individualized onboarding methods aligned with digital confidence to promote equitable engagement in precision health research.