JMIR Publications

ABSTRACT

Background:

Increasingly, there are more biomedical research studies that leverage digital platforms for recruitment, enrollment, and data gathering. Variability in digital literacy and technological acceptance, however, can be challenging for recruitment from groups that have traditionally been underrepresented, including those who access services from Federally Qualified Health Centers.

Objective:

The objectives of this study were to 1) assess participants' access to digital technology and comfort with using electronic platforms and (2) examine the relationship between technology access, technological comfort, and participants’ support preferences for enrollment and data submission.

Methods:

A cross-sectional analysis was done on the program's enrollment data from a Federally Qualified Health Center that is an enrollment site for the All of Us Research Program (AoURP). Survey information on availability of the internet, computer/technology comfort, preference for high-touch (staff-assisted) versus low-touch (self-directed) was gathered from enrolled individuals. Logistic regression analyses tested technology access/comfort levels, controlled for sociodemographic factors, for association with preference for support.

Results:

This study included n = 605 AoURP participants with complete survey data. The majority of participants were comfortable using technology (74.1%) and had access to the internet (89.1%). Among participants preferring High-Touch support (n = 346), 14.5% lacked internet access and 31.5% were uncomfortable with technology use. For Low-Touch participants (n = 259), 6.2% lacked internet access, and 3.9% were uncomfortable using technology (p < 0.001). Comfort using technology was significantly associated with preference for High-Touch support (AOR = 0.118, 95% CI: 0.055–0.255 for comfortable; AOR = 0.212, 95% CI: 0.077–0.587 for neutral), but internet access was not significantly associated in adjusted analyses.

Conclusions:

Comfort with technology and not merely availability strongly influences the support wanted by digital enrollment participants. These results highlight how participant-centered design features, including adaptive support pathways based on users' digital literacy, need to be incorporated into research interfaces. Individual onboarding, along with hybrid models of support, needs to be personalized to digital confidence if we are to facilitate inclusive engagement with precision health research.