JMIR Publications

ABSTRACT

Background:

The growth of patient-facing health technology has the potential to transform the delivery and receipt of patient-centered primary care. However, successful integration of data from these digital tools into clinical workflows depends not only on technical efficacy, but also on usability across diverse patient populations. To ensure the successful integration of digital tools, Tech Testing Panels (TTPs) can assess usability and provide feedback.

Objective:

This study aimed to assess technology usage and literacy among adult primary care patients that opted in a TTP and compare these measures between English-preferred and Chinese-preferred speaking patients.

Methods:

We conducted a cross-sectional online survey from April to July 2024 at an urban academic primary care based TTP composed of adult patients that use the patient portal and spoke English and/or Chinese. The survey assessed socio-demographic characteristics and technology usage and literacy, including comfort with app installation, video chat setup, and problem-solving tech issues. Respondents received a $5 online gift card for completion. Bivariate analyses were conducted using Pearson’s chi-squared and Fisher’s exact tests to compare responses by preferred language.

Results:

Of the surveys distributed, the response rate for surveys in English was 53.7%, while the response rate for surveys in Chinese was approximately 27.0% with a total sample size of 222 respondents. Respondents had a mean age of 61.6 years, with nearly half aged 65 or older. A majority had high educational attainment and household incomes. Most respondents strongly agreed that they could install applications (85.5%) and able to initiate video chats independently (82.4%). Internet access was nearly universal (99.1%), and patient portal usage was high (99.1%) with most accessing the portal via smartphones or tablets (54.8%). However, Chinese-preferring respondents reported significantly lower technology literacy across multiple domains compared to English-preferring respondents, including lower confidence in using applications (64.5% vs 89.0%, P=.001) and resolving technical issues (38.7% vs 60.0%, P<.001).

Conclusions:

While technology usage was high in this sample of adult primary care patients in a TTP, disparities by preferred language in technology literacy persist. Chinese-preferring patients were less confident in navigating digital tools, despite similar technology usage. These findings underscore the importance of TTPs with diversity in technology literacy to support inclusive development of culturally and linguistically responsive patient-facing digital tools. Addressing barriers identified among end users with different degrees of technology literacy will be essential to ensuring equitable adoption of digital health tools and supporting inclusive innovation in primary care.