Summary
Objectives: Underserved populations can benefit from consumer health informatics (CHI) that promotes
self-management at a lower cost. However, prior literature suggested that the digital
divide and low motivation constituted barriers to CHI adoption. Despite increased
Internet use, underserved populations continue to show slow CHI uptake. The aim of
the paper is to revisit barriers and facilitators that may impact CHI adoption among
underserved populations.
Methods: We surveyed the past five years of literature. We searched PubMed for articles published
between 2012 and 2017 that describe empirical evaluations involving CHI use by underserved
populations. We abstracted and summarized data about facilitators and barriers impacting
CHI adoption.
Results: From 645 search results, after abstract and full-text screening, 13 publications
met the inclusion criteria of identifying barriers to and facilitators of underserved
populations' CHI adoption. Contrary to earlier literature, the studies suggested that
the motivation to improve health literacy and adopt technology was high among studied
populations. Beyond the digital divide, barriers included: low health and computer
literacy, challenges in accepting the presented information, poor usability, and unclear
content. Factors associated with increased use were: user needs for information, user-access
mediated by a proxy person, and early user engagement in system design.
Conclusions: While the digital divide remains a barrier, newer studies show that high motivation
for CHI use exists. However, simply gaining access to technology is not sufficient
to improve adoption unless CHI technology is tailored to address user needs. Future
interventions should consider building larger empirical evidence on identifying CHI
barriers and facilitators.
Keywords
Medical informatics applications - consumer health information - ethnic groups - socioeconomic
factors - minority groups - health disparities
