Attitudes Toward the Environment and Use of Information and Communication Technologies to Address Environmental Health Risks in Marginalized Communities: Prospective Cohort Study

Abstract

Background Information and communication technologies, including mobile health (mHealth), can help isolated communities address environmental health challenges. The Puerto Rican island of Culebra has faced multiple sociopolitical and economic factors that have distressed the island’s environment and health. Culebrenses are technologically engaged and have demonstrated a use of technology that transcends socioeconomic barriers. As a result, technological interventions could potentially help manage environmental risks on the island. Objective This study aims to test and evaluate the potential benefits of an mHealth tool, termed ¡mZAP! (Zonas, Acción y Protección), for engaging communities with environmental risks through technology. Methods Participants using ¡mZAP! (N=111) were surveyed. Bivariate analyses were used to examine associations of mHealth use with sociodemographics, technology use, an adapted environmental attitudes inventory, and the multidimensional health locus of control. Logistic regression was used to examine associations between attitudes toward environmental health risks and mHealth use. Results Higher positive attitudes toward the environment were significantly associated with the use of ¡mZAP! (odds ratio 5.3, 95% CI 1.6-17.0). Environmental attitudes were also associated with the multidimensional health locus of control powerful others subscale (P=.02), indicating that attitudes toward the environment become more negative as feelings controlled by others increase. Participants felt that the authorities would resolve the challenges (63/111, 56.7%). Conclusions Perceived lack of control could present barriers to collective actions to address salient environmental health challenges in communities. The ongoing dependency on government-based solutions to community problems is worrisome, especially after the hurricane experiences of 2017 (which may potentially continue to be an issue subsequent to the more recent 2020 earthquakes).

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“…Ideally, the visual aids and complementary multimedia information would be available in those specific languages, with content adjusted to the corresponding culture. Qualitative positive feedback should be sought to capture insight such as “what has been helpful, why it has been valuable, and to whom (Spanish vs English speakers).” In addition, previous studies have suggested that sustainability among ICTs development and dissemination requires community engagement in the early phases [ 14 , 26 ]. As part of the UX with ICTs, such as chatbots, we encourage the use of short answers using simple language and a maximum of 2 monitor speed of responses and adjusting it accordingly to the answer’s length.…”

“…The onset of the COVID-19 pandemic with its sudden spread and high mortality rate, political polarization, intensified distrust, and misinformation, alongside public health messaging struggling to keep pace with evolving medical knowledge[ 14 ], created “a perfect storm” of confusion and concern, especially as COVID-19 vaccines were developed, tested, and rolled out to the public.…”

“…Within the context of medical systems that are perceived as untrustworthy, creative solutions that disseminate evidence-based information through other modalities are strongly needed. Information and Communication Technology (ICT) has demonstrably reduced marginalization gaps in education and access among communities globally [ 14 , 15 ]. ICT’s usefulness in daily life and long-term adoption is partially driven by preferences and perspectives of representative community members [ 16 ].…”

COVID-19 Vaccine Equity and Access: Case Study for Health Care Chatbots (Preprint)

“…Within the context of medical systems that are perceived as untrustworthy, creative solutions that disseminate evidence-based information through other modalities are strongly needed. Information and Communication Technology (ICT) has demonstrably reduced marginalization gaps in education and access among communities globally [14,15]. ICT's usefulness in daily life and long-term adoption is partially driven by preferences and perspectives of representative community members [16].…”

How Is Colonialism a Sociostructural Determinant of Health in Puerto Rico?

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